Stress Burden Research Articles

Substance Use Disorder and Suicidal Ideation in Rural Maryland

Background Rural areas in the United States have been disproportionately burdened with high rates of substance use, mental health challenges, chronic stress, and suicide behaviors. Factors such as a lack of mental health services, decreased accessibility to public health resources, and social isolation contribute to these disparities. The current study explores risk factors to suicidal ideation, using emergency room discharge data from Maryland. Methods The current study used data from the Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) from the State of Maryland. Logistic regression was used to assess the association between ICD-10 coded opioid use disorder, alcohol use disorder, cannabis use disorder, major depressive disorder, and the outcome variable of suicidal ideation discharge. We controlled for income, race, age, and gender. Results Lifetime major depressive disorder diagnosis (odds ration [OR] = 79.30; 95% confidence interval [CI] 51.91-121.15), alcohol use disorder (OR = 6.87; 95% CI 4.97-9.51), opioid use disorder (OR = 5.39; 95% CI 3.63-7.99), and cannabis use disorder (OR = 2.67; 95% CI 1.37-5.18) were all positively associated with suicidal ideation. Conclusions The study highlights the strong link between prior substance use disorder, depression, and suicidal ideation visit to the emergency room, indicating the need for prevention and intervention, particularly among those in rural areas where the burden of suicidal ideation and chronic stress are high. As health disparities between rural and urban areas further widened during the COVID-19 pandemic, there is an urgent need to address these issues.

The prevalence of intimate partner violence and risk factors for women and men in China during the Shanghai 2022 lockdown.

Intimate partner violence (IPV) is a global public health concern with negative effects on individuals and families. The present study investigated the prevalence, risk factors and gender disparities associated with IPV during the Shanghai 2022 Covid-19 lockdown - a public health emergency which may have exacerbated IPV. We estimated the total IPV prevalence and prevalence of physical, sexual and verbal IPV by using an adapted version of the Extended-Hurt, Insult, Threaten, Scream scale. This cross-sectional study was carried out using a population quota-based sampling of Shanghai residents across 16 districts during the 2022 Shanghai lockdown (N = 2026; 1058 men and 968 women). We found a distinct gendered dynamic, where women reported a significantly higher prevalence of experienced IPV (27.1%, 95% confidence interval [CI]: 23.1-31.4) compared to men (19.8%, 95% CI: 16.1-24.0). Notably, the prevalence estimate mirrored the national lifetime IPV prevalence for women but was over twice as high for men. In multivariable logistic regression analyses, economic stress (income loss: adjusted OR [aOR] = 2.42, 95% CI: 1.28-4.56; job loss: aOR = 1.73, 95% CI: 1.02-2.92; financial worry much more than usual: aOR = 1.89, 95% CI: 1.00-3.57) and household burden (one child at home: aOR = 1.81, 95% CI: 1.12-2.92; not enough food: aOR = 1.67, 95% CI: 1.04-2.70) were associated with increased odds of overall IPV victimization among women but not men. With regard to more serious forms of IPV, job loss (aOR = 2.27, 95% CI: 1.09-4.69) and household burden (two or more children at home: aOR = 2.95, 95% CI: 1.33-7.69) were associated with increased odds of physical IPV against men. For women, a lack of household supplies was associated with increased odds of physical IPV (water: aOR = 3.33, 95% CI: 1.79-6.25; daily supplies: aOR = 2.27, 95% CI: 1.18-4.35). Lack of daily supplies (aOR = 2.17, 95% CI: 1.03-4.55) and job loss (aOR = 2.66, 95% CI: 1.16-6.12) were also associated with increased odds of sexual IPV. Although a larger proportion of women reported IPV, men experienced greater IPV during the lockdown than previously estimated before the pandemic. Economic stressors, including job loss, and household burden were critical risk factors for serious forms of IPV. Improving gender equality that my account for disparities in IPV in China is critically needed. Policies that mitigate the impact of economic losses during crises can potentially reduce IPV.

Prevalence and Associated Factors of Stress and Coping Strategies of Nursing Students During Clinical Practice in School of Nursing, Wachemo University, Ethiopia.

The current professional nursing education program adopts various great attention for clinical practice to supply nursing students. To assess the prevalence and associated factors of stress and coping strategies of nursing students during clinical practice in the school of nursing, Wachemo University, Ethiopia, 2024. A facility-based cross-sectional design study was conducted between January 1 and 12/2024. The total number of students was 421. Data were collected using the validated tool and entered using Epi-data Version 3.1 and exported to SPSS Version 25 for analysis. Binary logistic regression was done, and variables with a p-value of <.05 were taken into the multivariable analysis. Statistically significant was declared at a p-value of <.05 with AOR and 95% CI. The prevalence of stress and coping strategies was 58.4% with 95% CI [53.6-62.8] and 52.0% with 95% CI [47.3-56.5] respectively. Male gender, private regular, and instructor guide were significantly associated with stress. Age group 19-24 years, having low grades, living in a university dorm, clinical staff guiding, instructor guiding, and asking unclear issues were significantly associated with coping strategies. About six in ten nursing students have stress. Being male gender, being a private, living with families, and instructor guide are significantly associated with stress. Therefore, managing gender-related issues, attending regular programs, living in a university dorm, and guiding the students might reduce the burden of stress during clinical practice. About five in ten nursing students have good coping strategies. Being age group of lower years old, having low grades, living in a university dorm, clinical staff guiding, instructor guiding, and asking the instructor about unclear issues were significantly associated with coping strategies. Therefore, improving grades, living in a university dorm, clinical staff and instructor guidance, and asking about unclear issues might enhance coping strategies.

A Qualitative Examination of Perceptions of Mindfulness Among Arab, Middle Eastern, and North African Americans: Implications for Cultural Adaptation of Mindfulness-Based Interventions.

Mindfulness-based interventions (MBIs) are well-positioned to address health disparities among racial-ethnic minority communities, given their focus on stress reduction and potential for greater accessibility and acceptability than conventional mental health treatments. Yet, there are currently no peer-reviewed studies of MBIs in an Arab, Middle Eastern, or North African (MENA) American sample. Addressing this gap in the literature is critical for advancing integrative health equity, given the high burden of stress and high prevalence of stress-related health conditions among Arab/MENA Americans. The present study sought to explore perceptions of mindfulness among Arab/MENA Americans and identify potential cultural adaptations to MBIs for this population. 4 focus groups were conducted with 26 Arab/MENA American adults who had participated in an introductory mindfulness workshop. Participants were asked about their experience learning mindfulness skills, the usefulness of mindfulness for problems they face, the alignment of mindfulness with their cultural values and practices, and suggestions for adapting mindfulness programs. Qualitative coding of focus group session transcriptions was conducted to identify themes in the data. The participants in this study described experiencing high levels of stress and identified micro- and macro-level stressors related to their Arab/MENA American identity, including discrimination, exclusion, historical and intergenerational trauma, and protracted sociopolitical crises in their heritage countries. They viewed mindfulness as a potentially useful approach to coping with stress. At the same time, participants identified aspects of mindfulness that could be adjusted to better align with their cultural values and experiences. Potential adaptations to MBIs for Arab/MENA Americans were identified based on suggestions from participants and issues they raised while discussing cultural strengths, stressors they face, and perceived barriers and facilitators to engaging in mindfulness practice.

COVID-19 pandemic as ahuge stressor of the 21st century.

The coronavirus disease 2019 (COVID-19) pandemic had asignificant impact on the somatic and psychological state of the population worldwide, leading to awide range of health complications. Most of the studies on the COVID-19 pandemic have focused on the direct psychological and somatic aspects of the disease. However, the negative consequences of the indirect aspect of the pandemic (i.e., stay-at-home orders leading to social isolation) represent amajor stressor on psychosomatic health and warrant greater interest. This study examines the COVID-19 pandemic as asignificant stressor of the 21st century through the lens of the "allostatic" stress response concept and highlights the stress-related psychosomatic consequences of the COVID-19 pandemic. Abetter understanding of the pathomechanisms underlying indirect impacts of the pandemic on psychosomatic health can contribute to the implementation of personalized interventions for managing stress responses, thereby reducing the pandemic-linked stress burden and preventing stress-associated disease emergence (Tab. 1, Fig. 1, Ref. 67). Text in PDF www.elis.sk Keywords: COVID-19 pandemic, social isolation, stress response, allostasis, allostatic load, psychosomatic symptoms.

Experience of Nurses Working in Emergency Centers during the COVID-19 Pandemic

This study was conducted to explore the experiences of nurses working in emergency centers during the COVID-19 pandemic. The participants comprised nine nurses employed at emergency centers in hospitals located in Seoul and the metropolitan area during the COVID-19 epidemic. Individual interviews were conducted by applying semi-structured questions to the participants, and the data collected from February to July 2023 were analyzed using the content analysis method. As a result of the study, a total of 281 statements were selected, and four areas, ten categories, and 14 major statements were extracted. The four areas identified are work change and increase, stress and psychological burden, safety and protection, and communication. The findings of this study will contribute to understanding the experiences of nurses and nursing phenomena within emergency centers during infectious disease epidemics. Moreover, the results will serve as fundamental data for the development of curricula and content within the healthcare system and related academic disciplines, as well as for improving working conditions.

Stressful life events, social support, and epigenetic aging in the Women's Health Initiative.

Elevated psychosocial stress has been linked with accelerated biological aging, including composite DNA methylation (DNAm) markers that predict aging-related outcomes ("epigenetic age"). However, no study has examined whether stressful life events (SLEs) are associated with epigenetic age acceleration in postmenopausal women, an aging population characterized by increased stress burden and disease risk. We leveraged the Women's Health Initiative, a large muti-ancestry cohort of postmenopausal women with available psychosocial stress measures over the past year and epigenomic data. SLEs and social support were ascertained via self-report questionnaires. Whole blood DNAm array (450 K) data were used to calculate five DNAm-based predictors of chronological age, health span and life span, and telomere length (HorvathAge, HannumAge, PhenoAge, GrimAge, DNAmTL). After controlling for potential confounders, higher SLE burden was significantly associated with accelerated epigenetic aging, as measured by GrimAge (β: 0.34, 95% CI: 0.08, 0.59) and DNAmTL (β: -0.016, 95% CI: -0.028, -0.004). Exploratory analyses showed that SLEs-GrimAge associations were stronger in Black women as compared to other races/ethnicities and in those with lower social support levels. In women with lower social support, SLEs-DNAmTL associations showed opposite association in Hispanic women as compared to other race/ethnicity groups. Our findings suggest that elevated stress burden is associated with accelerated epigenetic aging in postmenopausal women. Lower social support and/or self-reported race/ethnicity may modify the association of stress with epigenetic age acceleration. These findings advance understanding of how stress may contribute to aging-related outcomes and have important implications for disease prevention and treatment in aging women.

A 10-Year Retrospective Review of Playground-Associated Craniofacial Injuries in the Pediatric Patient Population.

This retrospective study utilized the National Electronic Injury Surveillance System (NEISS) database to identify pediatric emergency department (ED) patients with playground-associated craniofacial injuries between January 2012 and December 2021. A total of 25 414 patients were identified. The majority of injuries occurred in preschool and elementary school-age children (90.3%) and patients were more commonly boys (59.3%). Injuries most often involved the head/scalp (52.4%), face (30.4%), and mouth (11.9%). Infant (32.7%) and teen (40.0%) injuries most commonly involved swings, whereas preschool (23.1%) and elementary school (28.1%) injuries were mostly associated with slides and climbers, respectively. Most patients were treated in the ED and discharged to home (96.5%), a small portion required hospitalization (1.6%), and one death was reported. Although the majority of the injuries were relatively minor and resulted in same-day discharges, these injuries can result in serious physical harm, emotional stress, and unexpected financial burdens. Proper education and supervision regarding safe play is important to prevent these injuries.

Oxidative Stress: Use of Alternative Therapeutic Agents

Kalonji seeds are a powerhouse of crude fibers, amino acids, iron, sodium, calcium, and potassium. Kalonji is also rich in vitamins that include – Vitamin A, Vitamin B, Vitamin B12, Niacin, and Vitamin C. Kalonji oil is much better than other oil as it contains essential fatty acids, vitamins, and minerals. It comprised approximately 17% protein, 26% carbohydrates, and 57% plant fats and oils. Apart from drugs various substances and life style changes are being advised to correct oxidative stress burden in human body. Analysis of the lipid content in the oxidatively modified LDL from hyper lipidemic patients revealed that the level of lysophosphatidylcholine was greatly elevated, and the high level of the lysolipid was shown to impair the endothelium-dependent relaxation of the blood vessels. In alllopathy blood lipid levels are normalized by statins, fibrates, niacin and bile acid binding resins (BABRs). All of these allopathy related drugs have low compliance ranges from mild compliance due to metalic taste of BABRs to severe side effects like rhabdomyolysis by fibrates and statins. Cardiovascular diseases are leading cause of death in western and eastern countries of the world. Hyperlipidemia is one of the strong risk fractions for heart diseases. To evaluate hypolipidemic drugs efficacy, the study was conducted at Ghurki trust teaching hospital, Lahore Pakistan from January 2020 to August 2020. Ninty hyperlipidemic patients were selected from cardiology and medical wards of the hospital. They were divided in three groups, one at placebo therapy, another on Kalonji and third one on Vitamin B3. After one and half month, significant changes (p value ranging from &lt;0.05 to &lt;0.001) were observed in their LDL and HDL-cholesterol. Conclusion of the study was to recommend use of herbal medicine and vitamin B3 for prevention of any heart diseases with good patient compliance. KEY WORDS: kalonji, LDL cholesterol, HDL cholesterol, blood vessels.

RACIAL–ETHNIC DISPARITIES IN STRESS EXPOSURE AND THE ONSET OF LATER-LIFE LIMITATIONS IN ACTIVITIES OF DAILY LIVING

Abstract This study investigates the relationship between stress exposure – including cumulative stress burden and domain-specific stressors – and the onset of activities of daily living (ADL) limitations in later life and examines whether there are racial-ethnic and nativity differences in this relationship. Examining data from the Health and Retirement study (HRS), we apply logistic regression and Weibull accelerated failure-time models to examine associations between stress and baseline ADL limitations as well as stress exposure and age of onset of ADL limitations over a decade. Interaction tests between stress and race-ethnicity and nativity were employed to understand how stress exposure uniquely influences ADL limitations among White, Black, US-born Hispanic, and foreign-born Hispanic older adults. Black, US-born Hispanic, and foreign-born Hispanic adults were more likely to develop an ADL limitation at a younger age compared to White adults (β = -0.06; β = -0.07; β = -0.09; respectively). Cumulative stress burden, childhood traumatic events, adult financial strain, everyday discrimination, and major lifetime discrimination were associated with an earlier onset of ADL limitation among White, Black, US-born Hispanic and foreign-born Hispanic adults. Further, US-born Hispanic adults that experienced the same amount of childhood traumatic events as White adults experienced an earlier transition to ADL limitation by a factor of 0.65 or in about 35% of the time. Reducing racial-ethnic and nativity disparities in ADL limitations in later-life will require efforts to adjudicate the long lasting historical and structural disadvantages that contribute to differential stress exposure across the life course.

Reciprocity, Fairness and the Financial Burden of Undertaking COVID-19 Hotel Quarantine in Australia.

In late March 2020 in response to the COVID-19 pandemic, Australia introduced mandatory 14-day supervised quarantine at hotels and other designated facilities for all international arrivals. From July 2020, most states and territories introduced a fixed charge for quarantine of up to $3220 per adult. The introduction of the fee was rationalised on the basis that Australians had been allowed sufficient time to return and there was a need to recover some of the cost associated with administering the program. Drawing on an empirical study of 58 returned Australian citizens and residents quarantined between March 2020 and January 2021, this paper aims to explore how people experienced paying for hotel quarantine, particularly with respect to fairness and relatedly, the principle of reciprocity. Reciprocity requires that the state has an obligation to assist individuals in discharging their duty to comply with public health measures and avoid disproportionate burdens accruing to populations or individuals. Though participants had varying opinions on whether they thought it fair to be charged for their quarantine, for many, the fee constituted a significant burden and source of stress. Given the undertaking of quarantine is primarily for the benefit of the public good, we argue the financial cost imposed on individuals does not meet the demands of reciprocity. It is imperative that future quarantine and isolation arrangements consider seriously the need to minimise burdens of individuals subject to such measures, and that fees do not become a new norm in public health and infectious disease control.

Stress Factors among Nursing Students in Public and Private Institutions

Nursing education is renowned for its demanding nature, subjecting students to a multitude of stressors. This study investigates stress factors among nursing students in both public and private institutions, shedding light on their experiences in Pakistan. The research employs a quantitative approach, utilizing a 31-item questionnaire with a five-point Likert scale to assess stress-related factors, with values ranging from “Strongly Disagree” to “Strongly Agree.” The study encompasses a diverse participant pool, including 150 nursing students, revealing a relatively balanced gender distribution and representation from public and private institutions. The results underscore academic-related stress as the most prominent challenge faced by nursing students, affecting sleep patterns, self-study abilities, and punctuality. Additionally, issues such as uncooperative clinical staff, difficulties in accessing basic facilities and language proficiency barriers contribute to the stress burden. These findings emphasize the need for proactive support mechanisms within nursing education, encompassing mental health support and language assistance. Furthermore, the study outlines the limitations of using a self-generated questionnaire and highlights the necessity for future research in areas such as longitudinal studies, comparative analyses of different program formats, and the effectiveness of interventions to reduce stress and enhance well-being. By addressing these stress factors comprehensively, nursing institutions can better prepare students for the rigors of their profession, ultimately enhancing the quality of healthcare delivery in Pakistan.

Stress and skin diseases. Overview using acne vulgaris as an example

Stress is defined as the activation of complex physiological and psychological response mechanisms in situations that threaten physical as well as mental human homeostasis. Skin diseases and associated skin lesions can become a source of stress and psychological burden. Acne vulgaris affects appearance, which plays an important role in self-esteem, a person’s functioning in society, his or her psychological state, and quality of life. Stress is one of many factors considered in the etiopathogenesis of this dermatosis. Chronic stress hurts the condition of the skin because cortisol levels are increased, which inhibits the synthesis of collagen and proteins the skin’s building blocks. This study aimed to review the literature on the significance of stress in the onset and course of skin diseases, using acne vulgaris as an example. Due to the recurrent and chronic course of acne, treatment should be interdisciplinary, complemented by appropriate psychological care and effective methods of stress management, to increase the efficiency of dermatological therapy.

The Effect of Hippo Pathway Inhibitor Xmu‐mp‐1 on Cognitive Impairment in a Rat Model of Alzheimer’s Disease: Protection against Oxidative Stress, Tau Hyperphosphorylation, and Neurodegeneration

AbstractBackgroundAlzheimer’s Disease (AD), the most common form of dementia, is a growing global health concern with unmet clinical therapeutics. AD can be attributed to amyloid beta aggregation and tau hyperphosphorylation‐induced oxidative stress and neurodegeneration in the brain. Previous studies have implicated a hyper‐activated Hippo signaling pathway with neuronal loss in neurodegenerative disorders, including AD. However, it is still unknown if suppressing the Hippo pathway can rescue neuronal death in AD.MethodIn this study, we investigated the cognitive impairment ameliorative effect of the novel Hippo signaling inhibitor, Xmu‐mp‐1, in a rat model of AD. Adult male Wistar rats were stereotaxically injected with a well‐known AD inducer Streptozotocin (STZ), to mimic AD‐like features. A pharmacological antagonist of Hippo signaling component MST1 called Xmu‐mp‐1 was administered intraperitoneally at a dose of 0.5mg/kg body weight for 14 days. Then the effect of Xmu‐mp‐1 on cognitive impairment was assessed using the Morris water maze test and novel object recognition test. Further, we did biochemical and histopathological studies to explore the effect of Xmu‐mp‐1 on several AD‐associated pathophysiological changes, including oxidative stress, tau hyperphosphorylation, and neurodegeneration.ResultXmu‐mp‐1 significantly improved the cognitive impairment of the AD rats in the Morris water maze test and the novel object recognition test (n = 7). Biochemical analysis of the brain hippocampal and cortical tissues revealed that Xmu‐mp‐1 also ameliorated the AD‐associated oxidative stress burden as the levels of anti‐oxidants (SOD, Catalase, GSH) significantly increased and the levels of oxidative stress biomarkers (protein carbonyl and lipid peroxidation) significantly reduced after Xmu‐mp‐1 treatment in the AD rats (n = 6). Moreover, the level of tau phosphorylation, a prime characteristic of AD, was also reduced following Xmu‐mp‐1 treatment (n = 3). Finally, neuronal death was also found to be rescued after Xmu‐mp‐1 treatment in AD rats (n = 3).ConclusionXmu‐mp‐1 exhibits a neuroprotective role against AD as it improves the cognitive impairment induced by STZ. Further mechanistic investigations into the neuroprotective role of Xmu‐mp‐1 revealed that Xmu‐mp‐1 provides protection from oxidative stress, tau hyperphosphorylation, and aberrant neurodegeneration under an AD background. Future studies can explore the therapeutic potential of Hippo signaling inhibition against AD in more detail.

A Literature Review on the Burden of Alzheimer's Disease on Care Partners.

Many individuals with Alzheimer's disease (AD) are dependent on nonprofessional care partners. Providing informal care can result in emotional, physical, and financial burdens; however, there is a need for a better understanding of the impact of AD on care partners to support the clinical and economic assessment of potential new treatments. We conducted a literature review to evaluate the burden experienced by care partners of individuals with AD. Electronic screening and supplementary searches identified studies published from 2011 to 2022 describing the association between AD and the quality of life (QoL) and physical health of care partners, and the economic or financial burden of AD. Following electronic screening, 62, 25, and 39 studies were included on care partner burden, cost, and healthcare resource use in AD, respectively. Supplementary searches identified an additional 32 studies, resulting in 149 unique studies. These studies showed that care partners of individuals with AD report moderate to severe burden. Higher burden and lower QoL were observed in those caring for individuals with more severe AD. Care partners of individuals with AD experience higher burden, lower QoL, and higher levels of stress, depression, and anxiety than those without caring responsibilities. Informal care costs increased with AD severity and accounted for the greatest proportion of overall societal cost. Care partners of individuals with AD experience emotional and economic burden, which increases with AD severity. These impacts should be quantified comprehensively in future studies and captured in economic evaluations of AD interventions.

Difficulties in emotional regulation mediates the impact of burden on quality of life and mental health in a sample of family members of people diagnosed with Borderline Personality Disorder.

Although it has been suggested that family members of persons suffering from Borderline Personality Disorder (BPD) endure high levels of burden, however, the process and the impact of this burden in their lives, and specifically the relation between the burden and emotional regulation has not been broadly investigated among this population. The main objective of this study is to examine the impact of burden on quality of life and depression, anxiety and stress, as mediated by difficulties in emotional regulation in family members of persons diagnosed with BPD. Participants were 167 family members of persons diagnosed with BPD. The Burden Assessment Scale, Difficulties in Emotion Regulation Scale, Multicultural Quality of Life Index, and Depression Anxiety Stress Scale-21 were filled out. Mediation analysis was conducted using the Maximum Likelihood estimator, bootstrap method and listwise deletion for missing data. Burden showed a significant, negative effect on quality of life and positive on depression, anxiety and stress. Difficulties in emotion regulation significantly mediated these relations. After accounting for the mediating role of difficulties in emotion regulation, burden still had an impact on quality of life, depression, anxiety and stress. Women showed a higher level in both burden and stress than men. The caregivers with secondary and higher studies showed higher levels in burden than those with no studies. Not significant differences in burden, emotion regulation, depression, anxiety and stress were found related to marital status. Difficulties in emotion regulation mediate the relations between burden and quality of life, depression, anxiety, and stress. Family members could engage in group interventions designed specifically for family members of people with BPD, oriented toward understanding the disorder or learning skills.

Digital applications as tools for psychological adaptation of citizens to changes

As a result of the military aggression of the russian federation on the territory of Ukraine, citizens experience acute stress, other mental and emotional burdens, and psychological disorders. Digital technologies can serve as a tool to improve mental health and provide psychological support to citizens, especially for those who find it difficult to access a psychotherapist in direct contact, through the development of applications for psychological adaptation and mental balance support. The purpose of the work was to determine the availability and optimal content of mobile applications for mental health and psychological balance of citizens of Ukraine. A search and analysis of available solutions from the E-Mental-Health category (digital services for mental health) in Ukraine and other countries was conducted. An empirical study of their functions was carried out and a proposal of optimal content for mobile applications was formed as auxiliary tools for working with a specialist psychotherapist or for psychological assistance to citizens during martial law. To determine the need for such applications, a survey “My psychological state in evacuation” was conducted among respondents who are outside the country. In order to determine the most important functions among the list of the created proposal of the optimal content of the application according to the opinion of citizens, an online survey “Ukrainians and digital services” was conducted. It was mainly attended by young people who remained in the country during the military aggression. On the basis of the obtained results, the need of Ukrainian citizens, both those who remained in the country during hostilities and those who are evacuated in other countries, for mobile applications for mental health and psychological assistance to Ukrainians was empirically substantiated. Recommendations have been provided regarding the necessary features of such an application, which can be considered as a project specification for the creation or enhancement of a multifunctional E-Mental-Health app

Digital applications as tools for psychological adaptation of citizens to changes

Due to the military aggression of the Russian Federation in Ukraine, citizens experience acute stress, other mental and emotional burdens, and mental disorders. Digital technologies can serve as a tool to improve mental health and psychological support for citizens, especially for those who have limited access to direct contact with a psychotherapist, by developing applications for psychological adaptation and maintaining mental balance. The purpose of the study is to determine the availability and optimal content of mobile applications for the mental health and psychological balance of Ukrainians. A search and analysis of existing solutions in the category of E-MentalHealth (digital services for mental health) in Ukraine and other countries was conducted. An empirical study of their features was conducted, and a proposal for optimal content for mobile applications as auxiliary tools for working with a psychotherapist specialist or for providing psychological assistance to citizens during martial law was formed. To assess the need for such applications, a survey, “My psychological state in the evacuation”, was conducted among respondents outside the country. The online questionnaire “Ukrainians and digital services” was used to determine the most important features among the list of formed offers for optimal application content. It was attended mainly by young people who remained in the country during the military aggression. The results confirmed the need for mobile applications for mental health and psychological assistance among Ukrainian citizens, including those who stayed in the country during the war and those who were evacuated to other countries. Recommendations are given for mandatory features that can be considered technical requirements for developing or improving a multifunctional application in the category of E-Mental-Health

Prevalence of mental illness among women in an urban slum area of Jaipur: A cross- sectional study

Gender has been described as a critical determinant of mental health and mental illness. Depression is not only the most common women's mental health problem, but may be more persistent in women than men.To assess the burden of depression, anxiety and stress among women residing in urban slums of Jaipur and also to assess the factors affecting them. A community based cross-sectional study was conducted in an urban field practice area among women aged 18-59 years with calculated sample size of 503. Depression Anxiety Stress Scale (DASS)-21 questionnaire was used to capture the primary outcomes—depression, anxiety, and stress. Data was analyzed using SPSS and MS Excel. The statistical significance was evaluated at 95% confidence level. The difference in proportions was compared using Chi-square test and p-value &amp;#60;0.05 was considered significant. In our study, the overall, the prevalence of anxiety, stress and depression was 38.22%, 9.11%, and 18.61%, respectively which ranged from mild to extremely severe. There were meaningful correlations between probable factors like physical inactivity, poor sleep and generalized pain and DASS scores obtained by the participants. The study showed that the prevalence of anxiety was higher compared to other DASS symptoms. The DASS symptoms were poorly associated to demographic characteristics of the study participants although amongst the separated and widowed females there was significant statistical association.

Higher oxidative balance score decreases risk of stroke in US adults: evidence from a cross-sectional study.

The oxidative balance score (OBS) can be used to represent the overall burden of oxidative stress in an individual. This study aimed to explore the association between the risk of stroke and OBS. The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 was used to extract a series of variables for participants who took the stroke questionnaire. The construction of OBS relied on diet and lifestyle components, which included 16 nutrients and 4 lifestyle factors. Weighted multivariable-adjusted logistic regression was performed to investigate the association between stroke risk and OBS. A stratified analysis was also conducted. The dose-response relationship between stroke risk and OBS was elucidated by performing a restricted cubic spline function. A total of 20,680 participants were included for analysis, 768 of whom suffered from stroke. Based on weighted multivariable logistic regression analysis, we discovered that the stroke prevalence decreased by 2% for each OBS unit added [OR: 0.98 (0.97-1.00), P < 0.01]. For the OBS subgroup, we also discovered that higher OBS was related to a reduction in the risk of stroke [Q4 vs. Q1: OR:0.65 (0.46-0.90), P < 0.01]. The prevalence of stroke declined by 3% with every OBS unit added to the diet component [OR: 0.97 (0.96-0.99), P < 0.01]. For the dietary OBS subgroup, higher OBS in diet components was associated with a decrease in the prevalence of stroke [Q4 vs. Q1: OR: 0.65, (0.47-0.91), P < 0.05]. Further stratified analysis showed that every OBS unit raised was associated with a decline in stroke prevalence, which was statistically significant in participants in subgroups of ≥60 years, female, no-diabetes mellitus and no-hypertension. OBS and stroke prevalence were correlated in a linear manner. The study found that a higher OBS was associated with a decrease in stroke prevalence, which could be a significant indicator for evaluating stroke risk.