A complex interplay between behavioral, environmental, and genetic factors influences longevity. According to recent studies, psychological determinants, humor and self-care in particular, are crucial for fostering health and prolonging life. Evidence about the function of humor and self-care as psychological coping strategies that may promote longevity is compiled in this systematic review. A thorough search for peer-reviewed research published between January 2000 and March 2024 was conducted in PubMed, PsycINFO, Scopus, and Web of Science. Both qualitative and quantitative studies examining the relationships between humor, self-care behaviors, and longevity-related health outcomes were eligible. After screening 742 records in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 16 studies met the inclusion criteria and were included in the qualitative synthesis. Across the included studies, humor was consistently associated with reduced psychological stress, improved psychological well-being, enhanced immune and cardiovascular markers, and, in some longitudinal cohorts, lower mortality risk. Self-care practices, including mindfulness, physical activity, adequate sleep, and social engagement, were associated with reduced allostatic load, greater psychological resilience, and better functional and cardiometabolic health. These psychological elements may work in concert to promote healthy aging trajectories by acting as protective barriers against long-term stress and age-related decline. This review emphasizes the promise of self-care and humor as accessible, low-cost strategies for improving well-being and supporting healthy aging; however, further longitudinal and experimental research is required to establish causality and clarify underlying biological and psychological mechanisms.

Background How mental and physical attributes differ between doctors of different generations and specialities is undetermined. We aimed to compare how resilience, mental toughness, physical activity levels, and career satisfaction vary between medical professionals of different generations, specialities, career stages, practice settings, and genders. Methodology This was an electronic survey study that compared the Brief Resilience Score (maximum six points), Mental Toughness Index (maximum 56 points), International Physical Activity Questionnaire-Short Form, and career satisfaction (0-100 scale) between doctors and medical students at two affiliated teaching hospitals. All data are presented as median (interquartile range). Results In total, 289 medics responded. Baby Boomers (born 1946-1964) (4.2 (3.7, 4.8)) were more resilient than Generation Z (born 1997-2012) (3.8 (3.2, 4.0), p=0.0007), Millennials (born 1981-1996) (3.8 (3.3, 4.2), p=0.0091), and Generation X (born 1965-1980) (4.0 (3.5, 4.2), p = 0.0354). Generation Z (42 (39, 46)) were less mentally tough than Millennials (44 (41, 47), p=0.0330), Generation X (46 (41, 48), p=0.0062), and Baby Boomers (46 (43, 52), p=0.0005). Millennials were less mentally tough than Baby Boomers (p=0.0199). Generation Z were more physically active than Generation X (1,822 (1,052, 3,662) vs. 1,542 (777, 2,586), p=0.0383). Generation Z had lower career satisfaction than Millennials (73 (58, 80) vs. 80 (70, 89), p=0.0094), Generation X (85 (75, 90), p<0.0001), and Baby Boomers (90 (85, 94), p<0.0001). Millennials had lower career satisfaction than Generation X (p=0.0291) and Baby Boomers (p=0.0014), respectively. Medical students were less resilient than consultants(3.7 (3.2, 4.0) vs. 4.0 (3.5, 4.2), p=0.0193). Medical students (41 (38, 47)) and interns (42 (38, 45)) had lower mental toughness than both senior trainees (46.0 (41, 49), p=0.0096 and p=0.0022, respectively) and consultants (46 (41, 48), p=0.0022 and p=0.0005, respectively). Medical students (2,224 (1,370, 4,760) had higher physical activity levels (as defined by the International Physical Activity Questionnaire-Short Form score) than junior trainees (1,386 (731, 2,656), p=0.0038), senior trainees (1,395 (1,065, 3,034), p=0.0327), and consultants (1,533 (820, 2,546), p=0.0017). Career satisfaction increased with career stage (Spearman's (r=0.3219, 95% CI=0.2075-0.4277, p<0.001). Physician trainees were more satisfied with their careers (as per self-rated 0-100 satisfaction scale) than trainees of "other" (non-physician/non-surgical) specialities (80 (72, 90) vs. 75 (40, 80), p=0.0090). Consultant surgeons (4.2 (4.0, 4.5) and 48 (46, 53)) were more resilient and mentally tougher than consultant physicians (3.8 (3.3, 4.0) and 44 (39, 48), p=0.0002 and p=0.0003, respectively) and consultants of other specialities (3.8 (3.3, 4.2) and 44 (41, 47), p=0.0004 and p<0.0001, respectively). Consultants who worked in both private and public hospitals had greater mental toughness (47 (43, 51) vs. 44 (41, 47), p=0.0153) and career satisfaction (86 (80, 90) vs. 80 (70, 90), p=0.0053) than consultants who worked exclusively in public hospitals. Conclusions The present study found that self-reported resilience and mental toughness were the greatest among the Baby Boomers, and declined with subsequent generations. Among consultants, surgeons had the highest resilience and mental toughness scores. Career satisfaction increased with career stage.

Schema Therapy (ST) is an integrative therapeutic approach for addressing personality disorders such as Avoidant Personality Disorder (AvPD). This approach emphasizes the identification and healing of Early Maladaptive Schemas (EMS) and the use of schema modes that contribute to the development of PDs. Schema modes are moment-to-moment reflections of emotional and behavioral states triggered by the activation of different EMS. They comprise thoughts, emotions, and behaviors. Coping modes, a subset of schema modes, are unconscious strategies employed to manage distress that obstructs access to an individual's vulnerabilities. This article illustrates the therapeutic process of ST in working through the dysfunctional coping modes of Ms. A, a 22-year-old female diagnosed with AvPD and Depression. It highlights the significant challenges encountered in therapy with respect to the client's detached and avoidant protector modes. Therapeutic interventions, such as limited reparenting and empathic confrontation, played a crucial role in addressing dysfunctional coping modes and facilitating access to clients' vulnerable child modes. This study further underscores the importance of considering therapeutic relationships when engaging with clients' coping strategies. Finally, the implications of addressing coping modes in the treatment of clients with AvPD are discussed. As a single-case study, its findings have limited generalizability due to the presence of other confounding factors, including the role of concurrent medication in the outcome.

Caregivers of children with chronic conditions have mental health needs, with no known resources for caregiver coping in pediatric Inflammatory Bowel Disease (IBD) and autoimmune liver disease (AILD), which can be co-morbid. Quality improvement (QI) has previously co-produced resources within Learning Health Networks (LHNs). This QI work sought to co-produce a caregiver coping resource for caregivers of children with IBD and/or AILD.

A multidisciplinary QI team of caregivers and psychosocial clinicians applied QI methodology to iteratively develop a caregiver coping resource. This work took place within two connected LHNs, ImproveCareNow (pediatric IBD) and Autoimmune Liver Disease Network for Kids (AILD).

Over 1.5 years, a multidisciplinary QI team of eight caregivers and four psychosocial clinicians co-produced a caregiver coping resource. The formatted caregiver coping resource is 164 pages long with sections including caregiver coping (e.g., anxiety), caregiver support of child coping (e.g., discussing emotions), special considerations (e.g., surgery in IBD), and logistical topics (e.g., navigating insurance). The resource integrates caregiver and psychosocial clinician quotes and reputable resources. The resource is freely available and information about how to access the resource is included in the manuscript text.

While caregivers of children with IBD and/or AILD have known coping needs, caregiver-focused coping resources are urgently needed. A multidisciplinary team of caregivers and psychosocial clinicians within LHNs co-produced such a resource that is freely accessible. This QI work demonstrates the collaborative potential to build caregiver-focused resources for all families to benefit. Future work is needed to understand the clinical use of this resource as well as the impact of this resource for caregivers of children with IBD and/or AILD.

Digital literacy is critical for older adults to maintain social connections, access information, and support overall mental well-being. However, many older adults struggle with using digital devices. Guided by the self-fulfilling prophecy theory, this study investigates how digital reverse mentoring (DRM), referring to younger individuals assisting older adults in learning and using digital technology, is associated with digital literacy, with self-perceptions of aging and self-efficacy as mediators.

A cross-sectional study was conducted with 402 community-dwelling older adults aged 60+ in Macao, China. Control variables include gender, age, education, income, self-rated health, and home internet access. Structural equation modeling was employed to test hypothesized relationships and mediation effects.

DRM significantly improved digital literacy (B = .31, 95% CI: .19, .43). Positive perceptions of aging were positively associated with digital literacy (B = .05, p < .001), whereas negative perceptions showed a negative association (B = .09, p < .001). Contrary to expectations, self-efficacy did not show a significant association with digital literacy. Indirect effects revealed that DRM was positively associated with all mediators (B = .12, 95% CI: .04, .20), suggesting that improving perceptions of aging through DRM may enhance digital literacy.

This study highlights the importance of DRM educational interventions in boosting digital literacy among older adults by positively shaping their perceptions of aging. Addressing these perceptions can break down barriers and promote more inclusive digital participation. Future research should investigate the longitudinal effects and effective intervention strategies to enhance digital literacy.

This study addresses the age-related digital divide by examining DRM as a strategy to improve digital literacy among older adults. Using a psychological framework, we identify perceived aging as a key mediator, showing that increased positive perceptions of aging and reduced negative perceptions of aging enhance digital outcomes. Findings suggest that DRM, as an empowering approach, can be effectively integrated into social service programs and policies to promote digital inclusion and reduce the age-related digital divide. This work offers a practical and evidence-based model for improving individual and societal outcomes in later life through intergenerational engagement.

Millions of people around the world suffer from depression. While early diagnosis is essential for timely intervention, it remains a significant challenge due to limited access to clinically diagnosed data and privacy restrictions on mental health records. These limitations hinder the training of robust AI models for depression detection. To tackle this, this article proposes a parallel transfer learning framework for depression detection that integrates BERT and T5 through a fusion mechanism, combining the complementary advantages of these two large language models (LLMs). By integrating their semantic embeddings, the method captures a broader range of linguistic cues from transcribed speech. These embeddings are processed through a model with two parallel branches: a one-dimensional convolutional neural network and a dense neural network are used to construct each branch for preliminary prediction, which are then fused for final prediction. Evaluations on the E-DAIC dataset demonstrate that the proposed method outperforms baseline models, achieving a 3.0% increase in accuracy (91.3%), a 6.9% increase in precision (95.2%), and a 1.7% improvement in F1-score (90.0%). The experimental results verify the effectiveness of BERT and T5 fusion in enhancing depression detection performance and highlight the potential of transfer learning for scalable and privacy-conscious mental health applications.

To describe the experiences of U.S. tuberculosis (TB) program officials participating in contact investigations after TB exposures on aircraft in order to 1) characterize barriers to participation and 2) better understand reasons for low return of outcomes data.

We surveyed 51 TB professionals representing 47 jurisdictions about their experiences participating in TB aircraft contact investigations coordinated by the U.S. Centers for Disease Control and Prevention (CDC).

Most jurisdictions (43/47, 91%) reported that they attempt an evaluation for every contact in their jurisdiction, and a smaller proportion (33/47, 70%) reported that they always participate in voluntary return of outcomes to CDC. Approaches to distributing and completing requests for evaluation were highly variable, but in most cases (32/47, 68%) involved contributions by both state and local jurisdictions. Common challenges in evaluating contacts included difficulty reaching exposed individuals due to incorrect locating information or contact non-responsiveness (36/47, 76%), as well as limited staffing (24/47, 51%) and resources (17/47, 36%). Barriers to returning outcomes to CDC included (for states) difficulty getting responses from local jurisdictions (24/38, 63%), limited staff (17/47, 36%), and limited resources (16/47, 34%).

Many high-income, low TB burden countries, including the United States, conduct TB aircraft contact investigations, but limited available data suggest that TB transmission on aircraft is likely rare and not well-documented. Given the substantial challenges many jurisdictions reported, it may be appropriate for CDC to reconsider its approach to investigating TB exposure events on aircraft.

Few studies have examined the occurrence of adverse drug reactions (ADRs) in relation to the severity of cognitive impairment in patients with dementia. This study aimed to investigate the prevalence of ADRs among older adults living with dementia at the time of admission according to the severity of cognitive impairment.

This retrospective chart review included patients living with dementia between July 2021 and December 2022. Severity of cognitive impairment was classified using the Mini-Mental State Examination scores as mild (≥ 21), moderate (11-20), and severe (≤ 10). ADRs were evaluated based on national guidelines for appropriate medication use in older adults or pharmacologically plausible associations. ADR-related hospitalization was defined as ADRs that were considered to have directly or indirectly contributed to the decision to admit the patient. The collected data and the relationship between medication counts and ADR-related hospitalization (6-9 versus ≥ 10 medications) were analyzed according to the severity of cognitive impairment.

This study included 35, 100, and 78 patients in the mild, moderate, and severe groups, respectively. At discharge, the severe group was prescribed significantly fewer medications than the mild group (p < 0.05). The prevalence of ADRs decreased in each group from admission to discharge (mild: 77.1%-17.1%; moderate: 74.0%-16.0%; severe, 82.1%-33.3%). Among patients taking 6-9 medications, ADR-related hospitalization was more common in the severe (50.0%) group than the mild group (20.0%) (p < 0.016) at the time of admission.

Patients living with dementia who have severe cognitive impairment are particularly vulnerable to adverse drug reactions.

Early sexual debut among young women in Kinshasa, Democratic Republic of Congo (DRC), represents a complex and multifaceted issue that carries significant implications for a range of factors including individual health and social dynamics.

This research seeks to illuminate the factors influencing early sexual debut among young women in Kinshasa.

The analysis involved 1,352 young women using a chi-square test at p < 0.05 and 95% CI for categorical variables. A mixed-effects multilevel binary logistic regression identified determinants of early sexual debut, showing adjusted odds ratios (AOR) and related factors, with 95% CI.

The prevalence of early sexual debut among respondents aged 15-24 years was 16.3% with an average current age of 16.6 years. Being aged 20-24 years [AOR = 1.40, CI;1-1.97], cohabiting with a partner [AOR = 0.46, CI;0.31-0.69] or being married [AOR = 0.43, CI; 0.25-0.76], tertiary education [AOR = 7.91, CI; 3.11-20.08], high wealth index [AOR = 1.78, CI; 1.18-2.2], were significantly associated with early sexual debut. The analysis showed minimal differences across clusters, suggesting that individual factors predominantly shape attitudes towards sexual debut, while community-level attributes play a lesser role in predicting these attitudes.

The analysis showed minimal differences across clusters, suggesting that individual factors predominantly shape attitudes towards sexual debut, while community-level attributes play a lesser role in predicting these attitudes. Furthermore, reinforcing the legal marriage and providing resources to support single and cohabiting women in delaying sexual commitments can significantly mitigate early initiation.

Mental health remains a low priority issue in many low- and middle-income countries where both biomedical practitioners and traditional healers provide essential services. While the collaboration between these two types of providers is essential for comprehensive care, their integration within Uganda's mental health service delivery system remains insufficient. This study therefore explored collaboration between biomedical and traditional providers in mental health service delivery in Wakiso district, Uganda.

We conducted a qualitative study that employed key informant interviews to collect data. Thirty-four (34) key informants including 15 biomedical practitioners, 11 traditional healers, and 8 national level stakeholders such as policy makers participated in the study. All interviews were audio recorded and transcribed. Thematic analysis was conducted with the support of NVivo 2020 (QSR International).

Two main themes emerged from the study: the role of traditional healers in the mental health service delivery; and challenges affecting collaboration of traditional healers and biomedical practitioners. The study established that although not fully recognised, traditional healers played an important role in mental health through easing access to health services, affordability of their services, and the trust that communities had in traditional medicine. Non-inclusive mental health policy, power imbalances, and limited funding for mental health research were the main challenges identified regarding the collaboration between traditional healers and biomedical practitioners in mental health service provision.

Traditional healers are actively involved in mental health service provision in Uganda. Collaboration between traditional healers and biomedical practitioners could be enhanced by various stakeholders including policy makers recognising the contribution of traditional medicine, ensuring inclusive mental health policies, and increased resources for mental health research.