Search Results (2,029)

Background/Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and it tends to remain during adulthood. It not only affects cognitive abilities and behavior but also often presents emotional disturbances and alterations in the perceived quality of life. These symptoms are primarily related to dysfunctions in the ventromedial and dorsolateral prefrontal network. The main objective was to evaluate the feasibility and explore the initial outcomes of an integrated protocol combining neuropsychological treatment and transcranial direct current stimulation (tDCS). Methods: This study presents a single-case experimental A-B design of a 21-year-old woman, diagnosed with predominantly inattentive ADHD, treated at the University Psychology Clinic of Loyola Andalucía University. The treatment was carried out twice a week for 5 weeks (10 sessions in total), with 20 min of anodal tDCS at F3 and cathodal tDCS at F4 (2 mA), while digital neurorehabilitation exercises and psychotherapeutic support were provided. Results: An overall significant improvement was observed in cognitive functions (p = 0.008), with clinically significant gains in cognitive flexibility, visual working memory, and planning. Mixed results were found in inhibition, with improvement in interference control but no change in response inhibition. No significant changes were observed in sustained attention, auditory working memory, or processing speed. In terms of emotional state, an overall improvement was noted (p = 0.046), particularly in depression symptoms and perceived quality of life related to physical and psychological health. However, no significant changes were observed in anxiety symptoms or in areas related to the environment and social relationships. These findings reflect pilot-level evidence of clinical change within a feasibility framework. Conclusions: The combined treatment was found to be safe and feasible, showing promising preliminary improvements in cognitive and emotional domains. As a single-case study, these results serve as hypothesis-generating evidence for future controlled trials. Full article

A high prevalence of psychological distress and unmet mental health needs among youth, combined with a preference for self-reliance and informal support (e.g., peers), poses a major public health challenge. Growing reliance on digital platforms highlights the potential of anonymized online peer support forums as accessible first-line avenues of support. In India, research on peer support interventions remains scarce. This study aimed to identify the concerns for which Indian youth engage in an anonymized, moderated online peer support forum, as well as the purposes for posting. A retrospective qualitative design was employed, analyzing all 137 posts of 124 unique users received between February 2024 and October 2025 on the forum using hybrid thematic analysis. Findings revealed that user posts encompassed diverse concerns across personal, relational, social, and achievement domains. Feeling states emerged as the most prominent theme, frequently co-occurring with other themes, followed by self-related concerns. Several posts explicitly mentioned mental health concerns such as depression and social anxiety, often without mention of professional help-seeking suggestions. Family-related issues, romantic relationship concerns, academic pressures, social comparisons, and unmet needs for approval were some of the other themes that emerged. Shifting from content to motivations for posting, the analysis identified purposes such as venting distress, seeking suggestions, sharing reflections, engaging in meaning-making, and seeking reassurance or validation. Future work needs to examine whether such forums can function not only as spaces for strengthening self-help and peer support processes but also as avenues for improving professional help-seeking through normalization and encouragement of the same when appropriate. Full article

Background: Depression remains a major global health burden, yet fragmented care often leads to waiting times and unmet needs. Therefore, the Belgian collaborative Integrated Depression Care (IDECA) project strengthened primary care depression management by introducing a Reference Person Mental Wellbeing (RPMW) who functions as a case manager, supported by shared-care tools, structured psychoeducation modules, and targeted training for general practitioners (GPs). This study examines normalization in primary care practice. Methods: A single-arm, mixed-method study was implemented over 18 months in two Flemish Primary Care Zones (PCZ). Implementation outcomes were assessed every four months using the NoMAD questionnaire and analyzed using Wilcoxon signed-rank tests. Peer review sessions with professionals and interviews with patients were analyzed thematically. Caseload and service delivery were assessed using process evaluation logs. Results: Twenty-two professionals (17 GPs, two RPMWs, and three PCZ staff members) completed the NoMAD questionnaire. Intervention familiarity increased during the first eight months (T0–T1: p < 0.001; T1–T2: p = 0.022) and continued to rise thereafter (T3–T4: p = 0.008). Integration into daily practice and perceived impact on professional work improved progressively, reaching near-ceiling scores. Peer review sessions highlighted the RPMW’s central role in trust-building and care coordination. Over 12 months, one full-time equivalent RPMW supported 175 patients (mean age 40.7 years; 75% female), with an average of five consultations per patient. Patients reported high satisfaction, emphasizing accessibility, empathy, and practical support. Conclusions: Sustained results suggest successful normalization and support the potential of collaborative, low-threshold depression care. Future work will assess clinical and economic outcomes. Full article

Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness. Full article

We aimed to identify circumstances associated with feelings of pride in healthcare workers (HCWs) during the COVID-19 pandemic. A prospective cohort of Canadian HCWs reported pride-reinforcing events in April 2020 (Phase 1). In spring/summer 2022 (Phase 4), they completed a self-reported retrospective comparison rating of whether they ‘now feel more [professional] pride than before the pandemic’. Among 4964 HCWs, 4360 (88%) described pride-reinforcing events in Phase 1; 3926 (79%) rated feeling more professional pride than before the pandemic in Phase 4. Teamwork (34%) and public appreciation (13%) were most cited in Phase 1. At Phase 4, male and older HCWs and community-based staff reported feeling more pride. Working as a physician, in hospital, with COVID-19 patients, and early anxiety/depression were associated with lower pride. Higher ratings were associated with greater organizational support. Many HCWs reported feeling more professional pride than before the pandemic. External support may help mitigate negative feelings. Full article

Surface defects such as depressions, heaving, and irregular undulations frequently develop on aging concrete bridge decks under repeated traffic loading and environmental effects. Accurate and objective identification of such defects is essential for structural serviceability and safety, yet manual inspection remains labor-intensive and subjective. This study develops a systematic framework for surface defect identification through geometric feature augmentation with a streamlined point cloud learning strategy. In practical engineering scenarios, point cloud data of concrete bridge decks can be periodically acquired via vehicle-mounted mobile laser scanning (MLS) systems and subsequently streamlined for analysis. The proposed method heightens defect sensitivity by extracting interpretable geometric descriptors, further integrating multi-scale representations to capture surface defects across varying spatial extents. Evaluated on a public point-level annotated benchmark, the proposed method clearly outperforms the same network trained with geometric coordinates only. To improve result reliability, all experiments were repeated four times with different random seeds, and the performance is reported as mean ± standard deviation. Results show that the proposed method achieves a precision of 0.597 ± 0.021 and an accuracy of 0.933 ± 0.009 under the benchmark protocol. Overall, these results demonstrate a reproducible proof of concept under controlled benchmark conditions for bridge deck surface defect segmentation, while broader cross-site and cross-sensor validation will be pursued in future work. Full article

Background and Objectives: Emergency physicians practice in high-pressure environments and face occupational stressors that may affect their mental health. This study was designed to evaluate the prevalence of depression among emergency physicians in South Korea and examined environmental, sociolegal, and individual factors associated with depressive symptoms in the post-pandemic period. Materials and Methods: This nationwide cross-sectional study analyzed data from the 2025 Korean Emergency Physician Survey. Screening positive for depressive symptoms was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10, indicating moderate-to-severe depressive symptom severity. Measures included the PHQ-9, the Korean Epworth Sleepiness Scale (KESS), and the Adult APGAR, a brief self-administered instrument assessing overall wellness. Multivariable logistic regression was performed to identify factors associated with depression after adjusting for demographic, clinical, and work-related variables. Results: Of the 1050 physicians who responded (response rate: 37.5%), 743 emergency physicians completed the PHQ-9 section (completion rate: 70.8%; mean age, 43.2 ± 7.78 years; 86.5% male), and 111 (14.9%) screened positive for depressive symptoms. Objective workload indicators, including total work hours and number of night shifts, did not differ between physicians with and without depression. However, emergency physicians screening positive for depression reported higher perceived burdens related to staffing shortages and patient-related stressors. Protective factors included being married (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08–0.58), longer sleep duration (AOR, 0.65; 95% CI, 0.50–0.86), better sleep quality (AOR, 0.45; 95% CI, 0.27–0.74), fixed mealtimes (AOR, 0.60; 95% CI, 0.39–0.93), and higher Adult APGAR scores (AOR, 0.72; 95% CI, 0.60–0.86). Factors associated with increased odds of depression included a history of cancer (AOR, 14.63, 95% CI, 2.53–84.61), current alcohol consumption (AOR, 2.54, 95% CI, 1.14–5.68), daytime sleepiness (AOR, 1.17; 95% CI, 1.04–1.31), and more frequent verbal abuse during the previous 12 months (AOR, 1.25; 95% CI, 1.08–1.44). Conclusions: Depression was prevalent and was associated with perceived work burden, sleep health, lifestyle regularity, and psychosocial factors. Interventions should address sleep quality, workplace safety, and social support. Full article

Background: Return to work (RTW) after acute coronary syndrome (ACS) or acute heart failure (HF) is a pivotal outcome reflecting functional recovery and quality of life (QoL). While survival after cardiac events has improved through reperfusion and guideline-directed pharmacotherapy, sustainable RTW depends on an integrated set of clinical, psychological, social, and occupational determinants. Objective: This study aimed to synthesize and expand the evidence on predictors of RTW, delineate practical workload-matching rules using METs and CPET, and position multidisciplinary cardiac rehabilitation (CR) as the bridge from clinical recovery to durable vocational reintegration. Key findings: Beyond left ventricular ejection fraction (LVEF), depression, anxiety, illness perceptions, and RTW self-efficacy are robust predictors of vocational outcomes. CPET-guided exercise prescriptions and MET-based job matching ensure adequate metabolic reserve; sustained task demand should remain at ≤35–40% of maximal capacity, with peak capacity ≥2× average job demand. CR (Class IA in the 2023 ESC ACS Guidelines) improves exercise tolerance, medication adherence, psychosocial well-being, and deployment of vocational support, including stepwise reintegration plans and ergonomic adaptations. Telerehabilitation extends monitoring and counseling into the workplace and maintains adherence after RTW. Conclusions: Comprehensive CR that integrates exercise training, psychosocial counseling, lifestyle modification, and vocational interventions offers the most effective pathway to stable RTW, improved QoL, and reduced socio-economic burden. Early identification of vulnerable subgroups and personalized, digitally supported follow-up are essential for long-term job retention. Full article

The coronavirus disease 2019 (COVID-19) pandemic has disrupted both health and occupational functioning in participants with multiple sclerosis (PwMS). This review synthesizes evidence from 55 studies (30,830 PwMS) on psychological, social, and work-related outcomes during the pandemic. The findings indicate elevated depression and stress, variable anxiety, and substantial employment disruption, including job loss, reduced hours, and shifts to remote work. Socioeconomic stressors compound these effects, while workplace accommodations are rarely assessed. There are gaps in evidence regarding occupation-specific hazards, lived experiences, and long-term outcomes. These results underscore the need for disability-inclusive employment policies, mental health support, and longitudinal research to guide interventions for PwMS in crisis contexts. Full article

Burnout syndrome is conceptualized as a work-related psychological condition primarily marked by persistent exhaustion, emotional and cognitive impairment and mental distancing. In addition to these core dimensions, burnout may give rise to secondary symptoms, including psychological distress, psychosomatic complaints, and depressive mood. The Burnout Assessment Tool (BAT) includes specific measures for both primary and secondary symptoms. This study aimed to evaluate the validity evidence of the BAT’s secondary symptoms Brazilian version scale (BAT-S). The sample consisted of 1.750 professionals (71% women), with a mean age of 39 years (SD = 11). Confirmatory Factor Analyses indicated that a model of two oblique first-order factors, differentiating psychological distress from psychosomatic complaints, provided a superior fit compared to the unidimensional solution. The scale also presented satisfactory internal consistency for the scales of psychological distress (α = 0.88 and ω = 0.90) and psychosomatic complaints (α = 0.85 and ω = 0.87). The BAT-S represents a reliable tool to assess these secondary symptoms of burnout, advancing research that integrates behavioral and physiological markers, offering practical applications for occupational health interventions and preventive strategies in the workplace. Full article

Background: Hemophilia adversely affects several health domains and impairs the daily life of both patients and caregivers. Objectives: To assess the impact of hemophilia A without inhibitors on humanistic outcomes in adult and young patients and their caregivers in a real-life setting. Methods: This was a 12-month multicenter prospective observational study conducted in 18 Spanish hospitals. Patients who were diagnosed with hemophilia A (PWHs), without inhibitors, and who were 12 years of age or older, and their caregivers were included in the study. Results: A total of 85 PWHs (mean age: 33 years) and 12 caregivers participated in the study; 51 PWHs completed it, representing a 40% lost-to-follow-up rate. Twenty-five percent of PWHs showed maladjustment at study completion, with ‘leisure time’ and ‘work/studies’ being the most affected domains. Quality of life was particularly impaired in the sport, physical health and future areas. ‘Lying/sitting/kneeling/standing’ and ‘leisure activities and sports’ were the most impaired functions. Productivity was mainly affected by presenteeism in adult PWHs; 40 painful joint bleeding episodes were reported. Active strategies were mostly used for coping with chronic pain, and anxiety and/or depression were present in more than 10% of PWHs. Anxiety and depression were more frequently reported by caregivers. Conclusions: The study results suggest sustained impairments in adaptation to their disease, quality of life, and functionality in PWHs without inhibitors, especially related to leisure and sports activities, and a nontrivial proportion of them presented clinical levels of depression and anxiety. Overall impairment was more marked in adults than in children. In addition, due to the limited number of caregivers, their results must be considered exploratory. Full article

Traumatic experiences can disrupt one’s sense of safety, self-efficacy, and relationships. Prolonged stress may lead to anxiety, depression, and diminished agency. The embodied, subjective manifestations of trauma call for personalized therapeutic approaches that address symptoms and foster resilience. Group Creative Arts Therapies (CATs) offer relational aesthetic interventions that promote resilience and trauma recovery. Incorporating body-based methods, movement, materials and visual expression, CATs support interoceptive awareness, multisensory integration, embodiment, and emotional–cognitive processing. This article presents a review and conceptual framework of group CAT interventions during wartime, focusing on challenges related to body awareness, self-efficacy, and autobiographical memory. It examines how creative aesthetic approaches help process trauma and strengthen resilience. Drawing on predictive processing accounts of brain function, the article explores the neuropsychological impact of trauma and how creative group work may modulate related brain mechanisms. Creative techniques can foster bodily anchored self-awareness, self-efficacy and processes of traumatic memory reconsolidation. Aesthetic experiences are associated with changes in brain activation and connectivity through processes of embodiment, externalization, and meaning making. On an intrapersonal level, converging evidence highlights the role of sensory and sensorimotor processing, along with the dynamic interplay between Default Mode, Executive Control, and Salience networks, as conceptualized in the Triple Network Model. On an interpersonal level, the literature points to the dynamics of brain and body synchronization, as emerging phenomena during shared creative engagement. These neurodynamics provide a coherent framework for understanding how creative arts-based psychotherapeutic group work can support trauma processing and the cultivation of resilience. Full article

Major depressive disorder requires scalable, low-burden screening tools. We examined whether three-channel resting-state EEG can support reliable discrimination between major depressive disorder and healthy controls using a lightweight model compatible with portable implementations. This work makes three main contributions: (i) a compact hybrid fusion model combining raw-window Conv1D embeddings with per-channel spectral–statistical descriptors for three-channel resting-state EEG, (ii) a leakage-resistant subject-independent (cross-subject) evaluation protocol with subject-level inference via majority voting, and (iii) a preliminary external feasibility test on an independent portable three-channel cohort without fine-tuning. The proposed model fuses a Conv1D encoding of raw ≈15 s eyes-closed windows (3840 samples; 15.36 s at 250 Hz) with per-channel spectral and statistical descriptors. Training uses subject-independent splits to avoid leakage, class weighting, and data augmentation (including MixUp); hyperparameters are selected via randomized search with refinement. The model is trained on a publicly available MDD dataset and subsequently applied, without fine-tuning, on an independent acquisition of 20 subjects recorded with a portable three-channel device; we report both window-level and subject-level (majority-vote) performance. On the held-out test subjects from the public dataset, the hybrid model attains 93.43% window-level accuracy. The independent evaluation is reported as a preliminary external feasibility analysis; given the small cohort, we report subject-level performance with 95% confidence intervals to reflect uncertainty and avoid over-interpreting cross-device generalization. The model occupies approximately 40.19 MB on disk, and the architecture is compatible with post-training int8 (TFLite) quantization for resource-constrained hardware. These results, obtained on limited samples, support the feasibility of three-channel EEG for major depressive disorder detection using a lightweight hybrid architecture and motivate prospective clinical validation, on-device inference and quantization studies, and broader evaluation across centers and devices. Full article

Objectives: This study evaluated Quality of Life (QoL) and mental health among nursing technicians in Brazilian Unified Health System (SUS) emergency units, specifically exploring occupational safety and well-being in the post-COVID-19 era. Design: A quantitative, descriptive, exploratory, cross-sectional design was employed. Methods: Data from 146 nursing professionals in Brazilian SUS emergency units were collected remotely during the post-acute pandemic phase (July–Nov 2024). QoL (WHOQOL-BREF) and mental health (HADS) were assessed, followed by descriptive and correlational statistics. Results: The predominantly female, experienced sample showed heterogeneous general QoL but pervasive anxiety, reflecting a sustained psychological burden. Sociodemographic/professional factors had a negligible impact; the emergency environment’s overwhelming influence, intensified by post-pandemic challenges, was key. Psychological distress was strongly negatively correlated with overall QoL and depression in the social domain. Conclusions: The intrinsic nature of emergency work, amplified by persistent psychosocial effects of the global health crisis, drives anxiety and impairs QoL/social relationships. Interventions strengthening QoL, enhancing coping, and adapting work environments to new realities (e.g., loneliness, prolonged mental health impacts) are vital for professional well-being and patient care in this post-pandemic era. Full article

Background: Electrical injuries occur when an electric current comes into contact with or passes through the body. Electrical injuries can result from contact with faulty electrical appliances and machinery or from contact with open household wiring or electrical power lines. Aim: The aim of this study was to evaluate the psychosocial difficulties experienced by individuals who suffered electrical burns due to work accidents, using a phenomenological approach. Study Design: This phenomenological study was conducted with semi-structured in-depth interviews with 15 electrical burn survivors living in different regions of Turkey via the WhatsApp mobile application. The snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using Colaizzi’s phenomenological analysis method. The study was conducted and reported according to the COREQ checklist. Results: In the analysis of the data, two categories and five themes were identified: the effects of electrical burn at the time of occurrence and during the hospital process (psychological, social and physical), and adaptation to life after electrical burn treatment (emotions experienced, difficulties experienced and coping). Conclusions: This study revealed the life experiences, psychosocial difficulties and coping experiences of individuals with electrical burns. According to the results of the research, it is understood that individuals experienced negative emotions such as depression, helplessness and hopelessness as a result of electrical burns, could not cope with the psychosocial difficulties experienced and received psychological support. It was determined that social appearance anxiety due to deterioration in body image was very important in individuals. Full article