Neuroticism and cognitive correlates of depression and anxiety in endometriosis: A meta-analytic review, evidence appraisal, and future recommendations.

OBJECTIVE: This meta-analytic review aimed to synthesise evidence on personality and cognitive factors related to depression and anxiety in endometriosis and determine whether sociodemographic and clinical variables moderate factor-symptom relations. Additionally, this review aimed to evaluate the quality of research and formulate recommendations for future research. METHODS: A systematic search was conducted across databases (Medline, Embase, PsycInfo, Web of Science, ProQuest) through to February 2024. Search terms were used for endometriosis, depression, anxiety, cognitive factors and personality traits. Random-effects meta-analyses were conducted to produce pooled weighted effects (r) for factor-symptom relationships. RESULTS: Thirteen studies (11 samples; N = 3287; Mage 33.89 ± 2.48) were included in a narrative synthesis. One study provided evidence for a positive association between neuroticism and depression. Seven studies contributed to meta-analyses on three cognitive factors. Medium-to-large associations were identified between illness perceptions of low control/power (r = 0.35, 95 % CI: 0.01,0.62), rumination (r = 0.52, 95 % CI: 0.09, 0.78), pain-catastrophising (r = 0.37, 95 % CI: 0.28, 0.45) and higher levels of depression. The statistical power to detect significant effects was >80 %. Findings for anxiety were non-significant, although limited data were available. Quality appraisal revealed a high risk of within-study bias (4.69 ± 1.38, range: 3-7), with issues related to sample representativeness and measurement selection. CONCLUSION: Rumination, pain-catastrophising, and illness perceptions of low control/power are important in understanding depression in endometriosis. There is a lack of research on personality traits, necessitating further study. Findings highlight the importance of prioritising modifiable cognitive factors in psychological research and clinical practice in endometriosis.

Cognitive factors and actual usage of Fintech innovation: Exploring the UTAUT framework for digital banking.

Digital services and innovative solutions often emphasize providing an enhanced Fintech banking experience. This study identifies and examines the cognitive factors influencing the actual usage of Fintech-based digital banking among customers. The Unified Theory of Acceptance and Use of Technology (UTAUT) framework is applied taking behavioral intentions as the mediator of the study. By following purposive sampling, data was collected through a self-administrative survey and analysis made via Structural Equation Modeling (SEM). Findings demonstrate that performance expectancy, facilitating conditions, risk, and trust are significant predictors of digital banking usage. Furthermore, behavioral intentions fully mediate the relationship between these predictors and actual usage. This research holds several practical implications. The identified predictors, can enable providers to enhance their offerings and meet customer expectations, and recognition of behavioral intentions being a mediator highlights the importance of understanding customers' intentions and motivations to encourage favorable usage behavior; financial institutions can better promote the adoption and sustained usage of digital banking services. The originality of this research lies in examining the cognitive factors affecting the actual usage of fintech-based digital banking. This unique approach provides valuable insights into the underlying mechanisms driving customers' usage of digital banking services.

An explanatory study of factors influencing engagement in AI education at the K-12 Level: an extension of the classic TAM model.

Artificial intelligence (AI) holds immense promise for K-12 education, yet understanding the factors influencing students' engagement with AI courses remains a challenge. This study addresses this gap by extending the technology acceptance model (TAM) to incorporate cognitive factors such as AI intrinsic motivation (AIIM), AI readiness (AIRD), AI confidence (AICF), and AI anxiety (AIAX), alongside human-computer interaction (HCI) elements like user interface (UI), content (C), and learner-interface interactivity (LINT) in the context of using generative AI (GenAI) tools. By including these factors, an expanded model is presented to capture the complexity of student engagement with AI education. To validate the model, 210 Chinese students spanning grades K7 to K9 participated in a 1 month artificial intelligence course. Survey data and structural equation modeling reveal significant relationships between cognitive and HCI factors and perceived usefulness (PU) and ease of use (PEOU). Specifically, AIIM, AIRD, AICF, UI, C, and LINT positively influence PU and PEOU, while AIAX negatively affects both. Furthermore, PU and PEOU significantly predict students' attitudes toward AI curriculum learning. These findings underscore the importance of considering cognitive and HCI factors in the design and implementation of AI education initiatives. By providing a theoretical foundation and practical insights, this study informs curriculum development and aids educational institutions and businesses in evaluating and optimizing AI4K12 curriculum design and implementation strategies.

Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model.

Background: Diet and physical activity (PA) are pivotal behaviors for managing energy balance post-bariatric surgery. Given the need for dual behavioral management, understanding the interplay of cognitive factors influencing these behaviors is crucial. This study applied the compensatory carry-over action model (CCAM) to explore the impact of cognitive factors on behaviors and their subsequent effects on subjective health outcomes. Methods: This cross-sectional study was conducted among patients at the third month after bariatric surgery in China. Data on diet and PA status, behavioral cognitive factors (intention, self-efficacy, compensatory belief, transfer cognition), and subjective health outcomes (perceived stress, well-being, quality of life) were collected. Structural equation model (SEM) was employed to test hypotheses in CCAM and assess mediation relationships. Results: Analysis of data from 239 patients revealed the following: (1) Among antecedent cognitive factors, only compensatory belief significantly influenced diet (P<0.001). (2) Intention and self-efficacy directly correlated with their respective behaviors, while compensatory belief affected intention, and transfer cognition impacted self-efficacy (P<0.05), aligning with CCAM hypotheses. (3) PA demonstrated significant influence only on perceived stress (P=0.004), whereas diet significantly affected all subjective health outcomes (P<0.05). (4) Mediation analysis indicated intention partially mediated the relationship between compensatory belief and diet and fully mediated the relationship between compensatory belief and PA. Self-efficacy completely mediated the relationship between transfer cognition and diet and PA. Conclusion: Transfer cognition's carry-over effect did not directly influence behaviors among antecedent cognitions. Interventions should primarily target improving diet by mitigating compensatory belief. Moreover, diet exhibited a more pronounced impact on overall health compared to PA. Consequently, prioritizing dietary intervention over PA intervention is warranted based on the analysis of CCAM and the aim of promoting joint behaviors post-bariatric surgery.

Behavioral and cognitive factors influencing tick-borne disease risk in northeast China: Implications for prevention and control strategies.

The growth in ecotourism and nature-based recreational activities in China has resulted in an increased frequency of visits to green spaces, thereby elevating exposure to ticks and the subsequent risk of tick-borne diseases. This study comprehensively investigate individual behavioral and cognitive factors associated with the risk of contracting tick-borne diseases to facilitate the development of effective prevention and control strategies, supporting public health initiatives in high-prevalence regions. We conducted an extensive questionnaire survey among 3000 residents from three northeastern provinces in China (Heilongjiang, Jilin, and Liaoning), where tick-borne diseases exhibit relatively high prevalence. The survey focused on gathering information regarding participants' tick bite history, perception of tick-borne disease risks, and outdoor activity patterns. Using structural equations analysis, we explored the pathways and strengths of the associations between these factors. Our findings revealed an average self-reported tick bite rate of 14% among the participants. Notably, tick-borne encephalitis exhibited the highest self-reported prevalence of infection (4%) among tick-borne diseases, while both Lyme disease and Severe fever with thrombocytopenia syndrome had a prevalence of 2%. The average rate of tick bites among respondents' pets was 14%, with bites predominantly located on the ears, back, and abdomen. The strongest correlation was observed between tick bite rate and subsequent infections, emphasizing its role as the primary contributing factors to infectious status. Moreover, our results indicated that the causal structure of tick-borne disease infections varied across different cities, underscoring the significance of considering the ecological environment and regional knowledge on ticks. This study provides valuable insights into the current landscape of tick-borne disease infections in northeast China and identifies potential behavioral and cognitive factors, an aspect that has not been previously investigated. Our findings enable predictions on the future impact of knowledge dissemination efforts and improved urban facilities on mitigating tick bites and reducing tick-borne disease infections.

Validating the effectiveness of a self-report tool to predict unsafe behavior of industrial workers: a QEEG analysis.

Objectives. Unsafe behavior (UB) is defined as the likelihood of intentionally or unintentionally deviating from pre-defined plans. This study aims to investigate the validation of a self-report tool for measuring workers' cognitive-based UB using quantitative electroencephalography (QEEG). Methods. The cognitive-based unsafe behavior questionnaire (CUBQ) was completed by 632 front-line workers in a manufacturing industry to identify differences in the backgrounds of the subjects regarding UBs. Two groups were then selected as extreme groups and QEEG was conducted based on the international 10-20 electrode placement. Results. The mean values of absolute power (AP), alpha/beta ratio (ABR) and alpha/gamma ratio (AGR) from brain oscillations in different regions of the cortex were significantly different between the studied groups (p < 0.05). Additionally, these values were found to be significantly correlated with slips, lapses and mistakes, as measured by certain scales of the CUBQ (p < 0.05). Conclusions. The findings of this study indicated differences in brain oscillation activities among industrial workers with different UB backgrounds. These results confirm the effectiveness of CUBQ as a proactive tool for safety practitioners to predict industrial workers' UBs.

Pupillary Responses Reflect Dynamic Changes in Multiple Cognitive Factors During Associative Learning in Primates.

Associative learning involves complex interactions of multiple cognitive factors. While adult subjects can articulate these factors verbally, for model animals such as macaques, we rely on behavioral outputs. In our study, we used pupillary responses as an alternative measure to capture these underlying cognitive changes. We recorded the dynamic changes in the pupils of three male macaques when they learned the associations between visual stimuli and reward sizes under the classical Pavlovian experimental paradigm. We found that during the long-term learning process, the gradual changes in the pupillary response reflect the changes in the cognitive state of the animals. The pupillary response can be explained by a linear combination of components corresponding to multiple cognitive factors. These components reflect the impact of visual stimuli on the pupils, the prediction of reward values associated with the visual stimuli, and the macaques' understanding of the current experimental reward rules. The changing patterns of these factors during interday and intraday learning clearly demonstrate the enhancement of current reward-stimulus association and the weakening of previous reward-stimulus association. Our study shows that the dynamic response of pupils can serve as an objective indicator to characterize the psychological changes of animals, understand their learning process, and provide important tools for exploring animal behavior during the learning process.

Cognitive and psychological characteristics in patients with Cerebral Amyloid Angiopathy: a literature review.

AIM: To review the current data on cognitive and psychological characteristics of patients with CAA and on the instruments used for their evaluation. METHODS: A systematic search was performed in Embase, Scopus and PubMed with terms related to "cerebral amyloid angiopathy", "neuropsychological measures" and "patient-reported outcome measures" from January 2001 to December 2021. RESULTS: Out of 2851 records, 18 articles were selected. The cognitive evaluation was present in all of which, while the psychological one only in five articles. The MMSE (Mini Mental State Examination), TMT (Trail Making Test), fluency test, verbal learning test, digit span, digit symbol and Rey figure tests were the most used cognitive tests, while executive function, memory, processing speed, visuospatial function, attention and language were the most frequent impaired cognitive functions. Depression was the most considered psychological factor usually measured with BDI (Beck Depression Inventory) and GDS (Geriatric Depression Scale). CONCLUSIONS: The results of this study might be used in clinical practice as a guide to choose cognitive and psychological instruments and integrate them in the clinical evaluation. The results might also be used in the research field for studies investigating the impact of cognitive and psychological variables on the disease course and for consensus studies aimed at define a standardized evaluation of these aspects.

Effects of sleep quality on pain, cognitive factors, central sensitization, and quality of life in patients with chronic low back pain.

BACKGROUND: Sleep quality in patients with chronic low back pain (CLBP) may affect quality of life (QoL), possibly due to worsening pain, central sensitization (CS), and cognitive factors. However, causal relationship among the factors has not been confirmed yet. OBJECTIVE: The purpose of this study was to test the hypothesis that sleep quality in patients with CLBP is attributable to pain, cognitive factors, and CS, and influences QoL, by structural covariance analysis. METHODS: This is a cross-sectional study. Participants were recruited from six health care facilities and 101 patients with CLBP were included. Structural covariance analysis assessed the fit of data to the model using goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and mean squared approximation error (RMSEA). RESULTS: The structural covariance analysis showed that the goodness-of-fit indices were high (GFI = 0.993, AGFI = 0.964, CFI = 1.00, RMSEA < 0.01). Sleep quality was not directly influenced by QoL but rather by CS and cognitive factors. CONCLUSION: This study suggests that sleep quality in patients with CLBP is indirectly mediated through multiple pathways, including cognitive factors and CS, which may influence QoL.

The intention to get COVID-19 booster vaccination and its association with cognitive and emotional factors: A survey of Chinese COVID-19 infected people in Hong Kong.

BACKGROUND: Although the pandemic has ended officially, COVID-19 remains impactful. Booster COVID-19 vaccination is still needed to protect individuals against COVID-19 and the disease's harmful consequences. This study investigated the prevalence of the intention to get booster COVID-19 vaccination after receiving the COVID-19 diagnosis and its associated factors among people reporting prior COVID-19. METHODS: A population-based anonymous telephone survey was conducted in Hong Kong, China from June to August 2022 among Chinese people reporting prior COVID-1 between February and August 2022 and having taken up ≥2 doses of COVID-19 vaccines prior to COVID-19 diagnosis. RESULTS: The prevalence of the intention to get booster vaccination was 59.2 %. Older age (>60 years), being currently married, not employed full-time, and having chronic diseases were positively associated with the intention to get booster vaccination. Adjusted for the background factors, higher levels of the cognitive factors of perceived susceptibility to COVID-19, perceived acquired moderate-to-strong immunity against COVID-19, and perceived adequate knowledge of COVID-19 were positively associated with the intention to get booster vaccination; stronger perceived severity of prior infection despite vaccination was negatively associated with the intention outcome. In contrast, stronger mental distress due to COVID-19, illness concern, and emotional representation were positively associated with the intention. Self-perceived long COVID status was not a significant factor. DISCUSSION: The prevalence of the intention to get booster COVID-19 vaccination was limited, especially among younger people reporting prior COVID-19. Health promotion is still required among people reporting prior COVID-19 and may emphasize the significant cognitive factors positively associated with the intention. Future studies are needed to confirm the findings, clarify the role of emotional factors on booster vaccination, and explore other factors of the intention to get booster vaccination among people reporting prior COVID-19.

Logistic and cognitive-emotional barriers experienced by first responders when alarmed to get dispatched to out-of-hospital cardiac arrest events: a region-wide survey.

Out-of-hospital cardiac arrest (OHCA) is a major public health concern with low survival rates. First responders (FRs) and public access defibrillation (PAD) programs can significantly improve survival, although barriers to response activation persist. The Emilia Romagna region in Italy has introduced a new system, the DAE RespondER App, to improve the efficiency of FR dispatch in response to OHCA. The study aimed to evaluate the association between different logistic factors, FRs' perceptions, and their decision to accept or decline dispatch to an OHCA scene using the DAE RespondER App. A cross-sectional web survey was conducted, querying 14,518 registered FRs using the DAE RespondER app in Emilia Romagna. The survey explored logistic and cognitive-emotional perceptions towards barriers in responding to OHCAs. Statistical analysis was conducted, with responses adjusted using non-response weights. 4,644 responses were obtained (32.0% response rate). Among these, 1,824 (39.3%) had received at least one dispatch request in the past year. Multivariable logistic regression showed that being male, having previous experience with OHCA situations, and having an automated external defibrillator (AED) available at the moment of the call were associated with a higher probability of accepting the dispatch. Regarding FRs' perceptions, logistic obstacles were associated with mission rejection, while higher scores in cognitive-emotional obstacles were associated with acceptance. The study suggests that both logistical and cognitive-emotional factors are associated with FRs' decision to accept a dispatch. Addressing these barriers and further refining the DAE RespondER App can enhance the effectiveness of PAD programs, potentially improving survival rates for OHCA. The insights from this study can guide the development of interventions to improve FR participation and enhance overall OHCA response systems.

Correlates of Bullying Behavior Among Children and Adolescents in Physical Education: A Systematic Review.

Background and Objective: Bullying is notably prevalent among children and adolescents, especially within the context of physical education (PE) environments. Understanding the underlying factors that trigger bullying behavior is essential in designing strategies to prevent bullying and formulating more effective interventions in PE. There is a lack of integrated findings regarding the wide range of correlates of bullying behavior among children and adolescents within the PE context. Therefore, this systematic review aimed to synthesize the correlates of bullying behavior among children and adolescents within the context of PE. Methods: We conducted a systematic search across four databases (EBSCOhost, PubMed, Scopus, Web of Science) for relevant studies published before August 2023. Two reviewers independently examined the articles, assessed their methodological quality, and performed data extraction. Results: A total of 23 articles met the inclusion criteria. It is found that demographic, physical movement, physical appearance, psycho-cognitive, teacher-related, and contextual factors emerged as six prominent influential factors affecting adolescent bullying behavior. Specifically, demographic factors mainly encompassed age and gender; physical movement factors primarily include physical activity, sedentary behavior, physical exercise, and sports competence; physical appearance factors primarily include being overweight, too thin, too tall, or too short; psycho-cognitive factors chiefly involved cognitive empathy, motivation, enjoyment of physical activity; teacher-related factors primarily comprised activity choices, teachers competence, controlling style, autonomy support; and contextual factors primarily cover desolate climate, perceived caring climate, strong sense of competition and winning setting. Conclusion: The results indicate that bullying is a complex and multifaced behavior primarily determined by demographic, physical movement, physical appearance, psycho-cognitive, teacher-related, and contextual factors. Future studies need to enhance the diversity of research samples and comparative studies on the factors influencing bullying behavior among children and adolescents in different countries. Additionally, a more extensive range of intervention studies addressing bullying behavior among children and adolescents is warranted.

The relationship between chronic lung disease diagnosis and the susceptibility to e-cigarette use in adults: The mediation effects of psychosocial, cognitive influences, and the moderation effect of physiological factors.

INTRODUCTION: There is a paucity of studies on e-cigarette use among adults with chronic lung disease. In the present study, we aimed to assess whether psychosocial or cognitive factors elucidate the relationship between chronic lung disease (CLD) and susceptibility to e-cigarette use and whether the relationship between CLD and e-cigarette use is conditional on the presence of respiratory symptoms. METHODS: We recruited adults aged ≥18 years in Alabama with CLD from university medical clinics (n=140) and individuals without CLD (n=123 as a reference group). Information on sociodemographics, susceptibility to e-cigarette use, psychosocial factors, and cognitive factors were collected. Mediation analysis was used to assess whether the psychosocial factors or cognitive factors explained the association between CLD and susceptibility to using e-cigarettes, and moderation analysis was conducted to determine if respiratory factors would change the association between CLD and susceptibility to e-cigarette use. RESULTS: Psychosocial factors (stress, depression, anxiety) and e-cigarette positive expectancy were notably high among individuals with CLD. Having CLD was associated with a lower likelihood of susceptibility to e-cigarette use. Higher levels of stress, being a smoker, boredom, taste/sensorimotor manipulation, and social facilitation were associated with higher odds of susceptibility to using e-cigarettes among individuals with CLD. Mediation analysis indicated a statistically significant indirect effect of CLD on the susceptibility to using e-cigarettes through stress and boredom reduction. We did not find a statistically significant interaction between CLD and respiratory symptoms affecting susceptibility to using e-cigarettes. CONCLUSIONS: Individuals with CLD often exhibit stress, depression, and a positive view of e-cigarettes but are generally less inclined to use them. Stress, smoking habits, boredom, taste, and social influence can increase their susceptibility to e-cigarette use. Our findings call for further exploration to evaluate the temporal relationship between CLD status, psychosocial factors, cognitive factors, and susceptibility to using e-cigarettes. TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov, on 5 November 2019. Identifier: NCT04151784.

Development and Validation of the Cognitive Behavior Questionnaire in Nonspecific Chronic Low Back Pain (CBQ-NSCLBP).

Background It's common to experience chronic low back pain (CLBP), having serious psychological as well as physical implications. The experience of CLBP and its management depends greatly on cognitive and behavioral aspects. However, there is a requirement for a valid and reliable instrument that assesses the characteristics associated with this condition. Purpose The Cognitive Behavior Questionnaire in Nonspecific Chronic Low Back Pain (CBQ-NSCLBP), a questionnaire for measuring cognitive behavior was created and validated for this study. Methodology To validate the instrument, the consensus technique with two rounds of the modified Delphi process was used. With a varied background, 13 experts in the field were specifically chosen. Utilizing the literature review, an outline of the questionnaire was created. Each of the suggested things was evaluated by the experts using a five-point Likert scale. The items completed the descriptive analysis using the criteria for validation and elimination. Results The research findings showed that the CBQ-NSCLBP had good psychometric characteristics. The content Validity Ratio (CVR) (Critical) for a panel size (N) of 13 is 0.54 & for CBQ-NSCLBP is 0.70, which was regarded as indicative of strong content validity. Test-retest reliability showed that intra-class correlation coefficient (ICC) values for all the items were greater than 0.9 which indicates excellent reliability. Spearman's correlation test between CBQ-NSCLBP and the Survey of Pain Questionnaire-Brief (SOPA-B) has shown that all the items are valid since the correlation value is higher than the cutoff value (0.139). Exploratory Factor Analysis was performed and three factors were retained based on eigenvalue greater than one. Conclusion In order to evaluate cognitive behavior in Nonspecific Chronic Low Back Pain (NSCLBP), we created this tool. This will make it easy to understand the level of cognition in NSCLBP patients.

Investigating Latent Interactions between Students' Affective Cognition and Learning Performance: Meta-Analysis of Affective and Cognitive Factors.

Affective and cognitive factors play significant roles in influencing students' learning performance. However, limited studies exist that examine the latent interactions between these factors and students' learning performance. This study applied a meta-analytic approach to examine the relationships between affective and cognitive factors and students' learning performance through the selected publications. We identified 18 affective and cognitive influencing factors related to student learning achievement/performance. It was found that academic performance was significantly impacted by learning scores, future aspirations and goals, peer support for learning, and family support for learning. A moderate impact was observed for cognitive benefits, skill development, self-regulation, values, knowledge, character, self-belief, attitudes and beliefs, affective benefits, motivation, optimism, and behavioral engagement. A weak influence was observed for control and relevance of schoolwork and self-efficacy. The discussion and limitations of this study have also been provided in the last sections.

Correlates of physical activity habits in adolescents: A systematic review.

Physical activity habits are crucial for the physical and mental wellbeing of adolescents (individuals aged 10-19 years). However, few studies over the last two decades have systematically aggregated the influential factors of physical activity habits for adolescents. Five online databases (EBSCOhost (Eric), Psychology and Behavioral Sciences Collection, PubMed, Scopus, Web of Science) were searched for relevant studies published before 14 August 2022. Our systematic review indicated the following: 1) boys performed more physical activity habits than girls, whereas girls preferred to engage in moderate-to-vigorous physical activity; 2) physical activity in adolescents decreased with age; 3) African American adolescents performed significantly more habitual physical activities than white adolescents; 4) adolescents with higher literacy had better physical activity habits; 5) support from parents, teachers, friends, and others helped adolescents in developing physical activity habits; 6) adolescents who spent less time participating in habitual physical activity had a higher body mass index; 7) adolescents who reported higher levels of self-efficacy and satisfaction with school sports tended to have stronger physical activity habits; 8) sedentary behavior, smoking, drinking, prolonged screen time, negative emotions, and excessive use of media technology were correlated with reduced habitual physical activity in adolescents. These findings could help develop interventions to motivate adolescents and promote physical activity habits among them.

Cardiometabolic Patient-Related Factors Influencing the Adherence to Lifestyle Changes and Overall Treatment: A Review of the Recent Literature.

It is well acknowledged that most of the modifiable risk factors for Cardiovascular Diseases (CVDs) can be averted through lifestyle modifications beyond medication adherence. This review aims to critically evaluate the cardiometabolic (CM) patient-related factors that influence the adherence to lifestyle changes studied alone and/or in combination with medication. A comprehensive literature search of PubMed articles from 2000 to 2023 retrieved 379 articles. After removing the articles which were not relevant, a total of 28 cross-sectional studies was chosen (12 qualitative, and 16 quantitative). The findings confirmed that five groups of factors influence patients' adherence to overall treatment: (1) health beliefs, knowledge, and perceptions regarding the risks and challenges of disease and medication intake along with adherence process perceptions; (2) self-concept; (3) emotions; (4) patient-healthcare providers relationship/communication and (5) social and cultural interactions. It is worth mentioning that cultural issues, such as culinary particularities, ethnic identity, social life as well as patients' skills and abilities, play a profound role in the effectiveness of the recommended lifestyle modifications beyond the aforementioned common factors. The need for clear-cut culturally adapted guidelines along with personalized advice from physicians is imperative as it could improve patients' self-efficacy. These socio-psychological factors should be seriously considered as a means to increase the effectiveness of future community prevention programs.

Causes of higher levels of stress among students in higher education who used eLearning platforms during the COVID-19 pandemic.

Background: This work aims to study the levels of stress among students using e-learning platforms during the COVID-19 pandemic in higher education institutions. The major factors of higher-level stress among the student community focused on this study are: Changes in academic environment, family, social, personal, health and cognitive. Objective: the objective of this research the Partial Least Squares Structural Equation Modelling (PLS-SEM) procedure was used to explore the relationship and its impact on various levels of stress. Results: Data were collected by using a total of 1,000 email IDs of students that were made available by teachers from 12 Indian higher education institutions where they were enrolled and by using a random number method. With this procedure, a total of 800 email IDs were selected. The results drawn from this research are that students experienced more stress due to sudden changes in the academic environment, family, and personal factors. The stress levels of cognitive and social were found to be equally distributed among higher education students, but less than academic environment, family and personal. This research intends to fill the gap of short-term individual psychological changes that occur after the outbreak. Conclusion: Policy-makers can take note of the current study's observations in continuing their fight against COVID-19 pandemic by improving the stability for student risk groups.

Examining the relationship between cognitive factors and insight in panic disorder before and during treatment.

Individuals with Panic Disorder (PD) often have impaired insight, which can impede their willingness to seek treatment. Cognitive processes, including metacognitive beliefs, cognitive flexibility, and jumping to conclusions (JTC) may influence the degree of insight. By understanding the relationship between insight and these cognitive factors in PD, we can better identify individuals with such vulnerabilities to improve their insight. The aim of this study is to examine the relationships between metacognition, cognitive flexibility, and JTC with clinical and cognitive insight at pretreatment. We investigate the association among those factors' changes and changes in insight over treatment. Eighty-three patients diagnosed with PD received internet-based cognitive behavior therapy. Analyses revealed that metacognition was related to both clinical and cognitive insight, and cognitive flexibility was related to clinical insight at pre-treatment. Greater changes in metacognition were correlated with greater changes in clinical insight. Also, greater changes in cognitive flexibility were related to greater changes in cognitive insight. The current study extends previous studies suggesting potential relationships among insight, metacognition, and cognitive flexibility in PD. Determining the role of cognitive concepts in relation to insight may lead to new avenues for improving insight and can have implications for engagement and treatment-seeking behaviors.