Emerging trends in nanomaterial design for the development of point-of-care platforms and practical applications.

Nanomaterials and nanotechnology offer promising opportunities in point-of-care (POC) diagnostics and therapeutics due to their unique physical and chemical properties. POC platforms aim to provide rapid and portable diagnostic and therapeutic capabilities at the site of patient care, offering cost-effective solutions. Incorporating nanomaterials with distinct optical, electrical, and magnetic properties can revolutionize the POC industry, significantly enhancing the effectiveness and efficiency of diagnostic and theragnostic devices. By leveraging nanoparticles and nanofibers in POC devices, nanomaterials have the potential to improve the accuracy and speed of diagnostic tests, making them more practical for POC settings. Technological advancements, such as smartphone integration, imagery instruments, and attachments, complement and expand the application scope of POCs, reducing invasiveness by enabling analysis of various matrices like saliva and breath. These integrated testing platforms facilitate procedures without compromising diagnosis quality. This review provides a summary of recent trends in POC technologies utilizing nanomaterials and nanotechnologies for analyzing disease biomarkers. It highlights advances in device development, nanomaterial design, and their applications in POC. Additionally, complementary tools used in POC and nanomaterials are discussed, followed by critical analysis of challenges and future directions for these technologies.

Smart Multiplex Point-of-Care Platform for Simultaneous Drug Monitoring.

Recently, illicit drug use has become more widespread and is linked to problems with crime and public health. These drugs disrupt consciousness, affecting perceptions and feelings. Combining stimulants and depressants to suppress the effect of drugs has become the most common reason for drug overdose deaths. On-site platforms for illicit-drug detection have gained an important role in dealing, without any excess equipment, long process, and training, with drug abuse and drug trafficking. Consequently, the development of rapid, sensitive, noninvasive, and reliable multiplex drug-detecting platforms has become a major necessity. In this study, a multiplex laser-scribed graphene (LSG) sensing platform with one counter, one reference, and three working electrodes was developed for rapid and sensitive electrochemical detection of amphetamine (AMP), cocaine (COC), and benzodiazepine (BZD) simultaneously in saliva samples. The multidetection sensing system was combined with a custom-made potentiostat to achieve a complete point-of-care (POC) platform. Smartphone integration was achieved by a customized application to operate, display, and send data. To the best of our knowledge, this is the first multiplex LSG-based electrochemical platform designed for illicit-drug detection with a custom-made potentiostat device to build a complete POC platform. Each working electrode was optimized with standard solutions of AMP, COC, and BZD in the concentration range of 1.0 pg/mL-500 ng/mL. The detection limit of each illicit drug was calculated as 4.3 ng/mL for AMP, 9.7 ng/mL for BZD, and 9.0 ng/mL for COC. Healthy and MET (methamphetamine) patient saliva samples were used for the clinical study. The multiplex LSG sensor was able to detect target analytes in real saliva samples successfully. This multiplex detection device serves the role of a practical and affordable alternative to conventional drug-detection methods by combining multiple drug detections in one portable platform.

The Effect of the Meditation Based Mandala Programme on Distress, Anxiety and Depression in the Caregivers of Cancer Patients in Palliative Care Unit.

Mental health problems were found to be more common than physical health problems in cancer caregivers in palliative care units. This is a quasi-experimental study planned to determine the effect of the meditation based mandala programme on distress, anxiety and depression in caregivers of cancer patients in a palliative care unit. Planned as a single-group pre-test/post-test design, with a total of 11 caregivers. Data were collected with the Caregiver Diagnosis Form, Distress Thermometer, Beck Depression Inventory, and Beck Anxiety Inventory. Caregivers participated in the Meditation Based Mandala Programme once a week, which lasted 2 hours for 5 weeks. The distress, depression and anxiety levels of the patients were measured before the programme started and at the end of the programme. Meditation based mandala programme is effective in reducing the distress, depression and anxiety levels of caregivers of cancer patients in the palliative care unit.

Biomarker Detection in Early Diagnosis of Cancer: Recent Achievements in Point-of-Care Devices Based on Paper Microfluidics.

Microfluidics is very crucial in lab-on-a-chip systems for carrying out operations in a large-scale laboratory environment on a single chip. Microfluidic systems are miniaturized devices in which the fluid behavior and control can be manipulated on a small platform, with surface forces on the platform being greater than volumetric forces depending on the test method used. In recent years, paper-based microfluidic analytical devices (µPADs) have been developed to be used in point-of-care (POC) technologies. µPADs have numerous advantages, including ease of use, low cost, capillary action liquid transfer without the need for power, the ability to store reagents in active form in the fiber network, and the capability to perform multiple tests using various measurement techniques. These benefits are critical in the advancement of paper-based microfluidics in the fields of disease diagnosis, drug application, and environment and food safety. Cancer is one of the most critical diseases for early detection all around the world. Detecting cancer-specific biomarkers provides significant data for both early diagnosis and controlling the disease progression. µPADs for cancer biomarker detection hold great promise for improving cure rates, quality of life, and minimizing treatment costs. Although various types of bioanalytical platforms are available for the detection of cancer biomarkers, there are limited studies and critical reviews on paper-based microfluidic platforms in the literature. Hence, this article aims to draw attention to these gaps in the literature as well as the features that future platforms should have.

Design of Polymeric Surfaces as Platforms for Streamlined Cancer Diagnostics in Liquid Biopsies.

Minimally invasive approaches for cancer diagnosis are an integral step in the quest to improve cancer survival. Liquid biopsies such as blood samples are matrices explored to extract valuable information about the tumor and its state through various indicators, such as proteins, peptides, tumor DNA, or circulating tumor cells. Although these markers are scarce, making their isolation and detection in complex matrices challenging, the development in polymer chemistry producing interesting structures, including molecularly imprinted polymers, branched polymers, nanopolymer composites, and hybrids, allowed the development of enhanced platforms with impressive performance for liquid biopsies analysis. This review describes the latest advances and developments in polymer synthesis and their application for minimally invasive cancer diagnosis. The polymer structures improve the operational performances of biosensors through various processes, such as increased affinity for enhanced sensitivity, improved binding, and avoidance of non-specific interactions for enhanced specificity. Furthermore, polymer-based materials can be a tremendous help in signal amplification of usually low-concentrated targets in the sample. The pros and cons of these materials, how the synthesis process affects their performance, and the device applications for liquid biopsies diagnosis will be critically reviewed to show the essentiality of this technology in oncology and clinical biomedicine.

Papertronics: Marriage between Paper and Electronics Becoming a Real Scenario in Resource-Limited Settings.

Integrating electronic applications with paper, placed next to or below printed images or graphics, can further expand the possible uses of paper substrates. Consuming paper as a substrate in the field of electronics can lead to significant innovations toward papertronics applications as paper comprises various advantages like being disposable, inexpensive, biodegradable, easy to handle, simple to use, and easily available. All of these advantages will definitely spur the advancement of the electronics field, but unfortunately, putting electronics on paper is not an easy task because, compared to plastics, the paper surface is not just rough but also porous. For example, in the case of lateral flow assay testing the sensor response is delayed if the pore size of the paper is enormous. This might be a disadvantage for most electrical devices printed directly on paper. Still, some methods make it compatible when fit with a rough, absorbent surface of the paper. Building electronic devices on a standard paper substrate have sparked much interest because of its lightweight, environmental friendliness, minimal cost, and simple fabrication. A slew of improvements have been achieved in recent years to make paper electronics perform better in various applications, including transistors, batteries, and displays. In addition, flexible electronics have gained much interest in human-machine interaction and wireless sensing. This review briefly examines the origins and fabrication of paper electronics and then moves on to applications and exciting possible paths for paper-based electronics.

Comparison of the Otolaryngological Symptoms of Laboratory-Confirmed and Clinically Diagnosed COVID-19 Patients.

Objectives: Our aim is to determine prevalence, severity, duration of otorhinolaryngologic symptoms related to coronavirus disease 2019 (COVID-19), and correlation between the test results obtained by oronasopharyngeal swab and the symptoms of these regions by evaluating differences in ear, nose, and throat (ENT) symptoms between laboratory-confirmed COVID-19 patients and clinically and computed tomography (CT)-diagnosed COVID-19 patients. Methods: The study enrolled patients with a positive polymerase chain reaction (PCR) test diagnosed with COVID-19 that grouped as PCR (+), and those with repeated negative PCR tests but COVID-19 Reporting and Data System (CO-RADS) chest CT findings with high (CO-RADS 5) or very high (CO-RADS 6) similarity to COVID-19 that grouped as PCR(-)/CT(+). Demographic features, general symptoms, and otorhinolaryngological symptoms and severity of disease were evaluated and compared. Results: The most common ENT symptoms in the PCR(+) group were loss of taste (n=77), loss of smell, and sore throat with respective frequencies of 34.5%, 31.8%, 26.0%, and in PCR(-) CT (+) group loss of taste, loss of smell, and sore throat with respective frequencies 24.6%, 21.1%, and 18.4%. ENT symptom rates were found higher in PCR (+) group (65.0%) according to PCR(-)/CT(+) group (49.1%) with statistically significant difference (p=0.008). Loss of smell rates were found higher in PCR (+) group according to PCR(-)/CT(+) group with statistically significant difference (p=0.037). Conclusion: Loss of smell and taste were most common ENT symptoms in laboratory-confirmed COVID-19 cases. The presence of COVID-19 should definitely be considered in patients presenting with sudden loss of smell or taste. In addition, loss of smell and otolaryngologic symptoms were more common in laboratory-confirmed COVID-19 according to clinically and computed tomograpy diagnosed COVID-19 cases. There can be a correlation between positive sample region and symptom region. Location of symptoms must be considered for decision of sampling location.

Magnetic Nanoparticle-Based Electrochemical Sensing Platform Using Ferrocene-Labelled Peptide Nucleic Acid for the Early Diagnosis of Colorectal Cancer.

Diagnostic biomarkers based on epigenetic changes such as DNA methylation are promising tools for early cancer diagnosis. However, there are significant difficulties in directly and specifically detecting methylated DNA regions. Here, we report an electrochemical sensing system based on magnetic nanoparticles that enable a quantitative and selective analysis of the methylated septin9 (mSEPT9) gene, which is considered a diagnostic marker in early stage colorectal cancer (CRC). Methylation levels of SEPT9 in CRC samples were successfully followed by the selective recognition ability of a related peptide nucleic acid (PNA) after hybridization with DNA fragments in human patients' serums and plasma (n = 10). Moreover, this system was also adapted into a point-of-care (POC) device for a one-step detection platform. The detection of mSEPT9 demonstrated a limit of detection (LOD) value of 0.37% and interference-free measurement in the presence of branched-chain amino acid transaminase 1 (BCAT1) and SRY box transcription factor 21 antisense divergent transcript 1 (SOX21-AS1). The currently proposed functional platform has substantial prospects in translational applications of early CRC detection.

Smartphone-Based Multiplexed Biosensing Tools for Health Monitoring.

Many emerging technologies have the potential to improve health care by providing more personalized approaches or early diagnostic methods. In this review, we cover smartphone-based multiplexed sensors as affordable and portable sensing platforms for point-of-care devices. Multiplexing has been gaining attention recently for clinical diagnosis considering certain diseases require analysis of complex biological networks instead of single-marker analysis. Smartphones offer tremendous possibilities for on-site detection analysis due to their portability, high accessibility, fast sample processing, and robust imaging capabilities. Straightforward digital analysis and convenient user interfaces support networked health care systems and individualized health monitoring. Detailed biomarker profiling provides fast and accurate analysis for disease diagnosis for limited sample volume collection. Here, multiplexed smartphone-based assays with optical and electrochemical components are covered. Possible wireless or wired communication actuators and portable and wearable sensing integration for various sensing applications are discussed. The crucial features and the weaknesses of these devices are critically evaluated.

Nano-Scaled Materials and Polymer Integration in Biosensing Tools.

The evolution of biosensors and diagnostic devices has been thriving in its ability to provide reliable tools with simplified operation steps. These evolutions have paved the way for further advances in sensing materials, strategies, and device structures. Polymeric composite materials can be formed into nanostructures and networks of different types, including hydrogels, vesicles, dendrimers, molecularly imprinted polymers (MIP), etc. Due to their biocompatibility, flexibility, and low prices, they are promising tools for future lab-on-chip devices as both manufacturing materials and immobilization surfaces. Polymers can also allow the construction of scaffold materials and 3D structures that further elevate the sensing capabilities of traditional 2D biosensors. This review discusses the latest developments in nano-scaled materials and synthesis techniques for polymer structures and their integration into sensing applications by highlighting their various structural advantages in producing highly sensitive tools that rival bench-top instruments. The developments in material design open a new door for decentralized medicine and public protection that allows effective onsite and point-of-care diagnostics.

Fluorescent bioassay for SARS-CoV-2 detection using polypyrene-g-poly(ε-caprolactone) prepared by simultaneous photoinduced step-growth and ring-opening polymerizations.

The construction of a rapid and easy immunofluorescence bioassay for SARS-CoV-2 detection is described. We report for the first time a novel one-pot synthetic approach for simultaneous photoinduced step-growth polymerization of pyrene (Py) and ring-opening polymerization of ε-caprolactone (PCL) to produce a graft fluorescent copolymer PPy-g-PCL that was conjugated to SARS-CoV-2-specific antibodies using EDC/NHS chemistry. The synthesis steps and conjugation products were fully characterized using standard spectral analysis. Next, the PPy-g-PCL was used for the construction of a dot-blot assay which was calibrated for applications to human nasopharyngeal samples. The analytical features of the proposed sensor showed a detection range of 6.03-8.7 LOG viral copy mL-1 (Ct Scores: 8-25), the limit of detection (LOD), and quantification (LOQ) of 1.84 and 6.16 LOG viral copy mL-1, respectively. The repeatability and reproducibility of the platform had a coefficient of variation (CV) ranging between 1.2 and 5.9%. The fluorescence-based dot-blot assay was tested with human samples. Significant differences were observed between the fluorescence intensity of the negative and positive samples, with an overall correct response of 93.33%. The assay demonstrated a high correlation with RT-PCR data. This strategy opens new insights into simplified synthesis procedures of the reporter molecules and their high potential sensing and diagnosis applications.

Preparation of glutathione loaded nanoemulsions and testing of hepatoprotective activity on THLE-2 cells.

To improve bioavailability and stability of hydrophobic and hydrophilic compounds, nanoemulsions are good alternatives as delivery systems because of their nontoxic and nonirritant nature. Glutathione (GSH) suffers from low stability in water, where its encapsulation in nanoemulsions is a powerful strategy to its stability in aqueous systems. The aim of this study was to obtain nanoemulsions from the hydrophobic/hydrophilic contents of N. sativa seed oil so as to improve GSH stability along with bioavailability of N. sativa seed oil. Then, the prepared nanoemulsions were tested for in vitro hepatoprotective activity against ethanol toxicity. To the best of our knowledge, there is no study on the test of nanoemulsions by the combination of Nigella sativa seed oils and GSH in hepatoprotective activity. Here, nanoemulsions with different contents were prepared using Nigella sativa seed oils. Content analyses and characterisation studies of prepared nanoemulsions were carried out. In order to investigate the protective effects against to ethanol exposure, THLE-2 cells were pretreated with nanoemulsions for 2 h with the maximum benign dose (0.5 mg/mL of nanoemulsions). Ethanol (400 mM) was introduced to pretreated cells and nontreated cells for 48- or 72-h periods, followed by cell viability assay was carried out. Fluorescence microscopy tests revealed the introduction of the nanoemulsions into THLE-2 cells. The findings show that nanoformulations have promising in vitro hepatoprotective effects on the THLE-2 cell line against ethanol exposure.

Effects of art-based mandala intervention on distress and anxiety in cancer patients.

OBJECTIVE: This study was planned to determine the effect of art-based mandala intervention on the distress and anxiety experienced by cancer patients. METHODS: This semi-experimental study with a single group pretest-posttest design was performed with 12 breast cancer survival patients. The data were collected through "Patient Diagnostic Form", "Distress Thermometer", "Trait Anxiety Inventory". Patients participated in the "Art-Based Mandala Intervention" for eight weeks, one day a week, 2 h each. The distress and anxiety levels of the patients were measured before starting the program and at the end of the program. RESULTS: Cancer patients experienced moderate level of anxiety (50.66 ± 6.91) and clinically significant distress (4.08 ± 2.74). Anxiety scores of cancer patients decreased significantly after the program compared to before the program (p < 0.05). The distress scores of cancer patients increased after the program compared to before the program (p > 0.05). CONCLUSION: After the art-based mandala intervention program, anxiety scores of breast cancer survival patients decreased, and distress scores increased.

Could we predict the prognosis of the COVID-19 disease?

OBJECTIVES: Coronavirus 2019 disease (COVID-19) lead to one of the pandemics of the last century. We aimed to predict poor prognosis among severe patients to lead early intervention. METHODS: The data of 534 hospitalized patients were assessed retrospectively. Risk factors and laboratory tests that might enable the prediction of prognosis defined as being transferred to the intensive care unit and/or exitus have been investigated. RESULTS: At the admission, 398 of 534 patients (74.5%) were mild-moderate ill. It was determined that the male gender, advanced age, and comorbidity were risk factors for severity. To estimate the severity of the disease, receiver operating characteristic analysis revealed that the areas under the curve which were determined based on the optimal cut off values that were calculated for the variables of values of neutrophil to lymphocyte ratio (NLR > 3.69), C-reactive protein (CRP > 46 mg/L), troponin I ( > 5.3 ng/L), lactate dehydrogenase (LDH > 325 U/L), ferritin ( > 303 ug/L), d-dimer ( > 574 µg/L), neutrophil NE ( > 4.99 × 109 /L), lymphocyte (LE < 1.04 × 109 /L), SO2 ( < %92) were 0.762, 0.757,0.742, 0.705, 0.698, 0.694,0.688, 0.678, and 0.66, respectively. To predict mortality, AUC of values for optimal cutoff troponin I ( > 7.4 ng/L), age ( > 62), SO2 ( < %89), urea ( > 40 mg/dL), procalcitonin ( > 0.21 ug/L), CKMB ( > 2.6 ng/L) were 0.715, 0.685, 0.644, 0.632, 0.627, and 0.617, respectively. CONCLUSIONS: The clinical progress could be severe if the baseline values of NLR, CRP, troponin I, LDH, are above, and LE is below the specified cut-off point. We found that the troponin I, elder age, and SO2 values could predict mortality.

Ultrasensitive covalently-linked Aptasensor for cocaine detection based on electrolytes-induced repulsion/attraction of colloids.

A quick and easy colorimetric sensor based on gold nanoparticles (GNPs) and aptamers for the detection of cocaine was developed. The sensor was named as 'GAPTA' and showed extremely interesting results regarding cocaine detection with a sensitivity to doses of 0.2 nM. The experimental approach consisted of creating a conjugate between GNPs (10 nm size) and aptamers as a sensing base with the addition of an electrolyte (NaCl) that plays the role of aggregation inducer. In the absence of the aptamer, the electrolyte was able to induce aggregation of the GNPs turning the color of the solution from red to blue while the presence of the aptamer is able to hinder the charges attraction and protects the GNPs from aggregating. The optimization of the aptamer and electrolyte concentration was determined to be 118 nM and 55 mM, respectively, and the resultant GAPTA sensor had a detection limit of 0.97 nM. Furthermore, the selectivity of the platform was tested in the presence of different interferents and showed a specific response towards cocaine while interference ranged between 20 and 40%. The applicability of the GAPTA biosensor was tested on synthetic saliva and demonstrated a sensitivity range between 0.2 and 25 nM. These results suggest the potential of the current colorimetric sensor in abuse drugs screening and creates a stable base for new routine platforms for biomedical and toxicology applications. Graphical abstract.

Factors associated with physicians' assessment and management of child abuse and neglect: A mixed method study.

Physicians are a professional group that is highly likely to encounter abused or at-risk children. The aim of this study is to investigate physicians' experiences with abuse cases, their evaluations of abuse risk factors, and their attitudes toward becoming more educated on the subject. One-hundred-sixty-four family physicians at family health centers and public health centers completed a questionnaire, and a group of residents at a university training and research hospital were interviewed in a semi-structured format. One-fifth of the participants had managed a child abuse case at least once. Nearly half of the participants reported acting alone in diagnosing and managing abuse cases. Sixty-eight percent of these physicians stated they would like to receive training on this subject. Gender and having children did not make a difference as to the abuse-management experience of these medical professionals. Female participants placed more importance on risk factors related to "children with mental disabilities" and "alcohol and substance abuse in parents" than their male counterparts. Difficulties in diagnosis, concerns about handling the abuse cases, the impact of culture, various risk factors, the importance of teamwork and a holistic approach, the need for practical training, and the importance of primary prevention were themes that emerged from this survey. This study provides inferences as to which of the physician competencies should be targeted in undergraduate medical education.

Paper-Based Analytical Methods for Smartphone Sensing with Functional Nanoparticles: Bridges from Smart Surfaces to Global Health.

In this Feature, the most recent developments as well as "pros and cons" in smartphone sensing, which have been developed using various functional nanoparticles in paper-based sensing systems, will be discussed. Additionally, smart phone sensing and POC combination as a potential tool that opens a gate for knowledge flow "from lab scale data to public use" will be evaluated.

Surface Modification with a Catechol-Bearing Polypeptide and Sensing Applications.

A novel catechol-bearing polypeptide (CtP) was synthesized and used as a component of electrochemical biosensor involving both enzymatic activity and affinity-based sensing systems. Glucose oxidase (GOx) and anti-immunoglobulin G (Anti-IgG) were selected as model biorecognition elements for the selective analysis of glucose and IgG. Step-by-step surface modifications were followed using various techniques such as cyclic voltammetry (CV) and electrochemical impedance spectrometry (EIS) as well as X-ray photoelectron spectroscopy (XPS). Additionally, contact angles were measured in order to observe surface properties. Amperometric measurements using the GOx biosensor were performed at -0.7 V by following the oxygen consumption due to the enzymatic reaction in different glucose concentrations. Affinity-based interactions via IgG sensor were monitored using the differential pulse voltammetry (DPV) technique. As the "surface design with CtP" approach employed herein is generally applicable and easily adaptable to obtain functional matrices for biomolecule immobilization, CtP-coated surfaces can be promising platforms for the fabrication of various biobased sensing systems.

TEST-RETEST RELIABILITY OF TETRAX® STATIC POSTUROGRAPHY SYSTEM IN YOUNG ADULTS WITH LOW PHYSICAL ACTIVITY LEVEL.

PURPOSE/BACKGROUND: Assessment of postural sway with force plates can be affected by type of measurement and various clinical parameters such as age and activity level of the individual person. For this reason, variability is detected in postural reactions of healthy subjects without balance impairment. Test-retest reliability of postural sway in adolescent athletes has been measured using a force plate and additional test-retest studies have been suggested for subjects of different age groups with different activity levels. Therefore, the purpose of this research was to assess test-retest reliability of Tetrax® Static Posturography in young adults with low physical activity level, and examine the relationship between posturography results and low activity level. METHODS: Young adults older than 18 years of age were included in the study. Demographic characteristics of the cases were recorded including age, weight, height, body mass index (BMI, kg/m2) and dominant extremity. Number of falls in the previous six months, lower body endurance (sit to stand test) and single-leg eyes closed stance test were recorded. Activity level of participants was determined according to the International Physical Activity Questionnaire (IPAQ). Posturographic evaluation of all volunteers was completed using the Tetrax® Interactive Postural Balance System (Sunlight Medical Ltd, Israel). Fall risk and general stability index (SI) calculated by the Tetrax® were recorded. Following the first test, measurements were repeated 24 to 48 hours later for reliability purposes. RESULTS: Sixty-five subjects (28 male, 37 female; mean age 22.2 ± 1.1 years, mean BMI 22.6 ± 3.3 kg/m(2)) were evaluated. All participants were classified as minimally active according to mean IPAQ score (1042.1 ± 517.7 [231 - 2826] MET- minutes per week). ICC scores between the first and second tests for fall index and total stability index were excellent (ICC2,1=0.858, 0.850, respectively). Fall risk determined by using the Tetrax® device was negatively correlated with lower body endurance (p=0.001, r=-0.446), vigorous activity score (p=0.011, -0.312) and total activity score (p=0.029, r=-0.271), and positively correlated with single leg stance score (p=0.001, r=0.606). There was a weak correlation between fall risk history and the fall risk determined by using Tetrax® device (p=0.04, r=0.255). There were no correlations between fall risk and height, weight, and BMI (p>0.05). CONCLUSIONS: The results demonstrated the high test-retest reliability of Tetrax® interactive balance system in young healthy adults with low physical activity level. Future studies are needed to determine the effectiveness of increasing physical activity level on postural control. LEVEL OF EVIDENCE: III.

Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches.

This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life-satisfaction in patients suffering from primary headache.