Search Results (5,796)

Multiple cause data refer to all conditions reported on death certificates. Compared to the single underlying cause of death, these data provide additional information concerning the presence of comorbidities and complications leading to death. The objective of the study is to use a novel multiple cause approach for identifying comorbidities and complications of COVID-19. We analysed certificates referring to deaths that occurred in Italy in 2020–2021. With a double step chi squared test, we identified the conditions associated with COVID-19 and whether such conditions were reported as ‘cause of’ (comorbidities) or ‘due to’ (complications) COVID-19. For comparison, we adopted the same procedure for influenza deaths that occurred in Italy in 2016–2019. Pneumonia, respiratory failure and adult respiratory distress syndrome are the most frequent complications of COVID-19 and are also associated with it. These diseases have the same role for influenza, nevertheless this latter is strongly associated also with heart failure reported as a complication. Comorbidities are similar for COVID-19 and influenza: diabetes mellitus, chronic obstructive pulmonary disease (COPD) and obesity are the most frequent, with obesity much more frequent in COVID-19 cases. Hypertension is strongly associated with COVID-19 and is more frequent than in influenza cases. This approach is also suitable for other target diseases. Full article

Researchers are often interested in how changes in one variable influence changes in a second variable, requiring the repeated measures of two variables. There are several multivariate statistical methods appropriate for this research design, including generalized estimating equations (GEE) and latent growth curve modeling (LGCM). Both methods allow for variables that are not continuous in measurement level and not normally distributed. More recently, researchers have begun to employ area under the curve (AUC) as a potential alternative when the nature of change is less important than the overall effect of time on repeated measures of a random variable. The research showed that AUC is an acceptable alternative to LGCM with repeated measures of a continuous and a zero-inflated Poisson random variable. However, less is known about its performance relative to GEE and LGCM when the repeated measures are ordinal random variables. Further, to our knowledge, no study has compared AUC to LGCM or GEE when there are two longitudinal processes. We thus compared AUC to LGCM and GEE, assessing the effects of repeated measures of psychological distress on repeated measures of smoking. Results suggest AUC performed equally well with both methods, although missing data management is an issue with both AUC and GEE. Full article

This study analyzes and investigates how financial factors, namely, derivatives, debt shifting, and transfer pricing, influence tax avoidance, with financial distress as an interaction variable, within the framework of stakeholder theory and positive accounting theory. Adding more uniqueness, this study injected the Maqasid Syariah elements into the framework. Conventional banks and non-bank institutions listed on the Indonesia Stock Exchange (IDX) between 2017 and 2022 were selected, comprising 414 final company-year observations. The study utilized E-Views software for data processing. The findings indicate that debt shifting negatively impacts tax avoidance, while derivatives have no significant influence. Transfer pricing positively impacts tax avoidance. Financial distress does not moderate the relationship between these financial practices and tax avoidance. From an Islamic perspective, practices such as transfer pricing and debt shifting, when used to avoid tax, contradict the principles of Maqasid Syariah, which emphasize fairness, wealth distribution, and societal welfare. Full article

Anxiety in older adults is a prevalent yet under-recognized condition associated with significant societal and individual burdens. This study used a machine learning approach to compare the relative importance of 57 risk and protective factors for anxiety symptoms in a population-representative sample of middle-aged and older European adults (N = 65,684; ages 45–103 years; 55.7% women; 15 countries represented). The results revealed loneliness and self-rated poor health as primary risk factors (Nagelkerke R² = 0.272), with additional predictive contributions from country of residence, functional limitations, financial distress, and family care burden. Notably, follow-up analysis showed that none of the 16 social network variables were associated with loneliness; rather, cohabitating with a partner/spouse was most strongly associated with reduced loneliness. Further research is needed to elucidate directional associations between loneliness and anxiety (both general and sub-types). These findings underscore the imperative of addressing loneliness for mitigating anxiety and related mental health conditions among aging populations. Full article

Background/Objectives: Insomnia is a frequent and distressing symptom with limited treatment in patients with cancer. Among the available treatments for insomnia, psychological interventions are some of the most assessed. While studies and reviews show promise of interventions improving insomnia in patients with cancer, inconsistent approaches to operationalizing and measuring insomnia combined with the heterogeneity of available treatments render comparisons and synthetization difficult. This review sought to rigorously synthesize psychological interventions for patients with cancer and insomnia by describing current therapies, identifying gaps in the literature, and offering supportive interventions. Methods: A comprehensive search of five databases—Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, EBSCO CINAHL Plus with Full Text, and Cochrane Library—was conducted through 1 August 2024. The review included randomized trials and non-inferiority trials evaluating psychological interventions for patients with various types of cancers. Twenty-one studies were included, and study quality ranged from good to excellent, according to the PEDro scale. Results: The current evidence supports the use of cognitive behavioral therapy (CBT) to treat insomnia over and above psychoeducation alone, mindfulness-based stress reduction, Brief Behavioral Therapy, the Benson Relaxation Technique, progressive muscle relaxation, mindfulness meditation, mind-body bridging, and home-based psychological nursing. Digital, minimal, and internet-based intervention modalities are effective, though professional-delivered CBT proved most effective. Conclusions: CBT remains the most effective psychological intervention for insomnia in this population. Challenges exist regarding the implementation of CBT, so further research is warranted to identify the best psychological interventions for specific settings and subsets of patients with cancer. Full article

Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient treatments for these conditions before they become chronic and resistant to change. We developed and pilot-tested the Pain and Trauma Intensive Outpatient Treatment (PATRIOT) Program, a brief, intensive (3 weeks, six sessions) integrated chronic pain and PTSD treatment. An overview and session-by-session outline of the PATRIOT Program is provided, followed by results from the first pilot evaluation of the PATRIOT Program’s feasibility, acceptability, and preliminary efficacy in a sample of eight participating Veterans with comorbid chronic pain and PTSD. There were no treatment dropouts. At post-treatment, there were significant reductions in PTSD symptoms based on the Clinician-Administered Assessment of PTSD (CAPS). Pain and catastrophic thinking also decreased from pre- to post-treatment. With continued investigations and support, the PATRIOT Program may offer a brief, cost-effective, and more easily accessible treatment option for individuals who could benefit from learning skills to manage pain and PTSD more effectively. Full article

Background: Pediatric illnesses not only impose physical challenges on affected children, but also profoundly impact their emotional well-being. Understanding how parents respond to their children’s psychological distress during medical experiences is crucial for enhancing the overall support provided to these families. Aim: This study evaluated the internal structure of the Parental Response Styles Questionnaire (PRSQ), designed to differentiate parental responses to psychological distress in children with pediatric illnesses. Methods: A sample of 701 parents of children with medical issues responded to the PRSQ, reporting their different emotional expressions and responses to their children’s expressions of distress during the medical experience. Results: Factor analysis confirmed, in three of the five subsamples, an internal scale structure consisting of four factors: apathy and dysphoria, irritability and rejection, overprotectiveness, and perceived maladjustment. The invariance analyses revealed that congenital heart disease and neurological disorders are more similar in function to each other than pediatric cancer. Parents of children with neurological disorders exhibited a notably insecure pattern of parental responsiveness. Conclusions: In pediatric contexts, parental responses to their children’s emotional distress are significant factors in the process of adaptation. These responses can be measured, differentiated, and, ideally, managed by nurses and other healthcare professionals. The Parental Response Styles Questionnaire (PRSQ) is a promising tool for assessing parental reactions during their children’s treatment, and its structure appears to be particularly robust across diagnoses such as pediatric cancer, congenital heart disease, and neurological disorders. Full article

Around the world, family caregivers are an important source of support for people with intellectual disability (ID) and for those with severe mental disorder (SMD), although the level of support can be influenced by the culture and government healthcare systems in each country. However, there is little evidence about the mental health and coping mechanisms of these caregivers in low-income countries. To address this need, we aimed to elicit whether there are potential links between coping style, mental health, and perceived burden experienced by this group, using a sample from a central Asian upper middle-income country. Methods: We recruited 120 participants, of which 60 were caregivers of people with ID and 60 of people with SMD. All participants were recruited from Ulaanbaatar, the capital city of Mongolia, Central Asia, and were asked to complete of the Depression, Anxiety and Stress Scale (DASS) and the Coping Orientation to Problems Experienced inventory scale (COPE). Multiple regression analyses were used to investigate associations between these measures. Results: We found that DASS scores were significantly higher among the sample of caregivers of individuals with ID than in those of SMD. Mental and behavioral disorders were associated with higher DASS scores in the sample of caregivers of those with SMD. Good coping styles, indicated by higher scores in the COPE, were associated with increased age in caregivers of individuals with ID. Conclusion: Although overall the carers of people with SMD appeared to have better active coping skills and better acceptance of the caring role, they demonstrated comparatively high levels of stress. This study was not registered. Full article

In this paper, we analysed several emerging market (EM) and developed market (DM) sovereign yield curves to identify the proportion of parallel and non-parallel shifts over time. We found that non-parallel shifts are more prevalent in EM due to higher political and economic risks. Key drivers include systemic risk events like wars, debt distress, and pandemics. By backtesting a long butterfly strategy to extract non-parallel risk premia from June 2007 to March 2024, we observed that steeper slopes and greater curvature result in higher returns. We also quantified monetary and fiscal regimes to determine what types of policies are required to extract non-parallel risk premia from these sovereign yield curves. Our research suggests that countries with opposing monetary and fiscal policies possess higher return opportunities whilst countries with complementing policies require tactical butterfly strategies to optimise returns. Full article

Background: Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. Study Aim: This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. Results: Children with ADHD (N = 18,756) and controls (N = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; p < 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], p < 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], p = 0.001). Conclusions: This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research. Full article

Community lay leaders are critical in connecting professional services and general populations in communities. However, limited studies have explored the potential protective factors for psychological health among this group of people. In addition, based on the complex nature of spiritual health, the inconsistent findings of previous studies also suggested that different domains of spiritual health may shape psychological health differently in different contexts and among different socio-demographic groups. Therefore, we assessed the psychological health of Hong Kong community lay leaders after COVID-19 and examined the effects of different domains of spiritual health on psychological distress after controlling for age and gender. Cross-sectional data from 234 Hong Kong community lay leaders aged 18 to 84 were analyzed using structural equation modeling. The results showed that most Hong Kong community lay leaders reported moderate anxiety. In addition, personal and communal (one domain) and transcendental domains of spiritual health were negatively associated with depression, anxiety, and stress, and the environmental domain of spiritual health was positively associated with depression, anxiety, and stress. These findings imply the importance of considering both the positive and negative effects of spiritual health on psychological distress. Full article

Reactive oxygen species (ROS) encompass various molecular oxygen derivatives naturally produced during aerobic metabolism, including superoxide anions, hydrogen peroxide, and hydroxyl radicals. Excessive ROS production leads to oxidative distress, causing cellular damage and contributing to various pathologies, often alongside inflammation. Endogenous sources of ROS include mitochondrial activity and NADPH oxidases. The antioxidant system, comprising enzymes such as superoxide dismutase, peroxiredoxin, and catalase, mitigates ROS-induced damage. This review explores the regulation of ROS by membrane receptors, focusing on B1 and B2 kinin receptors and histamine H2 receptors, which are implicated in vasodilation, angiogenesis, inflammation, and gastric acid secretion. Understanding these interactions provides insights into ROS modulation and its role in disease mechanisms. Full article

A culturally adapted screening tool for mental health and dietary quality is needed to address the significant challenges in mental health and suboptimal diets among college students. The purpose of this study was to validate the Food-Mood Questionnaire (FMQ), originally developed in English, among Arab college students. Students attending the University of Sharjah were invited to complete the questionnaire (n = 224). Two weeks later, participants completed the same questionnaire again. An exploratory factor analysis revealed three main factors: mental distress, prudent and Western diets. Cronbach’s α was 0.86, 0.72, and 0.531 for the three factors, respectively. The Intra-Class-Correlation (ICC) for the test–retest reliability ranged from 0.67 to 0.87 (p < 0.001). The findings of this study showed that the Arabic version of the FMQ is a valid and reliable tool and could be used to screen for the mental distress and dietary intake of college students in the Arab world. Full article

Chronic pain (CP) affects about 30% of the global population and poses significant challenges to individuals and healthcare systems worldwide. The interactions between physiological, psychological, and social factors are crucial in the onset and development of CP conditions. This study aimed to evaluate the effectiveness of mindfulness-based intervention, examining its impact on perceived stress (PSS), depression and anxiety (BDI-II, PGWBI/DEP, SAS, STAI Y), sleep quality (PSQI), and mindfulness abilities (MAAS) in individuals with CP. Participants (N = 89, 84.3% female) underwent one of two diagnoses [fibromyalgia (FM) or low back pain (LBP)] and took part in an MBSR intervention. The mindfulness program proved effective in reducing PSQI scores (F = 11.97; p < 0.01) over time, independently of the type of diagnosis. There was also a marginal increase in trait mindfulness as measured by MAAS (F = 3.25; p = 0.07) in both groups. A significant difference between the two groups was found for the effect on PSS: F (1,87) = 6.46; p < 0.05. Mindfulness practice also reduced anxiety in FM and depressive symptoms in LBP, indicating a reduction in psychological distress among participants. Our findings suggest that mindfulness-based interventions may offer promising avenues for personalized pain management in clinical settings. Full article

The continued growth of the global cruise market has posed a major challenge to maritime search and rescue, as available rescue resources are limited compared to the scale of passenger ship disasters. To bridge the gap between the number of passengers in distress and the availability of rescue resources, this paper develops a two-stage Mass Rescue Operation (MRO) decision support model (MRO model) to fully utilize the available multiple rescue resources. Based on the combinatorial optimization theory, in the MRO model we consider the rescue capacity of multiple rescue resources and the synergy between them, the accident types and the marine environment conditions to optimize two objectives (rescue time and number of rescue resources dispatched) in two stages. In the first stage, the objective is to minimize the rescue time by Classical Selection Sort Algorithm. In the second stage, the rescue time and the number of rescue resources are simultaneously optimized by Simulated Annealing Arithmetic (SAA) integrated with Genetic Algorithm (GA). Furthermore, considering the actual role of helicopters in MROs, the MRO model is enhanced to schedule helicopters mandatorily or non-mandatorily. Finally, the MRO model was verified by simulating accidents in the Taiwan Strait. The simulation results show that compared with the first stage, the rescue time in the second stage model is saved by up to 16.18% and the number of rescue resources is reduced by up to 45.16%. Full article