Postmenopausal Research Articles

Sid Chaplin: A Writer with a Cause

The aim of this article is to recover the radical subtext of both the life and work of Sid Chaplin by reasserting the essentially political dimensions of his writing. Chaplin devoted the whole of his career as a writer to documenting not only the decline of the coal mining industry in the north-east of Britain where he lived, but he also traced the impact this process had on the working-class communities that were dependent on the pits. In his two later novels set in the city of Newcastle, The Day of the Sardine (1961) and The Watchers and the Watched (1962), Chaplin went on to dramatize similarly troubled changes in urban working-class life in the 1950s and 60s. The article not only argues that it is this nexus of class, politics and literature that translates so convincingly into his Newcastle novels, it also claims that it is the fundamental radicalism of his own literary project that explains the problematic neglect of his work by both critics and readers.

Effect of hold-type on cyclic life and microstructural evolution of an austenitic stainless steel

The present work investigates the effect of different type of hold on the change in microstructure and cyclic life. i.e., number of cycles to failure of the 304LN grade austenitic stainless steel at an elevated temperature. The strain-controlled low cycle fatigue and creep-fatigue interaction tests were carried out in air at 540 °C for constant total strain amplitude levels of ± 0.5 % and ± 0.7 %. The duration of hold-time was maintained at a constant level of 600 s at peak tensile, compressive and both peak tensile-compressive strain during different creep-fatigue interaction tests. Due to incorporation of creep damage, the cyclic life of the creep-fatigue interaction-tested samples has been found to be lower than that of the low cycle fatigue-tested samples. The tensile-hold appears to have maximum impact on reduction in cyclic life during creep-fatigue interaction tests followed by tension-compression hold and compressive hold. The scanning electron microscopy and electron back scattered diffraction analyses of creep-fatigue interaction-tested samples have revealed that the grain size coarsening, reduction in twin boundary fraction and increase in average Kernel Average Misorientation are the key factors in reduction of cyclic life.

'There are things I have learned the hard way' Patient experiences on lasting challenges 4 months after Transient Ischemic Attack: A qualitative study.

Fatigue, depression, anxiety and cognitive difficulties are reported by 1/3 of patients following transient ischemic attack (TIA). To explore the timeline and how the diagnosis impacts individuals experiencing lasting challenges after TIA. Furthermore, to identify what they believed facilitated return to everyday life. Qualitative exploratory study with a phenomenological-hermeneutic approach. Individual semi-structured interviews and thematic analysis. Fifteen patients were included. Four themes were identified; (1) 'They say it is transient - no, not for me' where all participants described lasting challenges emphasizing invalidating fatigue and impaired social participation, (2) 'I am a changed person; how does this impact my future?' which reflects altered identity and elevated alertness to symptoms, (3) 'Time has been my ally and new perspectives have evolved' where most participants described improvement over time and a few considered the diagnosis a wake-up call to change lifestyle. Lastly (4) 'What would have helped me recover?' which unfolds that close, trustful relations influence positively. In addition, the system often failed to support. Participants described pressure to return to work and lack of trust and negative experiences when involving their general practitioner. During the 4 months since diagnosis, participants experienced limitations impacting physical, psychological and social domains. They felt uninformed that lasting challenges could affect them. Different coping strategies were activated, and participants with close, supportive relations managed better. A pressure to return to work and a lack of trust in the general practitioner affected their recovery negatively. Overall, return to everyday life after TIA was considered stressful and appropriate support lacking. To be able to support patients with challenges following TIA, we as healthcare professionals need to understand the identified impact and life changing circumstances. Currently the system seemingly is not able to provide timely, sufficient and competent support. WHAT PROBLEM DID THE STUDY ADDRESS?: We know from the literature that up to 1/3 of patients following transient ischemic attack experience lasting challenges measured on a variety of questionnaires. This is paradoxical to a diagnosis defined by focal neurological symptoms that resolve within 24 h. It is unknown how patients with lasting challenges experience the timeline from diagnosis and until 4 months after, how the diagnosis impacts the lives of these individuals, and what they believe as beneficial in returning to their everyday life. WHAT WERE THE MAIN FINDINGS?: These participants with self-reported lasting challenges experienced substantial impacts on physical, psychological and social domains. Further, they felt alone with their struggles and when in need of support from the healthcare system, it failed to provide this. A pressure to return to work and a lack of trust in the general practitioner affected return to everyday life negatively, whereas close and supportive relations facilitated positively. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This study will have an impact on the healthcare professionals that provide support and the (limited) follow-up services to patients after TIA. These healthcare professionals are often specialized nurses who need to know what these patients experience and need in order to act upon their struggles and provide timely support. The Standards of Reporting Qualitative Research (SRQR). Patients with TIA was involved in planning this study. They participated in a panel to plan a prospective observational cohort study and emphasized the importance of exploring the subjective perspectives of impact and prognosis for those patients struggling in a longer term (through qualitative interviews).

Patient reported outcome measures at a large district general hospital post-mastectomy and implant based reconstruction.

11 Background: Breast reconstruction surgery for cancer can be a debilitating and life changing experience for patients, with complex affects on physical and mental health throughout the rehabilitation journey. We conduct a study on a cohort of patients undergoing this procedure, with focus on patient reported outcome measures. Methods: We reviewed all patients who underwent breast reconstruction surgery at our hospital from 2017 to 20223. Demographic, diagnosis, pre- and post-operative adjuvant treatment, and implant characteristics were collected. Psychosocial well being, physical wellbeing, satisfaction with breasts scales of the BREAST-Q were used. Independent t-test was conducted to find differences between PROMs for each group, and linear regression of age and implant size on each score. Results: 69 patients were contacted and 39 PROMS collected. The average age of patients was 57.6 years old. 40% were previous or current smokers and 40.8% had BMI>30. 29 had pre-pectoral placement and 40 sub-pectoral. 17 had smooth implants and 52 textured. The average size of implant was 330mm. Immediate reconstruction was associated with a lower psychosocial score (66.0vs86.9, p=0.02) compared to multi-stage implants. Sub pectoral placement was associated with a higher (75.7vs61.9 p=0.046) psychosocial score than pre pectoral placement. Textured surface was associated with lower physical score than smooth surface (34.7vs50.2 P=0.046). On linear regression, age was positively associated (p=0.007) with psychosocial score. Conclusions: These findings underscore the importance of personalized approaches in surgery, considering implant type, placement technique, and patient age. Surgeons should prioritize patient preferences and needs to optimize post-surgical satisfaction and well-being.

AUTISM IN ADULTS: Feelings and changes after a late diagnosis

Previously considered a rare childhood disorder, autism today is a frequent diagnosis with increasing demand in all age groups, including people who were not diagnosed in childhood, but who perceive characteristics of this condition. This study, which is part of a broader research on the experience of Brazilian adults who were diagnosed with autism spectrum disorder (ASD) after 18 years, aims to explore the feelings and life changes of this group of people after the diagnosis. To this end, a qualitative research was carried out in which 12 participants were interviewed and the data were analyzed using the content analysis method, in its categorical aspect. Considering the objective of this work, in the analysis of the interviews, these categories emerged: alexithymia, relif, revisiting the past, self-compassion and acquired rights. As a result, relief was observed as a feeling of great relevance and predominance, accompanied by a process of understanding the past and self-compassion and self-respect. It was concluded that the late receipt of the diagnosis of autism by this group of participants allowed a better understanding of their characteristics and behaviors, reducing the pressure they exerted on themselves, in addition to enabling access to rights guaranteed by law.

Changes in Daily life due to the COVID-19 Pandemic and Mental Health Status in Korean Adolescents.

This study assessed the relationship between daily life changes and mental health in Korean adolescents during the COVID-19 pandemic. Data from middle and high school students who responded to the relevant survey items the 2021 Korea Youth Risk Behavior Survey were analyzed (n = 53,868). The survey assessed changes in economic status, physical activity, skipping breakfast, drinking, smoking, and mental health, including stress, depression, generalized anxiety disorder, and suicidal ideation, due to the COVID-19 pandemic. The overall prevalence of perceived stress, depression, generalized anxiety disorder, and suicidal ideation was 38.6%, 26.4%, 12.2%, and 12.4%. Adolescents whose economic status worsened due to COVID-19 had a higher risk of perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Changes in physical activity and breakfast consumption due to the COVID-19 pandemic were significantly associated with increases in perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Adolescents who increased their alcohol consumption had the highest risk of perceived stress, depression, generalized anxiety disorder, and suicidal ideation. Changes in economic status and health behaviors caused by the COVID-19 pandemic had a negative effect on the mental health of Korean adolescents. These results can be used to identify adolescents at high risk of developing mental health problems.

Prevention of Ovarian Cancer: Where are We Now and Where are We Going?

To describe current and future strategies to reduce the burden of ovarian cancer through prevention. Current strategies in genetic testing are missing a substantial number of individuals at risk, representing a missed opportunity for ovarian cancer prevention. Past efforts at screening and early detection have thus far failed to improve ovarian cancer mortality, and novel techniques are needed. Surgical prevention is highly effective, but surgical menopause from oophorectomy has significant side effects. Novel surgical strategies aimed at reducing risk while minimizing these harms are currently being studied. To maximize ovarian cancer prevention, a multi-pronged approach is needed. We propose that more inclusive and accurate genetic testing to identify more individuals at risk, novel molecular screening and early detection, surgical prevention that maximizes quality of life while reducing risk, and broader adoption of targeted and opportunistic salpingectomy will together reduce the burden of ovarian cancer.

The Language Desert: Ecosystems of Praise and Barrenness in Saint-John Perse’s Anabase and Lorand Gaspar’s Sol absolu

Life changes that impelled Saint-John Perse and Lorand Gaspar into the desert are well known: Perse’s 1920 expedition into the Gobi Desert during his diplomatic assignment in China, and Gaspar’s residence in Jerusalem near the Judaean Desert, 1954 to 1970. More interesting is the poetic stratification that barren ecologies instill in Anabase (1924) and Sol absolu (1972). Perse’s adventurer prince encounters several climates during his inland journey yet binds particularly with the desert, which infiltrates his discourse and the texture of his self-image. Human geography becomes a means to master the habitat as a stepping-stone for personal assertion. Climate on the frontier inspires his encomiastic language of jubilation for quest and companions. Gaspar’s topography suggests a less rhetorical contact with environment, yet his desert’s materiality penetrates its inhabitants, nomads like the Beduin or the poet, who treks this desert via language. Gaspar’s poetics of barren environment is not as epic as Anabase (1924), yet the jubilation that tectonic challenge incites in his idiom is founded on interpenetration of psyche and ecosystem rather than the poetics of dominion deployed in Anabase. Omnipresent conceits of “living matter” and “material psyche” are critical to the understanding of these two desert poems.

Consulting citizens: Addressing the deficits in participatory democracy

‘Democracy’ is a pliable, and much abused concept, yet constitutional law cannot do without it. It is usually linked to the equally flexible notions of rule of law and constitutionalism. Due to many changes in public life around the world, entrenched ideas of governmental propriety, including being democratic, are undergoing a ‘loss of meaning’. The Constitution of the Republic of South Africa, 1996 explicitly requires democracy to be participatory. Despite various official efforts to formulate the modalities of public consultation and an established routine of public hearings and calls for comment on draft legislation and policies, it has not developed beyond a ‘box-ticking’ exercise, sometimes amounting to outright abuse. As a corrective to the shortcomings of standard electoral democracy a novel approach to the involvement of the citizenry in contentious decision-making has emerged in many parts of the democratic world. It takes the form of citizens’ assemblies composed to achieve descriptive representation rooted in an age-old method of randomised selection, known as ‘sortition’. To employ these mechanisms to realise genuine participatory democracy would require surmounting the difficulties presented by the complexity of South African society. Modern technology and advances in sortition methodology hold promises of overcoming the difficulties, but it would also require a political sea change.

Rising premature menopause and variations by education level in India

The proportion of women experiencing premature menopause is on the rise in India, particularly in the age groups of 30–39 years. Consequently, there is a need to understand the factors influencing the prevalence of premature menopausal status among women. Our study uses the data from 180,743 women gathered during the latest Indian version of the Demography Health Survey (National Family Health Survey-5). Our results suggest that close to 5% of women in rural areas and 3% of women in urban areas experience premature menopause, and this figure varies across Indian States. The regression results show that surgical menopause, lower levels of education, poorer wealth index, rural residence, female sterilization, and insurance coverage are key drivers of premature menopause. One of the striking factors is that the prevalence of premature menopause among those with the lowest levels of education (6.85%) is around seven times higher than those with the highest level of education (0.94%). We conducted a decomposition analysis to delve into the factors contributing to this inequality. The results show that undergoing a hysterectomy (surgical menopause) account for 73% of the gap in premature menopausal rates between women with the lowest and highest levels of education. This indicates that women with poor education are more likely to undergo hysterectomy at a younger age. This finding warrants further exploration as we would expect that women from lower socio-economic background would have limited access to surgical care, however, our results suggest otherwise. This perhaps indicates a lack of awareness, lack of alternative treatment options, and over-reliance on surgical care while neglecting conservative management. Our results have implications for addressing the diverse needs of the increasing number of women in their post-menopause phase and for focusing on conservative treatment options for these women.

Willingness to trade-off years of life for an HIV cure – an experimental exploration of affective forecasting

BackgroundIn the US, 1.2 million people live with HIV (PWH). Despite having near-normal life expectancies due to antiretroviral therapy (ART), many PWH seek an HIV cure, even if it means risking their lives. This willingness to take risks for a cure raises questions about “affective forecasting biases,” where people tend to overestimate the positive impact of future events on their well-being. We conducted a study to test two interventions to mitigate affective forecasting in the decisions of PWH about taking HIV cure medication.MethodsWe recruited PWH to complete a 30-minute survey about their current quality of life (QoL) and the QoL they anticipate after being cured of HIV, and assigned them to either no additional intervention, to one of two interventions intended to reduce affective forecasting bias, or to both interventions: (1) a defocusing intervention designed to broaden the number of life domains people consider when imagining life changes associated with new circumstances (e.g. HIV cure); and (2) an adaptation intervention to help them gauge fading of strong emotions over time. The study design included a 2 × 2 design: defocusing (yes/no) x adaptation (yes/no) intervention. We assessed PWH’s willingness to take hypothetical HIV sterilizing cure medication using the Time Trade-Off (TTO) and their quality of life predictions with WHOQOL-HIV.Results296 PWH participated. Counter to what we had hypothesized, neither intervention significantly reduced PWH’s willingness to trade time for a cure. Instead, the defocusing intervention increased their willingness to trade time (IRR 1.77, p = 0.03). Exploratory analysis revealed that PWH with lower current quality of life who received the defocusing intervention were more willing to trade time for a cure.ConclusionThese negative findings suggest that either these biases are difficult to overcome in the settings of HIV curative medication or other factors beyond affective forecasting biases influence willingness to participate in HIV curative studies, such as respondents’ current quality of life.

Loneliness and Expanding Social Ties in Later Life: Motivation, Perceived Success, and Implications for Emotional Health.

Social networks undergo changes in later life, reflecting proactive decreases as well as increases in size, but relatively little is known about the factors that motivate older adults to expand their social ties. Loneliness might be expected to motivate older adults to expand their social ties. Paradoxically, however, studies of younger age groups have linked loneliness to a self-protective reluctance to initiate social contact. The current study investigated whether loneliness fosters or inhibits older adults' efforts to expand their social ties and whether successful efforts are related to gains in emotional health. Loneliness, motivation to expand social ties, and emotional health were assessed in a subset of older participants (N = 375) from the Later Life Study of Social Exchanges. Greater loneliness was associated with less interest, less investment of effort, and less success in making new ties and rekindling dormant ties. Nonetheless, lonelier older adults who expanded their social ties, particularly by rekindling dormant ties, exhibited some gains in emotional health over a 1-year period. Greater attention to the role of loneliness in older adults' motivations for making new ties or rekindling dormant ties will broaden our understanding of social network changes in later life.

Life Changes and Adaptation of Herdsmen Entering the City: A Case of Ethnic Customs Street in Xilinhot, Inner Mongolia, China

Life Changes and Adaptation of Herdsmen Entering the City: A Case of Ethnic Customs Street in Xilinhot, Inner Mongolia, China

Patient-reported outcomes and functional assessments of patients with Alkaptonuria in a 3-year Nitisinone treatment trial

Alkaptonuria is a rare disorder of tyrosine catabolism caused by deficiency of homogentisate 1,2-dioxygenase that leads to accumulation of homogentisic acid (HGA). Deposition of HGA-derived polymers in connective tissue causes progressive arthropathy of the spine and large joints, cardiac valvular disease, and genitourinary stones beginning in the fourth decade of life. Nitisinone, a potent inhibitor of the upstream enzyme, 4-hydroxyphenylpyruvate dioxygenase, dramatically reduces HGA production. As such, nitisinone is a proposed treatment for alkaptonuria. A randomized clinical trial of nitisinone in alkaptonuria confirmed the biochemical efficacy and tolerability of nitisinone for patients with alkaptonuria but the selected primary outcome did not demonstrate significant clinical benefit. Given that alkaptonuria is a rare disease with slow progression and variable presentation, identifying outcome parameters that can detect significant change during a time-limited clinical trial is challenging. To gain insight into patient-perceived improvements in quality of life and corresponding changes in physical function associated with nitisinone use, we conducted a post-hoc per protocol analysis of patient-reported outcomes and a functional assessment. Analysis revealed that nitisinone-treated patients showed significant improvements in complementary domains of the 36-Item Short-Form Survey (SF-36) and 6-min walk test (6MWT). Together, these findings suggest that nitisinone improves both quality of life and function of patients with alkaptonuria. The observed trends support nitisinone as a therapy for alkaptonuria.

A Study of Stress Management and Causes of Stress Among Youth

Stress represents a state of mental strain experienced by individuals due to challenges in their environment and social interactions, often leading to various health issues. Adolescence is a critical phase marked by significant life changes, during which young people are expected to excel in society. Therefore, they should develop effective stress management skills to ensure a healthy transition into adulthood. As young individuals navigate through this period, they encounter numerous adjustments in their lives, including new relationships, experiences, and responsibilities, contributing to their stress levels. Recognizing the sources of stress and learning coping mechanisms are crucial for their well-being. Studies reveal that stress among youth commonly stems from academic pressures, social relationships, life transitions, and career decisions, resulting in psychological, physical, and behavioral challenges. Addressing these stressors requires a focus on positive developmental approaches, fostering supportive environments, promoting outdoor activities, and minimizing negative influences on learning. These findings offer valuable insights for students, educators, counselors, and career advisors.

Sociodemographic and Psychosocial Factors Affecting the Psychological Well-being of Preoperative Surgical Patients

PurposeThis study aimed to determine the subjective psychological well-being levels and sociodemographic and psychosocial factors affecting the psychological well-being of preoperative surgical patients. DesignThis was a cross-sectional study. MethodsThis study was conducted between January 15, 2021 and July 15, 2021. The sample consisted of 236 surgical patients in a public hospital in the Thrace region of Turkey. Data were collected using a personal information form and the five-item World Health Organization Well-Being Index (WHO-5). The data were analyzed using numbers, percentages, mean, standard deviation, independent samples t test, one-way analysis of variance, Tukey's multiple comparison test, and linear regression analysis. FindingsParticipants had a mean WHO-5 score of 10.76 ± 6.21, indicating low subjective psychological well-being. Economic status, chronic disease status, history of surgery, having been on psychiatric medication or receiving professional psychological support, tobacco use, experiencing a significant life change in the last 3 months, and reporting experiencing frequent stress in everyday life were significant predictors of WHO-5 scores. ConclusionsPreoperative surgical patients have low subjective psychological well-being, and their sociodemographic and psychosocial factors affect their psychological well-being.

People, places, systems and society:A qualitative exploration of socio-cultural factors in head and neck cancer survivorship

PurposePeople living with head and neck cancer (HNC) often endure permanent and life changing adverse effects of treatment and reduced health-related quality of life. Study of post-traumatic growth (PTG), is gaining traction to understand why some people living with cancer have better psychosocial outcomes than others. Current theoretical models on PTG point to the importance of ‘socio-cultural influences’ but do not provide insight into how such socio-cultural factors influence survivorship outcomes. This research aimed to illuminate pathways to PTG following HNC by exploring socio-cultural factors in experiences of living with, and moving on from, HNC. MethodSemi-structured interviews with people living with HNC (up to 5 years post-treatment) on experiences of diagnosis, treatment and recovery. Qualitative framework analysis using the environmental factors codes from the International Classification of Functioning, Disability and Health (ICF) HNC core set. Results20 people living with HNC were interviewed (11 male, 9 female; aged 46–83 years). Four inter-related themes described socio-cultural factors that influence (positively and/or negatively) the experience of living with HNC: (1) people and places; (2) healthcare systems and support services; (3) societal attitudes to cancer; (4) work and finances. ConclusionSupport from family, friends and healthcare professionals, as well as societal attitudes, financial and work security and personal experiences all appear to contribute to an individuals’ ability to navigate the HNC experience. These findings could inform development of interventions targeting the socio-cultural factors in the lives of people living with HNC, particularly for those at risk for poorer psycho-social outcomes.

The Role and Challenges of Women in Realizing Harmonious Families Towards Society Era 5.0 from an Islamic Law Perspective

This study aims to determine the Role and Challenges of Women in Realizing a Harmonious Family towards Society era 5.0. This research is descriptive qualitative research with the type or nature of literature research or literature research, as for the technique used, namely, researchers collect data related to research in the form of books, manuscripts, articles, previous research reports, and newspapers both online and offline and so on. The research results showed that women are creatures created by God (Allah) who have the nature of menstruation, pregnancy, childbirth, and adjustment. Society 5.0 is a concept of changing social, economic, and educational life in the digital era, where almost all human work will be replaced by machines. The roles and challenges of women in realizing a harmonious family towards Society 5.0 are life changes, managing households, educating children, supporting husbands' work, and fighting for gender equality. The challenge is the role—double, gender inequality, work-family balance, unfettered internet access, and changing values and morals.

Inventory System Design Using the First In First Out Method

The use of computers is growing rapidly in all fields according to the progress of the times, resulting in many changes in human life in dealing with every problem that occurs and is related to the development process as a whole. One of the developments in the business sector is the Inventory System. Businesses operating in the field of drug sales still use the method of stocking goods, where when one of the stocks of a drug runs low, it will be immediately stocked. The information system that will be created for drug supplies uses the First In First Out (FIFO) method. The FIFO method means that the company will first use old/first-in stock for sales. It is hoped that this research will help leaders and employees manage drug stock transaction data efficiently.

Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID-19.

While wearing masks during the pandemic poses communication and social challenges for people in everyday life, those with social anxiety might find them plausible, aligning with contemporary cognitive theories. Social anxiety involves fearing negative assessments and holding a negative self-image. Concealing anxiety symptoms during mask use may contribute to a more positive self-perception. Given that up to 60% of adults seeking stuttering treatment also meet criteria for social anxiety disorder, this study aims to investigate the complex relationship between communication freedom, self-perceived stuttering and anxiety in adults who stutter (AWS). The unique context of mandatory mask-wearing during the pandemic provides an opportunity to explore these dynamics and understand the conflicting relationships between stuttering, anxiety-related safety behaviours and the need for open communication in AWS. Twenty AWS participated in interviews, responding to open-ended questions to elucidate their affective, cognitive and behavioural experiences while wearing masks during the COVID-19 pandemic. Thematic analysis was used to identify the emerging themes and subthemes based on information-rich quotes, employing a six-phase recursive process. Various speech and anxiety-related measures were used to describe the characteristics of the study participants. Three main themes and sub-themes emerged. The first theme highlights communication challenges for AWS wearing masks, impacting verbal and nonverbal interactions. The second theme reveals AWS wearing masks to conceal stuttering cues, experiencing reduced stress. The third theme indicates that, despite the comfort in concealment, most AWS prefer speaking freely without a face mask. The conflict between the desire for authentic, fluent communication and the ease of hiding stuttering symptoms poses a major dilemma for AWS. According to the results of this study, most adults who stutter prioritize open communication. However, there were some individual differences. A major factor influencing their decision was their fear of negative evaluation. What is already known on the subject The prevalence of social anxiety is higher among adults who stutter (AWS), possibly stemming from their prior negative experiences with stuttering. In response, AWS may adopt adaptive or maladaptive coping behaviours to manage stuttering and mitigate fears of negative evaluation. Maladaptive strategies, like avoiding certain communication situations, can diminish their satisfaction with everyday speaking situations. What this study adds This study leveraged the mask-wearing mandate during the pandemic to explore the intricate relationship between anxiety-related symptoms and communication. While some participants saw masks as a plausible means to conceal stuttering and anxiety, most preferred open communication without the challenges posed by masks. Our findings offer additional support for the varied emotional, cognitive and behavioural responses that AWS may display in response to changes in daily life, emphasizing the individual differences within this population and highlighting that stuttering goes beyond observable speech dysfluencies. What are the clinical implications of this work? Our study underscores the need for comprehensive therapeutic interventions addressing both the physical and cognitive-emotional aspects of stuttering in AWS. Recognizing the role of safety behaviours and self-focused attention emphasizes the importance of an integrated approach, enhancing communication efficacy and social well-being for AWS. Addressing speech fluency alone, without considering pertinent cognitive-emotional factors, falls short in providing adequate stuttering treatment.