Biosocial Data Research Articles

Is social disadvantage a chronic stressor? Socioeconomic position and HPA axis activity among older adults living in England

IntroductionLiving in socioeconomic disadvantage has been conceptualised as a chronic stressor, although this contradicts evidence from studies using hair cortisol and cortisone as a measure of hypothalamus-pituitary-adrenal (HPA)11HPA axis: Hypothalamus Pituitary Adrenal axis axis activity. These studies used complete case analyses, ignoring the impact of missing data for inference, despite the high proportion of missing biomarker data. The methodological limitations of studies investigating the association between socioeconomic position (SEP)22SEP: Socio-economic Position defined as education, wealth, and social class and hair cortisol and cortisone are considered in this study by comparing three common methods to deal with missing data: (1) Complete Case Analysis (CCA),33CCA: Complete Case Analysis (2) Inverse Probability Weighting (IPW) 44IPW: Inverse Probability Weightingand (3) weighted Multiple Imputation (MI).55MI: Multiple Imputation This study examines if socioeconomic disadvantage is associated with higher levels of HPA axis activity as measured by hair cortisol and cortisone among older adults using three approaches for compensating for missing data. MethodCortisol and cortisone levels in hair samples from 4573 participants in the 6th wave (2012–2013) of the English Longitudinal Study of Ageing (ELSA)66ELSA: English Longitudinal Study of Ageing were examined, in relation to education, wealth, and social class. We compared linear regression models with CCA, weighted and multiple imputed weighted linear regression models. ResultsSocial groups with certain characteristics (i.e., ethnic minorities, in routine and manual occupations, physically inactive, with poorer health, and smokers) were less likely to have hair cortisol and hair cortisone data compared to the most advantaged groups. We found a consistent pattern of higher levels of hair cortisol and cortisone among the most socioeconomically disadvantaged groups compared to the most advantaged groups. Complete case approaches to missing data underestimated the levels of hair cortisol in education and social class and the levels of hair cortisone in education, wealth, and social class in the most disadvantaged groups. ConclusionThis study demonstrates that social disadvantage as measured by disadvantaged SEP is associated with increased HPA axis activity. The conceptualisation of social disadvantage as a chronic stressor may be valid and previous studies reporting no associations between SEP and hair cortisol may be biased due to their lack of consideration of missing data cases which showed the underrepresentation of disadvantaged social groups in the analyses. Future analyses using biosocial data may need to consider and adjust for missing data.

Exposure to Armed Conflict and HIV Risk Among Rwandan Women.

This article focuses on the link between past exposure to violence and a critical public health issue in sub-Saharan Africa: HIV-positive status in women of reproductive age. Specifically, we use biosocial data from the Rwandan Demographic and Health Survey (2005‒2014) to assess how the timing and intensity of women's exposure to the war and genocide in Rwanda (1990‒1994) may be associated with their HIV status. We find significant differences in risk across age cohorts, with the late adolescence cohort (women born in 1970‒1974, who were aged 16‒20 at the start of the conflict) having the highest risk of being HIV positive 10‒20 years after the violence, even after controlling for current socioeconomic and demographic characteristics. Women who reported two or more sibling deaths, excluding those related to maternal mortality, during the conflict years also had higher odds of being HIV positive, net of cohort and control variables. Age at first sexual intercourse and number of lifetime sexual partners partially-but not fully-explain the associations between cohort and sibling deaths and HIV. These findings advance research related to armed conflict and population health and indicate that experiencing conflict during key stages of the life course and at higher intensity may affect women's long-term sexual health.

EFFECT OF THE PERIOD OF THE COVID-19 PANDEMIC ON HYPERTENSIVE PEOPLE: A PROSPECTIVE COHORT STUDY

Objective: To analyze the influence of the COVID-19 pandemic period on habits and lifestyles, adherence to antihypertensive treatment, control of blood pressure and comorbidities, in hypertensive patients followed in a specialized outpatient clinic of high complexity. Design and method: Prospective longitudinal study that evaluated hypertensive patients treated at the hypertension outpatient clinic of a tertiary teaching hospital, in São Paulo - SP, Brazil before and during the covid-19 pandemic. The following were included: older than 18 years old and being followed up for at least six months. Pregnant women were excluded. In the pre-pandemic period, the interview and assessments were carried out between March and May 2019, in person (face to face). During the pandemic, assessments were carried out between March and August 2020, by telephone. Biosocial data, habits and lifestyles and disease history were evaluated. The study was approved by the Research Ethics Committee. Values of p less or equal 0.05 were considered significant. Results: 111 hypertensive patients were evaluated, the majority (61.3%) women, with a mean age of 66.0 (SD = 12.6) years, 66.7% white, 56.8% married, with an average schooling of 10.5 (SD = 4.2) years. When comparing before and during the pandemic, statistically significant differences (p less or equal 0.05) were observed, respectively, for the variables: monthly income (R$2,362.98 vs R$1,924.88); in the number of widowed (16.2% vs 19.8%) and divorced people (8.1% vs 22.5%), smoking habits (8.1% vs 7.2%), alcoholism (45.0% vs 21.8%) and physical inactivity (97.3% vs 89.2%); glycemia [116.1 (SD = 33.2) vs 129.6 (SD = 57.3) mg/dL] adherence to antihypertensive drug treatment (89.2% vs 54.9%), increase in diabetics ( 48.6% vs 52.2%) and chronic kidney patients (18.9% vs 28.8%). Despite the decrease in blood pressure control, there was no significant difference (67.6% vs 56.9%). Conclusions: The findings indicate that there were favorable influences for habits and lifestyles in hypertensive people in the period of the COVID-19 pandemic, but there was a compromise in income, comorbidities, and especially in adherence to antihypertensive treatment.

Adherence to antihypertensive treatment during the COVID-19 pandemic: findings from a cross-sectional study

BackgroundNonadherence to antihypertensive treatment is one of the main causes of the lack of blood pressure (BP) control. The coronavirus disease (COVID-19) pandemic imposes substantial social restriction impairing the medical care routine, which may influence adherence to the antihypertensive treatment. To assess the rate of nonadherence to antihypertensive drug treatment during the COVID-19 pandemic.MethodsThis is a cross-sectional study evaluating hypertensive adult patients from a tertiary outpatient clinic. From March to August 2020, patients were interviewed by telephone during the social distancing period of the COVID-19 pandemic. We evaluated biosocial data, habits, attitudes, and treatment adherence using the 4-item Morisky Green Levine Scale during the social distancing. Uncontrolled BP was defined by BP ≥ 140/90 mmHg. Clinical and prescription variables for drug treatment were obtained from the electronic medical record. We performed a multivariate analysis to determine the predictors of nonadherence to BP treatment.ResultsWe studied 281 patients (age 66 ± 14 years, 60.5% white, 62.3% women, mean education of 9.0 ± 4 years of study). We found that 41.3% of the individuals reported poor adherence to antihypertensive drug treatment and 48.4% had uncontrolled BP. Subsample data identified that adherence was worse during the pandemic than in the previous period. The variables that were independently associated with the nonadherence during the pandemic period were black skin color (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46–4.68), and intermittent lack of access to antihypertensive medication during the pandemic (OR, 2.56; 95% CI, 1.11–5.89).ConclusionsBeyond traditional variables associated with poor adherence, the lack of availability of antihypertensive medications during the study underscore the potential role of pandemic on hypertension burden.

EFFECT OF EDUCATIONAL PROGRAM ON NURSES’ PERFORMANCE FOR CHILDREN WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA

Introduction: Idiopathic Thrombocytopenic Purpura is an autoimmune blood disorder associated with decrease platelets level less than normal, which may result in bleeding occurrence. The actual cause is unknown. It may be progressive if untreated, but may remit spontaneously for several years. The aim of this study was to evaluate the effect of health educational program on nurses’ performance for children with Idiopathic-Thrombocytopenic-Purpura. Methods: The study was Quasi- experimental research design used for 50 nurses working at Pediatric Hematology Unit of Tanta University Hospital and Pediatric Hematology Unit of Al- Mabra Tanta Hospital. Two Tools were used to collect required data: structured interview schedule to collect biosocial data of nurses and observational check list regarding nursing practice. Results: The present study-represented that, three quarter of nurses had poor-knowledge and all of them had unsatisfactory level of practice before the-educational-program-implementation. While immediately and after one month from the implementation of the program the total-scores-of-nurses' knowledge and practice improved. Conclusion: There was a-significant improvement in nursing knowledge and practice in relation to nursing care for children with Idiopathic-Thrombocytopenic-Purpura. Recommendations: In-service-training program should be conducted periodically for nurses' teaching the basic knowledge and clinical skills.

Effect of Nursing Intervention Program related to Nursing Iatrogenic Events on Nurses Performance and Clinical Outcomes of Neonates at Neonatal Intensive Care Unit

Background: Iatrogenic events that cause harm to neonates in NICU is characterized as adverse events. Neonates are a particularly vulnerable population and may be at further risk of harm from medical errors because of their low birth weight, physiological immature, limited compensatory abilities and extensive exposure to medication in NICU. Nurses are the first line of defense to safeguard against iatrogenic errors. Aim of this study was to evaluated the effect of educational intervention program on nurses’ performance and clinical outcomes of neonates related to nurses’ iatrogenic at neonatal intensive care unit. Subjects and method The study was conducted at Neonatal Intensive Care Unit of Tanta University hospital. A quasi-experimental design was used. Sample All nurses (57) working in the previously mentioned setting were included the study and all neonates admitted within six months. Tools: Three tools were used to collect the required data; Structured Interview schedule, It was consisted of two parts, part one was biosocial data of nurses, neonate and part two was nurses' knowledge (tool I). Observation checklist to assess nurse's practice regarding iatrogenic errors at NICU (tool II). Neonate's clinical outcomes schedule to assess outcomes of neonate post program (tool III). Results of the study revealed that, before program the total knowledge scores of all nurses were poor while majority of them had good scores after implementing program. Total practice scores of all nurses were good also immediately and after one month. There were statistical significant difference between nursing knowledge, practice and biosocial data. The outcome of neonates showed an improvement in neonatal condition of discharge. Conclusion Intervention program was effective and improving nurses’ knowledge and practice as well as reducing iatrogenic errors at NICU. Recommendations were suggested that establish continuous monitoring system to assess nurses practice in NICU settings especially for iatrogenic errors

Effect of Guideline Education on Knowledge and Performance of Mothers regarding Using of Cook Salt for Management of Infants with Granuloma Umbilical

Granuloma Umbilical from major problem in neonates and young infants. It is reported frequently by mothers as continuous leakage of secretion at umbilicus site following cord separation. Delayed management of granuloma, it remain oozing and causes persistent irritation for long period reach weeks. Several management modalities were performed for umbilical granuloma including; using cook salt, ligation of the granuloma, cauterization chemically with silver nitrate or copper sulphate, electro-cauterization, cryocauterization and excision surgical . Aim of the study: Evaluate mother knowledge and performance regarding using of cook salt for management of infants with granuloma umbilical. Subject and Methods: Research Design: A quasi-experimental research design was used Setting: The study was conducted at outpatient pediatric department of Tanta and Menoufia University Hospital. Tools: Two tools were used: Structure interview schedule was developed by the researcher included three parts: Tool I: Biosocial data of infants and their mother, mothers' knowledge and reported practice was evaluated by using observational check list about cook salt use for umbilical granuloma. Tool II: Guideline reported educational intervention for the mothers Results: Infants with granuloma showed complete resolution after course of cook salt treatment. Conclusion: Using of cook salt for management umbilical granuloma is costeffective, simple curative and safe mode of treatment which can be performed by mothers at home. Recommendation: Using of cook salt as a treatment modality should be more encouraged by the health staff.

Comparing the effect of acupressure and ginger on chemotherapy gastrointestinal side-effects in children with leukemia

The biosocial data of 90 children with acute lymphoblastic leukemia, were collected along with assessment of gastrointestinal side-effects of chemotherapy using visual analogue scale. Ginger lozenges has more effect than acupressure in alleviating nausea and vomiting. Acupressure alleviate the nausea best in the group aged 13–15 years. Ginger helped more the other two groups (7–12 years, 69 % of the group didn’t suffer from nausea), versus 50 % aged 13–15). Both acupressure and ginger affected girls more than boys in alleviating nausea. The acupressure effect on vomiting incidence didn’t differ in both males and males, whilst ginger helped the males more.

ADHERENCE TO ANTI-HYPERTENSIVE TREATMENT ON THE COVID-19 PANDEMIC

Objective: To evaluate the adherence to antihypertensive treatment during the COVID-19 pandemic and associated variables. Design and method: Cross-sectional study was performed with outpatient, from a Hospital in São Paulo, Brazil. Inclusion criteria were: age >18 years old, telephone number, in treatment for at least six months. Pregnant women were excluded. The period defined to characterize the assessment of social distance due to the COVID-19 pandemic was from March, 24 until August, 31. Hypertensive patients were interviewed by telephone. The adherence to treatment was assessed by Morisky and Green scale and the BP control was systolic BP < 140 mmHg and diastolic BP < 90 mmHg. Biosocial data, habits and lifestyles and attitudes towards social distancing measures were evaluated. The study was approved by the Research Ethics Committee. The significance level was p< = 0.05. Results: The sample was 281 hypertensive patients: 62.3% women; 66 (14) years old; 348,7 (255,8) $USA monthly income; 43.8% completed high school; 60.5% white; 47.0% married; and 59.1% retired. It was found that 58.7% were adherent to antihypertensive treatment and BP control was 51.6%. The systolic BP was 138.5 (22.7) mmHg and diastolic BP was 77.3 (14.4) mmHg. As for drug treatment, 55.2% of hypertensive patients received the drugs sent by the hospital pharmacy via mail, 63.9% reported that during the COVID-19 pandemic there was a problem in receiving the drugs and 10% was without antihypertensive sometime at home. The variables associated with treatment adherence were: race black (OR 0.40; 95% CI: 0.21 – 0.73), education elementary school II (OR 2.97; 95% CI: 1.24 – 7.06), stayed without antihypertensive at home someday from quarantine (OR 0.40; 95% CI: 0.17 – 0.95) and diastolic BP (OR 0.98; CI: 0.96 – 0.99). During the period of the pandemic evaluated, it was also observed that 77.6% reported leaving home, 13.5% had contact with people with the disease and 91.8% reported not feeling safe to leave the house after the end of quarantine. Conclusions: The rate of non-adherence to antihypertensive treatment during the COVID-19 pandemic was high and was associated with unfavorable biosocial variables.

BLOOD PRESSURE CONTROL IN A HIGH-COMPLEXITY OUTPATIENT SERVICE WAS LESS THAN ADHERENCE TO ANTIHYPERTENSIVE TREATMENT

Objective: To evaluate the blood pressure control, adherence to antihypertensive treatment and associated variables. Design and method: A cross-sectional study was performed in a hypertension outpatient clinic from a Hospital in São Paulo, Brazil. Inclusion criteria were: age over 18 years old, in treatment for at least six months and also that accepted to participate signing the Informed Consent Form. Patients diagnosed with secondary hypertension, pregnant and unable to answer the interview were excluded. The sample calculation based on 60% of control rate and 5% of significance level was 253 participants. The blood pressure control was systolic blood pressure < 140 and diastolic blood pressure < 90 mmHg. The adherence to treatment was assessed by Morisky MMAS-8. Biosocial data, risk factors, habits, lifestyles, anthropometric measurements, comorbidities and psycho-emotional characteristics were evaluated. Multivariate analysis was performed by the Logistic Regression and the significance level was <0.05. Results: The blood pressure control was 69.2% and 82.2% had a high adherence to treatment. The characteristics of hypertensive patients were: 65.0 (13.3) years, 61.7% were female, 63.2% were white, 52.8% were married, 44.3% had completed high school studies, body mass index 29.5 (5.3) Kg/m2 (81.4% overweight or obesity), 47.4% had a low socio economic classification, 55.7% had never smoked, 60% hadn’t drunk alcoholic beverage currently, 84.5% hadn’t had common mental disorders, 39.9% had physical activity irregularly and 8.0 (4.0) number of drugs in use. The main comorbidities were: Dyslipidemia (71.5%), Diabetes Mellitus (40.7%), Chronic Kidney Disease (19%), Stroke (8.7%), Coronary Insufficiency (13.4%). The systolic blood pressure was 138.6 (12.1) mmHg and diastolic was 80.8 (7.2) mmHg. The most used antihypertensive drugs were: diuretics (78.3%), calcium channel blockers (68.8%), AT1 receptor blockers (61.7%), beta-blocker adrenergic inhibitors (50.2 %) and angiotensin-converting enzyme inhibitor (30.4%). The associated variables to blood pressure control were: married marital status (OR 2.3; IC95%:1.34 – 4.28), calcium channel blockers (OR 0.4; IC95%: 0.19–0.92) and number of antihypertensive drugs in use (OR 0.78; IC95%:0.66–0.92). Conclusions: The blood pressure control were more elevated than data from majority of Brazilian studies, although not coincident to the adherence to the treatment evaluated.

Mental Health, Wellbeing and Technology Use Amongst UK Adolescents: An Exploration of <i>Understanding Society</i>: The UK Household Longitudinal Study

Background: Most research explores the impact of digital technology, specifically social networking sites, on mental health and wellbeing amongst adolescents. Findings suggest small effects with a possible link amongst girls. This investigates whether levels of mental health and wellbeing impact use of digital technology amongst adolescents. Methods: Data come from waves 1-9 of Understanding Society: The UK Household Longitudinal Study, a longitudinal panel study with a youth panel (10-15 year olds) where household members are interviewed annually. Young people were asked about time spent using social networking sites, and gaming on a console or computer. Measures of mental health and wellbeing were the Strengths and Difficulties Questionnaire and a composite happiness measure. Random effects ordinal logistic models were used to test associations. Findings: Higher levels of happiness and lower levels of poor mental health were associated with lower levels of digital technology use. Slightly larger associations were observed amongst girls for social networking site use and amongst boys for console gaming. There were no gender differences in the association between levels of mental health and wellbeing and time spent playing computer games. Happiness with family was associated with social networking site use for girls while happiness with friends was associated for boys. Internalising behaviours showed associations across all types of digital technology with higher levels of internalising associated with increased time on digital technology. Interpretation: The findings of this study suggest that there is a relationship between existing mental ill health and increased use of digital technology for adolescents. There also appear to be certain aspects of these measures which may be important, particularly internalising behaviours. Future studies should explore the pathways of these relationships to identify characteristics of vulnerable young people and to inform policy and decisions of parents and young people in their use of digital technology. Funding Information: YK was supported by the Economic and Social Research Council (ESRC ES/R008930/1); CB was supported by (ESRC RES-586-47-0001/RES-586-47-0002). Understanding Society is funded through the following ESRC grants: Understanding Society: The UK Longitudinal Household Study (RES-586-47-0001); Understanding Society, the UK Longitudinal Studies Centre (RES-586-47-0002). The ESRC provided funding for the collection of UKHLS data; however they were not involved in the study design, analysis, interpretation of the data or writing up of this paper. Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: Parents or guardians provides consent for young people to participate. Young people are then asked for assent for a pen-and-paper questionnaire. The University of Essex Ethics Committee has approved all data collection on Understanding Society main study and innovation panel waves, including asking consent for all data linkages except to health records. Requesting consent for health record linkage was approved at Wave 1 by the National Research Ethics Service (NRES) Oxfordshire REC A (08/H0604/124), at BHPS Wave 18 by the NRES Royal Free Hospital & Medical School (08/H0720/60) and at Wave 4 by NRES Southampton REC A (11/SC/0274). Approval for the collection of biosocial data by trained nurses in Waves 2 and 3 of the main survey was obtained from the National Research Ethics Service (Understanding Society - UK Household Longitudinal Study: A Biosocial Component, Oxfordshire A REC, Reference: 10/H0604/2).

Implementation of foreign experience in the use of biosocial data of the identityof the criminal in judicial practice on the example of the MAOA-L genotype

Implementation of foreign experience in the use of biosocial data of the identityof the criminal in judicial practice on the example of the MAOA-L genotype

Effect of Guided psychosexual Instructions on Sexual Activity among Hypoactive Women’s Sexual Dysfunctions

Female sexual dysfunction (FSD) is a serious health problem because of its high prevalence and deleterious effects on women's quality of life. Practitioners of women's health must care able to detect FSD in its early stage so that timely treatment could be offered. Also, the clinicians have lack understanding about the approach for identification and evaluation of the sexual problem. The study aimed to investigate the effect of guided psychosexual health instructions on changes in sexual activity among women with reduced sexual dysfunctions (hypoactive). Methods: A quasi- experimental design was used (pre and posttest one group) Setting: The study was conducted at Kebly and Bahary Maternal& Child Health Care Centers at Shibin Elkom Sample 100 participants of women were selected according to their responses in two-scale of sexual dysfunctions and elicited as hypoactive sexual dysfunctions from MCH Tools of the study: 1- Structured interview questionnaire classified into two parts, the first part deal with a biosocial data as age, level of education, and the employment status as well as complaining from physical or gynecological problems hindering them for conducting healthy marital relationship with their partner. The second part was: The Female Sexual Function Index (FSFI), A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function in a 19-item questionnaire, It was developed by Rosen, et al. (2010) as a brief instrument for assessing the key dimensions of sexual function in women. 2-Sexual Dysfunction Questionnaire It was developed by Infrasca et, al (2011) to assess women's readiness and preparation for sexual functions disorders Introduced as a brief self-report inventory. Results showed that there was a highly statistically significant difference P well as vaginal lubrication, orgasm, and degree of satisfaction during sexual activity. It was concluded that the use of guided psychosexual intervention was effective in managing sexual dysfunctions problems and enhancing satisfaction to reach orgasm. Recommendations. All health care providers should include screening questions regarding sexual well-being as a standard of practice. Treating medical, psychosexual, relationship problems, and addressing sociocultural issues, which can be effective in helping women and their partners dealing with hypoactive sexual desire disorder. Health care providers should involve the woman’s partner in the assessment and treatment of sexual health concerns when it is appropriate and safe to do so. Also, health guidelines protocol of care for (SD) should be providers to involve the woman’s partner in addressing sexual issues,

Nurse effects on measurement error in household biosocial surveys

BackgroundBiosocial survey data are in high demand, yet little is known about the measurement quality of health measures collected by nurses in respondents’ homes. Our objective was to analyze the degree to which nurses influence measurement in anthropometric and physical performance indicators collected from respondents in two nationally-representative UK biosocial surveys.MethodsThe English Longitudinal Survey of Ageing and the UK Household Longitudinal Study – Understanding Society were used to analyze fourteen anthropometric and physical performance measures covering weight, height, pulse, grip strength, and lung capacity. Cross-classified multilevel models were used to estimate “nurse effects” on measurement error.ResultsOverall, there is a medium effect of nurses on measurement. Across all measures collected in both studies, nurses explain around 13% of all measurement variation. Variation in specific measures range between approximately 2 and 25%. Grip strength and lung capacity are more heavily influenced by nurses than are height, weight, and pulse. Lastly, nurse characteristics explain only a very small proportion of nurse measurement variation.ConclusionObjective health measures collected by nurses in household biosocial surveys are susceptible to non-trivial amounts of measurement variation. Nurse ID numbers should be regularly included in biosocial data releases to allow researchers to account for this unnecessary source of variation. Further, researchers are advised to conduct sensitivity analyses using control variables that account for nurse variation to confirm whether their substantive findings are influenced by nurse measurement effects.

Óvissa um leiðsagnargildi gagna? Notkun gagna við mótun menntastefnu og skólastarfs

Greinin fjallar annars vegar um þá miklu áherslu sem lögð er á notkun gagna í skólastarfi og hins vegar um það að þau gefi litla leiðsögn í mikilvægum efnum. Umfang og margbreytileiki gagna vex hratt og margir ólíkir heimar gagna sem tengjast menntun eru í þróun. Ljóst er að trúin á nytsemi gagna er sterk bæði hjá alþjóðastofnunum og öðrum sem stýra menntun, enda eru þau oft ómissandi. Lykilspurningin er tvíþætt: Að hvaða marki leiðbeina gögn um setningu markmiða í menntun og um hvað skuli gert í menntakerfum eða í skólastofum? Rök eru færð fyrir því að þótt þau séu nytsamleg dugi þau furðu skammt í þessum tilvikum. Sama á við um rannsóknir sem gegna samt lykilhlutverki í þróun skilnings og hugmynda. Umfjöllun um markmið menntunar ætti að vega þungt í menntun fagfólks og í umræðu um menntun og nauðsynlegt er að hafa hugfast að áhersla á gögn kann að jaðarsetja umræðu um markmið.

Psychosocial factors and Burnout Syndrome among mental health professionals

Objective:to identify biopsychosocial factors at work associated with the Burnout Syndrome in mental health professionals.Method:a cross-sectional study with a quantitative approach conducted with a sample of 293 mental health service workers from the public network of a municipality in the inland of the state of São Paulo, Brazil. An instrument composed of three self-administered questionnaires was applied, namely: biosocial data form, the Job Stress Scale (JSS) and the Maslach Burnout Inventory (MBI- HSS). The data were analyzed through the application of the Chi-squared and logistic regression tests, with the adoption of a 5% significance level.Results:Burnout Syndrome prevalence was 7% with a predominance of nursing professionals and was associated with the work sector, the use of psychotropic drugs, low satisfaction with the manager and with the low control over the work activity. Among the professionals with Burnout Syndrome, twelve performed functions considered of high wear, six performed passive work and two were in low wear activity.Conclusion:low control was the main psychosocial factor at work associated with Burnout Syndrome, making it necessary to develop actions that promote worker autonomy and improve the management of stress-triggering psychosocial factors.

An insight into Ribavirin post-exposure prophylaxis for Lassa fever infection prevention amongst health-care workers in a specialist hospital in North-Central Nigeria

Background: Oral ribavirin is used as standard post-exposure prophylaxis (PEP) in preventing the nosocomial spread of Lassa fever (LF) in outbreaks. This study sought to have an insight into the incidence and case fatality rate of Lassa fever infections, assess the biosocial data and outcome of the healthcare workers who received ribavirin PEP and determine the adverse effects associated with ribavirin PEP therapy at the Dalhatu Araf Specialist Hospital Lafia Nasarawa State Nigeria. Methods: This was a prospective study done between January 2017 to December 2018. Data on biosocial, details of exposure to the Lassa virus, the dosage of ribavirin therapy, adverse effects and outcomes were obtained. Results: The incidence of LF infection was 16% of all suspected cases, with a case fatality rate of 57.1%. General body weakness 30 (44.8%) and loss of appetite 25(37.2%) were the common adverse drug effects reported. The majority of the healthcare workers, 66 (98.5%) remained asymptomatic for secondary LF infection after completion of their oral ribavirin PEP, only, 1 (1.5%) became symptomatic for secondary LF infection, and expired on the sixth-day post-needlestick exposure. Conclusion: Lassa fever infection is common in Nasarawa State, and it is associated with a high case fatality rate. Healthcare workers on duty are at risk of being exposed when adherence to infection prevention and control is inadequate. Oral ribavirin PEP therapy was found to have a low adverse effect profile and efficacious in the prevention of symptomatic secondary LF infection.

A study of the predictive factors of mortality in acute poisoning with aluminum phosphide with special reference to echocardiography and SOFA score.

Aluminum phosphide (AlP) is considered now one of the most common causes of poisoning among agricultural pesticides. Poisoning with AlP is extremely toxic to humans with high mortality rate. The aim of this work was to evaluate the prognostic factors and outcome of acute aluminum phosphide poisoning in Alexandria Main University Hospital during a period of 6 months from 1 November 2017 until the end of April 2018, highlighting the role of SOFA score and echocardiography in predicting the mortality. The prospective study was conducted on all patients admitted with acute AlP poisoning to Alexandria Main University Hospital for those 6 months. Patients' data were collected in a special sheet and included biosocial data, medical history, poisoning history, complete medical examination, investigations, duration of hospital stay, and the outcome. All patients were assessed according to SOFA score on admission. Thirty patients were admitted during the period of the current study. Females outnumbered males in all age groups with a sex ratio of 2.75:1. The mean age of patients was 22.77 ± 12.79 years. 96.6% of patients came from rural areas. 93.3% of the cases were exposed to poisoning at home, where suicidal poisoning accounted for (86.7%) of cases. 43.3% of patients died (n = 13), and the median value of SOFA score among non-survivors was 10, versus 1 among survivors. The median value of ejection fraction among non-survivors (25%) was half its value in survivors (50%). Although there were many predictors of severity of AlP poisoning, SOFA score was the most predictive factor of mortality detected by multivariate analysis.

Stressed out? An investigation of whether allostatic load mediates associations between neighbourhood deprivation and health

Deprived neighbourhoods have long been associated with poorer health outcomes. However, many quantitative studies have not evidenced the mechanisms through which place ‘gets under the skin’ to influence health. The increasing prevalence of biosocial data provides new opportunities to explore these mechanisms and incorporate them into models of contextual effects. The stress pathway is a key biosocial mechanism; however, few studies have explicitly tested it in neighbourhood associations. This paper addresses this gap by investigating whether allostatic load, a biological response to chronic stress, mediates relationships of neighbourhood deprivation to physical and mental health. Data from UK Understanding Society is used to undertaken a multilevel mediation analysis. Allostatic load is found to mediate the association between neighbourhood deprivation and health, substantiating the biological mechanism of the stress pathway. More deprived areas are associated with higher allostatic load, and in turn worse allostatic load relates to poorer physical and mental health. Allostatic load is a stronger mediator of physical health than mental health, suggesting the stress pathway is more pertinent to explaining physical health gradients. Heterogeneity in the results between physical and mental health suggests more research is needed to disentangle the biosocial processes that could be important to health and place relationships.

Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors.

Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.