This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, in college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study\'s end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over 3 weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. The activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and 3 weeks post-program. The experimental group showed significant improvements in stress (F = 5.759, p < 0.05), anxiety (F = 4.790, p < 0.01), depression (F = 5.740, p < 0.01), self-efficacy (F = 3.723, p < 0.05), resilience (F = 4.739, p < 0.05), and the K-PPC total score (F = 3.740, p < 0.05) compared with the control group. These improvements were maintained at the 3-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times such as the COVID-19 pandemic.

UNASSIGNED: This study examined the relationship between occupational stress and organizational adaptation among nurses and analyzed the moderating effects of interpersonal competence on this association.
UNASSIGNED: In the rapidly changing medical industry, nurses must adapt to their healthcare organizations and competently provide care. Higher levels of stress in nurses, which have been reported recently, can decrease their organizational adaption levels. This highlights the need for more research examining ways to address the impacts of nurses\' occupational stress on organizational adaptation. Since interpersonal competence has been shown to mitigate the negative consequences of job stress, we hypothesized that improved interpersonal competence would moderate the relationship between occupational stress and organizational adaptation.
UNASSIGNED: We employed a cross-sectional study design using online survey data from 500 nurses in Korea, recruiting participants through a recruitment advertisement on a mobile application widely used by nurses. We used descriptive statistics and multiple linear regression to conduct our data analysis, testing eight models to fit occupational stress (7 subdomains and overall), interpersonal competence, organizational adaptation, and the interaction term (stress*interpersonal competence) while controlling for demographic variables.
UNASSIGNED: Of the 500 sampled nurses, most were female with a mean age of 27 and four years of nursing work experience. All models tested were significant, explaining 52-61 % of the variance in organizational adaptation. As hypothesized, our analysis revealed negative relationships between occupational stress (overall and subdomain scores) and organizational adaptation. Nurses\' interpersonal competence had significant moderating effects on the negative relationships between all subdomains of occupational stress and organizational adaptation, except job insecurity and interpersonal conflict.
UNASSIGNED: To raise nurses\' organizational adaptation levels, stakeholders should address occupational stressors. Cultivating interpersonal competence will alleviate the negative impacts of stress in nurses. Stakeholders should acknowledge the importance of interpersonal competence for nurses and prioritize providing continuing education in schools and hospitals to foster interpersonal competence.

BACKGROUND: The IMPACT BCN trial-a parallel-group randomized clinical trial where 1221 pregnant women at high risk for small-for-gestational age (SGA) newborns were randomly allocated at 19- to 23-week gestation into three groups: Mediterranean diet, Mindfulness-based Stress reduction or non-intervention-has demonstrated a positive effect of Mediterranean diet and Stress reduction in the prevention of SGA. However, the mechanism of action of these interventions remains still unclear. The aim of this study is to investigate the effect of Mediterranean diet and Stress reduction on placental volume and perfusion.
METHODS: Participants in the Mediterranean diet group received monthly individual and group educational sessions, and free provision of extra-virgin olive oil and walnuts. Women in the Stress reduction group underwent an 8-week Stress reduction program adapted for pregnancy, consisting of weekly 2.5-h and one full-day sessions. Non-intervention group was based on usual care. Placental volume and perfusion were assessed in a subgroup of randomly selected women (n = 165) using magnetic resonance (MR) at 36-week gestation. Small placental volume was defined as MR estimated volume <10th centile. Perfusion was assessed by intravoxel incoherent motion.
RESULTS: While mean MR placental volume was similar among the study groups, both interventions were associated with a lower prevalence of small placental volume (3.9% Mediterranean diet and 5% stress reduction vs. 17% non-intervention; p = 0.03 and p = 0.04, respectively). Logistic regression showed that small placental volume was significantly associated with higher risk of SGA in both study groups (OR 7.48 [1.99-28.09] in Mediterranean diet and 20.44 [5.13-81.4] in Stress reduction). Mediation analysis showed that the effect of Mediterranean diet on SGA can be decomposed by a direct effect and an indirect effect (56.6%) mediated by a small placental volume. Similarly, the effect of Stress reduction on SGA is partially mediated (45.3%) by a small placental volume. Results on placental intravoxel incoherent motion perfusion fraction and diffusion coefficient were similar among the study groups.
CONCLUSIONS: Structured interventions during pregnancy based on Mediterranean diet or Stress reduction are associated with a lower proportion of small placentas, which is consistent with the previously observed beneficial effects of these interventions on fetal growth.

BACKGROUND: Poor quality of care and patient safety, adverse patient outcomes, high rates of burnout and turnover, and increased job dissatisfaction are all linked to uncontrolled stress among nurses. Unmanaged nurse stress can lead to disorganized thinking, decreased ability to focus and concentrate, and can put patients at risk. The purpose of the integrative review was to determine the effects of a mindfulness-based stress reduction (MBSR) program to reduce the perceived stress levels of nurses.
METHODS: Included was a search of databases using key search terms and inclusion and exclusion criteria. Relevant peer-reviewed articles within the last five years were appraised to identify similarities and differences. This paper discusses the implications of unresolved stress on nurses and patients they care for including quality and safety of patient care, cost of nurse turnover rates related to stress, and poor work efficiency.
CONCLUSIONS: Literature results suggest that implementation of a mindfulness-based stress reduction (MBSR) program leads to a reduction in perceived stress levels among nurses resulting in improved patient outcomes, increased job satisfaction, and reduction of organizational costs associated with the hiring and onboarding process.
UNASSIGNED: It is the conclusion of this integrative review that implementation of a MBSR program leads to improvements in stress reduction and indirectly positively impacts patient outcomes. It is recommended that organizations implement a formal eight-week mindfulness-based stress reduction program.
UNASSIGNED: There are no conflicts of interest or financial gains for the recommendations for MBSR implementation resources. These resources are solely provided for additional learning and implementation purposes. There are both free resources and for purchase resources available that guides implementation and operationalization of the MBSR program.

Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant p-values (short-term SDNN: MD = 6.43, p = 0.01; 24 h SDNN: MD = 10.92, p = 0.004; short-term LF: MD = 160.11, p < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.

In this clinical trial, 60 nurses from three geriatric centers were enlisted and randomly split into two groups: control (n = 30) and intervention (n = 30). Statistical analysis using SPSS version 21 employed Kolmogorov-Smirnov, Chi square, and t-test to assess results. The intervention group received eight training sessions. After the MBSR Training in the intervention groups, results showed there was a statistically significant difference between the two groups concerning the scores of the subscales of death and dying (t = 6.161, P < 0.001), conflicts with physicians (t = 7.962, P < 0.001), inadequate preparation (t = t = 6.524, P < 0.001), lack of support resources (t = 5.532, P < 0.001), conflicts with nurses (t = -6.632, P < 0.001), workload (t = 6.587, P < 0.001), uncertainty of treatment (t = 5.587, P < 0.001) as well as the scores of the subscales of burnout.

Researchers, practitioners, and policy-makers are having to deal with the negative impact of body image concerns in populations globally. One cost-effective way of promoting healthier body image outcomes is through exposure to natural environments. A growing body of research has shown that spending time in, interacting with, and even just looking at natural environments can promote healthier body image outcomes. In this narrative review, I consider the different forms of evidence documenting an association between nature exposure and body image (i.e., cross-sectional and mediational, experimental and quasi-experimental, comparative, prospective, experience sampling, and qualitative research). Beyond this, I shine a critical light on the available evidence, highlighting concerns with methodological (i.e., who research has focused on and what types of natural environments have been considered), psychometric (i.e., how body image and nature exposure are measured), and conceptual issues (how the association is explained). I conclude that, although there are issues affecting the way the existing body of research is to be understood, there are reasons to be hopeful that nature exposure can be leveraged to promote healthier body image outcomes in diverse populations.

College campuses in the United States are experiencing high levels of mental distress without adequate psychological resources to address the need. In addition, the majority of university students do not meet the physical activity guidelines for mental and physical health. Effective and time efficient resources are needed to address poor mental health and low physical activity among university students on college campuses. Mindful walking may be a promising solution. The purpose was to 1) measure change in mental health and 2) estimate physical activity from participation in a guided mindful walk in a diverse student sample. Students participated in a mindful walking route which included seven stops (0.85 miles) during the Spring 2022 semester. Undergraduate students (n = 44) were mean ± SD age 20.9 ± 3.8 years and 68% female. Validated surveys were given pre- and post-participation measuring mental health constructs of state mindfulness (Toronto Mindfulness Scale; TMS), state anxiety (visual analogue scale), and state stress (Short Stress State Questionnaire; SSSQ). Physical activity was estimated via steps on a Yamax pedometer worn at the hip. After the guided mindful walk, total state mindfulness score significantly improved (mean ± SD) (pre: 27.5 ± 8.2, post: 32.8 ± 9.5; p < 0.001); state anxiety significantly decreased (pre: 3.7 ± 2.4, post: 2.4 ± 2; p < 0.0001) and total state stress score was reduced (pre: 66.1 ± 10.7, post: 63.4 ± 8.3; p = 0.03). Physical activity averaged 1,726 ± 159 steps. Completion of a guided mindful walk can reduce anxiety and stress, while increasing mindfulness among university students.

A sedentary lifestyle, low levels of physical activity and fitness, poor dietary patterns, and psychosocial stress are strongly associated with increased morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD). Conversely, engaging in regular physical activity, maintaining optimal fitness levels, adhering to a heart-healthy dietary pattern, effectively managing body weight, ensuring adequate sleep, implementing stress-reduction strategies, and addressing psychosocial risk factors are associated with a reduced risk of ASCVD. This comprehensive review synthesizes current evidence from large observational studies and randomized controlled trials on lifestyle factors as determinants of ASCVD health. It also briefly reviews mechanistic insights into how factors such as low shear stress, increased reactive oxygen species production, chronic inflammation, platelets and coagulation activation, endothelial dysfunction, and sympathetic hyperactivity contribute to the initiation and exacerbation of ASCVD risk factors. These include obesity, hyperglycemia, type 2 diabetes, hypertension, and dyslipidemia, subsequently leading to the development and progression of atherosclerosis, ultimately resulting in chronic ASCVD or acute cardiovascular events. To bridge the translational gap between epidemiologic and trial-based evidence and clinical practice, practical recommendations are summarized to facilitate the translation of scientific knowledge into actionable interventions to promote ASCVD health. Acknowledged is the gap between the evidence-based knowledge and adoption within healthcare systems, which remains a crucial objective in advancing cardiovascular health at the population level.

OBJECTIVE: In light of the mounting prevalence of stress in contemporary society and the growing interest in stress reduction methods, this review investigates the potential of taiji as a viable strategy for alleviating stress.
METHODS: MEDLINE, EMBASE, the Cochrane Controlled Trials Register (CENTRAL), PsycINFO, and Web of Science were searched up to April 2023 to identify randomized controlled trials of taiji. Studies in both patients and healthy populations were considered. They had to provide a measure of perceived stress and include a no treatment or placebo control group. Data were extracted by two reviewers. Pooled standardized mean differences (SMD) were calculated for perceived stress, biological stress markers, anxiety, depression, and quality of life (QoL). Meta-regression analyses were performed to identify sources of heterogeneity.
RESULTS: Eleven trials with a total of 1323 patients comparing taiji to no intervention met the inclusion criteria. The included studies varied strongly with regard to patient characteristics, taiji intervention, and methodological quality. The overall SMD for perceived stress was significant at -0.41 (95% confidence interval, CI, -0.63 to -0.19; I2 = 63%). Exclusion of studies with less than 100 participants yielded a diminished SMD at -0.26 (95% CI, -0.45 to -0.06). The SMD for perceived stress at follow-up was significant (-0.25, 95% CI -0.46 to -0.05). Secondary outcomes highlighted improvements in anxiety and physical QoL, while depression, mental QoL, and biological stress markers remained unchanged.
CONCLUSIONS: Results underscore taiji\'s potential in mitigating perceived stress in both patients and healthy populations, paralleled by enhancements in depressive symptoms, anxiety levels, and physical QoL.