Stress Reduction Strategies Research Articles

Supporting Mental Health During Pregnancy and Beyond

Biological and psychosocial changes during pregnancy affect a women’s emotional well being and ability to cope with stress, making them vulnerable to depression and anxiety. Building community-based mental health support for pregnant women requires input from stakeholders and consideration of their perspectives before designing interventions. The purpose of the study was to assess community awareness of mental health concerns during pregnancy to determine future strategies to address the problem. Community-based participatory research, qualitative focus groups. Focus-group sessions at community sites (e.g., library, community center). A total of 22 women (8 pregnant women; 14 women who were new mothers < 2 years) and 6 maternity nurse–lay caregivers. Four focus-group sessions were conducted with three different groups of stakeholders: (a) pregnant women, (b) new mothers, and (c) professional and lay caregivers recruited though community partners and health care agencies that care for pregnant women in the community. Structured, open-ended questions were used to determine perspectives on sources of stress and ways to reduce stress during pregnancy or early motherhood. The focus-group sessions were electronically recorded and later transcribed to text. Thematic analysis techniques were used to determine common codes and themes concerning mental health needs of pregnant women from the viewpoint of the respective group of stakeholders. Themes included the following: (a) Frustration and Stress; (b) Finding Positive Support; (c) A “Drop Off” in Care After Birth; and (d) Needing Knowledge About Available Resources. The data inform community-based mental health strategies that nurses can use to address the identified barriers for women seeking help for stress during and after birth and plan stress-reduction strategies to promote resilience and prevent mental health problems.

Complementary Therapies as a Strategy to Reduce Stress and Stimulate Immunity of Women With Breast Cancer.

The stress associated with cancer development leads to disturbances in the hypothalamic-pituitary-adrenal axis and suppresses important facets of the immune response. The use of complementary therapies in the treatment of women with breast cancer has demonstrated therapeutic benefits that entail improvements in the patients’ quality of life. The objective of this article is to present evidence on the use of complementary therapies as a stress reduction strategy and on its stimulating effects on the immune system of women with breast cancer. This is a reflexive updating article that will support the health professionals’ understanding on the use of complementary therapies in breast cancer care. The use of complementary therapies in the treatment of women with breast cancer has significantly improved these subjects’ stress, depression, fatigue, anxiety, and, consequently, their quality of life, as well as their immune response, which is mainly illustrated by the increased number and cytotoxic activity of natural killer cells. Clinicians, health professionals, and patients need to be cautious about using complementary therapies and fully understand the real benefits and risks associated with each therapy. Little or no supporting evidence is available to clarify the effects on the immune system of women with breast cancer, and the consequent therapeutic benefits obtained through the use of these practices.

Perceived stress and coping strategies among ICU nurses in government tertiary hospitals in Saudi Arabia: a cross-sectional study.

BACKGROUNDNo study has examined the stress level and coping strategies among critical care nurses in Saudi Arabia.OBJECTIVESExamine perceived stress and coping behaviors among nurses in intensive care units in Saudi Arabia, and the influence of coping mechanisms on stress.DESIGNDescriptive cross-sectional.SETTINGTwo tertiary training hospitals in Riyadh, Saudi Arabia.SUBJECTS AND METHODSNurses from cardiac, surgery and pediatric intensive care units responded to an online survey. Perceived Stress Scale-10 (PSS-10) and the Brief COPE Inventory were used as primary research tools. Multivariate methods were used to analyze the data.MAIN OUTCOME MEASURESStress levels, coping strategies, and associated factors.SAMPLE SIZE154 nurses.RESULTSThe majority of the respondents reported a moderate level of stress in the past month (87.0%). Mean (SD) scores for nurses working in the cardiac ICU indicated significantly higher levels of stress compared to surgical ICU (18.18 [3.88] vs 6.17 [3.21], P=.025). Belief in religion was the most common coping behavior while the use of substances was the lowest (mean scores [SD] 6.70 [ 1.72] vs 2.22 [0.81]). In the multivariate analysis, behavioral disengagement (P=.016) and self-blame (P<.001) intensified the PSS-10 score, whereas acceptance (P=.048) reduced the PSS-10 score.CONCLUSIONThe additional knowledge that behavioral disengagement and blaming aggravate stress can serve as the basis in formulating work-related stress reduction strategies among nurses caring for critical patients.LIMITATIONSThe use of self-reports, convenience sampling, and selected demographic factors may have limited the scope and generalizability of the findings and induced social desirability bias.

A Randomized Controlled Trial in the Evaluation of a Novel Stress Management Tool: A Lounge Chair Experience.

ObjectivesThe aim of this study was to compare the stress reduction effects of spending 25 minutes reclining in a SolTec™ Lounge between 2 intervention groups. Group 1 experienced the Lounge with multilayered music on an external speaker, while group 2 experienced the Lounge with multilayered music and synchronous vibration and magnetic stimulation from within the chair.SubjectsIn total, 110 participants with a self-reported stress level of 4 or higher on a 0- to 10-point scale were recruited from the local community including employees. Participants were randomized into receiving 1 of the 2 interventions. There were no significant differences between the group’s average stress levels prior to the interventions.InterventionsBoth groups received a 25-minute session in a dimly lit, quiet area on the Lounge with multilayered music. The second group also received vibration and magnetic stimulation that were synchronized with the music.DesignCurrent stress level as well as ratings or feelings of anxiety, tenseness, energy, focus, happiness, relaxation, nervousness, creativeness, and being rested were recorded before and after the session.ResultsBoth groups of participants reported equivalent decreased feelings of stress after using the Lounge. Participants receiving the synchronous multilayered music, vibration, and magnetic stimulation did report significantly reduced feelings of tenseness, feeling more relaxed, and feeling more creative when compared with the group that received music only.ConclusionSpending 25 minutes in the SolTec™ Lounge with multilayered music is an effective way to reduce self-reported stress in individuals who self-report having a high stress level. If confirmed by future studies, including synchronous vibration and magnetic stimulation with the multilayered music might be an effective stress reduction strategy.

Transitional Mentor Education Program Pilot

Nursing professional development practitioners and nursing leadership identified a need for a transitional mentoring program to assist staff nurses' transition beyond orientation. Mentoring was identified as an effective strategy to promote professional development. The benefits of this year-long transitional mentoring program include an increase in clinical confidence, integration of stress reduction strategies, and reflective practice into daily practice. The transitional mentoring program is a beneficial strategy for enhancing professional development of both mentors and mentees.

Mindfulness in Western Contexts Perpetuates Oppressive Realities for Minority Cultures

This paper examines mindfulness-based practices in North American classrooms as culturally appropriated through the dominantly western modality of individualism and scientific-rationalism. Through investigating MindUP™ and other mindfulness teaching resources, I demonstrate the construed qualities of mindfulness practices in western contexts. I argue that mindfulness is molded to fit colonial ontologies of values and knowledge and perpetuates oppressive realities for minority cultures. I propose that mindfulness should be reoriented into its Buddhist contexts through required lessons and trainings in Buddhist cultures, ontologies, and knowledges, and creators and supporters of mindfulness-based educational programs should refer to the practices they are promoting as attention-focusing and stress-reduction strategies and not as misconstrued, individualistic qualities of mindfulness. This paper intends to extend awareness to the broader sociopolitical consequences of culturally appropriating mindfulness practices.

Occupational Stress among Secondary School Heads: A Gender Based Comparative Study

&lt;p&gt;&lt;em&gt;The purpose of the study was to examine and compare the occupational stress of male and female secondary-school-heads in Khyber Pakhtunkhwa. All the male and female secondary school heads working in pubic secondary schools of Khyber Pakhtunkhwa constituted the population of the study. A total of 402 secondary school heads were selected as sample through multistage sampling technique in which 260 were males and 142 were females. Descriptive and quantitative survey research design was used. To seek the responses from the participants, a standardized tool i.e., “Occupational Stress Index (OSI)” was used. For statistical analysis, proper descriptive statistics i.e., mean, standard deviation and inferential statistics i.e., independent samples t-test were employed through SPSS. The findings revealed that both male and female secondary school heads were found occupationally stressful with respect to role overload, role conflict, strenuous working condition, unreasonable group &amp;amp; political pressure, under participation, and unprofitability. Comparatively, there was no significant difference between the overall occupational stress of male and female secondary school heads. Based on findings, it was recommended that Elementary &amp;amp; Secondary Education Department should have a collaboration with policymakers to develop comprehensive strategies for stress reduction for secondary school heads so that they may perform their duties effectively.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords:&lt;/strong&gt; comparative study, gender based study, occupational stress, secondary school heads&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/p&gt;

Depression and Functional Status in Colorectal Cancer Patients Awaiting Surgery; Impact of a Multimodal Prehabilitation Program

Depression and functional impairment frequently co-occur. Though both predict complications and mortality following surgery, there is a paucity of research examining functional status (FS) in depressed cancer patients awaiting surgery. Prehabilitation, a preoperative intervention including exercise, nutrition, and stress-reducing strategies, may help to improve FS; however, the extent to which depressed individuals can benefit from this intervention has not yet been explored. The primary objectives were to assess whether preoperative depression is associated with poor FS and whether prehabilitation can improve FS in depressed individuals. A secondary analysis was conducted on 172 colorectal cancer (CRC) patients enrolled in three studies comparing prehabilitation with a control group (rehabilitation). FS was assessed at baseline with the Six-Minute Walk Test, measuring distance walked during 6-minutes (6MWD), and the Hospital Anxiety and Depression Scale (HADS) was used to assess psychological symptoms. Measures were collected twice preoperatively, at 4-weeks and 48 hours before surgery, and at 4- and 8-weeks postoperatively. Subjects were divided into 3 groups: depression (HADS-D), anxiety (HADS-A), or no psychological symptoms (HADS-N). Main hypotheses were tested using analysis of variance, Chi-Square tests, and multivariate logistic regression. At baseline, depressed individuals had lower 6MWD (p=0.003), and a higher proportion walked <400m (45%; p<0.001). Prehabilitation was associated with significant improvements in 6MWD in HADS-D group (OR=2.36, 95% CI:1.53-3.66), but not in HADS-N (OR=0.97 95% CI:0.44-2.16) or --A groups (OR=1.47 95% CI:0.69-3.16). CRC patients with depressive symptoms had poorer FS, and these individuals benefited most from prehabilitation intervention.

The Effects of a Health Partner Program on Alleviating Depressive Symptoms Among Healthy Overweight/Obese Individuals.

Background and Purpose: Although lifestyle interventions have been shown to be effective in losing weight and increasing physical activity in community settings, little is known whether these programs may also ameliorate negative mood states in healthy overweight/obese adults when such programs are delivered in workplace settings. The aim of the study was to determine whether a health partner program may alleviate depressive symptoms among healthy overweight/obese individuals at 1 year. Methods: A secondary data analysis was performed using the Center for Health Discovery and Well Being database at Emory University in the United States. A total of 297 healthy overweight/obese university employees were recruited from the health partner program. Participants worked with health partners to establish an individualized health action plan, which might include changes in diet or exercise, modification of risk-related behaviors (e.g., tobacco use, alcohol use), and stress reduction strategies such as yoga. Depressive symptoms were measured by the Beck Depression Inventory-II at baseline and one-year follow-up. Results: At baseline, 9.7% of participants had depressive symptoms. At one-year follow-up, these participants had a small-to-moderate improvement in depressive symptoms (Cohen's d = 0.423), and the changes in depressive symptoms were statistically significant (p < 0.001). Implications for Practice: Since overweight/obese individuals are more likely to experience depressive symptoms than normal-weight individuals, early interventions to steer these individuals to better mental health are therefore essential. This study has demonstrated the potential benefits of a health partner program on alleviating depressive symptoms among overweight/obese individuals and this should be integrated into clinical practice.

Key Facts About Tinnitus

Tinnitus is the perception of sound when there is no external sound present, often described as a ringing, buzzing, humming, clicking, or cicada-like sound. Less commonly, tinnitus can be heard as a musical tune or a pulsing sound in time with a person's heartbeat. It may be one or multiple sounds, and it may be constant or intermittent. It can be heard as coming from one or both ears or from within the head. Research shows that most people hear tinnitus when they are asked to listen in a very quiet environment (i.e., when sitting in a sound-proof booth). Tinnitus is common and reported in all age groups. CAUSE AND HABITUATION The exact cause of tinnitus is hard to pinpoint, but it is generally understood that it results from some type of change, either mental or physical, but not necessarily related to the ear. Tinnitus can be associated with noise exposure, hearing loss, middle ear pathology or dysfunction, impacted wax, head or neck injuries, some medications, or a period of high stress. In many instances, the cause or the trigger is unknown. Tinnitus may dissipate over time or a person may habituate to it such that even though it may be audible, it is of little consequence. In some people, the tinnitus can be intrusively bothersome and significantly affect their general well-being. Seek assistance if the tinnitus: is associated with hearing difficulties. presents or changes suddenly. becomes intrusive and bothersome. interferes with sleep and/or your ability to concentrate. impacts general well-being. is in one ear only. Individuals with tinnitus are often told that “there is nothing that can be done” or that “you will have to learn to live with it,” but this is not the case. While there is no cure, treatment options are available, and patients can successfully manage the tinnitus to the point where it is no longer a concern. Consult a general practitioner to address any underlying medical factor that may be contributing to the tinnitus. Some people require a more involved intervention, and those with distressing tinnitus often benefit from a multidisciplinary approach. In addition to a general practitioner, an ENT specialist, and an audiologist/a tinnitus specialist, others who may be involved in the rehabilitation process include physiotherapists, counsellors, sleep specialists, and/or temporomandibular joint dental specialists. Factors influencing your ability to get used to the tinnitus include current stress levels and coping abilities, emotional and physical support systems, and insight into the mechanisms of the tinnitus. Plus, understanding how all of the above interact. FINDING SUPPORT Your experience of tinnitus and its impact on your life are unique, so it's important to seek the assistance of a tinnitus specialist who can offer a holistic, evidence-based tinnitus program designed specifically for your personal situation. A tinnitus management program should provide you with a deeper understanding of tinnitus and strategies you can use to manage and reduce the symptoms. These strategies may include a combination of: sound enrichment hearing devices neuromonics treatment behavioral techniques such as cognitive behavioral therapy and acceptance commitment therapy stress reduction and relaxation strategies sleep solutions TINNITUS AND HEARING If the tinnitus is accompanied by any hearing loss, the use of hearing aids can be helpful on a number of levels. Well-fitted hearing aids assist with communication, help reduce the stress and fatigue associated with intensive listening, and amplify low-level background sound. This can result in a reduction in tinnitus awareness. There are also devices that combine a hearing aid and a noise generator in a single unit, and these can provide the benefits of both. The timing and sequence of different types of intervention can play an important role in how individuals respond to treatment. A person with chronic tinnitus may be grieving for the perceived loss of silence and how this is affecting his or her life. This person may not be ready for certain types of intervention (e.g., hearing aids, maskers), and may even reject any early intervention. Before the rehabilitation process begins, it is helpful for the individual to be in a place of acceptance and to start coping emotionally. For additional resources, check out the following: American Tinnitus Association (www.ata.org), British Tinnitus Association (www.tinnitus.org.uk), https://www.nidcd.nih.gov/health/tinnitus, and https://hearinghealthfoundation.org/what-is-tinnitus.

Discovering the Health Promoting Potential of Fermented Papaya Preparation—Its Future Perspectives for the Dietary Management of Oxidative Stress During Diabetes

The simplistic morphological characteristics of Carica papaya fruit or “pawpaw” should not be the cause for underestimating its potential as a nutraceutical. The market for papaya has been expanding at a staggering rate, partly due to its applicability as a biofortified product, but also due to its phytochemical properties and traditional health benefits. Papaya or formulations of fermented papaya promotion (FPP) display effective free radical scavenging abilities thought to be influenced by its phenolic, carotenoid, flavonoid, or amino acid profile. The antioxidant properties of FPP have been extensively reported in literature to potently target a broad spectrum of free radical-induced diseases ranging from neurological impairments, such as senile dementia, to systemic diseases, to its interference at the cellular level and the support of normal biological ageing processes. FPP has thus been extensively investigated for its ability to exert cellular protective effects and reduce oxidative stress via the mitigation of genetic damage, reduction of lipid peroxidation, and enzymatic inactivation in specific diseases. The focus of this review is to appraise the potential of oxidative stress reduction strategies of FPP and discuss its holistic approach in disease prevention and management, with a particular focus on diabetes and cancer. However, with the current lack of information surrounding its mechanism of action, this review wishes to set the stage and aspire researchers to more profoundly investigate molecular pathways related to how FPP can unequivocally contribute to wellness in an aging population.

A psychosocial approach to supporting injured dancers

ABSTRACTProfessional dancers experience injury as a crisis and threat to identity that often leads to numerous psychosocial concerns. This article describes a group model designed to help injured dancers recover. As a program of The Actors Fund, this 10-week Support Group for Injured Dancers reduces unwanted isolation caused by injury and provides dancers with strategies for stress reduction and healing. The purpose of this article is to aid practitioners in mitigating emotional distress among injured dancers by providing the history and rationale behind the group, an overview of the group’s structure and methods, and suggestions for further research and growth.

INVESTIGATING ADVANCED LEARNERS’ USE OF AFFECTIVE STRATEGIES FOR DEALING WITH TEST ANXI-ETY

Language anxiety has been researched for many decades now and its significance for attainment cannot be questioned. In numerous research accounts anxiety related to learning a foreign/second language comes in different guises, as speaking anxiety, or communication apprehension, fear of negative evaluation, and finally, test anxiety. In fact, developing linguistic competence in the formal setting is inherently fraught with the need to have one’s skill and knowledge verified in the form of informal and formal, low- or high-stakes tests and examinations. Alleviating the negative consequences of anxiety seems imperative for effective learning, which in the opinion of the present author, will not be possible without gaining a deeper insight into the ways in which learners deal with negative feelings evoked by language study or use. Hence, an attempt has been made to explore the range of strategies employed by a specific group of learners – English majors in their final year of study – to cope with a stressful situation such as a regularly-scheduled achievement test in one of the components of the practical English course. What distinguishes this group of learners is their level of proficiency, which is C1 or nearing C2, but most importantly of all, their long-term experience of dealing with stress that has extended throughout formal education including the duration of MA studies in English Philology. Data collected by means of immediate reports and questionnaires revealed that the participants employed quite a limited scope of stress-reducing strategies and that there were characteristic trends, the analysis of which could serve as a point of departure for offering effective strategy instruction capable of relieving the consequences of negative affective states.

Emotional eating and weight regulation: a qualitative study of compensatory behaviors and concerns

BackgroundEmotional eating, or overeating in response to negative emotions, is a behavior endorsed by both normal weight and people with overweight/obesity. For some individuals, emotional eating contributes to weight gain and difficulties losing weight. However, there are also many who engage in emotional eating who maintain a normal weight. Little is known about the mechanisms by which these individuals are able to regulate their weight.MethodsThe present study seeks to gain insight into the behaviors of individuals of normal weight who engage in emotional eating through a series of one-on-one, 1-h long, qualitative interviews. Interviews were semi-structured and guided by questions pertaining to participants’ compensatory behaviors used to regulate weight and concerns regarding their emotional eating. All interviews were transcribed and then objected to a thematic analysis of their content.ResultsThe results of this analysis showed that participants endorsed using physical activity, controlling their eating behaviors, and engaging in alternative stress reduction and coping strategies to mitigate the effects of their emotional eating. They reported concern over the effects of emotional eating on their weight, body image, and health and saw this behavior as an unhealthy coping mechanism that was difficult to control.ConclusionsThese results suggest that programs promoting exercise, mindful eating, emotion regulation, and positive body image could have a positive effect on emotional eaters who struggle to maintain a healthy weight.

Stress-related laboratory eating behavior in adults with obesity and healthy weight

Stress is an important factor in the progression of irregular eating patterns and has an additional exacerbating impact in people with overweight and obesity. Therefore, in this study, the chewing and food intake was observed after standardized acute stress induction, as well as resting, in people with obesity and healthy weight controls. Twenty-eight women and men with obesity (BMI: 32.76 ± 2.25 kg/m2) were matched with regard to sex and age to 28 people with healthy weight (BMI: 22.58 ± 2.04 kg/m2). After two conditions (Trier Social Stress Test vs. resting condition) the chewing frequency and food intake were measured during a standardized laboratory meal on two separate days. Additionally, for manipulation check of stress induction salivary cortisol and two appraisal questionnaires (Primary Appraisal Secondary Appraisal, Visual Analogue Scale) were used. People with obesity showed after stress and resting condition a lower chewing frequency in contrast to healthy weight controls (F(1, 54) = 12.816, p ≤ .001). Thereby, both groups demonstrated a higher chewing frequency after the stress induction than after the resting condition (F(1, 54) = 7.436, p ≤ .01). There was no difference between the healthy weight controls and the people with obesity in food intake. In conclusion, the present data indicate a possible ‘obese eating style’ with regard to chewing performance. Furthermore, the demonstrated higher chewing frequency after stress induction, in people with obesity and people with healthy weight, might be a stress reduction strategy.

Mobile Apps for Caregivers of Older Adults: Quantitative Content Analysis.

BackgroundInformal caregivers of older adults provide critical support for their loved ones but are subject to negative health outcomes because of burden and stress. Interventions to provide information and resources as well as social and emotional support reduce burden. Mobile apps featuring access to information, assistance with scheduling, and other features can automate support functions inexpensively and conveniently and reach a greater proportion of caregivers than otherwise possible.ObjectiveThe aim of this study was to identify mobile apps geared towards caregivers of older adults, catalog features, and suggest best practices for adoption based on empirical findings of beneficial interventions in the caregiving literature.MethodsSearch for apps focused on ones catered for caregivers of older adults in Google Play and iTunes, compiling their features, and identifying features reflecting categories of support identified in successful intervention studies to negative caregiver outcomes. Intervention research indicates that provision of information and resources, assistance in practical problem solving, coordinating care among multiple caregivers, and emotional support reduce caregiver burden.ResultsDespite approximately over 200,000 mobile health–related apps, the availability of mobile apps for caregivers is relatively sparse (n=44 apps) as of October 2017. Apps generally addressed specific categories of support, including information and resources, family communication, and caregiver-recipient interactions. Few apps were comprehensive. Only 8 out of 44 (18%) had features that addressed three or more categories. Few apps provided specific stress reduction exercises for caregivers, which is important for reducing burden.ConclusionsMobile apps have the potential to provide resources, just­-in­-time information for problem-solving, and stress reduction strategies for caregivers. Many apps offer functions that have been shown to reduce burden and improve health outcomes in caregivers, but few provide emotional support. Using an evidence­-based practice approach, mobile apps for caregivers can provide multiple beneficial support functions. Apps can serve a much larger proportion of this highly underserved population in their mobile form than more traditional means, improving their health and quality of life.

The effectiveness of aromatherapy and massage on stress management in nurses: A systematic review.

To assess the effectiveness of aromatherapy and massage on relieving stress in nurses. Nurses face uncommon levels of stress in medical settings. Stress has a negative impact on nurses' well-being and the organisation where they work. Aromatherapy and massage are important strategies for stress reduction. However, the effectiveness of aromatherapy and massage on relieving stress in nurses currently lacks understanding. Systematic review. We performed a quantitative systematic review using Cochrane methods. We searched existing literature in the following databases: PubMed, PsycINFO, Embase, Web of Science and Cochrane Library, to examine any experimental design studies published from the earliest date available to August 2017 in English. Risk of bias per outcome was assessed. A total of 10 articles met the inclusion criteria, including aromatherapy (n=4), massage (n=4) and aromatherapy massage (n=2). Most studies reported that aromatherapy and massage exert a beneficial effect on the stress of nurses. One study showed that the aromatherapy massage with music interventions has no effect on the stress of nurses. However, the number of the studies is limited and has high or unclear risk of bias. This review revealed that the evidence does not sufficiently prove that aromatherapy, massage and aromatherapy massage are effective for reducing job-related stress of nurses. We need to conduct high-quality studies to verify the effects of these interventions on nurses' stress levels in the future. Moreover, we need to integrate outcome measures of stress levels for developing more appropriate tools than the ones used as present. Nurses' stress has a negative impact on their own and organisation where they work. All available opportunities should be taken to reduce nurses' stress. It will be beneficial for nurse shortage.

Effect of Environmental Enrichment and Herbal Compounds-Supplemented Diet on Pig Carcass, Meat Quality Traits, and Consumers' Acceptability and Preference.

Simple SummaryInterest in animal welfare has increased and been considered a relevant attribute for the concept of the ethical quality of pig products. The present study suggests that consumers would appreciate particular improvements on animal welfare such as providing environmental enrichment or herbal compounds. The provision of those welfare improvement strategies did not have a significant effect on technological carcass and meat quality parameters. However, the strategies used in this study that can increase animal welfare in production systems were valued by consumers.Animal welfare can be considered an ethical attribute of product quality, but consumers should appreciate its added value. The aim of this study was to evaluate consumer’s acceptability, preference, and the meat and carcass quality of pigs reared with two stress-reducing strategies: supplementation of an herbal compound (HC) containing Valeriana officinalis and Passiflora incarnata, and environmental enrichment (EE) by the provision of hemp ropes, sawdust, and rubber balls. A total of 56 pigs were divided in four treatments in two pens of seven pigs per treatment (2 × 2 factorial design). Meat and carcass quality were evaluated. Consumer’s acceptability and preference were analysed with a sensory test and a conjoint analysis in 110 consumers. Before slaughter, control pigs (no EE and no HC) presented lower live weight compared with other treatments (p = 0.0009). Although acceptance was the same for all of the treatments, consumers preferred systems aiming to increase pig welfare. The most important factor was production system, with a preference for those improving welfare, followed by feeding system, with a preference for those with natural herbs supplementation. Although price was the least important factor, a segment of consumers showed a clear preference for lower prices. These results suggest that welfare improvements could be appreciated by particular consumer segments.

Relation of Occupational Stress and Job Satisfaction: A Study of Secondary School Heads in Khyber Pakhtunkhwa, Pakistan

This paper examines the relationship between occupational stress and job satisfaction among secondary-school-heads in the province of Khyber Pakhtunkhwa. A sample of only 402 secondary-school-heads (Male n = 260, Female n = 142) was selected with the help of multistage sampling technique. A descriptive and correlative design was employed. Two standardized tools were employed i.e., "Occupational Stress Index (OSI)" and Minnesota Satisfaction Questionnaire (MSQ) for seeking the responses. Pearson's correlation and linear regression were employed to analyze data statistically. The findings exposed a strong inverse relation between occupational stress and job satisfaction. Furthermore, a substantial negative correlation between all the subscales of occupational stress and overall job satisfaction is also present. Eight subscales of occupational stress, i.e., role ambiguity, responsibility for persons, under participation, unreasonable group and political pressure, low status, strenuous working conditions, peer group relations, and unprofitability were found significant predictors and have negative effect on job satisfaction. So, the researchers recommend focusing reduction in the level of occupational stress among secondary-school-heads. Elementary and Secondary Education Department should have collaboration with policy makers to formulate rewarding and effective strategies for stress reduction for secondary school heads to have high spirit for yielding good outcomes.

Burden of care is the primary reason why insured women terminate in vitro fertilization treatment

To study the reason(s) why insured patients discontinue invitro fertilization (IVF) before achieving a live birth. Cross-sectional study. Private academically affiliated infertility center. A total of 893 insured women who had completed one IVF cycle but did not return for treatment for at least 1year and who had not achieved a live birth were identified; 312 eligible women completed the survey. None. Reasons for treatment termination. Two-thirds of the participants (65.2%) did not seek care elsewhere and discontinued treatment. When asked why they discontinued treatment, these women indicated that further treatment was too stressful (40.2%), they could not afford out-of-pocket costs (25.1%), they had lost insurance coverage (24.6%), or they had conceived spontaneously (24.1%). Among those citing stress as a reason for discontinuing treatment (n = 80), the top sources of stress included already having given IVF their best chance (65.0%), feeling too stressed to continue (47.5%), and infertility taking too much of a toll on their relationship (36.3%). When participants were asked what could have made their experience better, the most common suggestions were evening/weekend office hours (47.4%) and easy access to a mental health professional (39.4%). Of the 34.8% of women who sought care elsewhere, the most common reason given was wanting a second opinion (55.7%). Psychologic burden was the most common reason why insured patients reported discontinuing IVF treatment. Stress reduction strategies are desired by patients and could affect the decision to terminate treatment.