Stress responses, pressure ulcer development and adaptation

Metalloproteinases as Biomarkers and Sociomarkers in Human Health and Disease

Metalloproteinases (MPs) are zinc-dependent enzymes with proteolytic activity and a variety of functions in the pathophysiology of human diseases. The main objectives of this review are to analyze a specific family of MPs, the matrix metalloproteinases (MMPs), in the most common chronic and complex diseases that affect patients' social lives and to better understand the nature of the associations between MMPs and the psychosocial environment. In accordance with the PRISMA extension for a scoping review, an examination was carried out. A collection of 24 studies was analyzed, focusing on the molecular mechanisms of MMP and their connection to the manifestation of social aspects in human disease. The complexity of the relationship between MMP and social problems is presented via an interdisciplinary approach based on complexity paradigm as a new approach for conceptualizing knowledge in health research. Finally, two implications emerge from the study: first, the psychosocial states of individuals have a profound impact on their overall health and disease conditions, which implies the importance of adopting a holistic perspective on human well-being, encompassing both physical and psychosocial aspects. Second, the use of MPs as biomarkers may provide physicians with valuable tools for a better understanding of disease when used in conjunction with "sociomarkers" to develop mathematical predictive models.

Interface pressure reduction effects of wheelchair cushions in individuals with spinal cord injury: a rapid review

OBJECTIVE

Wheelchair cushion is routinely used to manage the sitting acquired pressure for an individual with spinal cord injury, but which kind of wheelchair cushion performs better in terms of interface pressure management is unclear. This review aims to compare different kinds of wheelchair cushions on their effect of interface pressure reduction in individuals with spinal cord injury.

METHODS AND RESULTS

The databases of MEDLINE, CINAHL, EMBASE and Web of Science were searched. Totally 10 studies were included in this review. Seven of the included studies indicated that air cushions were superior to gel cushions in interface pressure reduction. Three of the included studies reported that gel cushions were superior to polyurethane foam cushions in interface pressure reduction. The variables of measurement duration, measurement focus, measurement devices, cushion covering, sample variations and body positioning of patients may confound the comparison of interface pressure reduction effect of different wheelchair cushions among studies.

CONCLUSIONS

Air cushion was reported more consistently effective in interface pressure reduction than gel and foam cushions. While the variable parameters (measurement duration, focus, devices) and individual conditions (BMI, body positioning) may interfere the comparison among studies. Researches disseminating consistent parameters and clinical prescriptions with individualized evaluation are suggested for the establishment of an evidence-based practice in clinic.Implications for rehabilitationWheelchair cushion is routinely used for an individual post spinal cord injury to manage the sitting acquired pressure.Which kind of wheelchair cushion performs better in terms of interface pressure management is unclear.Air cushion is found more consistently effective in interface pressure reduction than gel cushion and foam cushion.Individualized evaluation of the interface pressure is suggested for the prescription of wheelchair cushion in clinic.

Investigating stress, anxiety, social support and sex satisfaction on physical education and sports teachers during the COVID-19 pandemic

Academia was no exception to the widespread impact of Coronavirus Disease (COVID-19). There is only a small amount of research conducted with regard to the consequences of the Pandemic in Fiji. Thus, in order to gather a longitudinal dataset, a cross-sectional survey was conducted from February to August 2020. 300 physical education and sports teachers used Google Forms to complete an online survey. There are questions on the form about age, gender, marital status, and other daily activities. A similar survey was conducted to study the long-term psychological effects (coronavirus fear and fascination with COVID-19). The characteristics of society have been explored. Efforts have been made to use different sets of psychological data, showing the anticipated results. Sex, age, marital status, and family type are significantly affected by stress, anxiety, sexual satisfaction, and social support. There is a substantial difference between marital status, gender, and social support when it comes to the Pandemic. According to research findings, fifty per cent of secondary school physical education and sports teachers in Fiji may have been affected by the Pandemic. Considerations should be taken to keep teachers calm during a pandemic. Because of this, it is necessary to submit some practical recommendations in order to minimize the adverse effects of this problem.

The Impact of Stress on Pressure Ulcer Wound Healing Process and on the Psychophysiological Environment of the Individual Suffering from them

Introduction:

The occurrence of a pressure ulcer constitutes a major psychological and physiological burden and it has been linked with a reduced quality of life and increased stress of the individual.

Objective:

The main objective was to investigate the impact that stress has on pressure ulcer healing process and on the psychophysiological environment of the individual suffering from them.

Method:

The scientific literature was reviewed through Cinahl, Pub-med, EBSCO, Medline and Google scholar. The articles were chosen due to their direct correlation with the objective under study and their scientific relevance.

Results:

Increased stress has been demonstrated to increase the glucocorticoids levels affecting negatively the production of wound healing cytokines (IL1α, IL1β and TNFα). Matrix metalloproteases has been identified to be unregulated in occasions of increased stress in acute wounds. Stress has also been correlated with poor health behaviors that may not have a direct link on the wound healing process, although they can in part explain or enhance some of the effects of stress on wound healing.

Conclusion:

The correlation between stress and wound healing in acute wounds has been thoroughly investigated and its negative effects have been established. The presence of a pressure ulcer can have a detrimental impact on the stress level of an individual although further investigation is needed to establish the role of stress in chronic wounds such as pressure ulcers.

Exploring Resilience When Living with a Wound - An Integrative Literature Review

The psychological impact for patients with wounds can be significant, and adverse psychological effects frequently occur when there are permanent changes in the body’s structure or function. Evidence suggests that anxiety, depression and stress can adversely affect the wound healing process. An integrative review examined any paper that discussed any patient in any health care setting who had experienced a psychological impact from the experience of having a wound and the experience of being resilient in that context. Ninety nine papers were located in the initial search with twelve meeting the inclusion criteria and being reviewed. A review of the papers identified that improvement and maintenance of quality of life was perceived to be an important aspect of patient management, but none focused on resilience as a primary endpoint. Further research is required into the clinical benefits of resilient behaviours in patients living with a wound.

ATHENA: a personalized platform to promote an active lifestyle and wellbeing based on physical, mental and social health primitives

Technology provides ample opportunities for the acquisition and processing of physical, mental and social health primitives. However, several challenges remain for researchers as how to define the relationship between reported physical activities, mood and social interaction to define an active lifestyle. We are conducting a project, ATHENA(activity-awareness for human-engaged wellness applications) to design and integrate the relationship between these basic health primitives to approximate the human lifestyle and real-time recommendations for wellbeing services. Our goal is to develop a system to promote an active lifestyle for individuals and to recommend to them valuable interventions by making comparisons to their past habits. The proposed system processes sensory data through our developed machine learning algorithms inside smart devices and utilizes cloud infrastructure to reduce the cost. We exploit big data infrastructure for massive sensory data storage and fast retrieval for recommendations. Our contributions include the development of a prototype system to promote an active lifestyle and a visual design capable of engaging users in the goal of increasing self-motivation. We believe that our study will impact the design of future ubiquitous wellness applications.

The change in the amount of immunoglobulins as a response to stress experienced by soldiers on a peacekeeping mission

PURPOSE

Recent studies have demonstrated various changes in systemic and mucosal immunity in people undergoing psychological stress. This study was designated for an assay of associations between the stress experienced by Lithuanian soldiers as a response to changed job conditions (deployment to Afghanistan) and level of immunoglobulins. Salivary and sera immunoglobulin concentrations were assessed and compared before and after the military mission; the associations between the deployment-related stress and the immunoglobulin level were examined.

METHODS

Special questionnaires covering state of health and strain experienced were used. Quantitative detection of immunoglobulins was performed by sandwich ELISA.

RESULTS

Comparison of the medians at three time points (before, after the deployment and 1 year after the mission) showed an increased level of salivary secretory immunoglobulin A (S-IgA) in association with deployment. Chi-square test of independence indicated statistically significant relationship between the stress and S-IgA amount. Correlation analysis using different health control methods revealed masked fear of soldiers to be expelled from the military service.

CONCLUSIONS

The results indicated that salivary S-IgA is the most sensitive representative of mucosal immunity system to psychological stress related to changed job conditions in military service.

Modulation of immune responses in stress by Yoga

Stress is a constant factor in today's fastpaced life that can jeopardize our health if left unchecked. It is only in the last half century that the role of stress in every ailment from the common cold to AIDS has been emphasized, and the mechanisms involved in this process have been studied. Stress influences the immune response presumably through the activation of the hypothalamic-pituitary adrenal axis, hypothalamic pituitary-gonadal axis, and the sympathetic-adrenal-medullary system. Various neurotransmitters, neuropeptides, hormones, and cytokines mediate these complex bidirectional interactions between the central nervous system (CNS) and the immune system. The effects of stress on the immune responses result in alterations in the number of immune cells and cytokine dysregulation. Various stress management strategies such as meditation, yoga, hypnosis, and muscle relaxation have been shown to reduce the psychological and physiological effects of stress in cancers and HIV infection. This review aims to discuss the effect of stress on the immune system and examine how relaxation techniques such as Yoga and meditation could regulate the cytokine levels and hence, the immune responses during stress.

Computer-mediated emotional regulation: detection of emotional changes using non-parametric cumulative sum

It has been demonstrated that negative emotions have adverse effects on the immune system of a person. This contributes to increased morbidity and mortality in the elderly population and has a direct impact on quality of life. Positive emotions on the other hand may not only undo the harmful effects of negative emotions but also protect against certain diseases. Hence the use of technology to facilitate emotional regulation that reduces negative emotions may be a good way to promote self-care and support well-being. In this paper we present the early design stages of an emotion detection system that aims to support remote support and self-regulation in situations of intense emotional distress. We provide evidence of the suitability of non-parametric cumulative sum (CUSUM) to indentify emotional changes from neutral to non-neutral and vice versa in real time.

Stress and social support

BACKGROUND

This is an experimental study and it discusses the effectiveness of social support in managing academic stress among students.

AIM

The purpose of this study is to understand the importance of social support in managing stress.

MATERIALS AND METHODS

Simple random sampling was assigned to a number of 120 students, equally divided into an experimental and a control group. Classes on social support as coping mechanisms were given to the experimental group only. The accumulated data were then analyzed, descriptive statistics were used to interpret and evaluate the prevalence of academic stress, and social support. Correlation analysis was employed in the examination of the relationship between stress and social support.

RESULTS

The findings of this study indicate that there are significant differences between the experimental group and the control group in relation to stress and social support. Eventually, the experimental group proved to cope with academic stress better than the control group, and they were satisfied with their academic performance during the experimentation.

CONCLUSION

Hence, it is highly advisable to encourage the students to use social support as coping mechanisms.

Men's perception of fatigue when newly diagnosed with localized prostate cancer

OBJECTIVES

Cancer is a complicated issue both medically and psychosocially, and the process of the disease affects the whole human being. Fatigue is the commonest symptom associated with cancer and its treatment. Prostate cancer is the third commonest male cancer worldwide and the leading cause of male cancer death. The aims of this study were: (i) to identify whether fatigue is found in men with newly diagnosed localized prostate cancer (predominantly early-stage, very low tumour burden asymptomatic patients); and (ii) to gain a perception of whether fatigue has an influence on these men and to try to find out what the cause of this fatigue was.

MATERIAL AND METHODS

Sixteen men who had been newly diagnosed with localized prostate cancer were interviewed to determine whether fatigue is experienced by such men and whether it has an effect on them. Verbal transcripts were analyzed using hermeneutical interpretation.

RESULTS

Five equivalent fusions were identified according to the time when the participants received their diagnosis of early-stage prostate cancer. These fusions occurred successively, in three steps. The first step was Enclosing Intrapersonal Emotions and Enclosing Interpersonal Attachments, when the men were living in a kind of vacuum. Moving onto step two, another two fusions were triggered and contributed to a positive attitude: Reopening Intrapersonal Emotions and Reopening Interpersonal Attachments. Finally, at step three, a unifying fusion was identified: Living with a New Perspective. This study provides insights and new knowledge indicating that prostate cancer does not in itself cause fatigue.

CONCLUSIONS

The clinical implications of these findings are that it is not possible to handle new and detailed information about prostate cancer at the first visit. The need for information occurs, however, relatively soon afterwards and it would seem appropriate to offer a new appointment within 1 week of the first visit.

Acceptance and denial: implications for people adapting to chronic illness: literature review

AIM

This paper reports an exploration of the terms acceptance and denial by exploring the literature, with the aim of understanding the implications of using these concepts to categorize people's responses to living with chronic illness.

BACKGROUND

People learning to live with a chronic illness or condition may be judged and labelled by others as being in denial, particularly when they do not adhere to prescribed treatment regimes.

METHOD

A literature search for the period between 1989 and 2003 was conducted using the electronic databases Medline, CINAHL, PSYCArticles, Health Source Nursing/Academic Edition, Academic Search Elite and Sociological Abstracts. Key terms used were 'acceptance and denial' and variations of such themes as 'chronic illness', 'disability', 'adjustment', 'illness discourse', 'medical discourse', 'illness experience', 'labelling', 'self' and 'identity'.

DISCUSSION

The theoretical background of the common constructs 'acceptance and denial' are discussed using the psychoanalytic theories of Freud and Kubler-Ross's work on death and dying. Healthcare professionals and lay people commonly refer to the terms acceptance and denial when describing a person's response to chronic illness. Those whose understanding of the illness experience relies on the acceptance-denial framework may not listen when people with chronic illness attempt to tell their own unique story of how they have experienced life with illness. Instead, their listening antennae may be focused on fitting aspects of the experience with stages of adjustment. When others use labels of acceptance and denial, people who are learning to live with a chronic illness may internalize these labels as reflections of the self. This may be most likely when the person using the label is perceived to have authority, such as a healthcare professional. The internalization of negative information associated with these labels may obstruct the reshaping of self-identity that is fundamental when making a transition to living well with chronic illness.

CONCLUSION

Healthcare professionals are urged to challenge the stage model of adjustment as a way of understanding the response to illness and to listen instead to the stories people tell. They are encouraged to privilege the person's experience as the basis for developing a sensitive, client-focussed response that takes into account the wider social context of people's lives as well as the medical aspects.

Analysis of the mechanisms of rabbit’s brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane

AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane.

METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model. Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve.

RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage. Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure.

CONCLUSION: Brainstem hemorrhage could cause intracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.