Symptomatic Group Research Articles

"Not feeling like myself" in perimenopause - what does it mean? Observations from the Women Living Better survey.

This study aimed to understand the meaning of the phrase "not feeling like myself" (NFLM) when used by those on the path to menopause by exploring the relationship of symptoms reported to ratings of NFLM. Participants responded to the item "Many women report just not feeling like themselves during this phase of life. How often was this true for you over the past 3 months?" choosing from "none of the time" to "all of the time." They rated bother associated with 61 symptoms and provided demographic information. Individual symptoms and the symptom bother scale scores were correlated with NFLM. Symptom scale scores were then entered in a two-stage multiple regression model to identify symptoms associated significantly with NFLM. Sixty-three percent (63.3%) of participants reported NFLM 50% of the time or more over the previous 3 months. Individual symptom ratings correlated with NFLM ( r > 0.300) included the following: fatigue ( r = 0.491); feeling overwhelmed/less able to cope ( r = 0.463); low feelings ( r = 0.440); anxiety, more nervousness ( r = 0.398); being irritable ( r = 0.380); harder time concentrating ( r = 0.378); difficulty making decisions ( r = 0.357); feeling like "I can't calm down on the inside" ( r = 0.333); being more forgetful ( r = 0.332); tearfulness/crying ( r = 0.306); and worrying more ( r = 0.302). A two-stage regression analysis revealed less education completed and greater overall stress ratings as significant predictors in stage 1. In stage 2, five symptom groups met the P < 0.001 criterion: anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. NFLM was associated with anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. Recognizing symptoms associated with NFLM may allow for more accurate expectations and improve perimenopause care.

Neoplasia detection in FIT positive screening colonoscopies compared with an age-controlled symptomatic cohort: a retrospective review

Colonoscopy following a positive FIT test in an average risk population is effective in reducing CRC incidence and mortality. While lower gastrointestinal symptoms remain a common cause for referral for colonoscopy, symptoms are poor predictors of clinically significant disease. The study was performed to compare neoplasia detection FIT +ve individuals and age-matched symptomatic cohorts. A single centre retrospective observational study was performed including all index colonoscopies performed on patients aged 60-70 from January 2015 to September 2021. Diagnostic yield was reported as adenoma detection rate, SSL detection rate, detection of high risk finding or adenocarcinoma. 8,106 colonoscopies were performed on patients aged 60-70 years. 3,695 (45.6%) originated from screening (FIT +ve). With exclusion criteria applied, 2,640 (59.9%) for screening and 1,767 (40.1%) for symptomatic patients were included. Median age in screening was 65 years (IQR 62-67) and 64 years in the symptomatic group (IQR 62-68), with male predominance in both groups (n=1,536, 58.1%, n=944, 53.4%). There were significant differences in both the ADR (56% vs 26.3%, p&amp;lt;0.01) and the SSLDR (10.4% vs. 8.1%, p=0.05) in the screening cohort compared to the symptomatic group. High risk findings (21.3% vs. 7.5%, p&amp;lt;0.01) were significantly more prevalent in the screening group with a considerably higher colorectal cancer (4.7% vs. 0.9%, p=&amp;lt;0.001) detection rate. FIT based triage significantly outperforms symptom based investigation for individuals in the 60-70 age group. Patients should be preferentially referred to organised colorectal cancer screening. FIT can be performed on symptomatic patients, to identify low risk individuals.

Coping Mechanisms and Posttraumatic Stress Exhibited by Children in Areas of Yemen's Armed Conflict in Southern Saudi Arabia.

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children's Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals.

DEFB126 2-nt Deletion (rs11467417) as a Potential Risk Factor for Chlamydia Trachomatis Infection and Subsequent Infertility in Iranian Men.

Chlamydia trachomatis (CT) is one of the most prevalent sexually transmitted infections, causing genital tract infections and infertility. Defensins have an immunomodulatory function and play an important role in sperm maturation, motility, and fertilization. DEFB126 is present on ejaculated spermatozoa and is essential for them to pass through the female reproductive tract. The purpose of the study was to determine the frequency of the 2-nt deletion of the DEFB126 (rs11467417) in Iranian infertile males with a recurrent history of CT. Semen samples of 1080 subfertile males were investigated. Among patients who had CT-positive results, sperm DNA from 50 symptomatic and 50 asymptomatic patients were collected for the DEFB126 genotype analysis. Additionally, a control group comprising 100 DNA samples from individuals with normal spermogram and testing negative for CT was included in the study. The PCR-sequencing for detecting the 2-nt deletion of the second exon of the DEFB126 was performed. The Chi-squared test comparing all three groups revealed no significant difference across the different genotypes. Moreover, no significant difference between the symptomatic and asymptomatic groups was seen. However, analysis within CT-positive patients and controls demonstrated significant difference between the frequencies of homozygous del/del. The higher frequency of the 2-nt deletion of the DEFB126 in CT- positive patients suggests that the occurrence of mutations in the DEFB-126 may cause the impairment of the antimicrobial activity of the DEFB126 protein and consequently makes individuals more susceptible to infections such as CT.

Measures of Awareness in Alzheimer's Disease and Clinical Differences Between Groups with Preserved, Impaired, and Absent Awareness.

Awareness is a heterogeneous construct that requires accurate assessment. There is no consensus on the best methodology for capturing the phenomenon, thus leading to inconsistent results in this area. We aim to evaluate the reliability of clinicians' ratings and a discrepancy assessment method, examining groups of people with Alzheimer's disease (PwAD) according to their degree of awareness and demographic and clinical aspects. We cross-sectionally assessed 134 PwAD and their caregivers. Individuals' level of awareness was assessed with two methods: clinicians' ratings identified three groups (preserved awareness, impaired awareness, and absent awareness), while discrepancy assessment identified four groups (preserved awareness, mildly impaired awareness, moderately impaired awareness, and absent awareness). Clinicians' ratings showed significant differences between PwAD with preserved, impaired, and absent awareness groups in cognition, functionality, and neuropsychiatric symptoms. There was a significant difference in caregivers' anxiety between the impaired and absent awareness groups. Discrepancy assessment showed no clinical differences between the preserved and mildly impaired awareness groups or between the absent and moderately impaired awareness groups. A significant difference in functionality was observed between the other groups. Clinical aspects of each measure tended to differ between the chosen methods. Impairments in awareness fluctuate despite disease progression. Cognition and severity of disease cannot explain deficits in awareness.

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease.

Body composition changes are important extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate the characteristics of body composition in patients with COPD, and its correlation with disease severity. A total of 105 COPD patients admitted to Zhongshan Hospital affiliated to Dalian University, from May 1, 2021 to January 31, 2023, were included as the COPD group, and 105 subjects without COPD were enrolled as the control group during the same period. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) comprehensive assessment indicators, COPD patients were divided into groups: the degree of pulmonary function airflow limitation was grouped according to FEV1%pred; clinical symptoms were grouped according to mMRC scores and CAT scores; the risk of acute exacerbation was divided into low risk and high risk groups. Body composition was measured by bioelectrical impedance analysis (BIA). (1) Concerning body composition, the body mass index (BMI), fat-free mass index (FFMI), and angle of phase (PhA) of COPD patients were lower than those of the control group. Extracellular water-to-total body water ratio (ECW/TBW) and extra-to-intracellular water ratio (ECW/ICW) were higher than those of the control group, and the difference was statistically significant (p < 0.05). (2) There were differences in body composition among COPD patients with different severity of disease: FFMI and PhA in the mild/moderate airflow limitation group were higher than those in the severe/very severe airflow limitation group. According to mMRC scores classification, the FFMI and PhA of the less symptomatic group were higher than those of the more symptomatic group, and ECW/TBW and ECW/ICW were lower than those of the more symptomatic group. According to CAT scores classification, FFMI and PhA in the mild/moderate disease group were higher than those in the severe/very severe disease group. The FFMI of the low-risk group was higher than that of the high-risk group, and ECW/TBW was lower than that of the high risk group. (3) Correlation analysis between body composition and disease severity indicators showed that FFMI and PhA were negatively correlated with mMRC scores and CAT scores, and positively correlated with FEV1%pred. ECW/TBW ratio and ECW/ICW ratio were positively correlated with mMRC scores and CAT scores, and negatively correlated with FEV1%pred, and the difference was statistically significant (p < 0.05). There are significant differences in body composition between COPD patients and the control group, and there are significant differences in body composition between COPD patients with different severity of disease, with correlations between body composition and severity of disease.

Post-COVID-19 condition: systemic inflammation and low functional exercise capacity.

Post-COVID-19 condition (PCC) is characterised by a plethora of symptoms, with fatigue appearing as the most frequently reported. The alterations that drive both the persistent and post-acute disease newly acquired symptoms are not yet fully described. Given the lack of robust knowledge regarding the mechanisms of PCC we have examined the impact of inflammation in PCC, by evaluating serum cytokine profile and its potential involvement in inducing the different symptoms reported. In this cross-sectional study, we recruited 227 participants who were hospitalised with acute COVID-19 in 2020 and came back for a follow-up assessment 6-12 months after hospital discharge. The participants were enrolled in two symptomatic groups: Self-Reported Symptoms group (SR, n = 96), who did not present major organ lesions, yet reported several debilitating symptoms such as fatigue, muscle weakness, and persistent loss of sense of smell and taste; and the Self-Reported Symptoms and decreased Pulmonary Function group (SRPF, n = 54), composed by individuals with the same symptoms described by SR, plus diagnosed pulmonary lesions. A Control group (n = 77), with participants with minor complaints following acute COVID-19, was also included in the study. Serum cytokine levels, symptom questionnaires, physical performance tests and general clinical data were obtained in the follow-up assessment. SRPF presented lower IL-4 concentration compared with Control (q = 0.0018) and with SR (q = 0.030), and lower IFN-α2 serum content compared with Control (q = 0.007). In addition, SRPF presented higher MIP-1β serum concentration compared with SR (q = 0.029). SR presented lower CCL11 (q = 0.012 and q = 0.001, respectively) and MCP-1 levels (q = 0.052 for both) compared with Control and SRPF. SRPF presented lower G-CSF compared to Control (q = 0.014). Female participants in SR showed lower handgrip strength in relation to SRPF (q = 0.0082). Male participants in SR and SRPF needed more time to complete the timed up-and-go test, as compared with men in the Control group (q = 0.0302 and q = 0.0078, respectively). Our results indicate that different PCC symptom profiles are accompanied by distinct inflammatory markers in the circulation. Of particular concern are the lower muscle function findings, with likely long-lasting consequences for health and quality of life, found for both PCC phenotypes.

Sequelae and post-thrombotic syndrome after venous thromboembolism in acute lymphoblastic leukemia survivors treated on the NOPHO ALL2008 protocol.

The treatment of acute lymphoblastic leukemia (ALL) is frequently complicated by toxicity, including venous thromboembolism (VTE) affecting roughly 8% of patients. VTE can lead to post-thrombotic syndrome (PTS), a group of signs and symptoms developed as a complication to deep venous thrombosis (DVT), imposing risk of permanent disability and reduced quality of life (QoL). PTS prevalence ranges from 0% to 70%, reflecting very heterogenous cohorts and assessment tools. We aimed to estimate sequelae, including PTS and QoL in children and adults (<45years old) who had a DVT during ALL treatment. PTS and QoL scores were obtained through use of Villalta and Modified Villalta Scale, PedsQL, and Short Form-36 questionnaires. The cohort comprised 20 children (<18years) and seven adults (median age: 12.9years, range: 2-44years) at the time of DVT diagnosis. In total, 25 ALL survivors underwent PTS examination. The examination took place when survivors were 7-48years (median age: 20.3years, median follow-up time 6.8years). QoL was assessed correlating cases with three matching ALL survivors without VTE. Two adults (15.4%) showed mild or moderate PTS. Eight children (66.7%) were diagnosed with mild PTS, while three cases had collaterals as sole symptoms. Pain or symptoms affecting daily life were reported by 16%. No difference in QoL was found (p=.9). This study underscores the need for comprehensive population-based investigations with validation of PTS instruments in ALL survivors.

Psychological implications of man-made trauma and efficacy of “Teaching Recovery Techniques” on children and adolescents exposed to trauma

Trauma is a mental state of distress and pain resulting from memories of an unexpected, terrifying experience that threatens the survivor's sense of security, especially in children. The present research aimed to examine the Psychological Implications of man-made trauma and the efficacy of Teaching Recovery Techniques (TRT) to children and adolescents exposed to trauma.The Study comprises two parts. First, it aimed to find out the relationship between Child trauma (ChT) and Post-Traumatic Stress and Depressive Symptoms (PSTD) in children and adolescents who were exposed to fire incidents and terrorist attacks. Non-probability Purposive sampling was used in which 80 participants (45 boys and 35 girls) aged 8—17 years were selected from Joseph Colony and Yohanabad Christian Community of Lahore, and the second aimed to assess the TRT on the children and adolescents exposed to terrorist attacks. The results revealed a significant positive relationship between ChT and PTSD in children and adolescents exposed to fire incidents and terrorist attacks. Significant differences were found between the two groups in PTSD symptoms experienced by the participants. Furthermore, participants exposed to terror attacks experienced more PTSD symptoms than fire attacks. Age and proximity to the traumatic incident were significant predictors of PTSD symptoms. The intervention was given in five sessions at the Sunday school of Christ Church Yohanabad Lahore, and the results were promising. It concludes that significant improvement in post-intervention reduces PTSD symptoms in children and adolescents. The study findings can be applied to other such man-made and natural traumas in the future.

Perinatal depression trajectories and child development at one year: a study in China

BackgroundThe objective of the current study was to investigate the correlation between trajectories of maternal perinatal depression (PND) spanning from early pregnancy to one year postpartum and developmental delays observed in one-year-old children.MethodsThe dataset under examination encompassed 880 women who took part in a mother-child birth study conducted in China. Latent class growth analysis (LCGA) was employed to identify patterns in Edinburgh Postnatal Depression Scale (EPDS) scores of women, spanning from early pregnancy to one year postpartum. To assess the neurodevelopment of one-year-old children, a Chinese version of the Bayley Scale of Infant Development (BSID-CR) was employed. Logistic regression was employed to explore the association between PND trajectories and developmental delays in children, with appropriate covariate adjustments.ResultsThe trajectories of maternal PND identified in this study included a minimal-stable symptom group (n = 155), low-stable symptom group (n = 411), mild-stable symptom group (n = 251), and moderate-stable symptom group (n = 63). Logistic regression analysis revealed that mothers falling into the moderate-stable symptom group exhibited a notably heightened risk of having a child with psychomotor developmental delays at the age of one year.ConclusionsThe findings drawn from a representative sample in China provide compelling empirical evidence that bolsters the association between maternal PND and the probability of psychomotor developmental delays in children. It is imperative to develop tailored intervention strategies and meticulously design mother-infant interactive intervention programs for women with PND.

Comparison of erector spinae and gluteus medius muscle thickness and activation in individuals with and without low back pain

BackgroundDysfunctional patterns of the erector spinae (ES) and gluteus medius (GM) muscles often accompany episodes of low back pain (LBP). Rehabilitative ultrasound imaging (RUSI) has been used to measure ES and GM muscle thickness, however such measurements have not been compared in individuals with and without LBP. ObjectivesTo compare ES and GM muscle thickness and change in thickness utilizing RUSI in individuals with and without LBP. DesignCross-sectional comparison. MethodsA volunteer sample of 60 adults with (n = 30) and without (n = 30) LBP was examined. Thickness measurements of the ES and GM at rest and during contraction were obtained by using RUSI during a single session. Statistical comparison was performed using ANCOVA. The demographic variable age was used as a covariate in the primary comparative analysis. ResultsMean difference for age between groups was 5.4 years (95% CI: 1.85, 8.94, p = 0.004). Average ODI score was 32.33±6.58 and pain level of 5.39±0.73 over the last 24 h in the symptomatic group. There was a statistically significant difference in the percent thickness change in both the ES, mean difference = −3.46 (95% CI: −6.71, −0.21, p = 0.039) and GM, mean difference = −1.93 (95% CI: −3.85, −0.01, p = 0.049) muscles between groups. ConclusionsIndividuals with LBP may have reduced percent thickness change of the ES and GM muscles when compared to asymptomatic individuals.

Association Between Atrial Fibrillation Symptoms and Clinical Outcomes: A Prospective Multicenter Registry Study

The presence of symptoms plays an important role in determining whether to focus on rhythm control or rate control when treating atrial fibrillation (AF). Previous comparative studies on the clinical outcomes of symptomatic and asymptomatic AF have yielded inconsistent results, and a link between AF symptoms and left atrial (LA) remodeling is not established. Patients selected from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, which is a prospective, multicenter study consisting of patients with non-valvular AF, were grouped into 2 groups: symptomatic and asymptomatic. The primary outcome was a composite of the following cardiovascular outcomes: all-cause death, ischemic stroke, transient ischemic attack, systemic embolism, myocardial infarction, and heart failure hospitalization. Of 10,210 patients with AF, 4,327 (42%) had symptomatic AF. The asymptomatic group had an older mean age, more men, and more patients with hypertension and diabetes mellitus than the symptomatic group. The asymptomatic group had a larger left atrium (LA) diameter (43.6 vs 42.2 mm, p <0.001) than the symptomatic group. During a median follow-up of 32.9 (29.5 to 36.4) months, the asymptomatic and symptomatic groups showed similar incidences of the primary outcome (1.44 vs 1.45 per 100 person-years; log-rank, p = 0.8). In conclusion, the absence of AF symptoms is associated with increased LA. However, symptomatic and asymptomatic patients with AF have a similar risk of cardiovascular outcomes. This suggests that beneficial treatment for AF may be considered regardless of whether patients have symptomatic or asymptomatic AF.

Blended BA.5 infection within 8 days after a boosted bivalent mRNA vaccination strengthens and lengthens the host immunity.

The impact of SARS-CoV-2 infection shortly after vaccination on vaccine-induced immunity is unknown, which is also one of the concerns for some vaccinees during the pandemic. Here, based on a cohort of individuals who encountered BA.5 infection within 8 days after receiving the fourth dose of a bivalent mRNA vaccine, preceded by three doses of inactivated vaccines, we show that booster mRNA vaccination provided 48% protection efficacy against symptomatic infections. At Day 7 postvaccination, the level of neutralizing antibodies (Nabs) against WT and BA.5 strains in the uninfected group trended higher than those in the symptomatic infection group. Moreover, there were greater variations in Nabs levels and a significant decrease in virus-specific CD4+ T cell response observed in the symptomatic infection group. However, symptomatic BA.5 infection significantly increased Nab levels against XBB.1.9.1 and BA.5 (symptomatic > asymptomatic > uninfected group) at Day 10 and resulted in a more gradual decrease in Nabs against BA.5 compared to the uninfected group at Day 90. Our data suggest that BA.5 infection might hinder the early generation of Nabs and the recall of the CD4+ T cell response but strengthens the Nab and virus-specific T cell response in the later phase. Our data confirmed that infection can enhance host immunity regardless of the short interval between vaccination and infection and alleviate concerns about infections shortly after vaccination, which provides valuable guidance for developing future vaccine administration strategies.

Efficacy of laparoscopic pyeloplasty for pediatric hydronephrosis caused by symptomatic versus asymptomatic endogenous ureteropelvic junction obstruction: a retrospective analysis.

To retrospectively compare the differences in the surgical efficacy and prognosis of laparoscopic pyeloplasty for hydronephrosis caused by symptomatic versus asymptomatic ureteropelvic junction obstruction (UPJO) in children and determine whether clinical symptoms affect the surgical outcome and prognosis. Children who underwent laparoscopic pyeloplasty in our hospital from January 2018 to December 2022 were retrospectively analyzed. The children were divided into symptomatic and asymptomatic groups according to their main symptoms. The primary outcomes were the surgical success rate, change in renal parenchymal thickness, and change in renal pelvis anteroposterior diameter. The secondary outcomes were postoperative complications, reoperation rate, operative duration, intraoperative blood loss, and drainage tube indwelling time. In total, 224 children with UPJO were enrolled; 148 (66.1%) were symptomatic and 76 (33.9%) were asymptomatic. The symptomatic group showed a significantly greater mean change in renal parenchymal thickness, significantly higher surgical success rate, and significantly lower postoperative complication rate. In the present study, asymptomatic children had a lower surgical success rate, less postoperative imaging improvement, and more postoperative complications than symptomatic children. The presence or absence of clinical symptoms may affect the surgical outcome and prognosis.

Longitudinal association of spirituality with depressive symptom trajectories among older adults in mainland China.

The relationship between spirituality and depressive symptoms among the Chinese elderly is not well known. The current study explores this relationship using longitudinal data and trajectory modeling of depressive symptoms. A longitudinal study design was used to measure depressive symptoms repeatedly from 2012 to 2021 using the Geriatric Depression Scale (GDS). Group-based trajectory modeling analysis was conducted to determine the trajectories of depressive symptoms, and multiple logistic regression was used to explore the association between spirituality and depressive symptom trajectories. A total of 2333 participants completed at least two GDS measures, and these were included in the Group-based trajectory modeling analysis. An optimal model of three trajectories was derived: no depressive symptoms group (75.2%), new-onset depressive symptoms group (14.4%), and persistent depressive symptoms group (10.4%). Logistic regression modeling revealed that higher spirituality was associated with a lower risk of both new-onset depressive symptoms (OR=0.68, 95% CI=0.49-0.93) and persistent depressive symptoms (OR=0.32, 95% CI=0.23-0.45). Spirituality predicts a lower risk of new-onset depressive symptoms and persistent symptoms among older adults in mainland China.

Lower serum uric acid and impairment of right cerebral hemisphere structural brain networks are related to depressive symptoms in cerebral small vessel disease: A cross-sectional study

Cerebral small vessel disease (SVD) may be associated with an increased risk of depressive symptoms. Serum uric acid (SUA), an antioxidant, may be involved in the occurrence and development of depressive symptoms, but the mechanism remains unknown. Moreover, the relationship between structural brain networks and SUA has not been explored. This study examined the relationship between SUA and depressive symptoms in patients with SVD using graph theory analysis. We recruited 208 SVD inpatients and collected fasting blood samples upon admission. Depressive symptoms were assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24). Magnetic resonance imaging was used to evaluate SVD, and diffusion tensor images were used to analyze structural brain networks using graph theory. Patients with depressive symptoms (n = 34, 25.76%) compared to those without (334.53 vs 381.28 μmol/L, p = 0.017) had lower SUA levels. Graph theoretical analyses showed a positive association of SUA with betweenness centrality, nodal efficiency, and clustering coefficients and a negative correlation with the shortest path length in SVD with depressive symptoms group. HAMD scores were significantly associated with nodal network metrics in the right cerebral hemisphere. Our findings suggested that lower SUA levels are significantly associated with disrupted structural brain networks in the right cerebral hemisphere of patients with SVD who have depressive symptoms.

Psychological and social determinants of adaptation: the impact of finances, loneliness, information access and chronic stress on resilience activation.

Many people who face adversity, such as disasters, demonstrate resilience. However, less is known about reactions to large scale disasters with longer recovery periods. The concern is that protracted disasters may result in more chronic or accumulated stressors with an uncertain or unknown end point and can exhaust the natural coping methods and ability to rebound. Thus, understanding patterns of longer-term disaster recovery, inclusive of resilience, is needed. Further resilience is not individual specific rather social determinants, such as support networks and available resources, are contributing factors. The purpose of this study is to improve understanding of mental health and resilience during increased stress, we aim to identify profiles of adaptation and psychological and social determinants that predict membership within predominant symptom groupings. We conducted an exploratory cross-section study (N = 334) with two phases of multivariate analysis. Latent profile models were estimated to identify groups based on depression, anxiety, and resilience scores. The second phase included a step-wise multinomial logistic regression to predict class membership. We identified four distinct groups: 33% of participants were categorized as anxious, 18% depressed, 9% comorbid, and 40% with above average levels of resilience. Psychosocial factors such as demographics, trauma history, information access, loneliness, and lack of financial resources predicted poorer mental health outcomes and lower resilience. This study identified factors that contribute to overall wellbeing despite chronic stressors. Social determinants of adaptation, found in this study population, include loneliness, finances, and information access. The findings from this study support the need for both psychological and social adaption supports, inclusive of mental health treatment, to strengthen resilience activation.

Understanding Trauma Symptoms Experienced by Young Men under Youth Justice Supervision in an Australian Jurisdiction

Exposure to adversity or maltreatment is known to correlate with high-risk behaviors that can increase the risk of contact with the criminal justice system; however, few studies have focused on the role of trauma symptoms and other behaviors that may develop in response to exposure to adverse life events. We also know far less about the role of these experiences in young men compared to young women who have been in contact with the youth justice system. In this study, we examine the associations between different patterns of trauma symptomatology and adverse childhood experienced (ACEs), substance use, behavioral difficulties, and re-offending in a sample of 141 young men under the supervision of a Youth Justice (YJ) agency in Australia. Trauma symptoms were reported by over ninety percent of participants, with Latent Class Analysis used to identify four subgroups of young men based on their clustering of trauma symptomatology: internalizing, externalizing, high, and low trauma symptoms groups. The characteristics of young men across these groups were, however, remarkably similar. Over four-fifths scored in the clinical range for substance use and externalizing behavior problems, while recidivism was reported in over three-quarters of young men across all groups. These findings have implications for the development of trauma-informed responses by specialist adolescent mental health services as well as for adult forensic services that seek to understand the developmental origins of psychopathology and offending behavior. There appears to be a strong rationale for more compassionate and trauma-informed justice system practices.

Impact of autonomic symptoms on the clinical course of Parkinson's disease.

Patients with Parkinson's disease (PD) exhibit various degrees of autonomic symptoms, which may be associated with Lewy body pathology distributed extensively in the autonomic nervous system. We hypothesized that the severity of autonomic symptoms reflects the severity of PD-related pathology, resulting in poor outcomes. The purpose of this study was to evaluate the impact of autonomic symptoms on PD progression. We conducted a follow-up study among consecutive patients with PD at Dokkyo Medical University Hospital. Patients underwent comprehensive baseline evaluations and were classified into high and low autonomic symptom groups using the Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT). The Kaplan‒Meier survival curves were used to analyze the time to discontinuation of their visits because of PD-related endpoints and to evaluate the association with high SCOPA-AUT scores. Of the 101 patients, 74 (73%) met the inclusion criteria. During the follow-up period (mean 1654days), 22/74 patients reached PD-related endpoints (death, 4; hospitalization, 9; nursing home institutionalization, 9). PD patients with high SCOPA-AUT scores reached the endpoints faster than those with low SCOPA-AUT scores. A high SCOPA-AUT score, including gastrointestinal, urinary, and thermoregulation domains; high motor symptom scores; and low specific binding ratios (SBRs) on 123I FP-CIT-SPECT (DAT-SPECT) were associated with reaching PD-related endpoints. A high SCOPA-AUT score was associated with reaching the endpoints even after adjustment for covariates. Patients with high autonomic symptom scores had a greater risk of reaching PD-related endpoints than patients with low autonomic symptom scores.

The role of estrogen receptor gene polymorphisms in menopausal symptoms and estradiol levels in perimenopausal women – Findings from the Swiss Perimenopause Study

ObjectivesFluctuating estradiol (E2) levels seem to be associated with menopausal symptoms, though not all women suffer from these symptoms to the same extent despite experiencing these hormonal changes. This suggests underlying, interindividual mechanisms, such as single-nucleotide polymorphisms (SNPs) influencing estrogen receptors α and β, and the g-protein-coupled estrogen receptor (GPER). As research is scarce, we aimed to address this research gap by assessing genetic traits, E2 levels, and menopausal symptoms longitudinally. Study design129 perimenopausal women (aged 40–56 years) participated in the 13-month longitudinal Swiss Perimenopause Study. Main outcome measuresMenopausal symptoms were assessed fortnightly using the Menopause Rating Scale (MRS II). Salivary E2 levels were assessed 14 times over two non-consecutive months. Blood samples were collected using the dried blood spot (DBS) technique to analyze ESR1 rs2234693, ESR1 rs9340799, ESR2 rs1256049, ESR2 rs4906938, and GPER rs3808350. Group-based trajectory modeling was performed to identify interindividual trajectories of menopausal symptoms. Multinomial logistic regression models were employed to identify factors associated with these trajectories. ResultsFour distinct trajectory groups of menopausal symptoms were identified (increase, moderate, rebound, decrease). ER gene polymorphisms and E2 fluctuation were significantly associated with group membership. Furthermore, ER gene polymorphisms modulated the effect of E2 fluctuations on menopausal symptom trajectory. ConclusionsThis study illuminates the multifaceted factors contributing to the individuality of the perimenopausal experience. ER gene polymorphisms emerged as integral factors by modulating the effect of E2 fluctuations on menopausal symptom trajectory. This underscores the intricate interplay of genetic factors, E2 fluctuations, and menopausal symptoms during perimenopause.