Ongoing Stress Research Articles

How Should Clinicians Respond to Patients Experiencing Ongoing Present Traumatic Stress of Industrial Meat Production?

Slaughterhouse work is traumatizing. Workers experience posttraumatic stress disorder (PTSD) symptoms, especially as dreams of perpetrating violence and as emotional numbing and detachment. Workers' increased likelihood of committing violence is demonstrated both anecdotally and quantitatively. This commentary on a case considers how clinicians should respond to workers' PTSD symptoms. Clinical interventions for trauma typically assume that the traumatic experiences are over, in the past-that is, not part of present, everyday work and life experiences of the trauma patient. This article suggests reasons why perpetration-induced traumatic stress should be understood as a continually present, in addition to being a post, traumatic stress disorder. Importantly, interventions for slaughterhouse workers must focus on cultivating their awareness of traumatization and its symptoms in real time. This article also describes the inadequacy of current research and practice for helping patients for whom retraumatization continues as part of their everyday work.

Cancer patient and provider responses to companion scales assessing experiences with LGBTQI-affirming healthcare.

Sexual and gender minority (SGM) persons are at a higher risk for some cancers and may have poorer health outcomes as a result of ongoing minority stress, social stigma, and cisnormative, heteronormative healthcare environments. This study compared patient and provider experiences of affirming environmental and behavioral cues and also examined provider-reported knowledge, attitudes, behaviors, and clinical preparedness in caring for SGM patients among a convenience sample. National convenience samples of oncology providers (n = 107) and patients (n = 88) were recruited separately via snowball sampling. No incentives were provided. After reverse coding of appropriate items for unidirectional analysis, lower scores on items indicated greater knowledge, more affirming attitudes or behaviors, and greater confidence in clinical preparedness to care for SGM patients. Pearson chi-square tests compared dichotomous variables and independent samples t-tests compared continuous variables. Other results were reported using descriptive frequencies. Both patient and provider samples were predominantly female sex assigned at birth, cisgender, and heterosexual. Providers were more likely than patients to report affirming cues in clinic, as well as the ability for patients to easily document their name in use and pronouns. Providers were more likely to report asking about patient values and preferences of care versus patients' recollection of being asked. Patients were more likely to report understanding why they were asked about both sex assigned at birth and gender identity compared to providers' perceptions that patients would understand being asked about both. Patients were also more likely to report comfort with providers asking about sex assigned at birth and gender identity compared to providers' perceptions of patient comfort. SGM providers had greater knowledge of SGM patient social determinants of health and cancer risks; felt more prepared to care for gay patients; were more likely to endorse the importance of knowing patient sexual orientation and gender identity; and were more likely to indicate a responsibility to learn about SGM patient needs and champion positive system changes for SGM patients compared to heterosexual/cisgender peers. Overall, providers wished for more SGM-specific training. Differences between patient and provider reports of affirming environments as well as differences between SGM and heterosexual/cisgender provider care support the need for expanded professional training specific to SGM cancer care.

Behind the Scenes of a Technologically Enhanced Intervention for Caregivers of People With Dementia: Protocol for a Feasibility and Acceptability Study.

Alzheimer's disease affects 55 million people worldwide. As the disease progresses, these individuals require a devoted caregiver, often a family member, who provides evolving complex care. Caregivers can experience a variety of ongoing stressors, resulting in reductions in caregiver emotional well-being (and other quality-of-life indicators). Information and communication technologies provide an excellent opportunity to train caregivers remotely and help them to manage these stressors and related distress. This protocol describes the theoretical rationale, study design, and methods of a new, technologically enhanced psychoeducational skill-building intervention for caregivers of people with dementia that includes a virtual reality component. Through Alzheimer's Eyes is a 4-week, single-arm, pre-post test pilot study consisting of 4 sessions of 90 minutes each that are delivered by videoconferencing. These sessions include a weekly virtual reality experience characterizing the journey of an older Latina with Alzheimer's disease from her perspective to help caregivers see through the eyes of a person with dementia. The 4 sessions cover the skill-training topics of communication, managing challenging behaviors and unhelpful thoughts, the importance of self-care, and mindfulness-all of which are key components designed to reduce stress and distress in family caregivers. Individual interviews conducted before and after the intervention gather participant insights into the intervention, evaluate its feasibility and acceptability, and assess its impact on key outcomes. Data collection for the study started in January 2022, and the results are expected to be submitted for publication in the second half of 2023. Twenty caregivers from the United States have completed the workshop to date. Preliminary data gathered from these participants support the intervention's feasibility and acceptability. Through Alzheimer's Eyes leverages existing technology combined with psychoeducational skill building to help caregivers manage their stress, regardless of their location. DERR1-10.2196/42655.

Цифрові психологічні інструменти в складних надзвичайних ситуаціях. Реалізація концепції в Україні

This text contains information about these digital psychological tools in complex emergency situations. Unprecedented number of civilians joined armed forces of Ukraine rapidly, increasing the total number of mobilised personnel 4-5 times. Civil mental health professionals were also mobilised to support service members and territory defence units and their family members. Since the beginning of war, international military psychiatry and psychology experts were supporting Ukrainian community in various ways, including participation in educational webinars and panel discussions in such topics as psychological first aid for military, psychiatric care during ongoing operation, survivability in combat situations, leadership in the army, transition back from war. However, due to shortage of military psychologists and psychiatrists, prohibition for civil psychologist to provide support at military hospitals and limited capacity to provide mental health support at the front line highlights the value of digital formats. On the second day of the war, a Telegram-based self-help chatbot called was activated for Ukraine. A chatbot simulates a text conversation with a virtual psychologist on a mobile phone. The chatbot is based on psychological first aid, with the recommendations adjusted for the ongoing stress of the war (Frankova et al, 2022). It contains various exercises, tasks, and useful recommendations on relaxation exercises and stress management. Eight weeks after being made available it has already reached more than 50 000 users. The chatbot was developed to promote mental health and based on existing resources, capable to deliver neuroscience and evidence-based recommendations during the ‘Golden Hours’ right after the escalation of war in Ukraine.

PARENTS’ DIGITAL COPING RESOURCES WITH ONGOING POLITICAL CONFLICTS

Mobile technologies such as the instant messaging application WhatsApp have become significant resources for information and social support in times of crisis, as well as for crisis communication. In times of crisis, these applications afford the exchange of real-time information and can influence users' coping behaviors. Conversely, they have also been reported to constitute a potential source of misinformation and increased exposure to emotional distress. To date, the role WhatsApp groups play for individuals, families, and communities living in regions affected by ongoing conflicts has yet to be investigated. This research draws upon the salutogenic and ecological theories to examine parents' digital coping processes with political violence in southern Israel. To this end, the study examines the types of coping resources provided in local online parent groups (OPGs) during violence escalation and relative calm periods. The study involves a mixed-methods approach comprising qualitative in-depth interviews with 15 couples who are parents of children under the age of 17 residing in communities near the Israel-Gaza border and an online ethnography of four local OPGs. Study findings reveal three levels of parents' coping resources on OPGs: personal, family, and communal digital coping resources. In addition, four WhatsApp affordances immediacy, reachability, mobility, and multimediality—contributed to WhatsApp's role as a shared and ubiquitous coping resource. This study expands the original models and core concepts of the salutogenic and ecological paradigms traditionally studied solely in offline environments and examines the effectiveness of digital contexts in helping parents cope with an ongoing collective stressor.

Post-traumatic stress disorder in doctors: Origins, approach and Eye Movement Desensitisation and Reprocessing therapy

Navigating a high-stakes clinical environment, medical doctors tend to consider trauma and adverse workplace events as 'part of their job'. This often leads to delays in help-seeking in doctors who develop acute traumatic stress symptoms (ATSS), post-traumatic stress disorder (PTSD) and their comorbidities. This article outlines the prevalence of acute traumatic stress and PTSD in this population and summarises the emerging evidence base for Eye Movement Desensitisation and Reprocessing (EMDR) early-intervention protocols of this population. Doctors have higher prevalence rates of ATSS and PTSD than the general public. Eye Movement Desensitisation and Reprocessing therapy's early-intervention protocols for recent, prolonged and ongoing traumatic stress have the potential to be a widely acceptable, timely and cost-effective intervention for doctors and other healthcare workers (HCWs), as highlighted in the emerging evidence base, which has grown considerably in response to the impact of the COVID pandemic on HCWs' mental health. These evidence-based interventions could potentially be routinely offered to doctors and other HCWs within 1month of an adverse workplace experience to reduce ATSS, PTSD and other comorbidities.

Assessing biotic response to anthropogenic forcing using mollusc assemblages from the Po–Adriatic System (Italy)

Abstract Preserving the adaptive capacities of coastal ecosystems in the Anthropocene requires an understanding of their natural variability prior to modern times. We quantified responses of nearshore molluscs assemblages to past environmental changes using 101 samples ( c. 57 300 specimens) retrieved from the subsurface Holocene succession and present-day seabed of the Po–Adriatic System (Italy). Present-day assemblages shifted in their faunal composition with respect to their mid-late Holocene counterparts. Major differences are observed in lower nearshore settings, where present-day samples show higher heterogeneity, reduced standardized richness, reduced relative abundance of Lentidium mediterraneum, and increased relative abundance of Varicorbula gibba , scavengers (genus Tritia ), and deposit feeders (nuculid bivalves). A dominance of infaunal opportunistic species and shifts towards detritus-feeding and scavenging are often associated with disturbed benthic habitats. Our results suggest that the ongoing anthropogenic stressors (mainly bottom trawling and non-native species) are currently shifting benthic communities into novel states outside the range of natural variability archived in the fossil record. Supplementary material: A document containing additional statistics, figures, and tables, also considering different filters applied to the molluscan dataset, is provided as a Word file. In addition, appendices concerning sample and taxa information and R-scripts are provided as .csv and .r files. These are available at https://doi.org/10.6084/m9.figshare.c.6351348

Do foraging ecology and contaminants interactively predict parenting hormone levels in common eider?

Global climate change is causing abiotic shifts such as higher air and ocean temperatures, and disappearing sea ice in Arctic ecosystems. These changes influence Arctic-breeding seabird foraging ecology by altering prey availability and selection, affecting individual body condition, reproductive success, and exposure to contaminants such as mercury (Hg). The cumulative effects of alterations to foraging ecology and Hg exposure may interactively alter the secretion of key reproductive hormones such as prolactin (PRL), important for parental attachment to eggs and offspring and overall reproductive success. However, more research is needed to investigate the relationships between these potential links. Using data collected from 106 incubating female common eiders (Somateria mollissima) at six Arctic and sub-Arctic colonies, we examined whether the relationship between individual foraging ecology (assessed using δ13C, δ15N) and total Hg (THg) exposure predicted PRL levels. We found a significant, complex interaction between δ13C, δ15N and THg on PRL, suggesting that individuals cumulatively foraging at lower trophic levels, in phytoplankton-dominant environments, and with the highest THg levels had the most constant significant relationship PRL levels. Cumulatively, these three interactive variables resulted in lowered PRL. Overall, results demonstrate the potential downstream and cumulative implications of environmentally induced changes in foraging ecology, in combination with THg exposure, on hormones known to influence reproductive success in seabirds. These findings are notable in the context of continuing environmental and food web changes in Arctic systems, which may make seabird populations more susceptible to ongoing stressors.

Alcohol Use disorders and harm-reduction in indigenous coastal communities of Hudson Bay Northern Canada

: Alcohol use disorders are a major contributor to morbidity and mortality across the globe. Binge drinking and suicide have a high prevalence in northern latitudes, including Canada, Alaska, Greenland, and northern Europe. Many factors are associated with alcohol misuse and suicide in these northern regions such as climate, geographic location, history of the population, which in Canada includes colonisation-related harms such as the introduction of alcohol and systematic suppression of native cultures, on-going psychosocial stressors, and governmental policies. Due to the high prevalence of alcohol misuse and suicide in the studied population, the authors introduced contextually relevant Brief Intervention (BI) into the ER and ambulatory care settings as a harm-reduction measure. The impact of BI on binge drinking and suicide is discussed. The co-ordination of BI with other harm-reduction strategies in the region include suicide awareness and intervention training, efforts by provincial and federal governmental agencies using special teams to limit the social and psychological impact of recent suicides in communities, the return of AA groups after a ten-year hiatus, and importantly the establishment of native healing programmes.

Guidance for Research with Trans and Gender-Diverse People.

When engaging in research with marginalized communities, it is important for researchers to reflect on their practice and consider what steps they can take to avoid perpetuating inequality or causing harm. This article provides guidance for researchers working with trans and gender-diverse individuals from the perspective of two speech-language pathologists. Key considerations presented by the authors include the importance of engaging in reflexive research practices-thinking deeply about and acknowledging impacts of one's personal beliefs, values, and practices on one's research-and developing an awareness of factors that contribute to the trans and gender-diverse community's ongoing minority stress. Specific suggestions to redress power imbalance between the researcher and the researched community are provided. Finally, practical methods for implementing the guidance are presented: the community-based participatory research model and an example in speech-language pathology research with trans and gender-diverse individuals.

Abstract MP42: Associations Between Psychological Resilience and Lifestyle Behaviors Among Adults in Puerto Rico Affected by Repeated Adverse Events

Residents of Puerto Rico have repeatedly experienced adverse events over the past five years including Hurricanes Irma and Maria in 2017, earthquakes in 2019-2020, Hurricane Fiona in 2022, sociopolitical unrest, a deep economic crisis, and the COVID-19 pandemic (including strict lockdown protocols). Higher psychological resilience, or the ability to “bounce back” after adversity, has been associated with better cardiovascular health in other contexts. One potential mechanism for this relationship is that higher resilience may contribute to engaging in healthier behaviors, such as higher diet quality, more physical activity, and healthier sleep duration and quality, as well as less smoking and drinking. However, such relationships have not yet been explored in this population. We cross-sectionally surveyed 1,240 adults in Puerto Rico in 2019-2022, with recruitment both before and during the COVID-19 pandemic, as part of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT). Participants responded to the Brief Resilience Scale (BRS) and Brief Resilient Coping Scale (BCS). Diet was assessed with a food frequency questionnaire and diet quality was defined by the Alternate Healthy Eating Index (AHEI). Physical activity was measured via the Harvard Alumni Activity Survey. We also collected data on average hours of sleep, quality of sleep, alcohol intake, and tobacco use. Logistic regression models estimated the odds ratios (OR, 95% CI) for following each healthy behavior by established categories of resilience (high and medium vs. low), adjusted for sociodemographic factors and co-morbidities. Of the sample, 39% (452 out of 1175) and 73% (851 out of 1170) were classified with high resilience and coping using the BRS and BCS, respectively. Adults with high resilience (vs. low) on the BRS had twice the odds [OR: 2.01, 95% CI: 1.22, 3.29] of reporting healthy sleep hours (7-8 hours/night compared to either 6 or fewer/night or 9 or more/night). High resilience was also associated with higher odds of being in the upper AHEI tertile (better diet quality) [OR: 1.61 (0.97, 2.68)], and having moderate or heavy physical activity [OR: 1.54 (1.04, 2.29) compared to sedentary or light activity]. These associations persisted when further adjusting for mental health disorders, perceived stress, and social support. Moreover, the relationships were stronger among participants interviewed during the COVID-19 pandemic, suggesting that psychological resilience may be particularly relevant during an ongoing stressor. No significant associations were noted between resilience and tobacco or alcohol use. Given Puerto Rico’s susceptibility to adverse events, seeking to improve population resilience in this and similarly vulnerable populations may lead to better health over the life course.

Patient perceptions regarding the process of obtaining oral prostate cancer medications.

120 Background: Various oral therapies exist and have improved outcomes for men with prostate cancer. These agents are expensive and put patients at risk for financial toxicity. Although assistance mechanisms exist to offset these costs, navigating through assistance can be complicated and places excess burdens on patients. We conducted a survey of men prescribed oral therapies for prostate cancer to assess financial toxicity and perceptions on the process of obtaining oral cancer medications for prostate cancer. Methods: Patients with prostate cancer who had been prescribed abiraterone, enzalutamide, apalutamide or darolutamide at our institution in the six months prior to survey distribution were identified. Those with an email address were eligible for inclusion and sent a survey. Financial toxicity was assessed using the FACIT-COST score. Perceptions of the process of obtaining medication were assessed with a novel measure, which included questions regarding affordability, delays in care and ease of obtaining medications. We assessed bivariate associations between financial variables and financial toxicity measures. Results: Of 238 patients identified, 188 had a listed email address. Response rate was 28% of eligible patients (n = 53). Among respondents, 53% reported household income < $100,000 and 32% > $100,000, 15% declined to answer. A total of 41% utilized commercial insurance, 23% Medicare D, 28% an alternative Medicare program, 2% Medicaid and 4% had no prescription coverage. Monthly costs were between $100 and $1000 for 15% of patients and > $1000 for 6%. A total of 25% of patients considered their medication somewhat or very unaffordable; 13% were somewhat or not at all confident about affording their medication in the future; 6% reported delays in starting; 15% found the initial process of obtaining their medication somewhat or very stressful; 9% reported ongoing stress about affording their medications. Those with monthly cost > $100 were less likely to consider their medication affordable (p = 0.001). Those with commercial insurance were least likely to perceive delays in care (p = 0.024). Primary insurance type but no other variable was associated with difference in COST score with those who had commercial insurance reporting less financial toxicity than those with Medicare. Conclusions: The costs of oral prostate cancer medications are a concern for many men with prostate cancer. In a survey at our institution, many patients have high costs, despite the availability of financial assistance. In addition, many reported distress and uncertainty related to the process of obtaining their prostate cancer medications. Our survey was limited by small sample size and low response rate utilizing email as primary contact. We expect that many patients without access to email would be those at higher risk of financial toxicity. Further studies will aim to recruit patients directly in clinics.

"I Know Myself Again, Which Makes Me Motivated for Life": Feasibility and Acceptability of Using Experience Sampling Methods With Trauma-Exposed Sexual Minority Women.

Intensive longitudinal designs (e.g., experience sampling methods [ESMs]) hold promise for examining the dynamic interplay between daily adversity, coping strategies, and behavioral and mental health issues among marginalized populations. However, few studies have used intensive longitudinal designs with sexual minority women (SMW), an understudied and at-risk population. We assessed feasibility and acceptability of using once-daily, interval-contingent ESM with 161 trauma-exposed SMW (Mage = 29.1, SD = 7.57); 20.5% nonbinary; 32.3% queer; 52.2% people of color; 14.3% with annual incomes ≤$9,999; and 30.4% in Southern United States (U.S.). SMW completed one comprehensive online baseline assessment and once-daily brief online assessments for 14 days. Daily surveys assessed past-24-hour stressors, stress responses, and behavioral and mental health symptoms. At the end of the 14-day ESM period, SMW answered three open-ended questions about participating in this study and about research with SMW. Regarding feasibility, 151 participants (94.0%) initiated the post-baseline ESM study portion and 72 (45.0%) completed all 14 daily surveys. An average of 11.70 (median = 13, SD = 3.31) daily surveys (83.5%) were completed by those who initiated the ESM. ESM completion level varied by race/ethnicity and U.S. region. Qualitative acceptability data revealed several themes, namely that SMW (1) enjoyed participating and felt positively about the ESM experience, (2) felt supported to reflect on impacts of early and ongoing stressors, (3) appreciated the chance to self-reflect and challenge existing thought patterns and coping behaviors, (4) recognized their capacity to tolerate trauma-related distress, (5) recommended that researchers focus on SMW's diverse stressors and daily experiences, (6) wanted a rationale for providing sensitive information and more space to narrate their experiences, and (7) recognized the need for affirmative treatment and policies. Findings could inform modifications to ESM protocols to improve their feasibility and acceptability among trauma-exposed SMW and promote ongoing utility of this valuable method.

Prevalence and predictors of mental health problems in refugee children living in informal settlements in Lebanon

Millions of people are currently displaced. About half of them are children who are at increased risk of mental health problems. While some risk factors such as war exposure are well established, less is known regarding the effects of the local refugee environment. Here we show that the prevalence and comorbidity of mental health problems in Syrian refugee children living in settlements in Lebanon are high. We assessed individual, familial and social factors in a prospective cohort study (N = 1,591 child–caregiver dyads interviewed between October 2017 and January 2018; n = 1,000 interviewed at 1 yr follow-up). Of these children, 39.6% met the criteria for post-traumatic stress disorder, 26.9% for conduct/oppositional defiant disorder, 20.1% for depression and 47.8% for anxiety disorders. Exposure to daily stressors was the factor most strongly associated with children’s mental health problems. Interventions and policies addressing ongoing daily stressors are as important as scaling up mental health services for refugee families.

Suicide among lawyers: Role of job problems.

Suicide research has neglected the legal profession. The present investigation determines what risk factors distinguish lawyers' suicides from those of the general population. Given the substantial investment in their careers, client dependency, and ongoing stress of work, job problems are seen as key potential drivers of lawyers' suicides. Data are from the National Violent Death Reporting System (NVDRS). They refer to 30,570 suicides. Fifteen predictors, including social strains, psychiatric morbidity, and demographics, are assessed as possible drivers of lawyers' suicides. The dependent variable is a dichotomy where lawyers' suicides=1 and other suicides=0. The results of a multivariate logistic regression analysis showed that after adjusting for the other 14 risk factors, lawyers' suicides were 91% more apt (Odds ratio=1.91, CI: 1.17, 3.14) than other suicides to have job problems that contributed to their suicide. Other constructs differentiating lawyers' suicides from other suicides included presence of a known mental health problem, age, presence of a known substance abuse problem, and marital status. The full model correctly classified 99.57% of the suicides. Job problems can serve as a key warning sign for lawyers' suicides. This is the first investigation of the drivers of lawyers' suicides.

A Qualitative Inquiry of Older Afghan Refugee Women's Individual and Sociocultural Factors of Health and Health Care Experiences in the United States.

Approximately 132,000 Afghans have resettled in the United States since the 1980s and are now aging. As older adults, sociocultural factors influence health and health-related behaviors. This study aimed to explore older Afghan refugee women's perceptions of individual and sociocultural factors of health and health care experiences. A focused ethnography methodology was conducted with 27 semi-structured interviews with older Afghan refugee women, family members, and community key informants in Southern California. Recorded interviews were transcribed and analyzed using inductive thematic analysis. Five themes were identified as key to health promotion in the post-migration setting: (a) health promotion through Islam, (b) the centrality of family, (c) ongoing stressors that impact health, (d) needing support in navigating health services, and (e) miscommunication leading to mistrust of health care providers. Health interventions should consider social and cultural contexts and faith-based and family-centered approaches when addressing older Afghan refugee women's long-term health and well-being.

We’re all in this together? Community resilience and recovery in Kaikōura following the 2016 Kaikōura-Hurunui earthquake

ABSTRACT The magnitude 7.8 earthquake that struck North Canterbury, on the east coast of New Zealand’s South Island on 14 November 2016 had significant impacts and implications for the community of Kaikōura and surrounding settlements. The magnitude and scope of this event has resulted in extensive and ongoing geological and geophysical research into the event. The current paper complements this research by providing a review of existing social science research and offering new analysis of the impact of the earthquake and its aftermath on community resilience in Kaikōura over the past five years. Results demonstrate the significant economic implications for tourism, and primary industries. Recovery has been slow, and largely dependent on restoring transportation networks, which helped catalyse cooperation among local hospitality providers. Challenges remain, however, and not all sectors or households have benefited equally from post-quake opportunities, and long-term recovery trajectories continue to be hampered by COVID-19 pandemic. The multiple ongoing and future stressors faced by Kaikōura require integrated and equitable approaches in order to build capability and capacity for locally based development pathways to ensure long-term community resilience.

Predictors of Adolescent Resilience During the COVID-19 Pandemic in a Community Sample of Hispanic and Latinx Youth: Expressive Suppression and Social Support.

The COVID-19 pandemic has created unprecedented disruptions in the daily lives and mental health of adolescents. Less attention has been given to the psychosocial resources that may mitigate the impact of COVID-19 on adolescent mental health, particularly among minoritized populations. In the present study, 259 youth (aged 11-18) were recruited from a community center for integrated prevention and intervention services in a predominantly Latinx and Hispanic community. Youth completed questionnaires about the impact COVID-19 has had on their lives, psychosocial resources (humor, optimism, emotion regulation, social support), and psychiatric symptoms (depressive symptoms, anxiety symptoms, sleep disturbances, aggression). After accounting for age, sex, and exposure to early life adversity, higher reported COVID-19 impact was associated with more depressive symptoms, b = 6.37 (SE = 1.67), 95% CI [3.08, 9.66], p < 0.001, more anxiety symptoms, b = 9.97 (SE = 1.63), 95% CI [6.75, 13.18], p < 0.001, and more sleep disturbances, b = 1.24 (SE = 0.34), 95% CI [0.57, 1.91], p < 0.001. Youth that reported infrequent expressive suppression and the lowest scores on giving social support were at the greatest risk for aggressive behavior in the context of high COVID-19 impact, ps < 0.007. Increasing emotion regulation skills, such as expressive suppression, and opportunities to give social support may promote resilience among high risk youth in the context of this ongoing community stressor.

Oxidative stress and related metabolic alterations are induced in ex situ perfusion of donated hearts regardless of the ventricular load or leukocyte depletion

We sought to determine the role of donor blood circulating leukocytes in mediating oxidative stress and inflammation during normothermic ex situ heart perfusion (ESHP). Normothermic ESHP allows preservation of donated heart in a perfused, dynamic state, preventing ischemia. However, the cardiac function declines during ESHP, limiting the potential of this method for improvement of the outcomes of transplantation and expanding the donor pool. Extracorporeal circulation-related oxidative stress plays a critical role in the functional decline of the donor heart. Hearts from domestic pigs were perfused in working mode (WM, whole blood-based or leukocyte-depleted blood-based perfusate) or nonworking mode. Markers of oxidative stress and responsive glucose anabolic pathways were induced in the myocardium regardless of left ventricular load. Myocardial function during ESHP as well as cardioprotective mechanisms were preserved better in WM. Leukocyte-depleted perfusate did not attenuate tissue oxidative stress or perfusate proinflammatory cytokines and did not improve functional preservation. Although ESHP is associated with ongoing oxidative stress and metabolic alteration in the myocardium, preserved cardioprotective mechanisms in WM may exert beneficial effects. Leukocyte depletion of the perfusate may not attenuate inflammation and oxidative stress effectively or improve the functional preservation of the heart during ESHP.

For ASD, Psychiatrists Must Continuously Monitor Patients, Assess Therapies

For ASD, Psychiatrists Must Continuously Monitor Patients, Assess Therapies