Search Results (371)

‘Analog horror’ is a subgenre of internet and media horror, beginning c.2015. Its texts use late 20th-century analogue technology as a locus of horror, both narratively and aesthetically, expressing contemporary technophobia and existential anxieties of the first quarter of the 21st century, using a deliberate and anarchic a-historicity to represent concerns surrounding techno-capitalism and its attendant ‘polycrisis’. This irreverent attitude to historical cause and effect, and technological progress, in subgenre texts such as “The Nixonverse” by creator Eve Casanas represents our modern-day conflict between the digital, techno-capitalist online world, and the corporeal crisis events affecting the real world. This diametric in analog horror expresses the central tenet of Mark Fisher’s concept of ‘capitalist realism’, the idea that capitalist ideology makes it appear that there are no viable alternatives to capitalism. In analog horror narratives, analogue–digital hybrid technologies channel techno-organic monster-figures, with the helplessness of the individual and/or groups to defeat these monstrosities being expressive of this capitalist realist impression that capitalism cannot be overcome, and its polycrisis avoided, enacting fantasies of societal destruction to alleviate this suspended state of anxious helplessness, in the tone of Freud’s ‘death drive’ wish fulfilment fantasies. Full article

In recent years, there has been an unprecedented upsurge in opioid prescriptions for pain management. Consequently, the widespread availability of these medicines has led to an increase in misuse and abuse. This has led to a greater number of overdose-related deaths. The high prevalence of drug misuse was born of multiple and complex societal factors. However, from a medical perspective, critical contributors to the dire consequences of the crisis have been the need for chronic pain relief, as well as mental health issues within communities. Chronic pain coupled with psychological distress exacerbates patients’ predicaments and thus further fuels the crisis. Anxiety and depression have bidirectional and complex relationships with pain. The somatic symptoms associated with anxiety potentially worsen pain, whilst pain emanating from a chronic condition worsens anxiety. The same relational dynamic applies to depression and pain. Thus, these psychopathological states may be major contributors to the opioid abuse epidemic. Thus, psychosocial management as a first-line treatment instead of starting with drug treatments seems an enlightened approach to this problem. Cognitive behavioral therapy (CBT) has been proven to be effective in managing specific symptoms associated with chronic pain. Similarly, patient education has been shown to be a viable alternative to drugs for certain aspects of chronic pain treatment. We consider that the opioid crisis could be addressed with a greater reliance and emphasis on non-pharmacological approaches to managing chronic pain patients. This mini-review examines non-pharmaceutical and monitoring-based interventions to reduce opioid misuse risk among adults prescribed opioids for chronic non-cancer pain. Studies were identified through PubMed/MEDLINE, Scopus, and Google Scholar using terms related to chronic pain, prescription opioid misuse, opioid use disorder, cognitive behavioral therapy, patient education, prescription drug monitoring programs, digital health, telehealth, and non-pharmacological interventions. Studies were included if they focused on adults with chronic pain who were prescribed opioids or at risk of misuse, and evaluated interventions aimed at reducing unsafe opioid use, misuse risk, or opioid-related harm. Evidence was synthesized narratively to identify key intervention approaches, limitations, and clinical implications. Full article

Domestic Violence affects 1 in 3 women worldwide. Empirical evidence from India suggests that women and girls experience a continuum of violence and discrimination from prenatal stages till death in families that largely continue to operate within a dominantly patriarchal framework. However, the literature on domestic violence in India suffers from problems pertaining to reductive and episodic framing, focusing on short-term prevalence, and frames the impact on survivors largely in terms of clinical constructs such as anxiety, depression, and PTSD. This work argues for a broader, thematic framing of domestic and familial violence and contends that the psychological sequelae of this kind of chronic and systemic discrimination and violence cannot be captured using rigid clinical constructs that dominate psychological literature. We propose a conceptual framework, i.e., SPECTRA (Socially and Psychologically Embedded Continuous Trauma in Relational Architecture), which is partially aligned with the propositions of complex trauma. However, we also critique the origin of complex trauma within hegemonic psychiatry and highlight the need for creating a culturally adapted expansion—to shift the emphasis from an individually rooted, diagnostic framework to a culturally contextualized continuous trauma framework. We utilize seven illustrative case studies to define the tenets of the SPECTRA model. Full article

Introduction: Cardiovascular diseases (CVDs) are a vast and widespread problem around the world, responsible for around one third of global deaths, of which 85% were due to heart attack and stroke in 2022. There are a lot of well-established risk factors for CVDs, including smoking, diabetes mellitus, obesity, poor diet, alcohol use, and sedentary lifestyle. Psychiatric disorders, however, are not among those frequently cited. Over a billion people worldwide suffer from some kind of mental disorder, with anxiety and depression being among the leading causes of long-term disability. All-cause death is significantly elevated in individuals with all mental health disorders. Methods: This narrative review aims to provide details on the selected psychiatric disorders and their pharmacotherapy with regard to the risk of developing cardiac illness by reviewing the available literature and the 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease. Results: Primary and secondary prevention of cardiovascular complications in the psychiatric disease population is an essential component in clinical healthcare. Conclusions: Taking all into account, it is essential to underline the role of the activation of the sympathetic nervous system and chronic inflammation, ultimately leading to metabolic syndrome in individuals with mental disorders, as well as an increase in residual cardiovascular risk and the development of CVDs, thereby worsening their long-term prognosis. In view of risky lifestyle behaviors in this population, it is essential to screen proactively, mitigate risk factors, consider the role of pharmacotherapy, and, if needed, initiate appropriate treatment. Full article

In sociocultural situations where aging is firmly associated with family roles, spirituality, and reliance, depression and death anxiety are prevalent mental health issues among older individuals. Although their functions may vary depending on the situation, psychological resources, such as purpose in life, self-worth, and life satisfaction, are often considered protective in later life. This descriptive–correlational study examined the relationships between meaning in life, self-esteem, life satisfaction, depression, and death anxiety among 119 community-dwelling older Filipinos aged 60 years and older. Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression in JAMOVI version 2.7.6. The standardized instruments included the Meaning in Life Questionnaire, Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Revised Death Anxiety Scale, and Beck Depression Inventory. Regression analysis revealed that while meaning in life and life satisfaction independently predicted higher death anxiety, they independently predicted lower depression. After adjustment, self-esteem predicted neither outcome. These results suggest that psychological resources have distinct effects on mental health in later life, acting as protective factors against depressive symptoms and raising awareness of mortality. To promote healthy aging among older individuals, culturally responsive therapies that address existential factors and emotional well-being are necessary. Full article

This article reexamines Liang Fa’s Riji Yanxing (Record of Words and Deeds, 1830) from the perspective of narrative structure rather than solely as a historical missionary document. Previous scholarship has shown that the diary was produced within the institutional framework of the London Missionary Society and functioned primarily as a record of early Protestant evangelization in China. Building on these studies, this article argues that the diary simultaneously records missionary work and narrates the formation of Christian faith. Through close readings of Liang Fa’s reflections, prayers, and recorded dialogues with potential converts, the study demonstrates how an institutional testimonial text develops a narrative configuration shaped by Christian theology. Within this framework, missionary responsibility, anxiety over divine judgment, and reflections on death and salvation form recurring cycles of crisis, repentance, and renewed commitment. Dialogues with potential converts further dramatize this theological logic by transforming doctrinal arguments into scenes of spiritual confrontation and hesitation. Although Riji Yanxing was not originally composed as a literary work, it reveals the emergence of a new mode of Christian narrative in Chinese writing. The diary thus illustrates how Christian concepts of sin, redemption, and judgment reshaped narrative consciousness in early nineteenth-century China. Full article

Many people experienced difficulties grieving the death of a loved one during the COVID-19 pandemic. The main objective of this research was to examine the psychological manifestations of grief for people who experienced the death of a loved one between March 2020 and March 2022 in Panama. A sample of 110 participants completed an online survey including sociodemographic questions and psychological questionnaires. A subsample of twenty-six participants was interviewed about their experience of loss leading up to death, at the time of death, and after death. Results indicated that 43.6% of participants suffered from complicated grief (CG). Participants who experienced CG had more post-traumatic stress symptoms, somatic symptomatology, anxiety/insomnia, social dysfunction, severe depression, use of avoidant coping mechanisms, and more anxiety about the pandemic than participants who did not experience CG. A logistic regression analysis indicated that anxiety/insomnia symptoms, denial as a coping mechanism, and post-traumatic stress symptoms increased the likelihood of CG. For qualitative analyses, the most relevant themes that emerged were distress associated with contagion and illness, hospitalization and access to healthcare services, communication with medical staff, the impact of the news of death, inability to view the body, emotions following the loss, farewell rituals, and coping mechanisms. Full article

Introduction: HIV remains a public health concern despite several decades of effort. In sub-Saharan Africa, where political, environmental, and economic challenges persist, progress toward “Getting to Zero,” including zero new infections and zero HIV-related deaths, has been significantly slow. Although sub-Saharan Africa has seen the successful implementation of HIV/AIDS interventions across behavioral, biomedical, and structural approaches, there has been limited focus on housing insecurity—the inability to access safe, affordable, and stable housing—and mental health among people living with HIV, despite the critical role of housing insecurity in overall health and well-being. Therefore, this study explores how housing insecurity shapes mental health experiences among PLHIV in Kisumu. Methods: Using a qualitative approach, we purposively recruited 70 individuals from households participating in the Pamoja community-based organization’s Orphans and Vulnerable Children (OVC) project. We then conducted in-depth interviews (IDIs) with 30 participants and 4 focus group discussions (FGDs) with 40 adult participants living with HIV (ALHIV). Audio-recorded interviews were transcribed verbatim, translated from Luo into English, and uploaded to Atlas.TI v.23, a qualitative data analysis software. We then performed thematic analysis guided by grounded theory. Results: Our findings showed that housing insecurity was a significant issue for individuals living with HIV. The majority of participants experienced heightened feelings of worry, shame, fear, anxiety, stress, and depression, which negatively impacted their adherence to HIV treatment and care. While some participants showed resilience through acceptance and disclosure, limited resources and ongoing insecurity heightened vulnerability to mental health issues. Discussions: These findings underscore the importance of housing in HIV care programs and offer valuable insights for practitioners and policymakers. The findings highlight the need to incorporate housing stability and mental health support into HIV programs. Full article

Alzheimer’s disease (AD) is a neurodegenerative disorder for which no effective treatments are currently available. PANoptosis is a coordinated cell death pathway involving pyroptosis, apoptosis, and necroptosis. Astragaloside IV (AS-IV) is a bioactive saponin derived from Astragalus membranaceus. Behavioral performance was evaluated using the Morris water maze and open field tests, while neuronal damage was assessed by Nissl staining. The expression levels of Aβ, IL-18, and PANoptosis-related proteins were analyzed by Western blot. Immunofluorescence was performed to assess the co-localization of PANoptosis-associated proteins with neurons in the hippocampal region. In addition, the effects of AS-IV on the expression of PANoptosis-related proteins were examined in Aβ-induced HT22 cells. AS-IV improved spatial memory performance and alleviated anxiety-like behaviors in AD mice. Furthermore, AS-IV treatment significantly reduced Aβ protein levels and attenuated neuronal loss in the hippocampus. Key markers of PANoptosis were downregulated following AS-IV treatment. Immunofluorescence revealed strong co-localization between PANoptosis-associated proteins and neurons. In vitro, AS-IV also inhibited the Aβ-induced upregulation of PANoptosis-related proteins in HT22 cells. Collectively, these results indicate that AS-IV exerts neuroprotective effects in AD models, which may be associated with reduced Aβ protein deposition, attenuated neuronal loss, and the regulation of PANoptosis-related proteins in the hippocampus. Full article

Background and Objectives: Hemodialysis (HD) patients represented a highly vulnerable population during the COVID-19 pandemic, both clinically and psychologically. Data regarding acute anxiety requiring pharmacologic treatment in this setting are limited. The aim of the study was to assess factors influencing clinical evolution, psycho-emotional disturbances reflected by “de novo” anxiolytic use, and vital prognosis of hospitalized COVID-19 patients on HD. Materials and Methods: The study included 211 patients followed between 2020 and 2023 (149 were COVID-19 positive and 80 required hospitalization) and comprised two sequential phases: an in-hospital phase during COVID-19, in which disease severity factors, in-hospital mortality, and the requirement for de novo anxiolytic therapy were assessed, and a follow-up phase, which evaluated overall mortality and the impact of vaccination on long-term outcomes. Results. Hospitalized patients were older, had lower dialysis adequacy, and a lower rate of COVID-19 vaccination. Severe COVID-19, associated with elevated inflammatory markers, prolonged hospitalization, and an increased need for anxiolytic therapy to control acute psychopathological disturbances, was significantly more frequent in patients with underlying oncological comorbidities. Patients who died from COVID-19 during hospitalization were older (69.364 ± 1.973 vs. 66.426 ± 1.546, p = 0.239), predominantly male (66.69% vs. 48.93%, p = 0.064), had similar BMI (26.836 ± 1.120 vs. 26.909 ± 0.943, p = 0.961), and had shorter duration on HD (5.182 ± 4.733 vs. 7.383 ± 6.060, p = 0.085). Patients who received anxiolytic therapy during hospitalization for COVID-19 were younger, predominantly male, and had a longer dialysis vintage as well as a higher body mass index. Although the de novo need for anxiolytics during COVID hospitalization was associated with multiple parameters in the linear regression analysis, the multivariable regression model showed a significant and strong association only with corticosteroid therapy (OR = 16.403, 95% CI = 4.433–62.111, p < 0.001). COVID-19 vaccination was associated with a significant reduction in mortality risk, with vaccinated patients exhibiting a 58% lower hazard of death compared with unvaccinated individuals (HR = 0.42; 95% CI: 0.28–0.62; p < 0.001). Conclusions: COVID-19 in HD patients is a multidimensional pathology, in which clinical severity and preventive strategies, such as vaccination, significantly influence survival. Acute anxiety requiring pharmacologic intervention was highly prevalent in hospitalized HD patients with COVID-19, but was not associated with worse survival (p = 0.903). Psychological burden should be recognized as an important component of care in this population. Full article

The COVID-19 pandemic has been associated with a substantial number of deaths, exposing many individuals to bereavement under particularly adverse circumstances, as public health restrictions often prevented individuals from engaging in customary farewell and mourning practices. In this context, the development of interventions capable of mitigating the psychological impact of grief is of critical importance. This mixed-methods study, with a predominantly qualitative design, aimed to develop and pilot-test a group intervention grounded in cognitive-narrative theory for individuals experiencing bereavement during the COVID-19 pandemic, in Portugal. Four patients aged between 18 and 65 years (M = 49.25; SD = 21.24) participated in the 6-week intervention, between July and August 2022. Quantitative data were collected using the Grief and Meaning Reconstruction Inventory, the Prolonged Grief Assessment Instrument, and the Hospital Anxiety and Depression Scale, with pre- and post-intervention comparisons. To assess the intervention process, participants completed an individual evaluation form, and a group interview was conducted at the end of the intervention. The results indicated a clinically significant reduction in feelings of emptiness and loss of meaning in most participants, with improved meaning-making related to the loss. The thematic analysis performed on the qualitative data highlighted the strengths of the intervention (e.g., adjustment to grief and sharing) and some areas for improvement (e.g., more regular feedback and group composition). Despite limitations, particularly the small sample size, the findings are promising and support further evaluation of this intervention in larger samples of individuals diagnosed with prolonged grief. Full article

Background: Multiple sclerosis (MS) is a long-term and unpredictable condition that can cause considerable psychological distress, including perceived stress and death anxiety. Identifying psychological factors that may mitigate these effects is important for improving the psychosocial well-being of patients with MS. This study aimed to examine the mediating role of self-compassion in the relationship between perceived stress and death anxiety in patients with MS. Methods: This cross-sectional, descriptive, and correlational study included 169 Turkish patients diagnosed with MS between October 2024 and April 2025. A regression-based mediation analysis using the Hayes PROCESS macro with bootstrapping was conducted to assess the mediating role of self-compassion. Results: Death anxiety scores were positively but weakly correlated with perceived stress scores (r = 0.172, p = 0.026). Perceived stress scores were strongly and negatively correlated with self-compassion scores (r = −0.704, p < 0.001), whereas self-compassion scores showed a weak-to-moderate negative correlation with death anxiety scores (r = −0.287, p < 0.01). In the mediation model, perceived stress significantly predicted self-compassion (B = −0.087, p < 0.001), and self-compassion significantly predicted death anxiety (B = −1.758, p < 0.001). The direct effect of perceived stress on death anxiety was not statistically significant (B = −0.058; p = 0.344), whereas the indirect effect was significant (B = 0.153; 95% CI [0.079, 0.232]). The total effect was also significant (B = 0.095; p = 0.036). Conclusions: The findings indicate that self-compassion mediates the relationship between perceived stress and death anxiety in patients with MS. Higher levels of self-compassion were associated with lower levels of perceived stress and death anxiety, suggesting that self-compassion may function as an important psychological resource in coping with disease-related stress and death-related concerns. From a clinical and nursing perspective, integrating strategies that support self-compassion within holistic care may contribute to improving the psychosocial well-being of patients with MS. Full article

Background/Objective: Heart disease is the leading cause of death for men and women across most racial and ethnic groups. Effective self-care improves patient outcomes. This study aimed to examine self-care and its associated variables in men and women with coronary heart disease. Methods: This cross-sectional survey enrolled patients with coronary heart disease through convenience sampling. Data were collected via in-person interview, including sociodemographic variables (e.g., age and sex) and clinical variables (e.g., comorbidities). We also used the Charlson Comorbidity Index to measure comorbidity; the Patient Health Questionnaire-9 to measure depression; and Generalized Anxiety Disorder-7 to measure anxiety. Self-care was evaluated with the Self-care Coronary Heart Disease Inventory and Self-Care Self-Efficacy Scale. Descriptive and multivariate analyses were performed. This study adhered to the CROSS guidelines. Results: The sample comprised 354 patients (57.6% men and 42.4% women). Self-care monitoring and management scores were inadequate with women. Self-care self-efficacy scores were marginally adequate. Men had worse depression, comorbidities, and smoking, while women had higher anxiety and a sedentary lifestyle. Older age, low education, public transportation use, sedentary lifestyle, comorbidity, anxiety, and depression were associated with worse self-care, whereas being single and ambulance accessibility improved self-care. Conclusions: Self-care monitoring and self-care management scores were inadequate for both sexes. Depression and public transportation use were inversely associated with all self-care domains. Depression and anxiety screening should be included in routine practice. Healthcare providers should enhance self-care education for CHD patients. Interventions must address sedentary lifestyles in women and cigarette smoking in men. Full article

Pregabalin, as the active ingredient of various medications, is used in humans to treat generalized anxiety disorder (GAD), epilepsy, fibromyalgia, and neuropathic pain. In animals, pregabalin is used as an anesthetic. The aim of the present study was to test the effect of pregabalin on the developmental parameters of Sarcophaga argyrostoma (Robineau-Desvoidy, 1830) (Diptera: Sarcophagidae), a fly used in forensic entomology. A culture of S. argyrostoma larvae was conducted on mouse carcasses. Two doses of the active substance were used in the experiment: 100 mg/kg (dose 1) and 300 mg/kg (dose 2). A control sample (without the drug) was used for comparison. The duration of the life cycle, the body weight of individual developmental stages (larvae, pupae, and adults), and their mortality were studied. The study showed that (1) pregabalin prolonged the life cycle of S. argyrostoma—dose 1 by two days and dose 2 by three days; (2) pregabalin caused an increase in body weight at each stage of development (larvae, pupae, and adults); (3) pregabalin caused high mortality among pupae. The highest mortality was observed in the treatment with 300 mg/kg. The preliminary results indicate that estimation of the time of death based on analysis of the developmental stages of S. argyrostoma on a carcass with a high content of pregabalin may be distorted relative to a case without the impact of this exogenous substance. Research on the effect of pregabalin on flies used in forensic entomology should be expanded to investigate how this compound affects the life cycles of these insects. Full article

Background/Objectives: Cardiovascular diseases represent a considerable burden on healthcare systems. In coronary intensive care units (CICU), nursing staff play a key role in the care of critically ill patients. Nursing diagnoses (NDs) based on the NANDA-I (North American Nursing Diagnosis Association-International) taxonomy enable the identification of human responses to various clinical conditions. However, their association with adverse outcomes, such as in-hospital mortality, remains understudied. Therefore, we evaluated the association between NDs and in-hospital mortality in patients with cardiac disease. Methods: A retrospective cohort study was conducted in a tertiary care hospital. The paper clinical records of 195 patients admitted to the CICU for at least 48 h between January 2023 and March 2025 were reviewed. The association of interest was assessed using Poisson regression models adjusted for confounding variables. Results: Mortality was 24.1%. NDs focusing on cardiac and extracardiac responses, such as fluid volume excess (risk ratio [RR] = 2.67; 95% confidence interval [CI] = 1.23, 5.76), impaired cardiac output (RR = 1.84; 95% CI = 1.50, 2.25), risk of shock (RR = 3.12; 95% CI = 1.91, 5.11), risk for impaired cardiovascular function (RR = 2.01; 95% CI = 1.28, 3.17), and impaired gas exchange (RR = 2.67; 95% CI = 1.64, 4.34) were significant predictors of mortality. In contrast, diagnoses such as anxiety (RR = 0.46; 95% CI = 0.23, 0.91), impaired psychological comfort (RR = 0.31; 95% CI = 0.09, 0.95), and risk of unstable glycemia (RR = 0.46; 95% CI = 0.23, 0.91) were associated with a lower risk of death. Conclusions: NDs are independently associated with in-hospital mortality in critically ill patients with cardiac disease and may represent useful clinical markers for risk stratification in intensive care settings. Full article