Search Results (213)

Background: As COVID-19 transitions to an endemic phase, long COVID symptoms remain a significant public health issue affecting both physical and mental health. A notable proportion of college students report symptoms such as fatigue, cough, and brain fog persisting for weeks or months post-infection. Objectives: This study explored the prevalence and contributing factors of long COVID symptoms among both infected and uninfected students in medicine-related departments. Methods: A cross-sectional study was conducted using online self-reported questionnaires completed by 1523 undergraduate and graduate students in medicine-related departments at a medical university. Participants who had tested positive for COVID-19 within the past three months were excluded. The survey assessed long COVID symptoms, with comparisons conducted between infected and uninfected groups. Multivariate logistic regression identified risk factors associated with long COVID symptoms. Results: Of the 1118 participants, 47.5% of those with a prior COVID-19 diagnosis reported long COVID symptoms within the past month. Significant differences between the infected and uninfected groups were observed in physical, cognitive, and psychological health. Logistic regression identified that prior COVID-19 diagnosis had an association with the presence of long COVID symptoms (odds ratio = 1.48, p = 0.024) after adjusted model analysis. Meanwhile, higher anxiety levels (odds ratio = 1.09, p < 0.001) and a BMI ≥ 24 (odds ratio = 4.50, p < 0.01) were identified as significant risk factors for post-infection syndrome among previously infected students. Sex and exercise habits also influenced symptom prevalence. Conclusions: Since late 2023, with those experiencing cumulative infections surpassing half of Taiwan’s population, long COVID symptoms have persisted as a widespread concern affecting both physical and mental health, continuing into 2025. This study underscores critical risk factors and symptom patterns among students in medicine-related departments, reinforcing the urgency of sustained surveillance and targeted interventions to facilitate comprehensive recovery. Full article

Colorectal cancer (CRC) remains a leading cause of cancer morbidity and mortality worldwide, especially in older adults where frailty complicates treatment outcomes. Multimodal prehabilitation—comprising nutritional support, physical exercise, and psychological interventions—has emerged as a promising strategy to enhance patients’ resilience before CRC surgery. Clinical studies demonstrate that prehabilitation significantly reduces postoperative complications, shortens hospital stays, and improves functional recovery. Nutritional interventions focus on counteracting malnutrition and sarcopenia through tailored dietary counseling, protein supplementation, and immunonutrients like arginine and glutamine. Physical exercise enhances cardiorespiratory fitness and muscle strength while modulating immune and metabolic pathways critical for surgical recovery. Psychological support reduces anxiety and depression, promoting mental resilience that correlates with better postoperative outcomes. Despite clear clinical benefits, the molecular mechanisms underlying prehabilitation’s effects—such as inflammation modulation, immune activation, and metabolic rewiring—remain poorly understood. This review addresses this knowledge gap by exploring potential biological pathways influenced by prehabilitation, aiming to guide more targeted, personalized approaches in CRC patient management. Advancing molecular insights may optimize prehabilitation protocols and improve survival and quality of life for CRC patients undergoing surgery. Full article

Background/Objectives: The increasing population of childhood cancer survivors presents new challenges for healthcare systems worldwide. While advances in oncological treatments have dramatically improved survival rates, survivors face a broad spectrum of late effects that extend beyond the biological to encompass profound psychological and social dimensions. Methods: This quasi-systematic review synthesizes data from recent studies on adolescent survivors, revealing significant disruptions in cognitive function, mental health, social integration, education, romantic relationships, and vocational outcomes. Results: This review highlights the inadequacy of a solely biomedical model and advocates for a biopsychosocial approach to long-term follow-up care. An emphasis is placed on the necessity of personalized, interdisciplinary, and developmentally informed interventions, especially in countries like Poland, where structured survivorship care models remain underdeveloped. Conclusions: The findings underscore the importance of integrating medical, psychological, and social services to ensure adolescent cancer survivors achieve not only physical recovery but also meaningful life participation and emotional well-being. Full article

(1) Background: Physical activity (PA) plays a crucial role in preserving and enhancing mental health, particularly in the aftermath of major health crises such as the COVID-19 pandemic. However, the specific levels and domains of physical activity that have the greatest impact on alleviating symptoms of anxiety, depression, and stress in the post-COVID-19 period remain unclear. The aim of this study was to examine the influence of different levels and domains of PA on mental health parameters, specifically symptoms of anxiety, depression, and stress, in individuals who had recovered from COVID-19. (2) Methods: The study included initial measurements (2–4 weeks post-recovery) and final measurements (14–16 weeks post-recovery). The sample comprised 288 participants aged 20 to 60 years (M = 47.06; SD = 12.41), with 95 men and 193 women. PA was assessed using the long version of the IPAQ questionnaire, while mental health was evaluated using the long version of the DASS scale. (3) Results: Stepwise regression analysis revealed that low- (p = 0.010) and moderate-intensity (p = 0.022) PA was significantly associated with reductions in anxiety symptoms as well as lower stress levels (low PA: p = 0.014; moderate PA: p = 0.042). Total PA (p < 0.001) and vigorous-intensity PA (p = 0.008) emerged as significant predictors of reduced depression levels. Among the domains of PA, home-based activities had a statistically significant impact on all three mental health components: anxiety (p = 0.005), depression (p = 0.002), and stress (p = 0.041). Transport-related PA was significantly associated with anxiety (p = 0.011) and stress (p = 0.022), but not with depression. (4) Conclusions: The results suggest that a combined model incorporating different levels and domains of PA may represent an effective approach to improving mental health in individuals recovering from COVID-19. Further longitudinal studies are needed to establish more precise causal relationships. Full article

Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically assisted and conventional manual TKA in community-dwelling elderly patients. Methods: This cross-sectional study included 50 elderly patients undergoing TKA, who were divided into robotically assisted (n = 25) and conventional manual (n = 25) groups. Demographic and clinical data, balance performance, and functional outcomes were compared at nearly 1.5 years postoperatively. Outcome measures included balance performance assessed by the Berg Balance Scale (BBS), pain via the Visual Analog Scale (VAS), knee function as measured by the Lysholm Knee Scoring Scale, quality of life using the Short Form-12 (SF-12), joint awareness as evaluated by the Forgotten Joint Score-12 (FJS-12), and surgical satisfaction. Results: The groups had similar demographic and clinical data regarding age, gender, follow-up duration, surgical time, and anesthesia type (p > 0.05). The robotically assisted group demonstrated better balance performance on the BBS (p = 0.043) and had a statistically shorter length of hospital stay (1.22 vs. 1.42 days; p = 0.005). However, no statistically significant differences were observed in VAS activity pain (p = 0.053), Lysholm Knee Scoring Scale (p = 0.117), SF-12 physical and mental scores (p = 0.174 and p = 0.879), FJS-12 (p = 0.760), and surgical satisfaction (p = 0.218). Conclusions: Robotically assisted TKA is associated with advantageous postoperative recovery, particularly in terms of balance performance, showing no clinical difference in other functional outcomes compared to the conventional manual technique. From a physical therapy perspective, these findings emphasize the importance of developing tailored and effective rehabilitation strategies in the medium term for functional recovery in the elderly population. Full article

Background and Objectives: Epithelial ovarian cancer (EOC) remains the deadliest gynecologic malignancy, yet the psychosocial dynamics of early survivorship are inadequately described. We prospectively quantified six-month trajectories in the quality of life in a consecutive cohort of 88 women newly diagnosed with EOC and explored clinical moderators of change. Methods: Eighty-eight consecutive patients (mean age 59.1 ± 10.7 years) completed the SF-36, WHOQOL-BREF, EORTC QLQ-C30, and 10-item Perceived Stress Scale (PSS-10) at baseline (pre-therapy) and six months after cytoreductive surgery ± platinum-based chemotherapy. Stage (FIGO I–II vs. III–IV) and treatment pathway (primary debulking surgery, neoadjuvant chemotherapy plus interval debulking, chemotherapy only) data were recorded. Results: Global QoL improved significantly (EORTC Global Health +5.9 ± 7.7 points; p < 0.001) while perceived stress declined (ΔPSS −3.6 ± 5.1; p < 0.001). SF-36 Physical Functioning rose 4.7 ± 7.9 points (p < 0.001) and Mental Health 4.4 ± 7.9 points (p = 0.004). The WHOQOL Physical and Psychological domains gained 4.7 ± 7.1 and 4.3 ± 7.4 points, respectively (both p < 0.01). Advanced-stage patients experienced larger stress reductions than early-stage patients (−4.1 ± 2.7 vs. −2.9 ± 2.2; p = 0.028) but comparable QoL gains. Greater stress relief correlated with greater mental-health improvement (r = −0.51) and global-health gains (r = −0.45) (all p < 0.001). Treatment pathway did not significantly influence trajectories. Conclusions: Early survivorship after first-line ovarian-cancer therapy was characterized by the clinically meaningful recovery of physical and emotional functioning together with the moderate alleviation of perceived stress. Improvements were observed irrespective of stage and treatment strategy, suggesting that contemporary multimodal regimens do not inevitably compromise patient-reported outcomes. Our estimates provide preliminary effect sizes that should be validated in multi-center cohorts with longer follow-up. Full article

Introduction: Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Methods: Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VO₂max), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. Results: A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VO₂max ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. Conclusions: HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care. Full article

Background: Since the pathophysiology of long COVID is not yet fully understood, there are no specific methods for its treatment; however, its individual symptoms can currently be treated. Long COVID is characterized by symptoms that persist at least 2 to 3 months after contracting COVID-19, although it is difficult to predict how long such symptoms may persist. Methods: In the present study, 774 patients who first visited our outpatient clinic during the Omicron period from February 2022 to October 2024 were divided into two groups: the early recovery (ER) group (370 cases; 47.8%), who recovered in less than 180 days (median 33 days), and the persistent-symptom (PS) group (404 cases; 52.2%), who had symptoms that persisted for more than 180 days (median 437 days). The differences in clinical characteristics between these two groups were evaluated. Results: Although the median age of the two groups did not significantly differ (40 and 42 in ER and PS groups, respectively), the ratio of female patients was significantly higher in the PS group than the ER group (59.4% vs. 47.3%). There were no significant differences between the two groups in terms of the period after infection, habits, BMI, severity of COVID-19, and vaccination history. Notably, at the first visit, female patients in the PS group had a significantly higher rate of complaints of fatigue, insomnia, memory disturbance, and paresthesia, while male patients in the PS group showed significantly higher rates of fatigue and headache complaints. Patients with more than three symptoms at the first visit were predominant in the PS groups in both genders. Notably, one to two symptoms were predominant in the male ER group, while two to three symptoms were mostly reported in the female PS group. Moreover, the patients in the PS group had significantly higher scores for physical and mental fatigue and for depressive symptoms. Conclusions: Collectively, these results suggest that long-lasting long COVID is related to the number of symptoms and presents gender-dependent differences. Full article

Firefighting is a physically, mentally, and emotionally demanding occupation. These demands are exacerbated by an increase in workload, resulting in an increase in stress and a decrease in recovery. While researchers have examined the influence of workload on stress perceptions, little is known about firefighter perceptions of recovery generally, and no research investigating perceptions of holistic recovery (i.e., physical, mental, and emotional) exists. The purpose of this study was to determine the association between acute workload (i.e., call volume) and firefighter perceptions of stress and recovery from pre-shift to post-shift. Sixteen active-duty firefighters completed the Short Recovery and Stress Scale pre- and post-shift and reported call volume after every shift (N = 156 total shifts). Repeated measures correlations were used to examine the common intraindividual associations between pre- to post-shift perceptions of recovery and stress and call volume. Results indicated that as call volume increased, firefighters perceived themselves to be significantly less recovered overall [r_rm (139) = −0.22, p < 0.001], physically [r_rm (139) = −0.31, p < 0.001], mentally [r_rm (139) = −0.26, p < 0.001], and emotionally [r_rm (139) = −0.27, p < 0.005] and significantly more stressed overall [r_rm (139) = 0.28, p < 0.001], mentally [r_rm (139) = 0.25, p < 0.005], and emotionally [r_rm (139) = 0.21, p = 0.012] post-shift compared to pre-shift. These findings suggest that to optimize firefighter health and well-being, practitioners should monitor call volume and implement appropriate physical, mental, and/or emotional recovery interventions. Full article

COVID-19 causes instant and often prolonged effects with multisystemic and heterogeneous symptoms, significantly affecting the bio-psychosocial life of patients. In view of this, the present prospective cohort study aims to document the evolution of symptoms in hospitalized COVID-19 patients, monitoring variations in their mental and physical health for eighteen months after clinical recovery. A sample of 117 patients was examined at four distinct time points: at 2, 6, 12 and 18 months after discharge from the Pulmonology Clinic of the General University Hospital of Larissa (single-center approach). The data collection focused on psycho-physical symptoms, sleep disturbances and quality of life indicators. The study results revealed that over the 18-month period the participants gradually recovered both physically and psychologically, as well as regained pre-disease sleep patterns. However, substantial recovery was noted by month 6, followed by stabilization of their health status. However, a complete return to the pre-disease state of all assessed variables was not achieved, confirming and reinforcing the need for long-term follow-up and overall patient care. Full article

Background: Informal caregivers of individuals with Alzheimer’s disease often experience high levels of emotional, physical, and psychological burden. Personalized nursing interventions are essential to support these caregivers and promote their well-being. Objectives: The objective of this study was to implement and evaluate a personalized psychoeducational intervention—Curae de Mim (Care for Me)—designed to reduce caregivers’ burden and enhance the emotional resilience among informal caregivers for people with Alzheimer’s disease. Methods: A mixed-methods study was conducted with 14 informal caregivers in a Portuguese community healthcare setting. The intervention consisted of six weekly group sessions guided by a mental health nurse, using cognitive–behavioral and recovery-oriented approaches. Results: After the intervention, the caregivers’ burden scores decreased significantly. The mean burden score dropped from 78 to 50. The thematic analysis revealed two key outcomes: emotional empowerment through peer interactions and reframing of the caregiver’s role through knowledge and self-care. Conclusions: This program proved effective in reducing caregivers’ burden and promoting adaptive coping. The integration of narrative reflection and specialized nursing care contributed to improved mental health outcomes. Full article

Persons with personality type D are characterized by an “unhealthy lifestyle”, which is manifested by low physical activity, less healthy eating behavior, and failure to comply with doctors’ recommendations. Persons with personality type D have an inadequate response of hemodynamic parameters to psychoemotional stress; the response of other parameters has not been sufficiently studied. The aim of this study was to investigate the association of personality type D with various psychophysiological parameters of the body during mental stress in healthy individuals. Material and Methods: The study involved 79 students of Kemerovo State Medical University aged 18 to 32 years (mean age 20.7 ± 2.4 years). Psychophysiological diagnostics was carried out using the BOSLAB complex; electromyogram, electrocardiogram, body temperature, respiration, galvanic skin response, and photoplethysmogram data were recorded. The stress testing protocol included cognitive tasks and recovery phases. Additionally, the presence of personality type D in students was assessed using the DS-14 questionnaire. The results of stress tests were compared in groups with the presence/absence of type D. Results: The frequency of detection of type D was high (54.4%). When examining the response of psychophysiological parameters, the most pronounced response to stress tests with mental load was noted for heart rate variability and respiratory system parameters. Individuals with type D personality showed more pronounced sympathetic activation in response to mental stress and a slower recovery at rest. Among the studied parameters, association with personality type D was noted for the following indicators during the mental arithmetic test: heart rate (p = 0.022), the Baevsky strain index (p = 0.004), respiratory rate (p = 0.020), and an indicator of regulatory process adequacy (p < 0.001). Conclusion: In the present study, we found differences in the reaction of psychophysiological parameters to mental stress in healthy individuals depending on the presence or absence of personality type D. These data can be useful for developing stress resistance programs and biofeedback training. The possibility of using the above psychophysiological parameters in biofeedback training programs for individuals with personality type D requires further research. Full article

Road traffic accidents (RTAs) are a leading cause of physical injury worldwide, but they also frequently result in post-traumatic stress disorder (PTSD). This systematic review examines the prevalence, predictors, comorbidity, and treatment of PTSD among RTA survivors. Four electronic databases (PubMed, Scopus, EBSCO, and ProQuest) were searched following PRISMA 2020 guidelines. Articles were included if reporting on the presence of post-traumatic stress disorder as a result of a road traffic accident in adults aged 18 years and older. Including peer-reviewed journal articles and awarded doctoral theses across all publication years, and written in English, Macedonian, Serbian, Bosnian, Croatian, and Bulgarian, identified 259 articles, and using Literature Evaluation and Grading of Evidence (LEGEND) assessment of evidence 96 were included in the final review, involving 50,275 participants. Due to the heterogeneity of findings, quantitative data were synthesized thematically rather than through meta-analytic techniques. Findings are reported from Random Control Trial (RCT) and non-RCT studies. PTSD prevalence following RTAs ranged widely across studies, from 20% (using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5 criteria) to over 45% (using International Classification of Diseases, 10th Revision, ICD-10 criteria) within six weeks post-accident (non-RCT). One-year prevalence rates ranged from 17.9% to 29.8%, with persistence of PTSD symptoms found in more than half of those initially diagnosed up to three years post-RTA (non-RCTs). Mild or severe PTSD symptoms were reported by 40% of survivors one month after the event, and comorbid depression and anxiety were also frequently observed (non-RCTs). The review found that nearly half of RTA survivors experience PTSD within six weeks, with recovery occurring over 1 to 3 years (non-RCTs). Even minor traffic accidents lead to significant psychological impacts, with 25% of survivors avoiding vehicle use for up to four months (non-RCT). Evidence-supported treatments identified include Cognitive Behavioural Therapy (CBT) (RCTs and non-RCTs), Virtual Reality (VR) treatment (RCTs and non-RCTs), and Memory Flexibility training (Mem-Flex) (pilot RCT), all of which demonstrated statistically significant reductions in PTSD symptoms across validated scales. There is evidence for policy actions including mandatory and regular psychological screening post RTAs using improved assessment tools, sharing health data to better align early and ongoing treatment with additional funding and access, and support and interventions for the family for RTA comorbidities. The findings underscore the importance of prioritizing research on the psychological impacts of RTAs, particularly in regions with high incident rates, to understand better and address the global burden of post-accident trauma. Full article

Youth sport participation provides undeniable physical, emotional, and social benefits. However, the current landscape of pediatric athletics has shifted toward early sports specialization (ESS), year-round training, and heightened competitive pressures. This has led to an increased prevalence of overuse-related traumatic injuries in adolescent patients, as well as increased risk of worsening mental health due to burnout, depression, suicide, and general psychological distress. There are numerous innovations and solutions aimed at addressing the increased risk of injury associated with current sporting trends, such as neuromuscular training programs, delayed specialization, promotion of free play, and pediatric specific surgical techniques mindful of future growth, such as those seen for anterior cruciate ligament reconstruction (ACL-R). However, the social factors associated with an injury remain problematic and are not adequately addressed; these include social isolation, depression, anxiety, and academic decline. Sport psychology is a promising solution to address many risk factors associated with poor performance, address the challenges associated with injury, and increase return-to-play in adolescent sports medicine. Integrating sport psychology into pediatric sports medicine offers the ability to directly address the emotional and cognitive demands of injury and recovery. Emphasizing mental health support and redefining success in youth sports—prioritizing enjoyment, personal growth, and long-term health over scholarships and professional aspirations—are key steps in preserving the overall benefits of pediatric sport participation. Yet sport psychology remains often underutilized and has been slow to gain traction, particularly in youth sports. This editorial serves to highlight the current state of mental health advocacy in pediatric sports medicine and how sport psychology can help young athletes manage the mental stress of high-performance athletics and mitigate the detrimental effect of injury and delayed return to sport. Full article

Background and Objectives: On 6 February 2023, two catastrophic earthquakes struck southeastern Türkiye, affecting over 13 million individuals and causing widespread destruction. While the physical damage was immediate, the psychological consequences—particularly posttraumatic stress disorder (PTSD) and depression—have proven long-lasting. This study aimed to evaluate the severity and course of PTSD symptoms among survivors and to examine the effectiveness of a telepsychiatry-based mental health intervention in a post-disaster setting. Materials and Methods: This naturalistic, observational study included 153 adult participants from the affected regions who underwent at least two telepsychiatry sessions between the first and sixth month post-disaster. Initial screening was conducted using the General Health Questionnaire (GHQ-12), and individuals scoring ≥ 13 were further assessed with the PTSD Checklist—Civilian Version (PCL-C) and the Beck Depression Inventory (BDI). Follow-up evaluations and pharmacological or psychoeducational interventions were offered as clinically indicated. Results: At the one-month follow-up, 94.4% of participants met the threshold for PTSD symptoms (PCL-C > 22) and 77.6% had severe depressive symptoms (BDI > 30). By the sixth month, PTSD symptoms had significantly decreased (mean PCL-C score reduced from 42.47 ± 12.22 to 33.02 ± 12.23, p < 0.001). Greater symptom reduction was associated with higher educational attainment and perceived social support, while prior trauma predicted poorer outcomes. Depression severity emerged as the strongest predictor of chronic PTSD. Conclusions: This study highlights the psychological burden following the 2023 earthquakes in Türkiye and demonstrates the feasibility and potential effectiveness of telepsychiatry in disaster mental health care. Integrating digital mental health services into disaster response systems may help reach vulnerable populations and improve long-term psychological recovery. Full article