Impaired Health Research Articles

Fatigue, impaired physical function and mental health in cancer survivors: the role of social isolation.

Cancer survivors experience an array of physical, psychological, and social problems after treatment has ended. Perceived social isolation may exacerbate the effects of physical problems on mental health. We examined the association between physical health (cancer-related fatigue and physical function) and mental health (depression and anxiety symptoms) in cancer survivors in the first year of survivorship (i.e., up to one year after the end of treatment with curative intent), as well as the moderating role of perceived social isolation. Survey data were collected from 118 cancer survivors who completed treatment with curative intent in the last year. We assessed mental and physical health symptoms, as well as perceived social isolation. In multivariable analyses, fatigue was significantly associated with both depression (β = 0.279, 95% CI: 0.193,0.362) and anxiety symptoms (β = 0.189, 95% CI: 0.106,0.272). Social isolation moderated the effect of fatigue on depression and anxiety such that higher social isolation exacerbated the association of fatigue with mental health. Cancer survivors who continue to experience fatigue after curative treatment are at risk for mental health problems, including depression and anxiety symptoms. For cancer survivors who feel socially isolated, the association between fatigue and mental health may be stronger. The current standard of care for survivorship does not sufficiently address psychosocial needs. Future research should evaluate the inclusion of social support interventions in early-term survivorship care.

Gendered Experiences of Ontological Insecurity Among Women Who Use Drugs and Experience Housing Insecurity: A Critical Narrative Analysis

Introduction: Research has established that experiences of substance use and housing insecurity leads to violence, alienation, and health deterioration for women. However, no literature has assessed how the gendered nature of substance use and housing insecurity influence the ontological insecurity of women. This paper examines the relationship between ontological insecurity, substance use, and housing insecurity for women. We provide considerations for the theorization of ontological (in)security to account for gender. Methods: Feminist-informed interviews were conducted with 20 women who were clients of a safer supply program located in Kitchener-Waterloo, Ontario. Interviews took place in person, were audio-recorded, and transcribed. Interviews focused on women’s experiences of substance use and housing insecurity across their lives. Data analysis was guided by a feminist re-reading of the theory of ontological security. All women completed a socio-demographic questionnaire. Results: Most women were aged between 22 and 43 ( n = 11), with nine being over the age of 44. Fifteen women identified as white, with five identifying as First Nation, Indigenous, or Metis. Ten women resided in supportive housing units, five resided in transitional housing units, social service agency run motels, or in the private rental market, and five resided in tents or encampments. Women shared how gendered experiences of substance use and housing insecurity, which were associated with trauma and violence, contributed to perceptions of ontological insecurity. Dimensions of ontological insecurity which were discussed by women included a disrupted sense of self, instability, and a loss of autonomy. Conclusion: Our results demonstrate how mechanisms of ontological insecurity for women who use drugs and experience housing insecurity are engrained in the gendered structuring of society. These findings suggest that the current theorization of ontological (in)security is insufficient in examining complete mechanisms which promote ontological security or insecurity for women. Future work which explores ontological (in)security must consider the gendered ordering of society.

Overcoming mental health challenges in higher education: a narrative review.

Mental health among higher education students is a critical public health concern, with numerous studies documenting its impact on student well-being and academic performance. However, comprehensive research on the factors contributing to mental health deterioration, including barriers to seeking psychological help, remains insufficient. Gathering evidence on this topic is crucial to advancing policies, advocacy, and improving mental health services in higher education. This review explores the unique challenges faced by vulnerable student groups and highlights the factors influencing student well-being and academic engagement, including those exacerbated by the COVID-19 pandemic. The review also addresses barriers to accessing mental health services across various regions and provides evidence-informed recommendations for improving mental health policies and services in higher education, covering both well-researched and underexplored contexts. This narrative review synthesizes findings from over 50 studies on mental health in higher education. A targeted search was conducted using PubMed, Google Scholar, PsycINFO, CINAHL, and Scopus for studies published between 2013 and 2023. Data were analyzed through a deductive thematic content analysis approach, focusing on key predetermined themes related to student well-being, barriers to mental health services, and recommendations for policy improvements. Several factors influence the mental health of higher education students, with vulnerable groups-including women, minorities, socioeconomically disadvantaged, international, and first-year students-experiencing higher levels of depression, anxiety, and stress. Factors that impact students' well-being and academic performance include academic pressure, financial stress, lack of social support, isolation, trauma, lack of inclusive practices, and pandemic-related stressors. Institutional barriers, inconsistent well-being measures, data-sharing issues, and regulatory limitations hinder students' access to mental health services, while stigma and lack of trust in mental health professionals impede care. Improving mental health strategies in higher education requires enhancing mental health services, addressing socioeconomic inequalities, improving digital literacy, standardizing services, involving youth in service design, and strengthening research and collaboration. Future research should prioritize detailed intervention reports, cost analyses, diverse data integration, and standardized indicators to improve research quality and applicability.

Exploring β-caryophyllene: a non-psychotropic cannabinoid's potential in mitigating cognitive impairment induced by sleep deprivation.

Sleep deprivation or sleep loss, a prevalent issue in modern society, is linked to cognitive impairment, leading to heightened risks of errors and accidents. Chronic sleep deprivation affects various cognitive functions, including memory, attention, and decision-making, and is associated with an increased risk of neurodegenerative diseases, cardiovascular issues, and metabolic disorders. This review examines the potential of β-caryophyllene, a dietary non-psychotropic cannabinoid, and FDA-approved flavoring agent, as a therapeutic solution for sleep loss-induced cognitive impairment. It highlights β-caryophyllene's ability to mitigate key contributors to sleep loss-induced cognitive impairment, such as inflammation, oxidative stress, neuronal death, and reduced neuroplasticity, by modulating various signaling pathways, including TLR4/NF-κB/NLRP3, MAPK, Nrf2/HO-1, PI3K/Akt, and cAMP/PKA/CREB. As a naturally occurring, non-psychotropic compound with low toxicity, β-caryophyllene emerges as a promising candidate for further investigation. The review underscores the therapeutic potential of β-caryophyllene for sleep loss-induced cognitive impairment and provides mechanistic insights into its action on crucial pathways, suggesting that β-caryophyllene could be a valuable addition to strategies aimed at combating cognitive impairment and other health issues due to sleep loss.

Assessing the Psychosocial Determinants of Mental Health Decline Among Bangladeshi University Students During the COVID-19 Pandemic: A Rapid Systematic Review

Background: The COVID-19 epidemic has profoundly impacted the mental health of university students. This review investigates the psychosocial factors contributing to the mental health decline of Bangladeshi university students, particularly in Dhaka city, with the objective of identifying the primary elements exacerbating their mental health issues during the pandemic. Method: Employing a mixed-methods approach, this review integrates quantitative and qualitative data, adhering to PRISMA guidelines. Data were extracted using MeSH keywords from databases such as PubMed, PsycINFO, EMBASE, Medline, and ARU-E-Library. Out of 822 initially identified publications, 24 met the inclusion criteria. Thematic analysis was used to investigate pertinent data, and studies were appraised using CASP and AXIS tools. Data interpretation involved SPSS and R, utilizing descriptive statistics, t-tests, ANOVA, and regression analyses. Results: The review identified critical factors contributing to mental health deterioration, including financial hardships, academic disruption, social isolation, excessive smartphone use, and career instability. High prevalence rates of anxiety (61.2%), depression (64.7%), and stress (52.4%) were found. Inferential statistics revealed significant differences in mental health outcomes across demographic groups, with female students showing a 20% higher risk of anxiety and those living with parents showing a 15% higher risk of depression. Discussion: The results emphasize the multifaceted nature of the mental health challenges that students encounter. The transition to online learning, financial instability, and social isolation were substantial stressors. The review emphasizes the necessity of legislative changes and targeted mental health interventions. Conclusion: To address the mental health crisis among university students, policymakers must reform frameworks and provide support systems, including flexible learning models and targeted mental health interventions, to ensure students’ long-term well-being and academic success.

The association between childhood maltreatment and multidimensional sleep health in adolescents at high-risk of emotional and behavioral problems.

Impaired sleep following trauma such as childhood maltreatment is both a prognostic factor for future mental illness and a feasible intervention point. Yet, associations between childhood maltreatment and objectively measured sleep components are rarely found. New approaches advance the use of multidimensional sleep health scores instead of individual sleep components. However, no such methodology has been used to study the consequences of maltreatment on sleep health in adolescent cohorts so far. We hypothesized that childhood maltreatment will be associated with poorer sleep health in adolescence. a cross-sectional sample of 494 adolescents at high-risk of emotional and behavioral problems (mean age 17.9) completed the Childhood Trauma Questionnaire short form (CTQ-SF) to assess five forms of maltreatment (emotional and physical abuse/neglect and sexual abuse) assessed as continuous sum scores. During 9 nights of actigraphy and sleep diary measurements data on sleep regularity, satisfaction, alertness, timing, efficiency, and duration was collected, which were combined into a sleep health composite score ranging from 0 to 6. Linear regression models were adjusted for age, sex, household income, ethnic origin, educational level, urbanization of living environment and parental psychopathological problems. associations were found between all forms of maltreatment and poorer sleep health (p<.031), except for sexual abuse (p=.224). Partial r effect sizes ranged from -0.12 [95%CI = -0.22, -0.01] for emotional neglect to -0.18 [-0.28, -0.08] for total maltreatment. maltreatment was associated with impairment in everyday sleep health, reflected in both subjective and objective measurements of sleep.

Remotely Delivered Video Interaction Guidance for Families of Children With an Intellectual Disability Referred to Specialist Mental Health Services: Protocol for a Feasibility Randomized Controlled Trial.

Children with an intellectual disability (ID) are 3-4 times more likely to present with behaviors that challenge and mental health problems than typically developing children. Parenting and the quality of parent-child relationships are risk factors for these families. The COVID-19 pandemic further exacerbated difficulties, leading to an increase in child mental health problems and behaviors that challenge, a deterioration in parental mental health, and further strain on family relationships. Remote family interventions could be an effective solution for both families and specialist mental health services. Video interaction guidance (VIG) has shown promise for improving child mental health. However, it is unclear whether it is widely acceptable to families and feasible to implement across specialist child mental health services. This randomized controlled trial aims to evaluate the feasibility of delivering VIG as a remote intervention for parents of children aged 6-12 years with ID who have been referred to specialist mental health services. The study will be undertaken across 5-7 National Health Service specialist mental health services in England, involving 50 participants randomly allocated on a 1:1 basis to either the intervention group (receiving remote VIG) or the treatment-as-usual (TAU) group. The intervention group will engage in 3-5 cycles of VIG delivered remotely over 12 weeks. The primary feasibility outcomes include the recruitment rate, retention at 6-month follow-up, and VIG cycle completion rate. The secondary outcomes will assess the acceptability of VIG and the feasibility of remote implementation, including fidelity to the intervention protocol. Data will be gathered through online surveys and telephone interviews at baseline, 3 months, and 6 months. Feasibility outcomes will be summarized using descriptive statistics, while thematic analysis will be applied to qualitative data from semistructured interviews with participants, VIG practitioners, and service managers. An embedded process evaluation will explore barriers and facilitators to engagement with VIG, and a parallel health economics evaluation will assess the feasibility of capturing service use data and intervention costs. The trial was open to recruitment between December 2022 and March 2024. The first results should be available in 2025. The study is the first randomized evaluation of VIG as offered to parents of children with ID who have been referred to specialist mental health settings. The outcomes from this feasibility trial will inform the decision to proceed with a definitive trial, using a traffic light system to evaluate recruitment, retention, and VIG completion rates alongside qualitative insights and economic evaluations. ISRCTN Registry ISRCTN13171328; http://www.isrctn.com/ISRCTN13171328. DERR1-10.2196/54619.

Revolutionizing Healthcare with Intelligent Remote Health Monitoring

Revolutionizing healthcare through intelligent remote health monitoring involves leveraging advanced technologies such as artificial intelligence, wearable devices, and IoT to provide continuous and real-time monitoring of patient's health conditions. This approach enables proactive healthcare management by collecting and analyzing vital health data remotely, facilitating Prompt identification of possible wellness issues, and reducing the need for frequent hospital visits. It promotes personalized healthcare, improves patient outcomes, and enhances the efficiency of healthcare systems by allowing healthcare providers to make data-driven decisions. This transformation in healthcare delivery ensures better access to care, particularly for individuals in remote or underserved areas, while also addressing the growing demand for healthcare services globally. Revolutionizing healthcare through intelligent remote health monitoring involves leveraging Cutting-edge innovations like synthetic intelligence, wearable devices, and the Internet of Things (IoT) to provide continuous and real-time monitoring of patient's health conditions. This approach enables proactive healthcare management by collecting and analyzing vital health data remotely, facilitating Prompt identification of emerging health issues, and reducing the need for frequent hospital visits. The integrationof machine learning algorithms allows for predictive analytics, which can anticipate health deteriorations and recommend timely interventions. It promotes personalized healthcare by tailoring treatments to individual needs, improves patient outcomes through constant monitoring and timely responses, and enhances healthcare systems by allowing healthcare providers to make data-driven decision.

Quality of cognitive-behavioural therapy in routine psychiatric care: therapist adherence and competence, and patient outcomes for depression and anxiety disorders

BackgroundQuality of care is essential for the dissemination of evidence-based practices, yet therapist adherence and competence are seldom assessed. We examined the quality of delivery of cognitive-behavioural therapy (CBT) in routine psychiatric care for depression and anxiety disorders, considering therapist adherence and competence, and therapy effectiveness, as well as their associations.MethodsTwenty-nine therapists recruited 85 patients with a principal diagnosis of depression or anxiety disorder from two routine psychiatric outpatient clinics in Stockholm, Sweden. Therapist adherence was assessed mid-CBT by observers and post-CBT by patients and therapists, respectively, using an instrument developed as part of the present study. Therapist competence was assessed using role-plays with a standardised patient. Patients rated symptoms, functional impairment, and global health pre- and post-CBT. Linear mixed models were used to analyse associations.ResultsTherapist adherence was high according to patients, moderate to high according to therapists, and moderate according to observers. Most therapists demonstrated competence in CBT, as assessed using the Cognitive Therapy Scale-Revised (M = 40.5, SD = 6.5; 76% passed the ≥ 36 points competence threshold). Patients improved significantly from pre- to post-CBT across outcome measures (Cohen’s ds = 0.80 – 1.36). Neither therapist adherence nor competence was associated with patient outcomes.ConclusionsIn routine psychiatric care, therapists delivered CBT with adherence, competence, and improvements for patients with depression and anxiety disorders, on par with previous research results in controlled settings. The implications for quality assessment and improvement are discussed.Trial registrationClinicalTrials.gov NCT03625024 10/08/2018.

Circulating and hepatic levels of growth differentiation factor 15 in patients with metabolic dysfunction‐associated steatotic liver disease

AbstractAimIncreased growth differentiation factor 15 (GDF15) may reflect impaired metabolic health and an inflammatory state in metabolic dysfunction‐associated steatotic liver disease (MASLD). We investigated the role of GDF15 in histologically verified MASLD in a meal test (discovery) cohort (n = 20) and a prospective (validation) cohort with 2 years of follow‐up (n = 276).MethodsParticipants were evaluated clinically and histologically in both cohorts. Fibrosis severity was classified as no/mild (F0/F1) or significant (F2–4). Plasma GDF15 was measured by enzyme‐linked immunosorbent assays and the SOMAScan platform. Hepatic GDF15 mRNA expression was analyzed by RNA in situ hybridization and bulk RNA‐sequencing. In addition, we used data from public single‐nucleus RNA‐sequencing datasets.ResultsIn both cohorts, plasma GDF15 was increased in MASLD compared with healthy controls (p &lt; 0.0001) with the highest levels in patients with significant fibrosis (area under the curve 0.83; 95% confidence interval [CI], 0.76–0.91). The GDF15 levels were unaffected by a standardized meal and there was no difference in peripheral or hepatic venous concentrations. After 2 years, the increase in GDF15 levels was reduced in patients treated with glucagon‐like peptide receptor agonists (GLP‐1‐RA) compared to patients receiving lifestyle advice (−28%; 95% CI, −44 to −8; p = 0.01). Plasma GDF15 was associated with circulating insulin‐like growth factor 1 and related proteins. Hepatic GDF15 mRNA was mainly expressed in hepatocytes and in cholangiocytes in fibrotic areas and was increased in MASLD (p = 0.02) with the highest expression in the group with steatohepatitis (p = 0.009).ConclusionsIncreased hepatic and circulating GDF15 are found in MASLD. Treatment with GLP‐1‐RA may reduce GDF15, possibly reflecting beneficial metabolic and inflammatory effects.

Research progress on influencing factors and intervention measures of pre-hospital delays in acute ischemic stroke

Background Stroke, a leading cause of health impairment globally, sees intravenous thrombolysis as the primary treatment during the acute phase, yet delays persist due to pre-hospital and in-hospital factors. While research has reduced in-hospital delays significantly, pre-hospital delays remain a concern both domestically and internationally. Objective This article aims to provide a comprehensive review of the research progress on the influencing factors and intervention measures of pre-hospital delays in acute ischemic stroke. Methods By analyzing the literature, summarize the risk factors leading to treatment delay in acute ischemic stroke (AIS), and provide a review of potential improvement methods. Results Pre-hospital delay in acute ischemic stroke (AIS) is influenced by both objective factors like age, gender, and regional economic status, as well as subjective factors such as stroke awareness. The introduction of “Stroke 120,” a stroke education slogan tailored to Chinese language habits, aims to improve stroke awareness and address delayed treatment and low AIS venous thrombolysis utilization among the Chinese public Conclusion In conclusion, collaborative efforts from the government, society, and hospitals are essential to enhance stroke education comprehensively. This will ensure widespread awareness of stroke knowledge, facilitating timely and effective treatment for AIS patients.

Respiratory Benefits of Multisetting Air Purification in Children

Particulate matter exposure has been linked to impaired respiratory health in children, but the respiratory benefits of air purification have not been fully elucidated. To assess the respiratory health outcomes among children exposed to multisetting air purification vs sham purification. This cluster randomized, double-blind, crossover trial was conducted among healthy school-aged children (10-12 years) in China from April to December 2021. Data were analyzed from December 2021 to July 2024. A multisetting (both in classrooms and bedrooms) air purification intervention compared with sham purification in a 2-stage intervention with more than 2 months (76 days) for each period and a washout period (88 days) to estimate the respiratory benefits of air purification. The primary outcomes were pulmonary function, airway inflammation markers, and metabolites in exhaled breath condensate (EBC) before and after the air purification intervention. Linear mixed-effects models were used to estimate the respiratory benefits of children related to air purification. Differential metabolites in EBC were identified using metabolomics analysis to explore their possible mediation roles. A total of 79 children (38 male [48%]; mean [SD] age, 10.3 [0.5] years) were included in the statistical analyses. During the study period, the mean (SD) concentration of outdoor fine particulate matter (PM2.5) at the school site was 32.53 (24.06) μg/m3. The time-weighted personal PM2.5 concentration decreased by 45.14% during the true air purification period (mean [SD], 21.49 [8.72] μg/m3) compared with the sham air purification period (mean [SD], 39.17 [14.25] μg/m3). Air purification improved forced expiratory volume in 1 second by 8.04% (95% CI, 2.15%-13.93%), peak expiratory flow by 16.52% (95% CI, 2.76%-30.28%), forced vital capacity (FVC) by 5.73% (95% CI, 0.48%-10.98%), forced expiratory flow at 25% to 75% of FVC by 17.22% (95% CI, 3.78%-30.67%), maximal expiratory flow at 75% of FVC by 14.60% (95% CI, 0.35%-28.85%), maximal expiratory flow at 50% of FVC by 17.86% (95% CI, 3.65%-32.06%), and maximal expiratory flow at 25% of FVC by 18.22% (95% CI, 1.73%-34.70%). Fractional exhaled nitric oxide in the true air purification group decreased by 22.38% (95% CI, 2.27%-42.48%). Several metabolites in EBC (eg, L-tyrosine and β-alanine) were identified to mediate the effect of air purification on respiratory health. This randomized clinical trial provides robust and holistic evidence that indoor air purification notably improved pulmonary health in children, highlighting the importance of intensified indoor air purification in regions with high air pollution levels. ClinicalTrials.gov Identifier: NCT04835337.

Establishing a telemedical supported trans-sectoral collaboration network from community support to emergency care for outpatient care recipients: study protocol of a prospective non-randomized complex intervention study with a pragmatic approach, Stay@Home – Treat@Home

BackgroundDemographic changes in Germany are increasing the number of outpatient care recipients, who often resort to emergency care due to difficulties accessing timely outpatient medical care. Previous studies suggest that early detection and telemedical interventions could reduce unnecessary hospitalizations. The new form of healthcare aims to provide continuous, flexible healthcare for outpatient care recipients using digital technologies to detect health deteriorations and facilitate interventions at home. The goal of our study is to evaluate, whether the number of emergency situations and hospital stays will be reduced, and health outcomes will be improved compared to standard care.MethodsIn this prospective non-randomized complex intervention study with a pragmatic approach, we aim to evaluate a new form of healthcare focused on establishing an interdisciplinary network for outpatient care in the homes of care-dependent individuals. Utilizing a digital interactive health diary, health data will be gathered from participants, caregivers, and healthcare providers, covering both stable primary care and acute situations. A telemedical network will coordinate measures, including non-medical aid, nursing care, and medical assistance. A total of 1,500 participants will be recruited for the intervention group, matched with a control group from health insurance data. A second control group with n=300 will provide self-reported measures. The study is planned to span eight quarters, with data collected from the digital interactive health diary and health insurance records. Evaluation perspectives include health insurance, patients, and healthcare providers, assessing utilization and costs compared to standard care, health status, health-related quality of life, care dependency, interdisciplinary cooperation, and usability of the new technology.DiscussionDemographic change results in a larger older people population, exacerbating mobility issues and care dependency, worsened by the shortage of medical personnel. Stay@Home – Treat@Home aims to enable home health monitoring and care, reducing hospitalizations. The digital interactive health diary supports direct communication, allows remote monitoring, and empowers patients and caregivers to manage health changes. Nursing aid personnel and physicians can access entries for informed interventions. The development of the digital interactive health diary aims to improve the situation of care-dependent individuals. Evaluating its effectiveness and efficiency is crucial for the development and implementation of new technologies.Trial registrationGerman Clinical Trials Register, ID: DRKS00034260, registered on May 14, 2024 (retrospectively registered): https://drks.de/search/de/trial/DRKS00034260 and https://who.int/clinical-trials-registry-platform/network/who-data-set.

Совершенствование организационных и лечебно-профилактических мероприятий, направленных на профилактику избыточной массой тела и ожирения.

Relevance. Obesity is a serious public health problem due to its high prevalence, increasing treatment costs and adverse effects. In this regard, the development of preventive measures aimed at preventing the formation and progression of obesity based on modern information and digital technologies seems to be an urgent and extremely important task. Research objective: development of a system for early diagnosis of overweight and obesity with the identification of predictors of their formation to prevent the progression of the pathological process and effective prevention of its occurrence. Materials and methods. To assess the prevalence of overweight and obesity, an analysis of the data of the reporting forms of federal statistical observation № 30 «Information about the medical organization» and № 12 «Information on the number of diseases registered in patients living in the service area of the medical organization» for the period 2012–2023 was carried out. To assess the economic component, we used the data from reports on the summary of expenses at the expense of budget funds, funds received from the provision of paid services. The study used the following methods: analytical, statistical, comparative analysis and content analysis. Statistical processing of materials was carried out using calculation tables in Excel format. Results. The article presents data on the relevance and prevalence of overweight and obesity in the adult group, including the workingage population. The risks of human health impairment with possible disability and mortality due to overweight and obesity are analyzed. Socioeconomic factors leading to obesity are considered. The economic consequences of this problem, as well as unresolved problems of obesity prevention are noted. Priority areas of comprehensive prevention programs are identified and prognostic models for the development of overweight and obesity are developed, taking into account the identified individual medical and social risk factors. The results of the study will allow personalizing preventive measures aimed at preventing obesity and its complications.

КОНЦЕПТУАЛІЗАЦІЯ ПОНЯТТЯ ПРОФЕСІЙНОГО ВИГОРАННЯ У НАУКОВІЙ ЛІТЕРАТУРІ

Purpose. The article reveals the concept of professional burnout in the scientific literature. Methods. To achieve the goal, the following methods of scientific and theoretical study of the problem were used in the study: analysis, synthesis, comparison, generalization, abstraction, systematization of scientific research on the issues of professional burnout. Results. According to the results, it was found that Professional activity occupies one of the key positions in human life, as it becomes not only a means of meeting material needs, but also an important factor for self-realization and self-expression of the individual. In the modern world, with its high dynamism and rapid changes in the socio-economic environment, employees are faced with growing competition in the labor market, continuous changes in the organizational environment and a large amount of work. The outlined trends create conditions for the emergence of professional burnout syndrome, which generates destructive consequences for both the individual and the organization as a whole, determining a decrease in labor productivity, loss of qualified personnel and deterioration of the working climate. Emotional exhaustion is the first reaction to excessive workload and professional stress, which manifests itself in a feeling of constant general fatigue, lack of energy, and a decrease in the level of enthusiasm. Loss of interest in professional tasks is accompanied by the emergence of beliefs about the lack of meaning in their implementation. Negative emotional states such as depression, irritability, depression, impulsivity are often combined with somatic manifestations, for example, sleep disorders, gastrointestinal disorders, headaches, etc. Conclusions. Burnout syndrome is a profound transformation of the personality, which is a consequence of experiencing chronic stress in the process of work and has a destructive effect on the emotional state of the employee, his relationships with the social environment and self-perception in the professional sphere. Burnout has negative consequences for both the individual employee and the organization. A person experiences the negative consequences of this condition in the form of deterioration of physical and mental health. Such disintegration of the personality “distorts” his further life and career prospects. In turn, employees with burnout syndrome do not properly perform their job duties, often make mistakes and make minimal efforts to achieve organizational goals, which leads to a number of negative consequences for the functioning of the institution in which such a specialist works.

Health effects of a glyphosate-based herbicide on Elliptio complanata: multi-biomarker approach

The active ingredient (a.i.) glyphosate is frequently detected in waterways at relatively high concentrations, posing a risk to aquatic organisms including freshwater mussels, North America's most endangered animal group. This research aims to evaluate for the first time the effect of a glyphosate-based herbicide on a freshwater mussel (Unionid) using a battery of biomarkers. The mussel Elliptio complanata was exposed for 21 days to Credit® Xtreme (at 0, 50, 100, and 150 µg/L a.i. of glyphosate). An integrated biomarker response (IBRv2) was used to visualize the overall impact of each glyphosate-based herbicide concentration on mussels’ health conditions. The biomarker results showed that glyphosate (used at 100 µg/L and 150 µg/L) induced lipid peroxidation in the gills and digestive gland and inhibited acetylcholinesterase in the foot and gills, indicating oxidative damage and neurotoxicity. Other biomarkers were influenced at the lowest concentration of glyphosate tested (50 µg/L): lipids (decrease), triglycerides (increase) and, to a lesser extent, vitellogenin (decrease). For the latter biomarkers, the sexes were not affected similarly, and they were only sensitive at 50 µg/L, only females showed a trend toward a decrease for vitellogenin and a decrease for lipids. Using IBRv2, we found a clear discrimination between concentrations, and the index values increased with glyphosate concentration, attesting to the deterioration in biomarker-defined mussel health when exposed to Credit® Xtreme at realistic glyphosate concentrations in agricultural rivers. This study shows that glyphosate-based herbicides can alter neurological function, induce oxidative damage, and selectively modify the E. complanata metabolism at relatively low concentrations.

Organization of occupational health in France

Inter-company services, and autonomous services in larger companies, aim to avoid any deterioration in workers' health, by preventing and assessing risks, advising employers and workers, and monitoring and analyzing working conditions. This is made possible by a multi-disciplinary team working in the field and providing regular support to each individual.

Primary components of MCT ketogenic diet are detrimental to bone loss associated with accelerated aging and age-related neurotoxicity in mice.

Medium chained triglycerides (MCT) ketogenic diet is being extensively investigated for its neuroprotective effects against adverse effects associated with aging and neurodegenerative disorders. Aging is a common risk factor for the development of both osteoporosis and neurological disorders. Hence, suppression of aging and age-related neurodegeneration might contribute to delaying skeletal aging. The present study was designed to investigate the effects of the primary components of the MCT diet, against bone resorption associated with D-gal-induced accelerated aging and D-gal /AlCl3-induced age-related toxicity. We report bone loss in accelerated aged mice and age-related neurotoxic mice through declined Sirtuin1 (SIRT1) expression, depleted bone turnover markers, (P1NP and β-CTX-1), low bone mineral density (BMD), and deterioration of trabecular bone microarchitecture in both the distal femur and proximal tibia bones. Administration of MCT dietary components decanoic acid and octanoic acid, led to a decrease in body weight and only octanoic acid increased serum levels of ketone body, β-hydroxybutyrate (β-HB), but both of them failed to reverse the diminishing effects on bone health associated with aging and age-related neurotoxicity. Surprisingly, decanoic acid, octanoic acid, and their combination also exhibited negative effects on trabecular bone microarchitecture and BMD in the distal femur and proximal tibia bones of healthy mice. The findings from this study provide supporting evidence on the deterioration of bone health associated with aging and age-related neurotoxicity, and the bone resorption potential of MCT dietary supplements that are being prescribed in healthy older populations and elderly persons diagnosed with neurological disorders.

Lipoprotein (a) in the Full Spectrum of MASLD; Evidence from Histologically and Genetically Characterized Cohorts.

Lipoprotein(a) (Lp(a)) is an emerging biomarker for cardiometabolic factors. We studied the role of Lp(a) in the full spectrum of metabolic dysfunction-associated steatotic liver disease (MASLD). Three independent analyses were implemented using a multi-center, cross-sectional, liver biopsy-based study (n=332) (Study 1) and the UK Biobank prospective study (n=270,004) (Study 2, median follow-up=12.47 years). In Study 1, we studied the cross-sectional association between Lp(a) mass and MASLD stages (Analysis A). In Study 2, we studied the prospective association between Lp(a) concentration and MASLD, liver cirrhosis, and hepatocellular carcinoma (HCC) (Analysis B). Finally, these analyses were accompanied by a prospective analysis using LPA Genetic Risk Score (GRS) (Analysis C). In Study 1, an inverse association between Lp(a) and at-risk metabolic dysfunction-associated steatohepatitis (MASH) (Odds Ratio (OR)per 1-SD increase= 0.64, 95% Confidence Interval (95%CI) (0.42, 0.97)) was observed. In contrast, when similar associations were examined prospectively (Study 2), subjects with Lp(a)<10.75 nmol/L had a higher risk for cirrhosis [Hazard Ratio (HR)=1.49, 95%CI(1.22, 1.81)] and HCC [HR=1.69, 95%CI(1.12, 2.56)], compared to subjects with Lp(a) within the 10.75-21.5 nmol/L range. Above these levels, the risk increased significantly and positively. Similarly, genetic analysis showed an L-shaped association with LPA GRS. The inverse association observed in cross-sectional studies should be attributed to reverse causality i.e. the presence of liver disease may decrease Lp(a) levels. Genetically predicted very low Lp(a) levels are also associated with impaired liver health prospectively. Clinical trials evaluating Lp(a)-lowering agents should thus be monitored carefully for adverse liver effects in subjects attaining extremely low concentrations.

The effects of European mistletoe (Viscum album L.) on urban tree health

Background. Urban forests play a crucial role in making the urban environment and provide for sustainable development of urban areas. At the same time, urban habitats are stressful for trees therefore the latter become more susceptive to a range of disturbances, in particular to biotic agents such as the European mistletoe. The paper aims to evaluate the detrimental impacts of this hemiparasitic plant on urban trees. Materials and Methods. The study was conducted in an urban watershed of central and northwestern parts of the city of Kharkiv, Ukraine. Urban tree health survey took place in different stand types along 4 transects of the total length of 6.54 km. Totally, 956 individual trees were surveyed during the vegetation season of 2019. The health status of individual trees was assessed applying the 7-grade scale after O. D. Maslov, modified by the Ukrainian Forestry Research Institute. The mistletoe presence on individual trees was quantified using a semi-logarithmic index. The statistical analysis of the data collected involved the comparison of two empirical distributions, the normality test of the initial data, and the determination of the relationship between two independent samples. Results and Discussion. The analysis of the collected data revealed that the studied trees divided into two groups – “non-infested” and “mistletoe-infested” – grew in quite similar conditions and showed quite similar distribution by stand types, classes of soil conditions and age classes. We found differences in the mean health status between non-infested (transient from “weakened” to “dry-top”), and mistletoe-infested trees (“dry-top”): the tree health index of 2.43±0.03 for the former vs. 2.98±0.08 for the latter. Empirical distributions of the number of trees by the tree health classes in both groups were different too (the Kolmogorov–Smirnov criterion λ = 3.14 at Р &gt;0.999). We found a significant positive correlation between both mistletoe abundance and the age of individual infested trees (Spearman’s R = 0.36 at Р &gt;0.999), as well as the health index of individual infested trees (Spearman’s R = 0.23 at Р &gt;0.95). Conclusions. The study has proven a negative effect of mistletoe’s infestation on the tree crown foliage assessed with the tree health index. Such an effect increases with the age of infested trees. The findings of this study suggest that in urban forests the mistletoe acts as a trigger towards acceleration of tree stand health deterioration.