Stress Levels Research Articles

The impact of modified Cognitive-Behavioral Group Therapy in social adjustment functions of children with attention deficit hyperactivity disorder and their parents' stress levels: A nonrandomized clinical trial.

This study aims to investigate the potential of a modified Cognitive-Behavioral Group Therapy (CBGT) intervention in promoting social adjustment and reducing their parental stress among children exhibiting symptoms of attention deficit hyperactivity disorder (ADHD). The research also highlights the mechanisms and advantages of employing modified CBGT to address negative symptoms associated with ADHD in children. The study was conducted at Fuzhou Children's Hospital of Fujian Province, with a total of 20 pairs of parents and children with ADHD participating. The assessment utilized measures including SNAP, Barratt Impulsivity, and Conners to evaluate changes in the children's social adjustment abilities and core/associated ADHD symptoms before and after CBGT intervention. Additionally, the Parental Stress Index was employed to gauge the level of stress experienced by the parents. Consequently, CBGT interventions have shown substantial improvements in children's social adjustment abilities and have proven to be a significant source of stress relief for parents.

The mitigating effect of para-hydroxycinnamic acid in bleomycin-induced pulmonary fibrosis in mice through targeting oxidative, inflammatory and fibrotic pathways.

This study investigated the therapeutic benefits of para-hydroxycinnamic acid in mice with bleomycin-induced lung fibrosis. Forty male BALB/c mice were randomly assigned to four groups: normal, which received 0.9% normal saline; induced, which received a single dose of bleomycin (5mg/kg) by oropharyngeal challenge; pirfenidone-treated; and para-hydroxycinnamic acid-treated, which challenged with bleomycin and received a daily oral dose of 300 and 50 mg/kg, respectively, from day 7 to day 21. Tissue pro-fibrotic and inflammatory cytokines, oxidative indicators, pulmonary histopathology, immunohistochemistry of fibrotic proteins and the assessment of gene expression by RT-qPCR were evaluated on day 22 after euthanizing animals. Pirfenidone and para-hydroxycinnamic acid managed to alleviate the fibrotic endpoints by statistically improving the weight index, histopathological score and reduced expression of fibrotic-related proteins in immune-stained lung sections, as well as fibrotic markers measured in serum samples. They also managed to alleviate tissue levels of oxidative stress and inflammatory and pro-fibrotic mediators. para-Hydroxycinnamic acid enhanced the expression of crucial genes associated with oxidative stress, inflammation and fibrosis in vivo. para-Hydroxycinnamic acid has demonstrated similar effectiveness to pirfenidone, suggesting it could be a promising treatment for fibrotic lung conditions by inhibiting the TGF-β1/Smad3 pathway or through its anti-inflammatory and antioxidant properties.

Comprehensive Toxicological Assessment of Halobenzoquinones in Drinking Water at Environmentally Relevant Concentration.

Halobenzoquinones (HBQs), an emerging unregulated category of disinfection byproduct (DBP) in drinking water, have aroused an increasing concern over their potential health risks. However, the chronic toxicity of HBQs at environmentally relevant concentrations remains largely unknown. Here, the occurrence and concentrations of 13 HBQs in drinking water from a northern megacity in China were examined using ultrahigh performance liquid chromatography coupled with triple-quadrupole tandem mass spectrometry (UHPLC-MS/MS). Four HBQs, including 2,6-dichloro-1,4-benzoquinone (2,6-DCBQ), 2,6-dibromo-1,4-benzoquinone (2,6-DBBQ), 2,3,6-trichloro-1,4-benzoquinone (TriCBQ), and 2,5-dibromo-1,4-benzoquinone (2,5-DBBQ), were detected beyond 50% occurrence frequency and at median concentrations from 4 to 50 ng/L. The chronic toxicity of these four HBQs to normal human colon and liver cells (FHC and THLE-2) was investigated at these concentrations. After 90 days of exposure, 2,5-DBBQ and 2,6-DCBQ induced the highest levels of oxidative stress and deoxyribonucleic acid (DNA) damage in colon and liver cells, respectively. Moreover, 2,5-DBBQ and 2,6-DCBQ were also found to induce epithelial-mesenchymal transition (EMT) in normal human liver cells via the extracellular signal regulated kinase (ERK) signaling pathway. Importantly, heating to 100 °C (boiling) was found to efficiently reduce the levels of these four HBQs in drinking water. These results suggested that environmentally relevant concentrations of HBQs could induce cytotoxicity and genotoxicity in normal human cells, and boiling is a highly efficient way of detoxification for HBQs.

The relationship between personality traits and happiness: the mediating role of emotional regulation

BackgroundUnderstanding the factors contributing to happiness in the nursing profession is essential, particularly considering the high levels of stress associated with the job. This study aimed to explore the role of emotion regulation in mediating the relationship between personality traits and nurses’ happiness.ObjectiveThis study aimed to explore the relationship between personality traits and happiness by examining the mediating role of emotion regulation.MethodsA cross-sectional study was conducted with 324 Jordanian and 408 Saudi nurses. Data, including the Big Five personality traits, happiness levels, and measures of emotional regulation, were collected through an online survey. The model’s fit and explanatory capability were verified by Structural Equation Modeling (SEM) using SmartPLS 3.ResultsIn the structural model, agreeableness had a significant effect on happiness, influencing both reappraisal and suppression. Extraversion strongly influences happiness, positively affects reappraisal, and negatively affects suppression. Neuroticism hampers happiness and reappraisal, and has a detrimental effect on suppression. Openness had a positive effect on suppression, whereas consciousness positively affected happiness. Mediation analysis revealed direct effects on happiness, with varying indirect contributions from emotional regulation. Multiple-group analysis revealed no significant differences between Jordan and Saudi Arabia in the association between personality traits and happiness.ConclusionThe findings emphasize the nuanced effects of agreeableness, extraversion, neuroticism, consciousness, and openness on happiness, mediated by emotional regulation. Implementing specific interventions to improve emotional regulation can increase nurses’ happiness regardless of their personality traits. The lack of significant differences between Jordanian and Saudi nurses implies that these relationships are consistent across cultures, offering valuable information for cross-cultural healthcare interventions.

Activated factor X stimulates atrial endothelial cells and tissues to promote remodeling responses through AT1R/NADPH oxidases/SGLT1/2.

Atrial fibrillation (AF), the most common cardiac arrhythmia favoring ischemic stroke and heart failure involves left atrial remodeling, fibrosis and a complex interplay between cardiovascular risk factors. This study examined whether activated factor X (FXa) induces pro-remodeling and pro-fibrotic responses in atrial endothelial cells (AECs) and human atrial tissues and determined the underlying mechanisms. AECs were from porcine hearts and human right atrial appendages (RAA) from patients undergoing heart surgery. Protein expression levels were assessed by Western blot and immunofluorescence staining, mRNA levels by RT-qPCR, formation of reactive oxygen species (ROS) and NO using fluorescent probes, thrombin and angiotensin II generation by specific assays, fibrosis by Sirius red staining and senescence by senescence-associated beta-galactosidase (SA-β-gal) activity.In AECs, FXa increased ROS formation, senescence (SA-β-gal activity, p53, p21), angiotensin II generation and the expression of pro-inflammatory (VCAM-1, MCP-1), pro-thrombotic (tissue factor), pro-fibrotic (TGF-β and collagen-1/3a) and pro-remodeling (MMP-2/9) markers whereas eNOS levels and NO formation were reduced. These effects were prevented by inhibitors of FXa but not thrombin, protease-activated receptors antagonists (PAR-1/2) and inhibitors of NADPH oxidases, ACE, AT1R, SGLT1/SGLT2. FXa also increased expression levels of ACE1, AT1R, SGLT1/2 proteins which was prevented by SGLT1/2 inhibitors. Human RAA showed tissue factor mRNA levels that correlated with markers of endothelial activation, pro-remodeling and pro-fibrotic responses and SGLT1/2 mRNA levels. They also showed protein expression levels of ACE1, AT1R, p22phox, SGLT1/2, and immunofluorescence signals of nitrotyrosine and SGLT1/2 colocalized with those of CD31. FXa increased oxidative stress levels which were prevented by inhibitors of the AT1R/NADPH oxidases/SGLT1/2 pathway. FXa promotes oxidative stress triggering premature endothelial senescence and dysfunction associated with pro-thrombotic, pro-remodeling and pro-fibrotic responses in AECs and in human RAA involving the AT1R/NADPH oxidases/SGLT1/2 pro-oxidant pathway. Targeting this pathway may be of interest to prevent atrial remodeling and the progression of atrial fibrillation substrate.

The impact of HBx protein on mitochondrial dynamics and associated signaling pathways strongly depends on the hepatitis B virus genotype.

Chronic hepatitis B virus (HBV) infections are strongly associated with liver cirrhosis, inflammation, and hepatocellular carcinoma. In this context, the viral HBx protein is considered as a major factor influencing HBV-associated pathogenesis through deregulation of multiple cellular signaling pathways and is therefore a potential target for prognostic and therapeutic applications. However, HBV-associated pathogenesis differs significantly between genotypes, with the relevant factors and in particular the contribution of the genetic diversity of HBx being largely unknown. To address this question, we studied the specific genotype-dependent impact of HBx on cellular signaling pathways, focusing in particular on morphological and functional parameters of mitochondria. To exclusively investigate the impact of HBx of different genotypes on integrity and function of mitochondria in the absence of additional viral factors, we overexpressed HBx in Huh7 or HepG2 cells. Key signaling pathways were profiled by kinome analysis and correlated with expression levels of mitochondrial and pathogenic markers. Conclusively, HBx of genotypes A and G caused strong disruption of mitochondrial morphology alongside an induction of PTEN-induced putative kinase 1/Parkin-mediated mitophagy. These effects were only moderately dysregulated by genotypes B and E, whereas genotypes C and D exhibit an intermediate effect in this regard. Accordingly, changes in mitochondrial membrane potential and elevated reactive oxygen species production were associated with the HBx-mediated dysfunction among different genotypes. Also, genotype-related differences in mitophagy induction were identified and indicated that HBx-mediated changes in the mitochondria morphology and function strongly depend on the genotype. This indicates a relevant role of HBx in the process of genotype-dependent liver pathogenesis of HBV infections and reveals underlying mechanisms.IMPORTANCEThe hepatitis B virus is the main cause of chronic liver disease worldwide and differs in terms of pathogenesis and clinical outcome among the different genotypes. Furthermore, the viral HBx protein is a known factor in the progression of liver injury by inducing aberrant mitochondrial structures and functions. Consequently, the selective removal of dysfunctional mitochondria is essential to maintain overall cellular homeostasis and cell survival. Consistent with the intergenotypic difference of HBV, our data reveal significant differences regarding the impact of HBx of different genotypes on mitochondrial dynamic and function and thereby on radical oxygen stress levels within the cell. We subsequently observed that the induction of mitophagy differs significantly across the heterogenetic HBx proteins. Therefore, this study provides evidence that HBx-mediated changes in the mitochondria dynamics and functionality strongly depend on the genotype of HBx. This highlights an important contribution of HBx in the process of genotype-dependent liver pathogenesis.

Network pharmacology combined with an experimental validation study to reveal the effect and mechanism of Lonicera japonica Thunb. extracts against immunomodulation.

Lonicera japonica Thunb. (LJT) is known for its valuable medicinal properties that highlight its potential application in the pharmaceutical and health food industry. We predict that LJT polyphenols by network pharmacology may be involved in immunomodulation, and the study of LJT polyphenols regulating immunity is still insufficient; therefore, we experimentally found that LJT enhances immunity by promoting the proliferation and phagocytic activity of RAW246.7 cells. A model of an immunosuppressed mouse was constructed using cyclophosphamide-induced, and LJT was extracted for the intervention. We found that LJT restored immune homeostasis in immune deficiency mice by inhibiting the abnormal apoptosis in lymphocytes, enhancing natural killer cell cytotoxicity, promoting T lymphocyte proliferation, and increasing the CD4+ and CD8+ T lymphocytes in quantity. Moreover, LJT treatment modulates immunity by significantly downregulating lipopolysaccharide-induced inflammation and oxidative stress levels. We verified the immunomodulatory function of LJT through both cell and animal experiments. The combination of potential-protein interactions and molecular docking later revealed that LJT polyphenols were associated with immunomodulatory effects on MAPK1; together, LJT intervention significantly modulates the immune, with the activation of MAPK1 as the underlying mechanism of action, which provided evidence for the utilization of LJT as a nutraceutical in immune function.

Association of Perception, Interest, and Barriers of Learning and Practicing Yoga with Levels of Stress in Life among Residents Living in Saudi Arabia

Association of Perception, Interest, and Barriers of Learning and Practicing Yoga with Levels of Stress in Life among Residents Living in Saudi Arabia

From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes

BackgroundNursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses’ well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals. Methods: This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction. Results: More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.

A biofloc system avoids the adverse effects of diets with suboptimal protein levels on zootechnical performance, intestinal histomorphometry, and protein metabolism of Nile tilapia juvenile fed Spirulina biomass (Arthrospira platensis) as an alternative protein source.

This study aimed to evaluate the effect of the biofloc technology (BFT) system and the replacement of fish meal with Spirulina biomass on productive performance, intestinal histomorphometry, plasma biochemistry, and oxidative stress of Nile tilapia juveniles (Oreochromis niloticus) fed suboptimal levels of protein. Two factors were evaluated: production systems (clear water × BFT) and replacement of fish meal with Spirulina (0, 33, 66 e 100%). The design was in a 2 × 4 randomized factorial scheme with four replications, and the fish were evaluated for 48days. Four isoproteic (28% crude protein) diets were formulated with gross energy values close to 4300kcalkg-1. Nile tilapia juveniles (0.23 ± 0.01g) were distributed in 16 circular tanks (70 L) at seven fish/tank. The diets were formulated with protein levels approximately 20% below that required for the species and life stage. No interaction was observed between the factors evaluated (production systems × Spirulina inclusion). Rearing the fish in the BFT system avoided the adverse effects of diets with suboptimal protein levels on performance, intestinal histomorphometry, and protein metabolism. Lower values lower lipid peroxidation and higher antioxidant capacity were observed in fish reared in the BFT system, showing evidence of improvements in antioxidant responses and lower levels of physiological oxidative stress. Spirulina completely replaced fish meal in the diets of Nile tilapia juveniles without adverse effects on intestinal morphometry, protein metabolism, and antioxidant response. Replacing 66% of fish meal with Spirulina improved the productive performance, regardless of the rearing system.

Numerical modeling of the behavior of concrete exposed to chloride ions by coupling age and mechanical stresses

This study proposes a quantitative examination of the issue of chloride ion infiltration in concrete under mechanical strain in a hostile setting while considering the influence of time, commonly referred to as the aging effect. The relationship between the diffusion coefficient and age, when subjected to specific levels of uniaxial or biaxial stresses for various W/C ratios, has allowed us to assess the concentration of chloride ions and the time needed for corrosion to begin through the coating layer in three dimensions. The numerical model results corroborate the notion that the corrosion process is affected by the fluctuation of the diffusion coefficient, which is directly linked to the age factor and the mechanical stresses exerted on the concrete. The model also emphasizes the extended distribution of chloride ion concentration at a certain depth, which is connected to the ratio of water to cement, influenced by the diffusion coefficient and the degree of mechanical stress in older structures.

Effects of non-ionizing radio frequency electromagnetic radiation on the development and behavior of early embryos of Danio rerio

ABSTRACT Biological effects of radio frequency electromagnetic radiation (RF-EMR) in the range of 900–1800 MHz emerging from the mobile phone were investigated and were found to influence the locomotor pattern when exposure was initiated from 1 hour post fertilization (hpf) in zebrafish embryos (ZE), Danio rerio. Mobile phones and other wireless devices offer tremendous advantages. However, on the flipside they are leading to an increased electromagnetic energy in the environment, an excess of which could be termed as electromagnetic pollution. Herein, we tried to understand the effects of RF-EMR emerging from the mobile phone, on the development and behavior of ZE, exposed to RF-EMR (specific absorption rate of 1.13 W/kg and 1800 MHz frequency) 1 hr daily, for 5 days. To understand if there could be any developmental stage-specific vulnerability to RF-EMR, the exposure was initiated at three different time points: 1hpf, 6hpf and 24hpf of ZE development. Observations revealed no significant changes in the survival rate, morphology, oxidative stress or cortisol levels. However, statistically significant variations were observed in the batch where exposure started at 1hpf, with respect to locomotion patterns (distance travelled: 659.1 ± 173.1 mm Vs 963.5 ± 200.4 mm), which could be correlated to anxiety-like behavior; along with a corresponding increase in yolk consumption (yolk sac area: 0.251 ± 0.019 mm2 Vs 0.225 ± 0.018 mm2). Therefore, we conclude that RF-EMR exposure influences the organism maximally during the earliest stage of development, and we also believe that an increase in the time of exposure (corresponding to the patterns of current usage of mobile phones) might reveal added afflictions.

Wilson Disease and the COVID-19 pandemic: exploring patients’ mental health and vaccination attitudes in a longitudinal study

IntroductionThe COVID-19 pandemic significantly impacted the mental health of individuals with chronic conditions such as Wilson’s Disease (WD). This study investigates stress, anxiety, depression, quality of life, cognitive function, vaccination rates, infection rates, and perceptions related to the pandemic and vaccines among WD patients.MethodsThe study analyzed COVID-19 perceptions and vaccine attitudes of 62 adult WD patients enrolled in the international multisite WD Registry. A subgroup of 33 participants completed a series of mental health scales. The effect of working essentially, income loss, wellness activity initiation, and infection of COVID-19 during the pandemic was observed.ResultsResults indicate that, overall, the pandemic did not exacerbate anxiety or cognitive function in WD patients but did lead to increased depression among essential workers. Patients experiencing income loss exhibited higher levels of stress and anxiety. Despite these challenges, WD patients showed high vaccination rates and positive attitudes towards vaccines.DiscussionThe findings underscore the significant impact of the pandemic on the mental health of WD patients.

Impact of a national audit on child and adolescent psychiatrists' prescribing practices.

A look back review of South Kerry Child and Adolescent Mental Health Services (CAMHS) in Ireland, known as the 'Maskey report' (MR), highlighted substandard prescribing practices. The aim of this 'Maskey Impact Study' (MIS) was to explore changes to child and adolescent psychiatrists' prescribing practices following the MR. The study was cross-sectional and mixed method. A study specific questionnaire was distributed electronically to psychiatrists working in CAMHS (n = 160). 102 psychiatrists participated in the study (response rate 63.8%). Perceived improvement in prescribing practices included improved medical record keeping (63.7%), consent documentation (53.9%), medication information provision (41.2%) and physical health monitoring (60.8%). However, 43.1% of psychiatrists reported a reluctance to prescribe medication even when clinically indicated and 50% were more likely to avoid off-label use. Most respondents reported increased stress levels (80.4%) with higher stress being significantly associated with reticence in prescribing (χ2 = 11.746, p < .001) and avoiding off-label use (χ2 = 15.392, p < 0.001). Thematic analysis highlighted increased medication hesitancy, enforced 'meaningless' bureaucracy and medication mistrust among families. Although improvements reported are welcomed, the increased hesitancy of medication use, avoidance of prescribing more than one medication, and avoidance of off-label use, is of concern with potential unintended adverse consequences. Reluctance in prescribing may deprive youth of access to evidence-based treatments and limit exposure of NCHDs to the safe practice of consultant-initiated psychopharmacology. Further research will be important to determine if this impacts clinical care. Continued education in psychopharmacology is essential along with increased public awareness of the evidence for medication, to help restore public confidence and trust in psychopharmacology.

DNA Walker-Driven Mass Nanotag Assembly System for Simultaneously Profiling Dual Markers of Oxidative Stress at Different Cellular Locations.

Simultaneous profiling of redox-regulated markers at different cellular sublocations is of great significance for unraveling the upstream and downstream molecular mechanisms of oxidative stress in living cells. Herein, by synchronizing dual target-triggered DNA machineries in one nanoentity, we engineered a DNA walker-driven mass nanotag (MNT) assembly system (w-MNT-AS) that can be sequentially activated by oxidative stress-associated mucin 1 (MUC1) and apurinic/apyrimidinic endonuclease 1 (APE1) from plasma membrane to cytoplasm and induce recycled assembly of MNTs for multiplex detection of the two markers by matrix-assisted laser desorption ionization mass spectrometry (MALDI MS). In the working cascade, the sensing process governs the separate activation of w-MNT-AS by MUC1 and APE1 in diverse locations, while the assembly process contributes to the parallel amplification of the ion signal of the characteristic mass tags. In this manner, the differences between MCF-7, HeLa, HepG2, and L02 cells in membrane MUC1 expression and cytoplasmic APE1 activation were fully characterized. Furthermore, the oxidative stress level and dynamics caused by exogenous H2O2, doxorubicin, and simvastatin were comprehensively demonstrated by tracking the fate of the two markers across different cellular locations. The proposed w-MNT-AS coupled MS method provides an effective route to probe multiple functional molecules that lie at different locations while participating in the same cellular event, facilitating the mechanistic studies on cellular response to oxidative stress and other disease-related cellular processes.

Influence of Daily Coping on Psychological Stress: A Multilevel Modeling Approach

The current study examined the association between approach and avoidance coping strategies and psychological stress during the novel coronavirus (COVID-19) pandemic. Participants were 62 adults who were recruited from Amazon’s Mechanical Turk. Data collection lasted for 29 d in May 2020. Multilevel modeling revealed no significant association between approach coping strategies and psychological stress among individuals, and engaging in approach coping more than the usual days was also not associated with lower stress. Regarding avoidance coping strategies, they were positively associated with psychological stress among individuals, and when individuals engaged in avoidance coping more than usual, those individuals were more likely to experience psychological stress. Interestingly, the strength of the association between approach coping strategies and psychological stress was dependent on the levels of psychological stress, where the strength became weaker as the level of stress increased. Similarly, the strength of the association between avoidance coping and stress was also dependent on stress at the beginning of the study, where the strength of the association became stronger as the level of stress increased. Current results raise the importance of being mindful of an individual’s psychological stress as the effectiveness of coping strategies may differ based on one’s level of stress.

Utilizing Machine Learning for Context-Aware Digital Biomarker of Stress in Older Adults

Identifying stress in older adults is a crucial field of research in health and well-being. This allows us to take timely preventive measures that can help save lives. That is why a nonobtrusive way of accurate and precise stress detection is necessary. Researchers have proposed many statistical measurements to associate stress with sensor readings from digital biomarkers. With the recent progress of Artificial Intelligence in the healthcare domain, the application of machine learning is showing promising results in stress detection. Still, the viability of machine learning for digital biomarkers of stress is under-explored. In this work, we first investigate the performance of a supervised machine learning algorithm (Random Forest) with manual feature engineering for stress detection with contextual information. The concentration of salivary cortisol was used as the golden standard here. Our framework categorizes stress into No Stress, Low Stress, and High Stress by analyzing digital biomarkers gathered from wearable sensors. We also provide a thorough knowledge of stress in older adults by combining physiological data obtained from wearable sensors with contextual clues from a stress protocol. Our context-aware machine learning model, using sensor fusion, achieved a macroaverage F-1 score of 0.937 and an accuracy of 92.48% in identifying three stress levels. We further extend our work to get rid of the burden of manual feature engineering. We explore Convolutional Neural Network (CNN)-based feature encoder and cortisol biomarkers to detect stress using contextual information. We provide an in-depth look at the CNN-based feature encoder, which effectively separates useful features from physiological inputs. Both of our proposed frameworks, i.e., Random Forest with engineered features and a Fully Connected Network with CNN-based features validate that the integration of digital biomarkers of stress can provide more insight into the stress response even without any self-reporting or caregiver labels. Our method with sensor fusion shows an accuracy and F-1 score of 83.7797% and 0.7552, respectively, without context and 96.7525% accuracy and 0.9745 F-1 score with context, which also constitutes a 4% increase in accuracy and a 0.4 increase in F-1 score from RF.

Experiences of emergency medical services personnel about barriers and facilitators in prehospital childbirth missions in Iran: a qualitative study

Objective: In Iran, the majority of emergency medical services (EMS) personnel are male; hence, one of their distinct and crucial missions is the prehospital childbirth mission, which might be significantly challenging for both personnel and patients. To obtain in-depth and authentic data, the present study was conducted to elucidate the barriers and facilitators of prehospital childbirth missions based on the experiences of EMS personnel. Methods: A qualitative study employing conventional content analysis was conducted in 2023. Participants were selected through purposive sampling from EMS personnel willing to participate in the study and who have experiences with missions leading to childbirth. Data saturation was reached through in-depth semi-structured interviews with 14 participants. Data accuracy and credibility were confirmed using the Lincoln &amp; Guba criteria. Results: The results included two main themes including barriers and facilitators. Barriers were categorized into "gender-related barriers" and "personnel barriers." While "appropriate communication" and "efforts to preserve privacy" were the primary facilitator themes. Conclusion: The findings revealed that EMS personnel face considerable barriers in the process of these missions. Therefore, for optimal performance quality in this prominent mission, it is recommended that clinical and educational policymakers consider actively recruiting female personnel, focusing on enhancing communication and practical skills and securing the patient's privacy. These approaches can result in childbirth missions with lower stress levels for patients, families, and personnel who provide the service.

Effect of high-risk pregnancy on prenatal stress level: a prospective case-control study

AbstractThe study aimed to determine the effects of high-risk pregnancy on prenatal stress levels. The study was conducted with a case-control design in Turkey in September-December 2019. The sample included pregnant women diagnosed with high-risk pregnancy and were at their 36th or later gestational weeks as the case group (n = 121) and healthy pregnant women as the control group (n = 245). The Antenatal Perceived Stress Inventory (APSI) and the Revised Prenatal Distress Questionnaire (NUPDQ-17 Item Version) were used to assess the stress levels of the participants in the study. It was determined that high-risk pregnancy was associated with higher rates of prenatal stress (APSI: p &lt; 0.001, effect size = 0.388; NUPDQ: p = 0.002, effect size = 0.272) compared to the control group. The results of the linear regression analysis showed that high-risk pregnancy affected APSI (R2 = 0.043, p &lt; 0.001) and NUPDQ (R2 = 0.033, p = 0.009) scores, but education levels, number of pregnancies, and number of abortions did not affect APSI and NUPDQ scores. According to the results of this study, high-risk pregnant women are in a risk group for stress. It is of great importance for the course of a pregnancy that healthcare professionals assess the stress levels of pregnant women in the high-risk pregnancy category and provide psychological support to pregnant women who have high stress levels or are hospitalized.

The Impact of Parental Solid Self, Treatment Involvement, Stress, and Parenting Styles on Children’s Mental Health Symptom Severity

AbstractWith the increasing rate of mental health disorders among youth in the United States (U.S.) and the essential role of parents in children’s development, many studies have investigated the relationship between parental factors and children’s mental health. The current study expanded on this research by exploring the impact of parent solid self (i.e., one subcategory of differentiation of self), parenting stress, parenting styles, and parent involvement in treatment on children’s mental health symptom severity. The sample included 216 parents (U.S. residents; Mage = 33.84, SDage = 5.384) with at least one youth aged 3–17 years actively or historically in mental health treatment. Participants completed an online survey that included a demographic questionnaire and measures of parenting styles, parental solid self, parental stress, and children’s symptom severity. A simple linear regression found that parental solid self and stress levels were associated with the severity of children’s symptoms. A two-way ANOVA revealed that parenting styles had a significant main effect on children’s symptom severity. Results also showed that the level of authoritative parenting style mediated the relationship between parental solid self and children’s symptom severity. This study further highlighted the importance of promoting individual therapy or psychoeducation for parents and how it might benefit children’s treatment. Future research may consider children’s perspectives, how parents engage with their child’s treatment, incorporating more expansive assessment methods, and longitudinal designs to further explore the impact of parents’ differentiation of self, parental stress, parenting styles, and parental involvement in treatment on children’s symptom severity.