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Is the United States \"the land of equal opportunity\" or is the playing field tilted in favor of those whose parents are wealthy, well educated, and white? If family background is important in getting ahead, why? And if the processes that transmit economic status from parent to child are unfair, could public policy address the problem? Unequal Chances provides new answers to these questions by leading economists, sociologists, biologists, behavioral geneticists, and philosophers. New estimates show that intergenerational inequality in the United States is far greater than was previously thought. Moreover, while the inheritance of wealth and the better schooling typically enjoyed by the children of the well-to-do contribute to this process, these two standard explanations fail to explain the extent of intergenerational status transmission. The genetic inheritance of IQ is even less important. Instead, parent-offspring similarities in personality and behavior may play an important role. Race contributes to the process, and the intergenerational mobility patterns of African Americans and European Americans differ substantially. Following the editors' introduction are chapters by Greg Duncan, Ariel Kalil, Susan E. Mayer, Robin Tepper, and Monique R. Payne; Bhashkar Mazumder; David J. Harding, Christopher Jencks, Leonard M. Lopoo, and Susan E. Mayer; Anders Björklund, Markus Jäntti, and Gary Solon; Tom Hertz; John C. Loehlin; Melissa Osborne Groves; Marcus W. Feldman, Shuzhuo Li, Nan Li, Shripad Tuljapurkar, and Xiaoyi Jin; and Adam Swift.

During previous pandemic outbreaks, medical staff have reported high levels of psychological distress. The aim of the current study was to report a snapshot of the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic and its correlated factors on medical staff in Guangdong, China. On the 2nd and 3rd February 2020, soon after the start of the COVID-19 pandemic, we surveyed medical staff at four hospitals in Guangdong, China, to collect demographic characteristics, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-14), and Insomnia Severity Index (ISI) scores. Complete responses were received from 1045 medical staff. Respondents were divided into high- and low-risk groups according to their working environment of contacting with potential or confirmed COVID-19 cases. The proportion of staff with anxiety (55.4% v. 43.0%, p < 0.001) or depression (43.6% v. 36.8%, p = 0.028) was significantly higher in the high-risk group than the low-risk group. The percentage of staff with severe anxiety was similar in the two groups. Doctors were more susceptible to moderate-to-severe depressive symptoms. The high-risk group had higher levels of clinical insomnia (13.5% v. 8.5%, p = 0.011) and were more likely to be in the upper quartile for stress symptoms (24.7% v. 19.3%, p = 0.037) than the low-risk group. Additionally, work experience negatively correlated with insomnia symptoms. It is important for hospitals and authorities to protect both the physical and psychological health of medical staff during times of pandemic, even those with a low exposure risk.

Background A cluster of pneumonia cases were reported by Wuhan Municipal Health Commission, China in December 2019. A novel coronavirus was eventually identified, and became the COVID-19 epidemic that affected public health and life. We investigated the psychological status and behavior changes of the general public in China from January 30 to February 3, 2020. Methods Respondents were recruited via social media (WeChat) and completed an online questionnaire. We used the State-Trait Anxiety Inventory, Self-rating Depression Scale, and Symptom Checklist-90 to evaluate psychological status. We also investigated respondents’ behavior changes. Quantitative data were analyzed by t -tests or analysis of variance, and classified data were analyzed with chi-square tests. Results In total, 608 valid questionnaires were obtained. More respondents had state anxiety than trait anxiety (15.8% vs 4.0%). Depression was found among 27.1% of respondents and 7.7% had psychological abnormalities. About 10.1% of respondents suffered from phobia. Our analysis of the relationship between subgroup characteristics and psychological status showed that age, gender, knowledge about COVID-19, degree of worry about epidemiological infection, and confidence about overcoming the outbreak significantly influenced psychological status. Around 93.3% of respondents avoided going to public places and almost all respondents reduced Spring Festival-related activities. At least 70.9% of respondents chose to take three or more preventive measures to avoid infection. The three most commonly used prevention measures were making fewer trips outside and avoiding contact (98.0%), wearing a mask (83.7%), and hand hygiene (82.4%). Conclusions We need to pay more attention to public psychological stress, especially among young people, as they are likely to experience anxiety, depression, and psychological abnormalities. Different psychological interventions could be formulated according to the psychological characteristics of different gender and age groups. The majority of respondents followed specific behaviors required by the authorities, but it will take time to observe the effects of these behaviors on the epidemic.

To investigate the effect of applying doctor-nurse-patient integration management mode to patients with endometriosis (EMT). A total of 160 patients with EMT from the Department of Neurology of The Fifth Affiliated Hospital Sun Yat-Sen University from January 2017 to October 2017 were selected. They were divided into control group and experimental group according to the time sequence of hospitalization, with 80 patients in each group. The traditional nursing management mode was implemented in the control group, and doctor-nurse-patient integration mode was implemented in the experimental group. The psychological status, quality of life, and satisfaction of the 2 groups of patients were compared one year after surgery. The anxiety and depression scores in the observation group were (41.89±7.50) and (42.40±7.40) points, respectively, and those in the control group were (57.55±9.68) and (55.00±9.35) points, respectively. The differences between the two groups were statistically significant ( =-11.44, -9.42, <0.05). The improvement rate of quality of life (sleep, work and sexual life) in the observation group was 87.5%, which was higher than that in the control group (63.8%). The difference between the 2 groups was statistically significant (U=583, <0.01). The satisfaction rate in the observation group was 90.00%, which was higher than that in the control group (78.75%) (U=592.00, < 0.01). The doctor-nurse-patient integration management mode can effectively improve the negative psychological status and quality of life of patients with EMT and improve patient satisfaction, which is worth popularizing.

Background COVID-19 poses the greatest challenge for the entire world since the Second World War. Governments are forced to define strict measures to avoid the spreading of the virus, which may further impose psychological burden for the majority of the population. The aim of this study was to evaluate the psychological distress in Austria during the initial stage of the COVID-19 outbreak. Methods From 25 March to 3 April 2020, an anonymous online survey was conducted. Target group included all members of the Austrian population older than 16 years. The survey addressed the following areas (1) and sociodemographic data, (2) physical and mental health; (3) knowledge and concerns about COVID-19; (4) contact with infected people; (5) prevention efforts; (6) need for further information. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess mental health. Analyses were based on 4126 individuals (74% female, age: M = 38.68, SD = 13.36). Results 43.3% rated the psychological impact as moderate (5.6%) or severe (37.7%). 26.5% reported moderate (13.3%) to severe (13.2%) depression; 20.3% moderate (8.9%) to severe (11.4%) anxiety and 21.2% reported to suffer from moderate (10.5%) or severe stress (10.7%). Being female, higher age, lower levels of education, concern about family members, internet as main source of information, student or pupil status, poor self-rated health, and downplaying the seriousness of the problem were significantly associated with higher psychological burden. Protective factors were the possibility to work in home office, frequent (indirect) contact with family or friends, the availability of virus-specific information, confidence in the diagnosis capability, and physical activity during the crisis. Conclusion This study is among the first in Europe on the psychological correlates of the COVID-19 pandemic. 37.7% of the Austrian study population reported a severe psychological impact on the event and 1 in 10 is considered to suffer from severe depression, anxiety or stress. The present findings inform about the identification of protective factors, psychologically vulnerable groups and may guide the development of psychological interventions.

Purpose Adolescent and young adult (AYA) cancer patients, aged between 15 to 39 years old, suffer from long-term psychological distress, confronting low self-efficacy and various psychological problems. This study constructs a group online-based peer support intervention combined with offline activities to explore its impact on the psychological distress of AYA cancer patients. Methods A randomized, two-arm clinical trial was conducted in which 90 AYA cancer patients were recruited. The control group ( N  = 45) received conventional psychological care and treatment, and the experimental group ( N  = 45) received 8 weeks of an online peer support intervention. Outcome measures included psychological distress (Distress Thermometer, DT), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), perceived peer support (Cancer Peer Support Scales, CaPSS), and readiness for return to work (Readiness to Return-To-Work Scale, RRTW). Results Eight-week peer support intervention was effective in improving psychological distress, anxiety, and depressive symptoms in the experimental group with statistically significant differences ( P  < 0.05). Time affected psychological distress, anxiety, and depressive symptoms in AYA cancer patients ( P  < 0.05), and there was an interaction with intervention factors ( P  < 0.05). The intervention has a positive effect on relieving the psychological status of AYA cancer patients. For readiness for return to work, the experimental group was in the preparation for the action-behavioral stage immediately, 1 month and 3 months after the end of the intervention ( P  < 0.01), supporting AYA cancer patients who have not returned to work to maintain optimal return-to-work readiness. Conclusions The group online-based peer support intervention is popular and has good scientificity, effectiveness, and practical significance for AYA cancer patients. Trial registration. This study was registered at clinicaltrials.gov. (ChiCTR2100053091, registered on 10 November 2021).

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that causes progressive autonomy loss and need for care. This does not only affect patients themselves, but also the patients’ informal caregivers (CGs) in their health, personal and professional lives. The big efforts of this multi-center study were not only to evaluate the caregivers’ burden and to identify its predictors, but it also should provide a specific understanding of the needs of ALS patients’ CGs and fill the gap of knowledge on their personal and work lives. Using standardized questionnaires, primary data from patients and their main informal CGs (n = 249) were collected. Patients’ functional status and disease severity were evaluated using the Barthel Index, the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and the King’s Stages for ALS. The caregivers’ burden was recorded by the Zarit Burden Interview (ZBI). Comorbid anxiety and depression of caregivers were assessed by the Hospital Anxiety and Depression Scale. Additionally, the EuroQol Five Dimension Five Level Scale evaluated their health-related quality of life. The caregivers’ burden was high (mean ZBI = 26/88, 0 = no burden, ≥24 = highly burdened) and correlated with patients’ functional status (rp = −0.555, p < 0.001, n = 242). It was influenced by the CGs’ own mental health issues due to caregiving (+11.36, 95% CI [6.84; 15.87], p < 0.001), patients’ wheelchair dependency (+9.30, 95% CI [5.94; 12.66], p < 0.001) and was interrelated with the CGs’ depression (rp = 0.627, p < 0.001, n = 234), anxiety (rp = 0.550, p < 0.001, n = 234), and poorer physical condition (rp = −0.362, p < 0.001, n = 237). Moreover, female CGs showed symptoms of anxiety more often, which also correlated with the patients’ impairment in daily routine (rs = −0.280, p < 0.001, n = 169). As increasing disease severity, along with decreasing autonomy, was the main predictor of caregiver burden and showed to create relevant (negative) implications on CGs’ lives, patient care and supportive therapies should address this issue. Moreover, in order to preserve the mental and physical health of the CGs, new concepts of care have to focus on both, on not only patients but also their CGs and gender-associated specific issues. As caregiving in ALS also significantly influences the socioeconomic status by restrictions in CGs’ work lives and income, and the main reported needs being lack of psychological support and a high bureaucracy, the situation of CGs needs more attention. Apart from their own multi-disciplinary medical and psychological care, more support in care and patient management issues is required.

Background With the rapid spread of Corona Virus Disease 2019 (COVID-19) in China, police officers were undergoing higher job stress, which made them physically and mentally exhausted, eventually leading to job burnout. The research aims to explore the mediating role of social support, psychological resilience, and sleep quality in the relationship between perceived stress and burnout. Methods Data collection was based on multistage cluster random sampling of police in Wuhan, China, from June 2021 to October 2022. A self-administered questionnaire was adopted. Perceived stress, social support, resilience, sleep quality and job burnout were measured using international standard scales. Spearman correlation analysis was utilized to explore the correlation between various psychological conditions and job burnout. Cronbach’s α coefficient methods and confirmatory factor analysis (CFA) were applied to check the scales’ reliability and discriminant validity. The structural equation model (SEM) was performed to adjust the model fitting. Results 2125 eligible participants were included. The job burnout score was 1.90, and 8.52% showed severe burnout. The Cronbach’s α coefficients of the above scales were all ≥ 0.8. The goodness of fit test for the first-order and second-order models reached all fit indices standards in CFA. Police’s burnout and its dimensions were correlated with sleep quality, perceived stress, and social support, except between burnout, emotional exhaustion, depersonalization, and resilience. Parallel multiple mediations showed that social support, sleep quality, and resilience mediated the relationships between perceived stress and job burnout. The mediating effect of the three factors accounted for 6.72%, 55.39%, and − 7.14% of the total effect, respectively. Conclusions Perceived stress affects burnout through mediating variables such as social support, sleep quality, and resilience. The mediating effect of sleep quality is the most potent.