Physiological Symptoms Research Articles

Experiences of compassion fatigue among Generation Z nurses in the emergency department: a qualitative study in Shanghai, China

BackgroundDue to the unique working environment and nature of work in emergency departments, nurses are prone to experiencing compassion fatigue (CF), leading to job burnout and attrition. As more Generation Z (Gen Z) nurses enter the emergency department with distinct personality traits compared to previous generations, studying their experiences with CF will inform future management strategies.MethodsThe qualitative phenomenological research method was utilised to investigate CF among Gen Z emergency nurses at a hospital in Shanghai, China. Data were collected through face-to-face semi-structured interviews and analyzed using Colaizzi’s seven-step phenomenological analysis method. Study participants were purposively selected.ResultsThree main themes and nine sub-themes emerged from the study: secondary traumatic stress, including physiological symptoms, psychological symptoms, and behavioral changes; cumulative effects, including impaired empathy, interference with family life, and post-traumatic growth (PTG); coping strategies, including cognitive reconstruction, seeking support, and facilitating action.ConclusionsThe aim of this study is to investigate the experience of CF among Gen Z emergency nurses, providing managers with a reference for future management strategies. The significance of multi-dimensional support for Gen Z emergency nurses is underscored by our findings. Additionally, interventions that enhance resilience and competency can facilitate their psychological transformation after experiencing CF and promote accelerated personal growth.

Kappa-opioid receptor antagonism in the nucleus accumbens shell distinguishes escalated alcohol consumption and negative affective-like behavior from physiological withdrawal in alcohol-dependence

Alcohol use disorder (AUD) is a chronic relapsing disease that is deleterious at individual, familial, and societal levels. Although AUD is one of the highest preventable causes of death in the USA, therapies for the treatment of AUD are not sufficient given the heterogeneity of the disorder and the limited number of approved medications. To provide better pharmacological strategies, it is important to understand the neurological underpinnings of AUD. Evidence implicates the endogenous dynorphin (DYN)/κ-opioid receptor (KOR) system recruitment in dysphoric and negative emotional states in AUD to promote maladaptive behavioral regulation. The nucleus accumbens shell (AcbSh), mediating motivational and emotional processes that is a component of the mesolimbic dopamine system and the extended amygdala, is an important site related to alcohol's reinforcing actions (both positive and negative) and neuroadaptations in the AcbSh DYN/KOR system have been documented to induce maladaptive symptoms in AUD. We have previously shown that in other nodes of the extended amygdala, site-specific KOR antagonism can distinguish different symptoms of alcohol dependence and withdrawal. In the current study, we examined the role of the KOR signaling in the AcbSh of male Wistar rats in operant alcohol self-administration, measures of negative affective-like behavior, and physiological symptoms during acute alcohol withdrawal in alcohol-dependence. To induce alcohol dependence, rats were exposed to chronic intermittent ethanol vapor for 14 h/day for three months, during which stable escalation of alcohol self-administration was achieved and pharmacological AcbSh KOR antagonism ensued. The results showed that AcbSh KOR antagonism significantly reduced escalated alcohol intake and negative affective-like states but did not alter somatic symptoms of withdrawal. Understanding the relative contribution of these different drivers is important to understand and inform therapeutic efficacy approaches in alcohol dependence and further emphasis the importance of the KOR/DYN system as a target for AUD therapeutics.

Evaluating physiological barriers to oral intake in hospitalized patients: A secondary analysis.

Oral intake in hospitalized patients is frequently below estimated targets. Multiple physiological symptoms are proposed to impact oral intake, yet many have not been quantified objectively. To describe the challenges of objectively measuring physiological nutrition-impacting symptoms in hospitalized patients. A secondary analysis of data from a single-center, descriptive cohort study of physiological nutrition-impacting symptoms in intensive care unit (ICU) survivors and general medical patients was conducted. Demographic and clinical characteristics were extracted for patients who completed the original study and collected retrospectively for those who were screened and recruited but did not complete the original study. Reasons for patient exclusion from the original study were quantified from the screening database. Descriptive data are reported as mean ± SD, median [interquartile range], or number (percentage). ICU survivors and general medical patients were screened for inclusion in the original study between March 1 and December 23, 2021. Of the 644 patients screened, 97% did not complete the study, with 93% excluded at screening. Of the 266 ICU survivors and 398 general medical patients screened, 89% and 95% were excluded, respectively. Major exclusion criteria included the inability to follow commands or give informed consent (n = 155, 25%), the inability to consume the easy-to-chew and thin-fluid buffet meal, and imminent discharge (both, n = 120, 19%). Understanding physiological factors that drive reduced oral intake in hospitalized patients is challenging. Exclusion criteria required to objectively quantify physiological nutrition-impacting symptoms significantly preclude participation and likely act as independent barriers to oral intake.

Predicting return of lung function after a pulmonary exacerbation using the cystic fibrosis respiratory symptom diary-chronic respiratory infection symptom scale

BackgroundPulmonary exacerbations (PExs) in people with cystic fibrosis (PwCF) are associated with increased healthcare costs, decreased quality of life and the risk for permanent decline in lung function. Symptom burden, the continuous physiological and emotional symptoms on an individual related to their disease, may be a useful tool for monitoring PwCF during a PEx, and identifying individuals at high risk for permanent decline in lung function. The purpose of this study was to investigate if the degree of symptom burden severity, measured by the Cystic Fibrosis Respiratory Symptom Diary (CFRSD)- Chronic Respiratory Infection Symptom Scale (CRISS), at the onset of a PEx can predict failure to return to baseline lung function by the end of treatment.MethodsA secondary analysis of a longitudinal, observational study (N = 56) was conducted. Data was collected at four time points: year-prior-to-enrollment annual appointment, termed “baseline”, day 1 of PEx diagnosis, termed “Visit 1”, day 10–21 of PEx diagnosis, termed “Visit 2” and two-weeks post-hospitalization, termed “Visit 3”. A linear regression model was performed to analyze the research question.ResultsA regression model predicted that recovery of lung function decreased by 0.2 points for every increase in CRISS points, indicating that participants with a CRISS score greater than 48.3 were at 14% greater risk of not recovering to baseline lung function by Visit 2, than people with lower scores.ConclusionMonitoring CRISS scores in PwCF is an efficient, reliable, non-invasive way to determine a person’s status at the beginning of a PEx. The results presented in this paper support the usefulness of studying symptoms in the context of PEx in PwCF.

Long-term impact of aerodigestive symptoms on adults with oesophageal cancer: A qualitative study

Purpose The impact of long-term aerodigestive symptoms following oesophageal cancer surgery is still not well understood. This study aimed to qualitatively understand the long-term impact of aerodigestive symptoms on quality of life in adults post-oesophagectomy. Method Participants who received curative transhiatal/transthoracic surgery for oesophageal cancer in Ireland’s National Oesophageal Cancer Centre were invited to attend semi-structured interviews. Surgery had to be completed at least 12 months prior. Reflexive thematic analysis was conducted. Result Forty participants were interviewed individually face-to-face. Four key themes were identified: (a) isolation, reflecting the reported solitude experienced by oesophageal cancer survivors when attempting to manage their ongoing aerodigestive symptoms; (b) fear, including fear of choking and fear that dysphagia symptoms may indicate recurrence of oesophageal cancer; (c) altered work capacity, caused by ongoing aerodigestive symptoms; and (d) avoidance of social situations involving food, due to the pain, discomfort, and embarrassment caused by these symptoms. Conclusion Oesophageal cancer treatment can be lifesaving, however, such medical interventions can result in distressing physiological aerodigestive symptoms throughout survivorship, which can significantly impact quality of life. Our findings indicate a need for greater community support to manage aerodigestive symptoms and reduce the impact these have on quality of life.

Novel Sleep Phenotypic Profiles Associated With Incident Atrial Fibrillation in a Large Clinical Cohort

BackgroundWhile sleep disorders are implicated in atrial fibrillation (AF), the interplay of physiologic alterations and symptoms remains unclear. Sleep-based phenotypes can account for this complexity and translate to actionable approaches to identify at-risk patients and therapeutic interventions. ObjectivesThis study hypothesized discrete phenotypes of symptoms and polysomnography (PSG)-based data differ in relation to incident AF. MethodsData from the STARLIT (sleep Signals, Testing, And Reports LInked to patient Traits) registry on Cleveland Clinic patients (≥18 years of age) who underwent PSG from November 27, 2004, to December 30,2015, were retrospectively examined. Phenotypes were identified using latent class analysis of symptoms and PSG-based measures of sleep-disordered breathing and sleep architecture. Phenotypes were included as the primary predictor in a multivariable-adjusted Cox proportional hazard models for incident AF. ResultsIn our cohort (N = 43,433, age 51.8 ± 14.5 years, 51.9% male, 74.9% White), 7.3% (n = 3,166) had baseline AF. Over a 7.6- ± 3.4-year follow-up period, 8.9% (n = 3,595) developed incident AF. Five phenotypes were identified. The hypoxia subtype (n = 3,245) had 48% increased incident AF (HR: 1.48; 95% CI: 1.34-1.64), the apneas + arousals subtype (n = 4,592) had 22% increased incident AF (HR: 1.22; 95% CI: 1.10-1.35), and the short sleep + nonrapid eye movement subtype (n = 6,126) had 11% increased incident AF (HR: 1.11; 95% CI: 1.01-1.22) compared with long sleep + rapid eye movement (n = 26,809), the reference group. The hypopneas subtype (n = 2,661) did not differ from reference (HR: 0.89; 95% CI: 0.77-1.03). ConclusionsConsistent with prior evidence supporting hypoxia as an AF driver and cardiac risk of the sleepy phenotype, this constellation of symptoms and physiologic alterations illustrates vulnerability for AF development, providing potential value in enhancing our understanding of integrated sleep-specific symptoms and physiologic risk of atrial arrhythmogenesis.

Evaluation of the relationship between occupational noise exposure and stress levels in a healthcare facility

Objectives. This study aimed to assess noise levels in various units in hospitals and explore the correlation between healthcare employees’ daily noise exposure level (L ex,8h) and their stress and symptoms. Methods. A healthcare facility was selected to study noise pollution. Personal noise dosimeters were used during 8-h working shifts. Data were collected from 126 employees using the 36-item ‘A stress scale’ and a socio-demographic information form. Results. The results of noise measurements exceeded World Health Organization and US Environmental Protection Agency recommended limits at all sites. The lowest L ex,8h (52 dB) was detected in the endocrinology clinic, while the highest (91 dB) was recorded in the podology unit. According to the stress scale scores, the lowest mean psychological symptom score (PsSS), physiological symptom score (PhSS) and total scale score (TSS) were observed in diagnostic units with 35 ± 14, 41 ± 14 and 76 ± 27, respectively, while the highest mean PsSS, PhSS and TSS were observed in the polyclinics with 44 ± 6, 64 ± 10 and 107 ± 10, respectively. The PsSS of employees exposed to noise (L ex,8h) above 75 dB was found to be higher than for other employees. Conclusion. L ex,8h above 75 dB can increase psychological symptoms in healthcare employees.

Investigating physiological symptoms associated with mental health symptoms in youth with cerebral palsy: An observational study

Over 50 % of children and youth with cerebral palsy (CP) experience mental health challenges, with anxiety and depression most common. Youth with CP also experience several physiological symptoms such as fatigue, pain, sedentary lifestyle, and sleep disturbances that impact their daily living; however, little is known about the impact of these symptoms on mental health outcomes in these youth. This study addressed this gap and examined the individual and cumulative impacts of physiological symptoms on anxiety and depression symptoms in youth with CP. Forty youth with CP aged 8 to 18 years, and their caregiver, participated in this cross-sectional observational study. Pain, fatigue, anxiety, and depressive symptoms were measured using caregiver- and self-reported questionnaires and participants wore accelerometers for seven consecutive days, providing non-invasive physical activity and sleep pattern data. Youth with CP experienced substantial physiological symptoms and elevated anxiety and depression symptoms. Linear regression models determined that all physiological factors were predictive of caregiver-reported youth anxiety (R2 = 0.23) and youth depressive symptoms (R2 = 0.48). Fatigue, pain severity, sleep efficiency, and physical activity outcomes individually and cumulatively contributed to caregiver-reported youth anxiety and depression symptoms. These findings highlight the important role of physiological symptoms as potential risk factors and potential targets for intervention for mental health issues for in youth with CP.

Breast cancer symptom profile longitudinal changes: data mining study

ObjectivesIdentifying stable co-occurring symptoms in breast cancer (BC) patients during chemotherapy can improve symptom management and the treatment process. This study examines symptom cluster stability in Iranian BC patients receiving...

Using prevention guidance of common physiological symptoms in pregnancy: a qualitative study

Information about pregnancy is widely accessed by pregnant women, ranging from electronic media, print media, and even social media. One of them is the guide to the prevention of common physiological symptoms in pregnancy (PGCPSP). This guide quantitatively has a very positive impact on the success of preventing pregnancy complaints. However, independent attitudes related to the experience of using this guide have not been measured. The satisfaction and success of pregnant women in using this media is a benchmark for researchers to develop this educational media. This study aims to explore in depth the experiences of pregnant women in preventing and managing pregnancy complaints using the PGCPSP. This research is a qualitative study with a phenomenological approach. Data was collected through in-depth interviews with six pregnant women and four midwives. Participants were selected by purposive sampling. Interviews were recorded, transcribed, translated, and thematically analyzed using NVivo 12 trial version software. We identified three themes and eight sub-themes related to the experience of using PGCPSP: personal condition before using PGCPSP, experience of using PGCPSP, and recommendations for PGCPSP development. Literacy media such as PGCPSP positively impact pregnant women's experiences in overcoming various complaints. Health service providers must develop strategies using educational media. so that pregnant women have the knowledge and foster self-confidence for a satisfying pregnancy experience. In addition, efforts to develop forms of educational media through digital platforms are needed for the development of digital literacy for pregnant women in the future.

Prevalence of Anxiety and Depressive Symptoms among Hospitalized Patients Diagnosed with COVID-19.

A series of acute, atypical respiratory diseases was identified in Wuhan, China, which was named Coronavirus disease (COVID-19) by the World Health Organization (WHO), and the disease was later declared a pandemic. This disease has psychological effects in addition to physiological symptoms. This study aims to find out the psychological impacts of disease in the form of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19. A multicentric descriptive cross-sectional study was conducted among patients diagnosed with COVID-19 who were admitted from July 1, 2021 to August 15, 2021 in six different hospitals. Ethical approval was obtained from the Nepal Health Research Council (reference number 284). COVID-19 was diagnosed using Reverse Transcription Polymerase Chain Reaction (RT-PCR) or COVID-19 antigen test. Data were collected from the patients using proforma containing the demographic profile and two questionnaires (Hospital Anxiety and Depression scale and Global Health Questionnaire-12) translated into the Nepali language. Among 360 patients who participated in the study, 194 (53.9%) were males and 166 (46%) were females. Symptoms of anxiety and depression were seen in 161 (44.7%) and 253 (70.3%) of the participants respectively. Similarly 349 (96.9%) of them were found to have clinically significant mental distress. The prevalence of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19 is significantly high compared to the general population.

Physiological responses of the nickel hyperaccumulator Bornmuellera emarginata under varying nickel dose levels and pH in hydroponics

Abstract Background and aims The nickel hyperaccumulator Bornmuellera emarginata (Brassicaceae) is a species adapted to thrive on naturally nickel-enriched ultramafic soils in the Balkans and a promising candidate for use in nickel agromining. The main aim of this study was to provide insight into the physiological mechanisms of nickel hyperaccumulation in B. emarginata. Methods Bornmuellera emarginata was cultivated under various nickel exposure concentrations (control, 1, 10, and 100 µM nickel in solution), and different pH levels of the hydroponic solution for four weeks. During this period, the plants underwent assessment for various physiological parameters, including photosynthetic pigments, leaf relative water content, tolerance index, and metal accumulation in plant tissues. Results The results show that the translocation factors and bioconcentration factors were > 1 even at 1 µM nickel in solution. This confirms the ability of B. emarginata to hyperaccumulate nickel (up to 6600 mg kg−1) over a wide range of nickel concentrations in hydroponics. Nickel at 100 µM (a concentration that is an order of magnitude higher than the highest soil solution nickel concentration found in ultramafic soils) induced only mild physiological stress symptoms (e.g. a minor proline response). Alterations in the solution pH did not cause any significant effect on nickel accumulation in the plants. Conclusions Bornmuellera emarginata is a highly adapted nickel-tolerant and nickel hyperaccumulating species that shows very little stress responses even to extreme nickel exposure concentrations in hydroponics. This species shows interesting trade-off responses between nickel and other metals, including non-competitive uptake of zinc. The potential for this species to accumulate zinc should therefore be further explored.

Soil flushing coupled with aminated-nanocellulose/MOF hydrogel nanocomposites adsorbents: A novel sustainable remediation strategy for Cr(VI)-contaminated agricultural soils

Soil flushing and adsorption-based soil remediation are promising options for removing heavy metals in agricultural soil. However, they encounter limitations in low removal efficiency, secondary pollution potential, or the need for a purification/recovery process. Optimizing flushing solutions or the functional properties of adsorbents could fundamentally eliminate the drawbacks of these methods. Yet, their practical application remains a formidable challenge. Herein, a new combined remediation strategy of multiple-pulse water soil flushing (MF) with novel aminated cellulose nanofibers (A-NFCs)/AEM/AM@MIL-100(Fe) nanocomposite hydrogel adsorbent (ANCMH) was adopted to remove Cr(VI) from agricultural soil. The characteristic analyses approved Cr(VI) adsorption-coupled reduction/swelling-based mechanisms on ANCMH with the maximum theoretical adsorption capacity of 338.24 mg g−1 at pH 6.8 governed by pseudo-second-order and Freundlich models. Instead of conventional MF application using environmentally problematic extractant fluids, a 5-day soil column simulation trial of MF coupled with ANCMH adsorbent layers (MF@ANCMH) was applied in medium-to-highly Cr(VI)-contaminated soil followed by easy ANCMHs separation, preventing secondary pollution. Innovatively, the water flushing-stop flux events favorably decreased the pH of neutral soil by 0.83 folds and allowed Cr(VI) release from the soil matrix to be adsorbed by ANCMHs, achieving a high Cr(VI) removal efficiency of 98.9 %. Compared to the soil treated with ANCMH individually and soil flushed with water or Na2EDTA, the MF@ANCMH-treated soil reached the corresponding regulation of permissible levels for Cr(VI) residential scenarios in agricultural soil of 5.6 ppm with 3-cycles of ANCMH reuse. The residual Cr in MF@ANCMH-remediated soil displayed minimal bioavailability at root-zoon soil of ≤4.2 ppm and a 97.66 % reduction in its exchangeable-carbonate fraction compared to untreated soil, corresponding to a risk assessment code score below 1 %. Also, the application of MF@ANCMH resulted in Cr bioaccumulation below 0.1 ppm in cultivated wheat plants, prevented the physiological phytotoxicity symptoms, and elevated their antioxidant enzyme activity, photosynthesis, growth, and yielding indicators compared to that grown in untreated soil. Furthermore, it improved soil organic matter, microbial community, diversity, and microecological functions. This study provides a promising alternative remediation strategy for neutral soil that can maintain soil/crop quality and soil health with high chemical/environmental stability of pollutants after remediation, demonstrating its sustainability and feasibility in agricultural soil.

A new framework for understanding stress and disease: the developmental model of stress as applied to multiple sclerosis.

This paper proposes a new model of stress that integrates earlier models and adds insights from developmental psychology. Previous models describe the behavioral and physical effects of stress events, but have not explained the translation of experiences into stress itself. The Developmental Model of Stress shows how psychosocial developmental challenges in childhood create persistent negative beliefs and behaviors that increase threat perception and maladaptive stress responses. These developmental challenges produce early psychological and physiological predispositions for increased stress responses over time. Ongoing stress leads to dysregulation of physical stress-response systems (allostatic load), which is associated with multiple diseases. High allostatic load provides the necessary preconditions for the diathesis-stress model, which says the addition of an acute stressor to a weakened or predisposed system can lead to disease development. The paper also documents the evolving measurement of stress to better understand the stress-disease relationship, helping to resolve conflicting results between studies. The Developmental Model of Stress was combined with clinician insight and patient reports to build an integrative framework for understanding the role of stress in the development and progression of multiple sclerosis (MS). It includes the first mapping of maladaptive beliefs and behaviors arising from developmental challenges that are common to people with MS. An initial comparison shows these may be distinct from those of people with other chronic diseases. These beliefs and behaviors form the predisposing factors and contribute to the triggering factors, which are the acute stressors triggering disease onset. These often took two forms, a prolonged incident experienced as feeling trapped or stuck, and threat of a breach in a relationship. The reinforcing factors add the stress of a chronic disease with a poor prognosis and seemingly random symptom fluctuation, still managed with the same beliefs and behaviors developed in childhood, increasing physiological dysregulation and symptom severity. A pilot study is described in which these three categories of stress factors in MS were explicitly addressed. This study noted clinically important improvements in physical and mental well-being, providing preliminary support for the Developmental Model. Future research might expand on the pilot using a more robust sample and design.

Psychische Belastungen bei Erwerbstätigen: Leistungsinanspruchnahme und Kosten für das deutsche Gesundheitssystem

ZusammenfassungEinleitungDie Inanspruchnahme von Leistungen durch Arbeitnehmer:innen mit psychischen Belastungen sowie die damit verbundenen Kosten im Gesundheits- und Sozialsystem wurden bisher nicht systematisch in Studien erhoben bzw. nur indirekt erfasst. Diese Publikation hat zum Ziel, die Inanspruchnahme in dieser Zielgruppe zu dokumentieren, die Kosten im Gesundheits- und Sozialsystem erstmalig abzuschätzen und mögliche Einflussfaktoren der Kostenvarianz zu untersuchen.MethodikAls Teil einer Multicenter-Studie wurden Häufigkeiten der Inanspruchnahme sowie Kosten im Gesundheits- und Sozialsystem von 550 Arbeitnehmer:innen mit psychischen Belastungen erhoben. Die Inanspruchnahme von Leistungen wurde mit der deutschen Version des Client Sociodemographic Service Receipt Inventory (CSSRI) erhoben. Kosten wurden für 6 Monate berechnet. Mithilfe eines Regressionsmodells wurden Einflussfaktoren auf die Kosten überprüft.ErgebnisseZu Studienbeginn betrugen die durchschnittlichen Gesamtkosten der vergangenen 6 Monate in der Stichprobe € 5227,12 (Standardabweichung € 7704,21). Das Regressionsmodell weist auf einen signifikanten Anstieg der Kosten mit zunehmendem Alter sowie bei Personen mit Depressionen, Verhaltensauffälligkeiten mit körperlichen Symptomen und anderen Diagnosen hin.DiskussionDie berechneten Kosten sind im Vergleich zu klinischen Stichproben ähnlich hoch. Des Weiteren sollte zukünftig untersucht werden, ob sich dieses Ergebnis durch die Analyse der Längsschnittdaten verändert und ob die Intervention einen Kosteneinfluss aufweist.

Impact of background music listening on anxiety in cancer patients undergoing initial radiation therapy: a randomized clinical trial

BackgroundPatients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT.MethodsFirst-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre–post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group.ResultsThis study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre–post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded.ConclusionsFor cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.

Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia

ABSTRACT Background Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence. Objective Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia. Methods A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women’s clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed. Results Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification. Conclusions The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.

Problems most concerning to parents of children with ADHD and emotional dysregulation in a randomized controlled trial of multinutrients: MADDY secondary analysis.

With dual focus on structured, objective quantification of parent observations of child's behavior and identifying behaviors most amenable to change, this report examines Parent Target Problems (PTP) as a secondary outcome in a randomized clinical trial (RCT) of children with attention-deficit/ hyperactivity disorder (ADHD) in which one primary outcome, Clinical Global Impression-Improvement, showed a significant advantage of multinutrients over placebo and the other, Likert-type parent ratings, showed significant improvement in both groups, without significant difference between them. In a multisite 8-week RCT of broad-spectrum micronutrients ("multinutrients"), parents of children ages 6-12 (N = 126, 73% male, 88% white) with ADHD and emotional dysregulation nominated their child's most concerning problem(s) at baseline and quantified them by frequency, duration, impairment, and consequences. At subsequent visits, parents re-quantified the problem(s). Blinded child psychiatrists independently reviewed the PTPs and rated change at two timepoints compared to baseline. PTPs were grouped into 9 categories. Mean ratings were compared between active and placebo groups and explored by category. By week 8, a significant separation favored multinutrients: 38% of the multinutrient group were "definitely improved" or better, compared to 25% of the placebo group, and ratings of "no change" or "worse" occurred in 35% with placebo versus 23% with multinutrients (p = 0.04). Inattention (72.2%) and emotional dysregulation (69.1%) were the most frequently reported PTP categories. Inattention and internalizing symptoms improved more with multinutrients than placebo (p = 0.01, d = 0.55; p = 0.03, d = 0.80, respectively). The multinutrient advantage was not significant for 7 other symptoms, including hyperactivity/impulsivity, aggression, autistic symptoms, or emotional dysregulation/irritable oppositionality. This secondary analysis found that the multinutrients, compared to placebo, were associated with improvements in parental concerns overall, and in two domains specifically: inattention and internalizing symptoms (anxiety/depression), but not in seven domains: hyperactivity/impulsivity, aggression, autistic symptoms or physiological symptoms, peer relationships or emotional dysregulation/irritable oppositionality.

Effect of Ramadan fasting on changes in smoking and vaping behaviors and withdrawal symptoms severity: a cross-sectional study

Background Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior. Aim The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting. Methods A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated. Results A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts. Conclusions The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.

The effect of selenium supplementation on oxidative stress, clinical and physiological symptoms in patients with migraine: a double-blinded randomized clinical trial.

The present double-blinded randomized clinical trial aimed to investigate the effect of selenium supplementation on oxidative stress, clinical, and physiological symptoms in patients with migraine. In total, 72 patients with migraine were randomly assigned to receive either 200 μg/day selenium (n = 36) or placebo (n = 36) for 12 weeks. Clinical traits of migraine (e.g., severity, frequency, and duration of headaches), mental health indices (e.g., depression, anxiety, and distress), quality of life, biomarkers of oxidative stress (e.g., nitric oxide [NO], malondialdehyde [MDA], total antioxidant capacity [TAC], total oxidant status [TOS]), and anthropometric indices were assessed at baseline and at the end of the study. Selenium supplementation resulted in a significant reduction in NO (-1.24 ± 0.43 vs. 0.16 ± 0.43; p = 0.03) levels and a significant increase in TAC (9.89 ± 2.50 vs. -0.18 ± 2.50; p = 0.01) compared to the placebo group. Moreover, selenium supplementation had a significant protective effect against MDA levels compared to placebo (0.33 ± 0.57 vs. 1.83 ± 0.57; p = 0.03). In addition, selenium intake was associated with a lower headache frequency (-8.15 ± 0.77 vs. -4.12 ± 0.77; p < 0.001) and severity (-2.89 ± 0.42 vs. -1.16 ± 0.42; p = 0.01) as well as a lower Headache Impact Test-6 (HIT-6) score (-9.22 ± 2.00 vs. -2.08 ± 2.00; p = 0.02) compared to the controls. For other outcome variables, we found no significant effect. Selenium supplement may be considered a complementary therapy in patients with migraine due to its beneficial effects on oxidative stress and migraine symptoms. Further studies are needed to affirm our findings.Clinical Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (https://www.irct.ir) on 27 May 2023 with code number of IRCT20121216011763N60.