Impaired Mental Health Research Articles

Impact of COVID-19 on the mental health of men experiencing homelessness: A cross-sectional study in Osaka, Japan.

The novel coronavirus infectious disease (COVID-19) pandemic has negatively impacted not only our physical health but also mental health, including increasing depressive and anxiety symptoms. In particular, socially and physically vulnerable populations, such as people experiencing homelessness (PEH), may be more likely to have their mental health worsened by the pandemic due to having more difficulty meeting basic human needs. Therefore, this study aims to assess the impact of COVID-19 on mental health of the homeless in Japan by evaluating depressive and anxiety symptoms and identifying the associated factors particularly, sociodemographic variables as age, employment status and the fear and perceived risk of COVID-19 infection. A cross-sectional interview survey among 158 PEH in Osaka Prefecture was conducted from April to May 2022. The survey included sociodemographic questions and history and perceived risk of infection with COVID-19. Depressive symptoms were measured using the nine-item Patient Health Questionnaire (PHQ-9) and anxiety symptoms using the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the fear of COVID-19 using the seven-item Fear of New Coronavirus Scale (FCV-19S). In this study, the prevalence of depression (PHQ-9≥10) was 38.6%, anxiety disorder (GAD≥10) was 19.0%, and high fear of COVID-19 (FCV-19S≥19) was 28.5%. Univariate logistic regression analysis revealed that PEH in younger age groups (18-34 years), and with joblessness, higher perceived infection risk, and higher fear of COVID-19 were more likely to suffer from depression and anxiety (p<0.05). These results indicate that the younger PEHs with worsened economic conditions and therefore, feel threatened by COVID-19 the pandemic are at higher risk of mental health deterioration. More focused research and mental health services need to be provided to this population in the future.

Mental health and quality of life across 6 years of medical training: A year-by-year analysis.

Despite growing evidence on medical students' mental health deterioration, studies have primarily used short follow-up periods and not followed the students throughout their medical training. To assess mental health (stress, anxiety, and depression) and quality of life changes throughout their medical program, we followed up with the same cohort of students for 6 years. This longitudinal prospective study followed up with the same group of medical students at a Brazilian public medical school from 2014 to 2020. The study analyzed sociodemographic data, mental health (including depression, anxiety, and stress [DASS-21]), quality of life (WHOQOL-BREF), satisfaction from studying to be a physician, and happiness with life. General linear mixed models were used for the analyses. The cohort included 80 Brazilian medical students (63.7% women; mean age = 19.6 years [SD = 2.21]). A high prevalence of depressive symptoms, anxiety, and stress was found throughout medical training, with more than 50% of students having significant symptoms. Mental health, happiness, and quality of life levels tended to be better in the first and last semesters, being worse in the middle of the program. However, satisfaction from studying to become a doctor decreased in the second semester, remained low throughout the program, and never returned to baseline levels. Mental health and quality of life levels remained high throughout the medical program, with better levels in the first and last semesters and falling in the middle of the program. These data can help managers and educators understand how psychological distress affects medical students.

Work-related consequences of losing a child with cancer: A nationwide population-based cohort study.

Parents who lose a child are at increased risk of impaired mental health, which may negatively affect their work ability. The aims of this study were to examine the risk for reduced labor market affiliation in parents who lost a child with cancer compared to a matched parent cohort, and factors associated with the bereaved parents' labor market affiliation. We conducted a nationwide population-based cohort study using Danish registry data. We followed bereaved parents (n=1609) whose child died with cancer at age less than 30 during 1992-2020, and a matched, population-based sample of parents (n=15,188) of children with no history of childhood cancer. Cox proportional hazard models and fractional logit models were performed separately for mothers and fathers. Cancer-bereaved mothers had an overall increased risk of long-term sick leave (hazard ratio [HR]=1.62; 95% confidence interval [CI]: 1.48-1.77), unemployment (HR=1.53; CI: 1.37-1.70), and lower odds of working in the first 2years following the loss (odds ratio [OR]=0.44; CI: 0.39-0.49), while bereaved fathers had lower odds of working (OR=0.65; CI: 0.53-0.79), and increased risk of permanently reduced work ability (HR=1.29; 95% CI: 1.01-1.66), compared to the matched cohort of parents of cancer-free children. Younger parental age, lower education, and being a single parent were identified as the main determinants of the bereaved parents' reduced labor market affiliation. Cancer-bereaved parents are at increased risk of reduced labor market affiliation, compared with a matched, population-based sample of parents. Certain groups of bereaved parents may be at particularly high risk, and targeted bereavement interventions are warranted.

Health-related quality of life and its determinants among South Indian type 2 diabetes patients with and without non-alcoholic fatty liver disease

Background and aimsNon-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease in type-2 diabetics. The quality of life among those patients was not explored well. Hence, the present study aimed to correlate the determinants with the quality of life (QoL) among the study subjects.MethodsA hospital-based case–control study was conducted at Bhargavi Gastro and Surgical Hospital, Warangal, Telangana, with 358 subjects, from 1 November 2019 to 31 October 2021 (24 months). A 358 of cohort type-2 diabetes mellitus (T2DM) subjects were recruited with 1:1 of NAFLD and without NAFLD. QoL was determined with the SF-36 questionnaire, which comprises eight domains. Statistical analysis included t test, chi-square, and Spearman correlation performed with SPSSV.25 software.ResultsOut of 358 subjects, 200 (55.8%) were males and 158 (44.1%) were females. Glycemic parameters (FBS and HbA1c), lipid profile, liver transaminases (SGPT and SGOT), and serum uric acid levels were significantly high in NAFLD subjects (p < 0.05). The SF-36 score, four domains (physical, energy, mental health, and pain) are significantly reduced in NAFLD subjects p < 0.05). A significant correlation between blood urea and impaired physical, emotional mental, and general health was observed in NAFLD subjects. In the NAFLD subjects, elevated FBS levels lead to impairment of physical and emotional status. Social functioning, general health, and pain were impaired with BMI and TG levels in NAFLD subjects. The mean, SD of SF-36 scores showed no significant difference in contrast to HbA1c among both groups (p > 0.05).ConclusionThe decreased QoL was observed in subjects of T2DM with NAFLD. The QoL is significantly influenced by elevated FBS, SGPT, SGOT, and TG levels. Hence, clinicians need to be vigilant and implement strategies to improve the quality of life in type 2 diabetics with NAFLD.

Memory lapses during a pandemic: Differential associations between COVID‐stress and daily memory lapses?

AbstractThe policies related to COVID‐19 pandemic such as stay at home orders and social distancing increased daily stress and associated impairments in mental health. This study examines the association between COVID‐related stress and cognitive functioning by examining two different types of daily memory lapses, those related to prospective memory (i.e., memory for future plans) and retrospective memory (i.e., memory for past information) as well as the perceived emotional and functional consequences of daily memory problems. As part of a larger study, 58 adults (18 men; 22 ± 3 years) completed a web‐based version of the daily inventory of stressful events including stress related to COVID‐19 and positive/negative affect for eight consecutive days between 8 September 2020 and 11 November 2020. Findings showed that prospective lapses were positively correlated with COVID‐19 stressors (r = 0.41, p = 0.002). At the within‐person level, daily COVID‐19 stressors were significantly associated with the number of prospective lapses (b = 0.088, SE = 0.040). COVID‐19‐related stressors were not significantly related to retrospective lapses (all ps &gt; 0.05). Our findings suggested that more daily COVID‐19 stressors were related to greater numbers of prospective lapses in daily life even among healthy younger adults. Thus, future research should address long term relations of COVID‐19 stress and cognitive functioning in addition to the specific cognitive impairments related to COVID‐19 infection.

Burnout in mental health services in Ireland during the COVID-19 pandemic.

Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort-Reward Imbalance scale. Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort-Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19.

Self-Reported Mental Health and the Demand for Mental Health Care After a Labor Market Shock: Evidence from the Spanish Great Recession.

This research examines the mental health inequalities between employed and unemployed individuals among the fluctuations over the business cycle. To analyze whether a recession affects self-evaluated mental health and consequently increases the demand for mental health care, I exploit the sudden increase of the unemployment rate in Spain during the period 2007-2009. First, I analyze the impairment of self-evaluated mental health as a consequence of the Great Recession and if it prevails during the economic recovery. In addition, I estimate if the effect on self-reported mental health is reflected in demand for mental health care. The results from an event study design show that the economic downturn increases the differences between employed and unemployed individuals in self-evaluated mental health. However, and despite the continuous improvement in unemployment, the mental health gap remained unchanged between 2014 and 2017, which could imply the persistence of some lasting impacts of the Great Recession on mental health. Nonetheless, I find a reduction in the differences of using drugs related to mental health during the period 2011-2012, when I estimate the largest inequalities in self-evaluated mental health.

Temporal Instability of Risk Preference among the Poor: Evidence from Payday Cycles

The poor live paycheck to paycheck and are repeatedly exposed to strong cyclical income fluctuations. We investigate whether such income fluctuations affect their risk preference. If risk preference temporarily changes around payday, optimal decisions made before payday may no longer be optimal afterward, which could reinforce poverty. By exploiting social security payday cycles in the United States, we find that the poor relying heavily on social security become more risk tolerant before payday. More than cognitive decline before payday, the deterioration of mental health and relative deprivation are likely to play a role. We find similar evidence among the Japanese elderly. (JEL D81, D91, G51, I12, I32, J14, J31)

Psychological Risk Assessment with Hamilton Scales Among Menopausal Women in Chennai, South India

Introduction: Menopausal women must undergo routine mental health screenings to ensure their best mental health. This study was designed to evaluate the mental health of women going through menopause, and to associate sociodemographic and clinical factors with mental health impairment. Methodology: In this cross - sectional study, 200 menopausal women were included after getting informed consent. Data was collected using self-administered questionnaire, Hamilton Scales for Anxiety and Depression and analysis was done using SPS software. Results: The mean age of the postmenopausal women in the study was 49.5 years. Nearly 28% of women had complete high school education and 11% were graduates. About 13% of the participants were engaged in semi-professional work, 13% in unskilled work and 8.5% in clerical jobs. The factors which were found to have a statistically significant association with mental health (p&lt;0.05) were age at menopause, education, occupation and duration of menopause. Conclusion: Numerous initiatives including regular yoga sessions, creation of self-help groups, and the provision of calcium, iron and vitamins can aid in lowering postmenopausal women's psychological stress. This can enhance their ability to cope with menopause and its effects. With the use of information, education, and communication (IEC) efforts, the community must be made aware of menopause.

CHRONIC SMOKING AND PORNOGRAPHIC ADDICTION IN SCHIZOPHRENIA PATIENT WITH URBAN LIVING: CASE REPORT

Introduction – Urban living, chronic smoking is a risk factor in schizophrenia. Pornographic addiction is also a potential risk factor of schizophrenia considering its neurobiological pathways. Schizophrenia is one of the most dangerous mental illness contributing to 2,8% years lived with disability. Considering many people with urban living, chronic smoking, and pornographic consumption, relation of these risk factors to schizophrenia is demonstrated in this case report. Methods – Presented the case of the patient, 39 years old with psychotic symptoms was found to be born and lived most of his life in urban area, smoking since junior high school, and often consumed pornographic contents since senior high school. Data were taken from psychiatric interviews, general, and mental status examinations in psychiatric clinics, then a literature review was carried out. Results – People who born, and live through their live longer in a larger city, have more risk of Schizophrenia. Patient was known to be born in one of the biggest city in Indonesia, before moved out to another urban area in different countries in last two years. Crave with chronic smoking and pornographic addiction become one of contraproductive conduct source which arise difficulty in patient’s side to take an health life style with the risk of poor prognosis and mental health deterioration. Discuss – People who born and live longer in urban areas such as cities are in increased risk of schizophrenia due to social status awareness and fast paced life induce brain stress. Chronic smoking is a risk factor of schizophrenia due to the effect of nicotine on dopamine levels. Pornographic addiction is a potential risk factor due to addiction pathway effect on dopamine threshold. Conclusion – Urban living, chronic smoking, and pornographic addiction are risk factors associated with schizophrenia found in this case report. Epidemiologic and pathophysiological mechanisms behind these risk factors are an interesting view for physician dealing with schizophrenia patients. Awareness of social status and fast paced life in urban lifestyle, pathways of nicotine in dopamine dysregulation, and dopamine-related impairment in addiction are the neurobiological mechanisms behind these risk factors which a physician needs to be aware of. Keywords: schizophrenia, urban living, chronic smoking, pornographic addiction

Mental health effects of COVID-19 lockdowns: A Twitter-based analysis

We use a distinctive methodology that leverages a fixed population of Twitter users located in France to gauge the mental health effects of repeated lockdown orders. To do so, we derive from our population a mental health indicator that measures the frequency of words expressing anger, anxiety and sadness. Our indicator did not reveal a statistically significant mental health response during the first lockdown, while the second lockdown triggered a sharp and persistent deterioration in all three emotions. Our estimates also show a more severe deterioration in mental health among women and younger users during the second lockdown. These results suggest that successive stay-at-home orders significantly worsen mental health across a large segment of the population. We also show that individuals who are closer to their social network were partially protected by this network during the first lockdown, but were no longer protected during the second, demonstrating the gravity of successive lockdowns for mental health.

You better stop hiding your true self! The relationship between perceived false self, academic burnout, and mental health problems

Introduction: False self is defined as the discrepancy between what we show and what we truly think and feel, and is associated with mental health and social problems. The present study aimed to examine the perception of false self-relationships with emotions, and educational and mental health problems. Specifically, the mediation effects of emotional regulation strategies and academic burnout on the association between perceived false self and depressive symptoms as well as life satisfaction were tested. Material and methods: The study design was cross-sectional. A paper-pencil method of data collection was used. The survey included the Academic Burnout Inventory (MBI-SS), the Perceived False Self Scale (POFS), the Depressive Symptoms Questionnaire (CES-D), and the life satisfaction scale (SWS). A total number of 149 participants took part in this study (aged: M=21.09; SD=1.72; 84.6% women). Results: The findings indicate that the perceived false self, emotional suppression, cognitive reappraisal, and academic burnout explain 31% of depressive symptoms and 31% of life satisfaction. The perceived false self was associated indirectly with depressive symptoms and life satisfaction via (1) emotional suppression, (2) academic burnout, and (3) emotional suppression, cognitive reassessment, and academic burnout altogether. Conclusions: Findings confirmed that inauthenticity is connected to mental health impairment and educational problems. Hiding the true self is associated with the suppression of true emotions, and for this reason, a person may experience tension. Consequently, a long-term struggle with distress generates burnout syndrome and an increased risk of mental health problems. In preventive interventions, it is important to include actions that strengthen authentic responses. Keywords: life satisfaction, emotional regulation, academic burnout, perceived false self, symptoms of depression

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. UK Research and Innovation and National Institute for Health Research.

Association of Outdoor Physical Activity and Sports with Life Satisfaction among Women of Reproductive Age According to a European Representative Sample-A Longitudinal Analysis.

(1) Background: Low life satisfaction (LS) is associated with impaired mental and physical health. Outdoor physical activity (PA) has diverse somatic and psychological benefits. This study aimed to analyse the associations between sports settings and LS in women of reproductive age. (2) Methods: Special Eurobarometer on Sport and Physical Activity (2022, 2018, 2013) data on regularity and settings of sports/PA, LS and sociodemographic variables were analysed. The representative sample consisted of 18,489 women (34.60 ± 9.36 years). Pearson χ2 test and multivariate logistic regression analysis were conducted, using IBM SPSS version 28.0 according to the STROBE guidelines. The significance level was set at p < 0.05. (3) There was a significant difference in LS based on sports settings (χ2 = 409.696, p < 0.001). In the outdoor group, a 21.4% higher probability of being "very satisfied" compared to the non-outdoor, 30.0% higher compared to the inactive group, was found (R2N = 0.151). Dividing the sample by age, a significant effect remained in middle adulthood (35-44 years p = 0.002 and 45-49 years p = 0.033). (4) Conclusions: Our results underline the importance of the promotion of outdoor, green exercise and the development of special interventions to maintain or improve the psychological well-being of women in reproductive age.

Collective action mitigates the negative effects of COVID-19 threat and anti-abortion restrictions on mental health

BackgroundThe COVID-19 pandemic changed our lives in many different domains, forcing people to adapt to countrywide lockdowns, school shutdowns, and business closures. The burden of the COVID-19 pandemic resulted also in deterioration of mental health. At the same time, political conflicts and social inequalities was reinforced and many people engaged in demonstrations to fight for their rights. This study examines whether collective acting for an important cause during the pandemic might mitigate the impact of both political tension related to anti-abortion restrictions and COVID-19 threats on mental health. MethodsWe conducted a two-wave study with a representative sample of the Polish population, investigating the effect of participating in Polish pro-choice demonstrations on depressive and anxiety symptoms. ResultsParticipating in protests attenuated the negative effects of COVID-19 threat and anti-abortion restrictions on mental health. Moreover, we found that the feeling of solidarity with other demonstrators and sense of agency derived from such demonstrations led to lower levels of depressive and anxiety symptoms. ConclusionThe results of the study indicate that participating in meaningful and value-oriented collective action may serve as a buffer against the detrimental effects of social and health threats.

PSYCHOLOGICAL DISTRESS, COVID-19 FEAR, QUALITY OF LIFE, AND COPING STRATEGIES AMONG GENERAL POPULATION DURING THE POST- LOCKDOWN PERIOD OF THE COVID-19 PANDEMIC IN MALAYSIA

This study examined the prevalence and predictors of psychological distress among the general population of Malaysia after nationwide lockdown restrictions were lifted, querying if psychosocial factors including quality of life, COVID-19 fears, and coping strategies affected levels of psychological distress beyond sociodemographic predictors. A total of 4,904 (male = 798, female = 4106) Malaysian adults participated in an online survey conducted in August- December 2021, just after the gradual release of lockdown restrictions. Psychological distress was assessed using the General Health Questionnaire-12; quality of life was measured by the WHOQOL-BREF. The Fear of COVID-19 scale and Brief COPE tool measured the level of COVID-19 fear and coping mechanisms, respectively. The prevalence of psychological distress among respondents was 37.6%, 95% confidence interval (36%—39%). Results suggested demographic indicators of higher psychological distress, specifically younger adults, childless adults, and adults with lower income. Prior medical diagnoses and COVID-19-related stressful events increased psychological distress. Results demonstrated an association between lower quality of life across all domains and higher psychological distress. Fear of COVID-19 and avoidant coping amplified distress while problem-focused and emotional coping mechanisms played protective roles. Pronounced and prolonged mental health deterioration was observed after the nationwide lockdown was relaxed; cost-effective interventions are needed to prevent new mental health issues and promote well-being and resilience.

Physical and mental health impairments experienced by operating surgeons and camera-holder assistants during laparoscopic surgery: a cross-sectional survey.

Surgeons may experience physical and mental health problems because of their jobs, which may lead to chronic muscle damage, burnout, or even withdrawal. However, these are often ignored in camera-holder assistants during laparoscopic surgery. We aimed to analyze the differences between operating surgeons and camera-holder assistants. From January 1, 2022, to December 31, 2022, a cross-sectional survey was conducted to evaluate the muscle pain, fatigue, verbal scolding, and task load for operating surgeons and camera-holder assistants. The Nordic Musculoskeletal Questionnaire, the Space Administration Task Load Index, and the Surgical Task Load Index (SURG-TLX) were combined in the questionnaire. 2,184 operations were performed by a total of 94 operating surgeons and 220 camera assistants. 81% of operating surgeons and 78% of camera-holder assistants reported muscle pain/discomfort during the procedure. The most affected anatomic region was the shoulders for operating surgeons, and the lower back for camera-holder assistants. Intraoperative fatigue was reported by 41.7% of operating surgeons and 51.7% of camera-holder assistants. 55.2% of camera-holder assistants reported verbal scolding from the operating surgeons, primarily attributed to lapses in laparoscope movement coordination. The SURG-TLX results showed that the distributions of mental, physical, and situational stress for operating surgeons and camera-holder assistants were comparable. Like operating surgeons, camera-holder assistants also face similar physical and mental health impairments while performing laparoscopic surgery. Improvements to the working conditions of the camera-holder assistant should not be overlooked.

Differential use of postoperative psychosocial and physical services among older adults with head and neck cancer

IntroductionOlder adults undergoing head and neck cancer (HNC) surgery often have significant functional and mental health impairments. We examined use of postoperative physical, nutritional, and psychosocial services among a cohort of older adults with HNC comanaged by geriatricians and surgeons. Materials and MethodsOur sample consisted of older adults who were referred to the Geriatrics Service at Memorial Sloan Kettering Cancer Center between 2015 and 2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional, and psychosocial service utilization was assessed. Physical services included a physical, occupational, or rehabilitation consult during the patient's stay. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of psychiatry, psychology, or a social work consult. Relationships between each service use, geriatric deficits, demographic, and surgical characteristics were assessed using Wilcoxon rank-sum test or Chi-square test. ResultsIn total, 157 patients were included, with median age of 80 and length of stay of six days. The most common GA impairments were major distress (61%), depression (59%), social activity limitation (SAL) (54%), and deficits in activities of daily living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (80% and 85% vs 31%, respectively). Receipt of services was associated with longer median length of hospital stay, operation time, and greater deficits in ADLs. SAL was associated with physical and psychosocial consult and lower Timed Up and Go (TUG) score; instrumental ADL (iADL) deficits were associated with physical services; and depression and distress were associated with psychosocial services. DiscussionThe burden of psychosocial deficits is high among older adults with HNC. Future work is needed to understand the limited utilization of psychosocial services in this population as well as whether referral to psychosocial services can reduce the burden of these deficits.

Women's strategies for navigating a healthy sex life post-sexual trauma.

Sexual trauma is common. Consequences of sexual trauma can include deterioration of mental and physical health and it can also affect future romantic and sexual relationships. Previous studies have identified common healthy and destructive coping mechanisms to recover after experiencing sexual trauma, but few studies have investigated useful strategies to move into a healthy sexual relationship focused on resilience. In-depth semi-structured interviews were conducted with 41 women with a history of sexual trauma who were in a healthy sexual relationship at the time of participation. Participants provided strategies that helped them move beyond the sexually traumatic event(s) toward a healthy sexual relationship. Reflexive thematic analysis identified 5 effective and 6 ineffective strategies reported by the participants. Rich examples of resilience and empowerment were overarching in the effective strategies used for moving toward healthy sexual relationships. Women were also able to reflect on the strategies that were ineffective for them with kindness and understanding for their coping at that time, a normalizing theme for women working through sexual trauma. The results of this study will help therapists and researchers working with women who have experienced sexual trauma learn from their experiences in working beyond trauma toward a healthy sexual relationship.

Impact of the new coronavirus (SARS-CoV-2) pandemic on climacteric women’s health: Websurvey

Objective The menopausal transition is an important milestone in female reproductive life. Many studies have been conducted to assess the impact of the COVID-19 pandemic on women, but few of them focus on the climacteric population. This study aimed to investigate changes in the health and health care of climacteric women aged 40–70 years residing in Brazil during the pandemic period. Method A cross-sectional study was carried out using an electronic form with questions related to sociodemographic, clinical and gynecological data, treatments, access to health services and changes in behavior. Results A total of 419 women answered the questionnaire. Sixty percent reported weight gain and 50.8% reported reduced physical activity practice. More than 80% reported worsening mental health and 66.1% had a change in their sleep pattern. More than half reported having difficulty accessing gynecological consultations and routine examinations. Women living in capital cities reported a greater change in alcohol consumption (p = 0.002). Income change was associated with a higher prevalence of weight gain (p = 0.033) and changes in sleep quality (p = 0.018). Conclusion We observed an important reduction in the health care of climacteric women during the pandemic period, such as a decrease in medical consultations and preventive examinations, worsening of life habits and deterioration in mental health.