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This study examined the relationship between alarm fatigue and turnover intention among dialysis nurses and investigated the mediating role of professional quality of life (ProQOL). An analytical cross-sectional study was conducted. This study employed a nonprobability sample of 140 dialysis nurses from hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran in December 2024. Data for this study were collected via a multi-section survey. This research initially focused on identifying demographic and occupational variables. Section two employed the Alarm Fatigue Questionnaire; section three, the ProQOL scale; and section four, the Turnover Intention Questionnaire. Data analysis was carried out using IBM SPSS Statistics, version 27.0. The mean scores for alarm fatigue and turnover intention were 34.02 (SD = 8.50) and 48.70 (SD = 11.66), respectively. Item-level means for alarm fatigue were 2.62 (SD = 0.65) on a 0-4 scale. Also, scores were 3.30 (SD = 0.81) for secondary traumatic stress (STS), 3.61 (SD = 0.90) for compassion fatigue (CF), 3.01 (SD = 0.78) for compassion satisfaction (CS), and 3.25 (SD = 0.78) for turnover intention on 1-5 Likert-type scales. Pearson's correlation showed that alarm fatigue was positively correlated with STS, CF and turnover intention, and negatively correlated with CS. Multiple linear regression explained 62.9% of the variance in turnover intention; single marital status, CS, CF and STS were significant independent predictors. Path analysis showed a significant total association between alarm fatigue and turnover intention, a non-significant direct association, and a significant indirect association through ProQOL components, a pattern consistent with mediation by ProQOL. Path analysis showed a pattern of associations consistent with ProQOL mediating the relationship between alarm fatigue and turnover intention. The association between alarm fatigue and turnover intention appeared to operate primarily in association with STS, compassion fatigue, and compassion satisfaction, although the cross-sectional design precludes causal inference. These findings are consistent with the hypothesis that improving ProQOL may be associated with a weaker link between alarm fatigue and turnover intention, though this should be confirmed in longitudinal studies.

BackgroundLower childhood socioeconomic status (cSES) has been linked to a higher risk of Alzheimer's disease and related dementia (ADRD). Yet, the mechanisms underlying this association remain unclear.ObjectiveThis study examined whether poorer health behaviors in adulthood mediate the association between lower cSES and ADRD risk. We further explored whether the mediating effects of health behaviors vary by gender or race/ethnicity.MethodsData were drawn from 26,631 participants in the Health and Retirement Study (Mage = 61.18 years). Cox proportional hazard models were used to estimate the association between cSES and ADRD risk, as well as the mediating effects of health behaviors, including smoking, heavy drinking, physical activity, and influenza vaccination.ResultsLower cSES was associated with a higher risk of ADRD (hazard ratio = 1.06, [1.02, 1.09]). Lower physical activity mediated this association, accounting for 17.1% of the total effect of cSES on ADRD risk. Subgroup analyses revealed that this mediation was consistent across all gender and racial/ethnic groups, except for foreign-born Hispanics. Smoking mediated the association only for men, explaining 4.2% of the total effect.ConclusionsThese findings suggest that lower cSES may be a risk factor for ADRD partially through lower physical activity across most demographic groups. Interventions promoting physical activity in adulthood could help mitigate the adverse effect of low cSES on ADRD risk. Furthermore, smoking prevention programs may be particularly beneficial for men from lower socioeconomic backgrounds.

Adolescent dairy intake supports physical and mental development accompanying this transitional life stage; however, research exploring the role of dairy on adolescent health outcomes provides inconsistent findings across studies. A comprehensive systematic review was performed (April 2024) to identify literature published within the past 25 years that investigated the association between dairy products and health outcomes among adolescents in the United States. Using the PubMed, Cumulative Index of Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials databases, eligible articles for inclusion had a primary exposure of bovine dairy or dairy-based products and 1 or more health outcomes critically important to adolescent development, defined a priori. Eligible articles (n = 97) examined the association of dairy with body composition (n = 41), bone (n = 31), metabolism (n = 26), skin (n = 4), mental/cognitive health (n = 5), and athletic performance, muscle strength, and recovery (n = 3). Most of the studies were observational (n = 80), included male and female participants (n = 55), and diverse populations (n = 30). Among adolescents in the United States (ages 9-18 years) who consumed dairy products including fluid milk, yogurt, and cheese, among others, the associations with body composition, metabolic outcomes, athletic performance, muscle strength, and recovery, and mental or cognitive health were inconclusive, with multiple studies reporting positive, negative, and nonsignificant findings. Overall, there were positive associations reported between dairy intake and bone health, and negative associations with skin health. The findings presented in this review are the impetus for future research to expand on existing evidence to examine dairy and health outcomes in diverse adolescent populations. Emerging biomarkers associated with health-related components of dairy posit the opportunity to explore understudied health outcomes in adolescents. Additional research should seek to understand the influences of dairy intake to inform interventions aimed at improving the nutritional quality of adolescents' diets. PROSPERO registration No. CRD42024540660.

Feelings of closeness are key to individual and relational well-being. However, individuals may desire different degrees of relationship closeness compared to the actual closeness they feel with their partners. Such discrepancies in closeness may affect marital interaction quality, especially in the context of chronic pain. This study aimed to investigate associations of daily closeness discrepancies with same-day marital interaction quality and the potential mediating effect of same-day loneliness among older individuals with chronic back pain (ICBPs; N = 147) and their partners. Participants reported daily actual and desired closeness, marital interaction quality, and loneliness for 30 days. Closeness discrepancy was defined by the absolute value of actual closeness minus desired closeness. Separate multilevel models were run for ICBPs and partners, and the Monte Carlo method was employed in multilevel mediation models. Closeness discrepancies on a given day were significantly related to decreased marital interaction quality that day in both ICBPs and partners, and such daily associations were in part explained by loneliness that day. Specifically, on days when participants reported greater closeness discrepancies, their levels of loneliness were also higher, and loneliness was in turn related to less positive and more negative marital interaction quality. These associations remained significant after including all covariates. Findings provide evidence for the daily dynamics of closeness discrepancies and marital interaction quality in the context of chronic pain and suggest loneliness as an indirect psychosocial pathway linking such daily associations in late life.

Predicting suicide risk remains a challenge. We examined whether neurocognitive performance on implicit associations toward suicide, motor speed, response inhibition, and executive functioning predicts suicide attempt and behavior in high-risk psychiatric patients. Our sample (N&#xa0;=&#xa0;298) consisted of inpatients (n&#xa0;=&#xa0;161) and outpatients (n&#xa0;=&#xa0;83) admitted for a suicide attempt (SA; n&#xa0;=&#xa0;78), for suicidal ideation (SI; n&#xa0;=&#xa0;76), or were non-suicidal psychiatric controls (PC; n&#xa0;=&#xa0;90), and healthy controls (HC; n&#xa0;=&#xa0;54). Participants were followed for 12&#xa0;months, with follow-up assessments at 3-, 6-, and 12-months. Neurocognitive tasks were administered at baseline. Clinical symptom measures, suicidality, and electronic health record data were collected at each timepoint. ANCOVA was used to compare groups on neurocognitive performance, and logistic and Cox regressions examined whether neurocognitive performance predicted future actual suicide attempt and suicidal behaviors. Participants had a mean age of 24.34&#xa0;years (SD&#xa0;=&#xa0;3.71). A total of 19 participants made an actual suicide attempt during the study. On neurocognitive tasks at baseline, the SA group had stronger implicit associations with death- and suicide-related words compared to the HC (d&#xa0;=&#xa0;0.88, p&#xa0;<&#xa0;0.001) and SI (d&#xa0;=&#xa0;0.63, p&#xa0;=&#xa0;0.005) groups and poorer executive functioning than the SI (d&#xa0;=&#xa0;0.44, p&#xa0;=&#xa0;0.043) group in multivariate models. Stronger implicit associations with death/suicide predicted higher risk of suicide attempts at the univariate (HR&#xa0;=&#xa0;1.68 p&#xa0;=&#xa0;000), but not multivariate level (HR&#xa0;=&#xa0;1.17 p&#xa0;=&#xa0;000), while slower motor speed predicted actual suicide attempts (HR&#xa0;=&#xa0;1.81 p&#xa0;=&#xa0;000) at the multivariate level. Slower motor speed predicts actual suicide attempt and may help identify psychiatric patients who are at high risk for suicidal behavior.

Irritability is a core symptom and diagnostic criterion in several childhood psychiatric disorders. Research has documented bidirectional associations between child irritability and parenting practices; however, cultural variations in these associations remain underexplored.Using three-wave longitudinal data (N = 2,408) from the Future of Families and Child Wellbeing Study (FFCWS) in the United States, this study examined associations between child irritability, parenting behaviors (psychological aggression, physical assault, neglect, and non-violent discipline) and parenting stress across three racial-ethnic groups: non-Latine Black (n = 1,167; 605 males), non-Latine White (n = 614; 314 males), and Latine (n = 627; 316 males) using cross-sectional and temporal network analyses.Parenting behaviors and stress were associated with child irritability concurrently and longitudinally across groups. Results showed bidirectional effects between parenting behaviors/stress and child irritability across ages 3, 5, and 9, with more similarities than differences between groups. Physical assault and lower use of non-violent discipline predicted higher future child irritability (partial correlations = 0.03-0.18 for physical assault and 0.04-0.07 for non-violent discipline) across racial-ethnic groups.These findings suggest parenting interventions may be scalable across cultural contexts to promote positive child outcomes and well-being, though future work should elucidate culturally specific factors that inform tailored practices.

Impaired lung development and lung function can lead to the development of chronic obstructive pulmonary disease (COPD). Genome wide association studies (GWAS) have identified associations between variants in the gene FAM13A with both lung function and COPD. Of the major FAM13A isoforms expressed in humans, only the shorter isoforms are expressed in mice. This species difference has hindered investigations into whether full-length, human-specific isoforms contribute to human lung development, a question that remains unstudied to date. To functionally address this question, we disrupted the long isoform of FAM13A in human induced pluripotent stem cells (iPSCs). Specific loss of this isoform prevented the emergence in culture of mature airway or alveolar epithelial lineages in directed differentiation protocols. We demonstrate that the FAM13A long isoform is critical to patterning NKX2-1&#x2009;+&#x2009;lung progenitor cells through dysregulating Wnt/&#x3b2;-catenin signaling during early stages of development in vitro. These findings provide the first evidence that the COPD risk gene FAM13A may be vital in the developing human lung epithelium.

This 15-year longitudinal study examined the association between family caregiving and cognitive function among middle-aged and older adults in South Korea, focusing on gender differences and the moderating role of social support. Using data from 6,481 participants in the Korean Longitudinal Study of Aging (2006-2020), cognitive function was assessed with the Korean Mini-Mental State Examination (K-MMSE). Family caregiving experience was defined as reporting caregiving in at least two survey waves between 2006 and 2020. Repeated caregiving exposure was associated with lower cognitive performance in later life, independent of baseline characteristics. Women caregivers showed significantly lower cognitive performance (&#x3b2; = -1.06, p < .001), roughly equivalent to two to three years of age-related decline, while higher education and more frequent social interactions mitigated these effects. Social support, measured by the frequency of meetings with friends or neighbors, moderated the caregiving-cognition association, suggesting a protective gradient. These findings highlight the cumulative cognitive burden associated with repeated caregiving involvement and underscore the need for gender- and age-sensitive interventions. Promoting sustained social engagement may represent a viable strategy to protect caregivers' cognitive health in rapidly aging societies.

In the general population, many people are affected by both insomnia and irritable bowel syndrome (IBS). In this study, we aimed to explore the prevalence of insomnia in patients with IBS and its association with the severity of gastrointestinal and extra-intestinal symptoms. Patients with IBS according to Rome IV criteria, referred to the Physiology Unit of Rouen University Hospital (France) between September 2022 and February 2025, who completed various validated questionnaires during their visit to assess insomnia (Insomnia Severity Index (ISI)), IBS severity (IBS-SSS), anxiety and depressive symptoms (HAD-S), quality of life (IBS-QOL), upper gastrointestinal symptom severity (PAGI-SYM), and somatic symptom severity (PHQ-15), were prospectively included in our study. Patients were considered insomniacs when their ISI score was &#x2265;&#x2009;15. Among 700 patients with IBS included in our analysis, 270 (38.6%) were insomniac. The presence of insomnia was associated with more severe gastrointestinal symptoms (IBS severity, IBS-SSS, p&#x2009;<&#x2009;0.001) and somatic symptom severity (PHQ-15, p&#x2009;<&#x2009;0.001). The hierarchical linear regression analysis showed that the ISI score was associated with higher scores of anxiety and depressive symptoms, the presence of functional dyspepsia and fibromyalgia, and, to a lesser extent, older age and higher IBS severity scores (Adjusted R2&#x2009;=&#x2009;0.265). Our findings suggest that in patients with IBS, insomnia is linked with psychological and somatic symptom burden, and the presence of comorbidities such as functional dyspepsia, but causality cannot be inferred. Future studies using objective sleep assessments, such as polysomnography, are needed to confirm these associations.

Maternal overnutrition during pregnancy predisposes children to increased adiposity later in life. This systematic review and meta-analysis examined how this association persists into adulthood and whether it differs by sex. MEDLINE, EMBASE, Scopus, and CENTRAL were searched for human studies published in English before May 2025. From 9191 screened records, 29 studies (430,764 mother-offspring pairs) provided quantitative data on the link between maternal pre-pregnancy body mass index (ppBMI) or gestational weight gain (GWG) and adiposity in adult offspring. The meta-analysis found significant positive associations between maternal ppBMI and offspring BMI, body fat percentage, or waist circumference. Each 1&#x2009;kg/m2 increase in maternal ppBMI was linked to a 0.4&#x2009;kg/m2 higher BMI and 0.35% more body fat in offspring. Maternal overweight/obesity predicted significantly higher offspring BMI or waist circumference, especially in females. Excessive GWG increased the odds of overweight/obesity in the offspring by 35% compared with adequate GWG. This correlation was stronger in early midlife (mean age 30-45) than in young adults. In early midlife offspring, each additional kilogram of GWG was linked to a 0.14&#x2009;kg/m2 higher BMI, independent of ppBMI. These findings underscore the importance of nutritional interventions before and during pregnancy to reduce obesity risk in adulthood.

'Ego dissolution' refers to a temporary state characterized by diminished self-referential processing, which leads to a breakdown of personal boundaries and an enhanced sense of unity with the environment. Both psychedelics, such as ayahuasca, and contemplative practices, like meditation, have been proposed as mechanisms for modulating the ego. While ayahuasca induces transient self-perception alterations, meditation promotes more sustained changes through cognitive and emotional regulation. This study examines whether ayahuasca consumption modulates the ego and compares its effects with those of meditation. A total of 37 ayahuasca users and 137 meditators participated. We used the "Delusion of Me" (DoM) index, a unidimensional self-report measure comprising three domains: acceptance, decentering, and non-attachment. It could be considered closely related to the concept of self 'as a content' and may potentially serve as a measure of ego. Meditators exhibited significantly higher DoM scores than ayahuasca users. The quadratic regression did not show a cumulative effect, with no significant relationship found between the number of ayahuasca sessions and DoM scores. Meditation practice correlated with higher DoM scores and cumulative practice showed a significant non-linear association with DoM. Conversely, repeated ayahuasca exposure demonstrated no evidence of a cumulative association in this sample.

Despite the increasingly visible anti-Asian racism, primary data collection studies highlighting both discrimination and resilience experiences are limited. Informed by Asian Critical Theory (AsianCrit), this study examined the associations among discrimination, resilience, and mental health of Asian and Asian American (AAA) older adults. Between 2023 and 2024, primary data were collected through surveys offered in English, Hmong, and Korean. A total of 126 community-dwelling AAA adults aged 50 and older were recruited, of whom nearly two-thirds lived in urban areas. Descriptive and multivariate regression analyses examined the associations among discrimination, resilience, and psychological well-being, controlling for known covariates. Higher levels of discrimination were associated with greater severity of depression, increased anxiety, and poorer mental health. Conversely, higher levels of resilience were associated with better psychological well-being. We highlight the impacts and innovative approaches to support AAA older adults and other minoritized communities.

Chronic obstructive pulmonary disease (COPD) is now a major contributor to illness and death on a global scale. Traditional classifications based on pulmonary-function variables like the FEV1 (% predicted), lack sensitivity to early inflammatory changes and disease heterogeneity. In contrast, MiRNAs have emerged as promising biomarkers for respiratory conditions including COPD. The aim of this study was to examine the association between selected MiRNAs and COPD. A total of 200 COPD patients (GOLD I-IV, n=50 each) and 50 healthy controls were enrolled. Differentially expressed miRNAs were identified from the GEO database and validated by RT-qPCR. Univariate analysis and LASSO regression were used for feature selection. A logistic regression model incorporating selected variables was established for the forecast COPD severity. KEGG pathway enrichment of miR-518b target genes was performed using DAVID. Five miRNAs (miR-216a, miR-518b, miR-106a, miR-1233, and miR-184) were substantially increased in COPD and correlated with disease severity (P<0.001). LASSO regression identified FEV1 (% predicted), DLCO (% predicted), CAT score, miR-518b, and age as key predictors. The combined model showed excellent classification performance (AUC=0.953; sensitivity=92.9%; specificity=81.3%). MiR-518b emerged as a strong independent risk factor (OR=18.91, P=0.003). Gene set enrichment of miR-518b targets pointed to involvement in both the Toll-like receptor and Hippo pathways, implicating its critical roles in inflammation and airway remodeling. MiR-518b is closely associated with COPD severity and may be useful in clinical practice. A model integrating miRNA expression and clinical parameters provides high predictive value for COPD classification and supports precision diagnosis.

Cognitive analytic therapy (CAT) is a relational, time-limited psychotherapy primarily evidenced to support adults with emotional and relational difficulties. The extent of evidence for CAT in younger populations is not known. This paper aimed to collate all published articles describing CAT with under-18-year-olds and establish feasibility and effectiveness of CAT in this population. An initial systematic search was conducted in MEDLINE, PsycINFO and CINAHL databases, with a second search using key terms and author names in the Association for Cognitive Analytic Therapy website bibliography. Thirty-seven articles were found to meet the inclusion criteria, 11 of which contained quantitative studies. Articles described CAT as individual therapy for young people or their parents, group therapy and consultation frameworks for staff and parents. The limited evidence published on CAT in under-18-year-olds suggests that it is feasible and accessible. Further randomised controlled studies and publication of practice-based outcomes are required.

The National Cancer Institute's Colorectal Cancer Risk Assessment Tool (NCI-CCRAT), an absolute risk prediction model, was developed using data from US White men and women. The model's performance has not been assessed for Black Americans, the US racial/ethnic group with the highest colorectal cancer (CRC) incidence. We externally validated the NCI-CCRAT using data from 53,324 Black Women's Health Study (BWHS) participants aged 40-84 years. We predicted 5-year absolute risks using data from 2001-2015 in three 5-year prediction periods: 2001-2005, 2006-2010, and 2011-2015. To assess model performance, we computed calibration (expected over observed CRC cases, E/O) and discriminatory accuracy (area under the receiver operating curve, AUC). During follow-up, 433 BWHS participants developed CRC. Based on the NCI-CCRAT, 579 CRC cases were expected (E/O=1.34,95% confidence interval [CI]:1.22-1.47). The NCI-CCRAT was well-calibrated in the first 5-year prediction period (2001-2005 E/O=1.10, 95%CI:0.94-1.29), but statistically significantly overestimated risk in later periods. We estimated discriminatory accuracy only for the 2001-2005 prediction period (151 CRC cases) and obtained an age-adjusted AUC=0.62 (95%CI:0.57-0.66). Associations of vigorous physical activity, aspirin/NSAID use, vegetable intake, and body mass index with CRC risk were weaker in the BWHS than in the studies used to develop the NCI-CCRAT. The NCI-CCRAT significantly overestimated the number of CRC cases in BWHS participants, possibly due to population-specific differences in associations of key CRC risk factors. This suggests that future research needs to determine important predictors of CRC risk in Black Americans and to develop a CRC prediction model for Black women.