Persistent negative thought is a hallmark feature of both major depressive disorder and generalized anxiety disorder. Despite its clinical significance, little is known about the underlying mechanisms of persistent negative thought. Recent studies suggest that reduced cognitive control might be an explanatory factor. We investigated the association between persistent negative thought and switching between internal representations in working memory, using the Internal Shift Task (IST). The IST was administered to a group of undergraduates, classified as high-ruminators versus low-ruminators, or highworriers versus low-worriers. Results showed that high-ruminators and high-worriers have more difficulties to switch between internal representations in working memory as opposed to low-ruminators and low-worriers. Importantly, results were only significant when the negative stimuli used in the IST reflected personally relevant worry-themes for the participants. The results of this study indicate that rumination and worrying are both associated with reduced cognitive control for verbal information that is personally relevant.

This study aims to investigate whether attentional biases typically associated with depression and anxiety already exist on a sub-clinical level. A transdiagnostic characteristic, both affective disorders have in common at a sub-clinical level, is persistent negative thinking (PNT), called rumination in depression and worrying in anxiety disorders. We investigated the association between these two types of PNT and attentional biases, using two different versions of the exogenous cueing tasks (ECT) in two different experiments. In Experiment 1, the cues of the ECT were negative and positive personality traits. This allowed us to investigate whether high-ruminators (N = 29), analogous to depressed patients, have difficulties to disengage attention from negative personality traits, as compared to low-ruminators (N = 40). In Experiment 2, the cues of the ECT were negative words related to themes participants frequently worry about versus positive words. This was done to investigate whether high-worriers (N = 26), analogous to anxious persons, have a strong tendency to automatically direct attention toward worry-related information, as compared to low-worriers (N = 27). The results of Experiment 1 showed that high-ruminators have difficulties to disengage their attention from negative personality traits. The results of Experiment 2 indicated that there were no attentional biases for high-worriers. These results show that the attentional bias typically associated with depression is already present at a sub-clinical level, whereas this seems not to be the case for the attentional bias typically associated with anxiety.

found that trait worry is associated with an impaired ability to inhibit negative words. A study by Beckwé et al. [11] recently indicated that high-worriers show shifting impairments when the verbal stimuli are personally relevant for them. As far as we know, the relationship between worrying and updating capacity, which represents the focus of the present investigation, has never been investigated before. In line with the ACT, and because previous research indicates that other factors of attentional control (inhibition and shifting) are impaired in highworriers, we expect that high-worriers will show a reduced updating efficiency when compared to low-worriers. Importantly, most studies in this field are correlational in nature, investigating the correlation between cognitive task performance and scores on questionnaires measuring trait anxiety or trait worrying. These correlational studies do not allow us to draw any causal conclusions about the relationship between attentional control and anxiety or worrying. In the present study, we have therefore opted for a worry-induction to investigate the direct influence of state worry on attentional control. We will do this using the only worry-induction that is described in relevant literature, a manipulation developed by McLaughlin et al. [12]. During this worry-induction participants are instructed to worry during 5 min about their favorite worry themes. In line with the ACT, we expect a worry-induction to impair general updating efficiency. If so, this would support the notion that worrying directly depletes cognitive resources. High-worriers inherently have more difficulties to control these induced negative thought intrusions than low-worriers [3]. Therefore we will compare the effect of the worry-induction on updating efficiency between highand low-worriers. Since high-worriers are characterized by higher uncontrollability of negative thought intrusions, we expect that the

The implementation of a new service is often challenging when translating research findings into routine clinical practices. This paper presents the results of the implementation study of a pilot project for a diabetes and cardiovascular diseases risk-assessment service in Belgian community pharmacies. To evaluate the implementation of the service, a mixed method was used that follows the RE-AIM framework. During the testing stage, 37 pharmacies participated, including five that dropped out due to a lack of time or COVID-19-related temporary obligations. Overall, 502 patients participated, of which 376 (74.9%) were eligible for according-to-protocol analysis. Of these, 80 patients (21.3%) were identified as being at high risk for the targeted diseases, and 100 (26.6%) were referred to general practice for further investigation. We presented the limited effectiveness and the key elements influencing optimal implementation. Additional strategies, such as interprofessional workshops, a data-sharing platform, and communication campaigns, should be considered to spread awareness of the new role of pharmacists. Such strategies could also promote collaboration with general practitioners to ensure the follow-up of patients at high risk. Overall, this service was considered easy to perform and feasible in practice but would require financial and external support to ensure its effectiveness, sustainability, and larger-scale implementation.

There is an increasing motivation to implement pharmacist-led screening services in community pharmacies. This study aims to develop tools to support the pharmacist in the context of a diabetes and cardiovascular disease risk assessment service. Our development involved a multistep process using a user-centred approach, including a need assessment phase (14 patients, 17 pharmacists) and a creative design phase, followed by the evaluation of the materials (10 patients, 16 pharmacists). Three following themes covering educational needs emerged from stakeholders’ discussions: “content”, “layout”, and “form”, with three additional themes regarding the practical organisation: “software”, “awareness”, and “referral”. Based on the need assessment, tools for patient education purposes and awareness campaigns were created. During the development, special attention was paid to the writing style and structure with less text and more graphical colourful elements to suit patients with different health literacy and educational levels. The evaluation phase allowed researchers to observe participants engaging with the materials. Overall, participants were satisfied with the tools. The contents were considered valuable and relevant. However, adaptations were necessary to ensure their understanding and long-term usability. Finally, future research is required to evaluate the materials’ impact on patients’ behaviour towards their identified risk factors and ensure their effectiveness.