External Stressors Research Articles

Climate change stands as the new challenge for whale watching and North Pacific gray whales (Eschrichtius robustus) in Bahia Magdalena, Mexico, after their recovery from overexploitation

IntroductionSocial-ecological systems (SES) recognize the intricate relationship between human activities and the environment and advocate for comprehensive approaches to address complex environmental issues. This study investigates the factors influencing whale watching, particularly the gray whale (Eschrichtius robustus) in northern Mexico, after significant recovery following overexploitation. Despite reaching a peak in 2015, the eastern North Pacific gray whales experienced unusual mortality events (UME), the most recent from 2019 to 2023, leading to a population decline and historically low calf production in 2022. This decline is evident in the reduced presence of whales and calves in winter breeding lagoons. Concurrently, whale watching has become a significant tourist attraction in these areas.MethodsOur objective was to develop a mental model of the SES of gray whale watching, integrating ecological and socioeconomic data to identify key variables and interactions that support system resilience. From an ecological perspective, we analyzed the long-term temporal trends of eight years of gray whale counts in the southernmost breeding and nursing lagoons within the Bahía Magdalena–Bahía Almejas Complex, Mexico. Additionally, we incorporated the current discussion in the literature about the potential impact of global climate change on gray whale populations. In the socioeconomic subsystem, we used participatory methods, including interviews, surveys, and workshops with government officials, tourism operators, and visitors. We also added on-site assessments of compliance with welfare regulations to understand tourism dynamics. ResultsOur findings identified as main external stressors the changes in ice levels in feeding areas and sea warming in breeding areas, and as internal stressors the compliance with official regulations and the number of vessels observing whales at the same time. The key socioeconomic factor of the system was tourist satisfaction, influenced by factors such as the quality of the information provided by operators. DiscussionUltimately, our mental model provides a framework for further exploration of relevant interactions and trajectories, offering insights for developing effective management strategies.

Endothelial Reactive Oxygen Species: Key Players in Cardiovascular Health and Disease.

Significance: Endothelial cells (ECs) line the entire vasculature system and serve as both barriers and facilitators of intra- and interorgan communication. Positioned to rapidly sense internal and external stressors, ECs dynamically adjust their functionality. Endothelial dysfunction occurs when the ability of ECs to react to stressors is impaired, which precedes many cardiovascular diseases (CVDs). While EC reactive oxygen species (ROS) have historically been implicated as mediators of endothelial dysfunction, more recent studies highlight the central role of ROS in physiological endothelial signaling. Recent Advances: New evidence has uncovered that EC ROS are fundamental in determining how ECs interact with their environment and respond to stress. EC ROS levels are mediated by external factors such as diet and pathogens, as well as inherent characteristics, including sex and location. Changes in EC ROS impact EC function, leading to changes in metabolism, cell communication, and potentially disrupted signaling in CVDs. Critical Issues: Current endothelial biology concepts integrate the dual nature of ROS, emphasizing the importance of EC ROS in physiological stress adaptation and their contribution to CVDs. Understanding the discrete, localized signaling of EC ROS will be critical in preventing adverse cardiovascular outcomes. Future Directions: Exploring how the EC ROS environment alters EC function and cross-cellular communication is critical. Considering the inherent heterogeneity among EC populations and understanding how EC ROS contribute to this diversity and the role of sexual dimorphism in the EC ROS environment will be fundamental for developing new effective cardiovascular treatment strategies.

Recombinant filaggrin-2 improves skin barrier function and attenuates ultraviolet B (UVB) irradiation-induced epidermal barrier disruption

The integrity of the skin barrier is essential for maintaining skin health, with the stratum corneum and filaggrin 2 (FLG-2) playing a key role. FLG-2 deficiency or mutation has been linked to diseases such as atopic dermatitis, while external stressors such as ultraviolet B (UVB) radiation further damage the epidermal barrier. This study investigated the effects of recombinant filaggrin (rFLG) on skin barrier function and UVB induced epidermal destruction. Cell experiments showed that 10 μg/mL of rFLG could increase the mobility of HaCaT cells from 20 % to 42 %, increase the epithelial resistance (TEER) value by about 2 times, and up-regulate the tight junction associated protein by about 2 times. In mouse models of UVB-induced epidermal barrier destruction, rFLG at concentrations of 0.5, 1, and 2 mg/mL showed effective cell uptake and skin penetration, alleviating erythema, and reducing skin thickness in mice by 1.5–3 times. Among them, 2 mg/mL of rFLG treatment restored the expression of tight junction proteins (LOR, ZO-1, and caspase-14), reduced collagen degradation, and reduced oxidative stress by normalizing serum hydroxyproline and superoxide dismutase levels. In addition, 2 mg/mL of rFLG inhibited UVB-induced upregulation of matrix metalloproteinases (MMP-3 and MMP-9) and reduced pro-inflammatory factors (IL-10, IL-1α, IL-6, and TNF-α) and apoptotic markers (P38, Bax, and Bcl-2) to normal levels. These findings suggested that rFLG effectively enhanced skin barrier integrity and mitigated UVB-induced epidermal barrier destruction, highlighting its potential as a therapeutic agent for diseases associated with skin barrier dysfunction.

Abstract B154: Effect modification of United States residency and length of time in US on the relationship between allostatic load and cancer mortality risk in Hispanic/Latinx Americans: Insights from NHANES (1999-2019)

Abstract Allostatic load (AL) a measure of the cumulative physiological stress occurs when external stressors exceed an individual's ability to adapt, increasing the risk of chronic diseases, including cancer. In the United States (US), Hispanic/Latinx people face acculturation-related stressors like family separation, low socioeconomic status, language barriers, racism, and discrimination, which can elevate AL and cancer risk. This study aims to examine the moderating role of US citizenship status and length of time living in US on the relationship between high allostatic load and risk of cancer mortality among Hispanic/Latinx people. We performed a retrospective analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 among 7,299 Hispanic/Latinx people linked with National Death Index with follow-up through December 31, 2019. We defined high AL as having more than three abnormal measures among the following nine biomarkers: body mass index, C-reactive protein, diastolic blood pressure, glycated hemoglobin, systolic blood pressure, total cholesterol, serum triglycerides, and serum creatinine (above the 75th percentile), or serum albumin (below the 25th percentile). We compared differences in participant characteristics using Rao-Scott Chi-Square tests for weighted survey data. We fit weighted Cox proportional hazards models to estimate hazard ratios and associated 95% confidence intervals of cancer death, stratified by US residence and length of time in US Among 7,299 Hispanic/Latinx people, 2,835 (33.4% weighted) had high AL, and 4,464 (66.6% weighted) had low AL. Hispanic/Latinx people with high AL were more likely to be male, aged 40-59, have a lower level of formal education (52.0% vs. 43.6%, p- value <0.001), and were more often surveyed during the 2007-2010 NHANES period (43.2% vs. 37.2%, p-value <0.001) compared to those with low AL. When considering US residency, participants with high AL were more likely to live in the US longer than 15 years (38.2% vs. 24.8%, p-value <0.001) and be US citizens (65.0% vs. 54.7%, p-value <0.001). Regarding health behaviors, participants with high AL were less likely to have been diagnosed with heart attack and less likely to have any history of smoking. We observed that among Hispanic/Latinx people, those with high AL have a 97% increased risk of dying from any cancer (HR = 1.97, 95% CI = 1.24 - 1.34) when compared to those with low AL. When stratifying by US citizenship status, among Hispanic/Latinx US citizen population those with high AL have a 2.3-times higher risk of cancer death when compared to those with low AL (HR = 2.30, 95% CI = 1.22 - 4.32). Among those who are Hispanic/Latinx non-US citizens, those with high AL have 48% increased risk of cancer death compared to those with low AL, though non-significant (HR = 1.48, 95% CI = 0.64 - 3.43). Our preliminary findings highlight that Hispanic/Latinx people with US citizenship who experience high levels of chronic stress, as measured by AL, have an increased risk of cancer mortality. Citation Format: Jessica Amezcua, Mellisa Lopez-Pentecost, Jessica Y. Islam, Marlo Vernon, Kathleen L. O'Connor, Justin X. Moore. Effect modification of United States residency and length of time in US on the relationship between allostatic load and cancer mortality risk in Hispanic/Latinx Americans: Insights from NHANES (1999-2019) [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B154.

Seasonal fluctuations of heavy metal accumulation and gastrointestinal helminth induce oxidative stress and histological lesions in resident catfish Clarias gariepinus

The exposure of the African catfish (Clarias gariepinus) to various environmental contaminants leads to physiological and histological alterations. Therefore, the study aimed to assess the impact of seasonal variations of ecological contaminants as external stressors and internal stressors via helminth infections on oxidative stress and histopathology in resident C. gariepinus at EL-Salam Canal, Egypt. Seasonal water and sediment samples were collected to assess physicochemical parameters and heavy metals. The length, weight, and sex were recorded for each fish sample. The gastrointestinal tract was dissected from the visceral cavity, and the helminths were extracted and identified using SEM photos based on their morphological characteristics. The parasitic dominance in the gastrointestinal helminths was calculated. The heavy metal concentrations, bioaccumulation (BAF), and biosedimentation (BSF) factors were considered in the muscles and intestine. Specimens of muscles and intestines were removed to determine oxidative status. In addition, pieces of skin, muscles, stomachs, and intestines were subjected to light microscopy to determine the alterations. The calcium, magnesium, and potassium levels were within safe limits. Sulfate levels consistently remained below the maximum permissible thresholds throughout the seasons. Among the heavy metals examined, the highest accumulation was found in the intestinal tissues of C. gariepinus, while muscle tissues showed lower levels. The variability in metal concentrations across water, sediment, muscles, and intestines underscores the different capacities of these environments to accumulate heavy metals. The elevated metal levels in fish tissues raise concerns about potential health risks for humans who consume contaminated fish, highlighting significant bioaccumulation within the food chain. The result indicated that Cu in the sediment samples was associated with parasite abundance. The dual stress from environmental pollutants and parasitic infections exacerbates oxidative stress and causes notable histopathological changes in the tissues of the catfish. These results highlight the intricate interplay between external and internal stressors, emphasizing the need for continuous monitoring and management of aquatic ecosystems to safeguard the health of resident fish populations. It provides insight into how these factors affect fish health.

Interactions of multiple stressors on the Bombay-duck Harpadon nehereus population in a complex estuarine ecosystem

In an era marked by unprecedented anthropogenic change, marine systems are increasingly subjected to interconnected and dynamic external stressors, which profoundly reshape the behavior and resilience of marine ecological components. Nevertheless, despite widespread recognition of the significance of stressor interactions, there persist notable knowledge deficits in quantifying their interactions and the specific biological consequences that result. To bridge this crucial gap, this research detected and examined the causal relationships between five key exogenous stressors in a complex estuarine ecosystem. Furthermore, a Bayesian Hierarchical Spatio-temporal modeling framework was proposed to quantitatively evaluate the distinct, interactive, and globally sensitive effects of multiple stressors on the population dynamics of a crucial fish species: Harpadon nehereus. The results showed that interactions were detected between fisheries pressure (FP), the Pacific Decadal Oscillation index (PDO), runoff volume (RV), and sediment load (SL), with five of these interactions producing significant synergistic effects on H. nehereus biomass. The SL*PDO and RV*PDO interactions had positive synergistic effects, albeit through differing processes. The former interaction amplified the individual effects of each stressor, while the latter reversed the direction of the original impact. Indeed overall, the synergistic effect of multiple stressors was not favorable, with FP in particular posing the greatest threat to H. nehereus population. This threat was more pronounced at high SL or negative PDO phases. Therefore, local management efforts aimed at addressing multiple stressors and protecting resources should consider the findings. Additionally, although the velocity of climate change (VoCC) failed to produce significant interactions, changes in this stressor had the most sensitive impacts on the response of H. nehereus population. This research strives to enhance the dimensionality, generalizability, and flexibility of the quantification framework for marine multi-stressor interactions, aiming to foster broader research collaboration and jointly tackle the intricate pressures facing marine ecosystems.

A qualitative investigation of demands, resources and self-regulation during Navy deployment

ABSTRACT Creating a sustainable workplace for Navy personnel is vital for their wellbeing and retention. This qualitative study explores the interplay between job and personal demands, resources, and stress self-regulation strategies affecting psychological strain among Navy personnel during deployment. We conducted semi-structured key informant interviews with 25 Navy personnel (68% male) to determine the demands and resources at sea that affect psychological strain. The findings identified that individual differences in coping strategies (e.g., recovery management), abilities (i.e. ability to make social connections), and their mind-set about deployment (e.g., sense of purpose) were perceived to play a role in the experience of strain. Additionally, the presence of supportive peers and leaders was identified as a key resource, whereas external stressors (e.g., family crisis) and social tension onboard, amplified by confined spaces, were commonly reported demands. Our findings also contribute to a growing body of research suggesting a nuanced interaction between individual coping strategies and job design. Formal organizational support was identified as enabling adaptive self-regulation strategies, while the capacity to form and maintain positive relationships helped foster a sense of belonging, countering isolation. Another key contribution was the individual differences in the appraisal of resources offered by the organization and the potential importance of resource appraisal in how effective resources were perceived to be for addressing shipboard demands. We provide recommendations relating to targets for personnel training, interventions, and leadership in terms of communication, supporting day-to-day and equal opportunity for recovery, resource access, maintaining morale, and shaping the evaluation of demands.

LncRNAs Are Key Regulators of Transcription Factor-Mediated Endothelial Stress Responses.

The functional role of long noncoding RNAs in the endothelium is highly diverse. Among their many functions, regulation of transcription factor activity and abundance is one of the most relevant. This review summarizes the recent progress in the research on the lncRNA-transcription factor axes and their implications for the vascular endothelium under physiological and pathological conditions. The focus is on transcription factors critical for the endothelial response to external stressors, such as hypoxia, inflammation, and shear stress, and their lncRNA interactors. These regulatory interactions will be exemplified by a selected number of lncRNAs that have been identified in the endothelium under physiological and pathological conditions that are influencing the activity or protein stability of important transcription factors. Thus, lncRNAs can add a layer of cell type-specific function to transcription factors. Understanding the interaction of lncRNAs with transcription factors will contribute to elucidating cardiovascular disease pathologies and the development of novel therapeutic approaches.

Lombalgia crônica e sua condução clínica

Chronic low back pain is a multifactorial condition that affects the spine and has a complex pathophysiological basis. This article aims to analyze the clinical consequences and factors that influence the phenotypic diversity of this condition. Phenotypic variation is crucial to allow adaptation throughout evolution, but this variation must be controlled to avoid compromising the vital functions of the musculoskeletal system. Vertebral structures maintain their characteristics and signaling pathways over time, with conserved epigenetic modifications. Phenotypic diversity in the vertebral unit occurs due to processes of ontogeny, remodeling, phenotypic variation, adaptation, and environmental sensitivity. These processes involve internal and external stressors, orderly transitions of cell development, temporal changes in development, rapid adaptation, and epigenetic modifications.

Osteoartrite: Consequência evolutiva?

Osteoarthritis is a degenerative disease that affects the joints and is a multifactorial disease. This article aims to analyze its evolutionary consequences and the factors that influence the phenotypic diversity of the disease. Phenotypic variation among living things is crucial to enable natural selection, but this variation needs to be limited to avoid the collapse of the vital functions of the organic system. Skeletal tissue cell types have their origins in aquatic animals and have maintained their characteristics and signaling pathways during the transition to terrestrial life, with conserved epigenetic modifications. Phenotypic diversity in the osteochondral unit occurs due to processes of ontogeny, remodeling, phenotypic variation, adaptation, and environmental sensitivity. These processes involve internal and external stressors, orderly transitions of cell development, changes in the timing of development, rapid adaptation, and epigenetic modifications.

Comparative study of multiple statistical damage mechanics models for rock behaviors under high temperature

Under the influence of external factors such as high temperature, chemical corrosion, and loading-unloading cycles, micro-cracks and pores may develop within rock structures. Continuum damage mechanics (CDM) characterizes these micro-defects arising within rocks, investigating the physico-mechanical behaviors of rocks in damaged states. This study, grounded in the theoretical framework of CDM and utilizing the Mohr-Coulomb failure criterion, integrates different probability distributions and damage coupling methods to develop three statistical damage models. The investigation primarily explores the effects of strength criteria, probability functions, and damage coupling mechanisms on the statistical damage models. In addressing the complex interplay between rock micro-defects and external stressors such as high temperatures and chemical corrosion, this study leverages the principles of CDM within the Mohr-Coulomb criterion framework. It advances the field by developing three innovative statistical damage models, enriched by diverse probability distributions and damage coupling methods. The research delineates the substantial impact of strength criteria, probability functions, and damage coupling mechanisms on the behavior of these models. Notably, it achieves a synthesis of theoretical constructs and experimental validation, demonstrating the models' capacity to reflect the nuanced behaviors of damaged rock accurately. Furthermore, this investigation contributes a methodological blueprint for statistical damage model construction, underscoring the critical selection of strength criteria and probability distributions. These efforts fortify the theoretical underpinnings necessary for the enhanced engineering application of statistics-driven damage analysis.

Ectoin attenuates cortisone-induced skin issues by suppression GR signaling and the UVB-induced overexpression of 11β-HSD1.

Accelerated pace of modern work and lifestyles subject individuals to various external and psychological stressors, which, in turn, can trigger additional stress through visible signs of fatigue, hair loss, and obesity. As the primary stress hormone affecting skin health, cortisol connects to the glucocorticoid receptor (GR) to aggravate skin issues induced by stress. This activation depends on the expression of 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) in skin cells, which locally converts cortisone-produced by the central and peripheral hypothalamic-pituitary-adrenal axis-into its active form. Our study delves deeper into stress's adverse effects on the skin, including the disruption of keratinocyte structural proteins, the loss of basement membrane proteins, and the degradation of collagen. Remarkably, we discovered that Ectoin, an amino acid derivative obtained from halophilic bacteria, is capable of mitigating the inhibitory impacts of cortisone on the expression of cutaneous functional proteins, including involucrin, loricrin, laminin-5, and claudin-1. Moreover, Ectoin reduces the suppressive effect of stress on collagen and hyaluronic acid synthesis by impeding GR signal transduction. Additionally, Ectoin counterbalances the UVB-induced overexpression of 11β-HSD1, thereby diminishing the concentration of endogenous glucocorticoids. Our findings illuminate the significant potential of Ectoin as a preventative agent against stress-induced skin maladies.

Common molecular basis of aging and cancer dynamics: complex interactions among age, diseases, external stressors, and environmental factors

There are incremental efforts to understand the multifaceted aspects of aging, particularly focusing on its biological interplay with various environmental stressors and diseases such as cancer. The concept of biological age, which is distinct from chronological age, and its importance in predicting disease onset and mortality patterns are emphasized. Furthermore, exploration of the reversible nature of biological aging under different stress conditions, such as surgery, pregnancy, and diseases such as cancer and coronavirus disease 2019, is intriguing. This narrative review attempts to address the potential impact of viral infections such as severe acute respiratory syndrome coronavirus 2 and the altered landscape of diseases such as cancer on biological aging and their interconnected relationships. Additionally, it also touches upon the influence of emerging technologies, particularly artificial intelligence-driven machines, on aging dynamics, prompting further research in this area. This article may provide insight into a comprehensive framework for interdisciplinary research to better understand the complex interactions among age-related dynamics, diseases, external stressors, and environmental factors, with implications for future interventions and healthcare strategies.

Associations between Daily Stressors, Health, and Affective Responses among Older Adults: The Moderating Effect of Age

Introduction: Reactivity to daily stressors may change as a function of stressor type and age. However, prior research often excludes older adults or compares them to younger age groups (e.g., younger and middle-aged adults). Recognizing older adults as a heterogeneous population with shifting motivations, this study focused on individuals aged ≥65 years and tested age differences in associations between different types of daily stressors, affect, and physical symptoms. Methods: A total of 108 older adults aged 65–92 years (M = 73.11, SD = 5.92; 58% women) completed daily dairy questionnaires on daily stressors, positive and negative affect, and physical symptoms for 14 consecutive days. Multilevel models were employed, adjusting for sex, age, education, living situation, and day-in-study. Results: Findings revealed age-dependent variations in the associations between daily stressors and affect and physical symptoms. Specifically, external stressors (e.g., finance and traffic stressors) and health stressors were more strongly associated with daily affective states and with overall physical symptoms (respectively) among older age adults. Age did not moderate associations between social stressors and affect or physical symptoms. Conclusion: These findings underscore the heterogeneous nature of older adults’ responses to daily stressors based on stressor type and age. Specifically, the oldest-old might benefit from personalized support for dealing with challenges such as health and financial stressors.

Enhancing flexible electronics: Unveiling the role of strain rate in the performance of molybdenum-coated PET films

This work analyzes the mechanical and electrical properties of molybdenum (Mo) thin films at 100 and 200 nm thicknesses under different strain and strain rate circumstances. The study examines Mo film deposition by RF magnetron sputtering on PET substrates and their mechanical stress behavior. The investigation reveals distinct patterns of crack initiation and propagation, where primary cracks predominantly appear perpendicular to the direction of applied strain, and secondary cracks develop due to stress redistribution, displaying a complex interplay between film thickness, strain rate, and crack morphology. A key finding of this study is the observation of more advanced and irregular crack patterns in thicker films (200 nm) subjected to higher strain rates (1000 mm/min), suggesting a heightened sensitivity to mechanical stress and a more chaotic fracture process compared to thinner films or those under lower strain rates. Additionally, instances of film edge delamination, particularly under high strain conditions, highlight the challenges in maintaining film-substrate adhesion and integrity under extreme mechanical deformation. The research provides critical insights into the mechanical robustness and electrical performance of Mo thin films, emphasizing the influence of microstructural properties, deposition parameters, and external stressors on their applicability in high-tech industries. The findings underscore the importance of optimizing deposition techniques and understanding material behavior under stress to enhance the durability and reliability of Mo thin films in practical applications, ranging from semiconductor devices to photovoltaic systems.

Financial strain, schooling modality and mental health of US adults living with children during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic upended contexts for families; relatively little work has studied the influence of rapidly changing contexts on the mental health of parents. We aimed to assess the relation...

Examining the perception, frequency, and intensity of domestic violence inflicted by Palestinian wives against their husbands

This study examines domestic violence perpetrated by wives against husbands in Palestine, utilizing structured interviews with 53 married participants. Findings reveal prevalent female-perpetrated domestic violence, often involving mutual conflict initiation. External stressors and power dynamics significantly influence behaviors, reflecting situational pressures and control issues. Verbal abuse and emotional manipulation are widespread, indicating covert and challenging violence dynamics. Responses to violence vary, suggesting barriers to accessing support systems. Effective conflict resolution is crucial to address ongoing relationship challenges. The study underscores the multifaceted nature of domestic violence, emphasizing the need to address underlying psychological factors and promote healthier relationship dynamics. Based on the study's findings, actionable recommendations include educational outreach, customized support services, legal advocacy initiatives, community engagement projects, professional development activities, and sustained research efforts to promote positive societal change.

Mechanisms of Senescence and Anti-Senescence Strategies in the Skin.

The skin is the layer of tissue that covers the largest part of the body in vertebrates, and its main function is to act as a protective barrier against external environmental factors, such as microorganisms, ultraviolet light and mechanical damage. Due to its important function, investigating the factors that lead to skin aging and age-related diseases, as well as understanding the biology of this process, is of high importance. Indeed, it has been reported that several external and internal stressors contribute to skin aging, similar to the aging of other tissues. Moreover, during aging, senescent cells accumulate in the skin and express senescence-associated factors, which act in a paracrine manner on neighboring healthy cells and tissues. In this review, we will present the factors that lead to skin aging and cellular senescence, as well as ways to study senescence in vitro and in vivo. We will further discuss the adverse effects of the accumulation of chronic senescent cells and therapeutic agents and tools to selectively target and eliminate them.

Chemical and non-chemical stressors in a postpartum cohort through wristband and self report data: Links between increased chemical burden, economic, and racial stress

Multiple external stressors are known to have adverse impacts on health and development. Certain groups are more vulnerable and/or more likely to be exposed toenvironmental, psychological, and social stressors simultaneously. Yet, few studies have examined combined exposure to environmental toxicants and psychosocial stress. Here, we integrated environmental chemical exposure data collected using silicone wristbands and self-report social stressor data within the Brain and Early Experience (BEE) perinatal cohort to understand co-exposure to environmental chemicals and social stress. Silicone wristbands were worn for one week by mothers throughout central North Carolina who were 6 months postpartum (n = 97). Exposure to 110 environmental chemicals across eight chemical classes was quantified on silicone wristbands using gas chromatography mass spectrometry. Social stress was evaluated using eight established self-report questionnaires (e.g., Brief Symptom Inventory, Perceived Stress Scale), quantifying experiences such as race-related stress, economic strain, and relationship conflict. Hair cortisol levels were measured as an additional metric of stress. The chemical exposure landscape and associations among chemical exposure, demographic characteristics, and social stress were characterized through individual variable analyses, cluster and data reduction, and compiled scoring approaches to comprehensively evaluate chemical and social stress burdens. We found that chemicals contain co-occurring patterns largely based on chemical class, with phthalates representing the chemical class with highest exposure and polychlorinated biphenyls the lowest. Chemicals showed differential exposure across racial groups, with diethyl phthalate, triphenyl phosphate, and tris(3,5-dimethyl phenyl) phosphate at higher levels in Black participants compared with White participants. Integrating social stressor profiling with chemical exposure data identified one particularly vulnerable subset of participants in which high chemical exposure burden coincided with high experiences of racism and economic stress. These findings demonstrate co-occurring chemical and social stress, warranting further investigation to better understand how these combined stressors may contribute to disparities in maternal and child health.

Patient perspectives on the Tailored intervention for Anxiety and Depression Management in COPD (TANDEM): a qualitative evaluation

BackgroundChronic obstructive pulmonary disease (COPD) is commonly associated with anxiety/depression which can affect self-management and quality of life. The TANDEM trial evaluated a cognitive behavioural approach intervention targeting COPD-related symptoms of anxiety and/or depression, comprising up to eight one-to-one sessions delivered by respiratory healthcare professionals prior to pulmonary rehabilitation (PR). The intervention showed no improvement in anxiety/depression or uptake/completion of PR. We present patient perspectives of the intervention to help understand these results.MethodSemi-structured individual interviews, using a semi-structured topic guide informed by Sekhon’s Theoretical Framework of Acceptability, were conducted with 19 patients between September 2019 and April 2020. The interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsThe following could have limited the impact of the intervention: (1) The lives of patients were complex and commonly affected by competing comorbidities or other external stressors which they managed through previously adopted long-standing coping strategies. (2) Some patients were reluctant to talk about their mood despite the Facilitators' training and person centred-skills which aimed to enable patients to talk freely about mood. (3) The intervention handouts and ‘home-practice’ were perceived as helpful for some, but not suitable for all. (4) Many patients perceived improvements in their physical and mental health, but this was not sustained due to a mix of personal and external factors, and some did not perceive any benefits. (5) PR non-attendance/non-completion was a result of personal and PR service-related reasons. (6) Discussing COPD and mental health with the Facilitator was a novel experience. Many patients felt that TANDEM could be of benefit if it was offered earlier on/at different time points in the COPD illness journey.ConclusionWe found the delivery of TANDEM prior to PR was not helpful for patients with advanced COPD often experiencing other comorbidities, and/or difficult personal/external events. These patients already utilised long-standing coping strategies to manage their COPD. Holistic interventions, that address the impact of COPD in relation to wider aspects of a patients’ life, may be more beneficial.Trial registrationISRCTN Registry 59,537,391. Registration date 20 March 2017.