Lung cancer is associated with substantial psychosocial burden for those affected and their relatives. This trial evaluates effects of CALM-based psycho-oncological counseling (Managing Cancer And Living Meaningfully) for relatives of lung cancer patients and explored indirect effects on patient outcomes. In this multi-center randomized controlled trial, patient-relative dyads were assigned to an intervention (IG; three to six CALM-based sessions) or control group (CG; usual care). All patients could access standard support. Assessments occurred at baseline and after six weeks. The primary outcome was relatives' anxiety; secondary outcomes were depression, distress, and quality of life. Patient outcomes included anxiety, depression, and distress. Effects were analyzed with ANCOVA, and within-group comparisons. Secondary analyses explored dyadic relationships using multilevel models. Among 86 relatives (40 IG, 46 CG), no group-level effects emerged. Within the IG depression and distress decreased significantly (medium to large effect). Patients whose relatives attended at least one counseling session experienced reduced distress. There was strong dyadic dependence for couples across all outcomes. Despite lacking group-level effects, individual improvements highlight the potential of CALM-based counseling and the importance of integrating relatives and dyadic counseling into psycho-oncological care.
The CALM Registry was a retrospective cohort study that assessed real-world outcomes of treating chronic noninfectious uveitis affecting the posterior segment (NIU-PS) with the 0.18-mg fluocinolone acetonide implant (FAi). Eligible participants were aged ≥18 years and diagnosed with chronic NIU-PS. Safety and effectiveness outcomes, as available, were collected from charts. Two hundred sixty-seven eyes from 200 participants received the FAi (mean age, 62.8 years; 10.5% phakic). Median intraocular pressure remained stable at 14.0 mmHg. Two cataract surgeries were reported. In the 12 months pre-FAi, 84.1% of eyes had ≥1 recurrence of uveitis; 12 months post-implant, the recurrence rate was 12.0%, and retinal thickness reduced significantly (P < .05). The proportion of eyes with ≥ 20/40 visual acuity was stable from baseline (49%) to 12 months (55%). Real-world data from the CALM Registry study indicate effective control of chronic NIU-PS with the FAi and no new safety signals.
On-farm welfare assessment of equines is a challenge given the large diversity of management practices, especially in terms of housing and activities. In our study, we tested time budget measures as a complementary tool to more conventional welfare indicators (e.g., stereotypic behaviours, ear position while foraging, neck shape). We observed 174 horses living in eight facilities (in their home environment) for which data on management practices and welfare were available. Time budget was assessed using the scan sampling method (1 min scan sampling over 30 min; 33 scans), while welfare assessment was based on classical measures. The study was performed in two parts: The first part consisted of validating time budget as a correlate of welfare state, which was performed at the individual level and according to the context of observation. In the second part, the data were analysed at the farm level by averaging data from all horses in the same facility. The results showed that the time spent feeding, in exploratory walking and observation behaviour were correlated with indicators of positive welfare and/or good practices in contrast to the time spent standing immobile resting or in fixed attention and/or in negative social interactions. Time budget varied greatly between facilities, reflecting welfare state and management (feeding, working) practices. This study shows that, provided that observations are made at different time periods when animals are calm, three sessions of 10 min. could give a good account of the local «atmosphere». These findings bring new insights into both methodological approaches and the significance of behaviours and, in particular, the importance of precisely defining and measuring the types of attention as a window into an animal's internal state.
There is limited understanding of how patients with acute infections experience the emergency department (ED) and how this relates to key aspects of person-centred care (PCC). Furthermore, the fast-paced and demanding nature of the ED presents challenges to the delivery of PCC. This study aims to explore the experiences of adult patients with acute infections in the ED and use these to identify strategies to better support healthcare providers in delivering PCC in the ED. Qualitative in-depth interviews were performed with adult patients who presented to the ED with a (suspected) acute infection between March and May 2023 in an academic hospital in the Netherlands. Thematic content analysis was performed on the interview transcripts. Sixteen interviews were performed, and seven themes were identified: 1. Information and expectation management, 2. Person-centred communication and interactions, 3. Accessibility and coordination of care, 4. Decision-making and patient participation, 5. Timeliness of care, 6. ED context and comfort and 7. Emotional experience and coping. In the overarching theme 7, three patient typologies were identified, the 'uncertain and alone' participants, the 'overwhelmed' participants and the 'calm and unhurried' participants, all of whom would benefit from specific communication and care approaches. This study highlighted several key aspects of PCC in the ED for patients with acute infections. While patients reported some unique experiences to infectious diseases, many were similar to those reported by patients with other conditions in the ED, as described in the literature. Three patient typologies were identified within the theme: 'emotional experience and coping'. Recognizing patient typologies can provide care providers with a practical framework to quickly tailor their care and communication strategies, enhancing the delivery of PCC in acute settings.
In conflict-affected regions, civilians are often exposed to traumatic events, leading to acute stress reactions and possibly posttraumatic stress disorder (PTSD). While negative emotions during and shortly after trauma are known predictors of PTSD, the role of positive affect as a potential protective factor remains underexplored. This study examines PTSD symptoms and positive affect in 65 participants during two distinct periods: acute conflict (2014 Israel-Gaza war) and 3.5 years later during relative calm. Using two-step multilevel longitudinal network analysis, we examined how temporal and contemporaneous relationships between PTSD symptom clusters and positive affect differ between periods. Results revealed significant predictive relationships during conflict that were absent at follow-up in the temporal networks. Notably, positive affect predicted reduced severity in negative cognitions and mood during conflict (partial r = -.24 contemporaneously; b = -.1 temporally), suggesting a possible protective role under acute stress. Arousal predicted other PTSD symptom clusters in the temporal network during conflict (b =.01 -.08). These findings highlight the importance of studying peritraumatic dynamics to better understand resilience and risk in trauma-exposed populations.
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Child maltreatment (CM) can have profound intergenerational impacts, with maternal CM experiences increasing the risk of adverse outcomes in the next generation. Using data from the Intergenerational Childhood Adversity and Lifetime Morbidity (I-CALM) study, we examined associations between self-reported CM and statutory child protection data, and adverse neonatal outcomes, including preterm delivery, resuscitation at birth, admission to special care nursery (SCN) or neonatal intensive care units (NICU), and morbidity within 28 days of birth. We also investigated whether risk factors identified at women's first antenatal care visit mediated these associations. The odds of preterm delivery, SCN or NICU admission units, and neonatal morbidity were significantly higher in births to women with both self-reported CM and statutory notifications. Smoking after 20 weeks' gestation partially mediated the relationship between statutory notifications and most adverse neonatal outcomes, but all other pathways were non-significant. These findings highlight several avenues for future research.
BackgroundItaly's Legislative Decree 81/2008 includes work-related stress and organisational factors in its definition of prevention. For young workers in unstable jobs, the gap between legal principles and daily experience may be wide.ObjectiveTo compare how young workers in Italy and Japan perceive physical and mental safety, stress, and economic risk, and to ask what the patterns suggest about where prevention struggles.MethodsMixed-method dataset of 206 young workers (92 Italy, 114 Japan). Descriptive statistics and qualitative responses.ResultsPhysical safety is high in both countries (88.8%), but mental safety is lower (74.4%). Stress affects 64.6%, rising to 77.2% in Italy against 54.4% in Japan. Main stressors are ordinary: responsibility, pace, heavy hours. In Italy, half report high precariousness risk; in Japan, one sixth. Stress does not decline with experience.ConclusionsYoung workers often feel physically safe but carry heavy psychosocial loads. The Italian framework already targets these dimensions, but the gap between principle and practice remains. Different risk bundles-precariousness in Italy, time intensity in Japan-require prevention to look beyond physical hazards.
Globally, paediatric burns are the fifth most common non-fatal injury in children. In England and Wales annually over 30,000 children receive outpatient burn treatment. A paediatric burn can have a significant negative psychological impact on parents and children. In the UK, where parents are often asked to undertake their child's burn wound dressing changes at home, the role of clinical caregiver can provoke significant emotional labour. This study explored the emotional dimensions and support available to parents administering children's burn dressing changes at home. This qualitative study formed part of a larger experience-based co-design project to develop service guidance to support parent-administered home dressing changes in paediatric burns care. Clinic observations were conducted across three paediatric burns centres in England and Wales. In addition, semi-structured interviews were conducted with healthcare professionals and parents on the perspectives and experiences of parent-administered home dressing changes. A thematic framework analysis identified two key themes and sub-themes. Healthcare professionals typically recognised parental anxiety and regularly provided parents with comfort and reassurance in clinics. Healthcare professional perceptions of severity of anxiety displayed through parents' behaviour were used as indicators of suitability for home administered dressing changes. Whilst parents dealt with the practical elements of dressing changes, they were unprepared for the emotional impact. Parents expressed feeling negative emotions when administering dressing changes and employing strategies to supress emotions to minimise distress to their child. The emotional impact of paediatric burns is recognised by parents and healthcare professionals. However, a disparity exists between these perspectives. Currently guidance and reassurance provided to parents does not address the emotional impact of parent-administered dressing-changes. Healthcare professionals provide emotional support in clinic and task-related support for home dressing-changes. Resources to support parents to administer dressings at home should include psychological coping strategies to manage the negative impact on families.
Café-au-lait macules (CALMs) constitute a major diagnostic criterion for neurofibromatosis type 1 (NF1), yet infants presenting exclusively with CALMs often do not fulfill full diagnostic criteria in early life. This retrospective cohort study aimed to quantify longitudinal changes in CALM burden during the first two years of life in children with NF1 and to assess the relevance of early lesion number for subsequent diagnostic threshold fulfillment. Sixty-three children with NF1 who initially presented with typical multiple CALMs were included. CALM counts were documented at 6, 12, and 24 months using standardized digital photography. CALM counts increased significantly over time (χ2(2) = 124.097, p < 0.001; Kendall's W = 0.985), rising from a mean of 5.86 ± 2.63 at 6 months to 17.49 ± 7.75 at 24 months. While 38.1% of infants met the six-lesion diagnostic threshold (≥ 6 CALMs) at 6 months, 96.8% did so by 24 months, and 94.5% of those initially below the diagnostic threshold (< 6 CALMs) met the diagnostic threshold during follow-up by 24 months.  CALM burden increases markedly during the first two years of life in children with NF1. By 24 months, nearly all children met the CALM-based diagnostic threshold (≥ 6 CALMs), indicating that this period represents a critical window for diagnostic threshold fulfillment. These findings support a time-dependent framework for the evaluation and follow-up of infants presenting with isolated multiple CALMs. • Multiple café-au-lait macules (CALMs) are a major diagnostic criterion for neurofibromatosis type 1 (NF1), with additional features often emerging later in childhood. • Infants presenting exclusively with CALMs frequently require longitudinal follow-up before diagnosis can be established. • Quantitative data on early longitudinal CALM progression in NF1 are limited. • This study demonstrates a marked increase in CALM burden during the first two years of life, with nearly all children meeting the diagnostic threshold by 24 months.
To evaluate the effect of a digital mindfulness-based program (Calm Health) on mental health outcomes in adults with non-infectious uveitis (NIU). Single-center, single-masked, waitlist-controlled randomized clinical trial. One hundred adults aged ≥18 years with active or inactive NIU and baseline mild or greater anxiety or depression were randomized 1:1 to immediate access to a mindfulness app (Calm Health) or to a waitlist control group. Participants in the intervention group were instructed to use the Calm Health mobile app for ≥10 minutes daily for 8 weeks. Controls received no new mindfulness intervention during this period. Outcomes were assessed at baseline and 8 weeks using validated surveys. The primary outcome was the mean difference in the anxiety symptom severity score measured by the Generalized Anxiety Disorder-7 (GAD-7) at 8 weeks. Secondary outcomes included changes in depression (Patient Health Questionnaire-9 [PHQ-9]), perceived stress (Perceived Stress Scale-10 [PSS-10]), and vision-related quality of life (National Eye Institute Visual Function Questionnaire-25 [NEI VFQ-25]). Outcomes were analyzed using linear analysis of covariance (ANCOVA) models, adjusting for baseline scores. Of 100 randomized participants (median age 43.5 years; 75% female), 70 completed the primary endpoint assessment. Median [Q1, Q3] total app use among intervention participants was 579 [397.79, 923.00] minutes over 8 weeks. After adjustment for baseline scores, the intervention group had a significantly lower GAD-7 score at 8 weeks compared with controls (mean difference -1.7 points; 95% CI: -3.17, -0.23, p=0.02). Secondary analyses showed significantly greater reductions in PHQ-9 scores (-1.90 points; 95% CI: -3.04, -0.76, p=0.001) and PSS-10 scores (-3.69 points; 95% CI: -6.00, -1.37, p=0.002) in the intervention group. Changes in NEI VFQ-25 scores were not statistically significant between groups (mean difference 1.98 points; 95% CI: -0.90, 4.86, p=0.18). Sensitivity analyses accounting for missing data and clinical covariates yielded similar results. A digital mindfulness-based intervention (Calm Health) significantly reduced anxiety, depression, and perceived stress in adults with NIU. Digital mindfulness tools may serve as a feasible, scalable adjunct to uveitis care, particularly in settings with limited access to traditional mental health services.
Calanoid copepods are key components of marine and estuarine food webs. Exposure to various classes of pollutants induces changes in their swimming behavior. This raises concerns about potential effects on critical processes such as feeding, mating, predator avoidance and vertical migration. The effect of pollution by microplastics is not well known. We investigated in a large experimental tank the effects of the smallest size fraction of microplastics on the swimming behavior of the estuarine copepod Eurytemora affinis. Because the motion of zooplankton is intrinsically linked to that of the ambient fluid, we recorded copepods moving freely in calm water and in grid-generated turbulence to recreate some of the hydrodynamic conditions they experience in their natural environment. Using an advanced implementation of 3D Lagrangian particle tracking velocimetry, we simultaneously measured copepod trajectories and the surrounding flow field at high temporal resolution. In calm water, copepods alternated between periods of cruising and sudden relocation jumps. In turbulence, copepod motion was dominated by transport by the flow, yet jumps allowed copepods to deviate from the flow streamlines. The measurement of the relative velocity of copepods with respect to the underlying flow enabled us to characterize the statistics of these jumps. Turbulence significantly increased jump frequency without modifying their amplitude or duration. Following a 12-hour exposure to polyethylene fragments at 300  μ g/L, copepods showed increased jump frequency in calm water corresponding to 40 % increase in energetic cost. In contrast, exposure to microplastics produced weak additional effects on swimming behavior under turbulent conditions. These results confirm the existence of an active response to turbulence in E. affinis and are consistent with a hyperactive behavior triggered by exposure to microplastic pollution.
To explore how patients and their relatives perceive and experience emergency care delivered at home by Mobile Emergency Teams (METs). An exploratory qualitative design was used to explore how patients and relatives experienced the care encounter. This approach was appropriate given the exploratory nature of the study. The study was approved by the Swedish Ethical Review Authority (No: 2023-02186-01) and conducted in accordance with the Declaration of Helsinki. Participants provided informed consent, were assured of confidentiality, and were informed of their right to withdraw at any time. The study was conducted in southwestern Sweden and included 20 semi-structured interviews with patients (n = 11), relatives (n = 4), and joint patient-relative interviews (n = 5) who had recently received care from METs. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using Braun and Clarke's six-phase thematic analysis. The analysis generated two overarching themes: Embraced by a calming environment and A sense of safety and security. Participants described METs' arrival as a turning point that brought calm and clarity to emotionally intense situations. The teams' respectful approach, clear communication and structured assessments contributed to emotional reassurance. Receiving care at home, in a familiar environment and in the presence of loved ones, supported participants' sense of dignity, autonomy and control. However, some participants expressed uncertainty about what would happen after METs' departure, indicating a need for improved follow-up and continuity of care. Findings are shaped by a specific Swedish context, joint interviews and purposive sampling, which may limit transferability. Emergency care at home was experienced as emotionally supportive and clinically competent. Attentiveness, clarity and a respectful presence were central to participants' sense of being thoroughly and considerately cared for.
Background The increasing reliance on smartphones and digital media to calm or occupy young children, often referred to as the "digital pacifier," has become widespread in Indian households. While this approach provides immediate convenience to caregivers, emerging research indicates potential adverse impacts on sleep patterns, behavior, and early developmental outcomes. Sociodemographic factors are likely to significantly influence this practice. Objective This study aims to characterize the sociodemographic characteristics and associated factors influencing the use of digital devices as tools for calming or engagement. Methods A cross-sectional observational study was carried out among 320 children aged 1-5 years. Data on age, gender, family structure, parental education, employment status, socioeconomic background, and children's screen exposure were obtained using a structured questionnaire. Descriptive statistical methods were applied, and findings were expressed as frequencies and percentages. Results Among 320 children, 248 (77.5%) were male and 72 (22.5%) were female. The mean daily screen exposure showed a progressive increase with age, ranging from nearly 2 hours/day in 1-year-olds to approximately 5-6 hours/day in children aged 4-5 years. Children belonging to nuclear families demonstrated greater screen use (4.5 ± 1.2 hours/day) compared to those from joint families (3.2 ± 1.0 hours/day). Children of illiterate mothers had significantly higher screen exposure compared to those of literate mothers (4.1 ± 1.2 versus 3.4 ± 1.1 hours/day; t = 2.94, p = 0.004). Similarly, children of working mothers demonstrated greater screen time than those of non-working mothers (4.6 ± 1.3 versus 3.5 ± 1.1 hours/day; t = 5.48, p = 0.002). The highest screen exposure was observed among children from dual-income families, where both parents were working (4.8 ± 1.3 versus 3.6 ± 1.1 hours/day; t = 6.21, p = 0.001). No statistically significant association was found with paternal education or employment. Conclusion Findings highlight the significant role of family dynamics, parental responsibilities, and socioeconomic context in shaping early childhood screen exposure. Addressing the "digital pacifier" phenomenon necessitates targeted awareness initiatives and culturally sensitive recommendations to promote healthier developmental environments for young children.
To develop a driving safety evaluation model for hazardous materials vehicle drivers based on visual characteristics. Twenty-three professional hazardous materials vehicle drivers were recruited to participate in driving simulation experiments under normal, cognitively distracted, and operationally distracted conditions. Based on the Big Five personality questionnaire, K-means clustering was applied to classify the drivers into three types: balanced, calm, and impulsive. Significance analyses were conducted to identify differences in visual characteristics among driver types across driving states. An evaluation model was subsequently constructed by combining the Analytic Hierarchy Process (AHP)-Entropy Weight Method with fuzzy comprehensive evaluation, and the model was validated with case studies. Under distracted driving, significant differences were observed in single fixation duration, cumulative fixation duration, fixation frequency, single saccade duration, blink frequency, and pupil diameter compared to normal driving. Pupil diameter emerged as a universal sensitive indicator across all personality types, while the response patterns of visual characteristics to distraction type varied heterogeneously by personality. The model evaluations for the three types-balanced, calm, and impulsive-were highly consistent with the drivers' personality traits and visual behavior changes. This study integrates personality traits with visual characteristic parameters, filling a gap in the visual-based safety evaluation of hazardous materials vehicle drivers. The proposed AHP-Entropy Weight fuzzy comprehensive evaluation model provides a scientific and reliable method for the safety management of hazardous materials road transportation and for personalized driver safety early warning systems.
Adenomyosis and endometriosis are two sister diseases that cause menstrual pain and other symptoms. We have previously reported that patients with these conditions have a less active 'calm-and-rest' system and a more active 'stress-and-alert' system. Other studies have shown that a gentle, non-invasive treatment called transcutaneous auricular vagus nerve stimulation (taVNS) can safely and effectively boost the 'calm-and-rest' system in many disorders. So we wanted to see if taVNS could also help with menstrual pain caused by endometriosis and adenomyosis. We tried it in a small pilot study with four patients with adenomyosis and two patients with endometriosis. They received taVNS for six months. We found that taVNS was well tolerated and relieved their pain three and six months after taVNS. These early results are encouraging, but because the study was small, we need larger, more rigorous studies to fully know how well taVNS works for this kind of pain.
Emergency nurses are frequently the first point of contact for patients presenting to the emergency department (ED) with the symptoms of acute psychosis. Altered perception, fear and disorganised thinking can impair communication and precipitate distress, which may lead to agitation or aggressive behaviour, placing patients and staff at increased risk of harm. In these circumstances, verbal reasoning alone may be ineffective. Evidence indicates that non-verbal communication, such as body posture, eye-level alignment, proximity and tone of voice, can have a pivotal role in these situations by promoting calm and conveying safety, thereby preventing escalation to coercive or restrictive measures. Drawing on research and trauma-informed care principles, this article explores how emergency nurses can adapt Safewards interventions such as soft words, talk down and reassurance into effective non-verbal communication strategies in their practice. The authors provide guidance on embedding non-verbal de-escalation in routine ED nursing practice, highlighting approaches that are transferable to a wide range of mental health-related presentations and have the potential to improve safety, preserve dignity and strengthen therapeutic engagement in emergency care.
We report a clinical case illustrating rapid, reversible, and reproducible hemispheric differences in subjective experience and autonomic arousal during lateral visual field viewing. A man in his 40s with longstanding anxiety and depression showed repeatable shifts in affective state, self-appraisal, and appraisal of the clinician when alternately viewing through the right versus left lateral visual field while holding the same shame-evoking interpersonal scenario in mind. Pulse rate measured with a fingertip pulse oximeter was observed to co-occur with these shifts (anxious/shame state ≈105 bpm; calm/secure state ≈85-90 bpm; baseline ≈95 bpm). Across 72 consecutive patients entered into the author's practice, 89% showed a clinically useful between-field difference in momentary anxiety and 49% showed a marked difference of the type described in this case report. Together with prior findings from split-brain research, Wada studies, fMRI, repetitive transcranial magnetic stimulation (rTMS), and lateral visual field stimulation (LVFS) paradigms, this observation is consistent with the partial functional independence of two hemispheric experiential systems-one of which is more childlike and more affected by past trauma-and with history-dependent meaning as a driver of physiological response. We interpret the case within Dual-Brain Psychology (DBP) and relate the findings to the Emotion-Type Hypothesis (ETH), proposing a distinction between lateralized emotional functions (as characterized by ETH) and hemispheric experiential dominance (as characterized by DBP). On this account, a hemispheric experiential system may function as the dominant organizing self while recruiting emotional and cognitive capacities distributed across both hemispheres. This synthesis may help reconcile population-level associations between emotion type and hemispheric specialization with the within-individual variability in hemispheric emotional valence observed under lateral visual field viewing.
As the health of an older parent deteriorates, their transfer to a nursing home becomes inevitable to ensure that they receive safe and sufficient care, with the decision to transfer often being made and implemented within a matter of days. Family caregivers such as adult children remain actively involved in providing care after their parent's transfer to a nursing home, and are often described as an 'invisible workforce'. However, the impact of this situation on the health and well-being of adult children is rarely acknowledged. This study aimed to characterize the transition experiences of adult children during the weeks after their older parent's transfer to a nursing home, which is referred to as post-transition phase. This research study formed part of a larger qualitative project that had a narrative, longitudinal, prospective design. We conducted 22 narrative interviews with 8 adult children of older parents on 3 occasions in 2022. Narrative analysis was used to structure and systemize the generated data. The findings are presented as two narratives of one daughter ('Susan') and one son ('Phillip') that exemplify common characteristics shared by all of the participants. They illustrate the facilitators and barriers of a healthy transition-defined as a positive and successful transition outcome-during the complex post-transition phase. Although sharing similar contextual circumstances, their narratives diverge with Phillip's account conveying a sense of calm and relief, while Susan's narrative reflects stress and tension. These exemplar narratives of adult children highlight how personal, organizational and social factors both facilitate and hinder a healthy transition. The transfer of an older parent to a nursing home is often emotionally challenging for adult children. Healthcare personnel can help reduce the burden during the transition by supporting role mastery, subjective well‑being and well-being of relationships. Promoting the well‑being of adult children may have positive implications for their older parents as well as the healthcare services and society as a whole.
Biological photoprotection refers to the enhancement, preservation, or mimicry of the skin's intrinsic defense systems to prevent or mitigate damage induced by solar and environmental stressors. Unlike conventional sunscreens, which primarily act by reducing photon penetration, biological photoprotection targets the downstream molecular and cellular responses triggered by these exposures. It is achieved by incorporating nonfiltering photoprotective ingredients (PINGs) into sunscreens, which act on key biological pathways involved in skin damage and recovery. Emerging evidence suggests that these ingredients may provide additive protection when combined with ultraviolet (UV) filters, particularly in mitigating oxidative damage, supporting DNA repair, and modulating inflammatory and pigmentary responses. However, the current evidence base remains limited, with many studies characterized by small sample sizes, short durations, and heterogeneous methodologies. Taken together, biological photoprotection represents a complementary, but still evolving, dimension of modern photoprotection. Further research is required to establish standardized evaluation methods and to determine its clinical relevance under real-world conditions. Sunlight does more than cause sunburn. It can trigger harmful changes in the skin, including damage to cells, inflammation, changes in skin color, and faster skin aging. Traditional sunscreens mainly work by blocking or absorbing ultraviolet (UV) rays before they enter the skin. However, they do not fully protect against all the ways sunlight and the environment can damage the skin. Biological photoprotection is an approach that helps support the skin’s natural defenses. It involves adding ingredients to sunscreens that help the skin protect and repair itself. These ingredients can help reduce damage, support the skin’s repair processes, calm inflammation, and help control changes in skin color. Research suggests that these ingredients can provide extra protection when used together with UV filters. However, most studies so far have been small and short-term, so more research is needed to understand how well they work in everyday use. For now, biological photoprotection should be seen as an addition to, not a replacement for, traditional sun protection methods such as using sunscreen, seeking shade, and wearing protective clothing.