Negative Health Impact Research Articles

Long Working Hours, Work-life Imbalance, and Poor Mental Health: A Cross-sectional Mediation Analysis Based on the Sixth Korean Working Conditions Survey, 2020-2021.

There has been growing concern about the negative mental health impact of long working hours and overwork. Our study examined how work-life imbalance (WLI) could be a mediator between working hours and poor mental well-being. We included 34,968 individuals from a nationwide cross-sectional survey in Korea. Self-reported working hours per week were collected, and mental health was assessed using the World Health Organization (WHO)-5 Well-Being Index. Counterfactual-based mediation models were employed to disentangle the total effects into a direct effect (work hour - poor mental health) and an indirect effect (work hour - WLI - poor mental health). Out of 34,968 participants, 52.6% worked 35-40 hours/week, 20.0% worked 41-48 hours/week, 11.7% worked 49-54 hours/week, and 15.6% worked ≥55 hours/week. The odds ratios (ORs) of the total impact of working hours on poor mental health were 1.08 (95% confidence interval [CI], 1.01-1.16) for 41-48 hours/week, 1.28 (95% CI, 1.17-1.39) for 49-54 hours/week, and 1.60 (95% CI, 1.48-1.74) for ≥55 hours/week in comparison to 35-40 hours/week. The ORs of the indirect effects were 1.04 (95% CI, 1.03-1.05) for 41-48 hours/week, 1.08 (95% CI, 1.07-1.09) for 49-54 hours/week, and 1.14 (95% CI, 1.12-1.16) for ≥55 hours/week, accounting for 51%, 31%, and 28% of the total effects, respectively. Our findings suggest that WLI can partially mediate the association of long working hours with mental health deterioration. Policy efforts are required to mitigate the adverse mental health effects of overwork.

Relationship quality and educational attainment links to development of cardiometabolic morbidity and multimorbidity across middle adulthood.

The prevalence of cardiometabolic morbidity (e.g., high blood pressure, heart attack, stroke, type 2 diabetes) and multimorbidity development (2 or more cardiometabolic morbidities) are rapidly growing in the US. Cardiometabolic morbidity and multimorbidity are linked to poor well-being outcomes, high healthcare costs, and mortality. There is little known about cardiometabolic multimorbidity health disparities, particularly regarding mutable factors that might be targeted in future health interventions. In the present study, using a biopsychosocial framework (Biobehavioral Family Model), we examine whether cardiometabolic morbidity and multimorbidity development are linked to premorbid family and marital relationships and if it differs depending on socioeconomic status (i.e., educational attainment) using three waves of Midlife in the US (N = 4951). We assessed cardiometabolic development with three conceptualizations: number of cardiometabolic morbidities (i.e., count variable), individual cardiometabolic morbidities (i.e., diabetes, high blood pressure, stroke, heart attack), and severity of cardiometabolic multimorbidity (e.g., 3+ vs. zero morbidities). Family strain increased the number of cardiometabolic morbidities (OR = 1.17) and the severity of multimorbidity (e.g., 3+ morbidities: OR = 1.38). People with a high school education experienced family support as a buffer to the negative health impact of education level. Generally, marital quality appeared less impactful on cardiometabolic morbidity and multimorbidity development compared to family strain. Positive and negative family characteristics appear to function differently across educational attainment. These findings indicate that adults' non-intimate family relationships predict important outcomes such as diabetes, heart attack, stroke, and cardiometabolic multimorbidity and should be considered targets for preventative health interventions.

Optimizing elderly care: a data-driven AI model for predicting polypharmacy risk using SHARE data

Abstract Background Polypharmacy (PP), which rises with age, is a growing public health challenge, affecting health outcomes and escalating healthcare expenditure. Leveraging the comprehensive European coverage and longitudinality of the Survey of Health, Ageing, and Retirement in Europe (SHARE) study, we aim to assess PP prevalence patterns and identify the most effective machine learning (ML) model for predicting long-term PP risk, as a foundation for a scalable predictive tool. Methods We used data from participants aged above 50 who were present in wave 6 and at least one of the subsequent three waves of the SHARE study, aiming to predict PP risk at 2, 4, and 6-year intervals. PP was defined as the concurrent use of five or more medications. We analyzed PP prevalence trends and selected the predictor variables from wave 6 using LASSO regression analysis. We evaluated eight ML models, namely, ANN, SVM, DT, RF, GB, XGBoost, LightGBM, and CatBoost, using a rigorous cross-validation strategy to ensure robustness and reliability. Results Our analysis reveals an upward trend in PP prevalence across the surveyed countries, with aggregate figures rising from 34.03% (95% CI 33.1-34.9) in wave 7 to 36.75% (95% CI 35.6-37.9) in wave 8, reaching 39.91 (95% CI 38.9-40.9) in wave 9. Additionally, using the Categorical Boosting ML model to predict PP resulted in overall accuracies of 75.08%, 73.7%, and 71.65% and recall rates of 72.83%, 70.48%, and 67.96% for the 2, 4, and 6-year intervals, respectively. Conclusions This study reveals a rising trend of PP across European countries and demonstrates the potential of using longitudinal data and ML to enhance PP prediction. The tool developed represents a step forward in risk stratification, which would be particularly beneficial in practical settings where family physicians or pharmacists could employ the tool to monitor elderly patients, predict and thus prevent PP, and reduce the negative health and economic impact associated with it. Key messages • The integration of machine learning with longitudinal data presents a significant advance in polypharmacy risk prediction. • The tool we developed highlights the potential translational impact of our findings.

Large scale OECD health valuation study to estimate the economic benefits of chemical regulation

Abstract Chemical regulation aims at protecting human health and the environment from the risks of chemicals, while recognizing the economic importance of the use of chemicals. Assessment of the societal impacts of chemical regulation and different policy options requires information on both costs and benefits. So far, regulators assessing chemicals regulations has not had access to high quality and internationally comparable data on the full monetary benefit of reducing health and environmental risk. The OECD has implemented a multi-country stated preference valuation project that covers ten chemicals-related health conditions (e.g. asthma, kidney disease, infertility, etc.) with more than 80 surveys with large samples in 22 countries. The OECD Surveys on Willingness-to-Pay to Avoid Negative Chemicals-Related Health Impacts (SWACHE) project aims to establish internationally comparable values for the willingness-to-pay (WTP) to avoid negative health effects due to exposure to chemicals. The values can be used to demonstrate and measure the economic benefits of minimising the morbidity impacts of chemical regulations, environmental policies and public policies in general. The latest valuation results of the project will be presented, along with key aspects of the joint methodology used and the plans to further expand this work. In addition, the OECD is collaborating with other intergovernmental organisations via the Inter-Organization Programme for the Sound Management of Chemicals (IOMC) to update the cost of inaction estimates for chemicals as part of the Global Framework on Chemicals. An update on this initiative, that can benefit from the results of the SWACHE project, will be provided.

Efficacy of community groups as a social prescription for senior health-insights from a natural experiment during the COVID-19 lockdown.

Loneliness and associated physical and cognitive health decline among the aging population is an important medical concern, exacerbated in times of abnormal isolation like the 2020-2021 Covid-19 pandemic lockdown. In this backdrop, recent "social prescribing" based health policy initiatives such as community groups as a support structure for the aging population assumes great importance. In this paper, we evaluate and quantify the impact of such social prescribing policies in combatting loneliness and related health degeneration of the aging population in times of abnormal isolation. To this end, we conduct a natural experiment across a sample of 618 individuals aged 65 and over with varying access to community groups during the Covid-19 lockdown period. Using a random-effects, probit model to compare the differences in health outcomes of participants with access to community groups (target) with those without access (control), we find that the target group was 2.65 times less likely to suffer from loneliness as compared to the control group, along with lower incidences of reported cardiovascular and cognitive health decline. These initial findings provide preliminary support in favor of the interventional power of social prescription tools in mitigating loneliness and its consequent negative health impact on the aging population.

What COVID-19 Vaccination Strategy Should Be Implemented and Which Vaccines Should Be Used in the Post-Pandemic Era?

COVID-19 vaccines have reduced the negative health and economic impact of the COVID-19 pandemic by preventing severe disease, hospitalizations and deaths. In the new socio-economic normality, the COVID-19 vaccination strategy can be universal or high-risk and seasonal or not seasonal, and different vaccines can be used. The universal vaccination strategy can achieve greater health and herd immunity effects and is associated with greater costs than the high-risk vaccination strategy. In each country, the optimal COVID-19 vaccination strategy must be decided by considering the advantages and disadvantages and assessing the costs, health effects and cost-effectiveness of the universal and high-risk vaccination strategies. The universal vaccination strategy should be implemented when the objective of the vaccination program is to achieve the greatest health benefits from COVID-19 vaccination and when its incremental cost-effectiveness ratio is lower than EUR 30,000-50,000 per QALY or LYG. The use of adapted vaccines targeting currently circulating variants of SARS-CoV-2 is necessary to avoid the immune escape of emerging variants.

Bovine Respiratory Syncytial Virus Nanovaccine Induces Long-Lasting Humoral Immunity in Mice.

With limited therapies and vaccines available, human respiratory syncytial virus (HRSV) has a significant negative health impact on all age groups but particularly on infants, young children, and older adults. Bovine respiratory syncytial virus (BRSV) is pathogenically and antigenically similar to HRSV. Building upon previous studies using a BRSV nanovaccine coencapsulating multiple proteins, this work demonstrates the development and comparative evaluation of a coencapsulated nanovaccine to a cocktail nanovaccine formulation composed of polyanhydride nanoparticles encapsulating BRSV postfusion (F) glycoprotein and CpG ODN 1668 coadjuvant delivered simultaneously with nanoparticles encapsulating BRSV attachment glycoprotein (G) and CpG ODN 1668. These nanovaccine formulations were administered to C57BL/6 mice by one of two prime-boost regimens (i.e., intranasal/intranasal or intranasal/subcutaneous) followed by assessment of humoral immunity. The cocktail nanovaccine induced sustained anti-F and anti-G serum IgG antibody responses for 12 weeks postprimary immunization. Using polyanhydride particles to deliver G protein in a prime-boost regime also significantly induced serum anti-G antibodies compared to protein and coadjuvant alone. Serum IgG induced by the nanovaccine demonstrated virus-neutralizing capability from 42 to 119 days postprimary immunization. Further, anti-F IgG antibodies were detected in the bronchoalveolar lavage fluid of vaccinated animals. Finally, the nanovaccine induced long-lived anti-F antibody secreting plasma cells that were detectable in the bone marrow 205 days postprimary immunization. Overall, the BRSV nanovaccine(s) successfully induced long-lived humoral immune responses capable of virus neutralization, making this a promising vaccine candidate for further evaluation in other relevant animal models.

Monitoring and Predicting Air Quality with IoT Devices

The growing concern about air quality and its influence on human health has prompted the development of sophisticated monitoring and forecast systems. This article gives a thorough investigation into forecasting the air quality index (AQI) with an Internet of Things (IoT) device that analyzes temperature, humidity, PM10, and PM2.5 levels. The dataset used for this analysis comprises 5869 data points across six critical parameters essential for accurate air quality prediction. The data from these sensors is sent to the ThingSpeak cloud platform for storage and preliminary analysis. The system forecasts AQI using a TensorFlow-based regression model, delivering real-time insights. The combination of IoT technology and machine learning improves the accuracy and responsiveness of air quality monitoring systems, making it a useful tool for environmental management and public health protection. This work presents comparatively the effectiveness of feedforward neural network models trained with the ‘adam’ and ‘RMSprop’ optimizers over different epochs, as well as the machine learning algorithm random forest with varying numbers of estimators to forecast AQI. The models were trained using both types of regression analysis: linear regression and random forest regression. The findings show that the model achieves a high degree of accuracy, with the predictions closely aligning with the actual AQI values, thus having the potential to significantly reduce the negative health impact associated with poor air quality, protecting public health and alerting users when pollution levels are higher than allowed. Specifically, the random forest model with 100 estimators delivers the best overall performance for both AQI 10 and AQI 2.5, achieving the lowest Mean Absolute Error (MAE) of 0.2785 for AQI 10 and 0.2483 for AQI 2.5. This integration of IoT technology and advanced predictive analysis addresses the significant worldwide issue of air pollution by identifying the pollution hotspots and allowing decision-makers for quick reactions, and the development of effective strategies to reduce pollution sources.

Physical Characterization of Microplastic Pollutants in Groundwater

The rapid urbanization and growth of the population have led to both the ever-increasing demand for water consumption and in tandem the levels of water pollution in Malaysia. Rapid development has produced great amounts of human waste including domestic and industrial which inevitably ends up in the water resources. Contamination of microplastic (MP) pollutants in groundwater has been a huge concern nowadays since groundwater often becomes a source of drinking water. Therefore, these MP (plastic particles < 5 mm) are concerned with having a negative health impact on human health through the consumption of drinking water that has been contaminated. While MPs in groundwater likely affect human health, only a handful of studies have examined the abundance and movement of MPs in groundwater. Because of that, this study was done in two different sampling stations of groundwater that were sources of drinking water. This study indicates a total of 182 microplastics were found in the sampled groundwater. Physical characterization has been done and they were divided into four categories according to their shapes. Fibers clearly prevailed in all water samples. Despite 10 different colors of the microplastics being identified, most of the MPs are comprised of transparent plastics. Moreover, polypropylene (PP) and polyethylene (PE) were found to be predominant in the water samples. This study contributes to filling the knowledge gap in the field of emerging microplastic pollution in drinking water sources specifically groundwater, which is of concern due to the potential exposure of MPs to humans.

Multiple risk-taking behaviors in Korean adolescents and associated factors: 2020 and 2021 Korea youth risk behavior web-based survey

ObjectiveDespite the negative health impact of multiple risk-taking behaviors (RTBs), there is a lack of understanding of adolescents who are more prone to multiple RTBs. This study aimed to identify sociodemographic, mental, and physical health variables associated with increased susceptibility to multiple RTBs in each sex. MethodsCross-sectional data from the 2020 and 2021 Korea Youth Risk Behavior Web-based Survey was used. A total of 106,979 Korean adolescents (55,460 men and 51,519 women) were assessed on five RTBs (alcohol use, smoking, sexual intercourse, illicit substance use, no seat belt wearing). In comparison to no RTB group, odds ratios of the relevant covariate factors were calculated in one RTB or multiple RTBs groups. ResultsMale and female adolescents engaging in multiple RTBs were 6.4% and 3.8%, respectively. Increasing age, low subjective socioeconomic status, and living in rural areas were associated with multiple RTBs regardless of sex. All mental health variables except anxiety were associated with multiple RTBs in both sexes. Physical inactivity and obesity were associated with decreased odds of multiple RTBs in both sexes. ConclusionThis study identifies diverse factors associated with multiple RTBs of Korean adolescents and demonstrates existing sex differences. Age and mental health status are the most critical factors that distinguish multiple risk-taking groups from those involved in one or no RTB.

Comparable to 17α- methyl testosterone, dietary supplements of Tribulus terrestris and Mucuna pruriens promote the development of mono-sex, all-male tilapia fry, growth, survival rate and sex-related genes (Amh, Sox9, Foxl2, Dmrt1)

To evaluate Tribulus terrestris and Mucuna pruriens for inducing all-male tilapia, mixed-sex Nile tilapia, Oreochromis niloticus, (mean weight 0.025 ± 0.009 g; mean length 1.25 ± 0.012 cm), were given a meal supplemented with either T. terrestris powder (commercial fish feed, 40% crude protein) (TT group), M. pruriens seed extract (MP group), MP + TT (mixed group), 17α-methyl testosterone (MT, control positive), or without supplements (control negative). The MP extracts significantly increased (P < 0.05) the final weight, weight gain, weight gain rate, and specific growth rate while feed conversion ratio was significantly decreased (P < 0.05). Plant extracts markedly improved (P < 0.05) the survival rate, proportion of males, and total testosterone compared to control and MT. Estrogen levels were lower in groups with plant extract than other groups. Fifteen days post-feeding, the Amh gene was expressed in the brain of O. niloticus fries with higher levels in MP, TT, and MT groups. Additionally, the expression of the Sox9 and Dmrt1 genes as a male related genes in fish fry gonads revealed significantly (P < 0.05) higher levels in groups fed on MP, TT, and MT compared to control after 30-day post-feeding, whereas; Foxl2 gene expression as a female related gene was significantly (P < 0.05) lower in fish fed on MP, TT, and MT compared to other groups after 30 days post feeding. Histologically, MT, MP, TT, and the mixture all exhibited solely male reproductive traits without noticeable abnormalities. This study concluded that each of the TT or MP extracts can induce sex reversal in tilapia while having no negative health impact compared to MT as the growth and survival rate in the treated groups with TT and MP were higher than control and group treated with MT.

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease.

While high levels of lead exposure, as occurs accidentally or occupationally, can cause toxicity across multiple organ systems, the hazard of commonly encountered levels of lead in the environment remains unresolved. Challenges to researching the health effects of lead include its complex interplay with renal function, rendering analyses at risk of unaccounted confounding, and the likely small effect size of environmental levels of exposure. While children are known to be disproportionately susceptible to lead toxicity, resulting in appropriately more stringent regulatory surveillance for those under 5 years old, emerging evidence suggests that those with chronic kidney disease (CKD) similarly are at a greater risk. This review summarizes the role of environmental lead toxicity as a potential cause and consequence of CKD. Whether environmental lead exposure causes CKD remains debatable, with little recent research advancing the conflicting, mostly cross-sectional, analyses from years ago. However, an emerging body of evidence suggests that CKD increases the susceptibility to lead toxicity. Higher circulating lead levels and lower urinary excretion result in greater lead accumulation in CKD, with simultaneous greater risk of clinically meaningful disease. Recent studies suggest that levels of lead found commonly in the United States drinking water supply, and currently permissible by the Environmental Protection Agency, associate with hematologic toxicity in those with advanced CKD. Whether environmental lead contamination may have additional negative health impact among this at-risk population, including cardiovascular and neurocognitive disease, warrants further study. The underlying pathophysiology of kidney disease synergizes the susceptibility to environmental lead toxicity for those with CKD. Low levels of exposure, as found commonly in the United States water supply, may have adverse health impact in CKD. Further research will be needed to determine if more stringent environmental regulations are warranted to protect the health of all.

Environmental and Health Influences of Crude Oil Spills in Niger Delta, Nigeria: Case Study Oporoma Community

Oil spills have been reported over several decades in many parts of the world including Nigeria. The region of Niger Delta is greatly affected by oil spills in recent years, Oporoma inclusive. About 635 persons (both females and males) from different groups e.g farmers, fisher men and women, community representatives, and youth leaders, were interviewed between the age of 18 and 90 years old. About 25 persons representing farmers and 25 persons representing fisher men and women from each of the twelve compounds that made up Oporoma community, 25 persons were randomly selected for community representatives, and 10 youth leaders were interviewed. The interview focused mainly on health and environmental impacts of crude oil spills in the community. The data and responses gotten from the interview shows negative health and environmental impact on crude oil spill in the community. The presence of crude oil and their constituents in the environment are capable of causing some acute and long-term adverse health effects. Some carcinogens like pyrene, benzene, and polycyclic aromatic hydrocarbons are always found in crude oil, which contaminates the surface water and soil. Therefore, affecting the environment through soil, water, and air, which directly or indirectly harms humans, plants and marine ecosystem. The influence of crude oil spills not only restricted to environment and human health, it has also had impacts on the nations and the local economy, which are includes; livelihoods, farmland, fishing, wild life, and the nations revenue.

‘Start Making Sense’: A qualitative exploration of a trauma psychoeducation group for people living with HIV

People living with HIV experience high rates of mental health issues and are disproportionately impacted by psychological trauma. Exposure to trauma can play a role in acquiring HIV, contribute to negative health outcomes and impact transmission behaviours. Start Making Sense is a Phase 1 trauma psychoeducation group for people living with HIV which aims to connect, educate and empower individuals living with the dual stigma of HIV and trauma. The group is run in collaboration between an NHS trust and a third sector charity, Blue Sky Trust, supporting people living with HIV. This qualitative study explored participants’ experiences of the group intervention. Two focus groups were held with nine participants who had completed the group. A thematic analysis of the data identified five main themes: (1) connecting with others living with HIV and trauma; (2) gaining insight and control over trauma symptoms; (3) developing self-compassion; (4) practical challenges and emotional difficulties; and (5) ‘Start Making Sense’: a catalyst for change and hope. The findings suggest that a trauma psychoeducation group has potential benefits for supporting people living with HIV in reducing social isolation and stigma, understanding trauma symptoms, developing coping strategies and increasing agency and empowerment. Delivering groups in community settings can enable people to stay connected to each other and the setting beyond the timeframe of the intervention and can strengthen co-production models. This study demonstrates the range of potential benefits that trauma psychoeducation groups can have for this population and we suggest that similar interventions are piloted and evaluated.

Food taboos practice and associated factors among pregnant women attending antenatal care at Doctor Bogalech Gebre memorial general hospital, Durame town, Southern Ethiopia, 2022.

Food taboos are customs that prevent certain foods and beverages from being consumed within a society for religious and cultural reasons. Due to the restriction of essential foods and beverages, it has a significant negative health impact on pregnant women and offspring. However, there is a lack of data regarding Ethiopian food taboos practices in general and in this study area particularly. To assess the magnitude of food taboos practice and associated factors among pregnant women in Dr. Bogalech Gebre memorial general Hospital, Durame Town, Southern Ethiopia. An institution-based cross-sectional study was conducted among 422 pregnant women from August 1 to 30, 2022 by using systematic sampling techniques. Data were entered into epi-data version 3.1 and exported to SPSS version 26 for further analysis. Statistical significance was declared at a P-value < 0.05 with a 95% Confidence level. From the total 422 pregnant mothers, 54.5% (95% CI 49.90-59.20) of them encounter food taboos practice at least for one food item. The age group of pregnant mothers was 25-34 years [AOR = 0.48, 95% CI (0.28-0.84)]; the number of family size was 4-6 were [AOR = 0.42, 95% CI (0.19-0.88)]. Previous antenatal care [AOR = 1.64, 95% CI (1.02-2.66)], change feeding habit [AOR = 1.52, 95% CI (1.02-2.33)], and nausea and vomiting during pregnancy [AOR = 1.83, 95% CI (1.16-2.91)] were significantly associated with food taboos practice. The magnitude of food taboos practice among pregnant women was public health problems. Age, family size, previous antenatal care follow-up, changing feeding habits, and nausea and vomiting during pregnancy were found to be factors affecting food taboos practice.

A content analysis of legal policy responses to xylazine in the illicit drug supply in the United States

BackgroundXylazine is a veterinary sedative that is quickly spreading in the U.S. illicit drug supply and is increasingly associated with fatal overdoses and severe wounds. In response, xylazine has been deemed an emerging public health threat and several policy initiatives have been introduced to combat its spread and negative broad health impact. We aimed to synthesize trends in all-time U.S. policy responses to xylazine in the drug supply. MethodsIn April 2024, we systematically identified and categorized proposed and enacted policy initiatives that related to human xylazine consumption by searching LexisNexis and Thomas Reuters Westlaw legal databases. ResultsOf 58 unique policy initiatives, most were introduced in 2023 (n = 37/58, 64 %) and concentrated in Northeastern states. Penalties for xylazine possession, often tied to state drug scheduling changes, were the most common provision (n = 34/58; 59 %) and Schedule III was the most frequently proposed scheduling level (n = 17/30; 57 %). Other provisions included proposals to enhance: test strip access (n = 11/58; 19 %), public awareness and education (n = 3/58; 5 %), xylazine-specific research (n = 4/58; 7 %), and surveillance (n = 8/58; 14 %). ConclusionU.S. state and federal policy responses to xylazine grew rapidly in 2023, were most concentrated in states affected most by xylazine, and scheduling was the most commonly proposed policy approach. Research measuring policy effects should be prioritized as policies are implemented.

Biosensors for Food Mycotoxin Determination: A Comparative and Critical Review

The need for performant analytical methodologies to assess mycotoxins is vital, given the negative health impact of these compounds. Biosensors are analytical devices that consist of a biological element for recognizing the analyte and a transducer, which translates the biorecognition event into a signal proportional to the analyte concentration. The biorecognition elements can be enzymes, antibodies, or DNA fragments. The modalities of detection can be optical, electrochemical, thermal, or mass-sensitive. These analytical tools represent viable alternatives to laborious, expensive traditional methods and are characterized by specificity given by the biorecognition element, sensitivity, fast response, portability, multi-modal detection, and the possibility of in situ application. The present paper focuses on a comprehensive view, enriched with a critical, comparative perspective on mycotoxin assay using biosensors. The use of different biorecognition elements and detection modes are discussed comparatively. Nanomaterials with optical and electrochemical features can be exploited in association with a variety of biorecognition elements. Analytical parameters are reviewed along with a broad range of applications.

Did childhood adversity increase the vulnerability of university students to the negative mental health impact of the COVID-19 pandemic?

Objective To examine a potential synergistic effect of history of childhood adversity and COVID-19 pandemic exposure on the association with mental health concerns in undergraduate students. Participants: We used U-Flourish Survey data from 2019 (pre-pandemic) and 2020 (during-pandemic) first-year cohorts (n = 3,149) identified at entry to a major Canadian University. Methods Interactions between childhood adversity (physical and sexual abuse, and peer bullying) and COVID-19 pandemic exposure regarding mental health concern (depressive and anxiety symptoms, suicidality, and non-suicidal self-harm) were examined on an additive scale. Results We found a positive additive interaction between physical abuse and pandemic exposure in relation to suicidality (combined effect was greater than additive effect (risk difference 0.54 vs. 0.36)). Conversely, less than additive interactions between peer bullying and pandemic regarding depression and anxiety were observed. Conclusions Childhood adversities have diverse reactions to adult stressor depending on the nature of the childhood adversity and the mental health outcomes.

Disease severity, treatment patterns, and quality of life in patients with moderate-to-severe psoriasis routinely managed with systemic treatment: results of the CRYSTAL observational study in Central and Eastern European countries.

Psoriasis is a common, life-long skin disease with a significant negative health and societal impact. Data on rates of disease control and treatment strategies are lacking in Central and Eastern European countries. We aimed to describe the real-world disease severity, control, and treatment strategies for psoriasis in patients from Central and Eastern European countries. CRYSTAL (EUPAS36459) was a cross-sectional, retrospective study in adults (18-75 years) from Bulgaria, Estonia, Hungary, Latvia, Lithuania, Romania, and Russia. We enrolled patients with moderate-to-severe psoriasis receiving continuous systemic treatment for ≥24 weeks. We used the Psoriasis Area and Severity Index (PASI) to describe disease severity and the Dermatology Life Quality Index (DLQI) to assess quality of life (QoL) and collected other outcomes [psoriasis work productivity and activity impairment (WPAI-PSO), patient satisfaction] at enrollment. Analyses were descriptive. A total of 690 patients were included in the analyses. Median disease duration was 11.8 years. Current treatment was monotherapy for most patients (95.8%) with either biological (BIO group; 88.4%) or conventional (NON-BIO group; 7.4%) agents. Mean (± standard deviation) absolute PASI scores were 3.5 ± 5.7, 3.1 ± 5.3, and 6.6 ± 7.4 in the overall population, the BIO group, and the NON-BIO group, respectively. Among patients treated with monotherapy, absolute PASI scores ≤1, ≤3, and ≤5 were observed for 44.1%, 72.0%, and 82.6% of BIO patients and 21.6%, 33.3%, and 49.0% of NON-BIO patients. Mean DLQI total score was 3.3 ± 5.1; higher scores were noted for higher absolute PASI. The most impacted WPAI-PSO domain was presenteeism; for all domains, impact increased with increased absolute PASI. A total of 91.8% of BIO patients and 74.5% of NON-BIO patients were satisfied with the current treatment. We observed a better disease control in BIO than NON-BIO patients. However, around half of BIO patients did not reach clear skin status and reported an impact on QoL. An improvement in treatment strategies is still needed in Central and Eastern European countries to optimize outcomes of moderate-to-severe psoriasis.

Stress and burnout in the context of workplace psychosocial factors among mental health professionals during the later waves of the COVID-19 pandemic in Hungary.

While literature is abundant on the negative mental health impact of the COVID-19 outbreak, few studies focus on the Central and Eastern European region. We examined stress, burnout, and sleeping troubles among mental health professionals in the context of psychosocial risk factors related to participation in COVID care during the fourth and fifth waves. Mental health professionals (N=268) completed an online cross-sectional survey in Hungary, between November 2021 and April 2022. Of the respondents, 58.2% directly participated in COVID care. The main data collection instrument was the Copenhagen Psychosocial Questionnaire (COPSOQ II), including 20 subscales on work-related psychosocial factors and 3 outcome scales (stress, burnout, and sleeping troubles). We added a question on competence transgression, and items on sociodemographic and professional background. Participation in COVID care was associated with higher work pace (59.08 versus 49.78), more role conflicts (55.21 versus 45.93), lower scores on the influence at work (38.18 versus 51.79), predictability (44.71 versus 57.03), reward (55.82 versus 65.03), role clarity (70.19 versus 75.37), social support from supervisor (59.24 versus 65.55), job satisfaction (54.36 versus 62.84), trust regarding management (55.89 versus 67.86), justice and respect (44.51 versus 54.35) scales. Among those involved in COVID care, only the stress score was higher (47.96 vs. 42.35) in the total sample; however, among psychiatrists, both stress (52.16 vs. 38.60) and burnout scores (58.30 vs. 47.06) were higher. Stepwise multiple regression revealed that work-family conflict, emotional demands and workplace commitment were independent predictors of higher stress and burnout scores; furthermore, competence transgression had a significant effect on stress, and being a psychiatric specialist had a significant effect on burnout. These models explained 40.5% of the variance for stress and 39.8% for burnout. During the fourth and fifth waves, although COVID care was more well-organized, psychiatrists, as specialist physicians responsible for the quality of the care, were still experiencing challenges regarding their competence and influence at work, which may explain their increased levels of stress and burnout.