Search Results (469)

Background/Objectives: The COVID-19 pandemic severely impacted healthcare systems globally, with Italian healthcare professionals experiencing heightened stress, organizational challenges, and a significant psychological burden. This study investigates the frequency of depressive symptoms and health-related quality of life (H-QoL) among outpatient healthcare workers in Italy, comparing pre-pandemic (2017) and post-pandemic (2025) periods. Methods: A cross-sectional study was conducted in 2025, including 97 healthcare professionals from five outpatient departments at the University Hospital of Cagliari. Participants completed demographic surveys, the Short Form Health Survey (SF-12), and the Patient Health Questionnaire (PHQ-9) to assess H-QoL and depressive symptoms. Data were compared with previously published data from the same facility collected in 2017 and with pre-pandemic Italian community surveys. Results: Compared to 2017, there was a statistically significant increase in depressive episodes (38.1% vs. 33.2%, p = 0.01) and a higher proportion of individuals with low H-QoL (62.9% vs. 43.5%, p < 0.0001) in 2025. After age- and sex-standardization, both depressive symptoms and low H-QoL were significantly more prevalent among healthcare professionals in 2025 compared with the general population before the pandemic. Within the 2025 sample, non-medical healthcare workers showed a significantly higher prevalence of depressive symptoms than medical doctors, while female healthcare workers were more likely to report low H-QoL. Conclusions: Despite the pandemic’s end, healthcare workers, especially those in outpatient settings, continue to face elevated psychological distress. Specific professional and gender-related vulnerabilities persist, and structural challenges, such as staff shortages and organizational issues, may exacerbate this burden. Sustained mental health support and targeted systemic interventions remain crucial to mitigate the long-term impact on the healthcare workforce. Full article

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

Background/Objectives: Public healthcare workers face significant occupational stress during crisis situations, yet research on this particular population remains limited compared to other healthcare workers. The aim of this study was to investigate the impact of the COVID-19 pandemic on distress levels and the sense of coherence among public health workers by integrating psychological assessments with physiological markers of stress to identify protective factors against pandemic-related occupational stress. Methods: This longitudinal study was conducted at the Teaching Public Health Institute of Split and Dalmatia County from July 2021 to February 2022 at two time points: the latency phase (between COVID-19 waves) and hyperarousal phase (during an active wave). Fifty-four public health workers participated in the study. There were three questionnaires assessing psychological distress: Kessler Psychological Distress Scale, Impact of Events Scale—Revised and Sense of Coherence Scale-29. Salivary and blood samples were collected at both time points to measure cortisol levels, cortisol awakening response, and interleukin-6 concentrations. Results: The cortisol area under the curve with respect to ground (AUCg) was significantly elevated during the stress phase compared to the latency phase (234.8 vs. 201.8; p = 0.023), indicating heightened physiological stress responses. Epidemiologists demonstrated significantly lower sense of coherence scores compared to non-epidemiologists (117.9 ± 9.1 vs. 125.6 ± 10.5; p = 0.029). A lower sense of coherence was significantly associated with higher psychological distress and post-traumatic stress symptoms. Multiple linear regression analysis revealed that sense of coherence and interleukin-6 levels were significant independent predictors of cortisol changes. Conclusions: The findings demonstrate that public health workers experience measurable physiological stress responses during pandemic peaks, with sense of coherence emerging as a protective psychological factor. Interventions targeting sense of coherence and organizational support may possibly enhance resilience and reduce mental health morbidity in this vulnerable workforce during crisis situations. Full article

Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article

Food systems operate as socio-ecological systems (SES) in which governance, markets, and biophysical constraints interact through feedback. However, how resilience capacities accumulate across sequential shocks, particularly in hyper-arid, import-dependent rentier states, remains under-traced. We analyze Qatar’s food-system SES across three distinct stress tests: the 2017–2021 blockade, the COVID-19 pandemic (multi-node logistics and labor shock), and the post-2022 Russia–Ukraine war (global price and agricultural input-cost shock). Using a qualitative longitudinal case-study design, we combine documentary review with process tracing and a two-layer coding scheme that maps interventions to SES components (actors, governance system, resource systems/units, interactions, outcomes/feedback) and to predominant resilience capacities (absorptive, adaptive, transformative). The results indicate path-dependent capability building: the blockade activated rapid buffering and rerouting alongside early adaptive investments; COVID-19 accelerated adaptive reconfiguration via digitized logistics, e-commerce scaling, and targeted controlled-environment agriculture; and the Russia–Ukraine shock validated an institutionalized portfolio (fiscal buffering, reserves, procurement diversification, and upstream linkages). Across episodes, supply continuity was maintained, but resilience gains also generated water–energy–food tradeoffs, shifting pressures toward energy-intensive cooling/desalination and upstream water demands linked to domestic buffers. We conclude that durable resilience in eco-constrained, import-dependent systems requires explicit governance of these tradeoffs through measurable performance criteria, rather than crisis-driven expansion alone. Full article

The growing prevalence of anxiety, depression, and stress among students highlights the urgent need for school-based strategies that promote psychological well-being and timely intervention. This study explores the use of artificial intelligence (AI) as a scalable and data-driven tool to support institutional mental health initiatives in higher education. Using synthetic and real datasets derived from validated psychometric instruments (the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and the Perceived Stress Scale (PSS-14)), we trained and evaluated 32 deep neural network architectures for the early detection of emotional distress. Optimized three- and four-layer dense models achieved classification accuracies exceeding 95%, demonstrating the feasibility of deploying AI-based screening tools in educational settings. Beyond prediction, this approach can support counselors and educators in identifying at-risk students and informing proactive, school-based interventions to improve mental health and resilience in post-pandemic academic environments. Full article

This study examines how the education sector in one Canadian province has navigated post-pandemic recovery between 2023 and 2025, drawing on cross-sectional survey data from a convenience sample of sector employees in the 2023–2024 (n = 1411) and 2024–2025 (n = 742) school years. The findings revealed selective improvement over time, including increased organizational commitment among teachers and other education workforce members, alongside reduced perceptions of students’ academic, social, and behavioural needs. Teachers indicated no corresponding increases in their perceived frequency of meeting students’ needs, whereas other educator sector employees indicated improvement in this area. In contrast, no year-over-year differences were found in the education workforce members’ and teachers’ stress, coping, well-being or connectedness, and job search behaviours remained high, ranging from 14 to 43%. Guided by the Job Demands–Resources (JD-R) model, these findings suggest that post-pandemic recovery reflects the establishment of a new and complex baseline. The coexistence of improved commitment with persistent job strain signals a paradox of stability amid depletion. Qualitative responses reinforced this interpretation, revealing how educators adapt to ongoing organizational resource constraints and shifting student needs. Together, the findings extend JD-R-informed understandings of post-crisis workforce adaptation and identify implications for leadership and policy aimed at supporting organizational health and workforce sustainability. Full article

Introduction: The impact of the COVID-19 pandemic on suicide risk has been documented during the acute phase, but less is known about people who attempted suicide during the post-acute period. This study investigates how adults who attempted suicide during the post-acute pandemic period (2021–2023) understood COVID-19’s role in their attempt. Method: We analyzed interview data from 329 adults (59% female; 41% male), enrolled following a recent suicide attempt between 2021 and 2023. Participants were asked about the general impact of COVID-19 on their lives and then specifically about whether stress related to COVID-19 was a primary reason for their attempt or contributed to their suicidal thoughts. Results: When asked about their recent attempt, 11% of participants identified stress related to COVID-19 as the primary reason for their attempt, and an additional 23% indicated it contributed to their suicidal thoughts. When describing general impacts, participants reported effects across multiple domains: social isolation, physical health concerns, mental health impacts, and economic effects. Discussion: The attribution of suicide attempts to COVID-19-related stress during the post-acute period highlights the extended impact of public health crises on vulnerable individuals. These findings emphasize the need for sustained, integrated medical and mental healthcare following such crises. Full article

Background/Objectives: A medical–government conflict in South Korea in 2024 led to the collective resignation of resident physicians, causing severe workforce shortages in tertiary hospitals. This study aimed to investigate temporal changes in stress, anxiety, and depression among healthcare workers during this conflict following the COVID-19 pandemic. Methods: This retrospective study analyzed data from 56,137 adults who completed validated questionnaires on stress (KNHANES), anxiety (Clinically Useful Anxiety Outcome Scale, CUXOS), and depression (Center for Epidemiologic Studies Depression Scale, CES-D) between January 2019 and February 2025 at Samsung Changwon Hospital. Temporal trends were assessed using linear mixed-effects models adjusted for demographic variables. Results: Among attending physicians, stress increased by 1.44 points in the post-COVID period (p < 0.001) and 1.17 points during the conflict (p = 0.006), while anxiety increased by 1.25 (p = 0.012) and 1.36 points (p = 0.013), respectively. The most vulnerable subgroups were women, those aged 30–40 years, and physicians with <5 years of service. Depression increased significantly among physicians in their 40s during the post-COVID period (p = 0.018). Nurses demonstrated a significant reduction in stress during the conflict (−0.91, p = 0.002), possibly reflecting a temporary decrease in direct clinical workload, whereas office workers showed continuous increases in depression (+1.66 post-COVID, p = 0.003; +1.74 conflict, p = 0.001). Conclusions: The psychological effects of systemic crises differed by occupation. Attending physicians, who bore the greatest clinical and organizational burden, experienced persistent psychological strain during the medical–government conflict following post-pandemic stress. Tailored, occupation-specific strategies are required to protect healthcare workers’ mental health during future systemic disruptions. Full article

The coronavirus disease 2019 (COVID-19) pandemic has revealed a close and multifaceted relationship between viral infection, systemic inflammation, and cardiovascular health. Among the cardiac complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), atrial fibrillation (AF)—especially new-onset atrial fibrillation (NOAF)—has emerged as a major determinant of disease severity and prognosis. Clinical studies and meta-analyses show that 5–10% of hospitalized COVID-19 patients develop AF, with markedly higher rates in critically ill individuals. Both pre-existing and NOAF are independently associated with increased risks of intensive care admission, mechanical ventilation, thromboembolic events, and mortality. The underlying mechanisms involve a combination of cytokine-mediated inflammation, endothelial dysfunction, microvascular injury, and dysregulation of the renin–angiotensin–aldosterone system (RAAS). Viral downregulation of angiotensin-converting enzyme 2 (ACE2) receptors contributes to myocardial fibrosis, while hypoxia, oxidative stress, and autonomic imbalance further promote electrical remodeling and arrhythmogenesis. Post-infectious studies indicate that atrial structural changes and autonomic dysfunction may persist for months, predisposing survivors to recurrent arrhythmias. Technological advances in telecardiology and digital medicine have provided new tools for early detection and long-term monitoring. Wearable electroencephalography (ECG) devices, implantable loop recorders (ILRs), and artificial intelligence (AI)-based diagnostic algorithms enable continuous rhythm surveillance and individualized management, improving outcomes in post-COVID patients. This review summarizes current evidence on the epidemiology, pathophysiology, clinical implications, and monitoring strategies of AF in COVID-19. It underscores the importance of integrating telemedicine and AI-assisted diagnostics into cardiovascular care to mitigate the long-term arrhythmic and systemic consequences of SARS-CoV-2 infection. Full article

We examine how capital structure related to firm performance for UK companies in the FTSE All-Share over 2018–2023, explicitly segmenting pre-pandemic (2018–2019), pandemic (2020–2021), and post-pandemic (2022–2023) periods. Using Bloomberg data for 516 firms and panel fixed-effects models (Hausman-tested), we assess the impact of short- and long-term leverage on ROA, ROCE, Tobin’s Q, and EPS, and compare financial versus non-financial firms. Leverage is, on average, negatively associated with ROA and EPS, consistent with pecking-order and agency-cost arguments: market-based outcomes (Tobin’s Q) show weaker, nuanced links. The adverse effects of debt are stronger for non-financial firms, particularly during and after COVID-19, while financial firms display a post-COVID positive association between short-term debt and ROA, suggesting sector-specific debt utilization under stress. Firm size relates negatively to Tobin’s Q for non-financials. Results highlight how crisis conditions and industry characteristics shape the leverage–performance nexus, offering practical guidance for managers and policymakers on capital structure decisions in turbulent environments. Full article

The COVID-19 pandemic was responsible for an unprecedented increase in psychological problems among post-secondary students worldwide. Drawing on data from a repeated cross-sectional (RCS) project, this study investigated changes in psychological symptoms, emotional regulation (cognitive reappraisal and emotional suppression), and academic, social, and personal–emotional college adjustment, and associations between these variables among students in two countries during the phases of lockdown (2021), lifting of restrictions (2022), and the endemic phase (2023). University students in Canada (n = 1014) and Spain (n = 447) completed online surveys during these periods. Students in both countries reported significant declines in perceived COVID-19 stress across the pandemic phases. In comparison with pre-pandemic rates, elevated psychological symptoms remained constant. There were some country differences, but sex differences were consistent. Psychological symptoms mediated the association between cognitive reappraisal and the adjustment measures among Canadian students during each pandemic period. Alternatively, they mediated the linkages of maladaptive emotional suppression with academic, social, and personal–emotional functioning of Spanish students at every phase, but only during the lifting of restrictions and the endemic phase for Canadian students. The results indicate the complexity of country and context in the role of emotional regulation during uncontrollable conditions and provide directions for intervention in stressful situations, including adjustment to university and future disastrous environmental events. Full article

The COVID-19 pandemic altered individuals’ worldviews. This study examined how cultural values shaped the ways students navigated stress and adapted after the COVID-19 pandemic. Drawing on Conservation of Resources (COR) Theory and cultural psychology frameworks of individualism and collectivism, we hypothesized that university students in two culturally distinct contexts—China and Canada—would demonstrate resilience differently. Chinese students would display collectivistic coping strategies (e.g., social responsibility and perspective-taking), while Canadian students would show resilience through individualistic strategies (e.g., personal reflection and self-efficacy). A total of 814 students completed a mixed-methods survey assessing resilience, cognitive reflection, and post-pandemic adaptations. Quantitative data were analyzed using factor analysis and stepwise regression to identify predictors. Qualitative responses were thematically analyzed for context. Results revealed cultural differences in resilience and adaptation, with social responsibility, healthy habits, and third-person perspective-taking predicting the responses of Chinese students, whereas internal emotional processing and personal moral reflection predicting it for Canadian students. This study enhances cross-cultural understanding of resilience and adaptation after collective trauma. Full article

The COVID-19 pandemic exposed the fragility of global health systems, as physicians faced extremely challenging conditions including excessive workloads, infection risk, and high patient mortality. We conducted a cross-sectional survey that aimed to assess the post-pandemic prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in a sample of Greek physicians who worked on the frontline during the SARS-CoV-2 (COVID-19) pandemic. An online survey was conducted between 1 March and 31 July 2023, in which 200 Greek physicians were invited via e-mail to voluntarily answer a confidential online questionnaire, and 58 of them responded. The survey included two clinically validated tools: the Patient Health Questionnaire-4 (PHQ-4) and the Impact of Event Scale—Revised (IES-R). Univariate correlations of 26 exposure variables with anxiety, depression, combined anxiety/depression, and PTSD were performed. In total, 58 eligible physicians (46.6% female) participated in this study. The rates of anxiety, depression, combined anxiety/depression, and PTSD were 27.5% (95% CI: 16.7–40.9), 31.0% (19.5–44.5), 22.4% (12.5–35.3), and 24.1% (13.9–37.2), respectively. Notably none of the physicians working in a laboratory developed any mental health symptoms. The following factors were found to be associated with the development of higher mental health symptoms: age ≤ 30, employment in healthcare ≤ 10 years, working in COVID-19 wards, working in intensive care units or COVID-19 wards, a history of mental health symptoms, a history of physical conditions, shortages of materials and equipment for diagnosing or treating patients, development of a disease other than COVID-19, and the development of a new mental health condition during the pandemic (p < 0.05 for all associations). Our findings highlight the need to better prepare physicians with adequate materials, infrastructure, and psychological support such that, in a potential future health crisis, they will not be at such high risk of mental health problems. Full article