Vacations reliably improve indicators of mental health, largely by providing relief from work-related stress. Low levels of work-related rumination, a key transdiagnostic factor linked to burnout and depression, are considered prerequisites for successful recovery both during vacations and in daily working life. However, such benefits are typically short-lived, with a rapid "fade-out" upon return to work. To address this challenge, we developed Holidaily, a low-threshold, gamified mobile health intervention designed to translate recovery science into daily digital practice and sustain the mental health gains of vacations.

In a randomized controlled trial (RCT), Holidaily was evaluated as a digital mental health intervention targeting work-related rumination, the primary outcome. Assessments were conducted two weeks prior to vacation and two weeks after the return to work, before waitlist controls were granted access. Given the novelty of the research, a wide range of exploratory outcomes was also assessed.

A total of 190 workers from the general population were randomized to either the intervention (n = 91) or waitlist control group (n = 99). ANCOVA, in accordance with the intention-to-treat principle, indicated that the intervention group reported significantly lower levels of work-related rumination at two weeks post-vacation compared with controls [p < 0.001, d = -0.67 (-1.0; -0.4)]. At this time, rumination levels were still reduced by 22.2% in the intervention group, compared with 6.9% in controls relative to baseline. Among app users, reductions persisted for up to four weeks (26.1%). Sensitivity analyses confirmed these results. These findings provide first evidence that a mobile health technology can extend vacation-related recovery benefits and reduce work-related rumination in workers.

This is the first RCT to show that the rapid fade-out of vacation benefits is not inevitable. Holidaily appears to improve workers' ability to reduce levels of work-related rumination. These results highlight the potential of scalable digital interventions to foster sustainable mental health in working populations and support preventive public health efforts.

https://drks.de/search/de/trial/DRKS00013650, German WHO DRKS00013650.

In the current context of increasing psycho-emotional strain within higher education, the emotional well-being of university faculty has become a strategic variable for institutional management. In response to this challenge, the present study aimed to predict emotional well-being among faculty members from the State University of Milagro and the Technical University of Manabí through the application of machine learning algorithms.

A quantitative, explanatory, and correlational-predictive design was adopted, using a stratified probabilistic sample of 1,470 university professors. Data were collected through a psychometrically validated questionnaire and analyzed using supervised learning models implemented in Orange Data Mining.

The findings revealed that Gradient Boosting, Random Forest, and Neural Network algorithms achieved the highest predictive performance, reaching optimal levels of accuracy, sensitivity, and calibration. The most significant predictors identified were emotional regulation, social competencies, emotional autonomy, and emotional awareness, whereas life and well-being competencies did not show a positive relationship. Additionally, age and level of academic training were associated with higher levels of emotional well-being.

The results highlight the capacity of machine learning algorithms to predict faculty emotional well-being with high accuracy and underscore their usefulness as decision-support tools for institutional management in occupational mental health.

ImportanceProgress in vestibular implantation offers hope for patients with bilateral vestibulopathy. However, surgically opening the semicircular canals risks breaching the membranous labyrinth, which may induce sensorineural hearing loss. A robotic drill sensing force and torque might prevent membranous labyrinth rupture.Primary objectiveTo assess the feasibility of force- and torque-based automatic cessation in a hand-guided robotic drill for fenestrating the bony semicircular canals without rupturing the membranous labyrinth.Secondary objectiveTo fit an electrode dummy through the fenestrations.DesignFeasibility study using human cadaveric temporal bones.SettingLaboratory.ParticipantsTen formalin-fixed human temporal bones.InterventionAfter performing a cortical mastoidectomy and skeletonizing the semicircular canals, a hand-guided robotic drill was used to drill 2 fenestrations in each semicircular canal. A silicone electrode dummy was inserted through each fenestration.Main outcome measuresProportion of fenestrations with intact membranous labyrinth, as evaluated with a surgical microscope. Proportion of fenestrations allowing electrode insertion without additional manipulation.ResultsA total of 60 fenestrations were made in 30 semicircular canals from 10 temporal bones. Technical issues related to drill bit fixation occurred in 6 fenestrations. The remaining 54 fenestrations were all made without visible damage to the membranous labyrinth. In 81% of these fenestrations (44/54), the electrode could be advanced without requiring additional manipulation. The technical issue was related to improper alignment of the drill bit, leading to incorrect force and torque sensing.ConclusionsForce- and torque-based automatic cessation in a hand-guided robotic drill is feasible for fenestrating the bony semicircular canals without rupturing the membranous labyrinth. However, improved burr fixation is required for consistent and reliable performance.RelevanceThe investigated approach holds potential to improve safety and precision in semicircular canal surgery, such as vestibular implantation. This may expand treatment options for patients with residual inner ear function.

Digital health interventions (DHIs) using behavior change techniques (BCTs) show promise in addressing adolescent health behaviors, but evidence of their effectiveness across health behavior domains remains fragmented and poorly summarized.

This systematic umbrella review synthesized evidence from existing systematic reviews on the effectiveness of BCTs within DHI targeting key adolescent health behavior domains: alcohol consumption, tobacco use, physical activity, dietary habits, and obesity management.

We systematically searched PubMed, PsycInfo, Embase, and CINAHL in April 2024 for reviews of DHI for adolescents (10-19 years old). We coded all identified BCTs using the Behavior Change Technique Taxonomy version 1 (BCTTv1). Data on BCT effectiveness, intervention characteristics, and review quality were extracted and narratively synthesized using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2).

A total of 20 reviews, comprising 224,135 participants, were included. These examined DHIs targeting physical activity (7 reviews), dietary habits (3 reviews), alcohol consumption (2 reviews), combined alcohol and nicotine use (1 review), and obesity management (1 review), with an additional 6 reviews covering multiple health behaviors. Across reviews, 65% (13/20) reported statistically significant positive effects on at least one health behavior outcome. "Social support (unspecified)" was the most consistently adopted and effective BCT, especially with parental/peer involvement. The combination of "self-monitoring," "goal setting," and "feedback" also commonly appeared in successful interventions. Intervention effectiveness appeared linked to strategic BCT selection and individualization rather than the total number of techniques. The methodological quality of included reviews was predominantly low, with only 2 rated high.

This umbrella review identified "social support (unspecified)" as a consistently effective BCT across multiple adolescent health behavior domains, particularly with parental/peer involvement. Intervention success appears linked to targeted and individualized BCT use. Future research should prioritize clarifying the specific components and delivery methods of effective social support, rigorously evaluating BCT configurations in underexplored areas such as adolescent smoking cessation, and examining their long-term impact on behavior change.

Persons affected by skin neglected tropical diseases (skin NTDs) commonly face stigma and violence, which perpetuates social exclusion, mental health issues, poverty and impedes health-seeking behaviour. Thus, stigma and violence limit the attainment of World Health Organisation (WHO) 2030 roadmap progress. Evidence on stigma related to skin NTDs pertains largely to leprosy, and experiences focus on the micro level, with limited consideration of the broader meso and macro social and structural conditions underpinning experiences of stigma. This study sought to explore experiences of stigma and violence among persons affected by skin NTDs in Liberia, within the context of an integrated skin NTD programme, including the application of intersectionality theory, considering how experiences change over time and in in relation to gender and condition, and making evidence-based recommendations.

This participatory action research study used participatory methods (e.g., photovoice) and worked with persons affected as co-researchers. We drew on longitudinal qualitative data (n=649 participants) from three distinct timepoints during 2019-2023 with respondents from across the health system, prioritising perspectives of persons affected. We conducted gendered thematic framework analysis, guided by a conceptual framework, drawing on the WHO violence typology, stigma forms and the social ecological model.

Stigma and violence, commonly attributed to myths and misconceptions, are hindering participation and inclusion. Stigma and violence seem to have reduced, however, emotional violence and internalised stigma remain prevalent. There has been a reported decline in stigmatising attitudes held by formal health workers, but some informal providers (traditional and faith healers) continue to perpetuate harmful myths. Harmful myths and gender shape the manifestation and determinants of violence, often mirroring gender norms and converging with other forms of inequalities, with women disproportionately impacted. Leprosy was associated with the most distressing and de-humanising accounts. The relationship between skin NTDs, stigma and violence is complex and multifaceted - we propose a framework to strengthen understanding. Addressing stigma and violence is paramount in the delivery of equitable, person-centred care, with implications beyond NTD programmes. More evidence is needed to deliver tailored, gender transformative interventions that engage informal providers and community-based groups (CBGs).

Older adults are the fastest-growing group of cannabis consumers in the US, seeking relief from age-related ailments (eg, pain or difficulty sleeping) and improved quality of life. However, little is known about the motivations and factors that influence their use of edible cannabis and product choice.

To explore the motivations of older adults in Colorado purchasing edible cannabis products to improve sleep, pain, or mental health concerns, and to understand how they perceive the benefits and drawbacks of different cannabinoid profiles: cannabidiol (CBD)-dominant, tetrahydrocannabinol (THC)-dominant, or a THC-CBD combination product.

This community-based, qualitative study was study conducted in Colorado from November 2021 to November 2023 as part of a larger clinical trial. Individual interviews were audio-recorded, transcribed, and analyzed. Participants were a convenience sample of adults aged 60 years or older who were interested in using edible cannabis for sleep, pain, or mental health symptoms. Participants completed an in-person interview prior to purchasing 1 of 3 edible product types.

Use of edible cannabis products.

The primary outcomes were self-reported motivations for cannabis use and perceived benefits and drawbacks of different cannabinoid profiles, assessed through semistructured interviews conducted before product purchase.

Among 169 participants (mean [SD] age, 70.8 [5.8] years, 89 female [54%]), 96 (57.5%) selected a THC and CBD combination product, 48 (28.7%) selected a CBD-dominant product, and 23 (13.8%) selected a THC-dominant product. Primary motivations for cannabis use included avoiding pharmaceuticals, exhausting other options, new or increasing problems, and evidence or claims of benefits. Evidence or claims of associated outcomes were seen as a benefit for all 3 product types. The most common drawback for THC and combination products was concern about getting high or being impaired, while limited efficacy was the most common drawback for CBD products. Combination products were perceived to offer dual benefits of THC-CBD, yet determining the ideal ratio was seen as a challenge.

In this qualitative study, older adults were motivated to use cannabis as an alternative approach to address health concerns. These findings highlight the importance of physician awareness of older adults' motivations and concerns to support informed counseling and resources.

Open surgical necrosectomy remains an important intervention for selected patients with infected pancreatic necrosis, yet data on post-recovery health-related quality of life (HRQoL) are limited. We aimed to describe HRQoL outcomes following open necrosectomy.

In this single-center observational study, consecutive patients who underwent open surgical necrosectomy for infected pancreatic necrosis were assessed for HRQoL at a single post-recovery time point using the Short Form 36 (SF-36) questionnaire. Domain and composite scores were analyzed descriptively and compared across age groups, disease severity (revised Atlanta classification), culture positivity, and the presence of bowel communication.

Eighty-two patients were included (mean age 34.7 ± 11.5 years; 87.8% male). Mean SF-36 domain scores clustered in the low-to-mid 80 s, indicating broadly preserved HRQoL. Highest mean scores were observed in Mental Health (86.5 ± 18.0) and Social Functioning (86.1 ± 19.9), while Role-Physical showed the greatest variability (76.5 ± 39.4). Composite Physical and Mental Health scores were consistent across age categories. Domain-specific differences were seen across severity categories without a clear severity-dependent trend. Patients with positive cultures and those with bowel communication tended to have higher scores across most domains.

Survivors of open surgical necrosectomy can achieve favorable post-recovery HRQoL across multiple domains, supporting inclusion of patient-reported outcomes in pancreatitis research and survivorship-focused postoperative care.

Cancer is a life-threatening health condition that, beyond its physical consequences, can lead to multiple coping challenges including psychological stress (PS), death anxiety and suicide behavior, which often, significantly, impact patients' resilience abilities. Meaning in life is a personal psychological resource that may protect people against the impact of psychosocial vulnerabilities on mental health outcome. This study examined the role of meaning in life in the relationship between PS, death anxiety, suicide behavior and resilience.

A cross-sectional study was conducted among 238 cancer patients (122 (51.3%) females, M age = 42.55; SD = 11.95) selected from a healthcare institution in South Africa. Participants were diagnosed with either prostate cancer 57 (23.9%), colon cancer 29 (12.2%), liver cancer 37 (15.5%), gastric cancer 22 (9.2%), breast cancer 79 (33.2%), or other kinds of cancer 14 (5.9%). Validated tools were used: The Resilience Scale (RS); Presence of Meaning in Life Subscale of Meaning in Life Questionnaire (MLQ); Impact of Event Scale (IES); Death Anxiety Inventory-Revised (DAI-R) and Suicidal Behaviors Questionnaire-Revised (SBQ-R). Moderation hypotheses were tested via Hayes PROCESS Macro Model 1 in SPSS vs. 31.

Findings revealed that meaning in life moderates the relationship between PS and resilience such that PS was associated with lower levels of resilience at low and average levels of meaning in life but not at high levels of meaning in life. Meaning in life moderated the association between death anxiety and resilience such that death anxiety resulted to lower levels of resilience only among patients with low but not among those with average and high levels of meaning in life. This same pattern of findings was observed when we examined whether meaning in life moderates the relationship between suicide behavior and resilience.

The findings have revealed that higher sense of meaning in life moderates the negative psychological impacts of PS, death anxiety and suicide behavior on resilience. Targeted interventions that enhance a sense of meaning in life and addresses PS, death anxiety, and suicide behavior are essential for fostering resilience and adaptive coping with cancer disease.

Metabolic and bariatric surgery (MBS) is surgery on the gastrointestinal tract aimed at weight loss and resolution of metabolic disease. These surgeries can result in remission of diabetes, hypertension, and sleep apnea in many patients, and can prolong life expectancy by 5 to 9 years. Because of the proven benefits, the American Society for Metabolic and Bariatric Surgery recommends surgery for all patients with a body mass index of 35 kg/m² or higher, except for patients with diabetes whose threshold is 30 kg/m² regardless of prior nonsurgical weight loss efforts. For children 13 years and older, MBS is recommended and has not been shown to negatively affect height or develop- ment. The MBS procedures have a very low risk of surgical complications but require careful preoperative counseling due to the major long-term effect expected on lifestyle. Family physicians are well suited to discuss MBS as an option for appropriate patients, refer to a qualified center, and monitor patients postoperatively. Attention must be given to effects on diet, fertility, and mental health, and adjustments must be made for long-term medications. These surgeries should not be viewed as a last resort for only patients with severe obesity but as an effective intervention to consider early in the treatment of obesity, especially when complicated by metabolic conditions.

Background shared decision-making (SDM) is essential in breast reconstruction following mastectomy, a setting where patients face complex and preference-sensitive choices. Decision aids help patients to understand treatment options by providing evidence-based information in a clear and accessible format. Objective to explore the utility of the GRETA-V2 decision aid in enhancing patient-centered decision-making in post-mastectomy breast reconstruction through expert evaluation and content refinement. Methods GRETA-V2 was developed through a multiphase process involving a core team of breast surgeons and psycho-oncologists. It was iteratively refined using feedback from semi-structured interviews with a multidisciplinary panel, including plastic surgeons, nurses, and patient advocates. Participants assessed the tool's clarity, usefulness, and alignment with patients' values. A qualitative thematic analysis was conducted to identify areas for improvement. Results: Experts highlighted the value of visual aids, accurate data presentation, and inclusive language. Key themes identified were design (visual clarity and realism), data presentation (statistical accuracy and cultural tailoring), and content (informational completeness, psychological aspects, clarity, and integration of patient experiences). The tool was recognized as supportive of SDM, but refinements were suggested to improve understanding of radiotherapy, surgical options, postoperative recovery, and emotional impacts. Conclusions: GRETA-V2 demonstrates potential as a patient-centered DA grounded in evidence and clinical insight. Further refinement based on user testing is recommended to enhance its relevance and effectiveness in real-world settings.