Significant Psychological Impact Research Articles

Navigating breast cancer brain metastasis: Risk factors, prognostic indicators, and treatment perspectives

In this editorial, we comment on the article by Chen et al . We specifically focus on the risk factors, prognostic factors, and management of brain metastasis (BM) in breast cancer (BC). BC is the second most common cancer to have BM after lung cancer. Independent risk factors for BM in BC are: HER-2 positive BC, triple-negative BC, and germline BRCA mutation. Other factors associated with BM are lung metastasis, age less than 40 years, and African and American ancestry. Even though risk factors associated with BM in BC are elucidated, there is a lack of data on predictive models for BM in BC. Few studies have been made to formulate predictive models or nomograms to address this issue, where age, grade of tumor, HER-2 receptor status, and number of metastatic sites (1 vs > 1) were predictive of BM in metastatic BC. However, none have been used in clinical practice. National Comprehensive Cancer Network recommends screening of BM in advanced BC only when the patient is symptomatic or suspicious of central nervous system symptoms; routine screening for BM in BC is not recommended in the guidelines. BM decreases the quality of life and will have a significant psychological impact. Further studies are required for designing validated nomograms or predictive models for BM in BC; these models can be used in the future to develop treatment approaches to prevent BM, which improves the quality of life and overall survival.

The psychological impact of the rise in media reporting of sexual violence after COVID-19 pandemic on Pakistani women's mental health.

Pandemics usually have inequitable effects on the most vulnerable groups of society. Since the start of COVID-19, there has been a horrifying upsurge in cases of sexual and gender-based violence against women, globally. Consequently, frequent breaking news of sexual violence in media aggravated mental distress and worry among women. In this cross-sectional study, we investigated the impact of the rise in active circulation of news of sexual violence on the mental health of working women and students using the validated DASS-21 questionnaire. A total of 303 women with diverse socio-demographic backgrounds participated in the study. We performed a chi-square test to analyze the association of increase in media reporting with DASS-21total and sub-categories scores. Multivariate linear regression was performed on propensity score-matched subjects to identify psychosocial predictors of mental distress. Increased self-reported worries in response to rise in media reports of sexual violence was found to be significant predictor of mental distress (p < 0.002). Moreover, highly significant correlation between the increase in media reports and scores of depression, anxiety, and stress was observed (p < 0.001). The rise in media reporting of sexual violence in the after math of COVID-19 was found to have a significant psychological impact on the mental health of Pakistani women. This is the first study of its kind on the subject and provides fundamental findings for shaping policy change on responsible media reporting of sexual violence.

Assessing vacuum erectile devices effect on post‐radical prostatectomy erectile function

AbstractIntroduction and ObjectiveRadical prostatectomy, as a treatment for prostate cancer, could lead to erectile dysfunction (ED) which affects the sexuality of patients and may have significant psychological impact and in quality of life. Vacuum erectile devices (VED) have emerged as a non‐invasive solution to aid post‐prostatectomy ED recovery. This study aims to assess the gains in erectile function (EF) with VED usage in patients submitted to Retzius‐sparing robot assisted radical prostatectomy (RS‐RARP) at 6‐ and 12‐months post‐surgery.Materials and MethodsBetween January 2022 and September 2022 our center performed 46 RS‐RARP, these patients had pre‐ and post‐operative evaluations every 3 months during the first‐year post‐surgery, led by urology nursing team. If ED was identified and/or patient reported intention to improve EF a penile rehabilitation programme (PRP) that included VED usage was recommended. We conducted a prospective observational single‐center study where EF was assessed using the International Index of Erectile Function (IIEF‐5) at 6‐ and 12‐months post‐surgery. We compared the results of patients that had IIEF‐5 score &lt;15 at 6‐month mark and started using VED, with IIEF‐5 score at 12‐month mark. The inclusion criteria are: patients that did not have adjuvant or salvage treatments during the follow up; have post‐operative evaluations with IIEF‐5 at 6 and 12 months and started PRP. A total of 43 patients were included. We have considered ED rehabilitation if the patient had at least 5 points gain on IIEF‐5 score at 12 months versus IIEF‐5 at 6 months. Every patient provided written informed consent for study inclusion, approved by the Institutional Ethics Committee (Approval 07.07.2017).ResultsFrom the total of patients included, 22 had an IIEF‐5 score &lt;15 at 6‐month mark. We recommended VED to 7 patients and 4 used a VED regularly. Regarding patients that used VED, 3 had better IIEF‐5 score at 12‐month mark comparing to 6‐month mark, with an average gain of 7,75 in IIEF‐5 score. Regarding the total of patients (n = 43), 16 still had IIEF‐5 score &lt;15 at 12‐month mark.ConclusionThis observational study underscores the potential benefits of VED in aiding EF recovery post RS‐RARP. Regular use of VED demonstrated significant improvement in IIEF‐5 score at 12‐month mark. Our findings suggest that integrating VED into the post RS‐RARP rehabilitation care plan could serve as an effective strategy for patients that do not respond effectively to phosphodiesterase type 5 inhibitors. Study limitations are small sample of patients that used VED and not having a stablished VED protocol. Further controlled trials are warranted to validate these findings and explore long‐terms effects.

DEPRESSION IN FAMILY MEMBERS OF ALCOHOL DEPENDENCE PATIENTS: AN OBSERVATIONAL STUDY

Objectives: The aim of the study was to find out prevalence and severity of depression in family members of alcohol-dependence patients. Methods: This was a cross-sectional, observational study in which 50 family members of patients with alcohol dependence according to mental and behavioral disorders diagnostic criterion for research (ICD-10 DCR) included on the basis of a predefined inclusion and exclusion criteria. The severity of alcohol dependence was assessed by Alcohol Use Disorders Identification Test-C (AUDIT-C) score. The incidence of depression and its severity in family members was assessed by Hamilton Rating Scale for Depression (HAM-D) score. The correlation of AUDIT-C score in alcohol-dependent patients and HAM-D score in family members was done by using Pearson coefficient correlation statistical purposes p&lt;0.05 was considered as statistically significant. Results: Out of the 50 patients with alcohol dependence, 48 (96.00%) were males and 2 (4%) were females. The mean age of the patients was found to be 41.12±11.02. The mean duration of alcoholism was 8.16±5.39 years. 19 (38%) patients had AUDIT-C score of 8 whereas AUDIT-C score of 10 and 12 was found in 16 (32%) and 15 (30%) patients each. The most commonly affected relative was spouse (40%), followed by mother (26%), brother (20%), and father (14%). Majority of the family members (82%) had mild depression (score between 8 and 13). Nine (18%) patients did not have any depression. Moderate, severe, or very severe depression was not seen in any family member. There was a significant positive correlation between AUDIT-C score in alcohol-dependent patients and HAM-D score in family members (R score=0.6333 and p&lt;0.005). Conclusion: There is a significant psychological impact, particularly depression, of alcohol dependence on family members. Severity of hazardous drinking correlated positively with the incidence of depression in family members.

Psychological Impact and Posttraumatic Stress Disorder Symptomatology After Ulnar Collateral Ligament Injuries in Baseball Players.

Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury. To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury. Cross-sectional study; Level of evidence, 3. Male baseball players of various competition levels (high school through Minor League Baseball [MiLB]) who underwent surgery for a UCL injury between April 2019 and June 2022 participated in the study. Before surgery, patients completed the Impact of Event Scale-Revised (IES-R) to assess PTSD symptomatology. Subgroup analysis was conducted according to level of play and player position. A total of 104 male baseball players with a mean age of 19.4 years (range, 15-29 years) were included in the study; 32 players (30.8%) were in high school, 65 (62.5%) were in college, and 7 (6.7%) were in MiLB. There were 64 (61.5%) pitchers, 18 (17.3%) position players, and 22 (21.2%) 2-way players (both pitching and playing on the field). A total of 30 (28.8%) patients scored high enough on the IES-R to support PTSD as a probable diagnosis, and another 22 patients (21.2%) scored high enough to support PTSD as a clinical concern. Nineteen patients (18.3%) had potentially severe PTSD. Only 4 players (3.8%) were completely asymptomatic. Subgroup analysis revealed college players as significantly more symptomatic than high school players (P = .02), and 2-way players were found to be significantly less susceptible to developing symptoms of PTSD compared with pitchers (P = .04). Nearly 30% of baseball players who sustained a UCL injury qualified for a probable diagnosis of PTSD based on the IES-R. Pitchers and college athletes were at increased risk for PTSD after UCL injury compared with 2-way players and high school athletes, respectively.

A Randomized Controlled, Single-Observer Blinded Study on the Safety and Efficacy of a Combination of 678nm Helmet-Type Low-level Laser Therapy and Topical Minoxidil 5% Versus Topical Minoxidil 5% Alone in the Treatment of Male Androgenetic Alopecia

Male pattern androgenetic alopecia is a chronic, progressive condition with significant social and psychological impact. Few preliminary researches have been done on the role of low-level laser therapy as a treatment modality for male pattern hair loss. This is a randomized, controlled, single-observer blinded clinical trial conducted from November 2019 to October 2021 at the East Avenue Medical Center Dermatology Out-Patient Department on the use of low-level laser therapy and topical minoxidil for the treatment of androgenetic alopecia. Twenty-four male adults with Norwood Hamilton Hair Loss Scale of IIa to V were randomly assigned into 2 groups: a control group (monotherapy with topical minoxidil 5%) and a treatment group (678 nm helmet-type low-level laser therapy and topical minoxidil 5%). A statistically significant higher increase in hair density was observed in the treatment group (14.58 and 15.08 for the right and left sides, respectively) compared to the control (5.83 on the right and 5.50 on the left, respectively, p=.000 &lt;.05). In addition, the investigator’s global photographic assessment and patient satisfaction were also significantly higher. Both treatments were well tolerated. The results of this study show that 678 nm helmet-type low-level laser therapy is an effective adjunctive treatment modality to topical minoxidil 5% solution for the treatment of male androgenetic alopecia.

Impact Of Walking And The OTAGO Exercise Program On Improving Balance Parameters In The Elderly

There will likely be a rise in fall rates as the population ages. This will impact our society and put more strain on healthcare systems by increasing the number of unintentional injuries and injury-related deaths. According to Zijlstra et al. (2007), falls have a significant psychological impact on individuals, frequently leading to diminished confidence, decreased functional activity, deconditioning, and an elevated risk of falls. Estimated costs of fall-related damage to older adults owing to demographic changes in Australia (2003) predict that by 2051, fall-related injuries, which currently account for 5% of the country's overall health budget, would triple and cost the Australian health system about $1,375 million annually. Exercise and other modifications in lifestyle can potentially reduce the risk of many physical falls (Gregg et al., 2000; Sherrington et al., 2011). The current recommendations for physical exercise among older persons, which include elements of aerobic, resistance, and balance training, are not met by many of them. According to Chodzko-Zajko et al. (2009), the American College of Sports Medicine (ASCM) advises older persons to engage in aerobic, muscle-strengthening, and flexibility exercises. People who have mobility issues or are at risk of falling should also engage in certain activities designed to enhance their balance. We determined that the study's subjects would be third-age individuals (over 65) who reside in assisted living facilities located in Tirana's district and city due to the issues that this demographic faces. Keywords: falls prevention, ageing, nursing home support services, quality of life, older people, walking, OTAGO exercise program, balance, preventive care.

Sensate immediate breast reconstruction.

As breast cancer therapies and associated oncologic outcomes continue to improve, greater attention has been placed on quality-of-life issues after breast cancer and breast cancer risk-reducing treatments. The loss of sensation that typically occurs after mastectomy can have significant negative psychological, sexual, and functional impact on patients after surgery. Further, injury of nerves not only leads to numbness, but can also cause chronic neuropathic pain, which can be very debilitating to affected patients. In order to minimize these impacts, there is expanding uptake of surgical approaches that preserve nerves at the time of mastectomy and reconstruct injured nerves either during mastectomy or during delayed reconstruction. These advances have been facilitated by anatomic studies investigating different variants of intercostal anatomy and better understanding the course of the nerves innervating the mastectomy skin and nipple-areolar complex (NAC). With improved knowledge of the intercostal nerve anatomy, surgeons are able to carefully preserve nerves at the time of mastectomy, thus improving sensory outcomes. Additionally, nerve reconstruction techniques have advanced, particularly with newer nerve allograft technologies, which allows for nerve reconstruction to be done both at the time of mastectomy, as well as in a delayed fashion. The focus of this article is to describe the current state of sensory preservation and immediate reinnervation at the time of mastectomy and the advances that have allowed for these new approaches.

Influence of social media on psychological health of youth during COVID-19 pandemic

ABSTRACT Context: Medical undergraduates, being away from their institutes due to the lockdown, are at a greater risk of being affected by the negative news, which may easily instill fear and panic among them. Therefore, the present study was planned with the objective to study the effects of media exposure on the psychological health of undergraduate medical students at a tertiary health institute. Aim: To assess the psychological effects of social media/media use and coping mechanisms adopted during the COVID-19 pandemic. Settings and Design: Tertiary care teaching Institute and Cross-sectional study. Material and Methods: It is a cross-sectional observational study performed among (under graduate) UG students, which was assessed using a pre-tested questionnaire including the pre-validated DASS-21 scale. Statistical Analysis: Data collected was entered in MS Excel. Descriptive statistics and correlation of the study variables were analyzed while controlling for demographics using Epi-info software version 7.2.2. Results: It was observed that around one-fifth of the participants have moderate depression, followed by mild 10.97%; one-fifth of the participants have moderate levels of anxiety 20.41% followed by extremely severe anxiety 13.27% and about two-thirds of the study participants having no stress 64.29% followed by mild stress 14.80% and moderate stress 9.69%. Conclusion: There was a significant psychological impact of the use of social media among young populations, particularly anxiety, stress, and depression with exposure to negative news and reports on social media platforms.

Psychological Impact of Sexual Disorders Related to Benign Prostatic Hypertrophy

Objectives: Lower urinary tract disorders related to BPH are today among the most frequent symptoms in urology. The aim of our study is to determine the prevalence of erectile dysfunction in patients with BPH-related lower urinary tract symptoms and the related psychological impact. Methods: We conducted a study to assess the psychological impact of BPH-related sexual dysfunction. We used two scores to assess anxiety-depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9), which gives an indication of the severity of depression, and the Generalized Anxiety Disorder - 7 (GAD-7) 1 for screening patients for generalized anxiety disorder. The severity of erectile dysfunction was specified using the SHIM score (Sexual Health Inventory for Men). Results: A total of 290 participants. The mean age was 58 years, 175 (60%) patients had erectile dysfunction, 120 (60%) of these patients with ED were treated with alpha blockers (OR=2.38, RR = 1.43, p = 0.04). The most represented age group was 60-69 years, 50 (28%) patients were treated with alpha blockers (OR=1.67, RR = 1.15, p = 0.01) while only 10 (5.7%) patients were treated with herbal extracts (phytotherapy). 65% of participants with erectile dysfunction showed varying degrees of depression and 53% of participants with erectile dysfunction showed varying degrees of anxiety. Conclusion: Micturition disorders caused by benign prostatic hyperplasia (BPH) and erectile dysfunction are frequent and often coexist. BPH-related erectile dysfunction has a significant psychological impact.

(205) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach

Abstract Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

(343) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach

Abstract Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

Living with myocardial ischaemia and no obstructive coronary arteries: a qualitative study

ObjectiveTo explore the lived experience of people with myocardial ischaemia with no obstructive arteries.DesignQualitative study using semistructured interviews.SettingTelephone interviews with 17 participants living in the UK.Participants17 people (2 males, 15...

Impact of Living with Stigma in Persons with Type 1 Diabetes: A Patient-Physician Perspective.

Type 1 diabetes mellitus (T1D) is an autoimmune disorder characterized by a complete deficiency in insulin due to the destruction of pancreatic beta cells. Globally, T1D accounts for nearly 5-10% of the total diabetes cases. Living with this life-long condition has a significant emotional, psychological, physical, mental, and social impact. Despite extensive research characterizing the underlying physiology of T1D, additional work is needed to address the psychosocial aspects associated with the condition and its effect on the quality of life (QoL) of people living with T1D. One area that warrants further exploration is the stigma-related stereotypes and prejudice of people living with T1D experience in real-life settings. Despite the acknowledgment of stigma for conditions such as obesity, mental illness, and epilepsy, its association with T1D and ensuing psychological distress remains relatively under-investigated. Health-related stigma is a huge barrier to seeking appropriate, timely support for enhanced healthcare management and engagement in such patients. Here, we provide the perspectives of an adult with over 33years of living with T1D and an expert endocrinologist who details their experience of T1D-related stigma. The self-reported factors explored by the person living with T1D include (but are not limited to) blame, mockery of the condition/person, diabetes-related shame, exclusion, rejection, negative judgments, fear, stereotyping, and discrimination. The lived experience supported by the clinical insights of the endocrinologist highlights the urgent need to decipher the severity, extent, nature, determinants, and consequences of stigma faced by a person living with T1D. Raising societal awareness, increasing education for caregivers, access to counseling for people living with diabetes, and engaging in shared decision-making remain the path forward.

Identifying Witnessed Suicides in National Violent Death Reporting System Narratives.

There is increasing attention to suicides that occur in view of others, as these deaths can cause significant psychological impact on witnesses. This study illuminates characteristics of witnessed suicides and compares characteristics of these deaths to non-witnessed suicides. We develop a codable definition of what constitutes witnessed (vs. non-witnessed) suicide. Our data include a sample of 1200 suicide descriptions from the 2003-2017 National Violent Death Reporting System (NVDRS). We first developed criteria to identify probable cases of witnessed suicide. The coding scheme achieved 94.5% agreement and identified approximately 10% (n = 125) of suicides as witnessed. Next, we examined differences between witnessed and non-witnessed suicides in demographics, manner of death, and social/environmental factors using bivariate Chi-squared tests, multivariate logistic regression, and ANOVA. Witnessed suicide decedents were significantly more likely than non-witnessed suicide decedents to be male, younger, and members of a sexual minority, and to have died in living spaces by means of a firearm. Two thirds of witnesses were strangers to the decedents, while 23.2% were romantic partners or ex-partners of the decedents. Our coding method offers a reliable approach to identify witnessed suicides. While witnessed suicides are relatively infrequent, these deaths have profound impact on witnesses. Articulating the features of witnessed suicides may contribute to identifying potential risk mitigation strategies.

Current and Future Role of HIFU in Obstetric Gynaecology

Obstetric gynaecology, as a field in which diagnostic ultrasound has quickly found its place, especially in screening for birth defects and monitoring pregnancies, is also a speciality in which therapeutic ultrasound is used extensively.In pelvic gynaecology, HIFU therapy is used more specifically in two types of uterine conditions: fibroids and adenomyosis. In both cases, studies have shown significant efficacy in reducing pain and bleeding associated with the conditions, secondarily (more moderately but still significantly) reducing the volume of the lesions. Impact on fertility has yet to be demonstrated.In rectosigmoid endometriosis, clinical data indicates good treatment feasibility and significant efficacy on digestive and gynaecologic pain symptoms, as well as on quality of life, with no associated severe complications. Should the efficacy of HIFU in treating endometriosis be confirmed over time, it could revolutionise the management of digestive endometriosis by offering a valid minimally invasive alternative to rectosigmoid surgery.In senology, where visible scars have a particularly significant psychological impact, several teams have been researching the use of HIFU for the destruction of some types of breast lesions (fibroadenomas and breast tumours).In obstetrics, HIFU could become a treatment of choice for vascular anomalies such as twin-to-twin transfusion syndrome in twin pregnancies. Promising studies are also available regarding the use of HIFU in the treatment of post-partum placenta accreta.

Resumption of dental practice after COVID-19 lockdown: perspectives of dental professionals in Karachi, Pakistan

Introduction: In the COVID-19 pandemic, the implementation of the lockdown led to the closure of dental practices. Restricting treatment to emergency patients, having to use Personal Protective Equipment and the fear of contracting the virus led to modifications in the techniques and methods used to provide efficient dental care to the patients. However, it caused a significant psychological and financial impact on the dental community. The purpose of this research was to evaluate dentists’ perceptions regarding the psychological, financial, and general impact of the COVID-19 pandemic on the reopening of their dental practices. Methods: This cross-sectional analytical study was conducted using a validated questionnaire, which was distributed among 257 dental practitioners working in Karachi through the social media app (WhatsApp®) from May 2021 to May 2022. The questionnaire included four sections and 26 items, recording data for demographics, psychological effects on resumption of dental practices, workplace disinfection, and precautionary measures along financial impacts. Data were analyzed using SPSS, version 21.0. p-value ≤ 0.05 was taken as statistically significant Results: A total of 200 filled questionnaires were received, making the response rate 77%. The majority of respondents were females (67%). More than half of the respondents (55.5%) were working in dental OPDs. Most participants affirmed that they did not have a COVID-19 screening area nor patient triage was being done in dental OPDs. Closure of dental practices caused financial problems for all dental practitioners, more specifically for those that were associated with both public and private types of practices (84.9%). The majority of the dentists in private practice (94.4%) declared that their workplaces were being disinfected, while 47.7% of dental practitioners working in the dental OPD affirmed that they had enough financial stability to keep using Personal Protective Equipment. Approximately 64.9% of professionals practicing in dental OPDs and 33.3% in private practice believed that the reopening of dental practices was responsible for the re-spread of the coronavirus Conclusion: Significant anxiety and stress related to COVID-19 were seen among dental practitioners. Some CDC-recommended guidelines such as the use of Personal Protective Equipment were being implemented whereas COVID-19 screening and patient triage were found deficient.

Characteristics of the pediatric population with gender incongruence attending specialized care in Cali, Colombia: an observational, descriptive and retrospective study

BackgroundGender incongruence can often manifest itself from early childhood [Olson KR, Gülgöz S. Child Dev Perspect. 2018;12:93–7. https://doi.org/10.1111/cdep.12268] with a significant psychological impact, altering social and school dynamics without the appropriate care.[Tordoff DM, et al. JAMA Netw Open. 2022;5(2): e220978. https://doi.org/10.1001/jamanetworkopen.2022.0978] Early identification and gender–affirming care are essential to reduce adverse mental health outcomes, such as depression and self-harm [Tordoff DM, et al. JAMA Netw Open. 2022;5(2): e220978. https://doi.org/10.1001/jamanetworkopen.2022.0978]..This study aims to analyze characteristics and to estimate relative frequencies of gender incongruence in a population of children and adolescents receiving gender-affirming care at a high-complexity university hospital located in the third largest city in Colombia.MethodsThis was a retrospective descriptive study of patients under 18 with gender incongruence that received gender-affirming care between January 2018 and June 2022 at Fundacion Valle del Lili in Cali, Colombia. Sociodemographic and clinical characteristics of 43 patients were assessed, as well as the relative frequencies of gender incongruence. Data analysis was performed with the statistical package STATA®. To determine significant differences between the characteristics of the patients who participated in the study, the Mann‒Whitney U test was performed for numerical variables with non-parametric distribution, while either Pearson's Chi-2 test or Fisher's exact test was performed for categorical variables.ResultsFor every ten individuals assigned female at birth, who manifested gender incongruence, there were eight assigned male at birth. The median age of onset of gender incongruence was ten years (IQR: 5–13 years), and the median time elapsed between the reported onset of gender incongruence and the first consultation with a multidisciplinary gender-affirming team was three years (IQR: 1–10 years).The frequency of transgender identity was notable in participants with ages between 15 and 17 years. Depressive symptoms, anxiety, and psychotropic drug use were significantly higher in individuals assigned female at birth. Among 25 individuals assigned female at birth who participated in this study, 60% self-recognized as transgender men.18 individuals assigned male at birth, 67% self-recognized as transgender women. The most frequent treatment was a referral to mental health services (46.51%).ConclusionBased on the cohort of our study, we can conclude that patients consult for gender-affirming treatment 3 years after the onset of gender incongruence. Anxiety and depression were higher in individuals assigned female at birth. Additionally, they presented at a later stage of sexual maturation, reducing the possibility of using puberty blockers.

Fear and Anxiety among Dental Students and Dentistry as a Career Choice Following the COVID-19 Pandemic in Saudi Arabia: A Cross-sectional Study

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has had a significant psychological impact on people's lives, including healthcare providers. This impact has manifested in the form of anxiety and fear. Since COVID-19 is a respiratory disease spread through the mouth and nose, dental practitioners have experienced anxiety due to their close proximity to the oro-nasal tissues. Aim: To assess the mental health condition, specifically fear and anxiety, of a group of dental students in Saudi Arabia during the COVID-19 pandemic and to explore students' perceptions about dentistry as a career choice following the pandemic. Materials and Methods: A cross-sectional questionnairebased study was conducted, which included demographic data, the Coronavirus Anxiety Scale (CAS), the Fear of COVID19 Scale (FCV-19S), as well as a few questions to assess why students chose dentistry as a career and their perceptions about dentistry as a career following the pandemic. A digital link to the questionnaires was distributed through social media outlets such as Twitter, WhatsApp, etc., with the aim of reaching dental students across all dental schools in Saudi Arabia. Dental students and those undergoing internships from both public and private Dental Colleges across Saudi Arabia were approached. The study included a total of 633 students from 21 dental schools across Saudi Arabia. Data were analysed using the Statistical Package for Social Sciences, including Analysis of Variance(ANOVA), independent t-tests, and Chi-square tests. Results: Fear and anxiety levels were found to be the highest among interns and fourth-year dental students, respectively. A total of 346 (54.66%) of the respondents reported that they chose dentistry as a career due to personal desire. Approximately, 239 (37.8%) of the respondents reported being either 'Not Sure' or would not choose dentistry as a career if they had the choice, considering the uncertainty created by the COVID-19 pandemic. Conclusion: Fear and anxiety were reported to be higher among dental students exposed to clinical practice. The majority of dental students reported that they would still choose dentistry as a career option despite the uncertainty caused by the COVID-19 pandemic.

Experiences of male irregular migrants during their migration process and reception in Spain: lessons learned from the COVID-19 pandemic.

The causes behind migration movements are complex. The COVID-19 pandemic highlighted how several countries failed to respond to the virus adequately, while simultaneously infringing on people's rights. Male irregular migrants fled their countries of origin and embarked on a perilous migration journey to Spain. The highly restrictive COVID-19 measures and border closures affected the mobility of male irregular migrants, whose reception in the host country posed a challenge. It led to the establishment of emergency facilities to accommodate male irregular migrants affected by COVID-19, which had repercussions on their mental health. The aim of this study was to describe and understand the experiences of male irregular migrants throughout their migration process and reception in Spain during the COVID-19 pandemic. Qualitative descriptive study. Sixteen male irregular migrants participated in this study. Data were collected between January and March 2023 through 16 one-on-one in-depth interviews. Thematic analysis was used to analyze the qualitative data using ATLAS.ti computer software. Three main themes emerged: (1) How the COVID-19 pandemic drove male irregular migrants to leave their countries of origin, (2) How COVID-19 lockdown policies affected the migration journey, and (3) Receiving male irregular migrants in a pandemic: a housing labyrinth marked by isolation and loneliness. The COVID-19 pandemic increased the social, employment and health inequalities experienced by male irregular migrants. Border closures exacerbated the migration journey and the social stigmatization of this group, who were seen as carriers of the virus in both transit and host countries. Strict control measures in emergency and reception facilities had a significant psychological impact on the male irregular migrants due to the social isolation they experienced. Health institutions should develop programs to guarantee the care needs of irregular migrants.