Abnormal expression of rno_circRNA_014900 and rno_circRNA_005442 induced by ketamine in the rat hippocampus

Long-lasting effects of post-traumatic stress disorder in Yazidi women living in Northern Iraqi camps

The severity of post-traumatic stress disorder and its long-lasting effects among the Yazidi population has not yet been investigated.

Objectives

This study evaluated the impact of PTSD severity and chronicity on physiological and anthropometric parameters in women survivors of the genocide-related events after the so-called Islamic State of Iraq and Syria (ISIS) attack in 2014.

Methods

The diagnosis PTSD was assessed using PTSD Checklist for DSM-5 (PCL-5). Participants were divided into: External control (healthy individuals living outside the camps), Internal control (healthy individuals living in the camps), and PTSD group (individuals diagnosed with PTSD). The PTSD group was subdivided according to chronicity <2 years, 2-5 years, and >5 years and subdivided according to PTSD severity into "Moderate", "Severe" and "Extreme". Systolic blood pressure (SBP), diastolic blood pressure (DBP), blood oxygen saturation (SPO2) and heart rate (HR) were evaluated. Weight, height and waist circumference were measured. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated.

Results

The PTSD group showed significant increases in SBP, DBP, heart rate, BMI, WC, weight, and WHtR compared to the control groups. SPO2 values decreased in the PTSD group. As the disease progressed, there were further increases in SBP, DBP, heart rate, BMI, WC, WHtR, and weight. Similar increases were observed with the severity of the disease.

Conclusion

Our data indicates that a long-term impact on physiological and anthropometric parameters is present in women diagnosed with PTSD which might be aggravated by the severity and chronicity of the disease.

Epigenetic mechanisms of rapid-acting antidepressants

BACKGROUND

Rapid-acting antidepressants (RAADs), including dissociative anesthetics, psychedelics, and empathogens, elicit rapid and sustained therapeutic improvements in psychiatric disorders by purportedly modulating neuroplasticity, neurotransmission, and immunity. These outcomes may be mediated by, or result in, an acute and/or sustained entrainment of epigenetic processes, which remodel chromatin structure and alter DNA accessibility to regulate gene expression.

METHODS

In this perspective, we present an overview of the known mechanisms, knowledge gaps, and future directions surrounding the epigenetic effects of RAADs, with a focus on the regulation of stress-responsive DNA and brain regions, and on the comparison with conventional antidepressants.

MAIN BODY

Preliminary correlative evidence indicates that administration of RAADs is accompanied by epigenetic effects which are similar to those elicited by conventional antidepressants. These include changes in DNA methylation, post-translational modifications of histones, and differential regulation of non-coding RNAs in stress-responsive chromatin areas involved in neurotrophism, neurotransmission, and immunomodulation, in stress-responsive brain regions. Whether these epigenetic changes causally contribute to the therapeutic effects of RAADs, are a consequence thereof, or are unrelated, remains unknown. Moreover, the potential cell type-specificity and mechanisms involved are yet to be fully elucidated. Candidate mechanisms include neuronal activity- and serotonin and Tropomyosine Receptor Kinase B (TRKB) signaling-mediated epigenetic changes, and direct interaction with DNA, histones, or chromatin remodeling complexes.

CONCLUSION

Correlative evidence suggests that epigenetic changes induced by RAADs accompany therapeutic and side effects, although causation, mechanisms, and cell type-specificity remain largely unknown. Addressing these research gaps may lead to the development of novel neuroepigenetics-based precision therapeutics.

CircKat6b Mediates the Antidepressant Effect of Esketamine by Regulating Astrocyte Function

The abundant expression of circular RNAs (circRNAs) in the central nervous system and their contribution to the pathogenesis of depression suggest that circRNAs are promising therapeutic targets for depression. This study explored the role and mechanism of circKat6b in esketamine's antidepressant effect. We found that intravenous administration of esketamine (5 mg/kg) treatment decreased the circKat6b expression in the astrocytes of hippocampus induced by a chronic unpredictable mild stress (CUMS) mouse model, while the overexpression of circKat6b in the hippocampus significantly attenuated the antidepressant effects of esketamine in depressed mice. RNA-sequencing, RT-PCR, and western blot experiments showed that the stat1 and p-stat1 expression were significantly upregulated in mouse astrocytes overexpressing circKat6b. In the CUMS mouse model, overexpression of circKat6b in the hippocampus significantly reversed the downregulation of p-stat1 protein expression caused by esketamine. Our findings demonstrated that a novel mechanism of the antidepressant like effect of esketamine may be achieved by reducing the expression of circKat6b in the astrocyte of the hippocampus of depressed mice.

Emotional and cognitive influences on alcohol consumption in middle-aged and elderly Tanzanians: a population-based study

Alcohol consumption in Tanzania exceeds the global average. While sociodemographic difference in alcohol consumption in Tanzania have been studied, the relationship between psycho-cognitive phenomena and alcohol consumption has garnered little attention. Our study examines how depressive symptoms and cognitive performance affect alcohol consumption, considering sociodemographic variations. We interviewed 2299 Tanzanian adults, with an average age of 53 years, to assess their alcohol consumption, depressive symptoms, cognitive performance, and sociodemographic characteristics using a zero-inflated negative binomial regression model. The logistic portion of our model revealed that the likelihood alcohol consumption increased by 8.4% (95% confidence interval [CI] 3.6%, 13.1%, p < 0.001) as depressive symptom severity increased. Conversely, the count portion of the model indicated that with each one-unit increase in the severity of depressive symptoms, the estimated number of drinks decreased by 2.3% (95% CI [0.4%, 4.0%], p = .016). Additionally, the number of drinks consumed decreased by 4.7% (95% CI [1.2%, 8.1%], p = .010) for each increased cognitive score. Men exhibited higher alcohol consumption than women, and Christians tended to consume more than Muslims. These findings suggest that middle-aged and elderly adults in Tanzania tend to consume alcohol when they feel depressed but moderate their drinking habits by leveraging their cognitive abilities.

The Relationship between Diet, Depression, and Alzheimer's Disease: A Narrative Review

PURPOSE OF REVIEW

This narrative review evaluates the role of diet in the relationship between depression and Alzheimer's disease (AD).

RECENT FINDINGS

AD and depression are often comorbid, and depression appears to independently increase the future risk of AD. Evidence suggests diet influences the risk of both conditions directly and indirectly. Diet impacts neurochemical and biological processes that may affect the development and progression of depression and cognitive dysfunction. The dietary components offering the greatest protection against depression and AD are yet to be determined. Current evidence highlights the importance of polyphenolic compounds, folate, B vitamins, and polyunsaturated fatty acids, along with adherence to dietary patterns like the Mediterranean diet, which includes multiple beneficial dietary factors.

SUMMARY

The investigation of dietary factors in the prevention of depression and AD is a comparatively young field of research. Comprehensive highly characterised longitudinal datasets and advanced analytical approaches are required to further examine the complex relationship between diet, depression, and AD. There is a critical need for more research in this area to develop effective preventive strategies aimed at maintaining mental and physical health with advancing age.

A longitudinal study of the impacts of a stay in a Prevention and Recovery Care service in Victoria, Australia

BACKGROUND

Prevention and Recovery Care services are residential sub-acute services in Victoria, Australia, guided by a commitment to recovery-oriented practice. The evidence regarding the effectiveness of this service model is limited, largely relying on small, localised evaluations. This study involved a state-wide investigation into the personal recovery, perceived needs for care, well-being and quality-of-life outcomes experienced by Prevention and Recovery Care services' consumers.

METHODS

A longitudinal cohort design examined the trajectory of self-reported personal recovery and other outcomes for consumers in 19 Victorian Prevention and Recovery Care services over 4 time points (T1 - 1 week after admission; T2 - within 1 week of discharge; T3 - 6 months after discharge; T4 - 12 months after discharge). T2-T4 time frames were extended by approximately 3 weeks due to recruitment challenges. The Questionnaire about the Process of Recovery was the primary outcome measure.

RESULTS

At T1, 298 consumers were recruited. By T4, 114 remained in the study. Participants scored higher on the Questionnaire about the Process of Recovery at all three time points after T1. There were also sustained improvements on all secondary outcome measures. Improvements were then sustained at each subsequent post-intervention time point. Community inclusion and having needs for care met also improved.

CONCLUSION

The findings provide a consistent picture of benefits for consumers using Prevention and Recovery Care services, with significant improvement in personal recovery, quality of life, mental health and well-being following an admission to a Prevention and Recovery Care service. Further attention needs to be given to how to sustain the gains made through a Prevention and Recovery Care service admission in the long term.

Effects of Social Support on Medication Adherence Among Patients with Schizophrenia: Serial Multiple Mediation Model

Purpose

This study aims to explore the serial mediating effect of stigma and depression on the association between social support and medication adherence.

Patients and Methods

A cross-sectional survey was undertaken in the Changning District of Shanghai using a five-part questionnaire from August to December 2023. A convenient sampling method was employed, and 35 patients with schizophrenia were invited from each of the 9 streets in Changning District to participate in the survey, resulting in a total of 305 valid questionnaires collected. The questionnaire measured social support, stigma, depression, medication adherence, and demographic characteristics. Data analysis involved descriptive statistics, independent samples t-tests, ANOVA, Pearson correlation analysis, and the bootstrap method.

Results

There was a direct and significantly positive association between social support and medication adherence (β = 0.69, p < 0.001). Moreover, increased levels of stigma (β = - 0.45, p = 0.013) and depression (β = - 0.09, p = 0.017) were both associated with a decline in medication adherence. Bootstrapping analysis revealed that the association between social support and medication adherence operated indirectly through stigma (β = 0.11, 95% CI: 0.03, 0.18). Additionally, social support was indirectly associated with medication adherence through depression (β = 0.15, 95% CI: 0.04, 0.30). Further analysis indicated that social support had an indirect association with medication adherence through both stigma and depression (β = 0.04, 95% CI: 0.01, 0.07).

Conclusion

Stigma and depression serially mediate the association between social support and medication adherence among patients with schizophrenia. This serial multiple mediation model underscores the importance of integrating social support interventions with psychological interventions aimed at reducing stigma and depression, thereby effectively enhancing medication adherence in patients with schizophrenia.

Smartphone survey data reveal the timecourse of changes in mood outcomes following vitamin C or kiwifruit intervention in adults with low vitamin C

Vitamin C-rich foods can improve mood; however, the timecourse of these benefits is unknown. This study utilised intensive longitudinal smartphone surveys from a three-armed placebo-controlled trial to determine mood-related changes following supplementation with vitamin C (250 mg tablet/d), kiwifruit (2 SunGold™ kiwifruit/d) or a placebo (1 tablet/d). Secondary data were analysed from the KiwiC for Vitality trial (Trial ID: ACTRN12617001031358). Adults (n 155, 63 % female, aged 18-35 years) with low plasma vitamin C (<40 μmol/l) completed a 14-d lead-in, 28-d intervention and 14-d washout. Participants self-reported vitality (SF-36), mood (POMS total mood disturbance), flourishing (flourishing scale), sleep quality, sleep quantity and physical activity every second day using smartphone surveys. Plasma vitamin C, measured fortnightly, reached saturation after 2 weeks of vitamin C or kiwifruit supplementation. Kiwifruit supplementation improved vitality and mood within 4 days, peaking around 14-16 days, and improved flourishing from day 14. Vitamin C marginally improved mood until day 12. Incremental AUC analyses revealed significant overall effects of kiwifruit consumption on vitality and mood compared with placebo, which were stronger than effects for vitamin C tablets, but attenuated when adjusting for covariates. Sensitivity analyses of participants with low baseline vitamin C status revealed improved mood (vitamin C and kiwifruit) and flourishing (kiwifruit only). This is the first study to use intensive smartphone surveys to model the day-to-day timecourse of mood-related states following vitamin C intervention and highlights the value of using smartphone surveys to reveal the temporal changes in mood-related outcomes following nutrient supplementation.

Prospective bidirectional relations between depression and metabolic health: 30-year follow-up from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study

OBJECTIVE

This study investigated prospective bidirectional relationships between depressive symptoms and metabolic syndrome (MetS) and the moderating effects of race, sex, and health behaviors in a diverse cohort followed for 30 years.

METHOD

Data were analyzed from the National Heart, Lung, and Blood Institute (NHLBI) Coronary Artery Disease in Young Adults (CARDIA) study, a 30-year prospective study of young adults (N = 5,113; Mage = 24.76 [SD = 3.63] at baseline; 45% male) who were tested every 5 years between 1985 and 2015. Measures included biological assessments of MetS components and self-reported depressive symptoms based on the Center for Epidemiologic Studies Depression (CESD) scale. Data analyses included bidirectional general estimating equations analyses of time-lagged associations between depressive symptoms and MetS.

RESULTS

There was a consistent, bidirectional relationship between depressive symptoms and MetS over time. Individuals with more CESD depressive symptoms were more likely to develop MetS over time compared to those reporting fewer symptoms, Wald χ²(1) = 7.09, p < .008, and MetS was similarly predictive of CESD. MetS more consistently predicted CESD scores at each 5-year exam than CESD predicted MetS. Race and sex moderated these relationships, with White females, White individuals overall, and females overall demonstrating significant relationships between CESD depressive symptoms and MetS. Health behaviors were not related to associations between CESD and MetS.

CONCLUSION

In a diverse young adult population prospectively followed into late middle age, MetS more consistently predicted depressive symptoms over time than depressive symptoms predicted MetS. The relation between MetS and depressive symptoms was moderated by race and sex, but not health behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of ncRNAs in depression

Depressive disorders have a significant impact on public health, and depression have an unsatisfactory recurrence rate and are challenging to treat. Non-coding RNAs (ncRNAs) are RNAs that do not code protein, which have been shown to be crucial for transcriptional regulation. NcRNAs are important to the onset, progress and treatment of depression because they regulate various physiological functions. This makes them distinctively useful as biomarkers for diagnosing and tracking responses to therapy among individuals with depression. It is important to seek out and summarize the research findings on the impact of ncRNAs on depression since significant advancements have been made in this area recently. Hence, we methodically outlined the findings of published researches on ncRNAs and depression, focusing on microRNAs. Above all, this review aims to improve our understanding of ncRNAs and provide new insights of the diagnosis and treatment of depression.

Perceived stress, coping strategies, symptoms severity and function status among carpal tunnel syndrome patients: a nurse-led correlational Study

BACKGROUND

Carpal tunnel syndrome (CTS) is a prevalent condition characterized by hand pain, tingling, and numbness. The severity of symptoms and functional status in CTS patients may be influenced by perceived stress and how individuals cope with it. However, scarce knowledge exists about the role of coping strategies as moderators in this relationship. Unfolding the role of perceived stress and coping strategies for CTS management will help the nurse to provide comprehensive and tailored nursing care. This will ultimately improve patient comfort, functionality, and quality of life.

PURPOSES

This study aimed to examine the role of coping strategies (adaptive and maladaptive) in the relationship between perceived stress and both symptoms severity and function status among those patients.

METHOD

We employed a multisite, correlational study design with moderation analysis. The study included 215 patients with CTS from neurosurgery outpatient clinics at three hospitals in Egypt. After obtaining their consent to participate, eligible participants completed anonymous, self-reported measures of perceived stress, the brief COPE inventory, and the Boston Carpal Tunnel Questionnaire. Demographic and biomedical data were also collected. The questionnaire took about 20 min to be completed. The data was collected over six months, starting in February 2023.

RESULTS

The results showed that perceived stress, adaptive coping, and maladaptive coping were significant predictors of symptoms severity and functional status. Adaptive coping moderated the relationships between perceived stress and both symptoms severity and function status, while maladaptive coping did not. The interaction between perceived stress and adaptive coping explained a moderate effect on symptoms severity and function status after controlling for the main effects and the covariates.

CONCLUSION

This study explored the relationship between perceived stress, coping strategies, and outcomes in patients with CTS. The results indicate that nurses play a vital role in assessing and assisting patients to adopt effective coping strategies to manage perceived stress and alleviate symptoms and functional impairment. Moreover, the findings support the need for psychological interventions that address both perceived stress and coping strategies as a way to enhance the functioning status and quality of life of patients with CTS.

Effect of Occupational Stress on Work Behavior as Perceived by Nurses at Benue State University Teaching Hospital Makurdi

Background

Every work environment, especially in hospital settings must be conducive, friendly, and stress-free in order to promote quality care and the well-being of healthcare workers, whose job demands are increasing by the day.

Aims

The purpose of this study was to determine the perceived effect of occupational stress on work behavior among nurses at Benue State University Teaching Hospital in Makurdi.

Methods

From the facility's population of nurses, a quantitative survey randomly chose 150 respondents nurses, for the purpose of gathering information and testing the hypothesis, a well- developed and validated questionnaire was employed to gather data. Using SPSS, the data were descriptively analyzed, and an inferential analysis with a significance level of 5% was performed using Pearson's Chi-square test (0.05).

Results

The majority of participants (56.6%) were men with a higher level of education. This study also shows the effect of occupational stress on work behavior as poor work performance 142 (94.7%), counterproductive work behavior 139 (92.7%), increases the incidence of absenteeism 112 (74.7%), high occurrence of medication error 120 (80%), Negative effect on teamwork 98 (65.3%), increases the incidence of Substance use disorders 95 (63.3), and aggressive attitude toward patients during nursing care 137 (91.3). Furthermore, there is a significant association between occupational stress and job satisfaction (x2 = 25.49, df = 8, and p < 0.001), patient safety (x2 = 51.07, df = 8, and P = 0.002), and nurses' attitudes toward their patients (x2 = 86.67, df = 12, and P = 0.012).

Conclusion

We discovered that workplace stress can affect how happy nurses are with their jobs and how they behave while providing nursing care. We recommend that hospital administrators implement a plan to create a stress-free working environment for nurses.

Associations Between Longitudinal Loneliness, DNA Methylation Age Acceleration, and Cognitive Functioning

OBJECTIVES

Loneliness may influence aging biomarkers related to cognitive functioning, for example, through accelerated DNA methylation (DNAm) aging.

METHODS

In the present study, we tested whether six common DNAm age acceleration measures mediated the effects of baseline loneliness and five different longitudinal loneliness trajectories on general cognitive ability, immediate memory recall, delayed memory recall, and processing speed in 1,814 older adults in the Health and Retirement Study.

RESULTS

We found that baseline loneliness and individuals who belong to the highest loneliness trajectories had poorer general cognitive ability and memory scores. Only DNAm age acceleration measures that index physiological comorbidities, unhealthy lifestyle factors (e.g., smoking), and mortality risk-mediated effects of baseline loneliness on general cognitive ability and memory functioning but not processing speed. These same DNAm measures mediated effects of the moderate-but-declining loneliness trajectory on cognitive functioning. Additionally, immediate and delayed memory scores were mediated by GrimAge Accel in the lowest and two highest loneliness trajectory groups. Total and mediated effects of loneliness on cognitive functioning outcomes were mainly accounted for by demographic, social, psychological, and physiological covariates, most notably self-rated health, depressive symptomatology, objective social isolation, and body mass index.

DISCUSSION

Current findings suggest that DNAm biomarkers of aging, particularly GrimAge Accel, have promise for explaining the prospective association between loneliness and cognitive functioning outcomes.

Lived experience of people living with HIV in Blantyre, Malawi: an exploratory qualitative study

Background

People living with the Human Immunodeficiency Virus (HIV) encounter a range of complex challenges that impact their physical, psychological, and social well-being. The combined effects of these challenges significantly impact their daily functioning. Despite the relatively high prevalence of HIV in Malawi, there is limited knowledge on how the challenges experienced by people living with HIV correlate with their societal participation and performance of activities.

Objectives

This study aimed to explore the lived experience of people living with HIV and how the challenges experienced impact societal participation and activity performance.

Method

A qualitative exploratory study design was used. Fourteen participants were purposefully selected for the study, with an equal number of males and females. The data was gathered through semi-structured interviews and manually analyzed using thematic analysis.

Results

It was found that participants faced discrimination, stigma, depression, anxiety, and worries. The study participants associated their taking of antiretroviral therapy with physical impairments such as dizziness, leg pain, yellow eyes, and fatigue. The physical impairments hampered participants' ability to walk, work, conduct business, perform household chores, and care for children.

Conclusion

This study identified the difficulties that people living with HIV faced in their communities and how these challenges impact societal participation and performance in activities. There is a need for a holistic approach to managing these challenges and making referrals to specialized professionals.

Correlated depressive symptoms within seroconcordant, expectant partners living with HIV in Zambézia Province, Mozambique: a cross-sectional study

Approximately 15% of people with HIV in sub-Saharan Africa have comorbid depression, which impacts treatment outcomes. We describe predictors of baseline depressive symptoms in 1079 female and 1079 male participants in a cluster-randomized trial in Zambézia Province, Mozambique from November 2017 to December 2020. We modeled each partners' depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) using proportional odds models adjusted for enrollment date, age, body mass index [BMI], partner's PHQ-9 score, district, relationship status, education, occupation, WHO HIV clinical stage, and antiretroviral therapy use history. A post hoc analysis assessed covariate-adjusted rank correlation between partner depressive symptoms. Females were younger than males (median 23 vs. 28 years) and more likely to report no education (20.7% vs. 7.9%). Approximately 10% screened positive for depression (PHQ-9 score ≥ 10). Partner depressive symptoms were predictive of higher participant PHQ-9 scores. A male partner PHQ-9 score of 10 (versus 5) increased the odds that the female partner would have a higher PHQ-9 score (adjusted odds ratio: 7.25, 95% Confidence Interval [CI]: 5.43-9.67). Partner PHQ-9 scores were highly correlated after covariate adjustment (Spearman's rho 0.65, 95% CI 0.57-0.72). Interventions aimed to reduce depressive symptoms and improve HIV-related outcomes during pregnancy should address both partners' depressive symptoms.

Insights on historical milestones of mental health in Nepal: Country profile

The present paper has highlighted the mental health development in Nepal. It covers the current state of mental health system and services and a throwback on the significant changes over a period of time. This review grabs a sneak into mental health plan/policies, prevalence; health facilities and human resources, monitoring and supervision, budget allocation, nongovernmental sector involvement, and international agreements. Every description in this paper is substantially based on the progression made at the different time frames, which provides clear understanding of the mental health situation in Nepal. Furthermore, this article throws insights on the main challenges to overcome the current situation on mental health and the associated treatment gap due to stigma toward mental illness, lack of appropriate budget allocation, shortage of human resources, and fear of discrimination.

Developmental cascades between insistence on sameness behaviour and anxiety symptoms in autism spectrum disorder

Autistic children experience high rates of anxiety. Insistence on sameness behaviour (IS) is a core feature of autism that appears correlated with anxiety severity. The objective of this study was to examine the longitudinal relations between anxiety and IS in autistic children using a developmental cascade model. A longitudinal cohort of 421 autistic children was followed between 4 and 11 years of age. Anxiety was quantified using items from the Anxiety Problems subscale of the Child Behavior Checklist; sameness behaviours were measured using the Repetitive Behavior Scale-Revised, Ritualistic/sameness subscale (both parent-report measures). Structural equation modelling was used to examine the longitudinal and directional associations between anxiety and IS at four time-points, through cross-lagged panel models (CLPM) with and without a random-intercepts component (RI-CLPM). Both the CLPM and the RI-CLPM had good fit. Significant directional associations were detected whereby elevated or increasing IS preceded elevated or increasing anxiety symptoms 1-2 years later, respectively. Stable baseline tendencies towards anxiety and IS as between-person traits (intercepts) were strongly associated (standardized estimate = 0.69, p < 0.001). The magnitude of the cross-sectional associations between anxiety and IS appeared to lessen with age. IS and anxiety symptoms in autism are closely related. They appear to be shared traits that mirror each other particularly in younger children. Increasing IS may be a sign of emerging future anxiety. Interventions that target IS to reduce or prevent anxiety amongst school-aged autistic children merit further study.

Profiles of Victimized Outpatients with Severe Mental Illness in India

Persons with severe mental illness (PwSMI) are at risk of being victimized due to persistent cognitive, emotional, and behavioral symptoms, which can become potential threats for effective reintegration into the community. A total of 217 PwSMI, receiving outpatient psychiatric treatment from a tertiary hospital, were screened for abuse, and if they were identified as abuse, then information about contextual factors contributing to abuse, sociodemographic, family, and clinical and legal profiles was created. Overall, 150 PwSMI were victimized, of which 56% were females, 50.7% were married, 20.7% were educated up to middle school, and 31.4% were homemaker. The most common form of diagnosis was schizophrenia (43.3%), with a mean duration of illness of 14 years. All the victimized PwSMI were subjected to emotional abuse. PwSMI were more likely to be victimized by multiple family members due to poor knowledge and understanding about illness (24%). The majority of the PwSMI had disclosed abuse (62.7%) to nonformal sources (33.3%) with no documentation in the clinical file (82.7%). PwSMI experience ongoing abuse and are more likely to be re-victimized, which increases the need for regular screening and culturally sensitive and comprehensive community-coordinated care and support.

Alcohol consumption and associated factors among pregnant women attending antenatal care at governmental hospitals in Harari regional state, Eastern, Ethiopia

BACKGROUND

Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia.

METHOD

From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level.

RESULTS

From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals.

CONCLUSION

In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions.

Fear of the unknown, anxiety, and social isolation in Iranian patients with Covid-19, the grounded theory

BACKGROUND

Coronavirus 2019 (COVID-19) pandemic has incurred a health challenge. Patients suffer from many physical and mental disorders. To accurately identify the experience of patients with Covid-19 in the Iranian society.

MATERIALS AND METHODS

This qualitative research was conducted using the grounded theory. The data of this grounded theory study were collected using 32 semi-structured interviews with participants and field notes including the patients with Covid-19, nurses, physicians, and the patients' families. Data analysis was performed using Corbin and Strauss (2008) approach for concepts, context, process, and categories' integration.

RESULTS

Qualitative analysis of data led to the extraction of 54 sub-categories and 7 final categories. "Isolation, fear of death, and fear of infection of relatives and family members" were identified as the main issue. The context to this concern was the "unfamiliarity with the virus due to its ambiguous nature that was obtained with a wide range of symptoms." Facing this issue, the patients used the strategy of "adherence to health protocol in the coronavirus infection process" that was recognized as the central variable.

CONCLUSION

The ambiguous and complex nature of the emerging virus, the appearance of different symptoms in different people, and the fear of infecting others, death and anxiety due to unknown complications of the disease make patients go through the most difficult experience of their lives. That requires ongoing training on up-to-date prevention and treatment protocols, along with the emergence of mutated viruses and new symptoms.

Impacts of COVID-19 on mental health in the US: evidence from a national survey

BACKGROUND

Studies have reported substantial effects of the COVID-19 pandemic on mental health, but little is known whether the impacts of COVID on individuals, such as being tested for COVID or experiencing disruptions to healthcare utilization, would affect their mental health differently.

AIMS

To examine the impacts of COVID-19 on depression and anxiety disorders among US adults.

METHODS

We included 8098 adults with no prior mental health problems using data from the National Health Interview Survey (2019-2020). We examined two outcomes: current depression and anxiety; and three COVID-related impact measures: ever COVID test, delayed medical care, and no medical care due to COVID. Multinomial logistic regressions were conducted.

RESULTS

Delayed or no medical care were significantly associated with current depression, with adjusted relative risks (aRRs) of 2.17 (95% CI, 1.48-2.85) and 1.85 (95% CI, 1.33-2.38). All three COVID-related impact measures were significantly associated with current anxiety. The aRRs were 1.16 (95% CI, 1.01-1.32) for ever COVID test, 1.94 (95% CI, 1.64-2.24) for no medical care, and 1.90 (95% CI, 1.63-2.18) for delayed medical care.

CONCLUSIONS

Individuals who were affected by COVID were more likely to experience depression or anxiety disorders. Mental health services need to prioritize these high-risk groups.

Functional Imaging Derived ADHD Biotypes Based on Deep Clustering May Guide Personalized Medication Therapy

Attention deficit hyperactivity disorder (ADHD) is one prevalent neurodevelopmental disorder with childhood onset, however, there is no clear correspondence established between clinical ADHD subtypes and primary medications. Identifying objective and reliable neuroimaging markers for categorizing ADHD biotypes may lead to more individualized, biotype-guided treatment. Here we proposed graph convolutional network plus deep clustering for ADHD biotype detection using functional network connectivity (FNC), resulting in two biotypes based on 1069 ADHD patients selected from Adolescent Brain and Cognitive Development (ABCD) study, which were well replicated on independent ADHD adolescents undergoing longitudinal medication treatment (n=130). Interestingly, in addition to differences in cognitive performance and hyperactivity/impulsivity symptoms, biotype 1 treated with methylphenidate demonstrated significantly better recovery than biotype 2 treated with atomoxetine (p<0.05, FDR corrected). This imaging-driven, biotype-guided approach holds promise for facilitating personalized treatment of ADHD, exploring possible boundaries through innovative deep learning algorithms aimed at improving medication treatment effectiveness.

Nonlinear, Multicomponent Physical Exercise With Heart Rate Variability-Guided Prescription in Women With Breast Cancer During Treatment: Feasibility and Preliminary Results (ATOPE Study)

OBJECTIVE

The purpose of this study was to examine the feasibility, safety, adherence, and preliminary efficacy of the ATOPE program during radiotherapy (RT) or chemotherapy (CT) for women with breast cancer.

METHODS

This single-blind, pretest-posttest feasibility study included 38 women with breast cancer at the beginning of their treatment. The ATOPE program consisted of 12 to 18 sessions of a multimodal physical exercise program, prescribed based on daily heart rate variability and clinimetric assessments using the ATOPE+ mHealth system. Overall health was assessed with quality of life, autonomous balance, and body composition, whereas health-related fitness was measured through functional capacity, physical activity levels, and upper and lower limb strength.

RESULTS

The rates of recruitment, retention, and adherence were 52.35, 73.68, and 84.37%, respectively, and the satisfaction rating was 9.2 out of a possible 10 points. The perceived health status change score was 3.83 points, scored on a -5 to 5 point scale. No adverse effects were found. Compliance results showed that the ATOPE+ mHealth system was used on 73.38% of the days, and the Fitbit bracelet (Google, Mountain View, CA, USA) was used on 84.91% of the days. Women stayed physically active 55% of days. Regarding preliminary results, for overall health, the percentage of body fat in the RT group decreased by 1.93%, whereas it increased by 5.03% in the CT group. Lower limb strength increased in the RT group, specifically knee extensor isometric strength (6.07%), isokinetic knee flexors 180 degree/second (1.53%), and isokinetic knee extensors 300 degree/second (4.53%), in contrast with the reductions found in the CT group (11.07, 18.67, and 14.89%, respectively).

CONCLUSION

The ATOPE program, through nonlinear prescription based on daily monitoring with the ATOPE+ mHealth system, is feasible and safe for application during breast cancer treatment. The results suggest that the overall health can be maintained or even improved regarding most variables.

IMPACT

This study focused on the feasibility, safety, and completion of a physical therapist-led program at early diagnosis for adults with breast cancer. The multimodal, supervised, tailored, nonlinear physical exercise program is feasible and safe, showed a good completion rate, and was able to prevent the quality-of-life deficits that are often triggered by systemic breast cancer treatment. This study highlights the importance of daily morning assessments using the ATOPE+ mHealth system in patients with breast cancer to prescribe nonlinear physical exercise.

The Effect of the Web-Based Psychosocial Health Promotion Program on the Burden of Care in Family Caregivers of Patients with Chronic Mental Disorders

Background

Family members of Chronic Mental Disorders (CMD), who are responsible for patient care, face many physical, psychological, and social problems which make them face the burden of care. This study aimed to investigate the effect of a psychosocial health promotion program on the care burden of family caregivers of patients with CMD.

Materials and Methods

This is a quasi-experimental study that was conducted in two intervention and control groups in the form of pretest and posttest. This study was performed on 67 family caregivers of patients with CMD in Farabi and Noor centers in Isfahan, Iran. Participants in this study were randomly divided into two intervention and control groups. Data from the intervention and control groups were collected in two stages, before and after the intervention by demographic information form and Zarit burden questionnaire. The intervention group received a web-based psychosocial health promotion program in eight sessions in 4 weeks. At the end of the intervention, the Zarit questionnaire was completed by the intervention and control groups.

Results

The mean score of care burden between the intervention and control groups was not statistically significantly different before the implementation of the program (p = 0.534). But after the intervention, the mean score of care burden was significantly different between the two groups (t65 = 3.43, p = 0.001).

Conclusions

This study provides evidence for the benefits of web-based psychosocial health promotion program in reducing the perceived care burden of the caregiver of CMD.

Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential

Major depressive disorder (MDD) is a chronic, generally episodic and debilitating disease that affects an estimated 300 million people worldwide, but its pathogenesis is poorly understood. The heritability estimate of MDD is 30-40%, suggesting that genetics alone do not account for most of the risk of major depression. Another factor known to associate with MDD involves environmental stressors such as childhood adversity and recent life stress. Recent studies have emerged to show that the biological impact of environmental factors in MDD and other stress-related disorders is mediated by a variety of epigenetic modifications. These epigenetic modification alterations contribute to abnormal neuroendocrine responses, neuroplasticity impairment, neurotransmission and neuroglia dysfunction, which are involved in the pathophysiology of MDD. Furthermore, epigenetic marks have been associated with the diagnosis and treatment of MDD. The evaluation of epigenetic modifications holds promise for further understanding of the heterogeneous etiology and complex phenotypes of MDD, and may identify new therapeutic targets. Here, we review preclinical and clinical epigenetic findings, including DNA methylation, histone modification, noncoding RNA, RNA modification, and chromatin remodeling factor in MDD. In addition, we elaborate on the contribution of these epigenetic mechanisms to the pathological trait variability in depression and discuss how such mechanisms can be exploited for therapeutic purposes.

Mapping Global Research in Emergency Medicine; a Bibliometric Analysis of Documents Indexed in the Web of Science Database

Introduction

Emergency medicine is a relatively new and rapidly growing specialty, and its research monitoring is important for future policies. This study aimed to analyze the published literature related to emergency medicine, to create a documented research perspective for this field.

Methods

This research is a bibliometric study that analyzes the research outputs of the subject area of emergency medicine indexed in the Web of Science database from the beginning to 2023. VOSviewer software was used to visualize and predict the trends in research on the topic.

Results

The findings showed that the University of California, The Journal of Neurotrauma and Brain Injury, Elsevier, and the USA were the most prolific units in the cycle of scientific productions in the field of emergency medicine. Results showed that most scientific productions in this field fall into 6 clusters: psychological impressions, injuries caused by traumatic events and the effects of traumas on children, pathophysiology and nervous system issues and related diseases, complications of traumatic events and injuries, biomechanics and complications caused by sports injuries, and consciousness.

Conclusion

In addition to interventions and clinical complications, research in the field of emergency medicine has also focused on psychological structures. So, based on various measurement indicators, the subjects of this field have been the focus of researchers' attention.

Physical activity counselling in women with HIV/AIDS and suicidal ideation: a secondary analysis of a real-world intervention in Ugandan HIV counselling centres

Introduction

people with HIV/AIDS have higher rates of suicidal ideation than the general population. Consequently, HIV counselling settings should implement suicide risk reduction initiatives. Physical activity (PA) counselling could be a relevant add-on intervention. The aim of this secondary analysis from a single-arm pre- and post-study exploring the efficacy of PA counselling for HIV/AIDS patients with mental health problems was to investigate the efficacy of PA counselling on reducing suicidal ideation.

Methods

out of 41 participants in an 8-week PA counselling intervention, 15 participants reported suicidal ideation. These 15 (15♀, median age=42 years, interquartile range=24 years) participants completed the Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorder Identification Test -10 (AUDIT-10), and the Simple Physical Activity Questionnaire (SIMPAQ) pre- and immediately post-intervention.

Results

the prevalence of suicidal ideation (PHQ-9 item 9≥1) dropped to 20% post-intervention, i.e. only three patients with HIV still reported suicidal ideation. Also, following the intervention significant (P<0.05) increases in walking and incidental PA (SIMPAQ) levels, and reductions in depressive and alcohol abuse symptoms were observed.

Conclusion

our data demonstrate that PA counselling might be promising in reducing suicidal ideation in most HIV patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.

Addressing the needs of Ethiopia's street homeless women of reproductive age in the health and social protection policy: a qualitative study

INTRODUCTION

Globally, homelessness is a growing concern, and homeless women of reproductive age are particularly vulnerable to adverse physical, mental, and reproductive health conditions, including violence. Although Ethiopia has many homeless individuals, the topic has received little attention in the policy arena. Therefore, we aimed to understand the reason for the lack of attention, with particular emphasis on women of reproductive age.

METHODS

This is a qualitative study; 34 participants from governmental and non-governmental organisations responsible for addressing homeless individuals' needs participated in in-depth interviews. A deductive analysis of the interview materials was applied using Shiffman and Smith's political prioritisation framework.

RESULTS

Several factors contributed to the underrepresentation of homeless women's health and well-being needs in the policy context. Although many governmental and non-governmental organisations contributed to the homeless-focused programme, there was little collaboration and no unifying leadership. Moreover, there was insufficient advocacy and mobilisation to pressure national leaders. Concerning ideas, there was no consensus regarding the definition of and solution to homeless women's health and social protection issues. Regarding political contexts and issue characteristics, a lack of a well-established structure, a paucity of information on the number of homeless women and the severity of their health situations relative to other problems, and the lack of clear indicators prevented this issue from gaining political priority.

CONCLUSIONS

To prioritise the health and well-being of homeless women, the government should form a unifying collaboration and a governance structure that addresses the unmet needs of these women. It is imperative to divide responsibilities and explicitly include homeless people and services targeted for them in the national health and social protection implementation documents. Further, generating consensus on framing the problems and solutions and establishing indicators for assessing the situation is vital.

Anodal stimulation of inhibitory control and craving in satiated restrained eaters

OBJECTIVES

Eating and weight disorders are severe and complex clinical conditions which, among other behaviors, include (attempts at) restrained eating, food avoidance, following dietary rules, and overeating. Comparable to women with obesity, restrained eaters (RE) without formal eating disorder diagnosis are worse at inhibiting their motor responses than unrestrained eaters (URE). According to neuroimaging studies, the right inferior frontal gyrus (rIFG) is involved in inhibitory control which, in turn, could be improved by neuromodulation such as anodal transcranial direct current stimulation (tDCS) across rIFG.

METHODS

This double-blind sham-controlled cross-over study was conducted after a standardized breakfast. Normal-weight female RE und URE performed a stop-signal task (SST) with food and non-food stimuli during sham or anodal tDCS. Food craving, hunger, and satiety were self-reported before and after tDCS. We employed a mixed between-subjects (group: RE vs. URE) and within-subjects factorial design (tDCS: anodal tDCS vs. sham; stimuli: food vs. control pictures).

RESULTS

Breakfast consumption was comparable for RE and URE, as well as craving, hunger, and thirst. Regarding inhibitory control, a significant two-way interaction between group and tDCS ermerged: RE had longer stop-signal reaction times (SSRTs) during sham tDCS, but they improved to the level of URE by application of anodal tDCS.

DISCUSSION

Results replicated an inhibitory control deficit in RE with longer SSRTs compared to URE without stimulation. During anodal tDCS to the rIFG, reduced SSRTs in RE indicated an improvement in inhibitory control. The findings suggest a specificity of rIFG stimulation in at-risk groups with regards to inhibitory control irrespective of craving.

A smartphone-based serious game for depressive symptoms: Protocol for a pilot randomized controlled trial

Background

Depression is the most prevalent mental disorder, with detrimental effects on the patient's well-being, high disability, and a huge associated societal and economic cost. There are evidence-based treatments, but it is difficult to reach all people in need. Internet-based interventions, and more recently smartphone-based interventions, were explored to overcome barriers to access. Evidence shows them to be effective alternatives to traditional treatments. This paper presents the protocol of a pilot study whose primary aim is to investigate the efficacy of a smartphone-based serious game intervention for patients with mild to moderate depressive symptoms.

Methods

This randomized controlled pilot trial protocol foresees two arms design: 1/ smartphone- based serious game intervention (based on Cognitive Behavior Therapy with particular emphasis on Behavioral Activation and Physical Activity), 2/ waiting list control group. The study is expected to recruit 40 participants (18+), which will be randomly assigned to one of the experimental conditions. The duration of the intervention is two months. The primary outcome measure will be depressive symptomatology. Secondary outcomes will include other variables such as physical activity, resilience, anxiety, depression impairment, and positive and negative affect. Treatment expectation, satisfaction, usability, and game playability will also be measured. The data will be analyzed based on the intention-to-treat and per protocol analyses.

Discussion

The study aims to establish initial evidence for the efficacy of a smartphone-based serious game intervention, to serve as input for a larger-scale randomized control trial. The intervention exploits advanced smartphone capabilities, such as the use of a serious game as delivery mode, with the potential benefit of engagement and treatment adherence, and motion sensors to monitor and stimulate physical activity. As a secondary objective, the study aims to gather initial evidence on the user's expectations, satisfaction, usability and playability of the serious game as a treatment.

Adolescent suicidal behaviour in Namibia: a cross-sectional study of prevalence and correlates among 3,152 school learners aged 12-17 years

BACKGROUND

While adolescent suicidal behaviour (ideation, planning, and attempt) remains a global public health concern, available county-specific evidence on the phenomenon from African countries is relatively less than enough. The present study was conducted to estimate the 12-month prevalence and describe some of the associated factors of suicide behaviour among school-going adolescents aged 12-17 years old in Namibia.

METHODS

Participants (n = 4531) answered a self-administered anonymous questionnaire developed and validated for the nationally representative Namibia World Health Organization Global School-based Student Health Survey conducted in 2013. We applied univariate, bivariable, and multivariable statistical approaches to the data.

RESULTS

Of the 3,152 analytical sample, 20.2% (95% confidence interval [CI]: 18.3-22.2%) reported suicidal ideation, 25.2% (95% CI: 22.3-28.4%) engaged in suicide planning, and 24.5% (95% CI: 20.9-28.6%) attempted suicide during the previous 12 months. Of those who attempted suicide, 14.6% (95% CI: 12.5-16.9%) reported one-time suicide attempt, and 9.9% (95% CI: 8.1-12.1%) attempted suicide at least twice in the previous 12 months. The final adjusted multivariable models showed physical attack victimisation, bullying victimisation, loneliness, and parental intrusion of privacy as key factors associated with increased likelihood of suicidal ideation, planning, one-time suicide attempt, and repeated attempted suicide. Cannabis use showed the strongest association with increased relative risk of repeated attempted suicide.

CONCLUSION

The evidence highlights the importance of paying more attention to addressing the mental health needs (including those related to psychological and social wellness) of school-going adolescents in Namibia. While the current study suggests that further research is warranted to explicate the pathways to adolescent suicide in Namibia, identifying and understanding the correlates (at the individual-level, family-level, interpersonal-level, school context and the broader community context) of adolescent suicidal ideations and non-fatal suicidal behaviours are useful for intervention and prevention programmes.

Application of Cognitive Emotion Regulation Questionnaire in Chinese Community Elderly

Background

The present study investigated the applicability of the Cognitive Emotion Regulation Questionnaire (CERQ) in the Chinese community elderly and explored the influence of cognitive emotion regulation strategies on late-life depression.

Methods

A total of 367 community elderly aged 60-94 were deemed eligible and completed CERQ, the Perceived Stress Scale-10, the Geriatric Depression Questionnaire-15, and the State Anxiety Inventory. Confirmatory factor analysis was adopted to verify the 9-factor structure of CERQ. Cronbach's α coefficient, Ω coefficient and split-half reliability were used to test the internal consistency of CERQ. Pearson correlations among scores of CERQ and other scales were calculated to examine its convergent validity. In addition, a structural equation model was used to further examine the effect of cognitive emotion regulation strategies on the association between perceived stress and late-life depression.

Results

All the fitting indexes of CERQ's 9-factor model met the criterion (χ 2/df= 2.26, CFI= 0.916, TLI= 0.904, RMSEA= 0.052). For the total score of CERQ, the Cronbach's α coefficient and Ω coefficient were both 0.90, and the split-half reliability was 0.74. For the nine subscales, the α coefficients ranged from 0.66 to 0.88, and the Ω coefficients ranged from 0.69 to 0.88. Significant positive correlations were found between the maladaptive dimension of CERQ and other scales (all p < 0.001). The maladaptive emotion regulation strategies indirectly affected the effect of perceived stress on late-life depression (effect size was 21.57%).

Conclusion

With good reliability and factor validity, the CERQ showed good applicability in the Chinese elderly population. The influence of perceived stress on depression in the elderly was mediated by maladaptive emotion regulation strategies.

Mental health promotion in youth sporting clubs: predictors of stakeholder participation

BACKGROUND

Young people are disproportionately affected by poor mental health. Youth sport settings hold immense potential to improve the mental health outcomes of this demographic. Efforts to leverage youth sport settings to promote mental health are limited by the lack of knowledge pertaining to engagement with mental health interventions in these settings. Therefore, this study aimed to examine the willingness of youth sporting club stakeholders (e.g., sportspersons, coaches, support staff, parents/guardians) to engage in mental health initiatives conducted by sporting clubs and ascertain possible determinants of engagement.

METHODS

This study used an observational cross-sectional design. Participants completed an online survey assessing likelihood of supporting a mental health campaign, mental health literacy (help-seeking, inclusive attitudes), and perceived club support. Perceptions pertaining to the importance of youth mental health and sporting clubs supporting youth mental health were also assessed.

RESULTS

The survey was completed by 275 stakeholders of youth sporting clubs in Australia (Mage = 40.2 ± 15.8 years, 60.3% female). The findings indicated that stakeholders were willing to participate in mental health initiatives in youth sport clubs. A linear regression analysis indicated that the significant predictors of stakeholders supporting such initiatives were older age (> 25-50 and > 50 years; β = 0.15, p = .033, β = 0.19, p = .005, respectively), along with perceived importance of youth mental health (β = 0.24, p = .003) and sporting clubs supporting youth mental health (β = 0.22, p = .004).

CONCLUSION

Youth sport settings have the capacity to improve the provision of mental health support among young people. There is a need for tailored approaches to enhance the engagement with, and effectiveness of, mental health resources in sport contexts.

The Effect of Occupational Moral Injury on Career Abandonment Intention Among Physicians in the Context of the COVID-19 Pandemic

Background

Since the advent of the COVID-19 pandemic, physicians have been the unsung heroes of the pandemic. However, many are about to give up the battlefield. This study investigated the effect of occupational moral injury on physicians' career abandonment intention, taking into account the possible mediating role of emotional exhaustion.

Methods

Cross-sectional data collected from 201 physicians were analyzed using the partial least squares structural equation modeling (PLS-SEM) with SmartPLS to determine the relationship among physicians' moral injuries, emotional exhaustion, and career abandonment intention.

Results

The results indicated that occupational moral injury was positively related to emotional exhaustion and career abandonment intention. In addition, emotional exhaustion was found to play a mediating role in the relationship.

Conclusion

To reduce physicians' intention to leave their career, physicians should be prepared for moral injury and psychological issues by offering psychological support and meeting their needs early at both the individual and organizational levels during and after the pandemic.

Differential associations between childhood maltreatment types and borderline personality disorder from the perspective of emotion dysregulation

BACKGROUND

Borderline Personality Disorder (BPD) is characterized by pervasive instability in a range of areas including interpersonal relationships, self-image, and affect. Extant studies have consistently identified significant correlations between childhood maltreatment (CM) and BPD. While exploring this CM-BPD link, a number of cross-sectional studies commonly emphasize the role of emotion dysregulation (ED). A better understanding of the associations between BPD and (1) CM and (2) ED are essential in formulating early, effective intervention approaches, and in addressing varied adverse impacts.

METHODS

This cross-sectional study analyzed a subset of baseline data collected for a larger community-based longitudinal study. Given that our current focus on CM and ED, only those participants who completed the baseline CM assessment and ED measure (N = 144) were included for the primary analyses. We conducted stepwise multivariate linear models to examine the differential relationships between BPD features, ED, and multiple CM types. A path analysis with latent factors using the structural equation modeling (SEM) method was performed to test the indirect effect from CM to BPD features via ED.

RESULTS

Linear regression models revealed that only emotional abuse (relative to other trauma types) was significantly associated with high BPD features. The SEM, by constructing direct and indirect effects simultaneously, showed that (1) ED partially mediated the path from CM to BPD features; and (2) CM played an important role in which the direct effect remained significant even after accounting for the indirect effect through ED.

CONCLUSIONS

Our results highlight a most consistent association between emotional abuse and BPD, indicating its unique role in understanding BPD features in the context of CM. Further, shame-related negative appraisal and ED were found critical when examining the association between CM and BPD, possibly providing promising treatment targets for future practices.

Alcohol use and associated factors among pregnant women during the mid-pandemic of COVID-19 at Debre Tabor Comprehensive Specialized Hospital, South Gondar Zone, Ethiopia

Objective

The aim of this study was to assess the proportion of alcohol use and associated factors among pregnant women attending antenatal care during the mid-pandemic of COVID-19 at Debre Tabor Comprehensive Specialized Hospital from May 1-30, 2021.

Methods

A hospital-based, cross-sectional study was conducted on 612 pregnant women attending a prenatal clinic. Data were entered into EpiData version 3.1 statistical software and then exported to Statistical Package for Social Science version 25 for analysis. A binary logistic regression model was used to predict the association between alcohol use and the independent variable. p = 0.05 variables were considered statistically significant associated factors.

Results

The prevalence of alcohol consumption by pregnant women was 26.3%: residence (Adjusted Odd Ratio (AOR) = 4.08, 95% confidence interval: 2.23, 7.48), antenatal care follow-up before the survey (AOR = 2.69, 95% confidence interval: 1.37, 5.26), unplanned pregnancy (AOR = 3.28, 95% confidence interval: 1.88, 5.70), partner alcohol use (AOR = 6.88, 95% confidence interval: 3.92, 12.06), and knowledge toward effect of alcohol on the fetus (AOR = 2.26, 95% confidence interval: 1.17, 4.33).

Conclusions

The magnitude of alcohol use during pregnancy was high and this might be related to the pandemic. Antenatal care follow-up before the survey, unplanned pregnancy, partner alcohol use, and knowledge were found to be statistically significant associated factors.

Circular RNAs: New players involved in the regulation of cognition and cognitive diseases

Circular RNAs (circRNAs), a type of covalently closed endogenous single-stranded RNA, have been regarded as the byproducts of the aberrant splicing of genes without any biological functions. Recently, with the development of high-throughput sequencing and bioinformatics, thousands of circRNAs and their differential biological functions have been identified. Except for the great advances in identifying circRNA roles in tumor progression, diagnosis, and treatment, accumulated evidence shows that circRNAs are enriched in the brain, especially in the synapse, and dynamically change with the development or aging of organisms. Because of the specific roles of synapses in higher-order cognitive functions, circRNAs may not only participate in cognitive functions in normal physiological conditions but also lead to cognition-related diseases after abnormal regulation of their expression or location. Thus, in this review, we summarized the progress of studies looking at the role of circRNA in cognitive function, as well as their involvement in the occurrence, development, prognosis, and treatment of cognitive-related diseases, including autism, depression, and Alzheimer's diseases.

Analysis of the Chagas disease situation in Japan: a cross sectional study and cost-effectiveness analysis of a Chagas disease screening program

Background

Japan is estimated to host 3000 cases of Chagas disease (CD). However, there are no epidemiological data and policies for prevention and care. We aimed to analyze the current situation of CD in Japan and identify possible barriers to seeking care.

Methods

This cross-sectional study included Latin American (LA) migrants living in Japan from March 2019 to October 2020. We obtained blood samples to identify participants infected with Trypanosoma cruzi, and data about sociodemographic information, CD risk factors, and barriers to access to the Japanese national health care system (JNHS). We used the observed prevalence to calculate the cost-effectiveness analysis of the screening of CD in the JNHS.

Findings

The study included 428 participants, most of them were from Brazil, Bolivia and Peru. The observed prevalence was 1.6% (expected prevalence= 0.75%) and 5.3% among Bolivians. Factors associated with seropositivity were being born in Bolivia, having previously taken a CD test, witnessing the triatome bug at home, and having a relative with CD. The screening model was more cost-effective than the non-screening model from a health care perspective (ICER=200,320 JPY). Factors associated with access to JNHS were being female, length of stay in Japan, Japanese communication skills, source of information, and satisfaction about the JNHS.

Interpretation

Screening of asymptomatic adults at risk of CD may be a cost-effective strategy in Japan. However, its implementation should consider the barriers that affect LA migrants in access to the JNHS.

Funding

Nagasaki University and Infectious Diseases Japanese Association.

Cultural adaptation of the mental health first aid guidelines for depression in Brazil: a Delphi expert consensus study

BACKGROUND

Depression is a significant contributor to disability in Brazil, with most Brazilians affected by depression receiving no treatment. As the community, including family and friends, plays a crucial role in providing support for someone with depression, it is important that evidence-based resources are available to support people who wish to help. The aim of this study was to culturally adapt the English-language mental health first aid guidelines for assisting a person with depression for the Brazilian culture.

METHODS

A Delphi expert consensus study was conducted, with two expert panels; health professionals (n = 29) and people with lived experience of depression (n = 28). One hundred and seventy-four statements from the English-language guidelines were translated into Brazilian Portuguese and administered as a survey. Participants were asked to rate statements based on how appropriate those statements were for the Brazilian culture and to suggest new statements if appropriate.

RESULTS

Data were collected over two survey rounds. Consensus was achieved on 143 statements. A total of 133 statements were adopted from the English-language guidelines, whereas 10 new endorsed statements were generated from suggestions of the two expert panels.

CONCLUSIONS

There were similarities between the English-language and Brazilian guidelines, mainly related to family involvement and the value of empathy. More research on dissemination and incorporation of the guidelines into the Mental Health First Aid (MHFA) training course for Brazil is required.

A situation analysis on postmenopausal women's self-care needs and priorities in Tehran: a population-based study

BACKGROUND

Women need special care during and after menopause. Due to the emphasis of the World Health Organization on promoting self-care in postmenopausal women, this study aims to analyze the situation and prioritize the self-care needs of postmenopausal women in the Tehran-Iran.

METHODS

This was a descriptive-analytical study on 486 postmenopausal women aged 46-85 years living in Tehran in 2021. The Subjects were recruited using a multi-stage sampling method. Data were collected using a socio-demographic and a valid and reliable questionnaire to assess postmenopausal women's self-care status with four domains including physical health, psychosocial health, reproductive-sexual health, and screening tests. The data were analyzed by SPSS-24.

RESULTS

The mean age of the participants was 62.58 ± 7.75 years. The mean score of self-care was 44.63 ± 21.64% in the postmenopausal women. The lowest score and highest scores were related to psychosocial health (25.12 ± 28.21%) and periodic tests (50.62 ± 24.40%) respectively. There were significant positive correlations between self-care with women's education level (r = 0.277; p < 0.001), husband's education level (r = 0.258; p < 0.001), as well as monthly income (r = 0.153; p = 0.001). There was a negative correlation between self-care with the number of children (r = - 0.215; p < 0.001). The level of self-care was higher in employed women (p = 0.001) and also, in women whose husbands were employed (p = 0.012). Multiple linear regression test showed the level of education of the husband (B = 2.72, p = 0.038) and the family size (B = -1.54, p = 0.023) are predictors of the self-care of postmenopausal women.

CONCLUSION

The findings showed more than 55% of challenges in the self-care behaviors of postmenopausal women in Tehran. The most and least challenging self-care behaviors were related to psychosocial health and performing periodic tests. The priorities were in psychosocial health and reproductive-sexual health dimensions. Self-care promotion is necessary, especially in postmenopausal women, who need special care due to various physical, psychological, and social changes.

Systematic review and citation content analysis of the CHIME framework for mental health recovery processes: recommendations for developing influential conceptual frameworks

OBJECTIVES

To identify design features of the CHIME conceptual framework of mental health recovery which are associated with high rates of citation.

RESEARCH DESIGN AND METHODS

Systematic review of all citations of the Connectedness, Hope, Identity, Meaning, and Empowerment (CHIME) framework of mental health recovery. Papers citing CHIME were screened and extracted from three citation databases. Citation content analysis was used to investigate associations between nine CHIME design features. Citations were investigated across six forms of visibility: all citations; Anglophone vs non-Anglophone; academic vs non-academic; academic discipline; professional group; and clinical population.

RESULTS

There were 915 eligible documents identified. Six CHIME framework design features met predefined thresholds for high levels of influence: (i) using a systematic review methodology for development, (ii) adopting a memorable acronym, (iii) having disaggregable components, and being unaligned to a (iv) particular discipline (i.e., transdisciplinary), (v) professional group, or (vi) diagnostic population. Documents from Anglophone countries were more likely to cite CHIME with reference to trans-professional (χ2=3.96, df=1, p=0.05) and ethnicity sub-group analysis (p=0.039) design features than non-Anglophone documents. Non-academic documents were more likely to cite the acronym design feature than academic papers (χ2=5.73, df=1, p=0.01). Public Health-related publications were more likely to cite CHIME within a trans-diagnostic framework (χ2=16.39, df=1, p<0.001) than other disciplines.

CONCLUSIONS

The influence and impact of conceptual frameworks for recovery are increased when the framework is underpinned by a systematic review, includes disaggregable components which can be summarized using a memorable acronym, and when the framework is transdisciplinary, trans-professional, and trans-diagnostic.

Synergic effects of Trigonella foenum-graecum, Ribes rubrum, Lavandula angustifolia, and Arctium Lappa extracts mixture on learning and memory deficits in streptozocin-induced diabetic rats

Objectives

The present study aimed to assess the efficacy of some known extracts on learning and memory impairment induced by streptozocin (STZ) in male rats.

Materials and Methods

Eighty male rats were randomly divided: 1) control, 2) STZ (50 mg/kg), 3) STZ+Trigonella foenum-graecum (200 mg/kg), 4) STZ+Ribes rubrum (500 mg/kg), 5) STZ+Lavandula angustifolia (400 mg/kg), 6) STZ+Arctium Lappa (200 mg/kg), 7) STZ+mix of extracts (quarter dose of each extract), and 8) STZ+metformin (100 mg/kg). Treatment was continued for 8 weeks and the after that, the behavioral tests related to learning and memory including Morris water maze (MWM) and passive avoidance (PA) were performed along with biochemical analysis associated with oxidative stress pathway and other related indicators.

Results

According to the results, all extracts demonstrated potential effect to ameliorate cognitive impairment caused by STZ in both MWM and PA tests along with attenuating oxidative stress indicators like malondialdehyde (MDA), while total thiol content and anti-oxidant enzyme activity like superoxide dismutase (SOD) and Catalase (CAT) remarkably increased in biochemical test results. Interestingly, the mixture of extracts illustrated much better results in ameliorating the brain-derived neurotrophic factor (BDNF), while attenuating the amyloid-B and glial fibrillary acidic protein (GFAP).

Conclusion

The present study demonstrated these extracts alone or in combination with a minimum dose have a strong potential to ameliorate learning and memory impairment induced by STZ along with lowering glucose levels by which they prevent or manage diabetes. It is noteworthy that the results matched those of metformin a well-known anti-diabetic drug.

Clinical Practices and Experiences about Screen Time: From the Perspective of Child and Adolescent Psychiatrists in Turkey - An Online Survey

Background

Both mental and physical preventable health problems related to screen time (ST) in children and adolescents are increasing. It is important that psychiatrists have awareness to prevent problems in this area.

Objective

The aim of our study was to evaluate the child psychiatrists' awareness about ST, their interventions for ST, and to what extent the recommendations of the associations are implemented.

Method

All child and adolescent psychiatrists in the country who could be reached via smartphone were invited to participate in the study. Child and adolescent psychiatrists were included regardless of whether they had attended any ST courses/panels. Data were collected through an online questionnaire. A total of 302 physicians volunteered for the study.

Results

It was determined that very few child and adolescent psychiatrists had attended an ST course/training in the past or followed any guidelines. A statistically significant difference was found between physicians who received training/courses and those who did not in terms of informing patients and offering interventions (p<0.05). Similarly, a significant difference was found between those who followed the guidelines and those who did not.

Conclusion

Raising awareness, increasing psychiatrist participation in trainings, and following guidelines can increase the effectiveness of ST interventions, in order to achieve good results.

Perceived stress and coping strategies among emergency department nurses and emergency medical services staff during the fifth wave of COVID-19 in Iran: A cross-sectional correlational study

Background and Purpose

Emergency department (ED) nurses and emergency medical services (EMS) staff as the main parts of care on the front line of treatment during the outbreak of COVID-19 experienced great challenges in their work and life, which caused them a lot of stress. Since limited studies have investigated perceived stress and coping strategies among ED nurses and EMS staff in Iran, this study was conducted to investigate perceived stress and coping strategies among ED nurses and EMS staff during the outbreak of the fifth wave of COVID-19 in Ardabil, Iran.

Materials and methods

This descriptive-analytical cross-sectional study was conducted on 327 ED nurses and EMS staff in 2021. The samples were selected by convenient sampling method, and data were collected by demographic and perceived stressors and coping strategies against the outbreak of COVID-19 questionnaires. Data were analyzed by SPSS (version 22) using descriptive (frequency, percentage, mean, and standard deviation) and analytical (Pearson correlation, t-test, and ANOVA) statistical tests and multiple linear regression analysis.

Results

The most stressful factors were related to the transmission of the disease to the family and seeing the death of COVID-19 patients in front of their eyes. The most commonly used coping strategies were strict personal protective measures for all hospitalized patients and the use of clothes that the hospital prepared separately to reduce the transmission of the virus. The results of multiple linear regression showed employees' emotions (β = 0.429, p < 0.001), gender (β = 0.225, p < 0.001), coping strategies (β = 0.209, p < 0.001), stress-reducing factors (β = 0.124, p = 0.014), worry (β = -0.182, p < 0.001), and workplace (β = -0.149, p = 0.045) were effective predictors of perceived stress.

Conclusion

Coping methods such as following strict personal protective measures, using special clothes, and seeing the recovery status of patients and colleagues were effective factors in reducing the perceived stress of health workers. Therefore, it is necessary to provide health workers with training on coping strategies and psychological support in the current crisis and possible epidemics in the future.

Reliability, validity, and psychometric properties of the Persian version of the Tayside children's sleep questionnaire

Tayside Children's Sleep Questionnaire (TCSQ) is a simple tool for screening the disorders of initiating and Maintaining Sleep among children aged between 1 and 5 years. This study aimed to translate TCSQ into Persian and evaluate its validity and reliability of TCSQ among Persian speakers. This cross-sectional study was conducted among 311 children aged 1-5 years in Isfahan. After permission, the forward-backward translation method was used to develop the Persian version. Finally, 311 children participated in this survey, which 30 were repeated a second time. Google Forms, SPSS16, and STATA14 were used for data collection, descriptive statistics, and factor analysis. BEARS questionnaire was used to assess concurrent validity. Three expert opinions were used for content validity. In this study, 404 mothers of children in Isfahan volunteered to participate in the survey, of which 311 remained. The mean and standard deviation age of their children were 3.47 ± 1.91 years. Cronbach Alpha of the Persian version of TCSQ was 0.76 CI (0.78-0.66). The intra-class correlation coefficient was 0.67 CI (0.60-0.74). The content validity index was 0.88, and three factors (disturbance, nighttime, parents) with a specific value greater than 0.4 is determined by factor analysis. The current study results indicate that TCSQ has good reliability and validity among Persian speakers.

Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults

BACKGROUND

Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety.

METHODS

The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality.

RESULTS

The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality.

CONCLUSION

Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.

Knowledge and its factors associated towards the prevention of COVID-19 among pregnant women in Ethiopia

Background

COVID-19 is caused by a single-stranded novel coronavirus that severely affects the respiratory system. The first human COVID-19 was reported in Wuhan city, China, in December 2019. Closing the gap and enhancing knowledge of pregnant women on COVID-19 prevention methods is crucial. However, the studies conducted in Ethiopia were inconsistent and non-conclusive. So, this review aimed to estimate the pooled knowledge prevalence on prevention of COVID 19 and factors associated among pregnant women in Ethiopia.

Methods

The data were extracted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We accessed studies through electronic web-based search from PubMed, Cochrane Library, and Google Scholar. We did all statistical analyses using STATA version 14 software with a random-effects model.

Results

Seven studies with 2,594 participants were included in this systematic review and the overall estimated status of assessment of knowledge towards prevention of COVID-19 among pregnant women in Ethiopia was 52.27% (31.60, 68.94). According to the region subgroup analysis, the highest ad the lowest estimated status of the knowledge is 85.34% in Jimma town and 19.01 in Metu town respectively in the Oromia region.

Conclusion

This systemic review showed that only half of the pregnant women in Ethiopia had good knowledge about COVID-19, and urban residence was significantly associated with knowledge towards the prevention of COVID-19 among pregnant women in this review. So, the responsible body better strengthen their awareness creation among rural residents and old-age pregnant women.

Validation of the Persian version of the Perinatal Anxiety Screening Scale (PASS) among antenatal and postnatal women

BACKGROUND

Anxiety disorder is more common in women than men. To some extent, it can be attributed to childbirth and factors related to pregnancy in women. Therefore, it is necessary for mothers to use valid and reliable scale to assess perinatal anxiety, such as the perinatal anxiety screening scale (PASS). The purpose of this study was to investigate the validity and reliability of the PASS in Persian language.

METHODS

The PASS was translated into Persian (PASS-IR). Generally, 224 women antenatal and 125 postnatal answered the questions of PASS, EPDS-10, BAI and DASS-21 questionnaires. The data was collected in the health centers of Kerman by random sampling method. Finally, content validity, factor analysis, internal consistency and test-retest reliability were evaluated.

RESULTS

The mean age of the participants was 32.89 years (range between 18 and 45 and SD = 6.23). More than half of the participating were at risk of severe anxiety (53.5%). Content Validity Index (CVI) and Content Validity Ratio (CVR) were 0.80 and 0.87. PASS-IR subscales include social anxiety and specific fears, general anxiety and adjustment, acute anxiety and trauma, and perfectionism and control. PASS-IR was significantly correlated with EPDS-10 (rho = 0.42), BAI (rho = 0.53), DASS-21 with three concepts of depression, anxiety and stress (rho = 0.51, rho = 0.49 and rho = 0.49), and adverse life events (rho = 0.30).

CONCLUSION

The results of this study show that PASS-IR has good validity and reliability. Therefore, it can be used to screen for anxiety disorder among Iranian women in the perinatal stage.

Research progress on molecular mechanisms of general anesthetic-induced neurotoxicity and cognitive impairment in the developing brain

General anesthetics-induced neurotoxicity and cognitive impairment in developing brains have become one of the current research hotspots in the medical science community. The underlying mechanisms are complex and involve various related molecular signaling pathways, cell mediators, autophagy, and other pathological processes. However, few drugs can be directly used to treat neurotoxicity and cognitive impairment caused by general anesthetics in clinical practice. This article reviews the molecular mechanism of general anesthesia-induced neurotoxicity and cognitive impairment in the neonatal brain after surgery in the hope of providing critical references for the treatments of clinical diseases.

Role of hippocampal circKcnk9 in visceral hypersensitivity and anxiety comorbidity of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by recurrent visceral pain and altered bowel habits (diarrhea or constipation). However, the molecular and pathological mechanisms are poorly understood. This study found neonatal colorectal distension to induce visceral hypersensitivity and anxiety. The expression of hippocampal circKcnk9, a novel circRNA, was significantly increased in IBS-like rats. Interestingly, CA1 shcircKcnk9 treatment inhibited long-term potentiation (LTP) and alleviated visceral hypersensitivity and anxiety in IBS-like rats, whereas overexpression of CA1 circKcnk9 induced LTP, visceral hypersensitivity, and anxiety in controls. Several experiments indicated that increased CA1 circKcnk9 acted as a miR-124-3p sponge, which resulted in the inhibitory effect of miR-124-3p on gene silencing. There was a negative correlation between circKcnk9 and miR-124-3p expression. As expected, CA1 administration of agomiR-124-3p decreased CA1 LTP, visceral hypersensitivity, and anxiety in the IBS-like rats. In contrast, CA1 treatment with antagomiR-124-3p induced LTP, visceral hypersensitivity, and anxiety in the controls. Furthermore, bioinformatic analysis and experimental data showed that EZH2 is a circKcnk9/miR-124-3p target gene, and increased EZH2 expression was involved in visceral hypersensitivity and anxiety in IBS-like rats by enhancing hippocampal synaptic plasticity. In conclusion, early life stress induces increased expression of circKcnk9 in the CA1 of IBS-like rats. Increased circKcnk9 expression regulates synaptic transmission and enhances LTP, leading to visceral hypersensitivity and anxiety in IBS-like rats. The underlying circKcnk9 signaling pathway is miR124-3p/EZH2. Increased circKcnk9 reinforces its sponging of miR124-3p and strongly suppresses miR124-3p activity, resulting in increased expression of the target gene EZH2. This study provides a new epigenetic mechanism for visceral hypersensitivity and anxiety in IBS-like rats.