Effects of adjunctive brexpiprazole on calmness and life engagement in major depressive disorder: post hoc analysis of patient-reported outcomes from clinical trial exit interviews

Background Though often overlooked, calming patients and increasing their life engagement are key factors in the treatment of major depressive disorder (MDD). This study aimed to test the hypothesis that adjunctive brexpiprazole increases calmness and life engagement among patients with MDD, based on clinical trial exit interviews. Methods This was a pooled analysis of exit interview data from three exploratory, open-label studies of adjunctive brexpiprazole 1–3 mg/day. The studies enrolled 105 outpatients with MDD (DSM-IV-TR criteria), a current depressive episode, and inadequate response to antidepressant treatment during the current episode. Patients were interviewed if they completed the end-of-treatment visit (Week 6 or Week 12, depending on the study). Exit interviews took the form of semi-structured telephone interviews in which patients were asked mostly qualitative questions about their symptoms prior to the start of the study, and about improvements they had noted during treatment. Interview transcripts were reviewed and codes were assigned to calmness and life engagement vocabulary, allowing aggregation of the frequency of improvement in various domains. Results 79.8% (83/104) of patients described improvements consistent with at least one calmness term, most commonly feeling less anxious (46.2%) or less irritable (44.2%). A four-domain concept of patient life engagement was developed in which 88.6% (93/105) of patients described improvements consistent with at least one domain, specifically, emotional (77.1%), physical (75.2%), social (41.9%), and/or cognitive (36.2%). Of the patients who described improvement in calmness, 96.4% (80/83) also described improvement in life engagement. Conclusions Analysis of exit interview data suggests that patients were calmer and more engaged with life following treatment with adjunctive brexpiprazole. Thus, adjunctive brexpiprazole may provide a benefit on subjective patient outcomes in addition to the improvement in depressive symptoms shown by clinical rating scale data. Trial Registration: Data used in this post hoc analysis came from ClinicalTrials.gov identifiers: NCT02012218, NCT02013531, NCT02013609.

Burnout digital monitoring on employee engagement at the company

Burnout is a condition of mental, and physical fatigue of a worker caused by a person's professional life. Engagement is the attachment that exists in an employee to a job where the employee works. The relationship between burnout and engagement in a company significantly affects the employees' performance and the company's results. This study aims to digitally record burnout, and engagement that exists in a company in improving its product quality. Digital-based monitoring is one of the tools that can be used to monitor employee performance activities in a measured manner to produce information that companies can use in decision-making. The method used quantitative research method approach using LISREL. Results achieved several variables that affect burnout and engagement related to employee work at that company. Implications for companies with the existence of employee digital data minimize burnout and increase employee engagement in the company. This digital data can be used as accurate information in looking at the condition of employees in a company.

Youth doing politics in times of increasing inequalities

Particularly in the current context of rapid political change it is key to understand the political participation of young people and what underpins their political engagement patterns as well the as the inequalities that may lay beneath them. While there is a rich literature on youth participation, to date we have lacked the data to carry out detailed subgroup analyses to understand differences in the political participation between different groups of youth cross-nationally. The papers in this Special Issue all examine different aspects of youth participation in the current context. They examine key questions for participation including the inequalities, socialising influences, polarisation, online participation, radical political views, tolerance, life engagement and opportunities for social inclusion. This Special Issue thus provides a contemporary analysis of youth participation in Europe in the current historical juncture.

EXPRESS: “It is the fear of exercise that stops me” – Attitudes and dimensions influencing physical activity in pulmonary hypertension patients

Pulmonary Hypertension (PH) is a progressive cardiorespiratory disease, that is characterized by considerable morbidity and mortality. While physical activity (PA) can improve symptoms and quality of life, engagement in this population is suboptimal. The aim of this study was to explore attitudes towards exercise and the dimensions that influence PA participation in individuals with PH. Virtual, semi-structured interviews were conducted with individuals, with a formal diagnosis of PH. Participants were recruited through the Pulmonary Hypertension Association of Ireland. Interviews were transcribed and analysed using thematic analysis. Nineteen patients were interviewed (n=19). There was a female preponderance (n=13) and the mean age was 50 ± 12 years. Three themes were identified and included fear; perceived value of exercise; and environmental factors. Fear was the primary theme and included three sub-themes of fear of (i) over-exertion, (ii) physical damage and (iii) breathlessness. The perceived value of exercise encompassed two distinct sub-themes of perceived (i) exercise importance and (ii) benefits of exercise. Environmental factors included the terrain, weather conditions and location. Fear of overexertion, harm and dyspnoea strongly influenced attitudes to and engagement in PA. This study revealed heterogenous patient perspectives regarding the importance of PA and exercise. Future interventions that mitigate fear and promote the value of PA for individuals with PH may have considerable benefits in promoting PA engagement. Such interventions require multidisciplinary involvement, including specialised PH clinicians and exercise and behaviour change specialists.

Symptoms of Depression, Anxiety, and Stress and Prevalence of Major Depression and Its Predictors in Female University Students

Depression, anxiety and stress are increasingly concerning phenomena in our society, with serious consequences on physical and mental health. The repercussions may be particularly devastating in particular population subgroups, such as female university students. The purpose of this study was to determine the levels of depression, anxiety, and stress and the prevalence of depression and associated factors, in Spanish university women. A cross-sectional study was conducted with a random sample of 871 students from the Santiago de Compostela University (mean age 20.7 years, SD = 2.8). Information was collected on sociodemographic and academic characteristics; symptoms of depression, anxiety, and stress; diagnosis of major depression; optimism, resilience, social support, life engagement, and five personality domains, using validated instruments. Of the participants, 18.1%, 22.8% and 13.5% presented with severe/very severe levels of depression, anxiety and stress, respectively. A total of 12.9% had major depression. Higher life engagement was associated with lower risk of depression (OR = 0.92, 95% CI 0.87–0.98), while higher levels of neuroticism (OR = 1.20, 95% CI, 1.12–1.28) and openness to experience (OR = 1.08, 95% CI, 1.02–1.14) were associated with greater risk. These findings reveal an alarming percentage of female university students who experience major depression and severe/very severe stress.

Estimation of the tooth gear service life by wear under misalignment conditions

A method of approximate estimation of the life of a tooth gear by the wear of the teeth of gear wheels in the presence of a misalignment is proposed. The dependences of the of the tooth gear life on loading, formulas for determining the maximum wear and contact pressure are obtained. Keywords tooth gear, wear, life, engagement, misalignment, wear resistance. [email protected]

Psychological (In)Flexibility Mediates the Effect of Loneliness on Psychological Stress. Evidence from a Large Sample of University Professors

Psychological stress, loneliness, and psychological inflexibility are associated with poorer mental health and professional performance in university teachers. However, the relationship between these variables is understudied. The aim of the present study is to analyze the mediating role of psychological (in)flexibility on the effect of loneliness on psychological stress. A total of 902 professors from 11 universities in Ecuador were analyzed using standardized scales: the Perceived Stress Scale (PSS-14) to assess psychological stress, the Loneliness Scale Revised-Short (UCLA-3) for loneliness, and the Avoidance and Action Questionnaire (AAQ-7) and Life Engagement Test as double measures of psychological (in)flexibility. Mediation was tested by using PROCESS macro for SPSS. The results indicated that psychological flexibility mediated the relationship between loneliness and stress in university professors, regardless of sex and the measure of psychological (in)flexibility considered. The practical implications of the results are discussed herein.

Patient Perspectives on Key Outcomes for Vocational Rehabilitation Interventions Following Traumatic Injury

Returning to work after traumatic injury can have a range of benefits, but there is currently little research that incorporates patient perspectives to identify outcomes of vocational rehabilitation interventions that are important to survivors. Trauma survivors (n = 17) participated in in-depth semi-structured interviews or focus groups exploring outcomes that were important to them for recovery and return to work. Data were analysed using thematic analysis. Participants identified a range of outcomes that they considered important and necessary to facilitate a successful and sustainable return to work: physical and psychological recovery, purposeful life engagement, managing expectations of recovery, managing expectations about return to work, and employers’ expectations. Our participants advocated for a multifaceted and biopsychosocial understanding of recovery and outcomes that need to be captured for vocational rehabilitation interventions. Implications for practice and research are discussed, and recommendations are given based on the findings.