The global nursing shortage poses a critical challenge to healthcare systems. The World Health Organization projects a shortage of 4.5 million nurses by 2030. Contributing factors include an aging workforce and an increasing rate of nurse turnover, driven by high workloads, limited development opportunities, and a lack of managerial support. Intentions to leave predict actual departure and threaten the quality of care, increase patient mortality, and impose high replacement costs. While retention strategies exist, many are not tailored to nurses because nurses' subjective experiences and perspectives are lacking, potentially limiting their effectiveness. Engaging nurses in designing these interventions may enhance their relevance and impact. (i) Identify the key factors associated with nurses' retention in hospitals, and (ii) provide an in-depth understanding of why nurses perceive these factors as critical in shaping their retention. A mixed-methods approach, utilizing Q-methodology and semi-structured interviews, was employed. Dutch hospitals. A diverse group of 26 practicing and three former nurses. Participants ranked 58 statements in response to the prompt: "I am willing to continue working as a nurse within the organization if…" Consecutively, individual interviews were conducted to provide further insight into the reasoning behind nurses' choices. Quantitative data were analyzed using centroid factor analysis with varimax rotation to identify shared viewpoints. Qualitative interview data were analyzed using the rigorous and accelerated data reduction method to deepen the understanding of the factors shaping nurses' retention. A total of 29 Q-sorts and interviews were analyzed. This resulted in three factors: (A) 'Challenging work and inclusive positioning for high-quality care', (B) 'Room to excel in nursing roles', and (C) 'Being seen, heard, and valued'. Together, these perceptions shaped participants' intention to stay. Additionally, a common pattern across all factors was participants' perception of being structurally unheard. A multifaceted interplay of factors influenced nurse retention. While meaningful and challenging tasks were essential, professional recognition, support systems, and growth opportunities were equally important. A systemic approach that addresses these various dimensions may be crucial for enhancing retention rates, maintaining a high-quality of patient care, and ultimately mitigating the impact of the nursing shortage in healthcare organizations. Nurses may play a crucial role in designing and implementing retention strategies. Their input is not just valuable but most likely necessary for the relevance and effectiveness of these strategies.

Cannabis modalities matter for momentary subjective drug effects.

With the acceleration of both globalization and population mobility, healthcare settings have become increasingly culturally diverse, presenting nurses with more complex cross-cultural challenges. Although cultural sensitivity promotes understanding and respect for cultural differences, its emphasis on knowledge accumulation limits its effectiveness in addressing the power imbalances and structural inequalities embedded in healthcare interactions. In contrast, cultural safety underscores that quality of care should be defined by patients' subjective experiences and highlights the important influence of power relations, critical self-reflection, patient autonomy, and structural contexts on care quality. In this article, the author examines the theoretical transition from cultural sensitivity to cultural safety in the nursing profession and analyzes the implementation of cultural safety in clinical practice, nursing education, and healthcare systems and its related challenges. The results of literature synthesis and analysis show that cultural safety facilitates the reconstruction of nurse-patient relationships, strengthens patient participation and trust, and provides a vital approach to addressing health inequities in multicultural societies. In the Taiwanese context, the health concerns of diverse populations, which include new immigrants, migrant workers, and transgender individuals, underscore the practical and policy implications of cultural safety. Future efforts should continue to integrate cultural safety into nursing education, clinical practice, and institutional design to develop culturally appropriate care models grounded in local contexts to further enhance care quality and promote health equity.

Pedestrian-AV interactions at unmarked midblock: Effects of eHMI onset timing and vehicle kinematics on young adult pedestrian behavior and subjective safety perception.

Human-inspired emotion and attention encoding for autonomous vehicles' decision-making: a lane-change timing optimization case.

Linguistic cues do not influence subliminal visual processing - An electrophysiological study.

Magical contagion beliefs in psychopathology: A review of cognitive mechanisms and maintaining factors.

Insomnia is a common symptom in depressive disorder, affecting up to 80% of those patients. Evidences suggest that sleep symptom improvements could alleviating depressive symptoms and reducing relapse. This article evaluated the efficacy of three antidepressants-agomelatine, mirtazapine, and trazodone-in treating insomnia symptoms in depressed patients, with a focus on polysomnographic (PSG) data, subjective sleep experience, improvement in depressive symptoms, and adverse drug reactions. A systematic search of PubMed, Cochrane Library, MEDLINE, Embase, and Web of Science was conducted for studies published from 1974 to August 2025; 30 studies (16 randomized controlled trials and 14 non-randomized controlled trials) were included. The primary outcomes were PSG measures; secondary outcomes included PSQI and HAMD scores, as well as adverse medication reactions. The PSG results showed that agomelatine may not significantly change percentage N1 of sleep period time (N1%) and Latency of REM sleep (L-REM). Mirtazapine significantly increased total sleep time (TST), slow-wave sleep of sleep period time (SWS%), and sleep efficiency (SE%), while reducing percentage wake after sleep onset of sleep period time (WASO%). Trazodone notably improved TST, and SE%. For adverse effects, agomelatine was well-tolerated; mirtazapine commonly caused weight gain and sedation; and trazodone frequently led to dizziness, sedation, headache, nausea, and somnolence. All three medications significantly enhance subjective sleep perception and alleviate depressive symptoms. However, agomelatine may lack a definitive effect on improving objective sleep parameters in depressed patients. Future studies should involve larger, high-quality trials with unified methodologies to strengthen the reliability of conclusions.

A contextual perspective on mental health is critical in developing a comprehensive understanding of wellbeing in line with the precepts of Geopsychiatry. A review of the literature indicates a limited understanding of how people deal with the global climate crisis using a geo-psychiatry perspective. The experience of awakening to the climate crisis has been described using the term “eco-anxiety”. A lack of in-depth exploration of this subjective experience has meant a fragmented theory. To contribute to our understanding of eco-anxiety, the current study explores qualitative aspects of this experience, looking at the reports of eco-anxiety experienced by people who self-reported attending a group psycho-ecological intervention for facing the climate crisis. Using a constructivist grounded theory approach, critical realist ontology and moderate social constructionist epistemology, semi-structured interviews were conducted with 13 adults who self-identified as experiencing “eco-anxiety” and had attended an ecopsychology support group. Two core categories of theory emerged: “the psychosocial processes of eco-anxiety” and “the psychosocial processes of regeneratively sustained eco-anxiety”. The results are explored through figures that analogise the seasons, demonstrating the participants' reported process of psychosocial adaptation: the growth and expansion of the self in the face of eco-anxiety, reflecting the integration of experiences. This metaphor does not suggest a linear process. Participants described moving bidirectionally. Despite the challenges, group participants report that the process of awareness can lead to a more connected way of life and ultimately the development of psychosocial resilience, which is essential for navigating sustained mutual care in the face of global environmental instability.

As Taiwanese society grows increasingly diverse and inclusive, the challenges faced in frontline clinical care are expanding beyond treating physical illnesses to include how to effectively embrace the life narratives and health beliefs of diverse populations. Although the long-standing emphasis on "cultural sensitivity" and "cultural competence" in the medical profession has encouraged healthcare professionals to learn about the customs and taboos of different cultures, research findings remind us that culture is not a fixed label. Lacking critical reflection on power imbalances, the accumulation of such knowledge may lead to the emergence and entrenchment of other forms of stereotyping (Curtis et al., 2019). The theme of this issue, "Cultural Safety in Nursing Practice", sincerely invites readers to reflect on whether our current standardized healthcare processes have unintentionally silenced certain voices. The articles featured in this issue provide accessible yet in-depth analyses of the multiple dimensions of cultural safety. At the theoretical level, we see how cultural safety resonates with emancipatory theory, cautioning against medical hegemony and advocating for returning to patients the authority to define their quality of care. In terms of practical application and implementation, cultural safety requires nurses to engage in critical self-reflection, active listening, and shared decision-making, thereby reconstructing a more equitable power relationship between healthcare providers and patients. Meanwhile, educational systems should strengthen the cultural teaching competencies of educators in the realms of foundational knowledge, facilitation skills, and curriculum design to foster more-inclusive learning environments. Ultimately, cultural safety must extend beyond the individual level into the organizational and policy levels as well. In one of the articles, the Indigenous Peoples Health Act (2023) is used to illustrate how respect for culture may be incorporated into healthcare indicators and administrative processes, suggesting a foundation for building a people-centered healthcare system that promotes health equity and social justice. Establishing a culturally safe care environment is a transformative process for healthcare professionals in diverse societies. However, cultural safety is not a one-time technical achievement. Thus, nursing practice must shift from merely "understanding cultural differences" to "examining the safety of care" by prioritizing the subjective experiences of care recipients and reconstructing power relations between providers and patients (Kaphle et al., 2022). Through the practical strategies introduced in this issue, we hope to inspire self-reflection and encourage all readers to become agents of change. Ultimately, every individual entering the healthcare system should feel seen and heard, and be able to receive care that is respectful of their cultural context within an environment of dignity.

Physio-Cognitive Decline Syndrome (PCDS) is a clinical characterized by concurrent declines in physical and cognitive functions that precede disability. Taiwan's rapidly aging population highlights declines in physical and cognitive functions as precursors to disability, posing key challenges in geriatric care. Research shows these declines begin in early middle age and progress with age. Understanding middle-aged and older adults' experiences and coping strategies for Physio-Cognitive Decline Syndrome (PCDS) is essential for developing effective interventions. This study explored the subjective experiences and perceptions of PCDS among middle-aged and older adults to identify key themes and coping strategies in response to such declines. This qualitative study utilized purposive sampling, semi-structured face-to-face interviews with middle-aged (55-64 years) and older (≥65 years) adults to explore PCDS perceptions. Data were analyzed using content analysis. Participant experiences and perceptions formed three themes: (1) aging accelerates PCDS progression, (2) PCDS threatening daily life, and (3) adapting to changes. These findings further delineate a four-phase PCDS process: Individual Perception (recognizing decline), Life Threat (impact on daily life), Adaptation (accepting reality), and Positive Coping (implementing management strategies). Correspondingly, participants developed coping strategies to mitigate physical and cognitive decline, seek professional assessment, and strengthen support systems. Middle-aged and older adults with PCDS face physical and cognitive declines, mobility limitations, psychological stress, and social isolation. They adopt coping strategies like health maintenance, cognitive training, and social participation. Family and social support systems play a crucial role in their coping processes, while seeking professional medical assistance and engaging in community activities further enhance their confidence in managing PCDS.

This study aimed to gain an in-depth understanding of the posttraumatic search for meaning and inner transformation experiences of psychologically traumatised individuals by examining their coping strategies and recovery from the existential vacuum through a phenomenological approach. It is known that trauma creates not only a psychological but also an existential crisis in individuals and triggers a search for meaning; however, studies on how this process is reflected in the subjective experiences of individuals are limited. The study was conducted with a qualitative phenomenological design, and in-depth interviews were conducted with 14 volunteer individuals who had experienced psychological trauma in the past and who had experienced psychological trauma at least 1 year ago, selected through snowball sampling. Data were collected using a semi-structured interview form and analysed using Colaizzi's method. COREQ guidelines were adhered to throughout the research process. Four main themes and twelve sub-themes were obtained from the in-depth interviews. "(1)In the Shadow of Identity: Existential Alienation, (2) In the Depths of the Void: Interrogation of Meaning, (3) Mental Exploration and Journey to Inner Light, and (4) Strength and Rebirth: Post-Traumatic Growth". The participants stated that they found themselves alienated and meaningless after the trauma; however, by facing this emptiness, they discovered their inner resources, built new meanings, and transformed the trauma into an opportunity for growth. The findings revealed that post-traumatic recovery is not only about symptomatic improvement; individuals can liberate themselves, take responsibility, and give their lives a unique meaning. The study suggests that developing meaning-focused and existentialist-based therapeutic approaches for mental health professionals can contribute to individuals' recovery and personal transformation. The study suggests that developing meaning-focused and existential-based therapeutic approaches for mental health professionals can contribute to individuals' recovery and personal transformation.

Dementia risk factor assessment in a local Alzheimer's prevention population: a German cross-sectional, observational study.

Digital mindfulness and the laboring self: A discourse analysis of burnout in Headspace.

While the negative experience of intensive care delirium has been established in adults, paediatric delirium (PD) is increasingly being recognized internationally. Knowledge, however, is still lacking regarding the experience of delirium in critically ill children. Therefore, we wish to provide insight into the subjective experience of delirium to better understand the children's perspective and enable the development of strategies to support children and their parents during and after the delirium episode. We aimed to describe the lived experience of delirium in a paediatric intensive care unit survivor. Our research question was: How does a child make sense of delirium after critical illness? We interviewed 16-year-old Eric 10 months after discharge from the intensive care unit, using Frank's narrative theory to analyse Eric's narrative and performing thematic analysis to further interpret his experiences. We identified Eric's story as a Quest narrative. According to Frank's theory, Eric uses his narrative to understand his experiences and perhaps to help others. We identified the following themes: Being lost, being pursued, being paralysed, and being back. During delirium, Eric lost control of reality during delusions and hallucinations. He experienced being pursued, being paralysed, and finally regaining his sense of reality. After discharge, Eric told and retold his story to his mother. Together, they developed a version of the story that was used to develop strategies to deal with delirium in the event of future admissions. Similarly to adults, children experience the distress of delusions and hallucinations during ICU delirium. The adolescent in our case was able to reflect on and suggest explanations for his delusional experiences. Mother and child prepared strategies to manage delirium during future admissions.

Concept of time-on-task induced fatigue in lay people: a survey-based examination using situational judgement paradigm

Understanding the relationship between post-stroke cognitive impairments and depression: The role of loneliness.

Conventional surgical instruments are often designed based on assumptions regarding hand size and grip strength that may not reflect the physical characteristics of all surgeons. Circular staplers require substantial manual force during firing and may be associated with perceived ergonomic burden and psychological stress during anastomosis. Powered circular staplers have been introduced to reduce manual effort; however, limited information is available regarding surgeons' subjective experiences with these devices. This exploratory study aimed to examine perceived ergonomic and psychological experiences related to powered circular stapler use among female gastrointestinal surgeons in Japan. This small exploratory cross-sectional survey used an anonymous web-based survey conducted between January and March 2021. Female gastrointestinal surgeons in Japan with experience using powered circular staplers were recruited through professional networks using a snowball sampling approach. The survey focused on self-reported perceptions of ergonomic workload, psychological stress during stapler firing, and usability impressions of powered circular staplers. Given the exploratory design and limited sample size, analyses were descriptive only and no inferential statistics were applied. Twenty-five female surgeons responded to the survey. Thirteen respondents (52%) reported that some surgical instruments were too large for their hands, and 20 surgeons (80%) perceived strength limitations with some devices. With conventional manual circular staplers, most participants (24/25, 96%) required both hands to fire the device and reported stress or perceived instability during firing. Among respondents with experience using powered circular staplers, many reported that the devices were easier to handle and less stressful. Sixteen surgeons (64%) reported perceived single-hand operability, and a similar proportion reported perceived improvements in procedural stability. Qualitative comments indicated subjective impressions of reduced physical effort and anxiety. In this small exploratory survey, powered circular staplers were perceived by female gastrointestinal surgeons as being easier to handle and less stressful to use during anastomosis. These findings reflect self-reported perceptions rather than objective ergonomic or clinical outcomes, and causal relationships cannot be established. These findings are hypothesis-generating and suggest that further studies incorporating objective ergonomic measurements and broader surgeon populations are warranted.

Understanding and optimizing advance care planning implementation for terminally ill older adults: a mixed-methods Meta Analysis of subjective experiences and implementation barriers.

Non-suicidal self-injury (NSSI) in pre-adolescents represents an escalating clinical concern, with early onset being a predictor of persistent self-harm and future suicidal behavior. Despite growing recognition of the role of family dynamics in youth NSSI, the specific mechanisms through which parental communication behaviors contribute to early-onset NSSI remain poorly characterized, particularly within the Chinese cultural context. This study aimed to investigate the relationship between a specific parental communication behavior-parental verbosity (excessive, repetitive verbal reasoning during discipline)-and pre-adolescent NSSI, testing a mediation pathway involving the Attentional Negativity Index (ANI: a self-reported measure of perceived attention to negative versus positive information) and emotional symptoms (EM). A total of 1,452 pre-adolescents (aged 10 - 12 years) and their parents were recruited from eight elementary schools in Tianjin, China. A multi-informant approach was employed specifically for emotional symptoms (EM), collecting data through both student-report and parent-report to enhance measurement validity and reduce single-informant bias. Parental verbosity was assessed via parent-report, while ANI and NSSI were assessed via student-report, as these constructs reflect children's subjective internal experiences that are most accurately captured by self-report. Serial mediation analyses using Hayes' PROCESS macro were employed to examine the proposed cognitive-emotional mechanisms. The prevalence of NSSI in this sample was 23.8%. Serial mediation analyses revealed a significant pathway from parental verbosity to NSSI via sequential mediation of ANI and emotional symptoms (indirect effect = 0.024, 95% CI [0.004, 0.049]); however, the total indirect effect across all pathways was non-significant (Effect = 0.026, 95% CI [-0.047, 0.103]). Specifically, parental verbosity was positively associated with self-reported ANI, which in turn predicted higher levels of emotional symptoms, ultimately linking to increased NSSI frequency. This serial mediation pathway remained significant in sensitivity analyses using parent-reported emotional symptoms (indirect effect = 0.008, 95% CI [0.001, 0.017]), providing preliminary evidence consistent with the proposed pathway, pending replication in independent longitudinal samples. The present findings are consistent with a cognitive-emotional cascade model in which parental verbosity, self-reported ANI, and EM are sequentially associated with NSSI in pre-adolescents. While these findings identify a potential mechanism linking a specific parental communication behavior to NSSI, the cross-sectional design precludes causal inference. Longitudinal research is needed to establish temporal precedence and causal directionality.