Neural Tracing Protein-Functionalized Nanoparticles Capable of Fast Retrograde Axonal Transport in Live Neurons.

Neural tracing proteins like horseradish peroxidase-conjugated wheat germ agglutinin (WGA-HRP) can target the central nervous system (CNS) through anatomic retrograde transport without crossing the blood-brain barrier (BBB). Conjugating WGA-HRP to nanoparticles may enable the creation of BBB-bypassing nanomedicine. Microfluidics and two-photon confocal microscopy is applied to screen nanocarriers for transport efficacy and gain mechanistic insights into their interactions with neurons. Protein modification of gold nanoparticles alters their cellular uptake at the axonal terminal and activates fast retrograde transport. Trajectory analysis of individual endosomes carrying the nanoparticles reveals a run-and-pause pattern along the axon with endosomes carrying WGA-HRP-conjugated gold nanoparticles exhibiting longer run duration and faster instantaneous velocity than those carrying nonconjugated nanoparticles. The results offer a mechanistic explanation of the different axonal transport dynamics as well as a cell-based functional assay of neuron-targeted nanoparticles with the goal of developing BBB-bypassing nanomedicine for the treatment of nervous system disorders.

Final-year medical students' perspective: a survey on the use of computed tomography in sepsis.

OBJECTIVES: To determine the perspective of final-year medical students on the use of computed tomography (CT) in patients with sepsis. METHODS: A total of 207 questionnaires were distributed to final-year medical students at a large university medical center, and 113 returned questionnaires met the criteria for inclusion in the analysis. Questions referred to sepsis guidelines, CT indications, and the use of contrast agents. Control variables included a level of practical experience as a final-year student (trimester of student's practical year) and previous radiological experience. Statistical hypothesis tests such as the Mann-Whitney U test and chi-square test were performed. RESULTS: The majority of participating students, 85% (n = 91/107), considered a Systemic Organ Failure Assessment (SOFA) score ≥ 2 as a diagnostic criterion for sepsis. The presence of ≥ 2 positive systemic inflammatory response syndrome (SIRS) criteria was considered relevant for diagnosing sepsis by 34% (n = 34/100). Ninety-nine percent (n = 64/65) of the participants who fully agreed with a SOFA score ≥ 2 being relevant for diagnosing sepsis would also use it as an indication for a CT scan. Seventy-six percent (n = 78/103) of the students rated a known severe allergic reaction to contrast agents as an absolute contraindication for its administration. Ninety-five percent (n = 78/82) considered radiation exposure as problematic in CT examinations, especially in repeat CTs. CONCLUSION: Most final-year medical students were familiar with the sepsis criteria. Still, some referred to outdated diagnostic criteria. Participants saw the ability to plan further patient management based on CT as a major benefit. Most participants were aware of radiation as a risk of CT. CRITICAL RELEVANCE STATEMENT: More detailed knowledge of CT in septic patients should be implemented in the medical curriculum. Retraining of medical students could help increase student confidence potentially improving patient care. KEY POINTS: 1. Whereas the majority of final-year medical students were familiar with sepsis criteria, some referred to outdated diagnostic criteria. 2. Participants saw the ability to plan further patient management based on CT as a major benefit. 3. Most participants were aware of radiation as a risk of CT.

Social connectedness and suicidal ideation: the roles of perceived burdensomeness and thwarted belongingness in the distress to suicidal ideation pathway.

BACKGROUND: Suicide is a serious public health issue. Distress has been identified as a common risk factor, with research also suggesting that a lack of social connectedness is involved. METHODS: This quantitative, cross-sectional study investigated the role of perceived burdensomeness and thwarted belongingness in the psychological distress/suicidal ideation pathway in a community sample of 480 Australian adults. RESULTS: As expected, distress was found to be a strong predictor of suicidal ideation. Perceived burdensomeness and thwarted belongingness both moderated and mediated the relationship between distress and suicidal ideation. Specifically, distress was more strongly linked to suicide ideation when burdensomeness or thwarted belongingness were also high. This moderating effect was stronger for thwarted belongingness than it was for burdensomeness. These variables also mediated the pathway, in that higher distress related to higher burdensomeness and thwarted belonging, which in turn related to higher suicide ideation. This mediating effect was stronger for burdensomeness than for thwarted belonging. CONCLUSIONS: Overall, the findings confirm the importance of our social relatedness in suicide. Increasing belongingness and reducing the perception of being a burden on others may be an important intervention strategy for weakening the link between distress and suicide ideation.

Investigating the influence of work-related stress on early labour market exit: the role of health.

Early labour market exit of large birth cohorts will put pressure on the social security systems of many European countries, especially Germany. Despite political efforts, many people retire before the statutory retirement age. A well-known predictor of retirement is health, which, in turn, is influenced by psychosocial working conditions such as work-related stress. This study examined whether work stress is associated with early labour market exit. In addition, we investigated whether health mediates this association. Survey data of the German Cohort Study on Work, Age, Health and Work Participation (lidA study) were linked to register data from the Federal Employment Agency, from which information on labour market exit was obtained (n = 3636). During a 6-year follow-up period, Cox proportional hazard models were used to investigate the influence of work-related stress and health on early labour market exit, adjusting for sex, age, education, occupational status, income and supervisor behaviour. Work-related stress was measured by effort-reward imbalance (ERI). Additionally, a mediation analysis was conducted to investigate a possible mediation of the association between ERI and early labour market exit by self-rated health. Higher work-related stress increased the likelihood of early labour market exit (HR 1.86; 95% CI 1.19-2.92). However, when including health in the Cox regression, the significant effect of work-related stress disappeared. Poor health was a risk factor for early labour market exit (HR 1.49; 95% CI 1.26-1.76) independent of all confounders. The results of the mediation analysis showed that self-rated health mediated the association between ERI and early labour market exit. The balance between effort and reward at work plays a major role in improving the self-rated health of workers. Interventions that reduce work-related stress can help to improve health and thus to maintain older employees in the German labour market.

Interdisciplinary perspectives on computed tomography in sepsis: survey among medical doctors at a large university medical center.

OBJECTIVES: This study aims to describe physicians' perspectives on the use of computed tomography (CT) in patients with sepsis. METHODS: In January 2022, physicians of a large European university medical center were surveyed using a web-based questionnaire asking about their views on the role of CT in sepsis. A total of 371 questionnaires met the inclusion criteria and were analyzed using work experience, workplace, and medical specialty of physicians as variables. Chi-square tests were performed. RESULTS: Physicians considered the ability to detect an unknown focus as the greatest benefit of CT scans in sepsis (70.9%, n = 263/371). Two clinical criteria - "signs of decreased vigilance" (89.2%, n = 331/371) and "increased catecholamine demand" (84.7%, n = 314/371) - were considered highly relevant for a CT request. Elevated procalcitonin (82.7%, n = 307/371) and lactate levels (83.6%, n = 310/371) were consistently found to be critical laboratory values to request a CT. As long as there is evidence of infection in one organ region, most physicians (42.6%, n = 158/371) would order a CT scan based on clinical assessment. Combined examination of the chest, abdomen, and pelvis was favored (34.8%, n = 129/371) in cases without clinical clues of an infection source. A time window of ≥ 1-6 h was preferred for both CT examinations (53.9%, n = 200/371) and CT-guided interventions (59.3%, n = 220/371) in patients with sepsis. CONCLUSION: Despite much consensus, there are significant differences in attitudes towards the use of CT in septic patients among physicians from different workplaces and medical specialties. Knowledge of these perspectives may improve patient management and interprofessional communication. KEY POINTS: Despite interdisciplinary consensus on the use of CT in sepsis, statistically significant differences in the responses are apparent among physicians from different workplaces and medical specialties. The detection of a previously unknown source of infection and the ability to plan interventions and/or surgery based on CT findings are considered key advantages of CT in septic patients. Timing of CT reflects the requirements of specific disciplines.

Outcomes and process evaluation of a cluster-randomised participatory organisational intervention among German healthcare workers.

BACKGROUND: In the present investigation the results of the outcome and process evaluation of a participatory workplace intervention are reported. The intervention aimed to increase the workers' self-assessed physical and mental work ability. METHODS: The intervention was a two-arm, cluster-randomised trial with healthcare workers in 10 hospitals and one elderly care centre in Germany. Outcome data on workers were collected in questionnaires at baseline, and two follow-ups between 2019 and 2021. The intervention consisted of interviews and workshops, in which employees proposed measures for reducing the physical and psychosocial load and strengthening resources at work. Outcome data were analysed with linear-mixed regression models. The process evaluation was based on the thematic criteria proposed in previous literature and the collection of the type of intervention measures and their implementation status. RESULTS: The regression analysis did not provide evidence of treatment differences or reductions of psychosocial load in the intervention wards. The process evaluation suggested that the measures did not address specifically the self-assessed work ability. In addition, there was no indication that the intervention measures were causally related to the intended goals. CONCLUSIONS: The planning and implementation of organisational interventions require a careful consideration of the definition of intervention goals, the theoretical rationale of the intervention and a project-oriented action plan during the delivery phase.

Prevalence of psychoactive substance use by adolescents in public schools in a municipality in the São Paulo Metropolitan Area, Brazil.

This study aimed to estimate the prevalence of psychoactive substance use by adolescents from public schools. This is a cross-sectional study that used a random sample of adolescents from five public schools located in a municipality in the central-west region of the São Paulo Metropolitan Area, Brazil. Information on demographic, socioeconomic, and drug use was collected using self-report questionnaires. The sample consisted of 1,460 students, 716 (49%) males, aged 10-19 years (13.19±2.04 years). The prevalence of psychoactive substance use in the last month was 51% for analgesics; 48.8% for alcohol; 37.3% for tobacco; 30.8% for tranquilizers; 23.1% for marijuana; 22.6% for anabolic steroids; 21.6% for ecstasy; 15.3% for amphetamines/stimulants; 13.4% for phencyclidine; 12.9% for cocaine/crack; 12.6% for inhalants/solvents; 11.5% for opiates; 11.4% for hallucinogens; and 16.2% for other unclassified drugs. Elementary and middle school students were more likely to consume tobacco (OR = 2.306; 95%CI: 1.733-3.068; p < 0.001), and male students were more likely to consume any type of substance. We identified a high use of psychoactive substances among this study participants, with a higher prevalence among male students.

Use of autologous platelet-rich plasma in androgenetic alopecia in women: a systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to verify the efficacy of using autologous platelet-rich plasma (PRP) in female pattern alopecia (FPA). BACKGROUND: Androgenetic alopecia is the leading cause of hair loss in men andwomen and often impacts self-esteem and quality of life. DATA SOURCES: MEDLINE/PubMed, Cochrane Library, ClinicalTrials.gov, and EMBASE up to May 2021. STUDY SELECTION AND DATA EXTRACTION: We identified all studies evaluating the effect of PRP in FPA. A narrative synthesis was performed from data on the efficacy of PRP treatment and adverse effects; quantitative results of PRP use compared to control treatment for female androgenetic alopecia (AGA) were synthesized. The outcomes analyzed were terminal density and hair thickness. RESULTS: Seven articles were selected for this review. Meta-analysis showed that PRP-based interventions were able to increase terminal hair density compared to control (standardized mean difference (SMD)=2.98, 95% confidence intervals (CIs)=1.10, 4.85), with no significant increase in hair thickness (SMD = 1.16, 95% CI= -0.96, 3.28). During and after treatment, no major side effects were reported by patients or researchers. CONCLUSIONS: The use of autologous PRP injections in female AGA seems to be promising, with more consistent results on terminal hair density. However, caution is recommended in the interpretation of these results until they can be replicated in larger and more representative samples. PROSPERO registration number CRD42021257154.

Quality of leadership and self-rated health: the moderating role of 'Effort-Reward Imbalance': a longitudinal perspective.

OBJECTIVE: Longitudinal studies on the influence of leadership behavior on employees' self-rated health are scarce. As a result, potential mechanisms describing the impact of leadership behavior on health have not been adequately investigated so far. The present study accounts for the influence of leadership behavior on self-rated health within the framework of the Effort-Reward Imbalance model. METHODS: The study was conducted on the basis of a cohort which comprised a random sample of healthcare workers from ten different hospitals and one elderly nursing home in Germany. A 2-level repeated measurement model with random intercept and slopes was modeled, since it was aimed to account for individual as well as intra-individual variation of subjective health across three time points over 36 months. Beside 'Effort-Reward Imbalance' and 'Quality of Leadership' from the Copenhagen Psychosocial Questionnaire, physical and mental health was assessed by German version of the SF12 multipurpose short-form measure of health status. RESULTS: 'Effort-Reward Imbalance' and a lack in 'Quality of Leadership' negatively affect self-rated physical health. No effect was found for self-rated mental health. Effort-Reward Imbalance significantly moderates the effect of 'Quality of Leadership' on self-rated physical health. CONCLUSION: The findings, and the interaction effects in particular, suggest that leadership behavior moderated by factors such as appreciation and support, influences self-rated physical health. The study therefore provides an interpretation for leadership behavior and its influence on employees' self-rated health within the 'Effort-Reward Imbalance' model.

Prevalence of psychoactive substance use by adolescents in public schools in a municipality in the São Paulo Metropolitan Area, Brazil / Prevalência do uso de substâncias psicoativas por adolescentes em escolas públicas de um município da Região Metropolitana de São Paulo, Brasil / Prevalencia de consumo de sustancias psicoactivas en adolescentes en escuelas públicas de un municipio de la Región Metropolitana de São Paulo, Brasil

This study aimed to estimate the prevalence of psychoactive substance use by adolescents from public schools. This is a cross-sectional study that used a random sample of adolescents from five public schools located in a municipality in the central-west region of the São Paulo Metropolitan Area, Brazil. Information on demographic, socioeconomic, and drug use was collected using self-report questionnaires. The sample consisted of 1,460 students, 716 (49%) males, aged 10-19 years (13.19±2.04 years). The prevalence of psychoactive substance use in the last month was 51% for analgesics; 48.8% for alcohol; 37.3% for tobacco; 30.8% for tranquilizers; 23.1% for marijuana; 22.6% for anabolic steroids; 21.6% for ecstasy; 15.3% for amphetamines/stimulants; 13.4% for phencyclidine; 12.9% for cocaine/crack; 12.6% for inhalants/solvents; 11.5% for opiates; 11.4% for hallucinogens; and 16.2% for other unclassified drugs. Elementary and middle school students were more likely to consume tobacco (OR = 2.306; 95%CI: 1.733-3.068; p < 0.001), and male students were more likely to consume any type of substance. We identified a high use of psychoactive substances among this study participants, with a higher prevalence among male students.

O objetivo foi estimar a prevalência de uso de substâncias psicoativas por adolescentes de escolas públicas. Trata-se de um estudo transversal com uma amostra aleatória de adolescentes de cinco escolas públicas localizadas em um município da zona centro-oeste da Região Metropolitada de São Paulo, Brasil. Informações sobre as características demográficas, socioeconômicas e de uso de drogas foram coletadas por meio de questionários autorreferidos. A amostra foi composta por 1.460 estudantes, sendo 716 (49%) meninos, com idade entre 10 e 19 anos (13,19±2,04 anos). A prevalência de uso de substâncias psicoativas no último mês foi de 51,0% para analgésicos; álcool 48,8%; tabaco 37,3%; tranquilizantes 30,8%; maconha 23,1%; esteroides anabolizantes 22,6%; ecstasy 21,6%; anfetaminas/estimulantes 15,3%; fenciclidina 13,4%; cocaína/crack 12,9%; inalantes/solventes 12,6%; opiáceos 11,5%; alucinógenos 11,4%; e outras drogas não classificadas 16,2%. Alunos do Ensino Fundamental foram mais propensos a consumir tabaco (OR = 2,306; IC95%: 1,733-3,068; p < 0,001), e os estudantes do sexo masculino foram mais propensos a consumir qualquer tipo de substância. Identificou-se um alto uso de substâncias psicoativas entre os participantes deste estudo, com maior prevalência entre os estudantes do sexo masculino.

El objetivo de este estudio fue estimar la prevalencia de consumo de sustancias psicoactivas por adolescentes de escuelas públicas brasileñas. Se trata de un estudio transversal, realizado con una muestra aleatoria de adolescentes de cinco escuelas públicas, ubicadas en una ciudad de la región centro-oeste de la Región Metropolitana de São Paulo, Brasil. La información sobre las características demográficas, socioeconómicas y de consumo de drogas se recabó de cuestionarios autoinformados. La muestra estuvo compuesta por 1.460 estudiantes; 716 (49%) de los cuales eran varones, con edades entre 10 y 19 años (13,19±2,04 años). La prevalencia de consumo de sustancias psicoactivas en el último mes fue: para analgésicos 51%; alcohol 48,8%; tabaco 37,3%; tranquilizantes 30,8%; marihuana 23,1%; esteroides anabólicos 22,6%; éxtasis 21,6%; anfetaminas/estimulantes 15,3%; fenciclidina 13,4%; cocaína/crack 12,9%; inhalantes/disolventes 12,6%; opiáceos 11,5%; alucinógenos 11,4%; y otras drogas no clasificadas 16,2%. Los estudiantes de primaria fueron los más propensos a consumir tabaco (OR = 2,306; IC95%: 1,733-3,068; p < 0,001), y los varones los más propensos a consumir cualquier tipo de sustancia. Se identificó un alto consumo de sustancias psicoactivas entre los participantes, con mayor prevalencia entre los estudiantes del sexo masculino.

Early retirement intentions: the impact of employment biographies, work stress and health among a baby-boomer generation.

In recent years, early retirement decisions have become more frequent in the European Union despite political efforts to prevent early retirement. This is a growing problem for the social security system. The study focuses on a life course approach using employment biographies and investigates the influence of work stress and health on early retirement intentions. Data of employees who were born in either 1959 or 1965 of the German cohort study on work, age, health and work participation are analysed (n = 3338). By linking survey and register data from 1993 to 2011, a sequence analysis is conducted to identify employment biographies. To analyse the relationship between the employment biographies and intended early retirement, a longitudinal path analysis is computed and includes work stress, measured through effort-reward imbalance, and self-rated health. The statistical analyses identify three adverse employment biographies, i.e. part-time work, episodes of unemployment or marginal employment. In addition, two favourable employment biographies are determined, characterised by full-time work and few episodes of unemployment. The results of the path analysis show that employment biographies with high work-related stress have early retirement intentions. Among adverse employment biographies, indirect effects of poor health on the association between work stress and early retirement intentions are found. Unexpectedly, among full-time workers, work stress is also associated with early retirement intentions with an additional mediation through health. The findings of this study highlight the importance of the life course perspective when analysing retirement decisions. In addition to health-promoting interventions in the labour market, effects of psychosocial factors should be focussed on in order to reduce early exits from the labour market. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-022-00731-0.

Informal care-giving and the intention to give up employment: the role of perceived supervisor behaviour in a cohort of German employees.

Current social policies in the European Union addressing employment, retirement and long-term care are expected to result in increasing employment rates among informal carers. The present investigation contributes to previous research by focusing on how specific work-related factors, in this case supervisor behaviour, may facilitate the fulfilment of the demands arising from paid work and care and ultimately influence the desire to give up employment. To this end, population data from the German Cohort Study on Work, Age, Health and Work Participation conducted in 2011 and 2014 are analysed (n = 3916). Three research hypotheses investigating the associations between care-giving, supervisor behaviour, the intention to give up employment and work-private-life conflict are tested by means of cumulative link models. The results suggest that the intention to give up employment is stronger among employed carers. In addition, the perception that one's supervisor is considerate towards subordinates and is effective in planning, coordinating work and solving conflicts is found to be negatively related to the desire to give up employment, especially among carers. The statistical analyses reveal that supervisor behaviour mediates the association between the level of work-private-life conflict and the intention to give up employment. It is concluded that the working conditions may exert a substantial influence on the levels of psychosocial load carers experience by facilitating or hindering the extent to which carers are allowed to accommodate their work schedules and job assignments to the conflicting demands of their dual role as workers and carers.

The Gender Paradox: Understanding the Role of Masculinity in Suicidal Ideation.

It is important to understand the role of social determinants, such as gender, in suicidal ideation. This study examined whether conformity to specific masculine norms, particularly high self-reliance and emotional self-control, moderated the relationship between psychological distress and suicidal ideation for men. The other norms explored were those pertaining to behavioral-emotional or social hierarchy status aspects of masculinity, and whether they moderated the psychological distress-suicidal ideation relationship for men and women. The Conformity to Masculine Norms Inventory, the Kessler Psychological Distress Scale, and the Suicidal Ideation Attributes Scale were administered to an Australian community sample in an online survey (n = 486). As predicted, higher psychological distress was associated with higher suicidal ideation. Self-reliance enhanced the relationship and was the only moderator among men. High self-reliance levels might be an important indicator of risk, which can be used when assessing and working with men who are hesitant to openly discuss suicidal ideation with clinicians. For female participants, higher endorsement of behavioral-emotional norms and lower conformity to social hierarchy status norms appear to increase suicide risk in the presence of psychological distress. Our findings suggest that high self-reliance is of particular concern for men experiencing psychological distress. It is also important to consider the roles of masculine norm endorsement in the psychological distress-suicidal ideation relationship among women.

Anti-Selection & Genetic Testing in Insurance: An Interdisciplinary Perspective.

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

Emotion-driven problem behaviour: The predictive utility of positive and negative urgency.

Impulsive urgency describes the tendency to act rashly when experiencing extreme emotions. This Australian study aimed to investigate the predictive utility of impulsivity, including impulsive urgency (positive and negative), across a range of problem behaviours. Data from two community samples, one retrospective (n = 281) and one current (n = 604), were analysed using hierarchical regression to determine which facets of impulsivity, as assessed with a comprehensive scale (i.e. negative urgency, positive urgency, lack or premeditation, lack of perseverance, and sensation seeking), best predicted a series of problem behaviours (i.e. problem gambling, disorderly alcohol use, online gambling disorder, obsessive-compulsive disorder behaviours, and social media addiction). The impulsive urgency facets were shown to be significant predictors across the behaviours examined. More specifically, negative urgency was the strongest predictor of disorderly alcohol use, obsessive-compulsive disorder behaviours, and social media addiction. Positive urgency was associated with problem gambling and online gambling disorder behaviours. These findings suggest that impulsive urgency is a key contributing factor in many behavioural problems and that the valence of the urgency is an important consideration when addressing a broad range of psychopathologies.

Cancer treatment regimens and their impact on the patient-reported outcome measures health-related quality of life and perceived cognitive function.

BACKGROUND AND PURPOSE: Breast cancer can be a significant challenge for those affected. Knowledge of physical function, social-emotional challenges, and perceived cognitive function based on the cancer treatment regimens may help to inform adequate support. METHODS: For this prospective observational pilot study, we collected data of seventy-nine women (mean age 54.6 ± 9.5 years) before (T0) and after (T1) initial breast cancer treatment. Functional Assessment of Cancer Therapy-Breast (FACT-B) and Functional Assessment of Cancer Therapy-Cognitive-Function (FACT-Cog) were used to collect data of four treatment subgroups: SCR = Surgery + Chemotherapy + Radiation Therapy; SC = Surgery + Chemotherapy; SR = Surgery + Radiation Therapy; S = Surgery. A mixed ANOVA and posthoc analysis (Tukey, Games-Howell) were used to detect interactions (group by time) and the main effect. A repeated-measures ANOVA displayed individual group differences (time). RESULTS: Significant interaction showed more deterioration was experienced with SC and SCR than SR and S for FACT-B (p < 0.01) and FACT-Cog (p < 0.001). The longitudinal comparison between T0 and T1 indicated a significant group main effect on all subscales (p < 0.001) except for Emotional Well-Being. Significant reductions (p < 0.05) in FACT-B, (- 19%); FACT-Cog, (- 21%) with most pronounced effect in Physical Well-Being (- 30%), Functional Well-Being (- 20%), Breast Cancer Subscale (- 20%), Perceived Cognitive Impairments (- 18%) and Impact of Cognitive Impairments on Quality of Life (- 39%) were detected for SCR. CONCLUSION: Our study showed that the extent of change in health-related quality of life (HRQoL) and perceived cognitive function (PCF) depends on the treatment regimen. Multidisciplinary support initiated early in breast cancer therapy is needed, especially for women undergoing combined cancer treatment. Routine assessment of patient-reported outcomes (PROs) in oncology practice may increase the transparency of patients' perceived circumstances, leading to personalized and optimized acute and survivorship care.

Routine cancer treatments and their impact on physical function, symptoms of cancer-related fatigue, anxiety, and depression.

BACKGROUND AND PURPOSE: Breast cancer can be a major challenge for affected women. Knowledge of the physical function, symptoms of cancer-related fatigue, anxiety, and depression based on the cancer treatment may help to guide adequate support. METHODS: For this prospective observational study, we collected data from seventy-nine women with a mean age 54.6 ± 9.5 years prior to the onset of breast cancer treatment (T0) and after (T1/T2). Handgrip strength test (HGS), six-minute walk test (6MWT), the phase angle (PhA), the hospital anxiety and depression scale (HADS), and functional assessment of chronic illness therapy-fatigue (FACIT-F) were used to collect data from four treatment subgroups SC, surgery + chemotherapy; SCR, surgery + chemotherapy + radiation therapy; SR, surgery + radiation therapy; and S, surgery. RESULTS: A mixed ANOVA revealed a significant interaction between time and group for PhA, F = 8.55, p < 0.01; HGS, F = 3.59, p < 0.01; 6MWT, F = 4.47, p < 0.01; and FACIT-F, F = 2.77, p < 0.05 with most pronounced deterioration seen in group SCR (PhA 4.8°; HGS 27.5 kg, 6MWT 453.4 m, FACIT-F 33.8 points). HADS data displayed moderate anxiety and depression predominantly after treatment. CONCLUSION: Our study showed that the extent of change in physical function, symptoms of fatigue, anxiety, and depression depends on the treatment conditions. The potentially higher risk of impaired function due to the prevalence of values below a critical threshold requires early initiated multidisciplinary support.

Assessing the Role of Collective Efficacy Beliefs During Participative Occupational Health Interventions.

Background: For group-based participatory interventions in the context of occupational health, no questionnaires exist to assess the participants' active engagement in the interventions. On the basis of the construct of collective efficacy beliefs, this study has developed a questionnaire with which the group-related efficacy beliefs can be assessed as a precondition for participants actively engaging in participative interventions. Methods: Participants were drawn from a two-arm cluster-randomized intervention study to fill out the questionnaire. A Factor analysis and an initial psychometric calibration were performed. In a second step, the group-related properties of the questionnaire were validated using a Multilevel analysis. Results: The factorial structure of the questionnaire is consistent with the theory of efficacy beliefs according to A. Bandura. Furthermore, the collective efficacy expectations of the interventions' participants are lowered in the absence of appreciation and support in the psychosocial environment of the worksite. Conclusions: Assessing participant's quality of interventional activity in participatory interventions by collective efficacy can be valuable in understanding the amount of interventional activity. In addition, it is recommended to consider the influence of the worksite's psychosocial environment on collective efficacy beliefs when implementing participatory interventions. Clinical Trial Registration: Registration trial DRKS00021138 on the German Registry of Clinical Studies (DRKS), retrospectively registered on 25 March, 2020.

Predicting Anxiety from the Complex Interaction Between Masculinity and Spiritual Beliefs.

Research suggests that adherence to traditional and hegemonic masculinities can be detrimental to men's mental health. In particular, anxiety can result from the incongruence between idealised and lived experiences. Emerging research suggests that holding spiritual beliefs may protect against such anxiety. This Australian study investigated whether two aspects of spiritualism (Spiritual Openness and Spiritual Support) could moderate the relationship between four stereotypical masculine behaviours (Success Dedication, Restrictive Emotionality, Inhibited Affection and Exaggerated Self-Reliance and Control) and anxiety. A cross-sectional, correlational design, with a heterogeneous, Western community sample included 331 male participants aged 18-67 (M = 24.57, SD = 10.37). In partial support of the hypotheses, two significant moderation models were found. Both Spiritual Support and Spiritual Openness moderated the relationship between Exaggerated Self-Reliance and Control and anxiety. There were no significant moderations for Success Dedication, Restrictive Emotionality, and Inhibited Affection. Masculinity and spiritualism did not have significant direct effects on anxiety. These findings suggest that when working with men and their mental health, it may be important to consider the congruence between their behaviors and belief systems, as spirituality was only protective against anxiety where these beliefs were congruent with masculine self-reliance and control. It appears that the potential benefit of spirituality in reducing masculine anxiety is dependent on the man being more open to external supports, and having a lower need for control.