Many factors have contributed to rendering frailty an emerging, relevant, and very popular concept. First, many pandemics that have affected humanity in history, including COVID-19, most recently, have had more severe effects on frail people compared to non-frail ones. Second, the increase in human life expectancy observed in many developed countries, including Italy has led to a rise in the percentage of the older population that is more likely to be frail, which is why frailty is much a more common concern among geriatricians compared to other the various health-care professionals. Third, the stratification of people according to the occurrence and the degree of frailty allows healthcare decision makers to adequately plan for the allocation of available human professional and economic resources. Since frailty is considered to be fully preventable, there are relevant consequences in terms of potential benefits both in terms of the clinical outcome and healthcare costs. Frailty is becoming a popular, pervasive, and almost omnipresent concept in many different contexts, including clinical medicine, physical health, lifestyle behavior, mental health, health policy, and socio-economic planning sciences. The emergence of the new “science of frailty” has been recently acknowledged. However, there is still debate on the exact definition of frailty, the pathogenic mechanisms involved, the most appropriate method to assess frailty, and consequently, who should be considered frail. This narrative review aims to analyze frailty from many different aspects and points of view, with a special focus on the proposed pathogenic mechanisms, the various factors that have been considered in the assessment of frailty, and the emerging role of biomarkers in the early recognition of frailty, particularly on the role of mitochondria. According to the extensive literature on this topic, it is clear that frailty is a very complex syndrome, involving many different domains and affecting multiple physiological systems. Therefore, its management should be directed towards a comprehensive and multifaceted holistic approach and a personalized intervention strategy to slow down its progression or even to completely reverse the course of this condition.

Postnatal depression (PND) is an important health problem of global relevance for maternal health and impacts on the health and wellbeing of the child over the life-course. Although recent multinational data is hard to locate, the economic burden of PND on health care systems have been calculated in several countries, including Canada and in the UK. In Canada, health and social care costs for a mother with PND were found to be just over twice that of mothers with no mental illness. The extra community care cost for women with PND living in the UK was found to be £35.7 million per year. We carried out a systematic search to the current literature to investigate the associations between attachment style and PND, using meta-narrative analysis methods, reporting statistical data and core narratives where appropriate. The following databases were searched: PsycInfo, PsycExtra Web of Science, The Cochrane Library and Pubmed. We focused on research papers that examined adult attachment styles and PND, and published between 1991 and 2013. Search terms used were as follows: Attachment, Adult, Maternal, Postnatal, Postpartum, Puerperium and Depression. The final searches in each database took the following form: (Adult OR Maternal] AND Attachment) AND ([Postnatal OR Postpartum OR Puerperium] AND Depress). We included any papers showing relationship between maternal adult attachment and PND. Out of 353 papers, 20 met the study inclusion criteria, representing a total of 2306 participants. Data from these 20 studies was extracted by means of a data extraction table. This systematic review is the first to examine and discuss the evidence for an empirical link between postnatal depression and maternal adult attachment style. We found that attachment and PND share a common aetiology and that ‘insecure adult attachment style’ is an additional risk factor for PND. Of the insecure adult attachment styles, anxious styles were found to be associated with PND symptoms more frequently than avoidant or dismissing styles of attachment. More comprehensive longitudinal research would be crucial to examine possible cause-effect associations between adult attachment style (as an intergenerational construct and risk factor) and PND (as an important maternal mental health), with new screening and interventions being essential for alleviating the suffering and consequences of PND. If more is understood about the risk profile of a new or prospective mother, more can be done to prevent the illness trajectory (PND); as well as making existing screening measures and treatment options more widely available.

Organ donation has a crucial impact on patient care and survival, of which the worldwide gap between organ demand and supply is currently one of the most challenging issues. Brain-dead patients are the main source of organs that can be donated, but donation requires the consent of family members—a choice that is often complex and stressful and leads to refusal of consent. This mini-review aims to provide an overview of the current knowledge on the impact of certain psychosocial factors on the decision-making process with regard to organ donation by family members. In particular, the influence of several aspects is emphasized, such as sociodemographic factors, knowledge of the organ donation process, religious beliefs, concerns that are related to the choice to donate, and mode of communication. Consistent with this evidence, we emphasize the need to examine these aspects further through interventions and guidelines that improve the organ donation application process and ensure a positive experience for the family that has to make the decision.

Objectives: Cardiovascular diseases (CVDs) are a leading cause of death worldwide, emerging from a combination of several factors. The aim of this review is to define the psychological factors that are significant in the development and progression of these disorders.Methods: Studies published through 2023 concerning adults with psychological vulnerability factors and/or cardiovascular disease were selected through searches of PubMed, PsychINFO, Science Direct, and Google Scholar.Results: Psychological stress may influence CVD, in combination with other risk factors, or it can act independently, as in cases of workplace stress, post-traumatic stress disorder, Takotsubo syndrome and bereavement. Coping strategies, anxiety and depression have also been identified as relevant psychological factors in cardiac patients. Adverse childhood experiences are linked to a reduced quality of life and have been identified as significant risk factors for the development of acquired CVDs.Conclusion: This review demonstrates that several psychological factors affect cardiovascular function. An in-depth study of the psychological correlates of CVDs would allow healthcare professionals to design more effective prevention and intervention programs.

Along with physical changes, psychological changes are detectable in patients with COVID-19. In these patients, the stressful experience of intensive care unit (ICU) hospitalization may aggravate psychological conditions. Our study examines the short- and long-term psychological consequences of COVID-19 in ICU patients. COVID-19 patients completed the self-rating questionnaires Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI) and were clinically interviewed 1 and 6 months after discharge. Altered behavioral-psychological symptoms and patients' strategies (adaptive vs. maladaptive) for coping with stress during and after hospitalization were coded during clinical interviews. Between 20 and 30% of patients showed moderate symptoms of depression or anxiety and perceived stress 1 and 6 months after discharge. Sleep problems, difficulty concentrating, confusion in placing events, and fear of reinfection were observed in many (6–17%) patients. At 6 months, only 7% of patients showed PTSD symptoms, and 50% showed post-traumatic growth in the “appreciation of life” sub-scale. Finally, 32% of subjects were classified as “maladaptive coping patients,” and 68% as “adaptive coping patients.” Patients who adopted “adaptive” coping strategies showed significantly lower levels of anxious-depressive symptoms and perceived stress when compared to subjects with “maladaptive” strategies at both time points. Coping strategy had no effect on PTSD symptoms or post-traumatic growth at 6 months. These findings clarify the short- and long-term psychological effects of intensive care due to COVID-19 infection and demonstrate that patient characteristics, particularly strategies for coping with stress, seem to play a critical role in psychological outcomes.

The central tenet of Place Attachment theory states that an individual has an inborn predisposition to form strong bonds with places as well as with people. Our qualitative study applies this theory to understand how, despite loss and adversity, refugees are able to reconstruct a sense of identity, community, and “home”. Participants included 15 forcibly displaced people from different countries of origin. Semistructured interviews explored factors that facilitate participants’ integration in a new context and the impact of this context on their sense of identity. Data were analysed using Consensual Qualitative Research Methodology to identify recurrent themes and their frequencies within interview transcripts. Within the relational dimensions of place attachment, affiliation, and seeking help from others, the study explores the factors that facilitate the integration of refugees in a new context and the impact of this context on their sense of identity, identifying recurrent themes and their frequencies within interview transcripts. The most frequent resulting themes were (a) a sense of identity and (b) expectations toward the resettlement country. Additional, though less frequent, themes included: (c) sense of belonging, (d) community integration, (e) trust, (f) opportunity seizing, (g) being a point of reference for others, (h) sense of community, (i) positive memories, (j) refusal. These results begin to describe the ways by which Place Attachment, toward both birth and resettlement countries, contributes to a restructured identity and sense of “feeling at home” for refugees.