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Today, it is common for medically complex patients who are receiving multiple medications, to seek routine and emergent dental care. It is essential for the practitioner to recognize and comprehend the impact of such medications on the patient's ability to tolerate the planned dental treatment and on dental treatment outcomes. An active appraisal of current literature is essential to stay abreast of emerging findings and understand their treatment implications. This article outlines the process of such active critical appraisal, illustrating key paradigms of the models that describe the impact of medications on treatment outcomes.

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Online knowledge-sharing platforms construct risk knowledge and provide the audience with risk-related scientific facts. We study how speakers organize narratives in past, present, and future foci to influence the audience's emotions through the audience's appraisal of motive congruency and coping potential. Empirical evidence from 210 Technology, Entertainment, Design talks about disasters from 2002 to 2018 demonstrates that emphasizing the past, present, and future in risk narrative leads to the audience's comments with more negative, less positive, and more positive emotions, respectively. Concrete (vs. abstract) portrayal of the risk narrative improves the audience's situational awareness, enhances their risk appraisal, and intensifies the impact of temporal focus on emotions, providing evidence of how temporal focus impacts. These findings demonstrate that temporal focus can effectively reduce risk overreaction or ignorance and facilitate emotion regulation in risk communication.

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Introduction: While abnormal responses to threat, including overgeneralization to conditioned fear, have been postulated to play a critical role in pathological anxiety, the relevance of previous findings to social anxiety disorder (SAD) is unclear. We investigated conditioned and generalized fear responses in patients with SAD using socially relevant stimuli. Methods: A total of 26 patients with SAD and 25 healthy controls participated in a fear conditioning and generalization paradigm consisting of two neutral faces as conditioned stimuli (CS+ or CS-) and an angry face with contemptuous comments as unconditioned stimuli. Eight morphed faces of two conditioned stimuli in each continuum were given to test generalization. Behavioral data and physiological responses were acquired. Results: Successful conditioning was observed in the risk ratings for both groups, while only a marginal indication of conditioning was noted in physiological measures. During the generalization phase, patients rated the risk higher than CS- when the stimuli close to CS- contained a portion of CS+ features. Larger skin conductance responses to this stimulus were linked to higher fear of negative evaluation. In addition, patients spent a longer time evaluating safe and ambiguous stimuli than healthy controls and exhibited consistently high levels of subjective arousal. Discussion: Taken together, our findings suggest that SAD patients may exhibit a tendency towards overgeneralization of fear responses and show distinct patterns in processing generalized threat stimuli compared to healthy controls. Even though overgeneralization was not evident in physiological measures, it is necessary to consider this behavioral characteristic in the clinical management of patients with SAD.

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BACKGROUND: The experience of self-hood in posttraumatic stress disorder (PTSD) is altered cognitively and somatically. Dysfunctional negative cognitions about the self are a central mechanism of PTSD symptomatology and treatment. However, while higher-order brain models of disturbances in self-appraisal (i.e., cognitive processes relating to evaluating the self) have been examined in other psychiatric disorders, it is unclear how normative brain function during self-appraisal is impaired in PTSD. METHODS: This paper presents a PRISMA systematic review of functional neuroimaging studies (n = 5), to establish a neurobiological account of how self-appraisal processes are disturbed in PTSD. The review was prospectively registered with PROSPERO (CRD42023450509). RESULTS: Self-appraisal in PTSD is linked to disrupted activity in core self-processing regions of the Default Mode Network (DMN); and regions involved in cognitive control and emotion regulation, salience and valuation. LIMITATIONS: Because self-appraisal in PTSD is relatively under-studied, only a small number of studies could be included for review. Cross-study heterogeneity in analytic approaches and trauma-exposure history prohibited a quantitative meta-analysis. CONCLUSIONS: This paper proposes a mechanistic account of how neural dysfunctions may manifest clinically in PTSD and inform targeted selection of appropriate treatment options. We present a research agenda for future work to advance the field.

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BACKGROUND: It is unknown whether large language models (LLMs) may facilitate time- and resource-intensive text-related processes in evidence appraisal. OBJECTIVES: To quantify the agreement of LLMs with human consensus in appraisal of scientific reporting (PRISMA) and methodological rigor (AMSTAR) of systematic reviews and design of clinical trials (PRECIS-2). To identify areas, where human-AI collaboration would outperform the traditional consensus process of human raters in efficiency. DESIGN: Five LLMs (Claude-3-Opus, Claude-2, GPT-4, GPT-3.5, Mixtral-8x22B) assessed 112 systematic reviews applying the PRISMA and AMSTAR criteria, and 56 randomized controlled trials applying PRECIS-2. We quantified agreement between human consensus and (1) individual human raters; (2) individual LLMs; (3) combined LLMs approach; (4) human-AI collaboration. Ratings were marked as deferred (undecided) in case of inconsistency between combined LLMs or between the human rater and the LLM. RESULTS: Individual human rater accuracy was 89% for PRISMA and AMSTAR, and 75% for PRECIS-2. Individual LLM accuracy was ranging from 63% (GPT-3.5) to 70% (Claude-3-Opus) for PRISMA, 53% (GPT-3.5) to 74% (Claude-3-Opus) for AMSTAR, and 38% (GPT-4) to 55% (GPT-3.5) for PRECIS-2. Combined LLM ratings led to accuracies of 75-88% for PRISMA (4-74% deferred), 74-89% for AMSTAR (6-84% deferred), and 64-79% for PRECIS-2 (29-88% deferred). Human-AI collaboration resulted in the best accuracies from 89-96% for PRISMA (25/35% deferred), 91-95% for AMSTAR (27/30% deferred), and 80-86% for PRECIS-2 (76/71% deferred). CONCLUSIONS: Current LLMs alone appraised evidence worse than humans. Human-AI collaboration may reduce workload for the second human rater for the assessment of reporting (PRISMA) and methodological rigor (AMSTAR) but not for complex tasks such as PRECIS-2.

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Introduction: The COVID-19 pandemic has affected nearly every facet of life, constituting a "new normal" and prompting an ongoing collective psychological crisis. People's ways of coping with the pandemic and corresponding well-being are of particular research interest; however, these constructs have largely been examined using deductive quantitative approaches, deficit-based lenses, and mononational samples. Methods: The current mixed-methods study used inductive-sequential (QUAL → QUAN) approaches to explore positive coping strategies (approach coping style and COVID-related connection appraisal) and well-being (loneliness, distress, and happiness) across individuals from the United States, Japan, and Mexico. Qualitative data were gathered from N = 141 U.S., Japanese, and Mexican adults to examine how people perceived connection during the pandemic. Results: Qualitative analyses illuminated common themes in which people appraised the pandemic as an opportunity for connection and strengthened interpersonal relationships. Quantitative measures, including a newly-developed questionnaire on COVID-related connection appraisal, were then administered to a separate sample of N = 302 adults in the U.S, Japan, and Mexico to assess associations among approach coping style, COVID-related connection appraisal, and well-being outcomes (loneliness, distress, happiness). Quantitative analyses found significant associations among approach coping style, COVID-related connection appraisal, and all well-being outcomes. Of note, these associations did not differ by country. COVID-related connection appraisal mediated the relationship between approach coping style and two well-being outcomes (loneliness and happiness). Discussion: Findings point to approach coping style and connection appraisal as pathways for resilience and growth in the face of global suffering.

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Performance evaluation is important for improving medical quality and services. But, there is a lack of research for medical quality in traditional Chinese medicine (TCM) hospitals. This study examines the medical quality and various indicators of tertiary public traditional Chinese medicine hospitals in Gansu Province, to establish a foundation for improving the medical and management standards of these hospitals. This study collected performance assessment data from 10 tertiary TCM hospitals in Gansu Province from 2019 to 2022. Thirteen indicators with TCM characteristics were selected and categorized into 3 aspects: control of medical costs, internal operational dimensions, and comprehensive management. The level of medical quality in different hospitals and in different years were determined using the TOPSIS method for ranking and the RSR method for grading. Firstly, in terms of TCM characteristic indicators, hospital H had the highest control of medical costs and comprehensive management among different hospitals, with 45.87% and 24.20% respectively. The highest values for control of medical costs and comprehensive management were observed in 2020, with 40.65% and 18.69% respectively among different years. When evaluating the medical quality of different hospitals using the TOPSIS method, it was found that hospital H had the highest ranking from 2020 to 2022, with Ci values of 0.725, 0.778, and 0.667 respectively. Additionally, the RSR method indicated that hospital H had a high level of grading from 2020 to 2022, with Pi values of 0.687, 0.690, and 0.723 respectively. These findings suggest that the medical quality of hospital H is at a high and stable level of development. Based on the TOPSIS method to evaluate the performance appraisal results and ranking of different hospitals from 2019 to 2022. The results showed that the highest ranking was hospital B(Ci = 0.913) in 2019. The highest ranking was hospital C(Ci = 0.809)in 2020. The highest ranking was hospital D(Ci = 0.689) in 2021. The highest ranking was hospital J(Ci = 0.865) in 2022. The RSR method indicated that high grading level were hospitals B(Pi = 0.899),F(Pi = 0.795) in 2019. The highest grading level was hospital C(Pi = 0.809) in 2020. The highest grading level were hospitals A(Pi = 0.868), D(Pi = 0.813), E(Pi = 0.689), G(Pi = 0.873), J(Pi = 0.813), K(Pi = 0.842) in 2022. Based on the above results indicate that there is a large variation in the medical quality profile of different hospitals from 2019 to 2022. By comparing the results of TOPSIS and RSR method from 2019 to 2022, we found that the hospitals with identical ranking were D and J, and the hospitals with ≤2 difference in ranking was A,B,C,E in 2019, the hospitals with >2 ranking was A, F in 2020, the hospitals with >2 ranking were C, G in 2021, and the hospitals with identical ranking results were B,D,E,G,J in 2022. Comparing the ranking results of TOPSIS and RSR methods, showed that the hospitals with identical rankings were B, F from 2019 to 2022. The difference in ranking results ≤2 were A, C, D, E, G, H, J, K, indicating that high consistency between TOPSIS and RSR methods and credible results. The findings reveal significant fluctuations in medical quality across different years, while the overall level of medical quality remains relatively stable among the various hospitals. It is recommended that TCM hospitals focus on improving management efficiency, optimizing hospital operations, enhancing the utilization of medical resources, and fostering the efficient development of hospitals.

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BACKGROUND: Binge drinking (BD) and tobacco use disorder (TUD) are prevalent among youth, with significant social and health implications. However, research into the emotional impairments associated with BD and TUD during adolescence is sparse and lacks integration within a comprehensive model of emotional processes. Moreover, the impact of comorbid BD and TUD on emotional deficits remains largely unexplored. We proposed the first review focused on the variation of emotional deficits in BD, TUD, or their comorbidity among adolescents and we systematically explored differences across various emotional abilities. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR), we conducted a preregistered review of existing literature on emotional processing impairments in BD and/or TUD among adolescents. From 481 papers initially identified, only 7 were included in this review. Additionally, we proposed experimental avenues for future research based on identified shortcomings in current literature. RESULTS: Our scoping review indicates that emotional deficits are likely prevalent in both BD and TUD populations, affecting emotional appraisal/identification, response, and regulation. However, further investigation is necessary to ascertain the magnitude and scope of these deficits in adolescents and adults, as well as to delineate the distinct or combined influence of BD and TUD on emotional disturbances. CONCLUSION: While some emotional deficits are apparent, we contend that examining emotional deficits in BD and TUD separately, as well as together, would offer a more comprehensive understanding of their nature and inform the development of novel treatment strategies.

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The ability to correctly identify Potential Key Fish Habitats (PKFH) before undertaking development assessments or stream restoration projects is a critical step for determining appropriate management interventions and offset strategies to minimize damage to all life stages of fish. However, there are no rapid, low-cost tools that can be universally utilised to identify PKFH in perennial streams and ephemeral streams in particular. We propose a conceptual framework for developing a rapid field appraisal based on a range of physical fish habitat-supporting features. Four steps are involved in developing the framework: 1) understand fish habitat features using published literature and sub-set model selection using actual data, 2) collect field data, 3) develop the conceptual framework, and 4) classify sites. We tested eight fish habitat-supporting features in the assessment and proposed a decision tree that guided the rapid appraisals at 104 ephemeral sites in southeast Australia. Out of 104 sites, 86% were identified as PKFH, 10% as likely key fish habitats and 4% as unlikely key fish habitats. The rapid field appraisal is cost-effective, simple to implement and does not require expert knowledge of fish habitats. Despite some limitations in the conceptual framework, this appraisal has great potential as a screening technique for PKFH in freshwater streams, particularly ephemeral streams in Australia and other overseas jurisdictions.

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BACKGROUND: Anticipatory grief is common among family caregivers of cancer patients and may be related to caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping strategies. The purpose of this study was to examine the mediating role of cognitive appraisal and coping strategies in the relationship between caregiver burden, family resilience, psychological capital, and anticipatory grief among caregivers of cancer patients. METHODS: This study surveyed from January to September 2023 among 265 caregivers of lung and breast cancer patients in two public hospitals. They completed measures of caregiver burden, family resilience, psychological capital, cognitive appraisal, coping, and anticipatory grief. AMOS software was used to model the data with Bayesian structural equation modeling. RESULTS: Bayesian structural equation modeling results showed that caregiver burden had a direct effect on anticipatory grief. The chain mediating effects for cognitive appraisal tendency and coping tendency between caregiver burden, family resilience, psychological capital, and anticipatory grief, respectively. Coping tendency acted as a mediator between psychological capital and anticipatory grief. CONCLUSIONS: The relationships between caregiver burden, family resilience, and psychological capital with anticipatory grief are embedded in the mediating effects of cognitive appraisal and coping. Early identification and intervention for caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping methods may prevent anticipatory grief in caregivers of cancer patients.

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Suffering and misfortunes of other people are often portrayed in the media. Recipients react to these portrayals with different emotions. This article elucidates and clarifies schadenfreude (pleasure at the misfortune of others) and sympathy (feeling concern or sorrow over another person's distress) in media experiences. A thorough literature review provides in-depth insights into the formation of affective dispositions and schadenfreude from various psychological perspectives. This conceptual analysis leads to the "Model of Individual and Social Appraisals of Misfortunes of Others" (MISAM) which first reveals the determining intrapersonal factors within the emotional experience of schadenfreude and sympathy. Second, it discloses the social component vital for understanding the construction and regulation of these emotions. The model combines individual and social appraisal processes and identifies the factors involved in the elicitation and regulation of schadenfreude and sympathy in the media reception of misfortunes. With the aim of integrating different perspectives, we incorporated Affective Disposition Theory and recent work from social psychology and used an appraisal framework. The MISAM opens the path for further investigation of schadenfreude and sympathy in media reception, beyond entertainment experiences.

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To inform environmental policy and practice, researchers estimate effects of interventions/exposures by conducting primary research (e.g., impact evaluations) or secondary research (e.g., evidence reviews). If these estimates are derived from poorly conducted/reported research, then they could misinform policy and practice by providing biased estimates. Many types of bias have been described, especially in health and medical sciences. We aimed to map all types of bias from the literature that are relevant to estimating causal effects in the environmental sector. All the types of bias were initially identified by using the Catalogue of Bias (catalogofbias.org) and reviewing key publications (n = 11) that previously collated and described biases. We identified 121 (out of 206) types of bias that were relevant to estimating causal effects in the environmental sector. We provide a general interpretation of every relevant type of bias covered by seven risk-of-bias domains for primary research: risk of confounding biases; risk of post-intervention/exposure selection biases; risk of misclassified/mismeasured comparison biases; risk of performance biases; risk of detection biases; risk of outcome reporting biases; risk of outcome assessment biases, and four domains for secondary research: risk of searching biases; risk of screening biases; risk of study appraisal and data coding/extraction biases; risk of data synthesis biases. Our collation should help scientists and decision makers in the environmental sector be better aware of the nature of bias in estimation of causal effects. Future research is needed to formalise the definitions of the collated types of bias such as through decomposition using mathematical formulae.

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Conducting high-quality overviews of reviews (OoR) is time-consuming. Because the quality of systematic reviews (SRs) varies, it is necessary to critically appraise SRs when conducting an OoR. A well-established appraisal tool is A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, which takes about 15-32 min per application. To save time, we developed two fast-and-frugal decision trees (FFTs) for assessing the methodological quality of SR for OoR either during the full-text screening stage (Screening FFT) or to the resulting pool of SRs (Rapid Appraisal FFT). To build a data set for developing the FFT, we identified published AMSTAR 2 appraisals. Overall confidence ratings of the AMSTAR 2 were used as a criterion and the 16 items as cues. One thousand five hundred and nineteen appraisals were obtained from 24 publications and divided into training and test data sets. The resulting Screening FFT consists of three items and correctly identifies all non-critically low-quality SRs (sensitivity of 100%), but has a positive predictive value of 59%. The three-item Rapid Appraisal FFT correctly identifies 80% of the high-quality SRs and correctly identifies 97% of the low-quality SRs, resulting in an accuracy of 95%. The FFTs require about 10% of the 16 AMSTAR 2 items. The Screening FFT may be applied during full-text screening to exclude SRs with critically low quality. The Rapid Appraisal FFT may be applied to the final SR pool to identify SR that might be of high methodological quality.

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Background: Text-generating artificial intelligence (AI) such as ChatGPT offers many opportunities and challenges in medical education. Acquiring practical skills necessary for using AI in a clinical context is crucial, especially for medical education. Objective: This explorative study aimed to investigate the feasibility of integrating ChatGPT into teaching units and to evaluate the course and the importance of AI-related competencies for medical students. Since a possible application of ChatGPT in the medical field could be the generation of information for patients, we further investigated how such information is perceived by students in terms of persuasiveness and quality. Methods: ChatGPT was integrated into 3 different teaching units of a blended learning course for medical students. Using a mixed methods approach, quantitative and qualitative data were collected. As baseline data, we assessed students' characteristics, including their openness to digital innovation. The students evaluated the integration of ChatGPT into the course and shared their thoughts regarding the future of text-generating AI in medical education. The course was evaluated based on the Kirkpatrick Model, with satisfaction, learning progress, and applicable knowledge considered as key assessment levels. In ChatGPT-integrating teaching units, students evaluated videos featuring information for patients regarding their persuasiveness on treatment expectations in a self-experience experiment and critically reviewed information for patients written using ChatGPT 3.5 based on different prompts. Results: A total of 52 medical students participated in the study. The comprehensive evaluation of the course revealed elevated levels of satisfaction, learning progress, and applicability specifically in relation to the ChatGPT-integrating teaching units. Furthermore, all evaluation levels demonstrated an association with each other. Higher openness to digital innovation was associated with higher satisfaction and, to a lesser extent, with higher applicability. AI-related competencies in other courses of the medical curriculum were perceived as highly important by medical students. Qualitative analysis highlighted potential use cases of ChatGPT in teaching and learning. In ChatGPT-integrating teaching units, students rated information for patients generated using a basic ChatGPT prompt as "moderate" in terms of comprehensibility, patient safety, and the correct application of communication rules taught during the course. The students' ratings were considerably improved using an extended prompt. The same text, however, showed the smallest increase in treatment expectations when compared with information provided by humans (patient, clinician, and expert) via videos. Conclusions: This study offers valuable insights into integrating the development of AI competencies into a blended learning course. Integration of ChatGPT enhanced learning experiences for medical students.

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This article provides a summary and critical appraisal of the systematic review conducted by Alidoust et al. (1) regarding the various effects of housing on both physical and psychological well-being. We aim to discuss the review's findings against existing published evidence to draw out policy and practical implications. Our mini-review illuminates a wide range of housing-related factors which impact on health around which we draw evidence-based policy initiatives and implications, and outline avenues for future research. This mini-review is part of the wider Rapid Conversion of Evidence Summaries (RaCES) program which aims to critically appraise systematic reviews and highlight evidence-based policy and practice implications.

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Microplastics (MPs) are being released into the environment in large quantities, especially in less developed parts of the world. This group of pollutants is mostly leached into the environment through heavy plastic dumpsites, pharmaceutical and personal care product containers, hospital wastes, plastic package accessories, and litter from food packaging. Consequently, these compounds are found in different compartments of the ecosystem, such as soils, sediments, biota, and, surprisingly, drinking water. The present study systematically appraised recent studies on MP pollution in the Asian and African environments. It also summarized the trends in the methods for the environmental monitoring of MPs and the removal strategies that have been employed. From the data gathered, the two key instrumentations involved are the microscopes for visualization and the Fourier transform-infra-red (FT-IR) spectrometer to classify or characterize the MPs. Based on the surveyed works of literature, China and South Africa have relatively more information on MP contamination of diverse matrices within their countries. Meanwhile, studies on the status of MP contamination should be conducted across all countries. Hence, this study becomes an eye-opener regarding the commencement of research works on the MP contamination of the environment, especially in other Asian and African countries with little or no information. Furthermore, the literature on ecotoxicity studies of MPs was investigated to ascertain the toxic nature of these compounds. This aspect of research is vital because it serves as a prerequisite for the remediation of these compounds. Microplastics have been declared lethal to biotic components, so all hands must be on deck to continuously remove them from the environment.

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In this diary study, we contribute to research on day-level multitasking in organizations by investigating why and when multitasking impairs employees' work-related flow and subjective job performance on a daily basis. Drawing on Lazarus and Folkman's transactional model of stress and coping, we propose that employees' appraisal of their daily tasks (i.e., less challenging and more hindering) may explain why multitasking has negative implications for flow and job performance. Moreover, we expect that daily work engagement can buffer the detrimental effects of multitasking on flow and job performance. A total of 33 professional workers in the food industry participated in our study and were asked to respond to 10 daily surveys at work across 4 weeks. In line with our expectations, results showed that on days when employees' working time was highly fragmented across a high number of tasks, they experienced less flow and, in turn, their job performance was lower on that particular day. Moreover, appraisal of daily tasks as less challenging - though not more hindering - explained why multitasking impairs flow. Finally, daily work engagement buffered the detrimental impact of multitasking on flow. The results presented in this paper offer novel and ecologically valid insights into why and when multitasking may backfire for employees.

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The convergence of researchers in the fields of flourishing, moral psychology, and social-emotional studies has reached a stage where developing a theory that connects emotional regulation and flourishing is meaningful. This theoretical investigation aims to uncover insights from the research of Magda B. Arnold, renowned for her theory of emotions, and lesser-known for her notion of the self-ideal, regarding the relationship between emotional regulation and flourishing. Our initial hypothesis posits that Arnold's concept of self-ideal provides a framework for understanding how to foster emotional regulation in individuals by directing it toward constructive life objectives. To achieve this, we explore the current state of emotional regulation and flourishing and the relationship between these concepts; we consider the interconnectedness of emotion and self-ideal within Arnold's theory and analyze its potential to serve as a foundation for building a theory relating flourishing and emotional regulation. We find in Arnold's theory substantial ideas about the relationship between emotional regulation, flourishing, and self-ideal, as well as emerging empirical research relating to these themes. We conclude that Arnold's research can serve as a catalyst for developing psychological intervention models that enhance emotional regulation and promote a flourishing life.

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Introduction: Professional classical musicians operate within a highly demanding environment, which includes organizational, social, and emotional demands. When not effectively coped with, these demands may cause stress and negatively impact well-being. This qualitative study explored the perceived stress and well-being experiences of professional classical musicians through a transactional theory of stress. The study employed a double hermeneutic interpretation of the lived experiences of the perceived demands faced, stress appraisals made, resources used, and the influence on well-being. Methods: Six professional classical musicians were purposefully selected for participation. Semi-structured interviews were conducted and participants reflected on two events: one they perceived as a positive experience and one that was negative. Transcripts were analyzed using Interpretative Phenomenological Analysis and Group Experiential Themes emerged. Results: Three Group Experiential Themes were identified: (a) Performance Demands; (b) Organizational Demands; and, (c) Relationship Demands. Participants predominantly appraised demands as a threat. A small number of demands were appraised as a challenge or benefit, and the fewest demands were appraised as causing harm or loss. Participants' appraisals were informed by underlying properties of stress appraisal such as self and other comparison, and preparation. Participants often relied on personal resources as opposed to available workplace resources. They perceived well-being to relate to stress appraisals with participants experiencing acute and long-term outcomes. Discussion: This study offers insight into the lived experience of the occupational stress process within professional classical musicians. The findings demonstrate that organizational interventions targeted at continuing professional development and social support are appropriate to help musicians cope more effectively with demands.

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INTRODUCTION: Cervical cancer is the fourth most common cancer in women globally. It is the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Research has shown an association between low levels of risk perception and knowledge of the prevention, risks, signs, etiology, and treatment of cervical cancer and low screening uptake, as contributing to high rates of cervical cancer-related mortality. However, there is scant literature on the perspectives of a wider group of stakeholders (e.g., policymakers, healthcare providers (HCPs), and women at risk), especially those living in rural and semi-rural settings. The main objective of this study is to understand knowledge and perspectives on cervical cancer risk and screening among these populations. METHODS: We adapted Risso-Gill and colleagues' framework for a Health Systems Appraisal (HSA), to identify HCPs' perspective of the extent to which health system requirements for effective cervical cancer screening, prevention, and control are in place in Tanzania. We adapted interview topic guides for cervical cancer screening using the HSA framework approach. Study participants (69 in total) were interviewed between 2014 and 2018-participants included key stakeholders, HCPs, and women at risk for cervical cancer. The data were analyzed using reflexive thematic analysis methodology. RESULTS: Seven themes emerged from our analysis of semi-structured interviews and focus groups: (1) knowledge of the role of screening and preventive care/services (e.g., prevention, risks, signs, etiology, and treatment), (2) training and knowledge of HCPs, (3) knowledge of cervical cancer screening among women at risk, (4) beliefs about cervical cancer screening, (5) role of traditional medicine, (6) risk factors, and (7) symptoms and signs. CONCLUSIONS: Our results demonstrate that there is a low level of knowledge of the role of screening and preventive services among stakeholders, HCPs, and women living in rural and semi-rural locations in Tanzania. There is a critical need to implement more initiatives and programs to increase the uptake of screening and related services and allow women to make more informed decisions on their health.

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