Identification Of Stressors Research Articles

Do aluminum, boron, arsenic, cadmium, lipoperoxidation, and genetic polymorphism determine male fertility?

Male infertility is a world multifactorial problem modulated by environmental and genetic factors. Male aspects account for 20–50 % of infertility cases. Our results are unique because they treat the importance of components participating in the determination of male infertility (environmental and immunogenetic determinants, seminological analysis, lipoperoxidation, genetic determinants, role of aluminum, arsenic, cadmium and boron). We analyzed agents affecting male reproductive potential (aluminum, boron, cadmium, arsenic, lipid peroxidation, gene polymorphisms (MTHFRv.C677T (rs1801133) (chromosome-1) and IL-4v.C589T (rs2243250) (chromosome-5) in men with semen disorders (n=76) and with normozoospermia (n=87) from Central Poland. Polymorphisms of MTHFRv.C677T and IL-4v.C589T genes indirectly shape toxic metals concentration and lipoperoxidation but do not exert direct influence on male fertility disorders (monomorphism and lack of differences in genotypes frequency). Men with genotype TT or CC (IL-4v.C589T) show some differentiation in elements concentration and intensity of lipoperoxidation. Analysis of TT or CC (IL-4v.C589T) genotype brought correlations with B, Al, Cd, and lipoperoxidation (P<0.05) and suggesting that mentioned factors jointly shape male reproductive capability. Toxic metals may play an important role in shaping of men genetic polymorphisms, since Cd was identified as a factor increasing risk of qualification to infertile group, predisposing to fertility disorders. B, Al and Cd may be considered as important modulators of reproductive condition. However, lipoperoxidation as an isolated predictive parameter does not produce convincing results in male reproductive potential (higher MDA concentration in healthy men). Our results may be helpful in the diagnosis of male infertility, in the reduction of idiopathic cases of unknown origin and in implementation of targeted and more effective treatment (pharmacological, hormonal). Identification of environmental stressors and their correlations with fertility disorders can help to eliminate or reduce the impact of factors unfavorable to fertility. Our results highlight the importance of environmental and immunogenetic factors in shaping of defensive potential against destruction of spermatozoa and infer a role of oxidative stress in the induction of gene polymorphisms, affecting male fertility.

Differential molecular biomarker expression in corals over a gradient of water quality stressors in Maunalua Bay, Hawaii.

Coral reefs globally face unprecedented challenges from anthropogenic stressors, necessitating innovative approaches for effective assessment and management. Molecular biomarkers, particularly those related to protein expressions, provide a promising avenue for diagnosing coral health at the cellular level. This study employed enzyme-linked immunosorbent assays to evaluate stress responses in the coral Porites lobata along an environmental gradient in Maunalua Bay, Hawaii. The results revealed distinct protein expression patterns correlating with anthropogenic stressor levels across the bay. Some proteins, such as ubiquitin and Hsp70, emerged as sensitive biomarkers, displaying a linear decrease in response along the environmental gradient, emphasizing their potential as indicators of stress. Our findings highlighted the feasibility of using protein biomarkers for real-time assessment of coral health and the identification of stressors. The identified biomarkers can aid in establishing stress thresholds and evaluating the efficacy of management interventions. Additionally, we assessed sediment and water quality from the inshore areas in the bay and identified organic contaminants, including polycyclic aromatic hydrocarbons and pesticides, in bay sediments and waters.

Distribution and Characteristics of Blackwater Rivers and Streams of the Contiguous United States.

Blackwater rivers and streams have stained or tea-colored water from tannins released by decaying plant matter. Natural conditions in these waters often differ from non-blackwater systems. For example, the pH and oxygen levels in waters can be very low, but completely natural. We examined an existing USEPA data set and found that blackwaters existed across the contiguous United States but were most common in the east. Water chemistry showed differences between blackwater and non-blackwater sites, but differences were not consistent across ecoregions making national scale generalizations difficult. Physical habitat data analysis did not show dramatic differences between blackwater and non-blackwater sites. Blackwater typically arises from streams that drain tannin-rich bogs/muskeg and wetlands, so as expected blackwater sites had a shorter Euclidean distance to wetlands than non-blackwater sites and existed in watersheds with a higher percentage of wetland habitat. Blackwaters in Northern and Temperate Plains tended to have higher acid neutralizing capacity, conductivity, and lower True Color; a visual color scale used for water purity. We posit that differences were because Color and Dissolved Organic Carbon at these sites were from buried wetland deposits rather than contemporary wetland habitats. Research needs that may increase our understanding and management of blackwaters include development of an operational definition that includes a classification framework and reference conditions for different blackwater types, identification of stressors and their associated dynamics that negatively impact blackwater systems, and development of data-driven, consistent, and repeatable assessment methods, including development of targets, protective of unique conditions in blackwater rivers and streams.

Panorama of Coffee Cultivation in the Central Zone of Veracruz State, Mexico: Identification of Main Stressors and Challenges to Face

Coffee is one of the most traded crops worldwide. In the state of Veracruz, Mexico, coffee has been a strategic crop due to its economic, social, environmental, and cultural characteristics that differentiate it from other crops, contributing to the economy of almost 86,000 producers. Several studies have shown that climate is the main cause of the decrease in coffee production and yield. Due to the multi-faceted importance of coffee for the state, the relationship of coffee production and yield with the variables of precipitation (mm) and temperature (°C) from 2003 to 2022 was analyzed through the implementation of a mathematical model that was able to identify that both the total volume of coffee production is decreasing on average at a rate of 7614.9 Mg year−1 as well as the yield, with a significant decrease of 0.106 Mg year−1. It was also found that the optimum temperature value is 18.7 °C, and the optimal precipitation is 1700 mm for the development of coffee. This model also shows that yield is more sensitive to temperature than to precipitation in the study area. Through the application of surveys to 360 producers in 16 coffee-growing municipalities, seven stressors were identified that together hinder the continuity of the coffee industry in the state. These stressors are (1) economic, (2) climatic, (3) land use, (4) technical, (5) social, (6) political, and (7) other. Finally, some strategies are herein proposed to improve coffee production towards greater sustainability, such as agricultural restructuring at the national, regional, and local levels as well as programs and policies to support producers for the continuity of the crop in the region.

Navigating Work-Related Stress: Strategies for IT Professionals in the Tech Industry

In the ever-evolving landscape of the technology industry, work-related stress has become an omnipresent challenge for IT professionals. This study aims to empower individuals in the tech sector by providing a comprehensive guide on navigating work-related stress through effective strategies. Recognizing the multifaceted nature of stressors in the tech industry, this research defines clear objectives, including the identification of prevalent stressors, evaluation of coping mechanisms, and the examination of their impact on job satisfaction and mental well-being. Drawing from a thorough review of existing literature, this study leverages the collective wisdom of past research to inform the strategies outlined. The research employs rigorous participant selection techniques to ensure diverse representation across job roles, experience levels, and organizational contexts within the tech sector. Data collection adopts a mixed-method approach, encompassing surveys, interviews, and observational techniques. Ethical considerations are paramount, with strict adherence to informed consent and participant confidentiality. Quantitative and qualitative data analysis methods are integrated to provide both statistical insights and a profound understanding of the nuanced experiences and perceptions of IT professionals. Comparative analyses are employed to uncover patterns and distinctions across various subgroups within the tech industry. Furthermore, the study suggests a proactive approach to stress management, emphasizing the importance of continuous self-assessment and the utilization of effective stress-coping strategies. It provides recommendations for individuals and organizations to foster a healthier work environment and promote employee well-being. With a longitudinal perspective, the research examines how stress and coping strategies evolve over time in response to industry changes and shifts in work practices. By shedding light on these dynamics, the study equips IT professionals with tools to thrive in the tech industry while managing the challenges of work-related stress effectively. In conclusion, this study serves as a valuable resource for IT professionals, tech organizations, and policymakers alike, offering actionable strategies and insights to alleviate work-related stress and enhance the overall quality of work life in the fast-paced world of technology.

Современные подходы к психотерапевтической реабилитации пациентов с хроническими сердечно-сосудистыми заболеваниями

The review is devoted to the topical problem of rehabilitation of patients with cardiovascular diseases, which remain the leading cause of morbidity, disability and mortality in Russia and worldwide. A number of works demonstrating a close relationship between the course and prognosis of cardiovascular diseases and the psycho-emotional sphere of patients were analyzed. International and Russian experts emphasized the importance of timely identification and correction of psychosocial risk factors, in particular, depression, anxiety disorders, psychosocial stressors and others. The question of the need for a multidisciplinary approach to the patient in cardiac rehabilitation programs is raised. Emphasis is placed on the expediency of combining psychocorrection, psychotherapy and psychopharmacotherapy to increase the effectiveness of rehabilitation measures. The leading goals of these interventions are to change the internal picture of the disease, to achieve psychosocial adaptation and to improve the quality of life of patients with chronic cardiac diseases. This approach contributes to the prevention of exacerbations, complications and chronicization of somatic pathology, which improves labor prognosis, reduces the risk of disability and early mortality. Thus, the conducted analysis allows forming a holistic view of the importance of specialized psychological and psychotherapeutic care, the existing methods of correction and pharmacotherapy within the framework of rehabilitation measures in patients with cardiac diseases.

Developing a system for measuring stress in the care for nursing home residents with dementia

Background:Measuring and monitoring stress has potential benefits for the care and self-management of stressors for people with dementia. Early identification of stressors may help to cope with challenging behaviours (CB), occurring in up to 80% of nursing home residents with dementia. The identification of stressors causing CB is difficult (as often residents cannot themselves indicate what is experienced as stressful or relaxing), hampering the psychosocial approach. Several studies have found that skin conductance and heart activity can be used as a proxy for stress. Measuring these physiological parameters using wearable sensors, might be helpful to identify (de)stressors and consequently, a psychosocial treatment approach. Therefore, wearables are promising as a supportive technology in the care of people with dementia and CB. However, stakeholders (i.e., (in)formal caregivers of people with dementia) indicate that current available (wearable) systems to measure stress are not fit for purpose within the everyday care of people with dementia. In addition, due to legislation, not all systems are allowed. The purpose of the current research is to develop a system prototype together with different stakeholders.Method:A prototype of a system measuring stress suitable in the care for people with dementia will be developed during different iterations between September 2022-July 2024. A community of stakeholders will be built, in which the needs, requirements and evaluations of people with dementia, (in)formal caregivers, legal- and IT-experts, will be collected through literature studies, focus groups, interviews and co-design sessions. The system will be developed and adjusted appropriately, taking social, technical and legal requirements into account.Results and discussion:Preliminary results will be presented regarding identified requirements for initial system prototypes as well as lessons learned from first iterations with conceptual and working prototypes. Implications for the care and self-management of people with dementia will be discussed.

Of causes and symptoms: using monitoring data and expert knowledge to diagnose the causes of stream degradation

Ecological status assessment under the European Water Framework Directive (WFD) often integrates the impact of multiple stressors into a single index value. This hampers the identification of individual stressors being responsible for status deterioration. As a consequence, management measures are often disentangled from assessment results. To close this gap and to support river basin managers in the diagnosis of stressors, we linked numerous macroinvertebrate assessment metrics and one diatom index with potential causes of ecological deterioration through Bayesian belief networks (BBNs). The BBNs were informed by WFD monitoring data as well as regular consultation with experts and allow to estimate the probabilities of individual degradation causes based upon a selection of biological metrics. Macroinvertebrate metrics were shown to be stronger linked to hydromorphological conditions and land use than to water quality-related parameters (e.g., thermal and nutrient pollution). The modeled probabilities also allow to order the potential causes of degradation hierarchically. The comparison of assessment metrics showed that compositional and trait-based community metrics performed equally well in the diagnosis. The testing of the BBNs by experts resulted in an agreement between model output and expert opinion of 17–92% for individual stressors. Overall, the expert-based validation confirmed a good diagnostic potential of the BBNs; on average 80% of the diagnosed causes were in agreement with expert judgement. We conclude that diagnostic BBNs can assist the identification of causes of stream and river degradation and thereby inform the derivation of appropriate management decisions.

Methods for Identification and Prioritization of Stressors at Impaired Sites

Methods for Identification and Prioritization of Stressors at Impaired Sites

Conservation of blackwater rivers and streams of the coastal plains of United States: Knowledge and research needs.

Blackwater rivers and streams are a distinct resource type in multiple ecoregions of the United States, including the Coastal Plains. Given the unique nature of blackwaters, they may not be fully protected if using typical water quality standards. Information provided by State agencies was used to identify specific research needs that would directly enhance current assessment approaches. Protection of blackwater rivers and streams would be aided by (1) development of an operational definition; (2) development of a classification framework that distinguishes among blackwater system types; (3) identification of undisturbed or minimally disturbed blackwater systems; (4) identification of stressors that challenge blackwater condition and resilience; and (5) development of criteria that are more suited to the unique conditions of blackwater rivers and streams. Benefits stemming from addressing these research needs may include identification of sites that are unrecognized as impaired and the re-evaluation of sites that may be erroneously listed as impaired when they are not. This would improve reporting by states for Clean Water Act (CWA) Section 305(b) and, for some states, could represent a significant resource savings by reducing the number of sites on CWA Section 303d lists.

Evaluation of the effect of melatonin in patients with Burning mouth syndrome: a double-blind, placebo-controlled randomized clinical trial

The present study was carried out to evaluate the effect of Melatonin and Placebo in the patient with the Burning mouth (BMs). This double-blind, placebo-controlled randomized clinical trial study was carried out on 30 patients who were suffering from BMS. During this period patients were divided into 2 study and control groups. The study group used four 3 mg Melatonin daily and the control group received a placebo. Then the severity of the burning sensation was measured by the physician Sleep quality was measured using the VAS scale using the Petersburg questionnaire. Data in the application Enter SPSS 20 and then using T test or equivalent Nonparametric was analyzed, mean sleep score and mean severity of oral irritation before and after treatment in two the group was evaluated using T-test Independent. Level significance was considered 0.05. The results of the present study show that the use of melatonin and a placebo in patients with BMS reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study severity of burning was 4.93±2.56 after treatment in the study group and 6.93±2.12 in the control group, which was statistically significant (P =0.036). No significant difference was observed between the two groups in the sleep quality score (P-value = 0.43). Using Melatonin can be a reliable way to treat pain for which there is no standard treatment to date. Although evidence suggests an association between sleep disorders and BMS, melatonin was not superior to a placebo in reducing BMS-induced burning in the present study. Identification of stressors and the ways to struggle with them, further studies with larger samples and higher oral doses, extended follow-up periods and control of psychological factors, and measurement of body mass index that may affect pharmacokinetics are recommended.

Approach and Clinical Practice of Functional Movement Disorders Among Neurologists in Saudi Arabia.

Background Functional movement disorders (FMDs) are neurological disorders that consist of abnormal and involuntary movements that have no specific organic cause. Given the prevalence of FMDs and the scarcity of information on neurologists' approaches to FMDs, we aimed to assess the neurologists' approaches and clinical practice in managing FMDs in Saudi Arabia. Methods A validated online questionnaire in English was used. The data were collected through a self-reported questionnaire. The data were analyzed using the statistical software IBM SPSS version 22 (SPSS, Inc., Armonk, NY). Results A total of 231 neurologists completed the study survey. A total of 129 (55.8%) were males. Regarding the predictors for a diagnosis other than FMD, the highest rating predictor was for evidence of physical injury and lack of psychiatric history of psychological stressors, while the lowest rating was for the male gender. Regarding the effective treatment strategies of FMD, the most effective treatment strategy reported by the clinicians was patient education, while the least was alternative or complementary medicine. The management ability of clinicians was generally restricted by cultural beliefs about psychological illnesses and the availability of referral services. The reported predictors by clinicians for a better prognosis of FMD include acceptance of the diagnosis by the patient followed by identification and management of psychological stressors and concurrent psychiatric disorder and a supportive social network. Generally, the most used terminology in this study was "functional movement disorder". Conclusions There is a variation in the approach and clinical practice of FMD among neurologists in Saudi Arabia. Shared knowledge regarding diagnosis and effective management is crucial. Collaborative efforts are required to establish practice guidelines in the future.

Assessing the relative importance of stressors to the benthic index, M-AMBI: An example from U.S. estuaries

M-AMBI, a multivariate benthic index, has been used by European and American (U.S.) authorities to assess estuarine and coastal health and has been used in scientific studies throughout the world. It has been shown to be related to multiple pressures and stressors, but the relative importance of individual stressors within a multiple stressor context has not generally been assessed. In this study, we assembled data collected between 1999 and 2015 by the U.S. Environmental Protection Agency using consistent methods. These data included sediment and water quality measures and benthic invertebrate data which were used to calculate M-AMBI. We further assembled watersheds for all US estuaries with benthic data and calculated land use metrics. Random forest (RF) was used to identify those variables most strongly related to M-AMBI. Because RF is a compilation of multiple, nonlinear models, we then assessed which of these variables had a direct relationship with M-AMBI. The resulting variables were then assessed using RF to identify the subsets of variables that produced an effective and parsimonious model. This process was conducted at the national and ecoregional scale and the variables identified as being most important to predict M-AMBI were compared with literature reports of ecological patterns in a given area. At the national scale, better condition was correlated with clearer waters, lower amounts of agriculture in the watershed, and lower carbon and metal concentrations in estuarine sediments. Other stressors were identified as being important at the ecoregional scale, although sediment metal concentrations and watershed agriculture were identified as being important in most ecoregions. Our results suggest that this technique is useful to identify the most important variables impacting M-AMBI at broad spatial scales, even when the percentage of sites in Bad or Poor condition is low. This technique also provides an initial identification of important stressors that can be used to target more intensive local studies.

Identification and assessment of stress and associated stressors among veterinary students in India using a cross-sectional questionnaire survey.

Veterinary education, is a rigorous professional training program, which exposes students to significant academic and non-academic pressures. The identification of stressors and stress levels among veterinary students mighty help the designing and implementation of coping strategies to protect the students' mental health. A 44-item based cross-sectional questionnaire survey was prepared and disseminated among veterinary students in India to identify the stressors responsible, measure the amount of stress, and relate stress to characteristics like gender, degree year, and family income. A total of n = 611 veterinary students across 14 states including 27 colleges/universities participated in the study. The collected data was evaluated for sampling adequacy, construct validity, and reliability using a set of statistical tests. The analysis revealed high sampling adequacy with a KMO value of 0.957 and a highly significant anti-image correlation (p < 0.001). The principal component analysis generated six factors or subscales which effectively explained 51.98% of the variance in the data, depicting high construct validity. The Cronbach's alpha value of 0.957 revealed high internal consistency for the questionnaire. Analysis revealed more than 94% of pupils under stress, with levels ranging from moderate to severe. Academic-related stressor (95.58%) was the leading cause of overall stress in the present study followed by inter- and intrapersonal and career related-stressors (93.12%) and exams and evaluation-related stressor (90.99%). In comparison to male students, female students reported significantly higher levels of overall stress, academic stress, and intrapersonal and interpersonal stress (p < 0.001) using Chi-square. The students from lower-income families experienced significantly higher overall stress as well as stress due to family responsibilities (p < 0.001). The first-year undergraduate students reported significantly higher (p < 0.001) stress due to family responsibilities-related stressors whereas second-year students due to social activities-related stressors. The hierarchal regression model predicted that gender, family income, academic-related stressors, inter- and intrapersonal and career-related stressors, and social activities-related stressors can be employed to evaluate overall stress among students, as they ensured the maximum variance in the data (p < 0.001). To the best of our knowledge, this is the first Indian study to identify stressors, quantify associated stress and predict major attributes to be targeted in future studies for veterinary students.

Applying the DPSIR framework to qualitatively assess the globally important mangrove ecosystems of Indonesia: A review towards evidence-based policymaking approaches

Indonesia has the largest extent of mangroves globally, supporting communities at the local scale while contributing to climate change mitigation at the global scale. Yet, they are highly threatened by multiple anthropogenic and natural stressors. Thus, in this study, we aim to qualitatively assess Indonesia’s mangrove ecosystems by conducting a literature review applying the Driver-Pressure-State-Impact-Response (DPSIR) framework. By using the framework, we identified multiple stressors and existing management efforts in 27 provinces of Indonesia. For instance, we identified aquaculture expansion as the most frequented driver of mangrove loss leading to the conversion of mangroves to shrimp farms in 20 provinces. In terms of responses, mangrove rehabilitation and community-based management have a long history in Indonesia while economic valuation and payment of ecosystem services are yet to be established across the country. The identification of multiple stressors and/or threats is instrumental to addressing the causes of degradation of globally-important mangroves in Indonesia if effectively translated into policies, which remains a future challenge.

Teen Advisory Council Survey's Factors Associated With Self-Harming Thoughts.

BackgroundThe evaluation of teens with self-harming thoughts (SHT) is a high-stakes task for physicians in community and emergency department (ED) settings. The lived experience of adolescents with stress and SHT provides an important source of insight for mental health professionals who evaluate and treat teens A snapshot of the lived experience of teens in northwest Louisiana was captured by the Step Forward Teen Advisory Council (TAC) in 2019. The TAC surveyed peers with the goal of identifying common stressors experienced by local teens in order to inform policy and practices in the local school system. The identification of stressors is a critical step in addressing SHT as adolescents who experience life stressors are at increased risk for self-harming thoughts (SHT), a known precursor to self-harm and suicide. Assessing youth for life stressors is a critical element of suicide prevention.MethodsLocal teens queried 5,070 peers attending Caddo Parish schools to better understand the stressors faced by high school students in Northwest Louisiana using a student developed survey. Results were presented to peers at a virtual summit where teens developed action items to reduce stress and presented findings to local leaders. Their efforts ultimately lead to increased supports for students in local schools.ResultsOver half of the teens surveyed reported stressors that negatively impacted their physical or emotional well-being. Students endorsing self-harming thoughts reported an average of 7.82 stressors as compared to 3.47 in peers without SHT. Teens with stressors at both home and school were more likely to experience SHT than teens with stressors in a single location.ConclusionThe Gen Z students who developed the TAC Survey identified stress as a major concern for teens in Northwest Louisiana. The TAC Survey data aligns local experience with established data regarding the association between stress, depression and SHT. Second, the results highlight the importance of diving deep to identify all stressors when assessing the risk of self-harm. Finally, the lived experience of local teens with SHT provides critical information for professionals to better understand risk for SHT and suicide in our region and beyond.

Amblyopia: An Uncommon Presentation of Paediatric Conversion Disorder

AimsConversion disorder is common among children and adolescents, particularly in non-Western societies like in Bangladesh. Diverse presentation of the disorder makes it difficult to diagnose which ultimately may lead to poor prognosis.MethodsPatient X is a 10-year-old girl, a 5th grade student, hailing from a District town, Bangladesh, attending child and adolescent consultation services with the complaint of sudden loss of vision in both eyes for 3 weeks. Earlier, she underwent thorough examination and investigation and intervention by the different specialists (GP, ophthalmologist, and neurologist). At one point she was given zero power glasses. Her symptom was then fluctuating. She was not attending school as she was away for treatment purposes. X complained of not seeing lines of books when her parents tried to persuade her to do schoolwork at home. Eventually she was referred for psychiatric evaluation after no improvement. Assessment was completed and parental discord, violent act of father towards mother, overprotective as well as inconsistent parenting, attention seeking behaviour of X were identified. General and systemic examinations were normal. Her finding was inconsistent with any physical disorder. Investigation was normal. Thus, diagnosis of conversion disorder was given. General treatment (reassurance, psychoeducation, adopting daily life programme) along with specific treatment (symptom reduction by suggestion, relaxation, and family therapy) were provided. Improvement was noted during the follow-ups.ResultsThe conversion disorder of this girl happened at her period of transition from childhood to adolescence. Psychopathology of hysteria still is not clear despite huge research efforts. Based on psychodynamic explanations, the core psychopathologies of her symptoms are primary gain - resolution of her witnessing severe parental discord that she failed to cope with happened through her presenting symptoms without awareness though later she does in awareness; secondary gain- she receives additional reinforcement in the form of extra care, parental help seeking behaviour, unnecessary interventions, demand fulfilment that mostly present in awareness. Other psychopathologies are conversion- the patient's psychological distress converted to presenting somatic symptoms through an intrapsychic process; repression-la belle indifference of the patient has developed through a process of displacing distressful experience, from awareness that gives relief to the distress.ConclusionManifestations of conversion disorder can simply be explained as cry for help, give indication of the problem areas, help in understanding personality traits, making intervention and prevention plans. Early identification of stressors is crucial for the treatment of this disorder.

Socioeconomic status associates with worse asthma morbidity among Black and Latinx adults

Asthma disproportionately affects African American/Black (AA/B) and Hispanic/Latinx (H/L) patients and individuals with low socioeconomic status (SES), but the relationship between SES and asthma morbidity within these racial/ethnic groups is inadequately understood. To determine the relationship between SES and asthma morbidity among AA/B and H/L adults with moderate to severe asthma using multidomain SES frameworks and mediation analyses. We analyzed enrollment data from the PeRson EmPowered Asthma RElief randomized trial, evaluating inhaled corticosteroid supplementation to rescue therapy. We tested for direct and indirect relationships between SES and asthma morbidity using structural equation models. For SES, we used a latent variable defined by poverty, education, and unemployment. For asthma morbidity, we used self-reported asthma exacerbations in the year before enrollment (corticosteroid bursts, emergency room/urgent care visits, or hospitalizations), and Asthma Control Test scores. We tested for mediation via health literacy, perceived stress, and self-reported discrimination. All models adjusted for age, sex, body mass index, ethnicity, and comorbidities. Among 990 AA/B and H/L adults, low SES (latent variable) was directly associated with hospitalizations (β= 0.24) and worse Asthma Control Test scores (β= 0.20). Stress partially mediated the relationship between SES and increased emergency room/urgent care visits and worse asthma control (β= 0.03 and= 0.05, respectively). Individual SES domains were directly associated with asthma morbidity. Stress mediated indirect associations between low educational attainment and unemployment with worse asthma control (β= 0.05 and= 0.06, respectively). Lower SES is directly, and indirectly through stress, associated with asthma morbidity among AA/B and H/L adults. Identification of stressors and relevant management strategies may lessen asthma-related morbidity among these populations.

Identification of Water Contamination Sources Using Hydrochemical and Isotopic Studies—The Kozłowa Góra Reservoir Catchment Area (Southern Poland)

The application of combined research methods, such as hydrochemical and isotopic analyses, facilitates understanding of the origin of water constituents and migration of contaminants in the aquatic environment. The presented study attempts to identify contamination sources affecting water quality within the Kozłowa Góra reservoir catchment area (southern Poland). A total of 100 water samples were collected from surface water (the Brynica river, streams, and the reservoir) and groundwater (a Quarternary aquifer) in four time periods. During fieldwork, the physicochemical parameters were measured (temperature, pH, electrical conductivity, redox potential, and dissolved oxygen). The chemical analysis included the determination of major ions (HCO3−, SO42−, Cl−, Ca2+, Mg2+, Na+, and K+), nutrients (NO3−, NO2−, NH4+, and PO43−), and total organic carbon. The study was complemented by isotopic analysis of sulphur and oxygen in sulphate, which enabled a more precise identification of stressors affecting water quality in different parts of the catchment area. Chemical and isotopic results (δ34S = 4.38–13.99‰; δ18O 3.59–13.30‰) revealed that wastewater discharges and agricultural activities have a significant influence on the chemistry of the Brynica River and other streams. At some sampling points, a lower quality of water was manifested by elevated concentrations of NO3− (up to 22.6 mg/L) and several other ions (e.g., up to 114 mg/L for Cl−, up to 51.52 mg/L for NH4+, and 12.5 mg/L for PO43−). The quality of groundwater was deteriorated mainly by infiltration of sewage from leaky septic tanks. The level of groundwater contamination varied depending on the location, as higher concentrations of major ions and values of electrical conductivity were observed in residential areas. The Brynica river, streams, and groundwater recharge the drinking water reservoir, and thus its quality depends on these sources. A dilution of water and the presence of biochemical processes led to a reduction of contaminant concentrations in the Kozłowa Góra reservoir (down to 3.5 mg/L for NO3−, 32 mg/L for Cl−, 0.21 mg/L for NH4+, and &lt;0.05 mg/L for PO43−) compared to water in the river and streams supplying the reservoir. The study revealed the role of wastewater discharge and agricultural activities in the evolution of surface water chemistry. The results will be used in further research on the origin and migration of other substances in water, including microcontaminants.

Crisis Leadership During and After the COVID Pandemic: Astute Nurse Leaders Make the Difference.

This article explores crisis leadership, with the purpose of offering a series of leadership behaviors and strategies for nurse administrators to limit and reduce the harm of crises, specifically the COVID-19 pandemic, to healthcare professionals. Based on the assumption that generic or universal crisis management approaches are generally ineffective and efficacious crisis management must be tailored to a specific crisis, a study was conducted to identify the most serious COVID-based stressors. The results revealed 5 categories of COVID stressors which are, in ascending order: miscellaneous, administration, patients/patient family issues, inherent aspect of the job (nursing), and personal issues. Personal issues comprised more than half of the greatest COVID-specific stressors. Building on relevant crisis management literature and the identification of COVID-specific stressors, this article provides suggestions and proven tactics for nurse administrators to guide their crisis leadership efforts for the COVID-19 pandemic. The lessons of this article are applicable to other crises.