High Psychological Stress Research Articles

Изменение склонности к девиантному поведению в процессе профессионального становления военнослужащих

<p>High physical and psychological stress has a negative and even detrimental effect on military personnel, which can lead to maladaptive and deviant forms of behavior. It is relevant to study the dynamics of the tendency to deviant behavior as military personnel grow professionally. Purpose: to study the differences in the manifestation of a tendency to deviant behavior in military personnel of different official categories: privates, corporals, sergeants and warrant officers; contract and conscription employees, persons with higher education and secondary education. Methods: Scales of propensity to addictive behavior; Questionnaire of propensity to delinquent and addictive behavior (DAB-2); SADS-30 (Suicidality, aggression, drug addiction, substance abuse); Questionnaire for detecting early signs of alcoholism; Questionnaire for diagnosing Bass-Perry aggression-24; factor analysis, Mann-Whitney and Kruskal-Wallis criteria. Subjects: 42 male military personnel of different job categories (under contract, conscription; privates, corporals, sergeants and warrant officers), aged 18—30 years. Results: it was found that the propensity to drug addiction is less pronounced in contract employees (p≤0.05) and in non-commissioned and junior officers (p≤0.05). Factor analysis has shown that most deviations constitute a single factor, which includes indicators of aggression both towards others and towards oneself; one can note a reduced tendency to delinquent and other forms of deviant behavior, but an increased risk of going into addictive or suicidal behavior. This is also accompanied by a low focus on military service. Conclusions: during the study, it was found that there are differences in the manifestation of a tendency to deviant behavior among military personnel of different official categories: privates, corporals, sergeants and warrant officers. Continuing to serve in the army (under contract) is associated with a decrease in the tendency to manifest deviations.</p>

Parental stress interaction with environmental factors in childhood allergic asthma: Early life significance

Although stress and indoor/outdoor environments have been independently linked with asthma, their interactions on childhood physician-diagnosed allergic asthma (PDAA) remain undisclosed. We aimed to research the effect of parental stress and their interactions with indoor/outdoor environmental factors on childhood PDAA. A retrospective cohort study was undertaken of preschoolers at Changsha, a city in central China. We collected information on parental stress levels and various indoor environmental exposures, through questionnaire surveys. Outdoor air pollution exposure was obtained from ten ambient pollution monitoring stations in Changsha, and individual pollution exposure were calculated. Using logistic regression models, we assessed the individual and synergistic impacts of parental stress and indoor/outdoor factors on childhood PDAA. We found that preschoolers' PDAA showed a significant association with high parental gross annual income and psychological stress indicators including fatigue, headache, and inattention, with ORs = 2.10 (1.31–3.35), 1.38 (1.04–1.82), 1.33 (1.07–1.65), and 1.42 (1.14–1.76), respectively. Furthermore, in preschoolers with high parental economic stress, the association between indoor mold/moisture spots and PDAA was notably more pronounced. Significantly stronger association between outdoor SO2 exposure in the past year in preschoolers with socially stressed parents. Parental headache and inattention exacerbated the effects of PM2.5-10 and PM10 exposure during the 7-9th months before pregnancy and throughout the pregnancy on PDAA. Preschoolers with high parental psychological stress and high exposure to outdoor atmospheric pollutants showed an increased likelihood of developing PDAA. Our research suggests that both parental stress and its interaction with hazardous environments from indoor sources and atmospheric pollutants contribute to PDAA.

Functional connectivity of the amygdala in relation to high stress and low mindfulness

BackgroundHigh psychological stress has been associated with several brain functional changes, including functional connectivity (FC) alterations in regions such as the prefrontal cortex and the amygdala. This study explored FC alterations associated with high perceived stress, and also investigated whether these neuroimaging features were correlated with low levels of mindfulness. MethodsThis study included 29 adults (12 males and 17 females; mean age: 27.6 ± 3.2) who complained of moderate or higher perceived stress and 31 adults (17 males and 14 females; mean age: 29.2 ± 7.2) who complained of low-level stress on the questionnaire scale. Seed-based resting-state FC analysis was conducted to compare between high and low stress groups. The dorsolateral prefrontal cortex (DLPFC), the ventromedial prefrontal cortex (VMPFC) and the amygdala were selected as seeds. ResultsHigh stress group showed weaker left amygdala-based FC in the left cerebellum crus II and the left orbitofrontal cortex compared with low stress group. High stress group had weaker FC between the left DLPFC and the left inferior parietal lobule. On the contrary, high stress group had stronger FC between the left VMPFC and the left caudate compared with low stress group. Weaker FC between the amygdala and the cerebellum crus II was correlated with lower level of awareness facet of mindfulness. ConclusionsThose with high perceived stress showed low levels of mindfulness and several FC alterations centered on the prefrontal cortex and amygdala. Our findings also suggest that weak amygdala-based FC alterations associated with high psychological stress are related to low-level awareness facet of mindfulness.

Association of Chronic Stress with Cardiovascular Diseases: A Single Centre Experience

Introduction: Cardiovascular diseases (CVD) pose a growing global health threat, with a 42.4% increase in deaths between 1990 and 2015 despite a 27.3% decline in age-standardized CVD mortality rates. Risk factors like smoking, inactivity, high blood pressure, obesity, hyperinsulinemia, hypercholesterolemia, and psychological stress contribute to CVD. Aim of the study: The study aims to assess the prevalence of stress and its association with cardiovascular diseases (CVD). Materials and Methods: This prospective study at Jessore Medical College and Hospital, Bangladesh, involved 110 patients aged 25-64 with cardiovascular diseases (CVDs) and chronic stress. The study duration was one year from January 2022 to December 2022. Result: The majority (54.55%) were aged 31-40, with females constituting 57.00% of the total sample. Work experience distribution revealed 50.91% with 1-10 years, 21.82% with 11-20 years, and 27.27% with over 20 years. Stress intensity analysis showed no mild stress, 71.82% with "Average to acute stress," 25.45% with "Average stress," and 2.73% with acute stress. Cardiovascular risk factors included 19.00% lacking sleep, 15.00% with low physical activity, and 12.00% each for smoking, hypercholesterolemia, and arterial hypertension. Conclusion: Research indicates that individuals experiencing stress face significant cardiovascular risk factors. However, the connections between stress and these risk factors appear complex and must be more apparent. This underscores the necessity for additional investigation into the relationship between stress and other cardiovascular risk factors while considering factors such as age, gender, and socio-economic characteristics within the population. Medicine Today 2024, Vol.36 (2): 127-131

Rosacea fulminans: An anti‐inflammatory‐based therapeutic approach

AbstractBackgroundThe treatment of rosacea fulminans still poses a significant challenge in daily clinical practice. The pronounced centrofacial inflammation accompanied by severe pustulation, pain and high psychological stress, mostly affecting young women, requires an appropriate fast‐acting treatment regimen. A major difficulty here is that if isotretinoin is recommended for therapy, sufficiently reliable contraception is absolutely necessary and not always given. So far, alternative therapies have not been extensively studied.ObjectivesOur goal is to show the efficacy of a treatment regimen with macrolide antibiotics (azithromycin) without the need for initial systemic isotretinoin or corticosteroids.MethodsWe present six female patients in our outpatient clinic treated with a combination of azithromycin and topical ivermectin reaching rapid inflammation control.Subsequently, maintenance with ultra‐low dose isotretinoin was initiated in 66% of cases. The patients were monitored for a median follow‐up time of 15.5 months [1–51 months].ResultsWe can show rapid improvement of inflammation under antibiotic‐treatment with azithromycin (500 mg 3x weekly for 4 weeks, 2x weekly for 4 weeks, 1x weekly 4 weeks) followed by ultra‐low dose isotretinoin maintenance treatment with minimal side effects. Topical ivermectin was administered additionally.ConclusionsMacrolides, in particular azithromycin, pose an alternative treatment method when retinoids are contraindicated extending the treatment regimen of rosacea fulminans. They are a fast‐acting and safe alternative to retinoids without the need for initial contraception. The antibiotic‐based approach is particularly suited to the control of inflammation.

Perceived stress and delay discounting in schizophrenia, cannabis use disorder, and co-occurring disorders

Steeper delay discounting (DD) reflects greater impulsivity and has been reported in individuals with schizophrenia (SCZ) and those with substance use disorder, who also tend to report high psychological stress. We sought to compare DD in people with SCZ, cannabis use disorder (CUD), and comorbid SCZ-CUD, and determine its relationship to psychological stress in these groups, to inform treatment improvements. Participants were healthy controls (HC; n = 31) and individuals with DSM-IV diagnoses of SCZ (n = 21), CUD (n = 61), and comorbid SCZ-CUD (n = 40). After one week or more of verified abstinence from substances, participants completed the Delay Discounting Questionnaire and the Perceived Stress Scale. DD and perceived stress were greater in all three clinical groups compared to HC, though the clinical groups did not differ. Analyses did not detect a consistent relationship between stress and DD in any group, though females showed greater DD with increased stress when all clinical groups were combined. Findings indicate that, overall, perceived stress cannot account for steeper DD in patients with SCZ, CUD, and SCZ-CUD; thus, interventions for stress would not be expected to impact DD.

Changes in sleep patterns in primary care workers during the first wave of the COVID-19 pandemic in 2022 in Shanghai: a cross-sectional study

The coronavirus disease (COVID-19) pandemic has significantly affected the sleep health of healthcare workers (HCWs); however, no studies have assessed this effect in primary HCWs. This cross-sectional, web-based study explored the prevalence and factors associated with sleep disorders among primary HCWs during the first COVID-19 outbreak in Shanghai from 12 July to 15 August 2022. Sociodemographic and work-related characteristics, various sleep dimensions, and exposure to patients with COVID-19 were assessed. They were screened for common mental disorders (depression, burnout, and stress). Overall, 313 primary HCWs were recruited. At least one sleep dimension in 84% of respondents deteriorated compared with that observed pre-pandemic; sleep quality (decline of 66%) and daytime sleepiness (increase of 56%) were the most affected domains. After excluding 145 primary HCWs with pre-pandemic ‘poor sleep’, depression (odds ratio [OR] 3.08; 95% confidence interval [CI] 1.59–5.98), weekly burnout symptoms (OR 2.57; 95% CI 1.32–5.03), and high psychological stress (OR 4.51; 95% CI 2.09–9.72) were associated with poor sleep patterns during the pandemic. After adjusting for significant differences between groups, for every 1-point increase in the Perceived Stress Scale score, an associated 12% increased risk of poor sleep (adjusted OR 1.12; 95% CI 1.05–1.21; p = 0.002) was observed. Most primary HCWs showed significant worsening of sleep quality, with increases in daytime sleepiness during the first wave of the COVID-19 pandemic in Shanghai. HCWs with high stress levels were at greater risks of sleep disorders.

Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer.

In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets.

Family and facility care variables attributing to postnatal depression among women in two tribal-dominated districts of Odisha: Log model analysis to suggest intervention.

It is a proven fact that women are affected by poor mental health predominantly in the postnatal period. This is authenticated by the use of a validated and tested Edinburg Postnatal Depression scale (EPNS), which is a simple tool to measure depression among women after delivery by posing 10 questions and this is also validated in Odia language. Odisha has made laudable progress in delivering Maternal and Child Health care to women even in tribal-dominated districts through its robust Comprehensive Obstetrics care network restricting home delivery almost to a mere 4%-5% and reducing maternal deaths by 60%-70% as per the National Family Health Survey (NFHS-5). As a part of an Indian Council of Medical Research (ICMR) extramural project to enhance contraceptive acceptance among males in districts that had a total fertility rate (TFR) higher than 3, a qualitative objective to measure mean postnatal depression in the early postpartum period (who are also the target to advocate contraceptive acceptance) was undertaken. A secondary objective was to compare family care vs. facility care as greater attributing factors for higher EPNS scores. Due to time constraints, the study was done on a fast-track mode wherein two villages each from the sampled blocks of Koraput and Boudh (with one of the highest birth rates) were selected. All women in villages who had a baby aged between 1 and 6 months, were the sampling frame and only those were selected who consented. A questionnaire was used that elicited information on familial sociodemographic details and also facility-based antenatal care (ANC) and postdelivery services that were availed for the last-born child. General Health Questionnaire-12 (GHQ-12) scores were used as an independent variable and a proxy measure of cumulative familial stress. Descriptives and log regression were used to measure the odds of family vs. facility-based services. A total of 98 women, 50 from Boudh and 48 from Koraput, participated in the study. Koraput's mean EPNS scores were 6 points higher than Boudh indicating much higher postnatal poor mental health. Log models showed that there was no difference between facility-based care in both districts as both reported 96%-97.3% institutional delivery, with out-of-pocket expenditure (OOP) being less than 520 Indian rupees on average and nearly 100% reported receipt of iron folic acid and calcium as well as streamlined Janani Suraksha Yojana (JSY) services. However, the odds of men's participation in Family planning was 2.77 times less in Koraput (SD = 2.582), fourth birth order 1.33 odds, and female gender 5.66 odds higher for the district as a result of which GHQ 12 score mean was 21.00 (CI: 19.18-22.82) hinting very high psychological stress as compared with Boudh where the mean was 17 (CI: 14.59-19.41). This clearly indicates that a robust healthcare delivery alone will not be able to address the holistic health of women in the childbearing age group. Familial stressors compound poor mental health and hence counseling of the family as a whole is necessary to achieve sound mental health in women in the postnatal period. The spousal role is emerging as a strong determinant, especially in terms of nonacceptance or casual approach to contraceptive use. Interestingly, a skewed gender bias is noted for the female child, which is also a contributor to postnatal depression (PND) in both districts, though a bigger sample would be needed to statistically prove it.

Perinatal mental health and Covid-19-related distress: the role of personality traits.

Perinatal mental health is a topic of growing interest, that could affect mothers in a period of high vulnerability, and the impact of coronavirus disease 2019 (Covid-19) pandemic is an important factor to consider in this field. The aim of our study is to study the correlations between five dimensions of personality and subjective Covid-19-related distress in a sample of women in the perinatal period. The study included 114 Italian women in the perinatal period. Subjects were asked to complete the Big Five Inventory (BIG-5) and a version of the Impact of Event Scale - Revised (IES-R) anchored to Covid-19-related distress. When the BIG-5 personality traits and several confounding variables were included in a regression model with IES-R total score as criterion, neuroticism subscale of BIG-5 inventory was the only variable independently associated with higher IES-R total score (p<0.001). Our study highlights the importance of considering the personality vulnerability factors that can worsen psychopathological symptoms of women in the perinatal period, especially in periods of high psychological stress.

P1222 Gut microbiome differences regarding lifestyle and the history of COVID-19 infection in ulcerative colitis patients

Abstract Background The microbiome contributes to the pathogenesis of ulcerative colitis (UC) but the contribution of different lifestyle and environmental factors to the compositional variability of the gut microbiota is unclear. Also, it is known that microbiota plays an important role in infectious diseases like coronavirus disease 2019 (COVID-19). Methods In 6-month time (June 2021 to December 2021) 49 UC outpatients from Riga East Clinical University Hospital were included in a Cross-sectional study. All patients were divided into groups according to COVID-19 status (COVID-19posvs COVID-19neg) within 6 months. The effect of the lifestyle (smoking cigarettes, alcohol intake, sports activities, and high psychological stress level) and COVID-19 to the gut microbiota in patients with UC was investigated. For taxonomical classifying of the gut microbiome metagenome data, MetaPhlAn v.2.6.0 tool was used. In further analysis gut microbiome (mostly bacteria phyla) and related data was analysed with SPSS 20.0. Results Out of 49 patients, 31(63%) were male and 18(37%) were female, the mean age was Md=38 [IQR:34-51]. Fourteen patients (28.6%) have been COVID-19 pos and 35(71.4%) COVID-19 neg. There were no statistically significant differences between COVID-19 pos and COVID-19 neg patients and their microbiota, nor between COVID-19 pos symptomatic 12(24.5%) and asymptomatic 37(75.5%) patients and their gut microbiome. Out of 49, 24(49%) were doing sports, of those 18(51.4%) were COVD-19neg vs. 6 (42.9%) COVID-19pos, p=0.82. Evaluating differences in the gut microbiome regarding physical activities there was no statistical significance. Of 49 patients, 30(61.2%) have smoked before, while 19(38.8%) haven’t smoked. Medium smoking time was 8 years Md=8 [IQR:4.50-20.0]. Analysing gut microbiome in smokers/non-smokers, and the length of smoking, there were found no statistically significant differences. Thirty-five (71.4%) were using alcohol, and 14(28.6%) were not. Those who were using alcohol had statistically significantly more Firmicutes in their gut microbiome Md= 64.8[IQR:53.7-70.4] than no users Md=48[IQR:37.5-66.3], p=0.041. Regarding high stress levels, those who had less stress 18(36.7%), had more Actinobacteria in their gut microbiome Md=11.7[IQR:6.92-14.8] vs stressful patients 31(63.3%) Md=6.03[IQR:2.23-13.8], p=0.03. Conclusion There were no changes in gut microbiome in COVID-19 positive and COVID-19 negative patients, nor in smokers and no smokers. Alcohol users had more bacteria Firmicutes in their gut microbiome. There were no differences in gut microbiome in UC patients doing or lacking sports. UC patients with less stress had more Actinobacteria in their gut microbiome.

Prevalence of psychological stress among the Russian population and its association with socio-demographic characteristics. Data from the ESSE-RF3 study

Aim. To assess the prevalence of psychological stress (PS) using the Perceived Stress Scale-10 (PSS-10) in various Russian regions and to analyze PS associations with socio-demographic characteristics and behavioral risk factors and some non-communicable diseases (NCDs).Material and methods. We studied representative samples of the population aged 35-74 years in the Russian regions, examined as part of the Epidemiology of Cardiovascular Diseases in Regions of Russian Federation-3 (ESSE-RF3) study. The subjects were interviewed using a questionnaire containing a section on the psychological stress — PSS-10. For men, PS levels are ranked as follows: "Low" — 0-11, "Medium" — 12-17, "High" — 18-40. For women, PS levels are ranked as follows: "Low" — 0-13, "Medium" — 14-19, "High" — 20-40. Statistical analysis was carried out using the open-source R 3.6.1 environment.Results. The average PS level was 12,0±7,3 (men: 10,7±7,0; women: 13,1±7,4). Every fifth person (20,3%) in the Russian population has a high PS level, with higher PS rates among women compared to men (high PS level — 21,6 vs 18,9%, respectively). A high PS level was associated with the income level (average or low), no marriage, unemployment, low level of physical activity, depression, anxiety, NCDs (type 2 diabetes, myocardial infarction, stroke), additionally for women — hypertension.Conclusion. The Russian population is characterized by a high PS prevalence, while PS rates are higher among women, which must be taken into account when predicting the NCD risks.

High psychological stress levels related to delivery can increase the occurrence of postpartum mental disorders.

The study sought to explore the relationship between high psychological stress levels related to delivery and postpartum mental disorders. A total of 284 parturients were included in the study from July 2021 to January 2022. The stress level at 1 month postpartum was assessed by the Impact of Event Scale-Revised (IES-R). Parturients with an IES-R score ≤ 9 were included in the low psychological stress level group, and those with an IES-R score > 9 were included in the high psychological stress level group. The Edinburgh Postnatal Depression Scale (EPDS), Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70), Symptom Checklist-90 (SCL-90) and Mini-International Neuropsychiatric Interview (M.I.N.I.) were conducted at 42 ± 7 days postpartum to assess the mental health of parturients.The parturients' mental health after birth was assessed by the EPDS, UPPSAQ-70, and SCL-90. Semi-structured diagnostic interviews were conducted at 42 ± 7 days postpartum by using the M.I.N.I. The incidence rate of postpartum mental disorders was 20.42% (58/284), the incidence rates of postpartum depression, anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder were 17.96% (51/284), 11.97% (34/284), 4.58% (13/284) and 1.41% (4/284), respectively, and the comorbidity rate was 58.62% (34/58). A history of mental disorders and pregnancy complications were risk factors for postpartum depression (p = 0.028, p = 0.040, respectively); a history of mental disorders, a lack of physical exercise, partner violence and pregnancy complications were risk factors for postpartum anxiety disorders (p = 0.003, p = 0.007, p = 0.031, p = 0.048, respectively); and the delivery of female infants was a risk factor for postpartum obsessive-compulsive disorder (p = 0.022).The risk of postpartum depression, anxiety disorders and obsessive-compulsive disorder was 9.125 times (95% CI = 3.900 ~ 21.349, p < 0.01), 7.310 times (95% CI = 2.588 ~ 20.649, p < 0.01) and 6.259 times (95% CI = 1.347 ~ 29.093, p < 0.01) higher in postpartum women with high psychological stress levels related to delivery than in those with low psychological stress levels, respectively. The incidence of postpartum mental disorders is high and has a positive correlation with the level of psychological stress. This may lead to a new perspective of the effect of psychological stress on postpartum mental disorders and attract more attention to other mental disorders in addition to postpartum depression.

The mutual overlapping impact of stress and infection on mental health problems in adolescents and youths during and after COVID-19 pandemic in China

BackgroundIt is unclear about the mutual impact of COVID-19 related psychological stress and infection on mental health of adolescent and youth students. This study aimed to explore the mutual impact of COVID-19 related psychological stress and infection on mental health problems among students. MethodsThis study was conducted from December 14, 2022 to February 28, 2023 in Sichuan, China. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Insomnia Severity Index, and Internet Addiction Test were used. Participants were grouped by COVID-19 infection and psychological stress level. The differences among groups were compared, and logistic regression analysis was used to investigate risk factors for depression, anxiety, PTSD and insomnia among groups. ResultsOf 90,118 participants, 82,873 (92.0 %) finished the questionnaires and were included in the study. Of 82,873 participants, 33,314 (40.2 %) reported to be infected with COVID-19. Participants had depression symptoms (38.1 %), anxiety symptoms (31.8 %), PTSD (33.9 %), insomnia (34.0 %), and internet addiction (60.3 %). Compared with participants uninfected with low psychological stress level, the risk for symptoms of depression, anxiety, PTSD and insomnia increased by 9.6 %, 12.3 %, 6.6 %, and 12.0 % in participants infected with low psychological stress level (p < 0.001), 106.8 %, 125.9 %, 125.2 %, and 95.7 % in participants uninfected with high psychological stress level (p < 0.001), and 147.3 %, 161.1 %, 158.7 %, and 141.0 % in participants infected with high psychological stress level (p < 0.001). LimitationThis study is a cross-sectional design, and no causal associations should be inferred. Infection status was based on self-report of participants with infectious symptoms. ConclusionCOVID-19 related psychological stress and infection per se have mutually overlapping impacts on mental health problems among students. Further health policies and psychosocial interventions should be developed to reduce mutually overlapping impact and improve the long-term mental health among students.

Central Serous Chorioretinopathy Risk Factors in An Iranian Cohort: A Case-control Study.

This study aimed to investigate the possible risk factors of central serous chorioretinopathy (CSCR) in an Iranian cohort. We recruited 39 consecutive CSCR cases and 80 age-matched controls with no ocular pathology from the same medical center from March 2019 to March 2021. Enrolled patients underwent complete ophthalmological examination and extensive history taking in a referral setting. Logistic regression analysis was performed to detect any possible association of potential risk factors with CSCR. The mean age of CSCR patients was 40.697.71 years. The male-to-female ratio in cases and controls was 1:1.79 and 1.22:1, respectively. Logistic regression analysis revealed that alcohol consumption (odds ratio, OR: 62.0, 0.001), smoking (OR: 4.0, 95% CI: 1.47-10.85, 0.006), corticosteroid use (OR: 6.95, 95% CI: 2.64-18.28, 0.001), and high psychological stress (OR: 13.34, 95% CI: 4.68-38.02, 0.01) were significant risk factors for developing CSCR. Ischemic heart disease (=0.550), hypertension (=0.750), and hyperopia (=0.467) were not associated with the risk of CSCR. The most common form of steroid use was oral in both groups. No pregnant female was present in the study sample, precluding the assessment of its potential association with CSCR. CSCR often affects individuals of productive working ages; thus, identifying its preventable risk factors is highly encouraged. Our results suggested that alcohol consumption, smoking, and high levels of psychological stress are independent, preventable risk factors for CSCR.

Against the mental stress-Resilient work in surgery

Surgery represents achallenging medical discipline. This article focuses on psychological stress in surgery and explains resilience as aprotective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. Narrative review. Surgery is classified as achallenging medical subspecialty with ahigh reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and ahigh dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by alack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, astrong sense of resilience to mental illness may be fundamental to this. Resilience can be present as apersonal characteristic or it can be learnt through aprocess or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. The consolidation of resilience as anotable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.

“We felt so proud by the president calling us my heroes.” An exploration of the nurse’s experiences in the management of COVID-19 patients in Uganda

IntroductionAdequate and intensive nursing care was a key characteristic of recovery of the COVID-19 patients globally and in Uganda. However, there is limited literature on the experiences of nurses who participated in the care of COVID-19 patients in Uganda, East Africa, and Africa at large, yet imperative in designing approaches to increase the efficiency of the health systems’ response to future pandemics. To address this gap, this study aimed to explore the experiences of the nurses who managed COVID-19 patients at Mulago National Referral Hospital in Uganda.MethodsThis was an exploratory qualitative study that used purposive sampling to identify 21 nurses who treated COVID-19 patients at Mulago National Referral Hospital in Uganda. Focus Group Discussions were used to collect data. Thematic Analysis was used to analyze the data. Common codes were identified and grouped to create subthemes and major themes.ResultsSix themes were identified: 1) Motivation to work on COVID-19 patients, 2 ) Roles performed by nurses, 3) High workload and professional role strain, 4) Challenges with maintaining personal health and relationships, 5) Institutional and government support, 6) Acquired professional knowledge and skills to manage critical patients and epidemics. Most of the nurses faced work burnout, social isolation, stress, and psychological trauma. However, interprofessional collaboration, financial incentives, government recognition, and provision of personal protective equipment, were key motivators for the nurses. The majority reported to have gained new knowledge and skills in the management of pandemics and highly infectious diseases.ConclusionThe nurses experienced negative scenarios like work burnout due to high workload, social isolation, and psychological stress. Therefore, there is a need for health systems to develop approaches and policies that support nurses’ well-being. Nevertheless, key attributes like resilience, adaptability, and diligence to serve enabled them to persevere despite the hardships faced.

Saliva Levels of Adrenergic Receptors in Relation to Psychological Factors in Patients with Oral Lichen Planus.

To evaluate the saliva level of α1 and β1 adrenergic receptors (ARs) in oral lichen planus (OLP) patients. This case-control study included unstimulated saliva samples from 33 OLP patients (14 erosive, 19 non-erosive) and 33 healthy controls. All participants were evaluated on psychological conditions via the Depression, Anxiety and Stress Scale - 21 items (DASS 21). The saliva levels of α1 and β1 ARs was measured by enzyme-linked immunosorbent assay (ELISA). Data were analysed with a t test using SPSS 25 (IBM, Armonk, NY, USA). The saliva levels of α1 and β1 ARs of OLP patients (both erosive and non-erosive forms) were significantly higher than in healthy controls. Stress levels in patients with both forms of OLP were significantly higher than in the healthy group. There was a positive correlation between salivary α1 and β1 ARs and stress, and this positive correlation was also seen for saliva β1 ARs between anxiety or depression. The saliva level of α1 ARs was inversely correlated with unstimulated salivary flow rates (r = -0.246; P = 0.046). This study indicated that OLP patients with both erosive and non-erosive forms have higher psychological stress and saliva levels of α1 and β1 ARs than healthy controls; however, the role of α1 and β1 ARs as salivary markers with regard to the development, severity of symptoms and outcome of OLP needs further investigation.

Public concerns and attitudes towards autism on Chinese social media based on K-means algorithm

To investigate the hot topics and attitudes of autism in the larger community. In this study, we analyzed and summarized experimental texts from the social media platform Zhihu using the TF-IDF algorithm and K-means clustering approach. Based on the analysis of the 1,740,826-word experimental text, we found that the popularity of autism has steadily risen over recent years. Sufferers and their parents primarily discuss autism. The K-means clustering algorithm revealed that the most popular topics are divided into four categories: self-experience of individuals with autism, external views of individuals with autism, caring and stressful behaviors of caregivers, and information about autism. This study concluded that people with autism face more incredible negative emotions, external cognitive evaluations of the autistic group reflect stereotypes, the caregiver’s family suffers high financial and psychological stress, and disorders caused by disease in autistic individuals.

Evaluation of loading behavior of a selfexpanding polymeric microstent for the treatment of Fallopian tube occlusions

Abstract Female sterility is caused by Fallopian tube occlusions in one of three cases. Current treatment methods achieve unsatisfying pregnancy rates and are associated with high costs or significant psychological and physiological stress. Our previously described microstent technology opens up new therapeutic possibilities to restore the lumen of the Fallopian tube without surgery. In this work, a Finite Element Analysis model of a physiologically relevant loading of the device is presented. Therefore, microstent radial force was analysed as a function of the device diameter up to a minimum diameter of 1.4 mm, which was found after microstent implantation ex vivo. A bilinear constitutive material model considering isotropic hardening was used for modeling of the microstent. The Finite Element Analysis results were validated using corresponding results of experimental investigations. In this context, a maximum deviation of 15% between experimental radial force and the corresopnding simulation results (1.33 N vs. 1.13 N) was found. Maximum von Mises stresses of approximately 88 MPa were determined. A good agreement between simulation and experiments was found. Therefore, future simulations will be carried out as a basis for microstent design optimisation.