Stress Burden Research Articles

Glutathione and Oxidized Low-Density Lipoprotein as Biomarkers of Oxidative Stress in Essential Hypertension

OBJECTIVE: This study aimed to compare the serum levels of Glutathione and Oxidized Low-Density Lipoprotein in early hypertensive and normotensive subjects and to evaluate the diagnostic accuracy of these biomarkers for detecting oxidative stress in essential hypertension. METHODOLOGY: An analytical cross-sectional study was conducted at Civil (Dr. Ruth K.M. Pfau) Hospital Karachi from July 2020 to March 2021 after approval from the ethical committee. After informed consent, the serum oxidized low-density lipoprotein and glutathione levels were measured with ELISA's help in 40 normotensive and 40 early hypertensive participants. The results were analyzed by SPSS 21, keeping a significant p-value at <0.05. RESULTS: The median levels of Oxidized Low-Density Lipoprotein were higher in hypertensive than in normotensive (i.e. 31.47 ng/ml vs. 15.27 ng/ml). The median levels of glutathione were also raised in hypertensive compared with normotensive(i.e. 15.69 ng/ml vs. 4.46 ng/ml). The differences were significant (p-value <0.001). Both markers showed adequate diagnostic accuracy, sensitivity and specificity to detect oxidative stress in early hypertension. CONCLUSION: Oxidized Low-Density Lipoproteins are raised in early hypertension, endorsing the detrimental role of oxidative stress, while the levels of glutathione are increased to compensate for and combat increased oxidative stress in early hypertension. These biomarkers can be utilized clinically to discern the burden of oxidative stress in early hypertension. KEYWORDS: Essential hypertension, Glutathione, Oxidized low-density lipoprotein, Oxidative stress, Reactive oxygen species

Maternal health-related quality of life at 1 year after a preterm birth: role of socioeconomic status at birth

BackgroundMaternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother–child attachment. Social disadvantage is a risk factor for preterm birth, which carries...

Importance of high sensitivity for shaping abnormal eating behavior in young adult women

“High sensitivity” is a relatively new construct, especially in Polish psychology. Although it is sometimes a subject of controversy in the scientific world, it seems to have explanatory significance, helping to understand the mechanism of human functioning in various spheres. The purpose of the research project was to explore the relationships between the intensity of sensitivity and eating behaviors in young adult women. The sample consisted of 213 participants in young adulthood (i.e., from 20 to 35 years old). The selection of respondents was purposeful, and the inclusion criteria were gender and age. The High Sensitivity Scale by Elaine Aron, adapted by Agata Borzyszkowska, and the Questionnaire of Eating-Related Behaviors by Nina Ogińska-Bulik and Leszek Putyński were used to measure the main variables. As a result of the analysis of the obtained research material, the main assumption about the existence of a relationship between the intensity of sensitivity and eating behaviors in the examined women was confirmed. The higher the level of sensitivity intensity, the higher the tendency for abnormal eating behaviors. A correlation was also found between the difference in real and ideal body mass and eating behaviors, both in their general dimension, emotional eating, and dietary restrictions. Additionally, it was documented that the greater the difference between real and ideal body mass, the greater the tendency of the examined women to exhibit abnormal eating behaviors. A partial relationship between the assessment of the adequacy of support and the burden of stress with eating behaviors was also confirmed.

Protective facemask-induced facial thermal stress and breathing burden during exercise in gyms

During the COVID-19 pandemic, more than 90% of infections occurred in indoor environments such as restaurants and gyms. In particular, gym attendees are facing challenges of both infection risks and extra heat and breathing burdens with the use of protective facemasks (PFMs) during intensive exercise. To evaluate the PFM-induced thermal stress and breathing discomfort during high-intensity exercise, this study investigated the mechanisms of heat and air exchange between environment of inside and outside PFM via experiments and computational fluid dynamics simulations. In the experimental phase, the effects of the activity intensity and type of PFM on thermal and breathing comfort were tested. An uncomfortable microenvironment of the face covered by a PFM was found when the air temperature and absolute humidity increased by 4.1% and 23.1%, respectively, during high-intensity exercise, relative to the sitting scenario (30.8 °C, 0.026 kg/m3), together with a higher CO2 concentration (31.0% increase) and lower O2 concentration (8.3% decrease). Moreover, the masks newly designed provided better thermal and breathing conditions than traditional masks due to the larger surface area and lower thickness. In simulation phase, the model sensitivity analyses were conducted to assess the effects of eight factors on thermal and breathing comfort. The mask surface area is found to most highly affect not only the thermal comfort indices (temperature, absolute humidity) but also breathing comfort indices (the concentration of CO2 and O2). The study results provide an important reference for government policymaking, mask design, and public health.

An automatic speech analytics program for digital assessment of stress burden and psychosocial health

The stress burden generated from family caregiving makes caregivers particularly prone to developing psychosocial health issues; however, with early diagnosis and intervention, disease progression and long-term disability can be prevented. We developed an automatic speech analytics program (ASAP) for the detection of psychosocial health issues based on clients’ speech. One hundred Cantonese-speaking family caregivers were recruited with the results suggesting that the ASAP can identify family caregivers with low or high stress burden levels with an accuracy rate of 72%. The findings indicate that digital health technology can be used to assist in the psychosocial health assessment. While the conventional method requires rigorous assessments by specialists with multiple rounds of questioning, the ASAP can provide a cost-effective and immediate initial assessment to identify high levels of stress among family caregivers so they can be referred to social workers and healthcare professionals for further assessments and treatments.

P22.03.A FEASIBILITY OF AND COMPLIANCE TO ELECTRONIC PATIENT-REPORTED OUTCOME ASSESSMENT IN THE MOLECULAR TUMOR BOARD IN (NEURO-)ONCOLOGICAL PATIENTS UNDER TARGETED THERAPY (TRACE)

Abstract BACKGROUND Comprehensive genomic profiling and biomarker-based therapies are increasingly used in clinical trials and in innovative health care systems including the center for personalized medicine network. Systematic assessments of patient-reported outcomes (PRO) are warranted to gain insight into the perspective of patients during biomarker-based therapies. In the present study, we focused on the feasibility of and compliance to an electronic PRO assessment in patients treated at our center. MATERIAL AND METHODS Based on a retrospective evaluation of symptom burden in 265 neurooncology patients in the Molecular Tumor Board (MTB), we developed an app by 14 expert rounds including validated assessments of health-related quality of life (HRQoL), burden of symptoms und psychological stress, and tested it in a pilot study. After informed consent, patients were introduced to the app by study staff and completed subsequently patient-reported outcomes at several time points (weekly, monthly, and quarterly). We conducted a structured interview with health care personnel and the patients as users after 3 months to assess the app’s usability and feasibility. The interview was transcribed and analyzed according to Mayring´s qualitative content analysis regarding handling, feasibility and applicability in daily routine.Furthermore, we assessed compliance and descriptive data of the ePROs. RESULTS So far, 14 patients and caregivers have been enrolled, (9 female, 5 male). Median age was 50 years (range 28 -79), 3 out of 14 patients dropped out due to death. A total of 4 study staff members, 9 patients and one caregiver were interviewed regarding usability /feasibility. Both evaluated as good (study staff members in total n=40 quotes, patients/caregivers n=112 quotes). Main advantages were the possibility to complete questionnaires at home and the easy implementation in daily life. Compliance to questionnaires was high, e.g., 91% of weekly distributed NCCN Distress Thermometer were answered in time (range 65-100%, assessment duration 5-56 weeks, 262 answers), we observed a median Distress score of 4 (range 0-9, n=262, weekly assessed) and a median Global health score of 66.7 (range 16.7-100, n=69, EORTC QLQ-C30, question 29 and 30, monthly assessed, compliance 94%). CONCLUSION This pilot study proved feasibility and acceptance of the app and might enable PRO assessment during biomarker-guided therapies.

Decoding Angiotensin Receptors: TOMAHAQ-Based Detection and Quantification of Angiotensin Type-1 and Type-2 Receptors.

Background The renin-angiotensin system plays a crucial role in human physiology, and its main hormone, angiotensin, activates 2 G-protein-coupled receptors, the angiotensin type-1 and type-2 receptors, in almost every organ. However, controversy exists about the location, distribution, and expression levels of these receptors. Concerns have been raised over the low sensitivity, low specificity, and large variability between lots of commercially available antibodies for angiotensin type-1 and type-2 receptors, which makes it difficult to reconciliate results of different studies. Here, we describe the first non-antibody-based sensitive and specific targeted quantitative mass spectrometry assay for angiotensin receptors. Methods and Results Using a technique that allows targeted analysis of multiple peptides across multiple samples in a single mass spectrometry analysis, known as TOMAHAQ (triggered by offset, multiplexed, accurate mass, high resolution, and absolute quantification), we have identified and validated specific human tryptic peptides that permit identification and quantification of angiotensin type-1 and type-2 receptors in biological samples. Several peptide sequences are conserved in rodents, making these mass spectrometry assays amenable to both preclinical and clinical studies. We have used this method to quantify angiotensin type-1 and type-2 receptors in postmortem frontal cortex samples of older adults (n=28) with Alzheimer dementia. We correlated levels of angiotensin receptors to biomarkers classically linked to renin-angiotensin system activation, including oxidative stress, inflammation, amyloid-β load, and paired helical filament-tau tangle burden. Conclusions These robust high-throughput assays will not only catalyze novel mechanistic studies in the angiotensin research field but may also help to identify patients with an unbalanced angiotensin receptor distribution who would benefit from angiotensin receptor blocker treatment.

Prevalence and predictors of depressive symptoms among caregivers of patients with epilepsy in Hong Kong

Study aimTo estimate the prevalence of high caregiving burden and depressive symptoms among caregivers (CG) of patients with epilepsy (PWEs) in Hong Kong and identify risk and protective factors for both outcomes after the Model of Stress and Carer Burden (MSCB). MethodsThis cross-sectional study recruited participants from local epilepsy clinics to complete a 15-minute survey on a tablet. Caregiving burden (CB) was assessed using the 4-item Zarit Caregiver Burden Interview. Depressive symptoms were assessed using the 2-item Patient Health Questionnaire. Family functioning was assessed using the Short-Form Family Assessment Device General Functioning Subscale. Sociodemographic data of the caregivers and clinical data of the PWE they cared for were described. Hierarchical logistic regression models were used to analyze the factors associated with the outcomes. ResultsA hundred and fifty-one CGs of PWEs were recruited for this study. The prevalence of high caregiving burden (ZBI-4 > 7) for CGs of PWEs was 58.9% (n = 89), whereas the prevalence of high depressive symptoms (PHQ2 > 2) was 23.8% (n = 36). Hierarchical logistic regression analysis revealed that entering patient characteristics and care situations did not enhance the model’s predictability. In the full model, a high perceived CB was a risk factor for elevated depressive symptoms. Good physical health protects against depressive symptoms. ConclusionsAmong caregivers of PWE in Hong Kong, a high perceived caregiving burden was a risk factor for elevated depressive symptoms; however, the clinical characteristics of the PWEs were not. Self-reported physical health is a protective factor against increased depressive symptoms.

The prevalence and correlates of suicidal ideation in Chinese psychiatric patients during the fifth wave of COVID-19 in Hong Kong

People with mental disorders have increased risk of psychological distress during COVID-19. However, there is limited research comprehensively examining factors associated with suicidal ideation, the strongest predictor of suicidal behavior, among psychiatric patients amidst pandemic. We investigated prevalence and correlates of suicidal ideation in 407 Chinese psychiatric outpatients (diagnosed with mood, anxiety or schizophrenia-spectrum disorders) aged 18–64 years during the peak of fifth COVID-19 wave in Hong Kong between 28 March and 8 April, 2022, based on a comprehensive array of variables encompassing socio-demographics, illness profile, psychopathological symptoms, psychological measures and pandemic-related factors. Univariate and multivariate logistic regression analyses were conducted to determine correlates of suicidal ideation. Results showed that 128 (31.4%) participants exhibited suicidal ideation. Univariate analyses revealed that being unemployed or full-time student, more severe depressive, anxiety, PTSD-like, insomnia and psychotic symptoms, higher levels of loneliness, avoidant-coping, greater pandemic-related stress burden and distress by social-distancing measures were related to suicidal ideation. Conversely, participants with higher monthly household-income, better quality-of-life, and greater resilience were less likely to have suicidal ideation. Notably, only depressive symptom severity was retained in final multivariate model as a factor significantly associated with suicidal ideation. Hence, we observed that approximately one-third of Chinese psychiatric patients experienced suicidal ideation during fifth pandemic wave. Our findings underscore the influence of depressive symptoms being above and beyond that of other psychopathological symptoms, psychological and pandemic-related variables on suicidal ideation. Longitudinal research is required to clarify suicidal ideation trajectories and predictors of persistent suicidal ideation across pandemic and post-pandemic periods.

Automatic Detection of Twitter Users Who Express Chronic Stress Experiences via Supervised Machine Learning and Natural Language Processing.

Americans bear a high chronic stress burden, particularly during the COVID-19 pandemic. Although social media have many strengths to complement the weaknesses of conventional stress measures, including surveys, they have been rarely utilized to detect individuals self-reporting chronic stress. Thus, this study aimed to develop and evaluate an automatic system on Twitter to identify users who have self-reported chronic stress experiences. Using the Twitter public streaming application programming interface, we collected tweets containing certain stress-related keywords (eg, "chronic," "constant," "stress") and then filtered the data using pre-defined text patterns. We manually annotated tweets with (without) self-report of chronic stress as positive (negative). We trained multiple classifiers and tested them via accuracy and F1 score. We annotated 4195 tweets (1560 positives, 2635 negatives), achieving an inter-annotator agreement of 0.83 (Cohen's kappa). The classifier based on Bidirectional Encoder Representation from Transformers performed the best (accuracy of 83.6% [81.0-86.1]), outperforming the second best-performing classifier (support vector machines: 76.4% [73.5-79.3]). The past tweets from the authors of positive tweets contained useful information, including sources and health impacts of chronic stress. Our study demonstrates that users' self-reported chronic stress experiences can be automatically identified on Twitter, which has a high potential for surveillance and large-scale intervention.

Investigating the association between educational attainment and allostatic load with risk of cancer mortality among African American women

BackgroundAfrican American (AA) women navigate the world with multiple intersecting marginalized identities. Accordingly, AA women have higher cumulative stress burden or allostatic load (AL) compared to other women. Studies suggest that AA women with a college degree or higher have lower AL than AA women with less than a high school diploma. We examined the joint effect of educational attainment and AL status with long-term risk of cancer mortality, and whether education moderated the association between AL and cancer mortality.MethodsWe performed a retrospective analysis among 4,677 AA women within the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2010 with follow-up data through December 31, 2019. We fit weighted Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) of cancer death between educational attainment/AL (adjusted for age, income, and smoking status).ResultsAA women with less than a high school diploma living with high AL had nearly a 3-fold increased risk (unadjusted HR: 2.98; 95%C CI: 1.24–7.15) of cancer death compared to AA college graduates living with low AL. However, after adjusting for age, this effect attenuated (age-adjusted HR: 1.11; 95% CI: 0.45–2.74). AA women with high AL had 2.3-fold increased risk of cancer death (fully adjusted HR: 2.26; 95% CI: 1.10–4.57) when compared to AA with low AL, specifically among women with high school diploma or equivalent and without history of cancer.ConclusionsOur findings suggest that high allostatic load is associated with a higher risk of cancer mortality among AA women with lower educational attainment, while no such association was observed among AA women with higher educational attainment. Thus, educational attainment plays a modifying role in the relationship between allostatic load and the risk of cancer death for AA women. Higher education can bring several benefits, including improved access to medical care and enhanced medical literacy, which in turn may help mitigate the adverse impact of AL and the heightened risk of cancer mortality among AA women.

Higher Subjective Burden in Psychiatric Compared to Somatic Healthcare Workers in Germany During the first wave of the COVID-19 Pandemic.

The COVID-19 pandemic has posed unprecedented challenges for health care workers (HCWs) worldwide. While the adverse effects of the pandemic on the well-being of HCWs in general have now been established, little is known about the impact on HCWs of psychiatric hospitals (PHCWs). PHCWs are of special interest, given that they faced both an increase in infection rates among psychiatric patients as well as in mental strain of the general public due to consequences of the pandemic. The aim of the present study was to investigate how the pandemic affected PHCWs as well as possible differences between PHCWs and other health care workers (OHCWs) in Germany during the first wave of the pandemic. We conducted a country-wide anonymous online survey early during the first pandemic wave between April 15th and May 1st, 2020, to assess different aspects of subjective burden and perceived stress using 5-point Likert-scale questions. We analysed data of 1530 PHCWs and 2114 OHCWs and showed that PHCWs reported higher subjective burden and stress compared to OHCWs (p<0.001). Overall, nurses from both groups of HCWs showed higher ratings in subjective burden and stress than physicians. These higher ratings for subjective burden were even more pronounced for nurses working in psychiatric hospitals. Future research is needed to investigate the causes for PHCWs' increased stress and subjective burden, especially when taking into account the long-term effects of the pandemic, which may lead to further challenges and an ever-increasing workload, especially for PHCWs.

Adversity type and timing predict temporal summation of pain in African-American adults.

African Americans are disproportionately exposed to adversity across the lifespan, which includes both stressful and traumatic events. Adversity, in turn, is associated with alterations in pain responsiveness. Racial differences in pain responsiveness among healthy adults are well established. However, the extent to which adversity type and timing are associated with alterations in pain responsiveness among healthy African-American adults is not well understood. The present study included 160 healthy African-American adults (98 women), ages 18 to 45. Outcome measures included pain tolerance and temporal summation of pain to evoked thermal pain. Composite scores were created for early-life adversity (childhood trauma, family adversity) and recent adversity (perceived stress, chronic stress burden). A measure of lifetime racial discrimination was also included. Higher levels of recent adversity were associated with higher temporal summation of pain, controlling for gender, age, and education. Neither early-life adversity nor lifetime racial discrimination were associated with temporal summation of pain. The present findings suggest that heightened temporal summation of pain among healthy African-American adults is associated with exposure to recent adversity events. Improved understanding of how recent adversity contributes to heightened temporal summation of pain in African Americans could help to mitigate racial disparities in pain experiences by identifying at-risk individuals who could benefit from early interventions.

PECULIARITIES OF THE COURSE OF THE DISEASE IN WOMEN WITH COVID-19

One of the most crucial topics at the moment is the viral infection caused by the SARS-CoV-2 coronavirus, which has acquired not only medical, but also, of course, social significance. The COVID-19 pandemic has challenged healthcare systems around the world.Pregnant women are the most vulnerable category of people, along with the elderly. Due to low immune reactivity, they are more susceptible to severe complications than others, which makes the problem of pregnancy in patients with COVID-19 a pressing issue.A successful pregnancy requires changes in the immune system of the pregnant woman to tolerate a genetically foreign fetus. These changes in the immune system, as well as in the cardiac, pulmonary, and other systems, can lead to increased susceptibility or increased morbidity and mortality due to infection during pregnancy. Considering the physiological adaptations associated with pregnancy, we found that the high metabolic demand to maintain normal intrauterine development increases the burden of oxidative stress during pregnancy. Intracellular redox changes associated with acute phase reactions at the maternal-fetal interface may be enhanced during pregnancy. Notably, mother-to-fetal transmission of SARS-CoV-2 has not been detected in most COVID-19 pregnancies. This relative absence of vertical transmission may be due to the presence of lactoferrin in the placenta, amniotic fluid, and breast secretions. However, the cytokine storm induced during COVID-19-associated pregnancies can cause severe inflammatory damage to the fetus and, if left uncontrolled, can subsequently lead to autism spectrum disorders and brain developmental abnormalities in newborns. Given this serious health threat to a child's growth and development, preventing COVID-19 during pregnancy should be a priority.We aimed to study risk factors and assess the course of pregnancy in women with COVID-19.The study was carried out within the framework of the research work "Clinical and pathogenetic substantiation of differentiated treatment of combined pathology of internal organs" (№0122U002209).

COVID-19 pandemic stress and cancer symptom burden

ObjectivesIn a sample of patients with cancer (n=1145) who were assessed during the height of the COVID-19 pandemic, latent profile analysis was used to identify subgroups of patients with distinct...

Effectiveness of a mixed lifestyle program in couples undergoing assisted reproductive technology: a study protocol

BackgroundThe desire for fertility is the manifestation of yearning for immortality. Infertility and assisted reproductive technology (ART) expose couples to great affective, anxiety, stress, and financial burden. Increasing evidence emphasize the impact of lifestyle on infertility. One of the most crucial factors affecting the fertility process is the nutrition patterns, the amount and quality of physical activities, emotional problems management; modulate stressors, relief from anxiety, and the living conditions of couples. Most ART treatment interventions in Iran are not integrated into lifestyle programs. Therefore, this research will investigate the impact of mixed fertility health-promoting programs in couples who use ARTs.Methodology/DesignThis study entails three steps. The first step includes the systematic review of literature on a health-promoting lifestyle in infertile couples undergoing ARTs, a systematic review of observational studies and interventions in couple’s lifestyle, then, a systematic review of qualitative studies on infertility in couples and their lifestyle, and in the final step couple’s life style literature systematically will evaluate in Iran. In case of failure to obtain the required results from systematic reviews, cross-sectional studies will be carried out to determine the lifestyle of infertile couples receiving ARTs. In the second stage, by holding a panel of experts, an intervention is planned based on the results of the previous stages in order to improve the lifestyle of couples. In the final step, the designed intervention will be administered as a random clinical trial—on ART candidates, in intervention or control groups in one of Iran University of Medical Sciences hospitals. Afterward, the data’s will be evaluated by using standard questionnaires, that include health-promoting lifestyle questionnaire (HPLII), Beck’s depression inventory (BDI), international physical activity questionnaire—short form (IPAQ-SF), and food frequency questionnaire (FFQ). The statistical analysis will be carried out in SPSS software. During the study, subjects meeting the inclusion criteria were randomly selected and randomized into the intervention and control groups. The health-promoting lifestyle training program will be executed for the intervention group while the standard care program is administered to the control group. The content of this program will be obtained from the consensus opinions of the expert panel. The program includes diet recommendations, physical activity, and stress management. Appropriate time, frequency, duration and number of activities will be considered. Communication with subjects will be possible through private meeting special comfort room. Support to the participants will also be through clinical visits social media, SMS and phone calls. Nutritional changes, physical activity amount, anxiety and stress level, abdominal circumference (AC), and body mass index (BMI) will be measured after the completion of the specified time interval. The initial outcome includes examining chemical pregnancy (2 weeks after the transmission) and clinical pregnancy by ultrasound (6 weeks after). The secondary outcome will be live birth rate. Retrieved oocyte and embryo numbers will also be reported.DiscussionHealth-promoting lifestyle programs are essential in assisted reproductive technologies to improve pregnancy results and live birth. These programs in association with in-vitro fertilization (IVF) influence the outcome of fertilization. In addition, enhancing parental health leads to healthy pregnancy outcome. Despite the frequency of lifestyle risk factors, employing proper methods helps reduce anxiety and stress, modify dietary patterns, and perform qualitatively and quantitatively balanced physical activities. In addition, having coping skills and mental health management methods, in nowadays modern world challenges seems crucial and effective in solving fertility problems and reducing them before pregnancy.

A comparative study on patient safety culture among high-risk hospital staff in the context of the COVID-19 and non-COVID-19 pandemic: a cross-sectional study in Taiwan.

The study aimed to compare the evolution of patient safety culture perceived by high-risk hospital staff in the context of the COVID-19 pandemic and non-COVID-19 pandemic and to examine the variations in patient safety culture across demographic variables. The study found that the COVID-19 pandemic has significantly impacted patient safety culture in healthcare settings, with an increased focus on safety climate, job satisfaction, teamwork climate, stress recognition, and emotional exhaustion. Safety culture and work stress vary among medical professionals of different age groups. To reduce stress, workload should be minimized, work efficiency improved, and physical and mental health promoted. Strengthening safety culture can reduce work-related stress, improve job satisfaction, and increase dedication towards work. The study recommends interventions such as psychological and social support, along with emotional management training, to reduce emotional exhaustion. Healthcare institutions can set up psychological counseling hotlines or support groups to help medical professionals reduce stress and emotional burden.

Higher Lifetime Stress and Symptom Burden Contribute to the Occurrence of Shortness of Breath

Among four classes of patients with distinct shortness of breath profiles, evaluate for differences in levels of global, cancer-specific, and cumulative life stress, as well as resilience; evaluate for differences in the occurrence rates for various stressful life events, and evaluate for differences in the severity of common co-occurring symptoms. Outpatients (N = 1338) completed questionnaires six times over two cycles of chemotherapy. The occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles. Differences among the classes were evaluated using parametric and nonparametric tests. Shortness of breath classes were labeled based on their distinct occurrence trajectories: None (70.5%), Decreasing (8.2%), Increasing (7.8%), and High (13.5%). Compared to None class, Decreasing and High classes had higher global and cancer-specific stress scores. The High class reported higher occurrence rates for several adverse childhood experiences. Compared to None class, Decreasing and High classes had higher depression, anxiety, and morning fatigue scores and lower morning energy and cognitive function scores. Given the additive or synergistic relationships between stress, co-occurring symptoms, and shortness of breath, multimodal interventions that include stress management, exercise training, and/or symptom management may decrease shortness of breath in oncology patients.

How do spine surgeons cope with psychological distress: results of a cross-sectional study

Cross Sectional Study/Online Survey. In this study, we sought to assess stress, psychological distress, resilience, and coping strategies among spine surgeons in German-speaking countries. Recent studies have reported high rates of stress and burnout among surgeons. A survey via Survey Monkey™ was conducted among spine surgeons practicing in German-speaking countries using validated questionnaires for perceived stress, mental burden, resilience, and quality of life. Data on working situation and demographics were also collected. 582 surgeons responded to the survey, representing 15% of those surveyed. 79% of respondents were satisfied with their professional success. Mental burden was higher than in the general population, as was perceived stress. Chairpersons were exposed to the lowest levels of perceived stress and mental burden. Mental distress was high (GHQ ≥ 12) in 59% of residents and 27% chairpersons. Self-reported psychological resilience was higher than levels found in the general population and highest among chairpersons. Quality of life was comparable to levels reported in the general population. There were statistically significant correlations between perceived stress and mental burden scores (r s = 0.65, p < 0.001). Career level (senior physicians vs. residents, OR 0.26; 95% CI 0.10-0.66), perceived stress (OR 1.54; 95% CI 1.33-1.77), self-reported resilience (OR 0.53; 95% CI 0.33-0.84), and mental composite score (SOR 0.86; 95% CI 0.83-0.90) were predictors of high mental burden. There was no interaction between perceived stress and resilience on mental burden (p = 0.835). Spine surgeons are exposed to higher levels of stress than the general population, which are associated with higher mental distress. More professional experience and higher levels of psychological resilience are associated with lower levels of stress.

The Relationship Between Intersectional Oppression and Affirmation and Latino Sexual Minority Men's Mental Health.

Purpose: Latino sexual minority men (LSMM) may experience oppression based on their ethnicity, sexual orientation, and migratory status, yet scientific literature is only beginning to explore the intersection of these experiences. This study examined mental health (MH) in relation to LSMM's experiences of intersectional oppression and affirmation. Methods: We conducted a secondary analysis of baseline data from a cohort study examining LSMM's (n = 290) health care engagement in Miami, FL, from February to September 2020. Latent class analysis (LCA) identified classes based on self-reported multiple identity discrimination (e.g., race, ethnicity, and skin color), sexual orientation stigma/affirmation, and migration-related stress. Logistic and linear regressions examined associations between class membership and anxious, depressive, post-traumatic stress, somatic symptoms, and overall MH burden. Results: The LCA revealed a three-class solution: (1) affirmed LSMM (73.8%), (2) LSMM with intersectional oppression (21.7%), and (3) LSMM with immigration stress (4.5%). The three classes varied in terms of multiple identity discrimination, sexual orientation stigma/affirmation, and migration-related stress. Compared with Class 1, Class 2 had greater conditional probabilities of reporting clinically significant depressive (p = 0.033) and post-traumatic stress symptoms (p = 0.031), and at least one MH concern (p = 0.018). Greater depressive symptoms (p = 0.007), post-traumatic stress symptoms (p = 0.049), somatic symptoms (p = 0.024), and clinically significant MH concerns (p = 0.018) were found among Class 2 than among Class 1. Conclusion: Findings identified three groups of LSMM based on their experiences of intersectional oppression and affirmation. Discrimination at the intersection of multiple identities, sexual orientation stigma/affirmation, and migration-related stress were associated with LSMM's MH outcomes, particularly among immigrants.