Acceptance and commitment therapy (ACT) for obsessive-compulsive disorder (OCD) has been found efficacious in randomized clinical trials (RCTs), but the two widely known RCTs were conducted within the United States with predominantly White samples. Research that evaluates treatments like ACT for OCD outside the typical Western cultures is needed. The current scoping review summarizes the key characteristics and findings from 18 RCTs that evaluated ACT for OCD in Iran. These RCTs are largely unknown in the broader scientific literature despite representing the vast majority of ACT for OCD trials, in part because the majority are published in Persian. The preponderance of RCTs treated participants in groups, and most protocols did not include exposure exercises. Of 18 trials, 5 were single sex. Use of selective serotonin reuptake inhibitors (SSRIs) was common with all participants on stable doses at pretreatment in many of the trials. Methodological quality was low to medium. ACT was inconsistent against nontraditional comparison conditions, slightly favorable to empirically validated treatments, and favorable compared with the waitlist and SSRIs. The process of change data indicated that ACT increased the psychological flexibility more than cognitive behavior therapy or SSRIs. These results highlight that findings on ACT for OCD from Western populations replicate and generalize to individuals in Iran. These findings also offer insights gained from studying ACT in Iran and significantly expand the literature based on ACT for OCD that can be integrated into scholarship by all researchers.

BACKGROUND: The wild boar (Sus scrofa) was extinct in Sweden when a few animals established in the 1970s. Over the past 35 years, the species has made a substantial comeback. In this paper, we analyse wild boar population growth using three indices of population size. We also map the legislative decisions and research prompted by the expanding population. We discuss to what extent, in the eyes of the state, the view of wild boar and the management focus has shifted over time, from a perceived pest (eradication) to scarce (conservation), overabundant (reduction/control) or somewhere in between (sustainable management).
RESULTS: Wild boar harvest started in the early 1990s with a few hundred animals annually and peaked at 161,000 in 2020/2021. The distribution now comprises most of southern Sweden. Analyses of harvest and traffic accidents involving wild boar showed that the population grew exponentially until 2010/2011, after which the increase levelled off. Thus, logistic growth models showed the best fit for the full study period. We recorded 38 legislative decisions or commissions to government agencies regarding wild boar. The first decision in 1981 was to eradicate the free-ranging population. In 1987 however, the parliament decided that wild boar is native to Sweden and should be allowed in restricted extent. Later decisions mainly concerned hunting regulations and hunting methods as direct means to increase harvest and regulate the population. Another topic, increasing in importance over time, was to facilitate the use of wild boar meat to indirectly stimulate harvest. A local outbreak of African swine fever in 2023 necessitated a stamping out strategy in the affected area. We found 44 scientific papers regarding the present free-ranging population. Topics include movements and feeding patterns, hunting, reproduction, and population development.
CONCLUSIONS: The state historically regarded wild boar as a pest to be eradicated. This changed with the decision that wild boar should be allowed in restricted extent, suggesting a conservation approach. In response to population growth, the focus shifted to means facilitating sustainable management and, lately, reducing growth. The story of wild boar in Sweden illustrates attempts to mitigate conflicts and balance interests in wildlife management.

Malaria poses a global threat to human health, with millions of cases and thousands of deaths each year, mainly affecting developing countries in tropical and subtropical regions. Malaria\'s causative agent is Plasmodium species, generally transmitted in the hematophagous act of female Anopheles sp. mosquitoes. The main approaches to fighting malaria are eliminating the parasite through drug treatments and preventing transmission with vector control. However, vector and parasite resistance to current strategies set a challenge. In response to the loss of drug efficacy and the environmental impact of pesticides, the focus shifted to the search for biocompatible products that could be antimalarial. Plant derivatives have a millennial application in traditional medicine, including the treatment of malaria, and show toxic effects towards the parasite and the mosquito, aside from being accessible and affordable. Its disadvantage lies in the type of administration because green chemical compounds rapidly degrade. The nanoformulation of these compounds can improve bioavailability, solubility, and efficacy. Thus, the nanotechnology-based development of plant products represents a relevant tool in the fight against malaria. We aim to review the effects of nanoparticles synthesized with plant extracts on Anopheles and Plasmodium while outlining the nanotechnology green synthesis and current malaria prevention strategies.

Substance misuse is a pressing public health concern, especially among emerging adults, with implications for psychological health and overall well-being. This cross-sectional study investigates the mediating roles of self-compassion and subjective well-being in the relationship between psychological flexibility and substance misuse among Turkish college students. The study included 445 emerging adults enrolled at a state university in Türkiye. University participants were recruited via convenience sampling using snowball methods. Data were collected using self-report scales. The sample was 69% female (n = 307) and 31% male (n = 138) and ranged in age from 18 to 26 years (M = 20.85, SD = 1.35). In the study, Pearson product-moment correlation analysis was conducted to examine the relationships between the variables and then the serial mediation model was tested. The findings have revealed that psychological flexibility significantly predicts substance misuse, subjective well-being, and self-compassion. Additionally, the study identifies self-compassion as a mediator in the relationship between psychological flexibility and subjective well-being. While self-compassion contributes significantly to well-being, it does not explain the impact of psychological flexibility on substance misuse. Furthermore, subjective well-being also appears to be a mediator in the relationship between psychological flexibility and substance misuse, emphasizing its potential significance in reducing the likelihood of resorting substance misuse. Overall, the study contributes to understanding the pivotal role of self-compassion and psychological flexibility in fostering well-being and preventing substance misuse in the college setting.

BACKGROUND: Nurse burnout leads to an increase in turnover, which is a serious problem in the health care system. Although there is ample evidence of nurse burnout, interventions developed in previous studies were general and did not consider specific burnout dimensions and individual characteristics.
OBJECTIVE: The objectives of this study were to develop and optimize the first tailored mobile intervention for nurse burnout, which recommends programs based on artificial intelligence (AI) algorithms, and to test its usability, effectiveness, and satisfaction.
METHODS: In this study, an AI-based mobile intervention, Nurse Healing Space, was developed to provide tailored programs for nurse burnout. The 4-week program included mindfulness meditation, laughter therapy, storytelling, reflective writing, and acceptance and commitment therapy. The AI algorithm recommended one of these programs to participants by calculating similarity through a pretest consisting of participants\' demographics, research variables, and burnout dimension scores measured with the Copenhagen Burnout Inventory. After completing a 4-week program, burnout, job stress, stress response using the Stress Response Inventory Modified Form, the usability of the app, coping strategy by the coping strategy indicator, and program satisfaction (1: very dissatisfied; 5: very satisfied) were measured. The AI recognized the recommended program as effective if the user\'s burnout score reduced after the 2-week program and updated the algorithm accordingly. After a pilot test (n=10), AI optimization was performed (n=300). A paired 2-tailed t test, ANOVA, and the Spearman correlation were used to test the effect of the intervention and algorithm optimization.
RESULTS: Nurse Healing Space was implemented as a mobile app equipped with a system that recommended 1 program out of 4 based on similarity between users through AI. The AI algorithm worked well in matching the program recommended to participants who were most similar using valid data. Users were satisfied with the convenience and visual quality but were dissatisfied with the absence of notifications and inability to customize the program. The overall usability score of the app was 3.4 out of 5 points. Nurses\' burnout scores decreased significantly after the completion of the first 2-week program (t=7.012; P<.001) and reduced further after the second 2-week program (t=2.811; P=.01). After completing the Nurse Healing Space program, job stress (t=6.765; P<.001) and stress responses (t=5.864; P<.001) decreased significantly. During the second 2-week program, the burnout level reduced in the order of participation (r=-0.138; P=.04). User satisfaction increased for both the first (F=3.493; P=.03) and second programs (F=3.911; P=.02).
CONCLUSIONS: This program effectively reduced burnout, job stress, and stress responses. Nurse managers were able to prevent nurses from resigning and maintain the quality of medical services using this AI-based program to provide tailored interventions for nurse burnout. Thus, this app could improve qualitative health care, increase employee satisfaction, reduce costs, and ultimately improve the efficiency of the health care system.

BACKGROUND: Non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is heterogeneous in both phenotypes and endotypes. Due to insufficient head-to-head comparison studies, it is hard to decide which biological to initiate. This study aimed to compare the efficacy of omalizumab and mepolizumab which can be used in the treatment of patients with severe eosinophilic asthma diagnosed with N-ERD.
METHODS: The population of this observational, cross-sectional study comprised of N-ERD patients who received omalizumab or mepolizumab for at least 6 months for severe asthma. Outcomes included the asthma control test (ACT), and sino-nasal outcome test scores (SNOT-22), blood eosinophil counts at initiation of biological treatment (T0, baseline) and at the end of 6th months (T6). Adverse effects related to biological treatment and changes of oral corticosteroids dose was recorded.
RESULTS: The study included a total of 22 patients, of whom 11 received mepolizumab and 11 received omalizumab. The change in ACT, SNOT-22, eosinophil counts, and adverse effects related to biologicals were similar at T6 (p = 0.606, p = 0.168, p = 0.05, p = 0.053, respectively). However, when examining the SNOT-22 and ACT based on the cumulative distribution curve (SUCRA), mepolizumab (SUCRA value: 0.61, 0.72, respectively) demonstrated greater efficacy compared to omalizumab (SUCRA value: 0.19, 0.35, respectively). The oral corticosteroids discontinuation rate was similar between the two groups (p = 0.05).
CONCLUSIONS: We found both omalizumab and mepolizumab to be effective in treatment; however, we determined that mepolizumab may have a potential superiority in efficacy.

UNASSIGNED: Unfractionated heparin is a widely used anticoagulant in critically ill patients. It has a well-established safety profile and remains an attractive option for clinicians due to its short half-life and reversibility. Heparin has a unique pharmacokinetic profile, which contributes to significant inter-patient and intra-patient variability in effect. The variability in anticoagulant effect combined with heparin\'s short half-life mean close monitoring is required for clinical efficacy and preventing adverse effects. To optimize heparin use in critically ill patients, effective monitoring assays and dose adjustment strategies are needed.
UNASSIGNED: This paper explores the use of heparin as an anticoagulant and optimal approaches to monitoring in critically ill patients.
UNASSIGNED: Conventional monitoring assays for heparin dosing have significant limitations. Emerging data appear to favor using anti-Xa assay monitoring for heparin anticoagulation, which many centers have successfully adopted as the standard. The anti-Xa assay appears have important benefits relative to the aPTT for heparin monitoring in critically ill patients, and should be considered for broader use.

OBJECTIVE: To assess clinical and demographic characteristics of severe asthma (SA) patients and their management in Russian Federation.
METHODS: This publication provides data for Russian part of population of the international observational study. In Phase I, retrospective analysis of medical records of patients with SA was performed with assessment of clinical and demographic data, medical history, comorbidities, treatment approaches and healthcare utilization. Phase II was a cross-sectional collection of patient-reported outcomes: level of asthma control assessed by ACT (Asthma Control Test) and health-related quality of life (HRQoL) measured using the EQ-5D-5L questionnaire. Phase I patients were enrolled into Phase II if they signed a written consent form.
RESULTS: A total of 315 patients were included in Phase I of the study, 106 (33.6%) of them entered Phase II. Majority of study participants were either obese (n=103; 39.8%) or overweight (n=94; 36.3%). The most common comorbidities were cardiovascular diseases (n=217; 71.4%), followed by chronic respiratory diseases (n=198; 68.8%). There were 268 (85.1%) patients who had at least one exacerbation during last 12 months. Data for blood eosinophil count were available in 176 patients; 81.3% of them (n=143) had only one test in the last 12 months. The mean (SD) last available blood eosinophil count was 161.2 (181.2) cells/mm3. Serum Immunoglobulin E (IgE) value was known for 88 patients, and the mean (SD) last measured IgE value was 254.3 (249.7) ng/mL. Only 4.7% of Phase II participants had ACT scores indicative of controlled asthma (>20). As much as 74.5% had scores ≤15 suggesting uncontrolled disease. Most patients also had impaired HRQoL.
CONCLUSIONS: Most SA patients had poor disease control with frequent exacerbations and high number of comorbidities. Blood eosinophils and IgE level measurements were not evaluated routinely which might be a barrier for appropriate phenotyping and treatment selection.
Цель. Оценить клинико-демографические характеристики и особенности ведения пациентов с тяжелой бронхиальной астмой (ТБА) в России. Материалы и методы. В публикации представлены данные российской популяции международного наблюдательного исследования. В Фазу I включены 315 пациентов, 106 (33,6%) из них вошли в Фазу II. Фаза I включала ретроспективный анализ медицинских документов взрослых больных ТБА с оценкой демографических данных, особенностей анамнеза, сопутствующих заболеваний, подходов к терапии и использования ресурсов здравоохранения. Фаза II представляла собой одномоментное исследование, проводимое для оценки контроля заболевания при помощи Теста по контролю над астмой (Asthma Control Test – ACT) и качества жизни, связанного со здоровьем (HRQoL), по Европейскому опроснику оценки качества жизни (EQ-5D-5L). Участников Фазы I включали в Фазу II после подписания информированного согласия. Результаты. Большинство участников имели ожирение (n=103; 39,8%) или избыточную массу тела (n=94; 36,3%). Самыми частыми сопутствующими заболеваниями оказались сердечно-сосудистые (n=217; 71,4%) и хронические заболевания органов дыхания (n=198; 68,8%). У 268 (85,1%) пациентов в предыдущие 12 мес отмечалось по меньшей мере одно обострение. Данные о количестве эозинофилов крови доступны у 176 пациентов; у 81,3% из них анализ выполнен однократно в течение 12 мес. Среднее значение последнего зарегистрированного количества эозинофилов крови (SD) составило 161,2 (181,2) клеток на 1 мкл. Уровень общего иммуноглобулина E (IgE) оказался известен у 88 пациентов. Средняя величина последнего значения общего IgE (SD) составила 254,3 (249,7) нг/мл. Лишь у 4,7% участников Фазы II показатели АСТ соответствовали контролируемой БА (сумма баллов >20). У 74,5% сумма баллов ACT составила ≤15, что предполагало отсутствие контроля. Пациенты также демонстрировали сниженные показатели качества жизни, ассоциированного со здоровьем. Заключение. У большинства больных ТБА отмечены неудовлетворительный контроль заболевания с частыми обострениями, а также значительное число сопутствующих заболеваний. Количество эозинофилов и уровень IgE редко оцениваются в рутинной практике, что может препятствовать подбору фенотип-ориентированной терапии.

BACKGROUND: Emotional eating, or eating in response to negative emotions, is a commonly reported short-term emotion regulation strategy but has been shown to be ineffective in the long term. Most emotional eating interventions based on Acceptance and Commitment Therapy (ACT) have been delivered in the context of weight loss trials, highlighting a need for ACT-based emotional eating interventions in weight-neutral contexts.
OBJECTIVE: This proof-of-concept study aimed to test the acceptability and efficacy potential of a brief virtual ACT workshop for emotional eating in a small sample of adults identifying as emotional eaters.
METHODS: Twenty-six adult emotional eaters completed an ACT workshop delivered in two 1.5-h sessions over two weeks. The workshop targeted awareness and acceptance of emotions and eating urges, and valued actions around eating.
RESULTS: The acceptability of the workshop was demonstrated by high participant satisfaction. Significant improvements on all outcome measures were found and maintained up to 3 months follow-up.
CONCLUSIONS: These proof-of-concept findings suggest that a brief virtual ACT workshop may improve emotional eating and associated ACT processes. Results from this study can inform a future randomized controlled trial to test the efficacy of the workshop and the role of theoretical processes of change.
BACKGROUND: ClinicalTrials.gov, NCT04457804.
METHODS: Level IV, evidence obtained from multiple time series with the intervention.

Purpose: Existing research suggests that Acceptance and Commitment Therapy (ACT) training is beneficial for healthcare workers\' professional practice and personal well-being. This review aimed to further understanding of healthcare workers\' experiences of ACT training by synthesizing existing qualitative studies.Methods: A systematic literature review identified papers published up until April 2022 using the Embase, Ovid MEDLINE, and PsycINFO databases as well as relevant studies within the gray literature. Nine studies were included in the review, which were analyzed using Thematic Synthesis (Thomas & Harden, 2008).Results: Three analytical themes were identified through the thematic synthesis: I am both the patient and the professional; a powerful and empowering experience; and it is not always comfortable.Conclusion: This review has highlighted the importance of experiential learning. The training was a powerful experience for staff, but as such, it was not always comfortable. Recommendations for the future delivery of ACT training are made.