Search Results (1,564)

The impact of cultural identity on music performance anxiety (MPA) is under-researched. This retrospective case study explores the treatment of a professional musician in her 30s who presented with MPA associated with performing music related to her estranged father’s cultural background. The case formulation identified attachment ruptures and negative cognitions associated with her mixed cultural heritage that contributed to an experience of imposterism—referred to in lay literature as ‘racial imposter syndrome’ (RIS). It was hypothesized that RIS served to perpetuate her MPA. An attachment-based approach and Acceptance and Commitment Therapy framework was adopted, drawing on evidence-based treatment for MPA and mixed heritage individuals. The Depression Anxiety Stress Scale-21 (DASS-21), Outcome Rating Scale (ORS) and Session Rating Scale (SRS) were used as outcome measures. These measures fluctuated throughout the therapy. While improvements were observed in depression scores midway through treatment, elevated stress and depression scores at the conclusion of treatment were understood to reflect situational factors related to financial and housing precarity. Nonetheless, at the conclusion of treatment, the client showed improvement in managing MPA, evidenced by her progress in recording an album and reengagement with public performances. This case study adds to the limited research on treating MPA in racially minoritized and mixed-race individuals, Further research is required across larger and more diverse samples to better understand the relationship between MPA and RIS and to develop effective interventions. Full article

Background/Objectives: Infertility, defined as the failure to achieve pregnancy after one year of regular unprotected intercourse, represents a significant global health challenge, with male factors contributing to approximately 50% of cases. In this epidemiological context, both primary male infertility (the inability to conceive a first child) and secondary male infertility (which occurs when a man who has already fathered a child faces difficulty conceiving again) remain poorly understood at the genetic level. This study explored the role of single-nucleotide polymorphisms (SNPs) in mitochondrial genes (MT-ND3, MT-ND4L, and MT-ND4) in primary and secondary male infertility. Methods: This study analyzed the genotype distributions of SNPs in 68 infertile males (49 with primary infertility and 19 with secondary infertility) using Sanger sequencing. Results: Key findings revealed that studied SNPs were significantly associated with infertility type. Specifically, rs2857285 (T>C,G) in the ND4 gene showed a significant correlation (p = 0.023) with the TT genotype, which is prominent in primary infertility. Another SNP, rs28358279 (T>A,C) in the ND4L gene, also demonstrated a significant correlation (p = 0.046) with the TT genotype, being more common in primary infertility. In addition, rs869096886 (A>G) in the ND4 gene had a borderline correlation (p = 0.051), indicating a possible association between this SNP and reproductive duration. Conclusions: This study emphasizes the potential relevance of mitochondrial malfunction in male infertility, specifically the effects of studied SNPs on sperm survival and function over time. These findings suggest that certain mitochondrial SNPs might be potential biomarkers for infertility risk. Larger studies are needed to confirm these associations and examine the functional effects of these SNPs. Combining genetic analysis with environmental and lifestyle factors could enhance our understanding of male infertility and improve diagnostic and therapeutic strategies. Full article

Background: Maternal and newborn health disparities remain a challenge in Puerto Rico, especially in underserved communities. Comienzo Saludable Puerto Rico, sponsored by the U.S. Department of Health and Human Services’ Healthy Start Initiative (HRSA), addresses these gaps through an integrated Networks of Care model known as Cuidado Compartido. Comienzo Saludable Puerto Rico is a maternal, paternal, and child health program aimed at improving the health and well-being of pregnant women, mothers, fathers, newborns, and children in Puerto Rico, particularly those from disadvantaged communities. Methods: This paper presents the Comienzo Saludable Puerto Rico program’s Cuidado Compartido model to integrate a network of healthcare providers and services across hospitals, community organizations, and families. This model aims to improve maternal and newborn/child health outcomes by focusing on the importance of integrated, hospital-community-based care networks. Results: Participants experienced significant improvements in key birth outcomes: low birth weight prevalence declined by 27.2% compared to the community baseline, premature birth rates decreased by 30.9%, and infant mortality dropped by 75%, reaching 0% by 2021 and remaining there through 2023. These results were complemented by increases in maternal mental health screening, paternal involvement, and breastfeeding practices. Conclusions: The Cuidado Compartido model demonstrates a scalable, culturally responsive strategy to improve maternal, newborn, and child health outcomes. It offers critical insights for implementation in other high-need contexts. Full article

Inherited epidermolysis bullosa (EB) is a heterogeneous clinical entity that includes over 30 phenotypically and/or genotypically distinct inherited disorders, characterized by mechanical skin fragility and bullae formation. Junctional EB (JEB) is an autosomal recessive disease characterized by an intermediated cleavage level within the skin layers, commonly at the “lamina lucida”. Laryngo-onycho-cutaneous syndrome (LOC) is an extremely rare variant of JEB, characterized by granulation tissue formation in specific body sites (skin, larynx, and nails). Although most cases of JEB are caused by pathogenic variants occurring in the genes encoding for classical components of the lamina lucida, such as laminin 332 (LAMA3, LAMB3, LAMC2), integrin α6β4 (ITGA6, ITGB4), and collagen XVII (COL17A1), other variants have also been described. We report the case of a 4-month-old male infant who presented with recurrent bullous and erosive lesions from the first month of life. At the first dermatological evaluation, the patient was agitated and exhibited hoarse breathing, a clinical sign suggestive of laryngeal involvement. Multiple polygonal skin erosions were observed on the cheeks, along with similar isolated, roundish lesions on the scalp and legs. Notably, nail dystrophy and near-complete anonychia were evident on the left first and fifth toes. Due to the coexistence of skin erosions and nail dystrophy in such a young infant, a congenital bullous disorder was suspected, prompting molecular analysis of all potentially involved genes. In the patient’s DNA, clinical exome sequencing (CES) identified a pathogenic variant, apparently in homozygosity, in the exon 1 of the LAMA3 gene (18q11.2; NM_000227.6): c.47G > A;p.Trp16*. The presence of this variant was confirmed, in heterozygosity, in the genomic DNA of the patient’s mother, while it was absent in the father’s DNA. Subsequently, trio-based SNP array analysis was performed, revealing a paternally derived pathogenic microdeletion encompassing the LAMA3 locus (18q11.2). To our knowledge, this is the first reported case of JEB with a LOC-like phenotype caused by a maternally inherited monoallelic nonsense mutation in LAMA3, unmasked by an almost complete deletion of the paternal allele. The combined use of exome sequencing and SNP array is proving essential for elucidating autosomal recessive diseases with a discordant segregation. This is pivotal for providing accurate genetic counseling to parents regarding future pregnancies. Full article

In China, grandparents play a significant role in childrearing. This study aims to identify latent profiles of intergenerational parenting styles and explore their impact on grandchildren’s behavioral outcomes. A total of 1432 Chinese children (M_age = 12.58 years; 45.25% boys) completed questionnaires assessing perceived grandparenting styles, while fathers and mothers independently reported their own parenting practices. Latent Profile Analysis (LPA) identified three distinct parenting profiles: “Grandparents Positive–Parents Negative” (GP–PN, 18.37%), “Grandparents Positive–Parents Positive” (GP–PP, 59.15%), and “Grandparents Negative–Parents Positive” (GN–PP, 22.48%). Regression analyses revealed that the number of siblings, grade level, and grandparent type could significantly predict profile membership. Notably, consistent and positive intergenerational parenting styles were associated with fewer problem behaviors in children. Furthermore, the relationship between parenting profiles and problem behaviors was mediated by the quality of the grandparent–parent relationship. These findings suggested that grandparents and parents should coordinate their parenting styles when raising grandchildren together. Full article

Background: Very preterm infants are at increased risk of impairment. The objective was to explore the effect of immediate parent–infant skin-to-skin contact at very preterm birth on cognition, motor, social, and language development during the two first years. Methods: The Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS) was a clinical trial with inclusions between April 2018 to June 2021, in three Scandinavian neonatal intensive care units. Infants were randomised at gestational age 28 + 0 to 32 + 6 weeks plus days, to immediate and continuous skin-to-skin contact at birth or conventional care, during the first six hours of life. Results: At three months, 42 infants underwent a General Movement Assessment. At four and 12 months, 69 and 62 infants, respectively, were assessed with the Alberta Motor Infant Scale. At 24 months, language and cognition were tested in 62 infants with the Bayley Scales of Infant and Toddler Development, third edition. Parents completed the Modified Checklist for Autism in Toddlers for 57 infants. There were no significant differences in motor development, cognition, or autism spectrum disorders. A significant difference in language scores in favour of immediate skin-to-skin contact, was found, when adjusted for fathers’ education, mothers’ education, and infants’ sex, Beta (95% CI): 32.00 (7.57, 56.43) p = 0.01, 11.51 (8.94, 55.06) p = 0.007, and 32.00 (7.85, 56.15) p = 0.01, respectively. Conclusions: Skin-to-skin contact immediately at birth did not enhance cognition, motor, or social development during the first two years of life but may have been important for language skills. Our findings support the World Health Organisation guidelines recommending iSSC for preterm born infants in all settings. Full article

This study explores the Bonaventurian synthesis of the human being as imago et similitudo Dei, highlighting its anthropological and existential implications. Against the backdrop of contemporary reductionist approaches that fragment the understanding of the human person, Bonaventure offers a holistic vision that integrates intellectual, affective, and volitional dimensions within a Christocentric and Trinitarian framework. Through a systematic analysis of Bonaventure’s primary texts—particularly the Itinerarium mentis in Deum and the Collationes in Hexaëmeron—and supported by critical scholarship, the article argues that human fulfillment transcends the limits of pure rationality and culminates in the unitive act of love with God. The study identifies two central principles of what Lázaro Pulido calls “Christian Socratism”: (1) human life as a journey to the Father’s house, and (2) the configuration of the soul, in wisdom and love, as a dwelling place of God. By situating the moral and spiritual life within the logic of divine attraction, Bonaventure overcomes both Aristotelian intellectualism and postmodern individualism. Ultimately, his thought presents happiness not as self-realization but as conformity with Christ crucified, revealing a path where suffering acquires meaning and the human vocation to love finds its ultimate horizon in the Trinity. Full article

When scholars view characters in King Lear through a Machiavellian lens, they read Edmund, Goneril, and Regan as stock Machiavels. In contrast, they often perceive Cordelia, Kent, and Edgar as selfless, apolitical characters. This essay argues that the latter characters are more complicated and politically adroit than they are often judged to be. They are Machiavellian as well, but Shakespeare conceives them within a more appreciative view of the concept of realpolitik. This essay explains the characters’ strategies by relating them to Machiavelli’s tenets of achieving and maintaining political power. The central quandary of the play is the lack of a male heir to the throne. Cordelia attempts to solve the problem by marrying the King of France for political reasons. She has an alliance with Kent, who helps her to justify her invasion of her homeland with French forces. Once the plans for a surprise attack go awry, Cordelia does not follow Machiavellian strategies and is consequently killed. Ironically, Edgar is as ambitious as Edmund, whom he lets plot against his father and bring about Gloucester’s slow decline so as to inherit his father’s fortune while Edmund incurs the blame for his father’s demise. Like Kent, he enlists a disguise for self-advancement. The most adroit Machiavellian characters—Edgar, Kent, and the King of France—all survive through chicanery and cunning. Shakespeare illustrates that secular methods of governorship defeat the old world of divine politics. Full article

Much U.S. research supports the effectiveness of parenting education delivered via the home visiting method. Home visitors are essential to reaching fathers in this context, but not all have favorable attitudes toward father engagement or feel confident working with fathers. Given that father involvement is important for a wide range of child and adolescent outcomes and that fathers benefit from parenting education, it is important to better understand the forces that shape home visitors’ attitudes toward fathers, and thus their subsequent efforts to include them in publicly funded programming. Using survey data from 95 home visitors in Tennessee, this study explores whether home visitors’ beliefs about fathers and attitudes toward father engagement vary as a function of home visitor or agency characteristics. Results suggest training in social work, reporting father-friendly organizational attitudes and behaviors at one’s agency, and reporting supervisor support specifically for father engagement relate to various favorable fathering attitudes. Home visitors’ strategies to engage fathers in home visiting are presented, including strategies for before, during, and after the home visit. Overall, family service agency administrators are in key positions to make decisions that can improve agency father-friendliness, home visitor attitudes toward fathers, and subsequent outcomes for fathers, mothers, and children. Full article

Background: Medical education is considered one of the most academically and emotionally demanding training programs. Throughout their education, medical students are exposed to various factors that can lead to psychological distress, depression, and anxiety. The aim of this longitudinal study was to examine the changes in psychological distress, depression, anxiety levels and internet addiction among medical students throughout their six-year education and to identify the contributing factors. Methods: The study cohort consisted of 282 students who enrolled in the medical faculty in the 2017–2018 academic year. A questionnaire including sociodemographic characteristics, the General Health Questionnaire-12 (GHQ-12), Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and Young Internet Addiction Test (IAT) was administered to the students during the first week of their education. The same questionnaire was readministered at the end of the third and sixth years. Friedman’s variance analysis was used to compare measurement data across the three time points, while Cochran’s Q Test was employed for categorical variables. Results: The median scores of the GHQ-12, BDI, S-Anxiety, and IAT significantly increased from the first to the sixth year (p < 0.05). The prevalence of depressive symptoms, S-Anxiety, and risky internet use significantly increased from the first to the final year, particularly between the third and sixth years. According to logistic regression analysis based on sixth-year data, students whose fathers were university graduates, who had been diagnosed with COVID-19, and who were dissatisfied with their social lives were found to be at increased risk for psychological distress and depression. Students with high parental expectations were found to be at risk of depression and S-anxiety. Those dissatisfied with their occupational choice were at risk for both psychological distress and S-anxiety. Conclusions: It was found that the mental health of medical students deteriorated during their education, especially during the clinical years. Given that these students will be responsible for protecting and improving public health in the future, it is essential to prioritize their own mental well-being. Interventions aimed at preserving the mental health of medical students should be planned. Full article

This study investigates the complex relationship between levels of religiosity and attitudes toward secularization among individuals receiving higher religious education in Türkiye. Secularization is defined as the diminishing influence of religion in public life and the rise of critical attitudes toward religious norms, a process that accelerated particularly during the modernization period following the establishment of the Republic. The primary aim of the research is to analyze whether there is a significant relationship between secular attitudes and the perceived influence of Islam among theology faculty students. The study employs a quantitative, descriptive survey design and includes a sample of 380 undergraduate, graduate, and doctoral students from the faculties of theology at Kocaeli, Sakarya, Marmara, and Istanbul universities. Data were collected using the “Perceived Influence of Religion Scale” and the “Secular Attitude Scale,” both of which demonstrated acceptable reliability (Cronbach’s Alpha = 0.70). Demographic variables such as age, gender, marital status, parental education level, type of education (formal or distance), and economic status were also incorporated into the analysis. The findings revealed statistically significant differences based on marital status, parental education level, type of education program, and previous educational background. For instance, single students reported perceiving a higher influence of religion compared to their married counterparts, while students with fathers who held university degrees perceived a lower influence of religion. These results offer valuable insights into how modern social transformations influence religious attitudes and practices. Full article

Accurately screening fathers for perinatal mental health problems requires well-validated screening instruments that assess the expression of paternal perinatal mental distress. This study aimed to identify and describe the psychometric properties of perinatal mental health screening instruments administered to paternal cohorts within the past two decades. A scoping review was conducted following Arksey and O’Malley’s scoping review framework and is reported in line with the PRISMA-ScR guidelines. A systematic search of Embase, PsycINFO, Medline, and ProQuest databases identified peer-reviewed literature published within the past 20 years that implemented a screening instrument for fathers’ perinatal mental health within the first 12 months of their child’s birth. Twenty-eight instruments used to screen fathers’ perinatal mental health were identified across 36 studies. The instruments most frequently assessed symptoms of depression. Only five were explicitly developed for fathers and while these instruments produced promising results, further evaluation is necessary before they can be considered a superior screening method compared to existing instruments. Full article

The relationship between Scripture and the Liturgy remains one of the most extensively debated subjects in theological discourse. In the wake of the Protestant Reformation and the Catholic Counter-Reformation, a divided Christendom witnessed the rise of a dichotomy between Scripture and Liturgy, as well as between the Word and the Sacrament. This dichotomy, however, is absent from the patristic thought, which perceives the unity and complementarity between Scripture and Liturgy, owing to their shared belonging to the one life of the Church—broadly defined as Tradition—and to the way they are understood and experienced as interconnected modes through which the singular Mystery of Jesus Christ is communicated to the faithful. The present study aims to demonstrate this unity by drawing on a substantial body of patristic writings, highlighting the fact that the life of the Church is one and is lived both as the rule of faith and the rule of prayer, and that through it, one and the same Christ communicates Himself to the faithful both through the Word and through the Holy Sacraments. For the Church Fathers, the Christian faith is not an abstract doctrine about Christ, but a real and personal encounter and communion with Him in the life of the Church. This patristic approach may offer a starting point for contemporary Christianity in addressing the current liturgical crisis and in rethinking and renewing future ecumenical dialogue. Such renewal presupposes a movement beyond secular formalism and nominalism, which have fostered excessive conceptualization and an antithetical view of Scripture and Liturgy, Word and Sacrament. Full article

Background/Objectives: Early childhood anemia is a severe public health concern and the most common blood disorder worldwide, especially in emerging countries. This study examines the sources of childhood anemia in Ghana through various societal, parental, and child characteristics. Methods: This research used data from the 2022 Ghana Demographic and Health Survey (GDHS-2022), which comprised 9353 children. Using STATA 13 and R 4.4.2 software, we analyzed maternal, social, and child factors using a model-building procedure, logistic regression analysis, and machine learning (ML) algorithms. The analyses comprised machine learning methods including decision trees, K-nearest neighbor (KNN), logistic regression, and random forest (RF). We used discrimination and calibration parameters to evaluate the performance of each machine learning algorithm. Results: Key predictors of childhood anemia are the father’s education, socioeconomic status, iron intake during pregnancy, the mother’s education, and the baby’s postnatal checkup within two months. With accuracy (94.74%), sensitivity (82.5%), specificity (50.78%), and AUC (86.62%), the random forest model was proven to be the most effective machine learning predictive model. The logistic regression model appeared second with accuracy (67.35%), sensitivity (76.16%), specificity (56.05%), and AUC (72.47%). Conclusions: Machine learning can accurately predict childhood anemia based on child and paternal characteristics. Focused interventions to enhance maternal health, parental education, and family economic status could reduce the prevalence of early childhood anemia and improve long-term pediatric health in Ghana. Early intervention and identifying high-risk youngsters may be made easier with the application of machine learning techniques, which will eventually lead to a healthier generation in the future. Full article