Young people are increasingly distressed by the climate and ecological crises (eco-distress). This has been associated with the failure of people in power to act appropriately, which may cause moral distress and moral injury. We examined this hypothesis by interviewing 13 young adults (19–25 years) in the UK about their climate concerns and perceptions of how State actors and authorities are responding to climate change. Using reflexive thematic analysis, four themes were developed: (1) Climate change is a wicked problem, (2) Moral distress is associated with witnessing acts of omission and commission, (3) Moral distress drives eco-distress, and (4) Opportunities for moral repair. Climate concerns extended to broader concerns about ecological degradation (eco-distress), linked to feelings of moral distress arising from repeatedly witnessing powerful people failing to act on climate change. Eco-distress was also exacerbated by (a) witnessing others in society failing to take appropriate responsibility, (b) realising the limitations of individual action, and (c) being embedded within a culture where personal contribution to climate change is inescapable. In contrast, eco-distress was lessened by seeing authorities engage with the issues morally, and further mitigated by collective, ethical, pro-environmental action. This adds empirical evidence to support the hypothesis that eco-distress involves moral distress and injury arising when State authorities and other powerful bodies engage in wrongful acts and omissions on climate change. We argue that this is affecting the wellbeing of young people and supports the argument that such wrongful (in)action infringes human rights. Clinical implications are discussed.

1. (1) To understand how and why moral distress and moral injury relate to the distress that young people feel about climate change (eco-distress).

2. (2) To consider the clinical implications of formulating eco-distress in a way that includes reference to the violation of core moral codes.

3. (3) To explore what opportunities exist that could reduce moral distress and support young people.

4. (4) To understand how research into moral distress and moral injury in relation to climate change can offer important insight into the relevance of eco-distress to human rights infringements and justice-oriented care.

5. (5) To discuss practical solutions that might support moral repair, both in psychotherapy settings and in broader social policy.

The father of Czech music, Bedřich Smetana was a brilliant, patriotic Romantic composer who spent his last decade completely deaf. He became progressively ill in his final years and passed away prematurely at 60 years old. Since then, there have been two main propositions for the etiology of his neurological symptoms, in particular his hearing loss: neurosyphilis or osteomyelitis of the temporal bone.

This article compares the clinical presentation and pathology of neurosyphilis and osteomyelitis.

This article infers which one is arguably the most likely cause based on Smetana’s own medical history, signs and symptoms and autopsy findings.

Smetana’s clinical presentation and pathological results grant us a clearer picture of his neurological condition and allows us to diagnose his final neurological deterioration as complications of neurosyphilis and not osteomyelitis of the temporal bone.

The purpose of this study is to examine the national impact of workplace factors during the SARS-CoV-2 pandemic on mental health experienced by non-physician healthcare workers (HCWs).

This study consisted of an online sample of non-physician HCWs across the United States, including nurses, medical assistants, and physician assistants. The survey consisted of 93 questions, which included the Perceived Stress Scale, the Center for Epidemiological Studies-Depression (CESD-10) scale, questions about COVID-19 vaccination, sources of trusted information, and questions about work environment and training during the COVID-19 pandemic. Descriptive statistics were used to evaluate associations.

In the final sample (N = 220), (81.8%) reported receiving at least one dose of a COVID vaccine. Most respondents trusted the CDC’s information on the SARS-CoV-2 virus and COVID-19 disease. Several workplace-related factors that occurred during the pandemic were associated with moderate to high levels of perceived stress, fatigue, and higher risk of developing depression. In particular, concerns about exposing others, experiencing discrimination related to their jobs, and caring for patients who died from COVID-19 were associated with increased perceived stress, depression, and fatigue.

The importance of planning by healthcare facilities should include planning for workplace factors associated with poor mental health among all HCWs.

In recent years, the importance of telemedicine has increased significantly. Especially in the field of echocardiography, virtual reality glasses offer the possibility of real-time data transmission without restrictions in the examination process. In particular, the care of critically ill newborns with suspected CHD might be improved by allowing a specialized paediatric cardiologist to remotely guide an echocardiographic examination. The current study aims to prove whether novices, under Google Glass guidance by a paediatric cardiologist, can perform an appropriate neonatal echocardiography.

The current study is a prospective monocentric single-blinded pilot study. Participants were supposed to perform two test runs: The first test run was “unguided” and the second test run was instructed via Google Glass. A validated training simulator for neonatal echocardiography “EchocomNeo, Echocom GmbH” was used. The study took place at the Leipzig Heart Center, Department of Pediatric Cardiology from April 2022 to November 2022.

A total of 21 medical students were enrolled. In total 252 views (126 views in each test run) were recorded. The overall performance was significantly higher in the Google Glass guided test run compared to “unguided” (structure score: 77.6% vs. 63.2%. p < 0.001 and quality score: 58.7% vs. 47.2%, p < 0.001). Also, the time was significantly lower in the Google Glass guided test run than in the unguided test run, p = 0.014.

Google Glass guidance by a paediatric cardiologist could optimize the performance of novices in echocardiography using a standardized neonatal echo-simulator with structural normal cardiac anatomy.

The Russian–Ukrainian War of 2022 (RUW-2022) was accompanied by the subsequent risk of accidents at a nuclear power plant in Ukraine. This study investigated posttraumatic stress (PTS) symptoms related to media reports of an attack on a Ukrainian nuclear power plant during the RUW-2022 among victims of the Fukushima nuclear disaster and revealed their association with radiation risk perception (RRP) of the accident.

This cross-sectional study targeted 1193 residents of Naraha Town in Fukushima Prefecture. PTS symptoms were measured using the Japanese version of the Impact of Events Scale-Revised (IES-R). Univariate and multivariate analyses explored the association between IES-R scores and background factors, particularly RRP.

Participants with higher RRP showed significantly higher IES-R scores; furthermore, the proportion of disruption because of radiation anxiety was significantly larger among higher RRP residents. Radiation anxiety mediated the association between RRP and PTS symptoms (total IES-R score and sub-item of intrusion).

People with higher RRP in Fukushima may continue to be at risk of persistent, unwanted PTS symptoms due to future nuclear crises. Therefore, mental health practitioners need to continue providing support in affected areas for a longer period than anticipated. Moreover, a population-based approach to cope with these stressors from media reports is essential.

This paper describes an interdisciplinary integration of the concept of environmental identity into cognitive behavioural approaches to facilitate psychotherapy interventions for climate distress. Environmental identity encompasses one’s sense of self in relation to the natural world and other species, and is an important sub-identity analogous to gender, sexual and other forms of self and social identity recognized in psychotherapy. We provide a background on the construct of environmental identity as developed in social and environmental psychology and share culturally responsive methods for mental health practitioners and the public to evoke and explore their own environmental identity. We then discuss steps to create environmental identity-based therapy interventions using cognitive and behavioural approaches for climate distress. We highlight the potential for acceptance and commitment therapy to foster mindfulness and values-based action, dialectical behaviour therapy to support emotional regulation, and radically open dialectical behaviour therapy to mitigate perfectionism and over-controlled coping styles. We also describe a composite case study of environmental identity-based cognitive behavioural therapy for an LGBTQ+ client.

1. (1) The paper presents new opportunities and techniques for adapting cognitive behavioural interventions in a climate conscious manner, with insights and observations from the authors based on clinical practice, which informs research into psychotherapy best practices in the context of environmental and climate issues.

2. (2) Readers will become familiar with the empirical basis of environmental identity drawn from theory and research in social and environmental psychology; how environmental experiences and values intersect with other forms of personal and social identity addressed in mental health practice; and culturally responsive ways to elicit environmental identity on the part of practitioners and those they serve.

3. (3) Readers are guided through examples of environmental identity-based cognitive and behavioural interventions including (1) promoting values-based action using acceptance and commitment therapy, (2) addressing emotional dysregulation using dialectical behaviour therapy, and (3) modifying over-controlled or perfectionistic coping styles using radically open dialectical behaviour therapy.

4. (4) A composite case study provides an example of environmental identity-based cognitive behavioural therapy for a 20-year-old LGBTQ+ person experiencing climate distress.