The mediating role of life satisfaction in the effect of caregiving burden on mental well-being in parents of children diagnosed with cleft lip/palate.

PURPOSE: This study aimed to examine the effect of caregiving burden on the mental well-being of parents of children with cleft lip/palate, with life satisfaction as a mediator. DESIGN AND METHODS: This descriptive, cross-sectional study was conducted with a sample of 347 parents of children with cleft lip/palate. Data were collected through face-to-face interviews with the parents between March 18 and September 4, 2023. The data collection tools included a sociodemographic data form, the Zarit Burden Interview, the Warwick-Edinburgh Mental Well-Being Scale, and the Satisfaction with Life Scale. RESULTS: It was found that parents with a higher caregiving burden had lower levels of life satisfaction. Additionally, parents with higher life satisfaction reported better mental well-being. The findings indicated that as the caregiving burden increased, the mental well-being of the parents decreased. The results suggest that life satisfaction mitigates the negative impact of caregiving burden on mental well-being. CONCLUSION: These findings suggest that life satisfaction plays a significant mediating role in maintaining and supporting parents' mental health. Parents with higher life satisfaction appear to cope better with the challenges posed by caregiving burden, which in turn helps them maintain better mental well-being. PRACTICE IMPLICATIONS: The findings show that as the caregiving burden increases, both life satisfaction and mental well-being decrease. Therefore, it is crucial to develop practical interventions to support these parents.

Support needed by parents when a child's mental well-being is threatened-A qualitative study of views of experts-by-experience.

BACKGROUND: In situations where a child's mental well-being is threatened, the parents also need support. The available support has been perceived as insufficient by both parents and professionals. AIM: To explore the views of experts-by-experience of the support needed by parents when a child's mental well-being is threatened. METHODS: A qualitative study with a phenomenological approach was conducted in Finland. The data were collected in six focus group interviews during the autumn of 2022. The participants (n = 26) were adult experts-by-experience who had experienced either mental well-being challenges in their own childhood (before the age of 18 years) or experienced the mental well-being challenges of a child from the role of a parent. The data were analysed using inductive content analysis. RESULTS: The support needed by parents in situations where the mental well-being of their child is at risk consists of support for parenting, support for sharing and support for surviving. CONCLUSION: Parents whose child's mental well-being is at risk, need support both for their own well-being and for their ability to support their child's well-being. Support is needed not only from professionals but also from peers.

Financial insecurity and mental well-being: experiences of parents amid the lebanese economic crisis.

BACKGROUND: This study investigates the impact of financial insecurity on the mental well-being and stress levels of parents in Lebanon amid the country's severe economic crisis. The context of Lebanon's economic collapse, coupled with the effects of the COVID-19 pandemic and the Beirut port explosion, has exacerbated financial and psychological distress among the population. This research aims to understand the correlation between financial instability and parental stress, identifying key factors contributing to mental health challenges in this demographic. METHODS: Employing a quantitative research approach, data was collected through an online survey from 785 parents from different backgrounds in Lebanon. The survey incorporated sociodemographic questions, the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), and the Arabic version of the Parental Stress Scale (PSS). Data analysis was conducted using SPSS version 25. RESULTS: Findings showed significant correlations between high levels of parental stress and factors such as age (r = 0.071, p = 0.047) and lower education levels. Notably, refugees residing in Lebanon exhibited higher stress levels compared to Lebanese parents (mean stress score: 51.73 vs. 45.71, p < 0.001). Similarly, employed participants exhibited higher stress levels compared to the nonworking (mean stress score: 46.75 vs. 44.60, p = 0.003). A significant inverse association was found between financial well-being and parental stress (r=-0.216, p < 0.001), emphasizing the profound impact of economic instability on mental health. CONCLUSIONS: This study highlights the adverse effects of financial insecurity on parents' mental health, primarily during a period of economic instability, emphasizing the urgent need for targeted support interventions. These findings contribute to the literature on economic crises and mental health, providing a basis for future research and policy development in similar contexts.

Prevalence of depression and anxiety in women with polycystic ovary syndrome (PCOS) and associated factors in a quaternary hospital in Thailand: a cross-sectional study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common gynaecological problem for women of reproductive age. Depression and anxiety are common conditions that occur in women with PCOS and have an impact on mental well-being. However, there is a lack of data on their prevalence and its associated factors in the Thai population. This cross-sectional study aimed to evaluate the prevalence of depression and anxiety among women with PCOS and identify the factors associated with depression and anxiety in women with PCOS as well as their impact on mental well-being in Thailand. METHODS: A total of 260 women aged 15 to 40 years diagnosed with PCOS based on the Rotterdam criteria were included in the study. Physical examinations were conducted, and participants completed Hospital Anxiety and Depression Scale (HADS) and Thai version WHO-Five Well-Being Index (WHO-5 Thai) questionnaires to assess depression, anxiety, and mental well-being, respectively. The prevalence and prevalence rations (PR) with 95% confidence interval (CI) for depression and anxiety were analysed using modified Poisson regression analyses with robust variance estimators. RESULTS: The prevalence of depression, anxiety, and poor mental well-being among women with PCOS was found to be 3.85%, 11.92%, and 16.92%, respectively. Abdominal obesity (PR 24.25, 95% CI: 2.75-219.50; p = 0.004), poor mental well-being (PR 16.68, 95% CI: 4.02-69.18; p = < 0.001), and snoring (PR 10.26, 95% CI: 2.06-51.14; p = 0.005) were identified as factors associated with depression in women with PCOS. Having children (PR 6.22, 95% CI: 2.90-13.35; p = < 0.001), alcohol drinking (PR 3.41, 95% CI: 1.52-7.65; p = 0.003), poor mental well-being (PR 2.32, 95% CI: 1.14-4.74; p = 0.021), and hirsutism (PR 2.23, 95% CI: 1.18-4.22; p = 0.014) were found to be relative factors for anxiety in women with PCOS. CONCLUSION: Women with PCOS is associated with high prevalences of depression and anxiety. Poor mental well-being was identified as key factors associated with both depression and anxiety in women with PCOS. Based on these findings, the present study suggests that screening for depression and anxiety should be conducted for all women with PCOS, especially those who present with poor mental well-being.

Factors associated with perceived social support among adolescents in Gamo Zone, Southern Ethiopia: a community-based cross-sectional study.

Introduction: Perceived social support plays a crucial role in adolescent development, health, well-being, and resilience. Understanding the factors associated with perceived social support among adolescents is essential for designing effective interventions. However, research in this area, particularly within specific contexts, remains limited. Therefore, this study aims to identify the factors associated with perceived social support among adolescents in the Gamo Zone, South Ethiopia Regional State. Method: A community-based cross-sectional study was conducted, involving 1172 adolescents selected through a stratified multi-stage sampling method. Structured face-to-face interviews were employed for data collection. Summary statistics were utilized for data presentation. Multiple linear regressions were then performed to identify factors associated with perceived social support. The strength and direction of associations were presented using ß coefficients and 95% confidence intervals (CIs). The level of statistical significance was set at alpha 5%. Result: The total mean for perceived social support among adolescents was 57.02 ± 12.68. Adolescents living with their biological parents reported significantly higher levels of perceived social support (ß = 4.17, 95% CI: 2.00 to 6.34) compared to their counterparts. Similarly, adolescents engaged in paid work within the last 12 months reported higher perceived social support (ß = 3.43, 95% CI: 1.39 to 5.46). Higher levels of parental monitoring were also associated with increased perceived social support (ß = 3.03, 95% CI: 1.23 to 4.82). Additionally, adolescents who perceived risks for sexual and reproductive health (SRH) problems reported higher levels of perceived social support (ß = 2.76, 95% CI: 0.84 to 4.69). Moreover, adolescents with good knowledge about SRH rights exhibited increased perceived social support (ß = 2.46, 95% CI: 0.89 to 4.02). Furthermore, adolescents residing in rural areas reported higher levels of perceived social support compared to those in urban areas (ß = 1.56, 95% CI: 0.16 to 3.11). Conclusion: The findings of this study reveal that factors such as living arrangements, employment status, parental monitoring, perceived risks for SRH problems, knowledge about SRH rights, and geographical context emerged as important predictors of perceived social support. Therefore, implementing interventions and initiatives to address these identified factors holds promise for nurturing resilient adolescent social support networks.

Building resilience among undergraduate health professions students: identifying influencing factors.

BACKGROUND: Resilience contributes to mental well-being, hence expediting recovery from stressful events. Health professions students, in particular, often experience heightened levels of stress and anxiety due to academic demands and other stressors. This study aimed to explore the factors contributing to resilience and identify support systems that universities can implement to help undergraduate health professions students build resilience and manage their mental well-being. METHODS: A total of 28 students from the fields of Medicine, Dentistry, Pharmacy, and Dietetics and Nutrition participated in semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The interviews were stopped when data saturation was achieved. The data were analysed using thematic analysis. RESULTS: Thematic analysis of the interviews identified five key themes contributing to resilience: life experience, socioeconomic factors, personal attributes, support resources, and role modelling. Universities play a crucial role in fostering resilience among health professions students through soft skills training, workplace-oriented training, mentoring, and extracurricular activities. These opportunities enable students to develop and strengthen resilience in both formal and informal settings. Such initiatives not only equip students to manage future career challenges but also support their overall personal and professional development. CONCLUSIONS: This study provided a comprehensive understanding of the contributing factors to health professions students' resilience. The availability of support resources together with a nurturing environment provided by university are crucial. By fostering resilience, students are better prepared to navigate the challenges of the demanding professions and develop the emotional fortitude necessary for long-term success in healthcare.

Adolescent mental well-being in time of crises: The role of social and residential contexts.

BACKGROUND: The extent of the impact and the interconnections among factors within social and residential contexts during the COVID-19 lockdowns on mental well-being remain to be elucidated. We identified latent classes of each of social and residential context during the lockdown and examined their associations with mental well-being among adolescents in France 1-year after the first lockdown. METHODS: We used data collected in 2021 in a cross-sectional school-based pilot study for EXIST, from 387 participants ages 12-15 years. Participants reported retrospectively on characteristics of their social and residential contexts during the lockdown, and their current mental well-being in self-report questionnaires. We used latent class analysis to identify latent classes of social and residential contexts, and linear regression models to examine the associations between these contexts and mental well-being. RESULTS: Four social context classes were identified: class 1 "Low opportunity for social contact at home," class 2 "Moderate opportunity for social contact at home," class 3 "High opportunity for social contact at home," and class 4 "Very high opportunity for social contact at home." Relative to class 4, lower levels of mental well-being were observed among adolescents in class 1 (b = -4.08, 95% CI [-8.06; -0.10]) 1 year after the lockdown. We identified four residential context classes based on proximity to nature, type of residence (e.g., apartment, house), and level of neighborhood deprivation. No association was detected between residential context during the lockdown and adolescent mental well-being one-year later. CONCLUSION: A limited social context may negatively impact adolescent mental well-being during crises.

Career women's mental wellbeing in the era of population decline: the effects of working environment and family environment on the mental wellbeing.

Introduction: In recent years, it has become increasingly evident that the population in many countries has been declining. China, which was previously the world's most populous nation and is often categorized as an emerging economy, officially entered an era of population decline in 2022. The advent of this era has make China's economic development more uncertain and aging of population more pronounced. To address the population decline, the Chinese government implemented the "Three-Child Policy" to encourage childbirth, aiming to reverse the negative population growth. However, this policy has not achieved the expected goals. Instead, it has increased the pressure on women to bear children, particularly for career women, where such pressure may conflict with their existing work and family environments, subsequently affecting their mental wellbeing. Methods: A survey was conducted to investigate the mental wellbeing status of career women in Changchun City, Jilin Province, Northeast China. It analyzes the impact of working and family environments on the mental wellbeing of these women. Results: Based on the survey, this study draws five conclusions: A. The mental wellbeing status of career women varies across different ages, industries, and childbirth statuses. B. The perceived adverse impact of childbirth on the working environment may negatively affect the mental wellbeing of career women. C. The perceived adverse impact of childbirth on the family environment may negatively affect the mental wellbeing of career women. D. Career women are not satisfied with the effectiveness of current policies in protecting women's rights. E. Compared to working environments, there is a greater demand for career women in the family environments, particularly in reducing various family burdens. Discussion: The pro-natalist policies introduced in response to negative population growth can worsen the mental wellbeing of career women, while the deterioration of their mental wellbeing could further accelerate population decline. Given the current challenges, this study suggests that effectively improving the mental wellbeing of career women requires building psychological resilience among childless career women, reducing the burden of family on career women, and continuously improving policies and regulations that protect the rights of career women.

How work engagement and workaholism relate to individuals' and their intimate partners' mental well-being: a test of the spillover-crossover model among Indonesian dual-earner couples.

This study investigated the relationship between work engagement, workaholism, and mental well-being of individuals and their intimate partners. This association was explored in the context of Indonesian dual-earner couples, using the Spillover-Crossover Model (SCM). The study examined how work-to-family spillover (i.e. work-to-family conflict and facilitation) and recovery experiences (i.e. psychological detachment, relaxation, mastery, and control) mediate these relationships. A cross-sectional survey was conducted among 186 Indonesian dual-earner couples with preschool children. Structural equation modeling was used to test the hypothesized model and bootstrap method was conducted to evaluate the indirect relationships. As hypothesized, among male and female workers, work engagement was positively related to individual's mental well-being through work-to-family facilitation and recovery experiences. In contrast, workaholism was negatively related to individual's mental well-being through work-to-family conflict and recovery experiences excluding psychological detachment. Individual's mental well-being, in turn, was positively related to intimate partner's mental well-being. These findings suggested that work engagement and workaholism were related to intimate partner's mental well-being differently. These results further supported the SCM, suggesting that higher work engagement could increase workers' and their intimate partners' mental well-being through work-to-family facilitation and their recovery experiences, while workaholism acts oppositely.

Adult stakeholders' perspectives on supporting or undermining the mental health of sexual and gender minoritised adolescents.

OBJECTIVES: To explore adult stakeholders' perspectives on what supports or undermines the mental health of sexual and gender minoritised adolescents (SGMA) in everyday life in order to better understand how to foster supportive psychosocial environments for SGMA. DESIGN: Descriptive qualitative study design, using framework analysis. METHODS: Semi-structured interviews were conducted remotely with 16 UK-based adult stakeholders which included parents of SGMA, health and social care professionals, community-based professionals, and professionals who commission services related to adolescent health and well-being. RESULTS: Nine themes were identified that represented barriers and enablers of fostering psychosocial environments that are supportive of SGMA mental health. Example barrier themes include SGMA 'facing chronic and acute safety threats and stress', 'psychological responses to social connection losses and navigating alienation', 'digital exposure and online risk and vulnerability' and 'conflicting messages, resulting divisions and adult distancing'. Example enablers include 'exploring, owning, and changing (personal) identities', 'advocating alongside adolescents whilst containing oneself as the adult in the situation' and 'personally fostering adolescents' psychological safety and inclusion'. CONCLUSIONS: Adult stakeholders report that SGMA are often exposed to environments hostile to key aspects of their identity which then by extension undermines their mental health. These experiences can threaten their sense of safety and evolving identity. Practitioners in particular should be aware of the stressors relating to SGMA identity and minoritisation experiences in order to develop the psychological safety and sense of inclusion needed for SGMA to trust in the relationship and the support offered.

Collaborative approaches to health education: perspectives of parents and teachers on self-care and managing common health issues in UK primary schools.

BACKGROUND: Health education in primary schools plays a critical role in equipping children with essential self-care skills, fostering health literacy, and addressing social determinants of health. This study explores the perspectives of parents and teachers on teaching self-care and managing common health issues in UK primary schools. Despite the recognized importance of health education, there is limited research on how self-care education is perceived and implemented in the primary school setting. METHODS: A qualitative study was conducted using semi-structured interviews with 18 participants, including 9 generalist primary teachers and 9 parents from diverse educational and socioeconomic contexts in the West Midlands, East Midlands, Northwest, and London of England. Participants were recruited via social media and professional networks, and interviews were conducted via video conferencing platforms. Data were thematically analysed using NVivo 12 to identify recurring themes related to the delivery and impact of self-care education in primary schools. RESULTS: Teachers and parents highlighted key self-care topics, including hygiene, managing common illnesses like colds and cuts, and mental well-being. There was a consensus on the importance of self-care education, but views diverged on whether the responsibility should lie primarily with schools, parents, or a collaborative approach. Teachers expressed concerns about their preparedness to teach sensitive topics, citing a lack of training and resources. Socioeconomic and religious contexts further influenced perceptions, with participants emphasising further importance of school-led self-care education for children from lower socioeconomic backgrounds. Strengths were identified in current self-care education efforts, particularly in practical lessons that empower children with age-appropriate skills. CONCLUSIONS: This study highlights the critical need for comprehensive and collaborative health education in primary schools to promote health literacy and reduce health disparities. Enhancing teacher training, integrating self-care topics into the primary curriculum, and fostering stronger partnerships between schools and families are essential to improving the quality and consistency of self-care education. Policymakers should consider implementing mandatory health education training in teacher education programs and providing ongoing professional development to support teachers. By addressing these gaps, schools can play a pivotal role in preparing children for lifelong health management, reducing the burden on healthcare services, and supporting public health objectives.

iCan, Empowering Recovery: Evaluating a Patient-Centred Cancer Rehabilitation Programme across the Cancer Care Continuum.

BACKGROUND/OBJECTIVES: The adverse effects of cancer and the long-term sequelae of associated treatments result in reduced quality of life and increased mortality for patients. Supporting patients with cancer to mitigate adverse outcomes is an important aspect of oncology care and the primary purpose of cancer rehabilitation. A retrospective service evaluation was conducted to evaluate the effectiveness of the core iCan patient-centred cancer rehabilitation service. METHODS: At the beginning and end of a five-week programme, a series of questionnaires evaluating changes in mental health and wellbeing, and physical activity performance/attitudes, and functional capacity were administered to participants. RESULTS: Following iCan, we found that functional capacity was improved (30 s sit-to-stand: +6.3 repetition; d = -1.00, p < 0.001) and that self-reported physical activity was increased (~1173 MET-mins/wk; d = -0.76, p < 0.001); participants also perceived greater capability, opportunity, and motivation to be active. Mental wellbeing was also improved (SWEMWBS: d = -0.69, p < 0.001), whilst fatigue was reduced (FACIT: d = -0.77, p < 0.001). CONCLUSION: It appears that iCan has beneficial effects upon the physical/functional and psychological health of its participants. Where data are available, there appear to be clinically significant improvements across the range of measured functional, wellbeing, and activity/sedentariness outcomes, which suggest that participation in iCan is instrumental in adding value to the health and wellbeing of patients.

Validation of the Warwick-Edinburgh Mental Well-Being Scale for the Mental Health Surveillance (MHS) of German adults.

BACKGROUND: Mental health encompasses more than just the absence of mental disorders. Thus, a Mental Health Surveillance (MHS) and reporting system for Germany should monitor mental well-being in addition to psychopathology to capture a more complete picture of population mental health. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) is an internationally established inventory for the integrated assessment of different aspects of mental well-being (i.e., hedonic and eudaimonic) in population samples that has not yet been validated for Germany. METHODS: Using data from a cross-sectional online survey of a convenience sample of N = 1.048 adults aged 18-79 years (51% female) living in Germany, the factorial structure, measurement invariance (age, sex) and psychometric properties of the WEMWBS in its long (14 items) and short (7 items) versions were analyzed. Additionally, correlations to relevant factors (e.g., health-related quality of life, psychological distress) were investigated as indicators of criterion validity. RESULTS: Means of model fit indices did not confirm a unidimensional factor structure for either version. The three-factor-correlative models showed moderate to good fit while the bifactor model with one general mental well-being factor and three grouping factors fitted the data best. The full range of possible responses was used for all items, and the distribution of both scales was approximately normal. Moreover, the results revealed measurement invariance across sex and age groups. Initial evidence of criterion validity was obtained. Internal consistencies were α = 0.95 and α = 0.89, respectively. Average mental well-being was comparable to that of other European countries at 3.74 for the long version and 3.84 for the short version. While there were no differences by sex, comparisons between age groups revealed higher mental well-being among the older age groups. CONCLUSIONS: Both versions of the WEMWBS showed sound psychometric characteristics in the present German sample. The findings indicate that the instrument is suitable for measuring mental well-being at the population level due to its distributional properties. These results are promising, suggesting that the scale is suitable for use in a national MHS that aims to capture positive mental health in the population as a foundation for prevention and promotion efforts within public mental health.

The relationship between physical activity environment, mental wellbeing, flourishing and thriving: A mixed method study.

Research shows that mental wellbeing contributes to a greater quality of life and longevity, superior overall health, life success, and fulfillment. High mental wellbeing, such as flourishing and thriving, is associated with a sense of meaning and purpose, mastery and accomplishment, social connectedness, optimism, and contribution to society. Nature-based physical activity participation has been linked with mental wellbeing enhancement over and above the impact of physical activity alone. The present study sought to address a gap in the research by exploring whether the environment in which physical activity takes place and one's gender moderate the relationship between activity time and various indices of mental wellbeing. Using a mixed methods design, participants (N = 235) aged 18 to 76 (M = 33.41, SD = 13.41) completed an online survey. We divided participants into three groups based on their preferred type of physical activity: indoor, outdoor non-nature-based, and outdoor nature-based physical activity. The moderation analyses highlight the importance of the environment in physical activity, with outdoor nature-based settings consistently showing positive associations with flourishing and thriving. These findings suggest that engaging in physical activities in natural environments can significantly predict an individual's mental wellbeing, for both males and females. Qualitative data supported the findings and also revealed that nature-based physical activity achieves these benefits through developing positive affect, social closeness and engagement, purpose, enhanced experiences, and interests beyond oneself. Findings from this study demonstrate the importance of nature-based physical activity for mental wellbeing promotion and protection, indicating that opportunities for nature-based physical activity should be more effectively provided, perhaps across multiple domains of life such as education, sport, public health, and urban planning.

A Descriptive Study to Assess the Impact of Social Media Platforms on Mental Well Being among College Student at Selected College in Chennai.

Social media has become an integrated part of daily life, with an estimated 3 billion social media users worldwide. The purpose of current study was to investigate to assess the impact of social media platforms on mental wellbeing among college student at selected college. A descriptive research design was used a study the Impact of social media Plat forms on mental wellbeing among college students. After obtaining the Institutional ethical approval, the investigator selected 300 samples by using randomized Sampling Technique. The samples who met the inclusion criteria were selected the study participants and obtained the written informed consent.

Resilience as Safety Culture in German Emergency Medical Services: Examining Irritation and Burnout.

BACKGROUND/OBJECTIVES: The stress levels in emergency services are enormous. The resulting stress can range from psychological irritation to burnout. This study examines the importance of resilience in the German EMS and its significance for the risk of irritation and burnout among EMS personnel. METHODS: A quantitative cross-sectional online survey was conducted among 285 EMS personnel in Germany. Resilience was measured by the RS-13 Scale, irritation by the Irritation Scale (IS), and burnout by the Maslach Burnout Inventory (MBI). Sociodemographic and job-related data were also collected. A classification into resilient groups was used to compare stress levels. RESULTS: More than one-third (39%) of the participants had a low level of resilience. EMS personnel with high levels of resilience had significantly lower scores on the cognitive and emotional irritation dimensions, as well as on the burnout dimensions of emotional exhaustion and cynicism. CONCLUSIONS: Resilience plays an important role in the safety culture of emergency services. The results support the hypothesis that high levels of resilience lead to less stress and help people cope better with stress. Almost two-fifths of the participants had lower resilience, underscoring the need for safe communication and targeted measures to strengthen resilience. Regular training, a supportive work environment, and promoting team cohesion and social support can improve emergency responders' mental health and job performance. Future research should develop specific intervention strategies and evaluate their effectiveness to ensure the long-term health of emergency responders and improve the quality of emergency care.

Empathic Conversational Agent Platform Designs and Their Evaluation in the Context of Mental Health: Systematic Review.

BACKGROUND: The demand for mental health (MH) services in the community continues to exceed supply. At the same time, technological developments make the use of artificial intelligence-empowered conversational agents (CAs) a real possibility to help fill this gap. OBJECTIVE: The objective of this review was to identify existing empathic CA design architectures within the MH care sector and to assess their technical performance in detecting and responding to user emotions in terms of classification accuracy. In addition, the approaches used to evaluate empathic CAs within the MH care sector in terms of their acceptability to users were considered. Finally, this review aimed to identify limitations and future directions for empathic CAs in MH care. METHODS: A systematic literature search was conducted across 6 academic databases to identify journal articles and conference proceedings using search terms covering 3 topics: "conversational agents," "mental health," and "empathy." Only studies discussing CA interventions for the MH care domain were eligible for this review, with both textual and vocal characteristics considered as possible data inputs. Quality was assessed using appropriate risk of bias and quality tools. RESULTS: A total of 19 articles met all inclusion criteria. Most (12/19, 63%) of these empathic CA designs in MH care were machine learning (ML) based, with 26% (5/19) hybrid engines and 11% (2/19) rule-based systems. Among the ML-based CAs, 47% (9/19) used neural networks, with transformer-based architectures being well represented (7/19, 37%). The remaining 16% (3/19) of the ML models were unspecified. Technical assessments of these CAs focused on response accuracies and their ability to recognize, predict, and classify user emotions. While single-engine CAs demonstrated good accuracy, the hybrid engines achieved higher accuracy and provided more nuanced responses. Of the 19 studies, human evaluations were conducted in 16 (84%), with only 5 (26%) focusing directly on the CA's empathic features. All these papers used self-reports for measuring empathy, including single or multiple (scale) ratings or qualitative feedback from in-depth interviews. Only 1 (5%) paper included evaluations by both CA users and experts, adding more value to the process. CONCLUSIONS: The integration of CA design and its evaluation is crucial to produce empathic CAs. Future studies should focus on using a clear definition of empathy and standardized scales for empathy measurement, ideally including expert assessment. In addition, the diversity in measures used for technical assessment and evaluation poses a challenge for comparing CA performances, which future research should also address. However, CAs with good technical and empathic performance are already available to users of MH care services, showing promise for new applications, such as helpline services.

Assessing the effects of spontaneous intracranial hypotension on quality of life, work ability and disability.

BACKGROUND: Spontaneous intracranial hypotension (SIH), characterized by headaches due to cerebrospinal fluid leaks or low pressure, is a challenging condition to diagnose and treat and affects the quality of life. METHODS: An 8­week online survey was conducted to assess the impact of SIH on symptoms, sociodemographics and quality of life. The cohort was comprised of patients who had a self-reported diagnosis of SIH and were divided into two groups: those with radiological evidence of SIH and those with clinical suspicion but no radiological evidence. Mental health and disability were evaluated using the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Henry Ford Hospital Headache Disability Inventory (HDI). RESULTS: A total of 86 participants were included in the study, 59 with radiological evidence and 27 without. Most participants were female (84.9%) with a mean age of 44.8 years. Orthostatic headache was more common in participants without radiological evidence (74.1% vs. 42.4%). The severity in those with radiological evidence was 27.1% mild, 27.1% moderate, 30.5% severe and 15.3% extremely severe, while those without had 7.4% mild, 18.5% moderate, 63.0% severe and 11.1% extremely severe headaches. Mental health assessment using the DASS-21 scale showed that 77.9% of all participants reported signs of depression, 96.5% reported anxiety and 89.5% reported stress. The HDI showed 2.3% total disability, 40.7% severe, 19.8% moderate and 37.2% mild. The impact on employment was significant: 15.1% were able to work full-time, 48.8% part-time, 30.2% were unable to work and 5.8% retired early due to SIH. CONCLUSION: The study demonstrates the broad impact of SIH affecting physical health, mental well-being, and socioeconomic status, and calls for multifaceted and robust management approaches to address its complex effects on patients.

Effects of Lacticaseibacillus rhamnosus HN001 on Happiness and Mental Well-Being: Findings from a Randomized Controlled Trial.

BACKGROUND/OBJECTIVES: Lacticaseibacillus rhamnosus HN001 (HN001) is a probiotic strain widely studied for its potential to improve human health. Previous studies have demonstrated promising results for HN001 in the improvement of mental well-being, particularly in terms of increased happiness and support for stress management in healthy adults. METHODS: To further explore these findings, a double-blind, placebo-controlled trial was conducted with 120 participants aged ≥ 18 years with mild to high stress measured by the Perceived Stress Scale (PSS). The participants were randomly assigned to receive either HN001 or placebo for 28 days. Psychological assessments, including the Oxford Happiness Questionnaire (OHQ), were completed at baseline, day 14, and day 28. Secondary outcomes included changes in PSS scores, as well as depression, anxiety, stress, and total score levels measured by the DASS-21 questionnaire. RESULTS: While not statistically significant, participants who received HN001 showed an improvement in OHQ (mean change, 13.3) and PSS total scores (mean change, -8.1) over time compared with the placebo group (mean change, 10.2 and -6.6, respectively). Furthermore, 39% of the participants moved from not happy to happy, compared with only 29% in the placebo group. Post-hoc analysis showed a statistically significant interaction between intervention and study day for OHQ and PSS total scores, with p-values of 0.014 and 0.043, respectively. No adverse effects were observed. CONCLUSIONS: HN001 showed improvements in both happiness and PSS scores. Furthermore, sex subgroup analysis revealed statistically significant differences in both outcomes, emphasizing the need for larger and longer intervention studies.

Thriving beyond the stethoscope: Unveiling positive mental health among medical students at a University in South Africa.

Introduction: Medical education presents significant challenges for medical students' mental health. Medical students are a vulnerable group, experiencing higher rates of mental health disorders, which can have implications for their well-being and academic performance. Consequently, evaluating Positive mental health (PMH) has become significant in a contemporary and demanding society, particularly among university students. Aim: This study aimed to assess the levels of PMH and identify the association between PMH domains and socio-demographic and health related variables among medical students enrolled at a university in South Africa. Methods: This quantitative, descriptive, and cross-sectional survey was conducted with 144 undergraduate medical students. Data were collected using a multi-dimensional PMH instrument and a sociodemographic and health related questionnaire, from 144 undergraduate medical students. The university's Research and Ethics Committee granted ethical clearance for the study. Results: The data were analysed using IBM SPSS version 29. The majority of the students were older than 20 years (79.2 %, n = 114), had no prior history of psychiatric illness, and had not previously taken any psychiatric medication (94.4 %, n = 136). More than half of the participants were single (66 %, n = 95), identified as Christians (76.4 %, n = 110), received a bursary (78.5 %, n = 113), had families living in rural areas (71.5 %, n = 103) and resided in the university housing (73.6 %, n = 106). Gender (p = 0.01), age (p = 0.02), religious affiliation (p = 0.03), history of psychiatric illness (p = 0.05) and treatment for psychiatric illness (p = 0.05) had a significant influence on the Total PMH score. Male participants reported higher mean scores in most PMH domains, excluding emotional support and spirituality domains. Participants aged between 22 and 23 years reported lower mean scores in Total PMH and most PMH domains. There is a significant difference in mean scores with gender (p = 0.02) and religious affiliation (p = 0.00) in the spirituality domain. Conclusion: The study results emphasised the complex nature of mental health and provided a rationale for assessing the various aspects of PMH in university students. By implementing evidence-based strategies and providing adequate support, medical schools can better support the mental health and well-being of their students, ultimately cultivating a healthier and more resilient future healthcare workforce.