搜索结果：praise

Although incentives modulate cognitive processes, their differential effects of monetary versus social reward gradients on emotional conflict resolution in subclinical depression remain poorly understood. This study investigated how reward type and magnitude influence emotional congruency effects in this population. Two experiments used a word-face Stroop paradigm with a Latin square design. Ninety-nine undergraduates (47 with subclinical depression) completed monetary (0, 20, 100, 500 CNY) and social (no praise to university-level praise) reward tasks. A mixed-design ANOVA examined effects of reward level, emotional congruency, and group. The subclinical depression group showed reduced emotional congruency, marked by lower accuracy in congruent trials than controls. Monetary rewards exhibited a threshold effect: accuracy gains plateaued beyond 100 CNY with no further improvement at 500 CNY. Social reward modulation was similar between groups, though reaction times under class-level praise were significantly higher in incongruent trials. Notably, under high monetary rewards (500 CNY), the subclinical group demonstrated shorter reaction times in congruent trials, indicating heightened sensitivity to substantial incentives. Emotional conflict processing in subclinical depression is differentially modulated by reward type and magnitude. Monetary rewards show saturating effects, while social rewards elicit uniform nonlinear influences. These findings highlight reward sensitivity as a crucial factor for cognitive-affective profiling and targeted interventions.

Although ego threat is known to influence workers' aggressive behavior, little is understood about how support and narcissism shape this relationship. Accordingly, the present study conceptualized narcissistic traits as distinct self-regulatory strategies for maintaining self-worth and examined whether the meaning of support under ego threat varies depending on these traits. An online survey was conducted with 1621 Japanese workers, and the participants were classified into three types-Self-Assertion, Need for Attention and Praise, and Sense of Superiority and Competence-based on the highest scores on the three factors of the Narcissistic Personality Inventory Short version. Hierarchical multiple regression analyses were then conducted separately for each type. The results showed that the behavioral consequences of ego threat varied substantially across narcissistic types and that support did not uniformly suppress power harassment. For the Self-Assertion type, perceived organizational support was positively associated with Invasion of Privacy. For the Need for Attention and Praise type, men and managers tended to choose Excessive Demands. For the Sense of Superiority and Competence type, supervisor support reduced harassment; however, under strong ego-threatening conditions, such support paradoxically amplified harassment. These findings suggest that support functions as a socially meaningful cue whose interpretation depends on narcissistic self-regulatory strategies.

Chronic kidney disease heavily burdens patients and health systems. Digital health interventions offer significant potential but face implementation challenges driven by stakeholders' emotional and practical experiences. This review synthesizes these affective dimensions to inform clinical practice. A qualitative systematic review was conducted across six databases for studies published through April 2025. Methodological quality was rigorously appraised. We integrated Python-based computational sentiment analysis to quantify stakeholder emotional polarity (positive, negative, neutral) with thematic analysis. Identified barriers were mapped to established implementation frameworks to select expert-validated implementation strategies. Twenty-three qualitative studies were included, revealing five domains: accessibility, communication, workflow, empowerment, and clinical effectiveness. Patients praised digital empowerment but highlighted socioeconomic access barriers. Nurses valued workflow efficiencies but reported role ambiguity. Clinicians expressed deep skepticism toward remote clinical effectiveness due to diagnostic limitations. To resolve these tensions, prioritized implementation strategies include identifying clinical champions, promoting intervention adaptability, and systematically assessing organizational readiness before deployment. Stakeholder emotions critically dictate digital health adoption. For clinical practice, these findings emphasize moving beyond generic deployments. Healthcare systems must address clinician diagnostic concerns via hybrid care models, resolve nurse workflow ambiguities through targeted training, and provide low-cost devices to bridge patient equity gaps. Tailoring solutions to these psychosocial needs is essential for successful integration into routine kidney care.

Adolescents experiencing psychiatric emergencies often require intensive interventions to prevent hospitalisation and support their return to education, employment or training. Intensive Community Care Services aim to provide an alternative to inpatient care. To evaluate the effectiveness of Intensive Community Care Services compared to treatment as usual in reducing the time to start or return to education, employment or training for young people with psychiatric emergencies. A multicentre, parallel-group, single-blinded, randomised controlled trial, including an internal feasibility phase, across seven NHS trusts in the United Kingdom. Adolescents aged 12-17 were randomised to receive either Intensive Community Care Services or treatment as usual. The primary outcome was the time to start or return to education, employment or training within a 6-month observation period. Secondary outcomes included clinical symptoms, functioning and service satisfaction. Process evaluation used semistructured visual interviews followed by thematic decomposition analysis. The impact of COVID-19 and the importance of continuity of care were explored in a series of cohort studies based in emergency departments. A consensus meeting was held to define the features of Intensive Community Care Services. Of the approximately 977 adolescents screened, 36 were randomised in a 1 : 1 ratio using a web-based randomisation system stratified by the NHS trust using variable block sizes to receive either Intensive Community Care Services or treatment as usual. A key reason for poor recruitment was the absence of an alternative to Intensive Community Care Services. The recruitment rate did not meet pre-specified progression criteria (n = 55 by the first 6 months of recruitment), and conducting a full evaluation trial was deemed not feasible. Thirty participants from the pilot sample (83.3%) returned to education, employment or training during the 6-month follow-up period, with a median time to education, employment or training of 9 days (interquartile range 1-49). The median time to education, employment or training was lower in the Intensive Community Care Services group (6 days) compared to the treatment-as-usual group (12 days), with a hazard ratio of 1.34 (95% confidence interval 0.63 to 2.86). Estimated effect sizes for secondary outcomes were also in the direction of a benefit under Intensive Community Care Services, with higher satisfaction with services and improvements in clinical symptoms and functioning. There was a greater total average cost for the treatment-as-usual group at £15,155 (standard deviation 31,560), compared to £7063 (standard deviation 10,605) for Intensive Community Care Services. Due to the small sample size, no inferences regarding Intensive Community Care Services effectiveness or cost-effectiveness can be drawn. Fourteen young people participated in the process evaluation. Inpatient care received both praise for effective diagnoses and therapeutic interventions and criticism for a sterile approach and inadequate staff attention. Intensive Community Care Services was valued for the personalised approach, exemplified by beneficial home visits. During COVID-19, there was a significant reduction in emergency presentations of young people, followed by a significant increase post pandemic. The follow-up attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in an emergency room (odds ratio 3.66, 95% confidence interval 1.65 to 8.13). Intensive Community Care Services teams should use the modified Dartmouth Assertive Community Treatment Fidelity Scale to assess their quality. Recruitment to a randomised controlled trial of this kind can be improved if all new Intensive Community Care Services teams are considered to be experimental services and an equipoise between Intensive Community Care Services and existing services acknowledged. Rigorous post-implementation research is warranted for those areas that choose to implement Intensive Community Care Services. An adequately powered randomised controlled trial is needed to confirm the pilot findings of the IVY study and explore the full potential of Intensive Community Care Services as an alternative to inpatient and other community-based services for young people with severe mental health needs. Clinicians' experience delivering Intensive Community Care Services should be explored in further qualitative studies. The most significant limitation of this pilot study is the very small sample size, which was a direct result of recruitment difficulties. As a result, we were unable to draw any inferences about the effectiveness or cost-effectiveness of Intensive Community Care Services relative to treatment as usual. It was not possible to blind participants to the intervention they were receiving. The 6-month follow-up period may have been insufficient to capture important long-term outcomes. No definitive conclusions can be drawn from this study. Preliminary results suggest that Intensive Community Care Services may support a faster return to education, employment or training than treatment as usual. Intensive Community Care Services may be cost-effective compared to treatment as usual. Additional mental health professionals should be deployed to Intensive Community Care Services during future lockdowns. The same Intensive Community Care Services professionals should offer assessments in emergency departments and provide community follow-up. Research with a larger sample is warranted to confirm these findings. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR127408. Adolescents in psychiatric crises often need intensive help to avoid hospital admission and get back into education, employment or training. Intensive Community Care Services aim to offer an alternative to hospital care for these young people. This study looked at how effective Intensive Community Care Services is compared to standard treatment, also called treatment as usual. We conducted a study across seven NHS trusts in the UK, where adolescents aged 12–17 were randomly assigned to receive either Intensive Community Care Services or treatment as usual. The main goal was to measure the time it took for them to start or return to education, employment or training within 6 months. We also looked at their clinical symptoms, daily functioning and service satisfaction. We used interviews to evaluate their experiences and also studied how COVID-19 and continuity of care affected outcomes. Out of 36 participants, 30 (83.3%) returned to education, employment or training within 6 months. The Intensive Community Care Services group returned faster (about 6 days) than the treatment-as-usual group (12 days), though the difference was not statistically significant. Still, Intensive Community Care Services showed some positive trends, like higher service satisfaction. Costs were lower for Intensive Community Care Services (£7063 on average) compared to treatment as usual (£15,155). Fourteen participants shared their experiences of using services; while hospital care was sometimes praised, Intensive Community Care Services was valued for its personalised approach. During COVID-19, fewer young people came to emergency departments, but this rose again afterwards. Follow-up attendance tripled when the same clinician was involved in emergency assessments and follow-up. Although the study did not provide conclusive results, Intensive Community Care Services shows promise in helping young people return to education, employment or training faster and maybe more cost-effective than treatment as usual. We recommend more mental health staff for Intensive Community Care Services in future lockdowns. The same clinicians should handle both emergency assessments and follow-up care. Further research with more participants is needed to confirm these findings.

Physical education (PE) teachers play a central role in shaping students' physical literacy, including motivation, confidence, physical competence, knowledge, and understanding that supports lifelong physical activity. Differentiation of task difficulty during lessons is widely considered essential in this process. Yet in game-based lessons, what challenges one student may overwhelm or bore another. To better understand how and why teachers differentiate task difficulty, this qualitative study explored how junior secondary school PE teachers adapt task difficulty during game-based lessons. Fourteen teachers participated in stimulated recall interviews based on 20-minute GoPro recordings of their own lessons. We analyzed the data using reflexive thematic analysis. Teachers described differentiation as an ongoing, situated process of monitoring and shaping students' engagement by verbal guidance, rather than primarily modifying task constraints (e.g., rules or equipment). Teachers emphasized fostering inclusive participation, cultivating a positive pedagogical climate, using praise to reinforce desired behaviors, and regulating gameplay by stepping in and out. Differentiation most often occurred through verbal feedback, with particular attention to supporting students perceived as less confident, while engaging higher-skilled students in role-model or leadership roles. In their reasoning, teachers placed students' confidence and motivation at the forefront, describing them as important building blocks from which physical competence may develop. We describe PE teachers as "motivational coaches", as their decision-making prioritizes students' emotional and relational experiences, with the expectation that skill development will follow. This contrasts with earlier research emphasizing skill-focused teaching. However, it can be questioned whether optimal motor learning occurs if teachers reduce task difficulty to support confidence. We suggest that acknowledging students' effort and progress while challenging a student may support both motivation and learning. Since challenge is a subjective concept, it is important to foreground students' experiences of challenge in game-based PE in future research.

Gastric cancer (GC) ranks as the third leading cause of cancer-related mortality worldwide, and its management remains formidable. Immunotherapy has been highly praised for its remarkable efficacy and acceptable toxicity, and its development has outpaced that of traditional therapies. However, molecular heterogeneity and the immunosuppressive tumor immune microenvironment (TIME) have hindered the treatment response of a considerable number of patients. This review synthesizes the latest therapeutic advances, spanning immune-checkpoint inhibitors (ICIs), adoptive cell therapy (ACT), monoclonal antibodies and antibody drug conjugates (ADCs), cancer vaccines, tumor-infiltrating lymphocyte (TIL) therapy, and CAR-T cells therapy. Emerging strategies such as RNA interference nano-delivery systems, immune adjuvants, and microbiota modulation are constantly evolving to transform "cold" tumors into "hot" tumors. Persistent challenges include primary resistance, immune-related adverse events (irAEs) and antigenic heterogeneity, underscoring the imperative for refined patient stratification. Classical biomarkers such as PD-L1 expression, tumor mutational burden (TMB), mismatch-repair status, Epstein-Barr virus (EBV) positivity and circulating tumor DNA (ctDNA) all demonstrate predictive value but remain constrained by spatial heterogeneity and temporal dynamics. Consequently, we highlight emerging biomarkers that integrate metabolic, epigenetic and cell-death signatures, providing a roadmap for precision immunotherapy and continuous optimization of GC treatment algorithms.

During the Covid-19 pandemic, Nordic states were praised for leadership on global vaccine equity, notably through strong support for the Access to Covid-19 Tools Accelerator (ACT-A) and COVAX. At the same time, like other high‑income countries, they took decisive measures to secure priority access to vaccines for their own populations, contributing to global inequities. Scholarship on global health security and diplomacy often treats global solidarity and national self-interest as a binary and focuses on great powers and inter-state dynamics, overlooking how domestic drivers also shape global pandemic response. This article instead proposes the concept of "strategic solidarity" to analyse how solidarity and self‑interest were combined and justified in Norwegian and Danish global health diplomacy during the acute phase of the pandemic (2020-2022). Through analysis of three key policy debates - support for vaccine R&D; contributions to global vaccine distributions and positions on intellectual property reforms to boost vaccine supply - the article shows how Norway and Denmark simultaneously enabled and constrained multilateral efforts for vaccine equity. Domestic political pressures, public opinion, national identity narratives, and inter-ministerial tensions shaped how authorities practiced multi‑level diplomacy and managed trade‑offs between national protection and global commitments. Strategic solidarity operated both as a policy orientation distinct from purely security‑driven logics and as a justificatory frame used to reconcile apparent policy incoherence and sustain the countries' self‑images as solidaristic states. Strategic solidarity better captures the empirical reality of pandemic policymaking than a strict solidarity/self‑interest dichotomy and can inform the design of future mechanisms for more equitable global health responses.

Global tobacco control efforts, influenced substantially by the World Health Organization Framework Convention on Tobacco Control and the MPOWER package, have lowered smoking prevalence in some populations but have failed to address the lived realities of the people who continue to smoke. These individuals increasingly come from communities marked by socioeconomic disadvantage, lower educational attainment, and limited access to healthcare, contexts where structural constraints, chronic stress, and reduced opportunity shape tobacco use far more powerfully than individual "choice." Yet tobacco control frameworks continue to prioritize abstinence-only strategies, punitive measures, and restrictive regulatory environments that rarely reflect the perspectives or needs of the people most affected. Countries are praised for adopting increasingly restrictive policies, with little attention given to the actual reductions in smoking rates. This editorial argues that further decreases in smoking rates can be achieved if the focus shifts from moralizing nicotine use in any form to empowering people who smoke with practical, science-based harm reduction tools. Noncombustible nicotine products that reduce toxicant exposure are often dismissed or prohibited despite growing evidence of their value for people unlikely to achieve abstinence. This disconnect widens health inequities and alienates those currently navigating stigma, misinformation, and limited cessation support. We propose a real-world EMPOWER framework that integrates evidence, pragmatism, risk-proportionate regulation, and person-centered communication. To reduce smoking-related harm more effectively, policy must move beyond ideology and prioritize autonomy, equity, and practical harm reduction.

Introduction: The COVID-19 pandemic disrupted immunization services in Togo, resulting in 69,672 "zero-dose" and 24,846 "under-vaccinated" children by the end of 2023. This study assessed the effectiveness, acceptability, and feasibility of a social marketing approach deployed during the 2025 Big Catch-Up initiative in Togo. Methods: A convergent mixed-methods study was conducted in 17 priority health districts. The quantitative component compared vaccination coverage before and after the intervention using administrative data. Chi-squared test for linear trend compared district-level coverages, and statistical significance was set at p < 0.05 for all tests. The qualitative component used in-depth interviews with key informants to collect data, followed by thematic content analysis. The intervention was grounded on the social marketing framework with 4 pillars (4Ps): Product, Price, Place, and Promotion. Results: Coverage increased dramatically: Penta1 from 1% to 64%, Penta3 from 1% to 45%, MR1 from 4% to 50%, and MR2 from 6% to 49% (all p < 0.001). Togo ranked 3rd out of 24 African countries for Penta1 progress. The approach demonstrated high community acceptability, with Vaccination Monitoring Committees praised as being culturally appropriate. Key concerns included sustainability and resource constraints. Conclusions: Social marketing was associated with increased community adherence and immunization coverage improvement. However, long-term sustainability requires the institutionalization of community structures with domestic funding and continued health system strengthening.

Fear of pain and anxiety are common among children undergoing needle procedures. Actively involving the child in communication can help reduce their distress and foster a stronger nurse-child relationship. Positive emotions have the potential to strengthen the patient-nurse connection and may also play an important role in managing children's distress, though further research is needed to fully understand their impact. This study aimed to identify expressions of positive emotions in procedural communication between children, parents, and nurses, using the seven categories of the Positive Emotion Communication (PEC) coding system. A secondary analysis of nine previously collected video recordings exploring fear and pain during needle injections among children recently diagnosed with rheumatic diseases. Positive emotions were identified using the PEC coding system, and the findings were analyzed using descriptive statistics. We identified 328 expressions of positive emotions (60% from nurses, 30.5% from parents and 9.5% from children). All participants widely used the category Positive Focus, while nurses and parents favored the category Praise or Support. Children used the category Humor more frequently than other participants. Communication was mainly directed at children, with parents also receiving encouragement. Nurses frequently used positive utterances in their communication with children and parents during this challenging healthcare procedure. The PEC coding system proved useful for identifying positive emotions in pediatric communication research; however, it lacks the ability to capture nonverbal communication and responses. Using positive emotions in medical conversations with children has significant potential to enhance their healthcare experience. However, further research is needed to refine the PEC coding system to better capture nonverbal communication and responses, ensuring a more comprehensive understanding of positive communication in pediatric care.

Family background is a recognised determinant of children's socio-emotional outcomes, yet its measurement and the conceptualisation of family (dis)advantage remain inconsistent across research, policy and practice. This study adopts a multidimensional inequality framework and a sibling design with random effects to (1) estimate the overall impact of family of origin, both observed and unobserved factors, on children's age-5 socio-emotional difficulties; (2) decompose this effect across five dimensions of family background observed at age three: family demographics, emotional environment, parenting, educational environment and socio-economic circumstances; and (3) assess the relative strength of family background indicators on socio-emotional difficulties. Using current data from the nationally representative United Kingdom Household Longitudinal Study (N = 2,204, including 916 siblings) and capturing socio-emotional difficulties with the Strengths and Difficulties Questionnaire (SDQ), family-of-origin accounted for 37 per cent of the total variance in SDQ scores, with 38 per cent of the family-of-origin influence explained by observed family dimensions. Parental occupational class, maternal psychological distress and parenting behaviours related to schedules, praise and punishment exhibited the strongest independent effects. Nonetheless, a substantial portion of the family-of-origin effect remains unexplained, underscoring the role of other unmeasured family factors. These results suggest that policy spaces should integrate a multidimensional approach to monitoring family (dis)advantage, and that holistic family support, while attending to children's individual differences, offers the best chance of reducing early childhood socio-emotional difficulties, thus reducing barriers to opportunity.