Analysis and evaluation of explainable artificial intelligence on suicide risk assessment.

This study explores the effectiveness of Explainable Artificial Intelligence (XAI) for predicting suicide risk from medical tabular data. Given the common challenge of limited datasets in health-related Machine Learning (ML) applications, we use data augmentation in tandem with ML to enhance the identification of individuals at high risk of suicide. We use SHapley Additive exPlanations (SHAP) for XAI and traditional correlation analysis to rank feature importance, pinpointing primary factors influencing suicide risk and preventive measures. Experimental results show the Random Forest (RF) model is excelling in accuracy, F1 score, and AUC (>97% across metrics). According to SHAP, anger issues, depression, and social isolation emerge as top predictors of suicide risk, while individuals with high incomes, esteemed professions, and higher education present the lowest risk. Our findings underscore the effectiveness of ML and XAI in suicide risk assessment, offering valuable insights for psychiatrists and facilitating informed clinical decisions.

An experience of multidisciplinary tutorials sessions about antibiotics in the third year of pharmacy studies in Angers, France: learning assessment and evaluation of students' feelings by a mixed approach.

For undergraduate pharmacy students, the first step of antimicrobial stewardship learning objectives is to integrate antimicrobial knowledge from the foundational sciences. We hypothesised that using a multidisciplinary approach including two sessions of tutorials could be relevant in term of students' interest, satisfaction and learning retention time. The evaluation of students' feelings was based on a questionnaire including different dimensions and three focus groups with four students. Quantitative data were analysed with the EPI-INFO 7.2 software and a thematic analysis was implemented for qualitative data by using NVivo 12 software. The evaluation of students' learning concerned both short-time learning retention (STLR) and medium-time learning retention (MTLR), six months after the last session. Overall, 63 students responded to the questionnaire. Most of them appreciated the tutorials according to the different dimensions envisaged. Focus groups confirmed the interest of students for the multidisciplinary approach, interactions with teachers and opportunities of learning transfers. Concurrently, a lack of self-efficacy, low confidence towards the other students, external regulation of motivation and poor autonomy were recorded for some participants. Finally, there was no significant decrease between the scores of the STLR assessment and those of the MTLR assessment (58.5 ± 12.1/100 and 54.4 ± 8.9/100, respectively).

Oncology clinicians' feelings towards patients presented in supervision: A pre-post assessment using the feeling word checklist.

OBJECTIVE: Clinical supervision of oncology clinicians by psycho-oncologists is an important means of psychosocial competence transfer and support. Research on this essential liaison activity remains scarce. The aim of this study was to assess the impact of supervision on oncology clinicians' feelings towards patients presented in supervision. METHODS: Oncology clinicians' (n = 23) feelings towards patients presented in supervision were assessed with the Feeling Word Checklist (FWC). The FWC was filled in by supervisees prior and after their supervision sessions (n = 91), which were conducted by experienced supervisors (n = 6). Pre- post-modification of feelings was evaluated based on a selection of FWC items, which were beforehand considered as likely to change in a beneficial supervision. Items were evaluated on session level using t-tests for dependent groups. Composite scores were calculated for feelings expected to raise and feelings expected to decrease and analysed on the level of supervisees. RESULTS: Feelings related to threats, loss of orientation or hostility such as "anxious", "overwhelmed", "impotent", "confused", "angry", "depreciated" and "guilty" decreased significantly after supervision, while feelings related to the resume of the relationship ("attentive", "happy"), a better understanding of the patient ("empathic"), a regain of control ("confident") and being "useful" significantly increased. Feeling "interested" and "calm" remained unchanged. Significant increase or decrease in the composite scores for supervisees confirmed these results. CONCLUSIONS: This study demonstrates modification of feelings towards patients presented in supervision. This modification corresponds to the normative, formative, and especially restorative function (support of the clinician) of supervision.

Is all anger created equal? A meta-analytic assessment of anger elicitation in persuasion research.

Although veritable libraries have been written about anger, the practical and theoretical understanding of its effects has been somewhat hampered by the difficulty of experimentally manipulating this emotion. Thus, key questions related to methodological precision and theoretical clarity remain, specifically with regard to whether and how anger induction techniques may interact with various moderators and elicit other co-occurring emotions in the process. Addressing this gap, a meta-analysis of 31 experimental studies in persuasion offers insights regarding the effect of anger elicitation on felt anger and its sensitivity to a host of theoretically meaningful moderators, as well as the relationship between anger induction and the arousal of other incidental emotions. Findings broadly affirm the complexity of anger as a contested emotion and offer new insight into methodological considerations and theoretical nuances of anger elicitations to be taken into account in persuasion research. These results should be interpreted with the caveat of an exclusive focus on persuasion and a Western-centric corpus of studies, further accenting the need to diversify and expand research into emotions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[Franco Basaglia's mind is still needed.] / Il pensiero di Franco Basaglia è ancora necessario.

Talking about Franco Basaglia traces the history of Italian psychiatry since the end of the Second World War, highlighting the radical changes attributable to his thought and practice. Basaglia profoundly influenced the history of psychiatry, both in Italy and throughout the world, with the closure of asylums and the taking into care of people with mental disorders, even severe ones, in the contexts of life, in the community, restoring citizenship rights to the patients. It has shone a spotlight on the issue of knowledge/power in the care relationship, on the historically determined transformation of diversity into social inequality, on the centrality of social indicators of health, and all the more on the fact that psychiatry is an instrument of social control rather than of cure and the asylum a container of misery rather than of madness.

Novel Assessment of the Impact of Irritability on Physiological and Psychological Frustration Responses in Adolescents.

OBJECTIVE: Irritability, typically defined as a proneness to anger, particularly in response to frustration, falls at the intersection of emotion and disruptive behavior. Despite well-defined translational models, there are few convergent findings regarding the pathophysiology of irritability. Most studies utilize computer-based tasks to examine neural responses to frustration, with little work examining stress-related responding to frustration in social contexts. The present study is the first to utilize the novel Frustration Social Stressor for Adolescents (FSS-A) to examine associations between adolescent irritability and psychological and physiological responses to frustration. METHOD: The FSS-A was completed by a predominantly male, racially, ethnically, and socioeconomically diverse sample of 64 12- to 17-year-olds, who were originally recruited as children with varying levels of irritability. Current irritability was assessed using the Multidimensional Assessment Profiles-Temper Loss scale (MAP-TL-Youth). Adolescents rated state anger and anxiety before and after the FSS-A, and usable salivary cortisol data were collected from 43 participants. RESULTS: Higher MAP-TL-Youth scores were associated with greater increases in anger during the FSS-A, but not increases in anxiety, or alterations in cortisol. Pre-task state anger negatively predicted the slope of the rise in cortisol observed in anticipation of the FSS-A. CONCLUSIONS: Results provide support for unique associations between adolescent irritability and anger during, and in anticipation of, frustrating social interactions. Such findings lay a foundation for future work aimed at informing physiological models and intervention targets.

Evidence Base Update on the Assessment of Irritability, Anger, and Aggression in Youth.

OBJECTIVE: Irritability, anger, and aggression have garnered significant attention from youth mental health researchers and clinicians; however, fundamental challenges of conceptualization and measurement persist. This article reviews the evidence base for assessing these transdiagnostic constructs in children and adolescents. METHOD: We conducted a preregistered systematic review of the evidence behind instruments used to measure irritability, anger, aggression, and related problems in youth. Searches were conducted in PsycINFO and PubMed, identifying 4,664 unique articles. Eligibility criteria focused on self- and proxy-report measures with peer-reviewed psychometric evidence from studies in English with youths ages 3-18. Additional measures were found through ancillary search strategies (e.g. book chapters, review articles, test publishers). Measures were screened and coded by multiple raters with acceptable reliability. RESULTS: Overall, 68 instruments met criteria for inclusion, with scales covering irritability (n = 15), anger (n = 19), aggression (n = 45), and/or general overt externalizing problems (n = 27). Regarding overall psychometric support, 6 measures (8.8%) were classified as Excellent, 46 (67.6%) were Good, and 16 (23.5%) were Adequate. Descriptive information (e.g. informants, scales, availability, translations) and psychometric properties (e.g. reliability, validity, norms) are summarized. CONCLUSIONS: Numerous instruments for youth irritability, anger, and aggression exist with varying degrees of empirical support for specific applications. Although some measures were especially strong, none had uniformly excellent properties across all dimensions, signaling the need for further research in particular areas. Findings promote conceptual clarity while also producing a well-characterized toolkit for researchers and clinicians addressing transdiagnostic problems affecting youth.

Micro-sequences of anger and shame and non-suicidal self-injury in youth: an ecological momentary assessment study.

OBJECTIVE: Non-suicidal self-injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self-punishment. Although characterizing moment-to-moment associations between shame and NSSI in individuals' real-world environment and partitioning between- and within-person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. METHOD: In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. RESULTS: We found that greater between-person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within-person increases in NSSI were linked to increased anger at self over and beyond between-person average levels of NSSI. CONCLUSIONS: These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth.

An extended emotion-eliciting film clips set (EGEFILM): assessment of emotion ratings for 104 film clips in a Turkish sample.

The primary aim of this study was to test emotion-elicitation levels of widely used film clips in a Turkish sample and to expand existing databases by adding several new film clips with the capacity to elicit a wide range of emotions, including a rarely studied emotion category, i.e., calmness. For this purpose, we conducted a comprehensive review of prior studies and collected a large number of new suggestions from a Turkish sample to select film clips for eight emotion categories: amusement, tenderness, calmness, anger, sadness, disgust, fear, and neutrality. Furthermore, we aimed to assess emotion-eliciting levels of short video clips, mostly taken by amateur video footage. In total, 104 film clips were tested online by rating several affective dimensions. Self-reported emotional experience was assessed in terms of intensity, discreteness, valence, and arousal. It was found that at least one of the existing film clips, most of the new film clips, and the short video clips were successful at eliciting medium to high levels of target emotions. However, we also observed overlaps between certain emotions (e.g., tenderness-sadness, anger-sadness-disgust, or fear-anxiety). The current results are mostly in line with previous databases, suggesting that film clips are efficient at eliciting a wide range of emotions where cultural background might play a role in the elicitation of certain emotions (e.g., amusement, anger, etc.). We hope that this extended emotion-eliciting film clips set (EGEFILM) will provide a rich resource for future emotion research both in Turkey and the international area.

Characterizing the role of impulsivity in costly, reactive aggression using a novel paradigm.

A lack of self-control has long been theorized to predict an individual's likelihood to engage in antisocial behaviors. However, existing definitions of self-control encompass multiple psychological constructs and lab-based measures of aggression have not allowed for the examination of aggression upon provocation where self-control is needed most. We introduce two versions of a novel paradigm, the Retaliate or Carry-on: Reactive AGgression Experiment (RC-RAGE) to fill this methodological gap. Using large online samples of US adults (N = 354 and N = 366), we evaluate to what extent dispositional impulsivity, self-control, aggression, and state anger contribute to aggression upon provocation when there is a financial cost involved. Results showed that costly retaliation on this task was related to trait aggression and being in an angry emotional state, but not related to social desirability. Importantly, we show that the tendency to act impulsively is a better predictor of costly retaliation than other forms of self-control, such as the ability to delay gratification, resist temptation, or plan ahead. As a browser-based task, the RC-RAGE provides a tool for the future investigation of reactive aggression in a variety of experimental settings.

Prevalence of internet addiction and psychological factors in adolescents during the covid-19 pandemic / Prevalência de dependência da internet e fatores psicológicos em adolescentes durante a pandemia de covid-19 / Prevalencia de la adicción a internet y factores psicológicos en adolescentes durante la pandemia de la covid-19

Addictive behaviors related to Internet are becoming more common and this tool has been essential once it enables home office, entertainment, homeschooling, and easy access to information. Despite the easiness brought by technology, the exaggerated use has affected users in different ways, including in the development of psychiatric disorders. This study aimed to assess internet addiction, depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), attention, impulsivity, and stress in 48 adolescents (26 young women and 22 young men), aged from 15 to 18 years, with a mean age of 16.74 (0.61), mostly students of public schools, during COVID-19, to investigate correlations between these variables according to sex and sociodemographic aspects. To assess the factors, the Internet Addiction Test (IAT); the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) Questionnaire ; the Depression, Anxiety, and Stress scale for brazilian adolescents (EDAE-A); the Barratt Impulsiveness Scale (BIS-11); and a sociodemographic questionnaire were applied. The data collection was performed in schools located in southern Brazil. The results indicated that 12 out of 48 adolescents were considered addicted to the Internet. Moreover, Internet addiction was a predictor of depression in regression analysis (p<0.001). In addition, participants classified as more addicted to the Internet scored lower averages in general attention (p<0.035) and higher averages in behavioral symptoms of inattention and ADHD (p<0.050), stress (p<0.003), anxiety (p<0.016), and depression (p<0.015), with effect sizes ranging from moderate to high. Therefore, the intense internet use by adolescents might cause psychological consequences such as depression in adolescents. Family support and professional intervention might help in the reduction of symptoms and consequences of internet addiction as well as in its prevention.(AU)

A dependência de internet é cada vez mais comum, pois essa ferramenta tem se tornado imprescindível, uma vez que possibilita home office, entretenimento, educação domiciliar e fácil acesso às informações. No entanto, o uso exagerado da tecnologia afeta os usuários de diversas formas, inclusive no desenvolvimento de transtornos psiquiátricos. Este estudo visou avaliar a dependência de internet, depressão, ansiedade, hiperatividade, atenção, impulsividade e estresse em 48 adolescentes (26 meninas e 22 meninos) de 15 a 18 anos, com idade média de 16,74 (0,61), estudantes de escolas públicas do Sul do Brasil durante a covid-19, para investigar correlações entre as variáveis anteriores de acordo com gênero e aspectos sociodemográficos. Para avaliar, aplicou-se o Internet Addiction Test (IAT), um teste de atenção, escala SNAP IV, escala de depressão, ansiedade e estresse para adolescentes (EDAE-A), escala de impulsividade de Barratt e um questionário sociodemográfico. Os resultados indicaram que 12 adolescentes foram considerados viciados em internet, e que a dependência desta foi preditora da depressão na análise de regressão (p < 0,001). Ainda, os participantes classificados como adictos tiveram médias mais baixas em atenção geral (p < 0,035) e mais altas em sintomas comportamentais de desatenção e hiperatividade (p < 0,050), estresse (p < 0,003), ansiedade (p < 0,016) e depressão (p < 0,015), com efeitos que variaram de moderado a alto. Portanto, o uso intenso da internet por adolescentes pode ter consequências psicológicas, como a depressão. Bom apoio familiar e intervenção profissional podem ajudar na redução dos sintomas e consequências, bem como na prevenção da dependência.(AU)

La adicción a Internet es cada vez más habitual, puesto que esta herramienta es esencial para el trabajo remoto, el entretenimiento, la educación domiciliar y el fácil acceso a la información. Sin embargo, su uso exagerado afecta a la vida de las personas de diferentes maneras, incluso en el desarrollo de trastornos psiquiátricos. El objetivo de este estudio fue evaluar la adicción a Internet, depresión, ansiedad, hiperactividad, atención, impulsividad y estrés en 48 adolescentes (26 muchachas y 22 muchachos), de entre 15 y 18 años, con una edad promedio de 16,74 (0,61), en su mayoría estudiantes de escuelas públicas del Sur de Brasil, durante la pandemia de la COVID-19, para investigar las correlaciones entre las variables mencionadas según género y aspectos sociodemográficos. Para evaluar los factores, se aplicaron el Test de Adicción a Internet (TAI), un test de atención, la escala SNAP IV, la Escala de Depresión, Ansiedad y Estrés para adolescentes (EDAE-A), la escala de impulsividad de Barratt y un cuestionario sociodemográfico. Los resultados indicaron que 12 adolescentes fueron considerados adictos a Internet, además, la adicción a Internet fue un predictor de la depresión en el análisis de regresión (p<0,001). Igualmente, los participantes clasificados como más adictos a Internet tuvieron promedios más bajos en atención general (p<0,035), y más altos en síntomas conductuales de falta de atención e hiperactividad (p<0,050), estrés (p<0,003), ansiedad (p<0,016) y depresión (p<0,015), con efectos que varían de moderado a alto. Por lo tanto, el uso intenso podría producir consecuencias psicológicas como la depresión en los adolescentes. Tener un buen apoyo familiar e intervención profesional puede ayudar a reducir los síntomas y las consecuencias de la adicción a Internet, así como prevenirla.(AU)

A fase terminal do filho com câncer: percepções dos profissionais hospitalares / The terminal phase of children with cancer: perceptions of hospital professionals / La fase terminal del hijo con cáncer: percepciones de los profesionales del hospital

O confronto com o câncer de um filho e a percepção da sua morte como inevitável dão lugar a experiências parentais relevantes para a pesquisa científica. Este estudo teve como objetivo investigar, por meio da percepção dos profissionais hospitalares, o modo como os pais experienciam a fase terminal e fim de vida do filho com câncer para melhor compreender os processos psicoemocionais experienciados por esses pais diante da cronicidade da doença e da morte do filho. No sentido de alcançar esse objetivo, realizou-se um estudo qualitativo de tipo fenomenológico envolvendo 17 profissionais de dois hospitais portugueses de referência em oncologia pediátrica. Os dados foram recolhidos com recurso a um guia de entrevista semiestruturada. Na percepção dos profissionais hospitalares, os resultados evidenciam que esses pais experienciam múltiplas dificuldades e preocupações na fase terminal da doença do filho e no pós-morte, bem como um sofrimento extremo e desestruturação biopsicossocial e espiritual na família. O conhecimento aprofundado da fenomenologia desses processos é essencial para o desenho e a implementação de intervenções emocionais, cognitivas, comportamentais e sociais mais ajustadas às dificuldades e preocupações parentais vividas no fim de vida e pós-morte.(AU)

Coping with children's cancer and the perception of their inevitable death give rise to parental experiences that are important to study. This study aimed to investigate, based on hospital professionals' perspectives, how parents experience the terminal phase and end of life of their children suffering from cancer to better understand the psycho-emotional processes these parents experienced in face of the chronicity of the disease and their children's death. To achieve this objective, a qualitative phenomenological study was carried out involving 17 professionals of two Portuguese hospitals that are reference in pediatric oncology. Data were collected using a semi-structured interview guide. From the perspective of hospital professionals, results show that these parents experience multiple difficulties and concerns in the terminal phase of their children's disease and postmortem, as well as the extreme suffering and biopsychosocial and spiritual disruption of the family. A deeper understanding of the phenomenology of these processes is essential to design and implement better adjusted emotional, cognitive, behavioral, and social interventions aimed at the parental difficulties and concerns experienced at the end of life and after death.(AU)

El enfrentamiento del cáncer de un hijo y la percepción de su muerte como inevitable dan lugar a experiencias parentales importantes que deben ser estudiadas. Este estudio pretende identificar desde la percepción de los profesionales del hospital cómo los padres viven la fase terminal y el final de la vida de su hijo con cáncer con el fin de comprender mejor los procesos psicoemocionales que viven estos padres ante la cronicidad de la enfermedad y la muerte de su hijo. Para ello, se realizó un estudio cualitativo, con enfoque fenomenológico, en el que participaron 17 profesionales de dos hospitales portugueses de referencia en oncología pediátrica. Para recoger los datos se aplicó un guion de entrevista semiestructurada. En cuanto a la percepción de los profesionales del hospital, estos padres experimentaron múltiples dificultades y preocupaciones en la fase terminal de la enfermedad de su hijo y postmuerte, así como un sufrimiento extremo y una desestructuración biopsicosocial y espiritual en la familia. El conocimiento en profundidad de la fenomenología de estos procesos es esencial para elaborar e implementar intervenciones emocionales, cognitivas, conductuales y sociales más acordes a las dificultades y preocupaciones parentales que se experimentan al final de la vida y la postmuerte.(AU)

Weighting Assessment of the Effect of Chinese State-Changing Words on Emotions.

Past studies of sentiment analysis have mainly applied algorithms based on vocabulary categories and emotional characteristics to detect the emotionality of text. However, the collocation of state-changing words and emotional vocabulary affects emotions. For example, adverbs of degree strengthen emotions, and negative adverbs reverse emotions. This study investigated the weighted effect of state-changing words on emotion. The research material comprised 73 state-changing words that were collocated with four emotions: happiness, sadness, fear, and anger. A total of 84 participants participated in the vocabulary assessment. The results revealed that state-changing words could be classified into four types: intensifying, weakening, neutralizing, and reversing. In a comparison of the weighting factors among emotions, the weighting effect of the same state-changing word in the positive emotion category was particularly evident. The results could serve as a reference for follow-up studies on detecting emotions in text.

Teachers' racialized anger: Implications for discipline disparities.

The contribution of racial bias to teachers' racialized discipline practices is increasingly clear, but the processes by which these biases are activated are less well understood. This study examined teachers' emotional responses to students' misbehaviors by student race as well as whether teachers' emotional responses serve to mediate the association between student race and teachers' discipline practices. Results from a sample of 228 teachers in the United States indicated that teachers were 71% more likely to report feeling anger as compared to concern when they read about a potentially challenging behavior of a Black student as compared to a White student. Additionally, teachers' anger mediated the association between student race and discipline, suggesting teacher anger as a potential point of intervention for change.

Laboratory assessment of aggression: The Taylor Aggression Paradigm in adults with and without a disorder of impulsive aggression.

INTRODUCTION: The modified Taylor Aggression Paradigm (TAP) has been used to study impulsive aggression in experimental designs and has been relatively successful in addressing critiques of aggression paradigms; however, little has been done to examine the potential of using the TAP as a direct measure of aggression. This study aimed to explore the psychometric properties of the TAP behavioral indexes as measures of aggression. METHODS: A community sample of 962 adults were divided into three groups based on diagnostic assessments: Intermittent Explosive Disorder; Non-Aggressive Psychiatric Disorder; or healthy controls. Participants then completed the TAP and self-report measures to assess construct validity. A subset of 47 participants completed a second TAP within one year to assess reliability. TAP indexes were based on number of "extreme" shocks selected (high shock index), average shock levels selected (mean shock index), and shocks levels selected without provocation (unprovoked aggression). RESULTS: Overall, TAP indexes were consistent and reliable. IED participants had the highest high shock and mean shock indexes of all groups (X2 = 49.93, p < 0.001). High shock index was related to trait aggression (ß = 0.184, p < 0.001) after including covariates; mean shock index had a trending association with trait anger (ß = 0.102, p = 0.059). CONCLUSION: TAP behavioral indexes demonstrated promising psychometrics as a measure of aggression. High shock index appears to be more strongly associated with aggressive behavior; mean shock index may better measure general hostile responding. Future research might include comparisons specifically with impulse control disorders.

Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders.

Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range ß = -0.31 for DASS-depression to ß = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (ß = -0.10) and PROMIS-anger (ß = -0.09) remained until follow-up. Moreover, positive affect (ß = 0.19), internal control beliefs (ß = 0.15), favorable coping (ß = 0.60), and unfavorable coping (ß = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).

The relationship of Facebook, Instagram, Twitter, TikTok and WhatsApp/Telegram with loneliness and anger of adolescents living in Turkey: A structural equality model.

PURPOSE: The aim of this study is to determine the relationship of social media with loneliness and anger levels of adolescents living in Turkey. DESIGN AND METHODS: This study used a cross-sectional descriptive design. Loneliness and anger were measured with "University of California, Los Angeles Loneliness Scale" and "Adolescent Anger Rating Scale". Data collection forms were prepared on Google Form and form' link was sent to adolescents. RESULTS: A total of 1176 adolescents aged 13-18 years within four high schools were included. The results obtained show use of Facebook and duration of Facebook use of adolescents were not related to mean scores of loneliness. Adolescents with high duration of Instagram use was to be found that loneliness scores were statistically high, but anger scores were similar. Twitter users had lower loneliness mean scores and higher anger scores. TikTok use was not related with loneliness scores. CONCLUSION: In conclusion, this study found that high duration of Instagram use was associated with higher loneliness scores in adolescents, while Twitter users had lower loneliness scores and higher anger scores. The use of Facebook and TikTok did not significantly affect loneliness and anger levels. PRACTICE IMPLICATIONS: This study suggest that pediatric nurses can play a significant role in promoting balanced social media use and healthy coping strategies to mitigate the negative impact of excessive social media use on adolescent mental health. Pediatric nurses can support adolescent emotional wellbeing and promote a healthier digital environment.

The Destructive Effects of Recreational Off-Highway Vehicles on Farmer Well-Being: Mental Health Consequences Outweigh Economic Losses.

In many countries, the use of recreational off-highway vehicles (ROVs) occasionally spills over into agricultural lands. The conflict between ROV users and farmers is escalating due to the growing popularity of ROVs. Determined action of authorities for mitigating the phenomenon may necessitate an understanding of the nature and extent of the actual damage caused by ROVs. However, it is currently unknown how ROVs harm agriculture and what is their main deleterious effect on farmers. We tested our hypothesis that economic costs are the leading reason for farmer distress using in-depth interviews with 46 Israeli farmers that are affected by ROVs. We found that contrary to our hypothesis, economic costs were low and negligible, despite high levels of anger, distress, or hopelessness expressed by almost all farmers. The main reason for outrage and frustration was the emotional impact of ROV activity on the farmers. Therefore, measuring the effects of ROVs on agriculture in terms of economic losses will probably be ineffective in convincing policymakers to act against the reckless use of ROVs in agricultural lands. On the other hand, conveying the emotional implications for the farmers can potentially promote change if accompanied by explanations on the importance of caring for the mental health and well-being of a sector that already suffers from levels of stress and mental health problems that are among the highest of any other industry in the world.

Dual-role nurse interpreter perceptions of language barriers and Spanish-speaking patients: A qualitative study.

AIM: As the United States population is ever changing and is growing in diverse population patterns, the health care system is called to initiate responsive health care practices that are based on the public's changing and diverse cultural patterns. This study sought to explore the perceptions of certified medical interpreter dual-role nurses and their experiences with Spanish-speaking patients from admission to discharge in hospital stays. DESIGN: A qualitative descriptive case study was applied in this study. METHODS: Data was collected from nurses working at a United States Southwest Borderland hospital using purposive sampling and semi-structured in-depth interviews. A total of four dual-role nurses participated, and thematic narrative analysis was applied. RESULTS: Four major themes emerged. The main themes were "being a dual-role nurse interpreter," "patient experience," "culture and competence, "and "nursing and caring," With each major theme multiple sub themes emerged. Two sub themes emerged with "being a dual-role nurse interpreter," and two sub themes emerged with "patient experiences." The major themes that emerged from the interviews indicated that the language barrier greatly affects Spanish-speaking patients in their hospital stay. Participants reported having at least one encounter with a Spanish-speaking patient that was not afforded interpretation services or had interpretation from someone other than a qualified interpreter. Patients experienced confusion, apprehension and anger associated with not being able to communicate their needs to the healthcare system. CONCLUSIONS: According to the experiences of the certified dual-role nurse interpreters, having a language barrier makes a tremendous impact on the care of Spanish-speaking patients. Nurse participants describe how patients and their family members experience dissatisfaction, anger and confusion when there is a language barrier and most importantly how language barriers have detrimental effects on patients with wrong medication prescriptions and wrong diagnosis. CLINICAL RELEVANCE: When hospital administration recognize and support nurses as certified medical interpreters as a key component for patient care when assisting persons with limited English proficiency, patients are empowered to become active members of their healthcare regimen. The role of dual-role nurses enables brokering between the healthcare system and serves as a tool to bridge health disparities based on linguistic inequities existing in healthcare. Recruitment and retention of certified medical interpreter trained Spanish-speaking nurses deter errors in healthcare and makes a positive impact on the healthcare regimen of Spanish-speaking patients enabling patient empowerment through education and advocacy.