Elevated Stress Levels Research Articles

A scoping review on heat indices used to measure the effects of heat on maternal and perinatal health

A previous systematic review has shown associations between exposure to high temperatures and negative birth outcomes. To date, a scoping review for heat indices and their use to measure effects...

What Do Farmers Need for Suicide Prevention: Considerations for a Hard-to-Reach Population.

Farmers have suicide rates much higher than the general population, with elevated mental health symptoms and high stress levels. Farmers are a hard-to-reach population due to occupational demands and a culture where conversations about mental health are often stigmatizing. This study explored ways to tailor suicide prevention strategies to unique characteristics of farmers by speaking with groups close to farmers who were open to discussing stress and suicide prevention: women married to farmers and agricultural Extension agents. Focus groups with women married to farmers (N=29) and interviews with agricultural agents from the university's local Cooperative Extension offices (N=13) from rural Georgia counties explored effective ways outreach and education about suicide prevention, mental health, and coping could be provided to farmers. Using a thematic analysis approach, qualitative coding was completed by two researchers (Cohens kappa=0.86), with initial codes collapsed into common themes. Four themes were identified: 1) Barriers due to the nature of farming, including time demands of farming and cultural stigma in help-seeking; 2) Acceptable messaging, including framing conversations as part of general health; 3) Make information accessible by making it brief, clear, and omnipresent through multiple media; and 4) Elements of effective information and education, including emphasizing "you're not alone" and connection, how to access supports and crisis services, educating people close to farmers, and motivating farmers by emphasizing that they could help another farmer with the information. Due to farmers' stoic identities and reluctance to admit mental health struggles, speaking with those close to farmers may help us better understand what is needed to tailor farmer suicide prevention strategies. The insights shared by participants suggest that culturally responsive outreach and education strategies, strengthening relationships through peer support, and gatekeeper training with specific trusted others are important ways to tailor suicide prevention strategies for this hard-to-reach group.

Magnesium promotes vascularization and osseointegration in diabetic states

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues. Magnesium has been proved to promote bone healing under normal conditions. Here, we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status. We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised, with significantly decreased angiogenesis. We then developed Mg-coating implants with hydrothermal synthesis. These implants successfully improved the vascularization and osseointegration in diabetic status. Mechanically, Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1 (Keap1) and the nucleation of nuclear factor erythroid 2-related factor 2 (Nrf2) by up-regulating the expression of sestrin 2 (SESN2) in endothelial cells, thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia. Altogether, our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.

Lonely and scrolling during the COVID-19 pandemic: understanding the problematic social media use and mental health link among university students.

Undergraduate university students experienced many academic and non-academic stressors during the first year of the coronavirus (COVID-19) pandemic, putting them at a greater risk of negative mental health outcomes. Reports worldwide have shown high incidences of depressive, anxiety, and stress scores among university students at the beginning of the pandemic. Emerging evidence also suggests that to cope with the stress and loneliness of the pandemic, many youth and young adults increased the amount of time they spent on social media platforms. Undergraduate students participated in an online study aimed to understand the link between time spent on social media, coping through the use of social media and problematic social media use (PSMU) with mental health symptoms, such as stress, depression, anxiety, and loneliness, during the COVID-19 pandemic. While time spent on social media was only weakly associated with stress, depression, anxiety and loneliness scores, PSMU more strongly mapped onto these outcomes. Additionally, students who were coping highly using social media displayed elevated stress, depression, anxiety and loneliness levels in comparison to those reporting low levels of coping with social media. Finally, students who reported high levels of coping using social media displayed higher PSMU scores, with this relationship appearing more pronounced in students who had higher levels of loneliness. These data support evidence that it is not necessarily time spent on social media but rather PSMU that is relevant for mental health symptoms, and that PSMU is exacerbated by loneliness. Moreover, the current results highlight the effects of maladaptive coping on mental health symptoms and PSMU among university students during the COVID-19 pandemic.

Spiritual Intelligence in Education Exploring the Impact of Teachers' Spiritual Intelligence on Student Satisfaction in Higher Education Using Dyad Analysis

The present study investigates the impact of elements associated with teachers on student satisfaction. The study adopts a quantitative approach with a cross-sectional design. A questionnaire-based survey was conducted among teachers and students at the Higher Education Institutes of Karachi, Pakistan. Both on-site and online. A total of 21 HEC-recognized universities having business schools/management sciences departments were contacted and visited in Karachi. The sample design involves collecting data from 344 teacher-student dyads. Non-probability sampling is used due to the lack of a complete subject list. As a result, studying the effect of teachers' spiritual intelligence on student satisfaction can potentially lead to improved learning outcomes and academic performance. Enhancing spiritual intelligence assists individuals in developing a positive mindset and attaining inner tranquility. This shift in attitude enhances self-motivation and self-control and aids in alleviating the elevated stress levels often caused by the fast-paced nature of contemporary society.

COVID-19 pandemic and its impact on medical interns’ mental health of public and private hospitals in Guadalajara

ABSTRACT Introduction Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated stress levels. Addressing this issue is crucial due to its impact on well-being and health-care quality. Materials and methods This cross-sectional survey study assessed fear of COVID-19 and burnout levels among medical student interns in hospitals in Guadalajara, Jalisco. The study used validated scales and collected data from September 2021 to September 2022. A snowball sampling method was employed and a minimum sample size of 198 participants was calculated. Results This study included 311 medical students (62.1% female and 37.9% male with a mean age of 23.51 ± 2.21 years). The majority were in their second semester of internship (60.5%) and from public hospitals (89.1%). Most students believed that the COVID-19 pandemic affected the quality of their internship (82.6%). Female students had higher personal burnout scores, while male students had higher work-related burnout scores. The mean score for fear of COVID-19 was 13.71 ± 6.28, with higher scores among women (p = 0.004) and those from public hospitals (p = 0.009). A positive weak correlation was found between COVID-19 scores and burnout subscales. Conclusion Our study emphasizes the significant impact of various factors on burnout levels among medical students and health-care professionals during the COVID-19 pandemic. Prolonged exposure to COVID-19 patients, reduced staffing, and increased workload contributed to burnout, affecting well-being and quality of care. Targeted interventions and resilience-building strategies are needed to mitigate burnout and promote well-being in health-care settings.

Multifaceted response mechanisms of Oryza sativa L. 'KDML105' to high arsenite and arsenate stress levels.

Toxicity resulting from high levels of inorganic arsenic (iAs), specifically arsenite (AsIII) and arsenate (AsV), significantly induces oxidative stress and inhibits the growth of rice plants in various ways. Despite its economic importance and significance as a potent elite trait donor in rice breeding programmes, Khao Dawk Mali 105 (KDML105) has received limited attention regarding its responses to As stress. Therefore, this study aimed to comprehensively investigate how KDML105 responds to elevated AsIII and AsV stress levels. In this study, the growth, physiology, biochemical attributes and levels of As stress-associated transcripts were analysed in 45-day-old rice plants after exposing them to media containing 0, 75, 150, 300 and 600µM AsIII or AsV for 1 and 7days, respectively. The results revealed that AsIII had a more pronounced impact on the growth and physiological responses of KDML105 compared to AsV at equivalent concentrations. Under elevated AsIII treatment, there was a reduction in growth and photosynthetic efficiency, accompanied by increased levels of hydrogen peroxide (H2O2) and malondialdehyde (MDA). Notably, the total contents of antioxidants, such as proline, phenolics and flavonoids in the shoot, increased by 8.1-fold, 1.4-fold and 1.6-fold, respectively. Additionally, the expression of the OsABCC1 gene in the roots increased by 9.5-fold after exposure to 150µM AsIII for 1day. These findings suggest that KDML105's prominent responses to As stress involve sequestering AsIII in vacuoles through the up-regulation of the OsABCC1 gene in the roots, along with detoxifying excessive stress in the leaves through proline accumulation. These responses could serve as valuable traits for selecting As-tolerant rice varieties.

Examining External and Internal Acculturative Factors: Cuban-Born Women’s Experience of Well-Being in the U.S.

Objective: This study investigates the influence of acculturative stress on the mental well-being of Cuban-born women and Latina immigrants, emphasizing their distinctive experiences. Methods: Utilizing data from the National Latino Asian American Study (NLAAS), a comprehensive nationwide mental health investigation among Latino and Asian Americans, this study examined 264 Cuban women (average age: 58) who migrated to the United States and live in south Florida. The study employed Family Stress Management (FSM) framework and Bekteshi et al.’s Contextual Influence on Acculturative Stress (CIAS) framework to scrutinize the interplay of contextual factors and individual characteristics impacting adolescents’ psychological distress. Results: The findings revealed several noteworthy associations. Higher levels of church attendance, challenges in visiting family overseas, and perceived racial discrimination correlated with elevated stress levels. Furthermore, the age at which individuals immigrated was positively linked to increased stress (b = 0.18; p = 0.04), indicating that older Cuban immigrants experienced greater psychological distress upon their arrival in the United States. Additionally, higher levels of conflict between family and cultural values, as well as intensified religious beliefs, were associated with elevated distress levels. Conclusion: This study underscores the intricate interplay of diverse contextual factors in shaping the mental health and well-being of Cuban-born women. The insights derived from this research have implications for the development of tailored interventions and support systems, aiming to address the unique needs of this population.

Tectonic Duets: Self-Similar Approach to Investigate Eastern Anatolian Fault’s Recent Seismicity, with Special Emphasis on the 6 February 2023 Earthquake Doublet

Abstract Earthquake clusters possess profound potential for discerning antecedent seismic cues. This study examines the self-similarity of earthquakes to characterize recent seismic patterns in the prolonged quiescent Eastern Anatolian fault zone (EAFZ). We thoroughly investigate the correlation fractal dimension (Dc) formulated upon the scale-invariant relative clustering in earthquake pattern identification. We provide a comprehensive examination of pre- and postseismicity patterns of the Mw 7.7 Nurdağı-Pazarcık, Mw 7.6 Ekinözü, and Mw 6.7 Elazığ earthquakes, each shattering different segments of the EAFZ. The spatiotemporal fluctuations of Dc suggest the commencement of the preparatory process observed around October 2021 to February 2022 for the 2023 dual catastrophe, whereas in the case of the Mw 6.7 Elazığ, this was witnessed from November 2018. Prior to the 2023 events, low-moderate Dc regions predominated on the Pazarcık segment and Cardak fault. The Pürtürge segment that ruptured with an Mw 6.7 event was within a low Dc area. We identified a consistent relationship between stress levels and Dc for the 2023 twin events and the Mw 6.7 earthquake, with low Dc indicative of high stress. Intriguingly, mainshocks and a substantial proportion of their aftershocks have occurred within areas characterized by low to moderate Dc. Various fault zones like Malatya, Amanos, and Adiyaman are situated in areas with low Dc. The southwestern area of the Amanos segment exhibits clustering, elevated stress levels, and low Dc, followed by the Mw 7.7. Therefore, it is imperative to maintain vigilant monitoring of this region to prevent another disaster.

Work-Life Balance and Service Delivery

Purpose: Police officers in Kenya face a wide array of stressors in the line of duty, including exposure to high levels of crime, violence, and the ever-present threat of traumatic incidents. Inadequate resources, long working hours, and the burden of meeting performance targets further contribute to elevated stress levels among officers. This study aimed to determine the effect of Work-Life Balance on service delivery at National Police Service in Nairobi City County, Kenya. The study was grounded based on Servqual model.
 Methodology: The study adopted desk review of empirical literature. Target population was National police officers working in Nairobi City County. The findings were derived from reviewed empirical literature.
 Results: The findings show that Work-Life Balance impacted the service delivery. The inspector general of police should work closely with inspectors for regularly assess the workload.
 Unique contribution to theory, practice and policy: The inspectors should conduct regular assessments of workload and staffing levels to ensure they are balanced and manageable.

A comprehensive case study on vitiligo: Navigating challenges and treatment strategies

This in-depth case study examines the complex terrain of vitiligo and the difficulties that thirty-year-old Mrs. A. must overcome. The storey is told via a thorough analysis of her clinical appearance, which includes the emergence of distinct, symmetrical white spots on several body regions. Given Mrs. A's medical history of general health and her elevated stress levels prior to the depigmentation, the diagnostic procedure is carefully broken down, including physical examinations, medical history evaluations, and pertinent laboratory testing. Examining the epidemiology of vitiligo, the study clarifies its worldwide frequency, age at start, genetic predispositions, autoimmune correlations, and subtle effects on people from various ethnic origins. This case study stands out for its examination of the discrepancy between traditional textbook representations and the dynamic, Mrs. A's emotional and psychological reactions to vitiligo require individualised care. A multidisciplinary approach guides the development of treatment strategies that include photo therapy, topical corticosteroids, and specialised psychological support. The storey ends with a discussion of the follow-up procedure, an assessment of the effectiveness of the treatment, emotional healing, and the continued difficulties of long-term care. This case study provides insightful information about the comprehensive care of vitiligo sufferers, highlighting the significance of customised, team-based approaches in addressing the complex aspects of this skin disease.

Unleashing the power of teacher’s wellbeing and selfcare

Teachers’ personal and professional life depends heavily on their health and self-care. This article examines the value of teacher wellbeing and self-care, educators’ difficulties, and the possible advantages of putting their physical, mental, and emotional health first. The many challenges teachers face can have an impact on their wellness. Teachers frequently struggle to maintain a healthy work-life balance because of the hard job, long hours, and time limits. Additionally, the emotional demands of the job, such as handling difficult circumstances or managing student behavior problems, might result in elevated stress levels. These issues are made more difficult by scarce resources, a lack of support networks, and a culture that puts teacher wellbeing last. Schools and higher tertiary institutions may establish a happy and encouraging environment that improves overall student results by recognizing and addressing the wellbeing of instructors. This paper will encourage teachers to release the power of self-care and prioritize their wellbeing. This research paper focused on the benefits of teachers’ wellbeing and self-care, the common challenges teachers face, and strategies for promoting teachers’ wellbeing and self-care. A qualitative secondary data research approach was used in data collection, which uncovered numerous elements that significantly impact teachers’ wellbeing.

The ORFIUS complex regulates ORC2 localization at replication origins.

High-grade serous ovarian cancer (HGSC) is a lethal malignancy with elevated replication stress (RS) levels and defective RS and RS-associated DNA damage responses. Here we demonstrate that the bromodomain-containing protein BRD1 is a RS suppressing protein that forms a replication origin regulatory complex with the histone acetyltransferase HBO1, the BRCA1 tumor suppressor, and BARD1, ORigin FIring Under Stress (ORFIUS). BRD1 and HBO1 promote eventual origin firing by supporting localization of the origin licensing protein ORC2 at origins. In the absence of BRD1 and/or HBO1, both origin firing and nuclei with ORC2 foci are reduced. BRCA1 regulates BRD1, HBO1, and ORC2 localization at replication origins. In the absence of BRCA1, both origin firing and nuclei with BRD1, HBO1, and ORC2 foci are increased. In normal and non-HGSC ovarian cancer cells, the ORFIUS complex responds to ATR and CDC7 origin regulatory signaling and disengages from origins during RS. In BRCA1-mutant and sporadic HGSC cells, BRD1, HBO1, and ORC2 remain associated with replication origins, and unresponsive to RS, DNA damage, or origin regulatory kinase inhibition. ORFIUS complex dysregulation may promote HGSC cell survival by allowing for upregulated origin firing and cell cycle progression despite accumulating DNA damage, and may be a RS target.

Do I want to learn today? Day-to-day variations in adolescents’ academic motivation and effort

In this preregistered study, we examined factors influencing academic motivation among secondary school students (aged 13 – 15) on a day-to-day basis. Using cognitive effort-discounting (Cog-ED) as behavioral manifestation of motivation and self-report for internal motivational state, we utilized a daily diary method (two-week protocol, N = 39, total N = 342 diaries) to explore how these measures relate to daily experiences of need satisfaction (i.e., autonomy, competence, relatedness), social support, invested homework hours, stress and physical (versus online) school attendance both at within- and between-person levels. Employing Bayesian hierarchical modeling, we found that motivation to invest effort in learning (Cog-ED) and self-reported academic motivation were higher on days when students experienced greater competence. In addition self-reported academic motivation was higher on days when students experienced more social support from classmates and teachers, invested more effort in homework and physically attended school, but lower on days when students experienced more stress. Additionally, both motivation to invest effort in learning (Cog-ED) and self-reported academic motivation were higher for those with greater average levels of perceived autonomy and support from parents. Moreover, students who, on average, dedicated more time to homework, reported elevated stress levels, and received greater support from teachers reported higher academic motivation. Conversely, those with greater support from classmates reported lower academic motivation. These findings stress the importance of cultivating feelings of competence, supportive environments and stress reduction on a daily basis, while highlighting the importance of perceived autonomy, adult social support and physical school attendance for academic motivation. Importantly, the current study contributes by assessing motivation both behaviorally and via self-report, and fills a gap by extending trait-level motivation research to the daily-level.

P66ShcA promotes malignant breast cancer phenotypes by alleviating energetic and oxidative stress

Significant efforts have focused on identifying targetable genetic drivers that support the growth of solid tumors and/or increase metastatic ability. During tumor development and progression to metastatic disease, physiological and pharmacological selective pressures influence parallel adaptive strategies within cancer cell sub-populations. Such adaptations allow cancer cells to withstand these stressful microenvironments. This Darwinian model of stress adaptation often prevents durable clinical responses and influences the emergence of aggressive cancers with increased metastatic fitness. However, the mechanisms contributing to such adaptive stress responses are poorly understood. We now demonstrate that the p66ShcA redox protein, itself a ROS inducer, is essential for survival in response to physiological stressors, including anchorage independence and nutrient deprivation, in the context of poor outcome breast cancers. Mechanistically, we show that p66ShcA promotes both glucose and glutamine metabolic reprogramming in breast cancer cells, to increase their capacity to engage catabolic metabolism and support glutathione synthesis. In doing so, chronic p66ShcA exposure contributes to adaptive stress responses, providing breast cancer cells with sufficient ATP and redox balance needed to withstand such transient stressed states. Our studies demonstrate that p66ShcA functionally contributes to the maintenance of aggressive phenotypes and the emergence of metastatic disease by forcing breast tumors to adapt to chronic and moderately elevated levels of oxidative stress.

Combined exposure of PVC-microplastic and mercury chloride (HgCl2) in sorghum (Pennisetum glaucum L.) when its seeds are primed titanium dioxide nanoparticles (TiO2-NPs).

The present work studied the impact of different levels of PVC-microplastics (PVC-MPs), namely 0 (no PVC-MPs), 2, and 4mg L-1, along with mercury (Hg) levels of 0 (no Hg), 10, and 25mgkg-1 in the soil, while concurrently applying titanium dioxide-nanoparticles (TiO2-NPs) at 0 (no TiO2-NPs), 50, and 100µgmL-1 to sorghum (Pennisetum glaucum L.) plants. This study aimed to examine plant growth and biomass, photosynthetic pigments and gas exchange characteristics, oxidative stress indicators, and the response of various antioxidants (enzymatic and non-enzymatic) and their specific gene expression, proline metabolism, the AsA-GSH cycle, and cellular fractionation in the plants. The research outcomes indicated that elevated levels of PVC-MPs and Hg stress in the soil notably reduced plant growth and biomass, photosynthetic pigments, and gas exchange attributes. However, PVC-MPs and Hg stress also induced oxidative stress in the roots and shoots of the plants by increasing malondialdehyde (MDA), hydrogen peroxide (H2O2), and electrolyte leakage (EL) which also induced increased compounds of various enzymatic and non-enzymatic antioxidants and also the gene expression and sugar content. Furthermore, a significant increase in proline metabolism, the AsA-GSH cycle, and the pigmentation of cellular components was observed. Although, the application of TiO2-NPs showed a significant increase in plant growth and biomass, gas exchange characteristics, enzymatic and non-enzymatic compounds, and their gene expression and also decreased oxidative stress. In addition, the application of TiO2-NPs enhanced cellular fractionation and decreased the proline metabolism and AsA-GSH cycle in P. glaucum plants. These results open new insights for sustainable agriculture practices and hold immense promise in addressing the pressing challenges of heavy metal contamination in agricultural soils.

Does school climate affect student well-being? Anxiety in school situations as a predictor of stress in high-school students.

When the school climate is not ideal and coping skills for school situations are not strengthened in adolescents, school anxiety and stress may be manifested, potentially harming development and mental health during adulthood. This study aimed to analyze the predictive ability of school anxiety on elevated levels of stress in high-school students. This cross-sectional predictive study was conducted with 1588 students aged 12-18 (M = 14.82; SD = 1.86) years in 2023. The School Anxiety Inventory (SAI) and the Depression, Anxiety, and Stress Scale (DASS-21) were administered to the participants. An inferential data analysis method was applied. Specifically, binary logistic regression was used for data analysis. The influence of school anxiety on stress was examined using the odds ratio statistic. The total score on school anxiety (OR = 1.02), the situational factors: anxiety about aggression (OR = 1.03), anxiety regarding social evaluation (OR = 1.02), anxiety about failure and school punishment (OR = 1.03), and anxiety about school evaluation (OR = 1.04), as well as the response systems: cognitive (OR = 1.04), behavioral (OR = 1.08), and psychophysiological (OR = 1.04), positively and significantly (P = 0.000) influenced the high scores on stress. The results demonstrate the need to detect school anxiety in adolescents at an early state to intervene in both anxiety-provoking situations and responses and in the resulting high stress. Similarly, schools should promote mental health work and self-regulation to prepare students for adult life.

Electronic cigarettes and their association with stress, depression, and anxiety among dental students in the UAE-a pilot cross sectional study.

During dental school, students may encounter stressful events that contribute to stress, anxiety, and depression; in response to these factors, some students use vaping or electronic cigarettes. To evaluate the relationship between electronic cigarettes use and stress, anxiety, and depression among dental students. A cross-sectional study included 142 dental students in their preclinical, clinical, or internship year was conducted. The 142 participants were split evenly between two groups: smokers and nonsmokers. The average age of the study's male and female participants was 21.6 years. Using the DASS 21 scale, participants were instructed to complete an electronic questionnaire assessing the association between electronic cigarettes use and stress, anxiety, and depression in smokers and nonsmokers. According to the findings of this study, stress, anxiety, and depression were significantly associated with electronic cigarette use. Compared to non-smokers, electronic cigarette smokers reported higher levels of severe/extremely severe depression (OR: 10.34, 95% CI: [4.23-24.1]), anxiety (OR: 13.8, 95% CI: [5.4-30.1]) and stress (OR: 27.6, 95% CI: [8.9-85.8]). Compared to males, females were 2.5 times (95% CI: [1.02-6.1]) more likely to report severe/extremely severe anxiety (P < 0.05). This study demonstrates a significant correlation between the use of electronic cigarettes and elevated levels of stress, anxiety, and depression among dental students in the UAE.

The Impact of Stress on Child Development and Healthcare Interventions for Children with Chronic Illnesses in Albania

This study is of paramount importance for advancing healthcare and improving the quality of life for children with chronic diseases in Albania. Chronic illnesses in children present significant challenges that extend beyond the physical aspects of the disease. These conditions often require continuous medical management and can have substantial emotional and psychological impacts. In Albania, it is estimated that approximately 15-20% of children are affected by chronic illnesses. Among these children, about 30-40% experience high levels of stress, which can significantly impact their overall health and well-being. Understanding the relationship between stress and chronic illnesses is crucial for developing effective healthcare strategies. Stress can exacerbate the symptoms of chronic diseases and contribute to a deterioration in the child’s condition. This study aims to explore the intricate relationship between stress and health interventions, analyzing how stress impacts the health and well-being of children with chronic illnesses. It investigates whether increased stress levels are associated with worsening of the child’s condition and evaluates the effectiveness of various health interventions in mitigating this stress. The methodology of the study includes using surveys to measure stress levels among children and medical monitoring to identify changes in their health status in relation to stress. The hypotheses guiding this research suggest that elevated stress levels may significantly increase symptoms and the risk of worsening chronic conditions. By examining these relationships, the study seeks to confirm the importance of stress management in the healthcare and treatment of children with chronic illnesses. The findings reveal a noticeable link between stress levels and the worsening of chronic illnesses, underscoring the critical need for effective stress management strategies. The results suggest that psychosocial interventions and family support are essential components in reducing stress and improving the quality of life for these children. Practical implications of the study include the development and implementation of targeted interventions designed to address the specific stressors faced by children with chronic conditions, potentially enhancing their overall care and support. However, the study does have limitations. Measuring stress and accounting for other variables that may affect health can be challenging, and these factors may impact the accuracy and comprehensiveness of the findings. Despite these limitations, the study’s insights have significant social implications. A deeper understanding of how stress affects health can contribute to the development of more effective policies and practices, fostering better healthcare environments for children with chronic illnesses. Overall, this study provides valuable new perspectives on the impact of stress on children with chronic conditions and highlights the necessity of effective interventions. By addressing both the physical and psychological aspects of chronic illness management, the study aims to improve the overall quality of life for affected children, reduce healthcare costs, and support their emotional and social well-being. Keywords: Stress, chronic illnesses, children, health interventions, quality of life, healthcare implications

Carnitine in Alleviation of Complications Caused by Acute Valproic Acid Toxicity; an Exprimental Study on Mice.

Hyperammonemia and hepatotoxicity are well-known complications of valproic acid (VPA) poisoning. The objective of this study is to evaluate the potential role of carnitine in mitigating the adverse effects of acute VPA toxicity in mice. 54 male mice (25-30 g) were randomly assigned to one of three categories, including acute, sub-acute, and chronic poisoning. Each category contained 3 groups, each consisting of 6 mice (Group 1: control, Group 2: VPA treated, and Group 3: VPA + carnitine treated). The animals were sacrificed 24 hours after the initial injection, and their blood, liver, and brain samples were compared between groups of each category regarding liver function biomarkers, oxidative stress markers, ammonia level, and liver histopathologic changes using one-way ANOVA followed by Tukey's multiple comparison test. The administration of VPA increased the serum level of aspartate aminotransferase (AST) (p=0.003) and alanine aminotransferase (ALT) (p=0.001), as well as serum, and brain level of ammonia (p=0.0001 for both) in the intervention group. Elevated levels of lipid peroxidation and oxidative stress (p=0.0001 for both) in the liver tissue, decreased liver glutathione (p=0.0001) and ferric ion-reducing antioxidant power (FRAP) (p=0.0001), and histopathologic changes in the form of moderate to severe inflammation were observed. Administration of VPA + carnitine reduced AST (p=0.05) and ALT (p=0.01), increased the FRAP, reduced free oxygen radicals and liver lipid peroxidation (p=0.0001 for all), and decreased tissue damage in the form of moderate inflammation. The administration of carnitine was ineffective in reducing brain or plasma ammonia levels in acute VPA-treated animals (p = 0.0115). Although the administration of carnitine has been suggested as a protective remedy in cases of VPA toxicity, according to the present study, it did not have an antidotal effect and did not prevent encephalopathy or liver injury in acute VPA toxicity.