Postoperative cognitive dysfunction (POCD) is a detrimental complication after surgery with lasting impact on patients' daily lives. It is most common after postoperative delirium. While dopaminergic dysfunction has been suggested to play a role in delirium, little knowledge exists regarding its relevance for POCD.

We hypothesised that POCD is associated with altered resting-state functional connectivity (FC) of the ventral tegmental area (VTA) and the substantia nigra pars compacta (SNc) in functional magnetic resonance imaging (fMRI).

Tertiary care centre, Germany.

Patients aged at least 65 years with a Mini-Mental Status Examination (MMSE) at least 24 points presenting for elective major surgery were eligible for this study. Of 747 included patients, 214 patients with POCD assessment and at least one preoperative fMRI dataset were analysed.

Resting-state fMRI and neuropsychological assessment before surgery and at follow-up 3 months later.

POCD after 3 months after surgery was determined as the Reliable Change Index (RCI). Connectivity between VTA or SNc and 132 regions was calculated.

Twenty-six patients (12%) developed POCD. Four components for VTA-FC and SNc-FC were selected for further analysis with principal component analysis. For both VTA and SNc connectivity, one component was significantly associated with POCD. Postoperative alterations of dopaminergic networks were observed in an exploratory voxelwise analysis in a left temporal cluster.

Higher dopaminergic connectivity to regions associated with spatial perceptive processes and lower connectivity to cognitive control-related areas may predispose to POCD.

clinicaltrials.gov, NCT02265263.

To evaluate the concurrent validity of assessing infants' gross motor performance with an at-home wearable measurement versus the Alberta Infant Motor Scale (AIMS).

This observational study used a new multi-sensor wearable Motor Assessment of Infants with a JUmpsuit (MAIJU) for 67 at-home measurements of 42 infants (60% males; mean age 11.5 months, SD 3.7 months, range 4-18 months). The study collates a normative cohort of typically developing volunteers (n = 17, 65% males; 27 measurements, mean age 11.8 months, SD 3.1 months, range 7-18 months) and a clinical cohort recruited from a neurodevelopmental follow-up clinic (n = 25, 56% males; mean age 11.2 months, SD 3.8 months, range 4-17 months). We correlated the expert-assessed total AIMS score to a holistic assessment of motor development (the BABA Infant Motor Score [BIMS]) from the MAIJU measurements. Additionally, detailed MAIJU-derived metrics were compared to the AIMS scores, to train machine learning-based AIMS predictions.

There was a very strong correlation (Spearman's rank correlation coefficient [rho] = 0.97, p < 10^-40) between BIMS and AIMS. Centile-based detection of low-performing individuals (cut-offs of 5% and 10%) showed high agreement between AIMS and BIMS (Cohen's kappa = 0.81). Performance of a machine learning-based AIMS prediction from the wearable data was comparable (rho = 0.96, p < 10^-37) to direct use of the BIMS score.

Assessing motor performance with scalable, at-home wearable measurements is highly comparable to the widely used AIMS assessment. An objective, quantitative, and expert-independent motor assessment holds promise for providing benchmarks in geographically distributed health care or clinical trials.

Female university students face an elevated risk of developing common mental health problems, including depression and anxiety. Rumination, a specific form of repetitive negative thought (RNT), is a well-documented risk factor for these conditions. Rumination-focused cognitive-behavioral therapy (RFCBT) represents a promising intervention for the prevention and treatment of depression and anxiety, fostering mental well-being during young adulthood. Although RFCBT has demonstrated effectiveness in numerous randomized controlled trials (RCTs), cultural adaptation has emerged as a critical consideration. This study aims to evaluate the effectiveness of a culturally adapted, guided RFCBT self-help intervention in reducing RNT as well as symptoms of depression and anxiety among Japanese female university students, employing an RCT design.

This study is a single-site, assessor-blinded, parallel-group, two-arm randomized controlled trial (guided self-help vs. waitlist), employing block randomization in a 1:1 ratio. A total of 102 female university students with elevated levels of RNT will be recruited. Participants will be randomly assigned to either the intervention group receiving guided RFCBT self-help, or the waitlist control group. The primary outcome is rumination, assessed using the Ruminative Responses Scale. Measurements will be conducted at 4- and 8-week post-randomization.

Empirical evidence regarding the effectiveness of culturally adapted RFCBT in mitigating RNT and symptoms of depression and anxiety among East Asian populations remains scarce. If proven effective, this study will provide empirical evidence supporting the effectiveness of RFCBT in reducing RNT, depression, and anxiety within an East Asian population.

Japan Registry of Clinical Trials (jRCT): jRCT1050240305, registered 27 March, 2025. (Initially registered with UMIN-CTR: UMIN000053430, on 24 January, 2024. Prospectively registered. Later transferred to jRCT.) PROTOCOL VERSION: Ver. 1.3, February 9th 2026.

Major depressive disorder (MDD) is a significant contributor to the global burden of disease, with a high prevalence in Pakistan. MDD is treatable, and eye movement desensitization and reprocessing (EMDR) therapy is recognized as an effective treatment worldwide. However, EMDR therapy, rooted in Western psychological frameworks, may require cultural and methodological adaptation to fit clients' needs in Pakistan. Notably, there is a lack of research on adapting EMDR therapy in Pakistan, and scarce studies on its effectiveness through online modalities. To bridge these research gaps, this study has two aims: first to develop an adapted DeprEnd EMDR therapy protocol in Pakistan; second, to test its feasibility, relevance, and clinical effectiveness across in-person and online modalities.

This research adopts a mixed-mode exploratory sequential randomized controlled trial design. In the first phase, an exploratory qualitative approach will be utilized to culturally and methodologically adapt DeprEnd EMDR therapy protocol through narrative review and focus group discussion. Data will be qualitatively analyzed. This phase has been previously reported in a separate peer-reviewed publication. In the second phase, a randomized controlled trial design will be used to test the feasibility, relevance, and clinical effectiveness of the adapted DeprEnd EMDR therapy protocol. Initially, it will be pilot tested among 25 handful clients, and later an estimated sample of 80 clients will be selected to test it on a large scale. Clients will be randomized via a covariate-adaptive technique to in-person and online arms with a 1:1 ratio. Symptom-related data will be collected at the baseline, midpoint, post-treatment, and follow-up stages. Data will be analyzed using a combination of univariate and multivariate statistics.

This research conducts the first known scientific adaptation and clinical testing of the DeprEnd EMDR therapy protocol in Pakistan. Through systematic adaptation and assessment of its feasibility and clinical effectiveness, this protocol is positioned to be scalable, showing potential for broader dissemination across South Asia. It contributes a vital framework for culturally sensitive mental health interventions that bridge global evidence-based practices and local sociocultural needs. This study paves the way for collaborative efforts to optimize trauma-focused psychotherapies in low-resource contexts, thus promoting health equity in the region.

The initial study protocol was registered in the ClinicalTrials.gov database under registration no: NCT-06439043. Last Updated:01/21/2025 and Initial Release:05/27/2024.

To assess how work-family conflict relates to depression, burnout, and ICU nurses' perceptions of patient safety culture in Saudi Arabia.

A cross-sectional, correlational study.

A total of 276 ICU nurses from four tertiary hospitals in the Western Region of Saudi Arabia completed standardized instruments assessing depression (BDI-II), burnout (MBI-HSS), work-family conflict (Carlson et al.), and selected items from the Hospital Survey on Patient Safety Culture (HSOPSC) between May and August 2021. Data were analyzed using descriptive and inferential statistics, including correlation analysis and group comparisons using t-tests and ANOVA.

High levels of psychological distress were identified: 28% of nurses reported moderate to severe depression, 24% reported high emotional exhaustion, and 89% experienced moderate to high work-family conflict. Depression was significantly correlated with burnout (ρ = 0.522, p < .001) and work-family conflict (ρ = 0.397, p < .001). Safety culture perceptions were fragmented, with low levels of error reporting and communication openness. Less experienced nurses showed higher depression levels.

ICU nurses in Saudi Arabia experience considerable mental health challenges that may compromise patient safety perceptions. Work-family conflict emerged as a key stressor linked to both depression and burnout.

These findings highlight an urgent need for system-level interventions to support nurses' well-being and psychological safety in ICU settings. Accordingly, mental health services and support programs should be integrated into ICU practice.

As this was a workforce study there was no patient or public contribution.

Not applicable. This study is not a clinical trial.

Racial discrimination has severe adverse mental and physical health consequences for Black Americans. As such, it is critical to understand how best to help protect the health of Black Americans in the face of this stressor. The emotional burden of chronic stress represents a key pathway through which stress damages health; thus, the ability to manage this emotional burden using emotion regulation may represent a core protective factor. Racial discrimination targets individuals' identities, which may have important implications for which regulation strategies will be most helpful. We predicted that successfully using strategies that are more likely to validate individuals' experiences (e.g., emotional acceptance) may be particularly helpful. Other strategies that are less likely to validate individuals' experiences may be less helpful (e.g., cognitive reappraisal). In a sample of Black individuals (N = 504, data from 2018), the link between discrimination and multiple indices of worse health was consistently buffered for people who reported more successful use of emotional acceptance, but not for those who reported more successful use of reappraisal or suppression. These patterns were replicated in a follow-up time point predicting mental health 2 years later (N = 251). These findings underscore the crucial role of context for emotion regulation, suggesting that emotional acceptance may be a uniquely useful approach that protects the health of Black Americans by validating justified emotions in the context of racial discrimination. This work underscores a useful pathway for culturally competent psychosocial interventions for reducing anxiety, depression, and stress-related chronic illness in Black Americans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Nursing students frequently experience high levels of stress, which can impact their psychological, physiological, and social well-being. Stress among nursing students is closely associated with cognitive, motivational, and behavioral determinants. The information-motivation-behavioral skills (IMB) model provides a coherent framework for conceptualizing these determinants and promoting adaptive stress regulation. Based on this model, the present study will implement an IMB-based stress self-management health education program to mitigate stress among nursing students.

This cluster-randomized controlled trial aims to evaluate the effectiveness of an IMB-based stress self-management health education program on reducing stress among nursing students. The 8-week program includes eight modules, with the first seven covering distinct topics and the final module for discussion. One hundred and six nursing students from 22 clusters, based on sample size estimation, will be randomly allocated to either the intervention or waitlist control group. The primary outcome is stress, with secondary outcomes including stress knowledge, stress mindset, perceived social support, self-compassion, and resilience. Baseline characteristics and outcome variables will be summarized using descriptive statistics. The program's effectiveness will be evaluated using an intention-to-treat approach, with longitudinal changes and between-group differences analyzed using a generalized linear mixed model that accounts for clusters as random effects.

The IMB-based stress self-management health education program is expected to enhance stress management among nursing students and highlight the innovative application of the IMB theory.

ChiCTR2400088589. Registered on August 21, 2024.

Public health scholars are increasingly interested in the Marxist concept of alienation to explain the existence of health inequities. Marx's use of the term stresses the crucial role of political economic structural factors in creating alienation. This article reports on a narrative review of literature that used Marx's theory of alienation and focuses on the mental and/or physical health effects of alienation. Our search resulted in 34 relevant articles. Collectively, they demonstrate the ongoing relevance of the concept of alienation to the creation of health inequities in contemporary society. Alienation results from the structure of class relations which are reflected in poor working conditions in which people do not receive the true worth of their labour and are alienated from themselves, others and nature. Alienation affects both workers and managers with effects resulting from their class positions. Consumption has also been identified as a cause of alienation particularly seen through the ceaseless advertising to persuade people to consume objects which do not yield satisfaction. Consumption creates alienation when bodies are commodified, and health services run for profit. We conclude that alienation is highly relevant to contemporary public health advocacy and practice by focusing attention on structural causes of health inequities.