搜索结果：Communications psychology

The metaphor of "scaffolding" originates from developmental psychology, and has become a central theoretical concept that plays explanatory roles in psychology, developmental biology, and evolutionary biology. In developmental psychology, the scaffolding process is typically characterized as a child's temporary reliance on external structure in training activities, which leads to long-term transformation of the child's capacities. In recent attempts to clarify this concept for wider usage (e.g., Caporael, Griesemer, and Wimsatt 2014a, b; Neto et al. 2023), the temporariness of dependence on scaffolds is still seen as a typical, if not defining, feature of scaffolding explanations. In this paper, we follow Bill Wimsatt's footsteps (Wimsatt 2014a, 2019; Wimsatt and Griesemer 2007) in examining the development of skills that require complex developmental trajectories. Our cases are jazz improvisation and scientific expertise, both of which are distinctively social and improvisational. We argue that the social scaffolds required to reach the maturity of such expertise are continually required thereafter for maintenance and further development. This is because improvisational training is somewhat indistinguishable from improvisational performance, and performance in social expertise aims at interactions, communications, and rapport between interlocutors.

Drawing on social identity theory (SIT), this qualitative study examines how AI adoption threatens the professional social identity of content creators in Vietnamese communications agencies and the identity-management strategies they employ in response. Despite research on technological disruption and professional identity in Western contexts, the role of cultural values in moderating identity threat and coping processes remains underexplored, particularly in collectivist Asian societies, where group membership rather than individual competence constitutes the primary source of self-concept. Through semi-structured interviews with 25 content creators across communications agencies in Hanoi and Ho Chi Minh City, we identified four forms of identity threat: competence threat, distinctiveness threat, categorization threat, and value threat. The findings reveal that Vietnamese content creators predominantly employ collective identity redefinition rather than individual repositioning or direct resistance, reflecting Vietnam's collectivist cultural orientation, high power distance, and face concerns. Participants reframed AI as a tool that enables a focus on strategic and culturally nuanced work, particularly Vietnamese cultural understanding, while delegating mechanical tasks, thereby preserving professional group distinctiveness through shared narratives rather than individual competitive positioning. This study demonstrates that cultural context fundamentally moderates the forms of identity threat that prove most salient and the coping strategies that are employed, contributing to cross-cultural organizational psychology and challenging Western-centric assumptions about professional identity transformation during technological disruption. Practically, the findings suggest that Western change management approaches emphasizing individual adaptation may prove ineffective in collectivist cultures, necessitating culturally responsive AI integration strategies that facilitate collective sense-making rather than mandating individual skill development.

Current efforts to understand Large Language Models (LLMs) are largely metaphorical. Researchers map LLMs onto familiar domains, from physics and neuroscience to psychology and sociology, each illuminating specific facets while obscuring others. We chart these metaphors across mechanistic, behavioral, and interactive scales and delineate their explanatory boundaries. Crucially, this metaphorical projection creates a recursive loop of anthropomorphism, fueling the "genuine understanding" versus "pattern matching" impasse. As an alternative approach, we propose machine experientialism, positing that LLMs build their own form of understanding from training corpora. The priority shifts from cataloging LLMs' human-like traits to uncovering their distinct logic that emerges from this text-based world.

To test the relationships between reasons for using e-cigarettes and responses to the FDA nicotine addiction warning and explore differences in associations by exclusive e-cigarette use versus dual use of e-cigarettes and cigarettes. In a within-subjects experiment, young adults who currently used e-cigarettes (N = 353) evaluated 11 e-cigarette advertisements that included the U.S. FDA text addiction warning on a range of cognitive and affective outcomes such as worry about health harms, discouragement to use e-cigarettes, and perceptions of e-cigarettes as a healthy alternative to cigarettes; and they answered questions about their reasons for using e-cigarettes. Those who dual use reported stronger reasons to reduce cigarettes relative to those using e-cigarettes exclusively. The two groups did not differ on social context or sensory experience reasons for using e-cigarettes. Stronger endorsement of any reason for use was associated positively with higher cognitive and emotional responses across most responses to the FDA e-cigarette warning, and this was most consistent for social context reasons to use. Use group moderated this relationship, particularly for endorsement of social context reasons, such that those who exclusively used had stronger responses to the warning. Use motivations could be helpful in tailoring health communications for youth and young adults so that they help mitigate e-cigarette marketing strategies that target this vulnerable population. Young adults who use e-cigarettes do so for a number of reasons. Reasons for using e-cigarettes may contribute to how young adults who use e-cigarettes respond to e-cigarette health warnings. Consideration of reasons to use e-cigarettes could contribute to approaches to educate and inform about health harms of e-cigarettes.

The increasing mental health gap in low- and middle-income countries (LMICs) represents a significant global public health concern. Access to mental healthcare remains challenging due to stigma, lacking quality treatment options, and skilled workforce shortages. Tele-mental health, which involves remote access to care through information and communications technologies (ICTs) and mobile communication systems, may represent a promising solution. However, most research in this area has been conducted in high-income countries. This scoping review aimed to explore known barriers and facilitators to implementing tele-mental health solutions to populations in remote, rural, and underserved communities in LMICs to inform evidence-based development and implementation of digital interventions and strategies that can improve access to quality and affordable mental healthcare. Studies published between 2010 and 2024 were identified through comprehensive searches across four databases, namely PubMed, PsycINFO, Web of Science, and SpringerLink. Nine studies were included for analysis. Barriers and facilitators were categorised using the Capability, Opportunity, and Motivation = Behaviour (COM-B) model. A narrative synthesis revealed several barriers for patients, primarily related to limited physical and social opportunities, such as lack of mobile devices, unstable or limited internet access, and lack of private space at home. Barriers for mental health providers were predominantly linked to psychological capability, including insufficient knowledge concerning tele-mental health interventions. Time and cost efficiencies were key facilitators for both service users and mental health service providers, which enhanced access to care. Infrastructure development, educational initiatives, and training for providers are essential to create a more equitable tele-mental healthcare system.

Widespread change toward transactional and technological health care is contrary to the generalist philosophy and is challenging the ability of family medicine physicians to enact its values and meet patient needs. This research seeks to build understanding of generalism by asking international generalist physicians to reflect on the often tacit features of generalism that provide much of its value. Researchers conducted a 2-phase qualitative study. Phase 1 consisted of Zoom (Zoom Video Communications, Inc) individual interviews with 13 international generalist physicians and researchers. Phase 2 included personal reflections to prompts via an app and handwritten reflections after small group conversations among 89 generalist physicians and primary care researchers at an international family physician conference. Combining data from both phases 1 and 2, we discerned themes in an iterative, reflexive analysis. Analyses identified 3 themes: (1) "The Way" of being of the generalist; with subthemes of "anything and everything," "putting all the pieces back together," "walking the journey together," and "widening my small world"; (2) "The Privilege" of emotional connection and gratefulness toward patients for meaningful work, with subthemes of "privilege that touches you" and "privilege of holistic care"; and (3) "The Indescribable Whole" of the valuable, but often invisible and misunderstood essence of generalism, with subthemes of "a great big huge idea," "deep care," and "invisible when done well." These findings bring to light the integrative, relational, wholistic work of the generalist physician. Understanding, valuing, and supporting these aspects of generalist care could serve as an antidote to health care systems that are increasingly fragmented, impersonal, and ineffective.

Returning to work after cancer offers important psychological and economic benefits. However, individuals with head and neck (H&N) cancer face a higher risk of leaving the workforce due to the functional consequences of treatments. This study examined the association between H&N cancer and job separation within 2 years of diagnosis and identified patient profiles at higher risk. An integrated database was created by linking the Turin Longitudinal Study, the regional Mandatory Communications archive, and the national INPS archive. Incident H&N cancer cases were identified through hospital discharge records, and employment status was defined using occupational data. Each worker with H&N cancer was matched with four cancer-free workers of similar sociodemographic characteristics (non-cases). Patient profiles were defined through latent class analysis. Robust Poisson models were used to estimate the risk of job separation. Between 2008 and 2020, 255 employed individuals were diagnosed with H&N cancer. They showed a twofold higher risk of job separation compared with matched non-cases (RR = 2.00, 95% CI: 1.59-2.51). Some profiles were more likely to exit the workforce, particularly workers with more severe disease (RR = 2.14, 95% CI: 1.04-4.42) or with lower education and higher socioeconomic deprivation (RR = 1.74, 95% CI: 1.02-2.95). H&N cancer diagnosis substantially increases the likelihood of job separation, particularly among socioeconomically disadvantaged workers. Identifying vulnerability profiles is essential for developing targeted return-to-work strategies. Integrated health and administrative data can support tailored interventions that better address survivors' long-term employment needs.

Loneliness is a prevalent concern across the United Kingdom. While validated scales exist to quantify the severity of loneliness across populations, there remains a gap in understanding how loneliness manifests and is addressed within therapeutic practice. Given the associated stigma surrounding loneliness, practitioner perspectives offer crucial insights into how clients express loneliness within digital therapeutic environments. These insights can inform more nuanced conceptualizations of loneliness. This study aimed to gather the practitioners' perspectives on loneliness within a digital therapeutic context and were defined as follows: (1) understand how practitioners identify loneliness concerns, (2) identify how loneliness is elicited in digital mental health interventions, and (3) identify co-occurring themes (such as grief, shame, and social disconnection) that signal loneliness concerns in client communications within digital therapeutic environments. Semistructured interviews were conducted with 9 practitioners. Participants included specialists in grief counseling, lesbian, gay, bisexual, transgender, and queer or questioning plus support; and digital mental health therapists. Interview transcripts were analyzed using thematic analysis, using an inductive, data-driven approach to allow themes to emerge from participant accounts rather than fitting data to preexisting theoretical frameworks. The following four themes were identified: (1) Conceptualizing Loneliness: practitioners distinguished between social contact and meaningful connection; (2) Contextual Causes: loneliness emerged from life transitions, stigmatized identities, and resource reduction (eg, youth services closures and social support); (3) Expressions and Language: clients rarely expressed loneliness directly, instead using proxy terms, with disclosure patterns varying by age; and (4) Mental Health Co-occurrence: severe mental health conditions created bidirectional cycles of loneliness, exacerbated by symptoms of mental health difficulties. Practitioners reported that many clients experienced loneliness concerns, yet direct disclosure was absent across all participants' experiences. Practitioners identified multiple stigmatizing experiences as contextual drivers of loneliness, particularly demonstrating how loneliness emerges not only from individual experiences but from broader patterns of social exclusion and marginalization. For therapeutic practice, these insights suggest that practitioners can use awareness of stigmatizing experiences as potential indicators when assessing loneliness risk. The presence of contextual patterns was consistent across practitioners' experiences, providing a foundation for developing more targeted interventions to address both the emotional experience of loneliness and the underlying social drivers.

Sports betting is a common activity for emerging adults (ages 18-29) and is associated with financial harm, academic decline, and psychological distress. Responsible gambling (RG) messages aim to mitigate such harms, but generic slogans like "gamble responsibly" often lack actionable guidance and credibility, particularly when sponsored by gambling operators. Drawing from Cialdini's theoretical framework of persuasion, this study experimentally examined how RG advertisement message framing (generic vs. self-appraisal) and sponsor type (sportsbook vs. State Department of Health) influenced perceived trust in the advertisement, behavioral intentions, and gambling desire among emerging adult sports bettors. A total of 255 crowdsourced participants (Mage = 24.77; 47.8% men, 48.2% women) were randomly assigned to view one of four 20-s RG video advertisements varying by sponsor type and framing. Measures included perceived trustworthiness, personal responsibility toward RG, intentions to sports bet and engage in RG, and gambling desire. Sponsor type significantly influenced the perceived trustworthiness of the advertisement, with Department of Health-sponsored ads rated as more trustworthy than sportsbook-sponsored ads. There was no significant interaction between sponsor type and message framing, and message framing did not significantly influence trust. Additionally, neither sponsor type nor framing significantly affected personal responsibility toward RG, intentions to sports bet or engage in RG, or gambling desire. Findings indicate that while Department of Health advertisements enhance perceived trustworthiness, these effects did not translate into changes in behavioral intentions or gambling desire. Results highlight the importance of message source within RG communications. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

To identify latent profiles of change fatigue among nurses in Southwestern China and explore factors associated with distinct profiles. Healthcare resources in Southwestern China are unevenly distributed, and the region features considerable ethnic diversity. Against the backdrop of ongoing reforms in the healthcare system, nurses-as frontline implementers-are constantly exposed to intensive and frequent updates in policies, technologies, and workflows, making them susceptible to change fatigue. This sustained exposure precipitates "change fatigue," a syndrome that erodes psychological resilience and professional identity, and is prospectively linked to heightened turnover intention, measurable deterioration in nursing quality and an increased incidence of patient-safety events. From July to September 2025, we recruited nurses from various tiers and types of medical institutions across Southwestern China. Data were collected using a general information questionnaire, the Change-Related Stress Scale, the Grandey Emotional Labor Strategy Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the Chinese Nurse Job Stressors Scale. Latent profile analysis (LPA) was employed to identify subgroups of change fatigue. Univariate analysis and multinomial logistic regression with Firth's penalized likelihood estimation were used to examine factors associated with profile membership. A total of 1383 valid questionnaires were included. LPA revealed three distinct profiles of change fatigue: low fatigue (17.5%, n&#x2009;=&#x2009;242), moderate fatigue (61.6%, n&#x2009;=&#x2009;852), and high fatigue (20.9%, n&#x2009;=&#x2009;289). Multinomial logistic regression showed that nurses in the high fatigue group were significantly more likely to work in the intensive care unit (OR&#x2009;=&#x2009;2.31, 95% CI: 1.40-3.85, p = 0.001) and internal medicine (OR&#x2009;=&#x2009;2.12, 95% CI: 1.26-3.61, p = 0.005). Working 1-2 night shifts per week increased odds of high fatigue by 53% (OR&#x2009;=&#x2009;1.53, 95% CI: 1.03-2.27, p = 0.034). Compared with minimal emotional labor (Level 1, 14-30 points), both moderate (Level 2, 31-50 points: OR&#x2009;=&#x2009;0.14, p = 0.030) and high (Level 3, 51-70 points: OR&#x2009;=&#x2009;0.09, p = 0.010) emotional labor levels were associated with significantly lower odds of high fatigue, suggesting that deficient emotional labor engagement may represent a risk configuration. Work stress Level 3 increased odds of high fatigue 33-fold (OR&#x2009;=&#x2009;32.71, 95% CI: 13.27-103.37, p < 0.001). Psychological resilience showed no independent significant association with profile membership in multivariate models. Change fatigue exhibits a heterogeneous tripartite structure. Minimal emotional labor engagement (Level 1) was associated with higher odds of high fatigue compared with moderate and high levels, suggesting that deficient emotional labor may represent a distinct risk configuration. Both modifiable workplace factors (ICU/internal medicine placement, night shifts, and job stress) and emotional labor patterns were associated with profile membership, supporting the potential value of organizational interventions and targeted emotional labor training. These findings provide an evidence-based foundation for precision prevention. Nursing leaders should integrate the six-item Change Fatigue Measurement Scale into routine occupational health surveillance to enable profile-based risk stratification. High-fatigue nurses (20.9%) require immediate workload relief and mental health referral; moderate-fatigue nurses (61.6%) represent a critical prevention window for resilience training and peer support; low-fatigue nurses (17.5%) should serve as peer mentors and change champions. Priority interventions should target ICU and internal medicine units given the 2- to 2.3-fold increased high-fatigue risk. Leaders should limit consecutive night duties to &#x2264;&#x2009;2 shifts, ensure &#x2265;&#x2009;11&#x2009;h rest between shifts, and enforce weekly overtime caps (&#x2264;&#x2009;8&#x2009;h). Differentiated emotional labor training is essential: Nurses with minimal engagement need professional identity strengthening and authentic expression workshops, while those with excessive engagement require boundary-setting training and mindfulness-based stress reduction. Resilience-building interventions must be embedded within organizational support initiatives rather than implemented as standalone programs. In ethnically diverse, resource-constrained contexts, culturally tailored change communications and phased implementation timelines are critical to avoid "reform stacking."

We examined the longitudinal associations between relational victimization, depressive symptoms, and e-cigarette use intentions among adolescents in Guam, a U.S.-Affiliated Pacific Island in the Western Pacific region. We also explored potential gender differences in these associations. Data were drawn from three waves of surveys that were administered to public middle school students (N&#x2009;=&#x2009;528; M&#x2009;=&#x2009;12.66, SD = 0.89). In a parallel process growth curve model, our results indicated that, at the intercept level, higher levels of relational victimization were associated with greater levels of depressive symptoms, which were, in turn, related to stronger intentions to use e-cigarettes. However, relational victimization was not directly associated with e-cigarette use intentions. Girls experienced more relational victimization and showed more depressive symptoms than boys, but not e-cigarette use intentions. Furthermore, at the slope level, changes in relational victimization were associated with changes in e-cigarette use intentions. Although the changes in relational victimization covaried with changes in depressive symptoms, there was no mediation effect. The overall mediation model did not differ between boys and girls. In the context of the Pacific Islands, we discussed clinical and developmental implications, as well as directions for future research.

Cigarettes are a global public health concern, as cigarette smoking is the leading cause of death in the United States and throughout most high-income countries. Exposure to tobacco retail has been linked to adverse smoking outcomes, but research using naturalistic and causal approaches to quantify these effects in the real world remains relatively sparse. To address these gaps, this study used geolocation tracking, ecological momentary assessment, and neuroimaging to assess smoking outcomes in daily life and conducted a randomized controlled trial focused on the effects of exposure to tobacco retail. The GeoSmoking study aimed to evaluate (1) within-person associations between real-world tobacco retail exposure and cigarette craving and smoking, (2) causal effects of real-world tobacco retail exposure, and (3) neural cue reactivity as a mechanism for real-world tobacco retail effects. This paper describes the implemented protocol, including study status and flow reporting. In a 2-week baseline period, the study collected reports of craving and smoking multiple times per day using ecological momentary assessment, in addition to other measures. Simultaneously, geolocation tracking was used to quantify tobacco retail exposure through the creation of a tobacco retail database across 3 US states (Pennsylvania, New Jersey, and Delaware). A 4-week intervention period followed, in which participants were randomly assigned to make a purchase at either a nontobacco retail store 5 days per week (nontobacco retail condition) or a tobacco retail store 5 days per week (tobacco retail condition), or follow their normal routines (control condition). An optional functional magnetic resonance imaging (fMRI) session concluded the study. Individuals participated remotely, unless they opted into the fMRI session, which was completed at the University of Pennsylvania. The GeoSmoking study was approved by the Institutional Review Board at the University of Pennsylvania. Data collection started on May 25, 2022, and ended on June 10, 2024. In total, 310 participants were enrolled, 282 participants completed the baseline phase, 244 participants completed the intervention phase, and 24 participants completed the optional fMRI scan. This study protocol was implemented successfully. Findings from planned analyses will quantify the strength of relationships between naturalistic exposure to tobacco retail, craving, smoking, and a range of other outcomes. These findings have significant implications for our understanding of health behaviors and outcomes, as well as policy.

The teaching profession is inherently characterized by high job demands and chronic stressors, frequently leading to burnout. While literature consistently links excessive workload and classroom challenges to emotional exhaustion, there is a growing need to identify personal resources that may be associated with lower levels of burnout and emotional exhaustion. Psychological hardiness, a personality construct comprising commitment, control, and challenge, has been identified in various high-stress occupations as a key resilience factor, yet its specific moderating role in the educational context requires further empirical evidence. This cross-sectional study examined 844 primary and secondary education teachers from Greece and Cyprus. The variables investigated included three types of job stressors (workload/time pressure, student learning problems, and organizational issues), emotional exhaustion, and the three facets of psychological hardiness. Data were collected using the Teachers' Professional Stress Questionnaire, the Maslach Burnout Inventory, and the Hardiness Resilience Gauge. Statistical analysis was performed using Confirmatory Factor Analysis (CFA) and Latent Moderated Structural Equation (LMS) modeling to test interaction effects. Findings revealed that hardiness significantly moderates the relationship between job stressors and emotional exhaustion. Notably, the three hardiness facets (3Cs) functioned differentially, with certain attitudes showing stronger moderating associations with specific stressors than others. These results support the "hardiness mindset" approach, suggesting that hardiness may be relevant in understanding how teachers appraise and respond to job demands and emotional exhaustion. The study highlights the potential for hardiness-based intervention programs to address teacher burnout. However, the cross-sectional design and the use of convenience sampling limit the ability to draw causal inferences and generalize findings to all educational systems.

Synchrony refers to similarity in movement between different actors such as dancing, clapping, or singing together. Prior research demonstrates that synchrony often elicits emotions that may be characterized as aesthetic or self-transcendent (e.g., awe, connectedness). Our research situated the concept of synchrony in media contexts, examining viewers' affective responses to videos featuring synchronous movement. Study 1 employed an experiment, showing that synchronized videos elicited greater awe, with awe associated with a host of prosocial outcomes reflecting connectedness and motivations to do good. Study 2 employed content analytic procedures to examine how the synchrony present in a large sample of YouTube videos was associated with user comments reflecting self-transcendent emotions, and how these emotions were associated with the salience of moral foundations. The results showed that synchrony was associated with greater feelings of awe, admiration, and elevation. Further, comments reflecting self-transcendence were associated with the salience of moral foundations, and particularly the foundation of care.

Swiping-based dating apps have become a pervasive feature of contemporary social life, reshaping how individuals seek intimacy, curate self-presentation, and encounter psychological feedback. This systematic review and meta-analysis compared dating app users vs non-users across 27 studies (N&#x2009;=&#x2009;21,263) to assess associations with mental health outcomes. Across six theoretically derived domains, meta-analytic results indicate small-to-moderate associations between dating app use and emotional distress, appearance concerns, body image disturbance, behavioral dysregulation, and interpersonal sensitivity, with the strongest effects observed for behavioral dysregulations (g&#x2009;=&#x2009;0.44) and body-related outcomes (g&#x2009;=&#x2009;0.32). Effects for general wellbeing were small and non-significant. Women and men who belong to a sexual minority exhibited elevated appearance- and body-related vulnerability. Although mechanisms cannot be inferred from available evidence, converging patterns across studies suggest that visually driven, evaluative interaction features may compound appearance-based concerns, and that high-volume partner choice may correlate with compulsive or dysregulated patterns of use. Considerable heterogeneity across studies underscores the influence of individual susceptibility and social context. Overall, findings indicate significant associations between dating app use and adverse psychological outcomes, while highlighting substantial gaps in longitudinal and mechanistic evidence. Future research should employ prospective and intersectional designs to clarify temporal pathways and inform digital mental health interventions.

Tuberculosis (TB) is the leading global cause of death from a single infectious agent. Recent reductions in global health funding have threatened TB control, making comprehensive assessment of TB, HIV-related TB, and drug-resistant TB burdens before these disruptions essential for shaping effective responses. The WHO End TB Strategy sets targets of a 95% reduction in TB deaths and a 90% reduction in TB incidence between 2015 and 2035. Using results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, this study aims to assess the burden of TB and multidrug-resistant TB (MDR-TB) across 204 countries and territories, and to evaluate progress towards the WHO End TB incidence and mortality targets. We quantified TB mortality using the Cause of Death Ensemble modelling platform with global vital registration, surveillance, verbal autopsy, and minimally invasive tissue sampling data. For TB morbidity estimation, we simultaneously modelled incidence, prevalence, and mortality by age and sex using DisMod-MR 2.1. A population attributable fraction (PAF) approach was applied to stratify morbidity and mortality estimates by HIV and drug-resistance status. We also calculated disability-adjusted life-years (DALYs) as the sum of years of life lost and years lived with disability. For the risk factor analysis, a comparative risk assessment framework was used and PAFs were derived for alcohol use, smoking, and high fasting plasma glucose to determine the proportion of TB burden associated with these risk factors. In 2023, there were an estimated 9&#xb7;11 million (95% uncertainty interval 8&#xb7;04-10&#xb7;3) incident cases of all-form TB, 1&#xb7;22 million (0&#xb7;98-1&#xb7;49) deaths, and 54&#xb7;6 million (43&#xb7;8-65&#xb7;5) DALYs globally. HIV-related TB comprised 781&#x2008;000 (690&#x2008;000-879&#x2008;000) incident cases and 210&#x2008;000 (142&#x2008;000-279&#x2008;000) deaths, contributing 11&#xb7;0 million (7&#xb7;56-14&#xb7;3) DALYs. MDR-TB accounted for 466&#x2008;000 (198&#x2008;000-1&#x2008;080&#x2008;000) incident cases, 102&#x2008;000 (31&#x2008;700-238&#x2008;000) deaths, and 3&#xb7;96 million (1&#xb7;31-9&#xb7;01) DALYs. From 2015 to 2023, global all-form TB incidence rates declined by 19&#xb7;2% (17&#xb7;8-20&#xb7;5) and deaths declined by 22&#xb7;6% (4&#xb7;7-35&#xb7;7); declines were larger for drug-susceptible TB than for MDR-TB. Sub-Saharan Africa and south Asia had the highest mortality burdens in 2023; reductions in all-form TB incidence and mortality were uneven between 2000 and 2023, with limited progress in both measures in Latin America and the Caribbean. Removing smoking, alcohol use, and high fasting plasma glucose would reduce global TB deaths to 768&#x2008;000 (592&#x2008;000-970&#x2008;000) and DALYs to 34&#xb7;9 million (27&#xb7;8-43&#xb7;8) in 2023; MDR-TB deaths would decrease to 77&#x2008;200 (23&#x2008;400-183&#x2008;000) and DALYs to 3&#xb7;12 million (1&#xb7;03-7&#xb7;29). Global progress towards WHO End TB targets is disparate and fragile. Although many regions achieved meaningful gains, others have stagnated in recent years. The complexity of TB prevention is amplified by divergent MDR-TB trends, the persistent burden of HIV, and growing exposure to modifiable risk factors. Recent volatility in global health financing threatens to further destabilise this vulnerable epidemiological landscape; concerted action is urgently needed to temper disruptions and preserve progress. Gates Foundation.

Childhood maltreatment is a well-established transdiagnostic risk factor for psychopathology. Effective intervention requires a precise understanding of how distinct dimensions of adversity-neglect (deprivation) and abuse (threat)-uniquely shape emotion regulation. In a large, matched sample constructed using cardinality and optimal pair matching methods, we examined the differential associations between neglect, abuse, and their combination and a broad spectrum of emotion regulation difficulties and mental health outcomes including depression, anxiety, and suicide risk. Neglect was linked to a decreased use of regulatory strategies, reflecting a lack of essential developmental inputs. Abuse was associated with disrupted application of existing strategies, indicating interference with functional regulation. Critically, combined exposure to both neglect and abuse resulted in the most pervasive impairments across basic, cognitive, and interpersonal regulation. These findings support dimensional models of adversity and underscore the need for future research on trauma-specific interventions tailored to early-life experiences of threat and deprivation.

To examine the associations of smartphone addiction, physical activity, and sedentary time with sleep quality and neck/shoulder symptoms during the previous 7&#x202f;days in university students, and to assess the potential modifying role of physical activity in outcomes associated with smartphone addiction. A cross-sectional survey was conducted among 585 students from a single university in Jilin Province, China. Smartphone addiction, physical activity, sedentary time, sleep quality, and neck/shoulder symptoms were assessed using validated questionnaires. Multivariable linear regression and Poisson regression with robust variance were used to examine adjusted associations and interaction terms. Of the participants, 43.8% were classified as having poor sleep, and 46.2% reported at least one neck/shoulder symptoms during the previous 7&#x202f;days. After adjustment for covariates, higher smartphone addiction and longer sedentary time were both associated with higher PSQI scores, a higher prevalence of poor sleep, and a higher prevalence of neck/shoulder symptoms during the previous 7&#x202f;days. Meeting physical activity recommendations was associated with lower PSQI scores and a lower prevalence of poor sleep, but showed no independent association with neck/shoulder symptoms. After further adjustment for PSQI, smartphone addiction, sedentary time, and PSQI score were still significantly associated with a higher prevalence of neck/shoulder symptoms. Interaction plots showed descriptively lower predicted PSQI scores and lower predicted probabilities of neck/shoulder symptoms among students who met physical activity recommendations at comparable levels of smartphone addiction; however, the formal interaction terms were not statistically significant. Smartphone addiction and sedentary time were consistently associated with poorer sleep quality and more frequent neck/shoulder symptoms. Physical activity was more consistently associated with sleep outcomes than with neck/shoulder symptoms. These findings support considering smartphone use, sedentary behaviour, physical activity, and sleep management together in campus health promotion research.

Spontaneous thought unfolds as a dynamic stream that reflects continuously changing internal states and is closely tied to individual differences in mental health. However, quantifying the temporal structure of spontaneous thought remains challenging due to limited behavioral paradigms and analytic tools that preserve its continuous, multidimensional nature. Here, we introduced Density Map-Based Predictive Modeling, a framework that characterizes spontaneous thought dynamics elicited by the Free Association Semantic Task within valence-self-relevance-time space. Density Map-Based Predictive Modeling summarizes each individual's thought stream using rating and vector density maps that capture both where thoughts concentrate and how they transition over time. Across multiple independent datasets (total N&#x2009;=&#x2009;392), Density Map-Based Predictive Modeling yields robust, generalizable predictions of positive affectivity and negative affectivity using principal component regression. Feature analysis indicated that affectivity is reflected not only in the content of thoughts, but also in transition dynamics, with self-relevance as a key organizing dimension. Furthermore, higher predicted positive affectivity was associated with lower salivary C-reactive protein, suggesting a link between thought dynamics and inflammation. Together, these findings establish a scalable, interpretable approach for quantifying spontaneous thought dynamics and relating them to transdiagnostic affective traits and potential physiological correlates.