The pediatric self-management model in asthma: A theory analysis and evaluation.

THEORETICAL PRINCIPLES: The Pediatric Self-management Model (PSMM) is a middle-range theory geared at understanding the relationship between factors influencing chronic illness management in children. PSMM is a family-centered model that focuses on the unique factors present in the pediatric population. PHENOMENA ADDRESSED: Pediatric asthma is a leading chronic respiratory illness in the United States, affecting over 4.6 million children in 2020. Over 40% of children with asthma will have at least one exacerbation per year. On average, a child with asthma will miss nine additional school days annually. Using the Walker and Avant framework for theory analysis, the PSMM is examined through the lens of pediatric asthma to evaluate its applicability to pediatric asthma shared management and adherence. RESEARCH LINKAGES: The PSMM has been used as a framework for understanding the roles of managing chronic illness in children, but it has yet to be applied to pediatric asthma. Asthma outcomes inherently depend on preventative medicine and home care strategies for symptom management and response outside the healthcare facility. The PSMM is a new framework for understanding barriers and facilitators within pediatric asthma management and highlights the importance of the dyadic relationship between child and parent to successfully share healthcare responsibility.

Compassion in Italian palliative care: Investigating healthcre professionals' perspectives using focus groups.

Compassion, a complex response aimed at alleviating suffering, plays a crucial role in healthcare professionals' (HCPs) patient care, especially in palliative settings. This study explored compassion in Italian palliative care HCPs using focus groups. A total of 52 palliative care HCPs participated in this study across five focus groups. The transcripts of the discussions were subjected to content analysis. Compassion emerged as "being with someone," a relational dimension deeply influenced by various factors, including patients, caregivers, work environment, and HCPs themselves. While often perceived as innate, the participants expressed their potential to be nurtured through training and group discussions. Compassion is integral to the HCP-patient relationship, shaped by multifaceted aspects. These findings emphasize the importance of cultivating and enhancing compassion through training and group discussions.

Implementation and analysis of clinic administered behavioural health screen in an outpatient paediatric cardiology clinic.

Previous studies investigating behavioural health screening processes have focused on selected diagnoses within paediatric cardiology and focused on a smaller number of potential concerns. We developed and administered a brief survey in our paediatric heart centre to assess the presence of a wider variety of behavioural health concerns and to connect patients with resources. A cohort of 305 patients aged 2-29 years (M = 11.97 years; SD = 6.00 years; 50.49% female), representing a variety of indications for a cardiology clinic visit, or a parent, completed a survey of 14 common behavioural health concerns. Behavioural health concerns were included based on practice patterns within paediatric psychology. Respondents indicated if they were currently receiving behavioural health services and if they were interested in behavioural health follow-up. Surveys were administered during check in and collected by clinic staff. A behavioural health provider attempted to reach all those who indicated interest by phone. Approximately 45% of the sample endorsed one or more behavioural health concerns and 30.16% of the sample endorsed at least one concern but were not already connected to services. Only 27.17% of this group requested follow-up. Most commonly endorsed concerns were anxiety, sleep problems, depressed/irritable mood, and somatic complaints. Survey results converge with existing literature to indicate that behavioural health concerns are common among youth seen in a paediatric cardiology clinic but most patients are not connected to appropriate services. Screening programmes can help meet this need but challenges remain. Clinical implications and future directions are discussed.

Current approaches to the identification and management of gambling disorder: a narrative review to inform clinical practice in Australia and New Zealand.

Gambling disorder is a recognised psychiatric disorder in the Diagnostic and statistical manual of mental disorders (DSM-5) and is classified as an addiction alongside alcohol and substance use disorders. The DSM-5 describes a past-year timeframe, episodic or persistent specifiers, early or sustained remission specifiers, and three gambling disorder severity specifiers (mild, moderate and severe). Although anyone can develop gambling disorder, there are known risk factors. In studies involving general adult populations, the likelihood of developing the disorder varies with the type of gambling, and is particularly high for internet gambling, casino table games and poker machines. Australia and New Zealand have shifted the focus of gambling disorder to the identification of gambling harm, in recognition that efforts targeting the prevention of harm may be more effective as they potentially influence a larger segment of the population. Temporal categories of gambling harm (crisis harms versus legacy harms) affect help-seeking and need for treatment. Crisis harms often motivate people to change their behaviour or seek help, whereas treatment addresses legacy harms, which emerge or continue to occur after gambling behaviour ceases. The evidence base and clinical guidelines recommend cognitive behavioural therapy and motivational interviewing but there are many gaps in our understanding of treatment for gambling disorder, including an absence of high quality evaluations that assess treatment effectiveness over the longer term, especially for treatment delivered in community settings. There is also an urgent need to understand how, why and for whom treatment works so that interventions can be optimised to individual needs, thereby facilitating client engagement. Because of limited access to health care and poor retention in treatment, in recent years there has been an increase in treatment choices in the form of internet therapies and smartphone applications.

Embracing a different outlook: Strengths and goals of individuals currently in treatment for anorexia nervosa.

PURPOSE: Developing personal goals beyond weight and shape, and promoting the agency to pursue those goals, could aid in treatment and recovery from anorexia nervosa (AN). This research explores the strengths, interests and goals of individuals currently receiving treatment for AN and evaluates how treatment services are supporting them to work towards personal goals across all areas of everyday life. METHOD: A total of 58 community-dwelling adults currently receiving treatment for anorexia nervosa at any stage of recovery completed the Client Assessment of Strengths, Interests and Goals Self-Report (CASIG-SR). Participants reported their goals for accommodation, work and study, interpersonal relationships, recreational activities, spirituality, religion or life purpose, physical health and mental health, and the personal strengths and supports needed to achieve those goals. Concordance scores were calculated between importance of personal goals and level of support from current services regarding these goals. RESULTS: Themes identified across goals, strengths and supports were Connection, Independence & Confidence, Meaning & Self: The Real Me, and Stability & Balance. Work and study goals and strengths were identified strongly. The key support needed was stability from the current treatment team to provide a stable base for change. Concordance scores indicate support provided for personal goals was less than the importance of the goal to the individual. CONCLUSION: Results suggest goals for everyday living are critical to recovery in anorexia nervosa. Specific clinical considerations to increase motivation and hope are increased access to peer support, a focus on increasing positive affect, supporting safe exercise and promoting outdoor experiences and connection with nature. LEVEL III: Evidence obtained from well-designed cohort or case-control analytic studies.

The energy crisis differentially impacted Swiss and German citizens' energy literacy and efficiency preferences but not their support for climate policies.

The energy crisis reshaped energy politics, resulted in energy price surges, increased energy capacity, and large-scale energy-saving campaigns. While an energy demand reduction was observed in Europe, little is known about how the crisis impacted citizens' climate-relevant judgment and decisions. Here we report a preregistered two-wave cross-national study (N = 1040) spanning the winter of 2022/2023 to investigate how support for renewable energy policies, energy literacy, and energy-efficient product choices developed as this crisis unfolded. We couple longitudinal experimental data with real-world energy price data. This natural experiment indicates that energy-efficiency preferences were impacted by the salience of the crisis and real-world price signals. Changes in energy literacy were contingent on the numerical abilities of participants, suggesting that the crisis increased knowledge gaps between different groups in society. Support for renewable energy policies, and prioritization of key policy attributes, remained stable in Germany and Switzerland despite shifts in public attention and uncertainty.

Using an integrated motor imagery and physical training intervention after knee injury: an interim analysis of the MOTIFS randomised controlled trial.

Objectives: Physical function is often a main focus of knee injury rehabilitation, but recent recommendations include increasing attention to psychological factors. We have developed the MOTor Imagery to Facilitate Sensorimotor re-learning (MOTIFS) training model which integrates dynamic motor imagery into physical rehabilitation. The objective is to report interim analysis results of an adaptive randomised controlled trial regarding the pre-defined continuation criteria. Methods: Following a 12-week intervention in which participants were randomised to either MOTIFS or Care-as-Usual training, n=42 people undergoing rehabilitation for a traumatic knee injury were assessed for change from baseline to follow-up in psychological readiness to return to activity, using the ACL Return to Sport after Injury Scale (ACL-RSI), and side hop limb symmetry index. Continuation criteria included differences of ≥5 points in ACL-RSI and ≥8 points in side hop limb symmetry index in favour of the MOTIFS group. If these were not met, ≥5 points change in enjoyment was acceptable. Results: Pre-defined continuation criteria were not met for ACL-RSI (mean difference -8.1 (SE 4.1)), side hop limb symmetry index (mean difference 4.4 (SE 7.8)), nor enjoyment (mean difference 3.9 (SE 4.5)), indicating that major modifications are required for continuation of the MOTIFS trial. Conclusion: While results of this interim analysis did not show differences in psychological readiness to return to activity or side hop performance, previous research shows that the MOTIFS model is positive and enjoyable. Further research is warranted to evaluate more appropriate outcomes related to the holistic nature of physical and psychological readiness to return to activity. Trial registration number: NCT03473821.

Perception and Social Impact of Blackboard-Based Online Learning in a Psychology Course: Al-Qunfudhah Medical Students' Opinion.

BACKGROUND: Online learning was considered a novel method of teaching that affects university lifestyle and health. This study focused on online perception of Al-Qunfudhah medical students during psychology course learning and the effect of online teaching on social life. METHODS: Fifth-year students participated in an online psychology course. The online questionnaire consisted of 15 questions: three for demographic distribution, seven to assess online perception, and five to measure the effect of online teaching on students' social health. Questionnaire validity was checked by a preliminary pilot study, and Cronbach's alpha was used to assess internal consistency. A p-value less than 0.05 was considered significant. RESULTS: Seventy-five (83.3%) students participated in the study: 48 (64%) female and 27 (36%) male. Fifty-eight (77.3%) medical students documented a good perception of online learning of a psychology undergraduate course, whereas 17 (22.7%) had a poor perception. Additionally, 29 (78.4%) female students reported online teaching had a significant effect on their social and psychological health (p < 0.010), whereas eight (21.6%) male students showed that online teaching does not affect their social life. CONCLUSION: Al-Qunfudhah medical students, both men and women, highly participated in the psychology course online learning; however, female students were socially and psychologically affected by online learning more than male students.

How can restaurants entice patrons to order environmentally sustainable dishes? Testing new approaches based on hedonic psychology and affective forecasting theory.

Encouraging restaurant guests to order vegetarian dishes plays a key role in creating a more environmentally sustainable tourism sector. However, for many consumers eating a meat dish is an important aspect of their enjoyment-focused restaurant experience. Identifying new approaches that support restaurants in selling more vegetarian dishes are urgently needed. Drawing from hedonic psychology and affective forecasting theory, this study tests two interventions aimed at directing ordering towards specific vegetarian dishes in a scenario-based survey experiment with 742 consumers. Results show the potential of affective forecasting as a promising psychological mechanism. Displaying an appetising picture of a vegetarian dish on a menu increases stated ordering of the dish because the picture directs consumer attention to the dish and triggers them to imagine eating the dish. Consumers who imagine eating the dish feel stronger anticipated enjoyment of eating it. Adding to the picture an invitation to imagine eating the dish does not further increase the effect. This study explains the psychological mechanism of how a picture of an appetising vegetarian dish changes food choices and provides restaurants with a cost-effective measure to direct ordering towards more environmentally sustainable dishes.

Digital mental health intervention for schizophrenia spectrum and psychotic disorders: Protocol for a pragmatic feasibility study of Horyzons-Canada.

Background: Schizophrenia spectrum and other psychotic disorders (SSPD) are among the most debilitating of all mental disorders. While the evidence for psychosocial interventions such as cognitive behavioral therapy and peer support has significantly improved, access to these services remains limited. This paper describes a protocol for a pragmatic feasibility study of a digital mental health intervention (HoryzonsCa) that provides access to evidence-based psychosocial interventions, social networking, and clinical and peer support services through a secured, web-based platform for adults diagnosed with SSPD. Objective: The objectives are: (1) Adapt and translate HoryzonsCa for implementation in English and French; (2) Develop an implementation and training strategy; (3) Assess the acceptability, safety, and demand of HoryzonsCa; (4) Assess clinical outcomes and perceived impacts; (5) Examine the experiences and process of adapting and implementing HoryzonsCa; (6) Explore the role of sociocultural and demographic factors on HoryzonsCa outcomes and implementation. Methods: This feasibility study will use a single-group, pre-post, mixed-methods (QUAN-QUAL convergent) research design, with assessments at baseline and 12 weeks. The study aims to recruit 100 individuals (ages 18-50) diagnosed with SSPD from two healthcare settings in Canada. Data collection includes interview-based psychometric measures, self-reports, focus groups, and interviews with participants. The study will also collect qualitative data from moderators and the research team, and will be conducted entirely remotely. Conclusions: This study has been prospectively registered and is underway. It will provide timely information on the feasibility and potential impacts of using digital mental health services for individuals with chronic mental health conditions. Trial Registration: ISRCTN12561259; https://doi.org/10.1186/ISRCTN12561259 (250/max 250 words).

Mental wellness and health-related quality of life of young adult survivors of childhood cancer in Singapore.

Introduction: Childhood cancer survivors (CCS) are at risk of experiencing psychological distress years after completing cancer treatments. We aimed to assess the prevalence and associated risk factors affecting psychological distress and health-related quality of life (HRQOL) among CCS in Singapore, and compare with their siblings without a history of or existing cancer as control. Method: We recruited 143 young adult CCS aged ≥18 years attending survivorship clinics at KK Women's and Children's Hospital in Singapore who were in remission for ≥5 years and treatment-free for ≥2 years, and 57 siblings. CCS and siblings were matched at a 1:1 ratio based on sociodemographic factors yielding 46 pairs for comparison. Among CCS participants, 79 (55.2%) were male, 86 (60.1%) had leukaemia, 29 (20.3%) had solid tumours, 15 (10.5%) had lymphoma and 13 (9.1%) had brain tumours. All participants completed the Brief Symptom Inventory-18 (BSI-18) and Medical Outcomes Short Form-36 (MOS SF-36) questionnaires from August 2021 to July 2022. Results: There were 35 (24.5%) CCS who reported psychological distress in the BSI-18 Global Severity Index. Five (3.5%) and 31 (21.7%) CCS reported low HRQOL in the physical and mental composite scores, respectively. Mean scores between CCS and their siblings were not statistically significant across all domains of the BSI-18 and MOS SF-36. Associated risk factors for psychological distress and low HRQOL among CCS were history of psychiatric illness after cancer diagnosis and mood affected by the COVID-19 pandemic. Conclusion: CCS reported significant psychological distress and low HRQOL although they were not statistically different from their siblings. A holistic and risk factor-centric follow-up programme can aid early detection and mitigation of psychological late effects for CCS and their families.

Sleep quality and sleep duration are associated with charitable donations: Evidence from two population-based surveys.

STUDY OBJECTIVES: Insufficient sleep alters emotional processing, leading to mood disturbances, reduced gratitude, and potentially the withdrawal of compassionate helping. Using data from two national surveys, we investigated whether sleep quality and sleep duration were associated with willingness to donate to local charities and places of worship. METHODS: We conducted secondary analyses of two Gallup-administered studies that used random address-based sampling methodologies to approximate population-representative samples. BRS-5 included 1501 respondents and BRS-6 included 1336 respondents (independent samples). Each survey inquired about sleep quality and whether participants had donated in the last year to local organizations and places of worship. In addition, BRS-5 included questions about sleep duration. RESULTS: In both studies, participants who had better sleep quality and better sleep durations were more likely to donate charitably to local organizations and places of worship (ORs of 1.07-1.45). Most associations remained significant when accounting for age, gender, and income. CONCLUSION: Better sleep was associated with a greater likelihood to donate charitably. Experimental work is needed to determine if the relationship between sleep health and prosocial behaviors is uni- or bi-directional.

The Psychology of Rock Climbing: A Systematic Review.

BACKGROUND: Psychology plays an important role in rock climbing performance and safety. Many studies have examined the psychology of rock climbing, a sport that has grown in popularity and status over the past few decades. OBJECTIVE: This systematic review aimed to summarize published research on the psychology of rock climbing, find commonalities and disagreements within the current research and illuminate future research areas. METHODS: A systematic literature search was conducted in three electronic databases (Scopus, PsycINFO and SPORTDiscus) in July 2023. Key search terms such as 'sport climbing' and 'psychology' were included and combined using the operators "AND", "OR". The search syntax initially identified 504 records. After screening abstracts and full texts, 83 studies examining the psychology of rock climbing remained. RESULTS: Studies were sorted by whether they measured climbing-specific or psychological variables. Climbers are conscientious, intrinsically motivated and task-oriented. Flow is brought on by novel, challenging climbing situations and increases enjoyment and performance. Climbing ability correlates with self-confidence, decision-making ability, tactile and spatial perception and anxiety facilitation. Better and more experienced climbers better manage risk with less psychophysiological effects. Weaknesses of the current body of literature and avenues for future research were highlighted. CONCLUSION: Findings from this review suggest rock climbers are a unique group of athletes who balance risk with performance in different environments. Flow, confidence, anxiety facilitation and perception all play key roles in climbing performance. The optimal levels and development of these and more psychological variables have yet to be clarified by existing literature.

Shame and Stigma Over Long-Term Survival in Postoperative Cases of Head and Neck Cancer.

Background: Surgical excision of the tumor remains the primary choice for the treatment of head and neck cancer patients, but it often leads to facial disfigurement, which further causes mutilation in the patients. Mutilation causes shame and stigma, which imparts significant psychological strain on patients, and tends to impair their quality of life. Objective: The present study aimed to assess the shame and stigma over long-term postoperative survival duration in head and neck cancer patients. Methodology: Total 100 postoperative patients of head and neck cancer were recruited from the outpatient department of the host institute, and shame and stigma was assessed using the Hindi version of the shame and stigma scale. Results: The global shame and stigma score was 22.67 ± 16.22, with the highest perceived stigma due to changes in appearance (11.94 ± 8.805), followed by impaired speech (4.490 ± 3.243), feeling of regret (3.950 ± 3.313), and feeling of stigma (4.490 ± 3.243). The shame and stigma was found to be significantly higher in maxillary cancer patients (33.22 ± 16.60), followed by larynx cancer patients (22.06 ± 13.41) and oral cancer patients (21.53 ± 16.49). Patients with stage III and stage IV of cancer were found to perceive higher shame and stigma (35.91 ± 22.23 and 27.36 ± 14.71, respectively) compared to the patients having stage I and stage II cancer (9.583 ± 9.709 and 16.44 ± 11.82, respectively). A significantly declining linear trend was found between shame and stigma and postoperative survival duration. Conclusion: We concluded that shame and stigma act as important determinants of quality of life over long-term survival in head and neck cancer patients, and should be considered while designing psychological interventions and surgical reconstruction protocols. The present study will help clinicians to assess the mutilation among head and neck cancer patients in a better way and will help in devising new psychological strategies to manage psychological aspects associated with mutilation, which will ultimately enhance the quality of life of patients.

The role of impact on the meaning of generic sentences.

Generic sentences (e.g., "Dogs bark") express generalizations about groups or individuals. Accounting for the meaning of generic sentences has been proven challenging, and there is still a very lively debate about which factors matter for whether or not we a willing to endorse a particular generic sentence. In this paper we study the effect of impact on the assertability of generic sentences, where impact refers to the dangerousity of the property the generic is ascribing to a group or individual. We run three preregistered experiments, testing assertability and endorsement of novel generic sentences with visual and textual stimuli. Employing Bayesian statistics we found that impact influences the assertability, and endorsement, of generic statements. However, we observed that the size of the effect impact value may have been previously overestimated by theoretical and experimental works alike. We also run an additional descriptive survey testing standard examples from the linguistic literature and found that at least for some of the examples endorsement appears to be lower than assumed. We end with exploring possible explanations for our results.

Research in Defense Mechanisms: What Do We Stand?

More than a century is passed since Freud conceived the concept of defense mechanisms. In this article, we retrace the historical evolution of the construct and offer a narrative review of current clinical and empirical literature on its relevance in clinical psychology. Conceptual contributions and empirical findings on the relationship between defenses and personality, as well as between defensive styles and psychopathology (e.g., eating, depressive, and personality disorders) were described. Findings showed that defense mechanisms can help clinicians in understanding the function of patients' symptoms and in tailoring therapeutic interventions. Lastly, we reviewed studies on the potential role of defense mechanisms in unpredictable and changing environmental conditions, such as the outbreak of Covid-19 pandemic. All these studies support the view that defensive functioning is a key topic in the mental health field, and that the further application of reliable and clinically relevant assessment tools is a pivotal future direction in both research and clinical practice.

The Moral Brain: a Neuropsychiatric Perspective on Moral Behavior and Motivation.

This review explores the interplay between neurobiological, psychological, and social factors that underpin moral behavior and motivation. Integrating insights from neuropsychiatry, it examines the roles of key brain regions such as the prefrontal cortex, amygdala, and anterior cingulate cortex, as well as neurotransmitters like serotonin and dopamine, in shaping moral reasoning and ethical decision-making. The historical evolution of moral motivation theories, from ancient philosophy to modern psychological and neurobiological perspectives, provides a foundation for understanding intrinsic and extrinsic motivators, emotional influences, and the impact of social norms and cultural contexts. The review also addresses the effects of psychiatric disorders on moral behavior, highlighting how conditions like antisocial personality disorder, frontotemporal dementia, and schizophrenia can lead to moral deficits. By presenting a multidisciplinary approach, this review offers a comprehensive understanding of moral motivation and behavior, emphasizing the importance of fostering ethical conduct and addressing moral challenges in clinical, educational, and societal settings.

Resilience and Burden Related to Clinical Assistance: a Clinical Psychological Study.

BACKGROUND: The literature consistently highlights the significant burden faced by healthcare professionals, often describing caregivers as "invisible patients." Resilience is a critical factor in their well-being and quality of life. This study aimed to examine the presence of variables such as resilience and burden in caregivers, along with factors like age, gender, education, and work commitment, to understand the correlations among these independent and clinical variables. METHODS: The sample consisted of 126 carers aged 18-30 years old (M: 26.15; SD: 3.21) with a 77.8% of the sample being female. The variables included the socio-demographic (age, sex, education, hours/days of speech per week and years of service) and clinical status, therefore burden (time dependence, development, physical, social and emotional burden) and resilience (self-perception, planned future, social competence, structured style, family cohesion and social resources). RESULTS: Regarding the correlational analyses involving socio-demographic variables and resilience, only a few significant correlations were found. However, significant positive correlations were identified between socio-demographic variables and burden, specifically with age, hours and days of work per week, and years of service. Conversely, education showed a significant negative correlation with burden, highlighting its protective role. Significant correlations between resilience and burden variables were generally positive, except for self-perception and developmental burden. Multivariate linear regression analyses revealed numerous dependencies, with predictors such as age, sex, education, hours/days of work per week, and years of service influencing the dependent variables related to burden and resilience. CONCLUSIONS: This study examined fundamental socio-demographic, occupational, and psychological variables in the lives of caregivers. It highlights not only the presence of factors that negatively impact caregivers' quality of life but also important relationships between personal variables, resilience, and burden risk. Therefore, it is crucial to consider the findings of this study, along with existing literature, to design interventions aimed at reducing burdens and improving the quality of life for caregivers.