Student Stress, Coping, and APPE Readiness at Two Public Institutions before and during the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic significantly impacted pharmacy students' education and well-being. The primary aim of this study was to evaluate the effects of the pandemic on students' perceived stress by comparing third- and fourth-year students from the pre-pandemic Class of 2019 with mid-pandemic Class of 2021 at two public institutions. Secondary aims were to evaluate the pandemic effects on students' academic and professional development skills and practice readiness. The Perceived Stress Scale (PSS) and the Brief Coping Orientation to Problems Experienced (COPE) scale were used to measure student well-being. Students' self-rated problem-solving, time management, and study skills were used to measure their academic and professional development; practice readiness was measured using students' self-rated confidence levels. PSS scores were significantly higher in mid-pandemic than pre-pandemic students, and the Brief COPE avoidant coping subscale differed between pre-pandemic and mid-pandemic students. No differences were found in any academic and professional development skills between the pre- and mid-pandemic students, and there were significant improvements in student confidence levels for practice readiness among the mid-pandemic students. In conclusion, the pandemic appeared to affect students' stress and avoidant coping mechanism but had variable effects on academic and professional development and practice readiness.

Informed Dialysis Modality Selection Among Veterans With Advanced CKD: A Community-Level Needs Assessment.

Rationale & Objective: The Advancing Americans Kidney Health Executive order has directed substantial increases in home dialysis use for incident kidney replacement therapy (KRT). Clinical guidelines recommend patients' self-selection of KRT modality through a shared decision-making process, which, at the minimum, requires predialysis nephrology care and KRT-directed comprehensive prekidney failure patient education (CoPE). The current state of these essential services among Americans with advanced (stages 4 and 5) chronic kidney disease (CKD) and their informed preferences for home dialysis are unknown. Study Design: We conducted a community-based, cross-sectional, observational cohort study across a large regional Veteran Healthcare System from October 1, 2020, to September 30, 2021. Setting & Participants: Of the 928 Veterans with advanced CKD, 287 (30.9%) were invited for needs assessment evaluations. Of the 218 (76% of invited cohort) responding, 178 (81.6%) were receiving nephrology care, with approximately half of those (43.6%) receiving such care from non-Veterans Affairs providers. Outcomes: The study was targeted to assess the prevalent state of ongoing nephrology care and KRT-directed pre-kidney failure education among Veterans with advanced CKD. The secondary outcome included evaluation of dialysis decision-making state among Veterans with advanced CKD. Analytical Approach: Veterans with advanced CKD with 2 sustained estimated glomerular filtration rates <30 mL/min/1.73 m2 were identified through an electronic database query, and a randomly selected cohort was invited for their current state of and outstanding needs for predialysis nephrology care and CoPE, essential for informed KRT selection. Results: Basic awareness of kidney disease was high (92.2%) among Veterans with advanced CKD, although only 38.5% were aware of the severity of their CKD. KRT-directed education during clinical care was reported by 46.8% of Veterans, of which 21.1% reported having received targeted CoPE classes. Three-quarters (74.3%) of Veterans expressed interest in receiving CoPE services. Overall, awareness of CKD and its severity and receipt of KRT-directed education were significantly higher among Veterans with nephrology care than among those without. Of the 61 Veterans providing their KRT preferences, overall decision making was poor, with three-quarters (73.8%) of the cohort unable to choose any KRT modality, irrespective of ongoing nephrology care. Only 8 (13%) felt confident choosing home KRT modalities. Limitations: The study results are primarily applicable to the Veterans with advanced CKD. Furthermore, a limited numbers of respondents provided data on their KRT decision-making state, prohibiting broad generalizations. Conclusions: In a first-of-its-kind community-based needs assessment evaluation among Veterans with advanced CKD, we found that awareness of kidney disease is positively associated with nephrology care; however, the informed KRT selection capabilities are universally poor, irrespective of nephrology care. Our results demonstrate a critical gap between the recommended and prevalent nephrology practices such as KRT-directed education and targeted CoPE classes required for informed patient-centered home dialysis selection in advanced CKD.

The Advancing American Kidney Health Executive Order recommended substantial, potentially unrealistic increases in societal home dialysis use. Unfortunately, we have not examined patient preferences for these targets to guide health care policies. Conducting a community-level needs assessment study among Veterans with advanced kidney disease, we found significant deficits in basic clinical care, namely the specialty nephrology care and dialysis-directed patient education services essential for informed patient-centered dialysis selection. This was expectedly associated with a suboptimal state of dialysis decision making, with about three-quarters of those surveyed being unable to select any dialysis modality. Our results show a critical need for provider and system-level efforts to ensure universal availability of specialty kidney care and targeted education for all patients with advanced chronic kidney disease.

Elucidating Heavy Atom Tunneling Kinetics in the Cope Rearrangement of Semibullvalene.

In this work, we characterize the temperature dependence of kinetic properties in heavy atom tunneling reactions by means of molecular dynamics simulations, including nuclear quantum effects (NQEs) via Path Integral theory. To this end, we consider the prototypical Cope rearrangement of semibullvalene. The reaction was studied in the 25-300K temperature range observing that the inclusion of NQEs modifies the temperature behavior of both free energy barriers and dynamical recrossing factors with respect to classical dynamics. Notably, while in classical simulations the activation free energy shows a very weak temperature dependence, it becomes strongly dependent on temperature when NQEs are included. This temperature behavior shows a transition from a regime where the quantum effects are limited and can mainly be traced back to zero point energy, to a low temperature regime where tunneling plays a dominant role. In this regime, the free energy curve tunnels below the potential energy barrier along the reaction coordinate,  allowing much faster reaction rates. Finally, the temperature dependence of the rate constants obtained from molecular dynamics simulations was compared with available experimental data and with semi-classical transition state theory calculations, showing comparable behaviors and similar transition temperatures from  thermal to (deep) tunneling regime.

Size matters in metabolic scaling: Critical role of the thermodynamic efficiency of ATP synthesis and its dependence on mitochondrial H+ leak across mammalian species.

In this last article of the trilogy, the unified biothermokinetic theory of ATP synthesis developed in the previous two papers is applied to a major problem in comparative physiology, biochemistry, and ecology-that of metabolic scaling as a function of body mass across species. A clear distinction is made between intraspecific and interspecific relationships in energy metabolism, clearing up confusion that had existed from the very beginning since Kleiber first proposed his mouse-to-elephant rule almost a century ago. It is shown that the overall mass exponent of basal/standard metabolic rate in the allometric relationship [Formula: see text] is composed of two parts, one emerging from the relative intraspecific constancy of the slope (b), and the other (b') arising from the interspecific variation of the mass coefficient, a(M) with body size. Quantitative analysis is shown to reveal the hidden underlying relationship followed by the interspecific mass coefficient, a(M)=P0M0.10, and a universal value of P0=3.23 watts, W is derived from empirical data on mammals from mouse to cattle. The above relationship is shown to be understood only within an evolutionary biological context, and provides a physiological explanation for Cope's rule. The analysis also helps in fundamentally understanding how variability and a diversity of scaling exponents arises in allometric relations in biology and ecology. Next, a molecular-level understanding of the scaling of metabolism across mammalian species is shown to be obtained by consideration of the thermodynamic efficiency of ATP synthesis η, taking mitochondrial proton leak as a major determinant of basal metabolic rate in biosystems. An iterative solution is obtained by solving the mathematical equations of the biothermokinetic ATP theory, and the key thermodynamic parameters, e.g. the degree of coupling q, the operative P/O ratio, and the metabolic efficiency of ATP synthesis η are quantitatively evaluated for mammals from rat to cattle. Increases in η (by ∼15%) over a 2000-fold body size range from rat to cattle, primarily arising from an ∼3-fold decrease in the mitochondrial H+ leak rate are quantified by the unified ATP theory. Biochemical and mechanistic consequences for the interpretation of basal metabolism, and the various molecular implications arising are discussed in detail. The results are extended to maximum metabolic rate, and interpreted mathematically as a limiting case of the general ATP theory. The limitations of the analysis are pointed out. In sum, a comprehensive quantitative analysis based on the unified biothermokinetic theory of ATP synthesis is shown to solve a central problem in biology, physiology, and ecology on the scaling of energy metabolism with body size.

An Application of the Stressor-Vulnerability Model of Drinking in College Student Drinkers.

Background: The stressor vulnerability model provides theoretical support for conditions under which drinking to cope (DTC) is likely to occur (i.e., decreased adaptive coping, increased positive alcohol expectancies). However, research has only tested this model in a college sample reporting trauma. Generalizability to a non-trauma-specific sample college drinkers would support applications of the model and inferences about coping-related drinking across a broader group of young adults. Objectives: Our sample included 565 college student drinkers (Mage = 20.3 years; SDage = 2.0 years; 77.0% female; 54.2% White) from a large southeastern university. Mediation analyses examined DTC as a mediator between negative affect and alcohol-related outcomes (i.e., drinking quantity, drinking frequency, binge drinking frequency, and alcohol-related consequences). Moderated mediation models tested the influence of tension reduction expectancies and cognitive reappraisal on mediation pathways. Results: Drinking to cope was found to be a full mediator for associations between negative affect and drinking-related outcomes. For associations between negative affect and alcohol-related consequences, DTC was a partial mediator. For all alcohol outcomes, results indicated the mediation between negative affect and outcomes through DTC is strongest for individuals with greater cognitive reappraisal use. Positive alcohol expectancies did not moderate any indirect effects. Conclusions: Although cognitive reappraisal is typically considered an adaptive emotion regulation technique, our results suggest that this may not always be the case with drinking outcomes. Given our findings, further research is needed to discern the conditions wherein cognitive reappraisal may and may not be adaptive. This could be useful in informing interventions to reduce harmful DTC behaviors.

Computation-guided scaffold exploration of 2E,6E-1,10-trans/cis-eunicellanes.

Eunicellane diterpenoids are a unique family of natural products containing a foundational 6/10-bicyclic framework and can be divided into two main classes, cis and trans, based on the configurations of their ring fusion at C1 and C10. Previous studies on two bacterial diterpene synthases, Bnd4 and AlbS, revealed that these enzymes form cis- and trans-eunicellane skeletons, respectively. Although the structures of these diterpenes only differed in their configuration at a single position, C1, they displayed distinct chemical and thermal reactivities. Here, we used a combination of quantum chemical calculations and chemical transformations to probe their intrinsic properties, which result in protonation-initiated cyclization, Cope rearrangement, and atropisomerism. Finally, we exploited the reactivity of the trans-eunicellane skeleton to generate a series of 6/6/6 gersemiane-type diterpenes via electrophilic cyclization.

Alcohol-related Consequences: Factor Structure and Associations With Trait Mindfulness and Drinking Motivations.

BACKGROUND: This study aimed to determine if motivations to use alcohol (coping and social motivations) mediate the relationship between trait mindfulness and a variety of alcohol-related consequences and to determine if the relationship between motivations to use alcohol and alcohol-related consequences is moderated by alcohol use. We determined the factor structure of positive and negative consequences of alcohol use and used this structure as outcomes across eight moderated mediation models. METHODS: Data were obtained from 296 undergraduate students to confirm the alcohol-related consequences factor structure and to test eight moderated-mediation models. RESULTS: Four alcohol-related consequences scales (romantic/sexual, positive, mild negative, and severe negative consequences) were confirmed. The motive of drinking to cope significantly mediated the relationship between trait mindfulness and all four of the alcohol-related consequences scales. Drinking to socialize did not significantly mediate the relationship between trait mindfulness and all of the alcohol-related consequences scales. CONCLUSIONS: The identified four-factor structure suggests that alcohol-related consequences should be assessed in a more specific manner. Additionally, different motivations for alcohol use relate differentially to trait mindfulness and different alcohol-related consequences; drinking to cope is particularly problematic for this population. Future research on the usefulness of promoting mindfulness to reduce problematic drinking appears warranted.

Assessment of the impact of COVID-19 and political instability on mental health of university students in Sudan.

Background: The mental health of students plays a crucial role in their learning and performance. The COVID-19 pandemic, the political turmoil and a coup in Sudan has exacerbated stress and anxiety among university students in Sudan due to uncertainty about their academic activities. Aim: To assess post-traumatic stress disorder (PTSD) occurrence and coping strategies adopted by university students in Sudan. Methods: This cross-sectional survey was conducted from March to June 2022. It used the Coping Orientation to Problems Experienced (Brief-COPE) and Impact of Event Scale-Revised (IES-R) questionnaires to assess the occurrence of PTSD and coping strategies among 596 university students in Sudan. Descriptive statistics were used to determine the frequency and percentage, Student's t test was used to compare the means of 2 groups and one-way analysis of variance to compare the means of ≥ 3 groups. Results: There was a high prevalence of PTSD among the students, with a score of 31.2 (SD 16.4). The total score of PTSD was higher among female students. Around 36% of the students had a PTSD score > 37, which is considered high enough to suppress immune function. The most widely adopted coping strategies were religion and acceptance of the situation, while substance use was the least. Students who had COVID-19 infection during the pandemic differed significantly from uninfected students in the application of coping strategies. In contrast, students whose family members or friends had COVID-19 were not significantly different from students with uninfected family members or friends in the application of the coping strategies, such as self-blame, denial, substance use, and behavioural disengagement. Conclusion: We recommend the initiation and implementation of psychological counselling programmes for university students in Sudan onsite or remotely. Further research should be carried out to assess the long-term effects of the pandemic and the political conflicts so as to design and implement appropriate and efficient interventions.

Gold-Catalyzed Arylative Cope Rearrangement.

Cope rearrangements have garnered significant attention owing to their ability to undergo structural reorganization in stereoselective manner. While substantial advances have been achieved over decades, these rearrangements remained applicable exclusively to parent 1,5-hexadienes. Herein, we disclose the gold-catalyzed arylative Cope rearrangement of 1,6-heptadienes via a cyclization-induced [3,3]-rearrangement employing ligand-enabled gold redox catalysis. Detailed mechanistic investigations including several control experiments, cross-over experiment, HRMS analysis, 31P NMR and DFT studies have been performed to underpin the mechanism.

Associations of coping and health-related behaviors with medical students' well-being and performance during objective structured clinical examination.

Objective structured clinical examination (OSCE) is a valid method to evaluate medical students' competencies. The present cross-sectional study aimed at determining how students' coping and health-related behaviors are associated with their psychological well-being and performance on the day of the OSCE. Fourth-year medical students answered a set of standardized questionnaires assessing their coping (BCI) and health-related behaviors before the examination (sleep PSQI, physical activity GPAQ). Immediately before the OSCE, they reported their level of instant psychological well-being on multi-dimensional visual analogue scales. OSCE performance was assessed by examiners blinded to the study. Associations were explored using multivariable linear regression models. A total of 482 students were included. Instant psychological well-being was positively associated with the level of positive thinking and of physical activity. It was negatively associated with the level of avoidance and of sleep disturbance. Furthermore, performance was negatively associated with the level of avoidance. Positive thinking, good sleep quality, and higher level of physical activity were all associated with improved well-being before the OSCE. Conversely, avoidance coping behaviors seem to be detrimental to both well-being and OSCE performance. The recommendation is to pay special attention to students who engage in avoidance and to consider implementing stress management programs.Clinical trial: The study protocol was registered on clinicaltrial.gov NCT05393206, date of registration: 11 June 2022.

Approach to the Core Structure of Signermycin B.

Among the natural tetramic acids with a decalinoyl part, signermycin B is unique because it contains a cis-decalin. In this paper, we demonstrate that the cis-decalin section of signermycin B can be accessed by an anionic oxy-Cope rearrangement. The substrate, a tricyclic dienol was prepared by an intramolecular Diels-Alder reaction of a masked ortho-benzoquinone, generated by oxidation of an α-methoxyphenol in presence of cis-2-hexenol. After a superfluous bromine on the cycloadduct was removed, reaction of the tricyclic ketone with isopropenylmagnesium bromide led to the tricyclic trienol that underwent the oxy-Cope rearrangement to a cis-decalinone. While we could show, that introduction of the 4-ethyl substituent (signermycin B numbering) is possible by enolate alkylation, the 4-epi-isomer was formed.

Gender-responsive Classification of Women in Prison: A Typology Based on Mental Health Symptoms and Coping Strategies.

Despite the increase in the incarceration rates of women, most correctional practices are still normed on male samples, including prison classification. Moreover, those classifications do not take into account women's particular experiences, needs, and unique pathways to criminality. The current research proposes a typology based on female prisoners' mental health symptoms and coping strategies. The data was derived from a survey conducted with 194 women housed in a Northeastern prison. A two-step clustering analysis was used to obtain three classification types-each with different symptomatology, coping mechanisms, demographic, and background characteristics. The results suggest that identifying and relying on needs-based typologies has important correctional policy implications in terms of the management and the treatment of incarcerated women.

Shame, guilt, and drinking motives as mediators between child maltreatment and problematic alcohol use in college students.

Objective: Drinking for emotion regulation may be a concern for college students who have experienced childhood maltreatment, due to high levels of shame and guilt. The present cross-sectional survey study tested how trait shame-proneness, trait guilt-proneness, and trauma-related guilt are differently related to drinking motives and how these pathways mediate the links between maltreatment severity and alcohol outcomes. Participants: Undergraduate student drinkers (n = 464; M age = 19.50, SD = 2.20) from a midsized midwestern University. Methods: Participants completed an online survey inquiring about demographics, childhood maltreatment, shame, guilt, drinking motives, alcohol use, and alcohol-related consequences. Results: There were several significant serial indirect effects of maltreatment on alcohol consumption and related consequences, through trauma-related guilt, shame-proneness, guilt-proneness, drinking-to-cope, and drinking for mood enhancement. Conclusions: On college campuses, to address problematic drinking among childhood maltreatment survivors, interventions may target maladaptive feelings of shame and guilt stemming from trauma exposure.

Turkish validity and reliability of the Premenstrual Change Coping Inventory.

OBJECTIVE: This study was conducted to investigate the validity and reliability of the Turkish version of the Premenstrual Change Coping Inventory (PMS-Cope). METHODS: A total of 170 women who met the inclusion criteria were included in the methodological study. Data were collected between the dates of November 5, 2018 and May 5, 2019 with personal information form, PMS-Cope Turkish version, and Premenstrual Syndrome Scale. RESULTS: The PMS-Cope was obtained through the translation-back translation method and the content validity was obtained according to expert opinions. After the factor analysis, the Turkish version of the PMS-Cope consisted of three sub-dimensions as in the original scale. The factor loadings of the three-dimensional scale ranged from 0.46 to 0.84, and the explained variance (60.329%) was at the desired level. As a result of structural equation modeling; ×2/SD values of the scale were found to be 4.19, GFI 0.93, AGFI 0.91, CFI 0.95, RMSEA 0.079, and SRMR 0.082, and this scale was acceptable. The Cronbach alpha coefficient of the PMS-Cope was 0.86. It was determined that item-total score correlations were higher than 0.30 in all items of PMS-Cope and there was no need to remove items from the scale. When the mean scores of the lower 27% and upper 27% of the scale were compared, a statistically significant difference was found between the groups (p < 0.05). The PMS-Cope score was 41.04 ± 8.99. CONCLUSION: It was determined that the Turkish version of the PMS-Cope was a valid and reliable measurement tool.

The Moderating Role of Stress Mindset on the Relationship between Drinking to Cope and Alcohol Consumption among Undergraduate College Student Drinkers.

OBJECTIVE: Previous research suggests drinking alcohol to cope with negative affect, including stress, is a risk for increased alcohol consumption and alcohol-related problems. Stress mindset, the individually held belief that stress can lead to either enhancing or debilitating outcomes, has yet to be studied within the context of alcohol use. Studying stress mindset among college students as it relates to alcohol consumption may provide important insight into heavy alcohol use in this population. METHOD: A sample of 320 undergraduates (Mage = 19.06 (SD = 0.06); 63.44% female; 65.49% White) who endorsed past-year alcohol use completed self-report measures of drinking motives, stress mindset, alcohol consumption, and alcohol-related consequences. Zero-inflated negative binomial regressions were utilized to examine the moderating effect of stress mindset on the relationship between drinking to cope and alcohol consumption. RESULTS: Stress mindset significantly moderated the relationship between drinking to cope and alcohol consumption (IRR = 0.98, se = 0.01, p < 0.05, CI = 0.96, 1.00), such that the relationship was stronger among those with a debilitating stress mindset compared to those with an enhancing stress mindset. Stress mindset did not significantly moderate the relationship between drinking to cope and alcohol-related consequences. CONCLUSIONS: Individuals with high drinking to cope scores and who hold a debilitating stress mindset may be at a particular vulnerability for heavy alcohol consumption. The present study furthers our understanding of predictors of alcohol use in a college sample and suggests the importance of future research focused on stress mindset among college student drinkers.

A latent profile analysis of social anxiety, depression, and pregaming motives among heavy-drinking college students.

BACKGROUND: Pregaming is a high-risk drinking behavior that is associated with heavy drinking and negative alcohol-related consequences. College students may engage in pregaming for several reasons, including to enhance social experiences or cope with negative affect. Research shows that associations between drinking, social anxiety, and depression are multifaceted. However, our understanding of the complex associations of mental health symptoms with pregaming motives and behaviors remains limited. METHODS: This study examined heterogeneity in how pregaming motives, social anxiety, and depression associate with past 30-day pregaming variables (quantity, frequency, and negative consequences). We used latent profile analysis (LPA) in a sample of heavy-drinking university students (N = 479). RESULTS: LPA results indicated four profiles: mild/moderate social anxiety and depression symptoms, moderate motives (n = 285), minimal social anxiety and depression symptoms, low motives (n = 61), subclinical/elevated social anxiety and depression symptoms, high motives (n = 75), and clinically elevated social anxiety and depression symptoms, moderate motives (n = 58). The subclinical/elevated symptoms, high motives profile reported the highest pregaming frequency and consequences, including blackouts. Individuals in the clinically elevated symptoms, moderate motives profile reported more consequences than those in the minimal symptoms, low motives and mild/moderate symptoms, moderate motives profiles. Individuals in the minimal symptoms, low motives profile reported the fewest consequences. CONCLUSIONS: Among these students, social anxiety and pregaming motives were associated with more frequent pregaming and social anxiety and depression were associated with greater negative consequences. Interventions that target pregaming-specific motives among students with mental health symptoms may be warranted to reduce this risky behavior and associated drinking-related harm.

Pilot Evaluation of a Remote Psychotherapy Service for Students Who Self-Harm: University-Community Outpatient Psychotherapy Engagement (U-COPE).

Self-harm is becoming increasingly common in student populations. Brief psychological therapies might be helpful for those who have recently self-harmed. The current paper reports on an evaluation of a brief psychotherapy service delivered via remote means, namely University-Community Outpatient Psychotherapy Engagement (U-COPE). The service combines elements of psychodynamic interpersonal and cognitive analytic therapy to help students who present with self-harm related difficulties. The primary aim was to understand students' and practitioners' experiences of a remote psychotherapy service. Semi-structured interviews were conducted with a total of nine participants (seven students and two practitioners). Interview data were analysed using thematic analysis. Analyses of the interviews across the stakeholders revealed three overarching themes: 'Accessibility'; 'Therapeutic experiences'; and 'Spaces and places of therapy'. Students appreciated the rapid access to intervention, especially as student services are typically characterised by long waiting lists. Despite the brief nature of the intervention, many students reported feeling a sense of control over the direction and pace of the therapeutic sessions, which is an important consideration for those who self-harm. The findings suggest that U-COPE may be helpful to students with difficulties related to self-harm. Further investigation of this brief intervention is warranted in order to ascertain whether U-COPE has a long-term impact on difficulties and distress-related behaviours.

Effect of a supportive-educational program, based on COPE model, on quality of life and caregiver burden of family caregivers of heart failure patients: a randomized clinical trial study.

BACKGROUND: Heart failure (HF) is one of the most common and spreading diseases worldwide. As HF symptoms progress, it is affected the quality of life and the caregiver burden of the family. The present study aimed to determine the effectiveness of the supportive-educational program, based on the COPE (creativity, optimism, planning and expert advice) care model, on the quality of life and caregiver burden of family caregivers of HF patients. METHOD: This clinical trial was conducted on 90 caregivers of HF patients admitted to Isfahan in 2021. The samples were divided into experimental (n = 45 people) and control (n = 45 people) groups based on random allocation (card method). The experimental group received problem-solving skills based on the four components of the COPE model in six sessions during one month. to collect data, the 36-Item Short Form Survey (SF-36) and the Zarit Burden Interview (ZBI) were used in two groups before, after and three months after the intervention. RESULTS: There was a significant difference between the experimental and control groups regarding gender, but This confounding factor had no significant effect on the two components of quality of life and caregiver burden. There was a significant difference between the two groups in terms of the mean score of quality of life immediately(75.99),and three months after the intervention (78.78) (P < 0.05) and the mean score of care burden, immediately (16.60) and three months after the intervention (12.73) (P < 0.05). CONCLUSIONS: One of the important duties of nurses is to implement educational-supportive programs for patients after the discharge of patients, These programs are family-oriented remotely for their caregivers. TRIAL REGISTRATION: This study was registered by the Iranian Registry of Clinical Trials with decree code: IRCT20211128053202N1on 2022-02-20.

Stress and alcohol-related coping mechanisms linking lifetime suicide ideation and attempt to multidimensional quality of life.

BACKGROUND: Suicide ideation and attempt are linked to adverse mental health outcomes, but few studies have examined their associations with quality of life (QoL). This study examined the impact of lifetime history of suicidal ideation and attempt on four QoL domains via perceived stress and problematic drinking. METHODS: Participants were drawn from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol (N = 1055), including those with no history of suicidality (78.6 %), suicidal ideation only (15.3 %), and a history of suicide attempt (6.2 %). Structural equation modeling (SEM) was utilized to test perceived stress and drinking as mediational pathways to multidimensional QoL. RESULTS: Individuals with a history of suicide ideation and/or attempt reported higher perceived stress in the past month, more problematic drinking in the past year, and lower QoL domains in the past two weeks. SEM showed significant mediation effects through dimensions of perceived stress (helplessness, lack of self-efficacy) and alcohol problems. When these mediators were considered simultaneously, the mediation effects through alcohol problems were attenuated, while several direct effects of suicidality on physical, psychological, and social QoL were weakened but remained significant. LIMITATIONS: Cross-sectional data with retrospective report of suicidality history. CONCLUSIONS: A lifetime history of suicidality was associated with lower multidimensional QoL. These associations were partially explained by stress and alcohol-related coping mechanisms such as feeling helpless or inadequate when encountering stressors and problematic drinking. Perceived stress and drinking to cope may be important intervention targets to improve QoL among those with a history of suicidality.

Wine-Mom Culture, Alcohol Use, and Drinking Motives: A Descriptive Study and Cross-Cultural Exploration of American and British Mothers.

Objective: "Wine-mom" culture, which promotes the idea that women should use alcohol to cope with the stressors of parenting, is pervasive in modern society, yet remains an under-researched variable in the context of women's alcohol use. The present investigation was a descriptive study and cross-cultural exploration (United States vs. United Kingdom) of the association between wine-mom culture (perceptions of wine-mom culture and related behaviors) and various alcohol-related outcomes, parenting experiences, and drinking motives. Methods: This study included 233 American and 233 British mothers recruited through Prolific. Participants completed the study questions/questionnaires in Qualtrics; they completed nine items measuring their perceptions of and engagement with wine-mom culture, the Alcohol Use Disorders Identification Test, the Parental Stress Scale, and the Drinking Motives Questionnaire-Revised, along with questions about their alcohol use and parenting experiences. Results: Our results indicated that although American mothers were more familiar with wine-mom culture than British mothers, the correlations observed were similar for both groups. Some of the wine-mom culture variables were associated with problematic alcohol use and parenting stress. Additionally, wine-mom culture-related behaviors had moderate to strong positive correlations with drinking to cope motives. Conclusion: Our findings suggest that future research should examine the role of wine-mom culture in the perception that alcohol can-or should-be used as a form of self-medication. Other future directions and considerations for this area of study are discussed.