Associations of global and specific components of positive psychological well-being with mortality risk: Findings from two cohort studies.

Previous studies have examined how various aspects of positive psychological well-being (PPWB) independently relate to healthy aging, yet a notable gap remains in understanding the effects of their overlap (i.e., shared variance). We used data from two longitudinal cohorts, the Midlife Development in the United States Study and the Health and Retirement Study (N = 3,302 and 7,209), each of which assessed hedonic and eudaimonic facets of PPWB (positive affect, purpose in life, personal growth, and self-acceptance) and tracked mortality status across 14-15 years of follow-up. We derived a global factor identifying elements common across PPWB facets and also specific PPWB factors from a bifactor model. Then, we examined if higher PPWB levels (global and specific) are associated with mortality risk. Across cohorts, higher global well-being factor levels were associated with reduced mortality risk, even after adjusting for a range of potential confounders. Fewer independent associations were evident with the specific PPWB factors. Findings suggest that variance common across hedonic and eudaimonic facets of PPWB is associated with lower mortality risk. Considering the shared versus unique effects of different PPWB facets can offer valuable insights for theorizing mechanisms underlying health benefits of PPWB and guiding decisions about intervention targets.

A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia.

PURPOSE: Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia. DESIGN/METHODOLOGY/APPROACH: The project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants. FINDINGS: The model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender. SOCIAL IMPLICATIONS: Supporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism. ORIGINALITY/VALUE: Only one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

Pre-widowhood social support is linked to loneliness patterns: a growth mixture model using the health and retirement study.

OBJECTIVES: The first aim of the study is to compare loneliness levels between widowed and non-widowed older adults. The second aim is to identify distinct loneliness patterns among widowed individuals and explore the impact of pre-spousal loss social support on loneliness during and after bereavement. METHOD: Data from the Health and Retirement Study were utilized to compare loneliness levels between widowed (n = 137) and non-widowed (n = 2361) older adults (Mage = 69.01). T-tests and latent growth curve models were conducted to compare loneliness levels between the two groups. Growth mixture models were computed to identify distinct loneliness patterns among the widowed individuals. A multinomial logistic regression analysis was conducted to determine how pre-widowhood social support was associated with the obtained classes. RESULTS: The results revealed that widowed individuals reported significantly higher levels of loneliness at T2. Among widowed individuals, three distinct loneliness patterns were identified: Increased Loneliness (IL) group (n = 32); Low and Stable Loneliness (LSL) group (n = 88); and Decreased Loneliness (DL) group (n = 17). The IL and DL group were less likely to receive social support from spouse, children, and friends compared to the LSL group. CONCLUSION: This study provides evidence of the protective effect of pre-widowhood social support on the psychological well-being of older adults after spousal loss.

A reasoned action approach to meditation behavior among cadets at the United States Military Academy.

Military members face emotion-regulation challenges due to the high-pressure nature of the profession as evidenced by rates of mental health issues within military populations. Identifying behaviors that are efficient and effective at promoting emotion-regulation and helping military members adopt them is essential. Recently, meditation has been shown to reduce stress, enhance attention control and emotion regulation, along with reducing military-related Post Traumatic Stress Disorder symptoms. One way to promote this behavior in a military context is to enable future officers to adopt the behavior. We aimed to examine determinants of meditation intention and behavior among cadets at the United States Military Academy using the Reasoned Action Approach, a behavior framework used to explain and change behavior. By identifying these determinants, military practitioners can tailor meditation interventions to increase the likelihood that cadets will adopt the practice and eventually help soldiers under their command use meditation as well. We conducted a pilot study and a replication study that confirmed Reasoned Action Approach constructs were predictive of behavior and behavioral intention. Of significance was the perceived norm impact on meditation intention, specifically injunctive norms. Implications include the importance of authority figures within cadets' social context providing support for meditation's utility.

An exploration of the emotional impact of working in an adult hospice service for Irish healthcare professionals.

PURPOSE: An ageing population and a global pandemic has placed greater demands on palliative care services. Numerous studies describe the patient experience in palliative care, however, few explore the healthcare professional's experience of caring in this setting. This study explored the emotional challenges faced by palliative care professionals working in adult hospice services in Ireland. DESIGN/METHODOLOGY/APPROACH: A narrative phenomenological approach was adopted, using interpretative phenomenological analysis to analyse results from five participants' semi-structured interviews. FINDINGS: The type of challenge experienced reflected the impact it had on the participant's emotional wellbeing. Challenges perceived as achievable contributed to high levels of emotional wellbeing. These challenges often offered the opportunity for skill development and elicited positive feelings. Challenges perceived as uncontrollable negatively impacted the professional's emotional wellbeing and increased their risk of burnout. Examples of this included the shift in service provision and professional expectations. The challenges palliative care professionals experience on a daily basis can negatively or positively impact their emotional wellbeing. CONCLUSION: Overall, this study highlighted challenges and their impacts experienced by palliative care professionals, illustrating key areas for improvement to prioritise staff wellbeing.

The effects of inpatient suicide on nurses at Weskoppies Hospital: A qualitative study.

Background: Inpatient suicide is a serious adverse event in psychiatric wards. Suicide can cause severe trauma to both patients and health professionals, who may develop maladaptation with poor coping skills. Healthcare practitioners are the second victims and historically, this concept has been overlooked. The psychological effects and lack of support have not been sufficiently explored. Aim: The emotional well-being and clinical practice of nurses who experienced inpatient suicide at Weskoppies Psychiatric Hospital was explored. Setting: Weskoppies Psychiatric Hospital, South Africa. Methods: In this qualitative case study, 12 nurses who had lost a patient to inpatient suicide some time during their employment were purposefully selected. Data were collected through individual in-depth interviews, which were audio recorded and transcribed. The data were thematically analysed. Results: Nurses were negatively affected by inpatient suicide resulting in a range of emotional and psychological effects, including fear, anger, sadness, flashbacks, guilt, and difficulty in coping. Clinical practice factors included being doubtful and extra vigilant. Although nurses received psychological support from the institution, they recommended in-service training with periodic reviews to prevent and manage inpatient suicide. Conclusion: Inpatient suicide is a serious adverse event, and mental health practitioners become second victims. These events do not only impact the psychological well-being of nurses but also influence the clinical practice. Mental health practitioners should receive adequate training and support in preventing and handling inpatient suicide. Contribution: This study provided insights into nurse's perspectives on the effects of inpatient suicide and how they can be supported.

Yoga as a therapeutic approach to mental health in university students: a randomized controlled trial.

Objectives: The purpose of this study has been to analyze the efficacy of a yoga-based intervention on stress, emotional wellbeing, state anxiety and trait anxiety in university students. Methods: This study was a randomized controlled trial. The sample consisted of 129 university students, of which 65 underwent a yoga training for 12 weeks and a control group that did not carry out any type of intervention. The primary outcome was stress, which was collected through The Perceived Stress Scale (PSS). The secondary outcomes were emotional wellbeing which was measured through the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and anxiety through State-Trait Anxiety Inventory (STAI). All variables were measured before and after the intervention. Results: Participants in the experimental group showed statistically significant improvements in the primary outcome perceived stress (Cohen's d = 0.44) and the secondary outcomes emotional wellbeing (Cohen's d = 0.47), and both state anxiety (Cohen's d = 0.38) and trait anxiety (Cohen's d = 0.80) compared to the control group that did not carry out any type of physical training. Conclusion: This study demonstrated that a 12-week yoga intervention can significantly reduce perceived stress and anxiety, and improve emotional wellbeing in university students. Initially, the experimental group (EG) reported higher levels of stress and anxiety than the control group (CG), but after the intervention, the EG experienced significant improvements compared to the CG.

Practitioner perspectives on the nature, causes and the impact of poor mental health and emotional wellbeing on children and young people in contact with children's social care: A qualitative study.

BACKGROUND: Children and young people (CYP) who are in contact with social care are at higher risk of developing mental health difficulties compared to the general population. This has been attributed to their experience of significant childhood adversity. With an increased likelihood of experiencing poorer health outcomes which can persist into adulthood, it is crucial that key factors for their positive mental health development are identified. OBJECTIVE: To identify factors associated with the poor mental health of CYP in contact with social care from the perspective of practitioners working in children's social care and mental health. PARTICIPANTS AND SETTING: Social care and mental health practitioners; three Local Authorities across the North-East of England. METHODS: Four focus groups were conducted with 23 practitioners between April and May 2022. A semi-structured topic guide exploring the nature and associated factors of mental health was used to focus discussion. Data were thematically analysed and informed by the four levels of the socio-ecological model. RESULTS: Individual level risk factors were associated with the CYP's emotional health and included what practitioners described as the 'sense of shame'. Interpersonal level risk factors were most recurrent and included parental factors within the home environment. Community level risk factors consisted of characteristics of settings and institutions that increased the risk of the CYP developing mental health and wellbeing difficulties. Societal level risk factors included broader societal factors such as poverty. Practitioners maintained that certain protective factors possessed or developed by CYP including secure attachments, prevent the development of mental health difficulties. CONCLUSIONS: Our current study provides strong evidence for the interlinkage between multiple levels of risk and their interacting impact on the CYP's mental health and emotional wellbeing. It is imperative that this, and the need to strengthen protective factors, whilst reducing risks are carefully considered for the development of effective support interventions for CYP in contact with social care.

Exploring the impact of sleep on emotional and physical well-being in professional cricketers: a cohort study over an in-season training period.

Background: Professional athletes navigate a multitude of unique challenges associated to sport-specific factors (e.g., training, travel and competition) and non-sport factors (e.g., performance pressure, stress and anxiety) that can interfere with healthy sleep behaviors. Sleep plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. As poor sleep quality is known to impair proper brain function, this study aimed to investigate the effect of sleep quality on a professional athlete's ability to train, recover, and perform, as well as their overall emotional and physical well-being. Methods: A cohort study was performed in 40 professional male cricket athletes from the Dutch national cricket team (mean age 26.5 ± 5.1 years). The athletes were monitored across a 22 weeks in-season training period. Sleep quality and overall emotional and physical well-being were assessed using daily sleep diaries and questionnaires which scored the readiness to train, stress levels, fatigue, muscle soreness and flu symptoms respectively. Quality of sleep and subsequent association with the consecutive elements of the well-being questionnaire were assessed through statistical using the student t-test and clinical differences with the methodology of Osoba and colleagues: <5% "no change", 5%-10% "little change"; 10%-20% "moderate change"; and >20% "very much change". Results: The results demonstrated that the professional athletes assessed their sleep quality as average with a mean score of 3.4 out of 5. Lower perceived quality of sleep (<75th percentile) was correlated with a decreased readiness to train (mean score 3.2 [IQR: 3.0-4.0] vs. 3.5 [IQR: 3.0-5.0]; P < 0.001) and increased extent of muscle soreness (2.7 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2-3]; P < 0.001), stress level (mean score 2.3 [IQR: 2.0-3.0] vs. 1.9 [IQR: 1.0-2.0]; P < 0.001) and perceived fatigue (mean score 2.9 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2.0-3.0]; P < 0.001). Likewise, in patients with lower perceived quality of sleep, the proportion of players presenting with flu symptoms increased over 4-fold (4.1% vs. 17%; P < 0.001). Conclusions: This study highlights that good sleep quality positively influences the overall emotional and physical well-being of professional athletes. Our results emphasize the importance of targeted sleep interventions to improve sleep quality and subsequently optimize psychological and physiological wellness.

Economic, Psychological, and Emotional Well-Being of Pregnant Women During the COVID-19 Pandemic.

INTRODUCTION: The intersection between perinatal mental health and the coronavirus disease 2019 (COVID-19) pandemic remains of significant public health importance. The current study examined the emotional and financial well-being and predictors of elevated depressive symptoms among pregnant women during the COVID-19 pandemic. METHODS: This online survey was conducted with 2118 women ≥18 years old who were pregnant at the time of the survey and living in the United States or Puerto Rico. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale, with scores ≥10 indicative of elevated depressive symptoms. The final logistic regression model included housing insecurity, financial distress, COVID-19 diagnosis, exposure to COVID-19, and demographic covariates. RESULTS: More than half the sample (53.8%) had elevated depressive symptoms. In logistic regression analyses, the odds of having elevated depressive symptoms were significantly higher for participants reporting housing insecurity (adjusted odds ratio [aOR], 1.56; 95% CI, 1.22-2.01), financial distress (aOR, 1.57; 95% CI, 1.17-2.12), COVID-19 diagnosis (aOR, 2.53; 95% CI, 1.53-4.17), and COVID-19 exposure (aOR, 1.41; 95% CI, 1.07-1.86), after adjusting for covariates. The association of elevated depressive symptoms with housing insecurity was especially strong among those who experienced COVID-19 (aOR, 6.04; 95% CI, 2.15-17.0). DISCUSSION: Our findings are consistent with previous literature revealing that diagnosis, exposure, concerns about family, and effects on financial stability were related to depressive symptoms during the pandemic. The relationships between financial and housing concerns with elevated depressive symptoms, independent of concerns about infection in family members, suggest that there may be direct and indirect effects of the pandemic on mental health.

The effect of social support on the emotional well-being of people with amyotrophic lateral sclerosis: Exploring the mediating role of spirituality.

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that, so far, is considered always fatal. Treatments mainly consist in increasing survival and aim to improve the quality of life of people with ALS (pwALS). Social support and spirituality have been shown to play a key role in pwALS' quality of life. Our study explored it in depth by investigating the underlying mechanisms linking social support, spirituality, and emotional well-being. METHODS: Thirty-six pwALS underwent a battery of tests evaluating emotional well-being (emotional well-being scale of the 40-item Amyotrophic Lateral Sclerosis Assessment Questionnaire), social support (6-item Social Support Questionnaire), and spiritual well-being (12-item Functional Assessment of Chronic Illness Therapy - Spiritual well-being). Our recruitment was web-based through the FILSLAN and the ARSLA websites as well as through Facebook® advertisements (ALS groups). Data were analyzed by Pearson correlation analysis and Process macro was used in an SPSS program to analyze the mediator variable effect. RESULTS: Availability of social support, spiritual well-being, and 2 of its dimensions, i.e., meaning and peace, were positively correlated with emotional well-being. The mediational analyses showed that spiritual well-being, meaning, and peace act as mediators in the association between availability of social support and good emotional well-being. SIGNIFICANCE OF RESULTS: Availability of social support and spirituality are essential for the emotional well-being of pwALS. Spirituality as a mediator between availability of social support and emotional well-being appears as real novel finding which could be explored further. Spiritual well-being, meaning, and peace appear as coping resources for pwALS. We provide practical guidance for professionals working with pwALS.

Journeying together: spousal experiences with prostate cancer in Ghana.

Background: Prostate cancer (PCa) is a significant global health concern for men. In Sub-Saharan Africa, PCa rates witnessed a 69% increase from 1990 to 2010. Despite this, there is a dearth of literature examining the experiences of spouses of men with PCa in Africa, as the majority of studies concentrate primarily on men. Methods: The study used a qualitative exploratory design, conducting in-depth face-to-face interviews with a semi-structured guide. Participants were selected through purposive sampling, with 35 recruited. Data was recorded, transcribed verbatim, and analysed using content analysis, resulting in 2 themes and 11 subthemes. Results: The research revealed that spouses providing care for husbands with PCa faced notable effects on their physical and emotional well-being. Notably, they reported experiencing leg pains due to prolonged sitting by their partners, as well as disruptions in sleep and a loss of appetite triggered by the hospital smell. Conclusion: Women encounter challenges in caring for their partners with PCa. Understanding these experiences will contribute to improving public support and assistance. Future studies should concentrate on developing interventions to help them cope with these challenges.

A Comparative Study of the Impact of the Covid-19 Pandemic on Mental Health, Healthcare Access, and Pain Levels of Patients with Chronic Pain from Spring 2020 to Spring 2021.

Purpose: The short-term impact of the Covid-19 pandemic on patients with chronic pain has been under the microscope since the beginning of the pandemic. This time-lag design study aimed to track changes in pain levels, access to care, mental health, and well-being of Greek chronic pain patients within the first year of the Covid-19 pandemic. Patients and Methods: 101 and 100 chronic pain patients were contacted during the Spring of 2020 and 2021, respectively. A customized questionnaire was used to evaluate the perceived impact of the pandemic on pain levels and healthcare access. Psychological responses, personality characteristics, and overall well-being were evaluated using the Depression, Anxiety, and Stress Scale (DASS-42), the Ten-Item Personality Index (TIPI) and the Personal Wellbeing Index (PWI). Results: The perceived effect of the pandemic and the Covid-related restrictions affected significantly access to healthcare, pain levels and quality of life. Differences were detected in the PWI sub-scales regarding Personal Safety, Sense of Community-Connectedness, Future Security, Spirituality-Religiousness, and General Life Satisfaction. Marital status, parenthood, education and place of residence were associated with differences in pain levels, emotional and psychological responses. Conclusion: Changes in chronic pain levels, emotional responses, and overall well-being took place throughout the year. Also, an evident shift took place in the care delivery system. Both tendencies disclose an ongoing adaptation process of chronic pain patients and healthcare services that needs further monitoring.

Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy.

BACKGROUND: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. METHODS: We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. RESULTS: A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. CONCLUSIONS: Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction.

Enhancing patient well-being in oncology waiting rooms: a pilot field experiment on the emotional impact of virtual forest therapy.

Introduction: This study explores the emotional impact of virtual forest therapy delivered through audio-visual recordings shown to patients in the oncology waiting rooms, focusing on whether simulated forest walks can positively influence patients' emotional states compared to traditional waiting room stimuli. Methods: The study involved 117 participants from a diverse group of oncology patients in the outpatient clinic waiting room at the Masaryk Memorial Cancer Institute. Using a partially randomized controlled trial design, the study assessed basic emotional dimensions-valence and arousal-as well as specific psychological states such as thought control, sadness, anxiety, and pain. This assessment used the Self-Assessment Manikin and the modified Emotional Thermometer before and after participants watched three video types (forest, sea, news). Baseline stress levels were measured using the Kessler Psychological Distress Scale (K6). Results: Participants exposed to forest and sea videos reported significant improvements in emotional valence and reduced arousal, suggesting a calming and uplifting effect. No significant changes were observed in the control and news groups. Secondary outcomes related to anxiety, sadness, and pain showed no significant interaction effects, though small but significant main effects of time on these variables were noted. Discussion: The findings suggest that videos of forest and sea can be a beneficial intervention in the oncology waiting rooms by enhancing patients' emotional well-being. This pilot study underscores the potential for integrating virtual mental health support elements into healthcare settings to improve patient care experience.

Synergies of affordances and place-based relationality in Forest School practice: implications for socio-emotional well-being.

Research shows that the human-nature relationship positively impacts human well-being. Forest School (FS) practice offers young children a structured program of nature connection through activities, aiming to enhance their self-esteem and social skills. FS is now adapted in countries such as Australia, Canada and New Zealand where a unique cultural interface occurs between European settlers and Indigenous peoples. Responding to socio-cultural diversities, geographical contexts, and the traditional ecological knowledges, FS needs to go beyond play pedagogy and incorporate theoretical perspectives that promote human-nature relationship in local context-specific environments. We argue that the synergies between Western perspectives on affordances perceived in person-environment relationship and Indigenous place-based relationality perspective provide a more suitable approach for developing reciprocal relationships between FS participants and land/place/nature. We propose that the synergies between affordances perceived in FS and place-based relationality cultivated in participants will enhance social and emotional well-being. We call for specific research investigating such synergies supporting participant well-being. Future research on FS practice should be directed toward initiating and exploring co-designed studies by Indigenous and non-Indigenous researchers incorporating methodologies that study participant experience as well as evaluating the impact of FS programs embedding affordances and place-based relationality perspectives.

Internet Use and Loneliness Among Urban and Non-Urban Chinese Older Adults: The Roles of Family Support, Friend Support, and Social Participation.

OBJECTIVES: This study investigated the association between internet use and loneliness among older Chinese adults, and the mediating effects of family support, friend support, and social participation. These associations were evaluated in the context of urban and non-urban geographic settings. METHODS: This study used data from the 2018 wave of the China Longitudinal Ageing Social Survey (N = 10,126), examining samples of urban (n = 3,917) and non-urban (n = 6,209) older adults separately. Linear regression and path analysis within a structural equation modeling framework were employed. RESULTS: Internet use was negatively associated with loneliness for both urban and non-urban residing older adults. Family support and social participation mediated the association between internet use and loneliness for both urban and non-urban residing older Chinese adults, but friend support mediated this association only for urban older residents. DISCUSSION: This study shed light on our understanding of the relationship between internet use and loneliness among older adults in the Chinese context. Also, these findings suggested that digital interventions for loneliness should pay special attention to the different characteristics of urban and non-urban dwelling older Chinese adults.

Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle.

Introduction: The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods: This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results: Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion: This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.

Walking together in friendship: Learning about cultural safety in mainstream mental health services through Aboriginal Participatory Action Research.

OBJECTIVE: Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. METHODS: We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. RESULTS: Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. CONCLUSIONS: A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.

Efecto del programa nutricional “Tusuy” en la composición corporal y bienestar emocional en personas con síndrome de Down / The effect of the “Tusuy” nutritional program on body composition and emotional well-being in people with Down syndrome

Introducción. El síndrome de Down es una condición genética que afecta física y cognitivamente al ser humano. Los programas nutricionales basados en el fomento de la actividad física mejoran la hipotonía muscular y el bienestar emocional en personas con síndrome de Down.Objetivo: Evaluar el efecto del programa nutricional “Tusuy” en la composición corporal y bienestar emocional de personas con síndrome de Down, durante ocho semanas de intervención. Material y métodos: Investigación de enfoque cuantitativo, diseño experimental, nivel pre-experimental. La muestra final fue conformada por 25 personas con síndrome de Down, con asistencia regular al taller de danza; fueron excluidos personas con diagnóstico severo de síndrome de Down. El programa nutricional Tusuy tuvo una duración de ocho semanas, que incluía el taller de danza, sesiones educativas para mejorar la alimentación y seguimiento a través de WhatsApp de los padres de familia. El perímetro abdominal se midió a través cinta métrica marca Lufkin, consignado en una ficha antropométrica; el bienestar emocional fue evaluado a través de la escala de bienestar psicológico, validada mediante juicio de expertos. Para comparar los resultados antes y después de la intervención, se utilizó la prueba estadística no paramétrica de Wilcoxon. Resultados: Antes de la intervención, al analizar el perímetro abdominal, se obtuvo 36 % en riesgo muy alto, con promedio de 91,17 ± 11,39 cm; asimismo, el 64,0 % presentó bienestar psicológico. Al término de la intervención, el 20,0 % presentó riesgo muy alto; el promedio del perímetro abdominal fue de 89,18 ± 11,84 cm; el 98,0 % presentó bienestar psicológico. Al comparar ambos grupos experimentales, se obtuvo un valor p<0,05. Conclusión: El programa nutricional “Tusuy”, que duró ocho semanas de intervención, mejoró la composición corporal y el bienestar emocional en personas con síndrome de Down.(AU)

Introduction: Down syndrome is a genetic conditionthat affects humans physically and cognitively. Nutritionalprograms based on promoting physical activity improvemuscle hypotonia and emotional well-being in people withDown syndrome. Objective: To evaluate the effect of the “Tusuy” nutri-tional program on the body composition and emotional well-being of people with Down syndrome, during eight weeks ofintervention. Material and methods:Research with a quantitative ap-proach, experimental design, pre-experimental level. The fi-nal sample was made up of 25 people with Down syndrome,with regular attendance at the dance workshop; People witha severe diagnosis of Down syndrome were excluded. TheTusuy nutritional program lasted eight weeks, which includedthe dance workshop, educational sessions to improve nutri-tion, and monitoring of parents via WhatsApp. Abdominalperimeter was measured using a Lufkin measuring tape,recorded on an anthropometric sheet; Emotional well-beingwas evaluated through the psychological well-being scale, validated through expert judgment. To compare the resultsbefore and after the intervention, the non-parametricWilcoxon statistical test was used. Results: Before the intervention, when analyzing the ab-dominal perimeter, 36% were found to be at very high risk,with an average of 91.17 ± 11.39 cm; Likewise, 64.0% pre-sented psychological well-being. At the end of the interven-tion, 20.0% presented very high risk; the average abdominalperimeter was 89.18 ± 11.84 cm; 98.0% presented psycho-logical well-being. When comparing both experimentalgroups, a p value <0.05 was obtained.Conclusion: The “Tusuy” nutritional program, which lastedeight weeks of intervention, improved body composition andemotional well-being in people with Down syndrome.(AU)