Panic disorder during pregnancy: A scoping review

Background

Panic Disorder is a serious anxiety disorder, and one of the severe mental problems that impacts mothers' mental health and fetal health as well.

Aim

The current scoping review aims to provide a wide overview of the literature regarding panic disorder during pregnancy.

Methods

Twenty-five eligible articles were selected for full review from SAGE, CINAHL, PubMed, Medline, Research Gate, Science Direct, and Google Scholar literature searches. This review followed the framework suggested by Arksey and O'Malley for a scoping review.

Results

Content analysis of the studies was done, and five categories have been identified: Panic disorder course during pregnancy; prevalence of panic disorder during pregnancy; factors associated with pregnancy panic disorder; impact of panic disorder during pregnancy; and treatment of panic disorder during pregnancy.

Conclusion

A significant gap in the literature, and inconsistent and mixed findings regarding prevalence, impact, associated factors, and treatment of PD during pregnancy exist. This scoping review revealed that more studies need to be conducted to further understand and examine PD during pregnancy.

Emerging effects of temperature on human cognition, affect, and behaviour

Human body core temperature is tightly regulated within approximately 37 °C. Global near surface temperature has increased by over 1.2 °C between 1850 and 2020. In light of the challenge this poses to human thermoregulation, the present perspective article sought to provide an overview on the effects of varying ambient and body temperature on cognitive, affective, and behavioural domains of functioning. To this end, an overview of observational and experimental studies in healthy individuals and individuals with mental disorders was provided. Within body core temperature at approximately 37 °C, relatively lower ambient and skin temperatures appear to evoke a need for social connection, whereas comparably higher temperatures appear to facilitate notions of other as closer and more sociable. Above-average ambient temperatures are associated with increased conflicts as well as incident psychotic and depressive symptoms, mental disorders, and suicide. With mild hypo- and hyperthermia, paradoxical effects are observed: whereas the acute states are generally characterised by impairments in cognitive performance, anxiety, and irritability, individuals with depression experience longer-term symptom improvements with treatments deliberately inducing these states for brief amounts of time. When taken together, it has thus become clear that temperature is inexorably associated with human cognition, affect, and (potentially) behaviour. Given the projected increase in global warming, further research into the affective and behavioural sequelae of heat and the mechanisms translating it into mental health outcomes is urgently warranted.

Socioeconomic and geographic variations of disabilities in India: evidence from the National Family Health Survey, 2019-21

BACKGROUND

Increasing disability is of global and national concern. Lack of evidence on disability across socioeconomic groups and geographic levels (especially small areas) impeded interventions for these disadvantaged subgroups. We aimed to examine the socioeconomic and geographic variations in disabilities, namely hearing, speech, visual, mental, and locomotor, in Indian participants using cross-sectional data from the National Family Health Survey 2019-2021.

METHODS

Using data from 27,93,971 individuals, we estimated age-sex-adjusted disability rates at the national and sub-national levels. The extent of socioeconomic variations in disabilities was explored using the Erreygers Concentration Index and presented graphically through a concentration curve. We adopted a four-level random intercept logit model to compute the variance partitioning coefficient (VPC) to assess the significance of each geographical unit in total variability. We also calculated precision-weighted disability estimates of individuals across 707 districts and showed their correlation with within-district or between-cluster standard deviation.

RESULTS

We estimated the prevalence of any disability of 10 per 1000 population. The locomotor disability was common, followed by mental, speech, hearing, and visual. The concentration index of each type of disability was highest in the poorest wealth quintile households and illiterate 18 + individuals, confirming higher socioeconomic variations in disability rates. Clusters share the largest source of geographic variation for any disability (6.5%), hearing (5.8%), visual (24.3%), and locomotor (17.4%). However, States/Union Territories (UTs) account for the highest variation in speech (3.7%) and mental (6.5%) disabilities, where the variation at the cluster level becomes negligible. Districts with the highest disability rates were clustered in Madhya Pradesh, Maharashtra, Karnataka, Tamil Nadu, Telangana, and Punjab. Further, we found positive correlations between the district rates and cluster standard deviations (SDs) for disabilities.

CONCLUSIONS

Though the growing disability condition in India is itself a concerning issue, wide variations across socioeconomic groups and geographic locations indicate the implementation of several policy-relevant implications focusing on these vulnerable chunks of the population. Further, the critical importance of small-area variations within districts suggests the design of strategies targeting these high-burden areas of disabilities.

Gender differences in long term sickness absence

PURPOSE

Sickness absence is a major public health problem, given its high cost and negative impact on employee well-being. Understanding sickness absence duration and recovery rates among different groups is useful to develop effective strategies for enhancing recovery and reducing costs related to sickness absence.

METHODS

Our study analyzed data from a large occupational health service, including over 5 million sick-listed employees from 2010 to 2020, out of which almost 600,000 cases were diagnosed by an occupational health physician. We classified each case according to diagnosis and gender, and performed descriptive statistical analysis for each category. In addition, we used survival analysis to determine recovery rates for each group.

RESULTS

Mean sickness duration and recovery rate both differ significantly among groups. Mental and musculoskeletal disorders had the longest absence duration. Recovery rates differed especially during the first months of sickness absence. For men the recovery rate was nearly constant during the first 1.5 year, for women the recovery rate was relatively low in the first three months, and then stayed nearly constant for 1.5 year.

CONCLUSION

Across almost all diagnostic classes, it was consistently observed that women had longer average sickness absence durations than to men. Considering mental disorders and diseases of the musculoskeletal system, women had relatively lower recovery rates during the initial months compared to men. As time progressed, the recovery rates of both genders converged and became more similar.

Global google trends for construction demonstrate low search volume index for stress, mental and suicide

The comparison of Google internet searches for English words in construction for "construction stress", "construction mental" and "construction suicide" with reference to "construction worker" has not previously been undertaken. It is important to understand internet interest across these 3 terms as all are relevant to mental health and stress in construction. Suicide risk is significantly complex and multifactorial. Our aim is to investigate internet search interest across construction with a focus on mental, stress and suicide, and determine whether there is consistent interest across these search terms.

METHODS

Using Google Trends, data on global search queries we compared "construction mental" or "construction stress" and "construction suicide". Two time periods were compared, the last 5 years and the last 24 months, both till December 8th, 2022. The relationship between web search interest, reflected by search volume index (SVI) for society and community versus the business and industrial category and health category were evaluated.

RESULTS

Open category searches on Google trends for the key words "construction mental" or "construction stress" demonstrated moderate SVI peaks over a 5-year period. Sub-group analyses for the industrial and business category demonstrated consistent low interest in suicide compared to search terms related to stress or mental health.

CONCLUSION

There is limited online interest in construction mental and stress and even less interest in suicide.

Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study

BACKGROUND

Addiction to smart phones is classified clinically as behavioral addiction resulted from an excessive problematic usage of smart phones that effect the daily life of the users. Therefore, this study aims to explore the prevalence of smart phone addiction, its associated psychological distress risk, and its associated predictors among university students in Jordan.

METHODS

Between November 2022 and January 2023, a cross-sectional online survey study was conducted in Jordan. In this study, we used previously developed questionnaire instruments, the psychological Distress scale of Kessler and the Smartphone Addiction Scale. A score of 30 was used to identify the dummy variable in the binary logistic regression analysis to identify predictors of severe psychological distress, and smartphone addiction score of 38.7 was used to to identify predictors of smartphone addiction.

RESULTS

A total of 2337 university students participated in this study. The mean psychological distress score for the study participants was 30.0 (SD: 8.9). More than half of the study participants (59.1%) had a psychological distress score of 30 and above, which indicates a severe mental disorder state. More than half of the study participants (56.7%) had a smartphone addiction score of 30 and above, which reflects a smartphone addiction state. Females, divorced, those who feel that their mental abilities have been negatively affected by the use of smart phones, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to have severe psychological distress compared to others (p < 0.05). Females, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to be smartphone addicted compared to others (p < 0.05).

CONCLUSION

Mental diseases are a major public health concern in Jordan, especially among university students. Females, those who thought smartphone usage hurt their mental capacities, and those who had trouble sleeping and fatigue were more likely to develop serious psychological discomfort and smartphone addiction. Smartphones are indispensable, but excessive use can lead to addiction and harm university students' mental health.

Evaluation the validity and reliability of persian short form of the literacy of suicide scale (LOSS): a methodological study in 2022

INTRODUCTION

This research was conducted with the aim of evaluating the validity and reliability of Persian short version of the Literacy of Suicide Scale (LOSS) among the general population.

METHODS

This methodological study was conducted to evaluate the validity and reliability of Persian short form of LOSS among the general population, using a sample of 1175 participants in Iran, 2022. Participants were entered to study using method of proportional stratified sampling. The validity of Persian short form of LOSS was checked by four measures of validity: qualitative face validity, qualitative content validity, EFA (exploratory of factor analysis), and CFA (confirmatory factor analysis). The measure of reliability of Persian short form of LOSS was checked by three reliability of McDonald omega coefficient, ICC (Intraclass Correlation Coefficient), and Cronbach's alpha coefficient.

RESULTS

Based on the findings of EFA, 4 components with eigenvalues > 1 were extracted and these 4 factors were able to explain 57.96% of variance. In EFA section, only 1 question was deleted due to entry into the non -relevant sub -scale. Based on the results of CFA, all items had the factor loading greater than 0.4 and none of the items were removed at this stage. In CFA, based the results of goodness-of-fit indexes for example: χ2/df = 2.077, NFI: 0.957, IFI = 0.977, RMSEA = 0.030, GFI: 0.988, and PGFI = 0.569, the final mode was approved with 11 items and 4 factors. In this study for all items, Cronbach's alpha coefficient was 0.739, McDonald omega coefficient was 0.753, and ICC was 0.860. Finally, the Persian short form of LOSS was approved with 11 items and four dimensions of signs/ symptoms with 3 questions, the risk factors with 2 questions, treatment/ prevention with 2 questions, and causes/ triggers with 4 questions.

CONCLUSION

The Persian short form of LOSS with 11 items and four subscales is a valid and reliable scale to survey the suicide literacy status in the general population.

Immigrants: A Systematic Review

Structural and cultural barriers have led to limited access to and use of mental health services among immigrants in the United States (U.S.). This study provided a systematic review of factors associated with help-seeking attitudes, intentions, and behaviors among immigrants who are living in the U.S. This systematic review was performed using Medline, CINAHL, APA PsycInfo, Global Health, and Web of Science. Qualitative and quantitative studies examining mental help-seeking among immigrants in the U.S. were included. 954 records were identified through a search of databases. After removing duplicates and screening by title and abstract, a total of 104 articles were eligible for full-text review and a total of 19 studies were included. Immigrants are more reluctant to seek help from professional mental health services due to barriers such as stigma, cultural beliefs, lack of English language proficiency, and lack of trust in health care providers.

Internal consistency reliability of mental health questionnaires in college student athletes

OBJECTIVES

To examine the internal consistency reliability and measurement invariance of a questionnaire battery designed to identify college student athletes at risk for mental health symptoms and disorders.

METHODS

College student athletes (N=993) completed questionnaires assessing 13 mental health domains: strain, anxiety, depression, suicide and self-harm ideation, sleep, alcohol use, drug use, eating disorders, attention deficit hyperactivity disorder (ADHD), bipolar disorder, post-traumatic stress disorder (PTSD), gambling and psychosis. Internal consistency reliability of each measure was assessed and compared between sexes as well as to previous results in elite athletes. Discriminative ability analyses were used to examine how well the cut-off score on the strain measure (Athlete Psychological Strain Questionnaire) predicted cut-offs on other screening questionnaires.

RESULTS

Strain, anxiety, depression, suicide and self-harm ideation, ADHD, PTSD and bipolar questionnaires all had acceptable or better internal consistency reliability. Sleep, gambling and psychosis questionnaires had questionable internal consistency reliability, although approaching acceptable for certain sex by measure values. The athlete disordered eating measure (Brief Eating Disorder in Athletes Questionnaire) had poor internal consistency reliability in males and questionable internal consistency reliability in females.

CONCLUSIONS

The recommended mental health questionnaires were generally reliable for use with college student athletes. To truly determine the validity of the cut-off scores on these self-report questionnaires, future studies need to compare the questionnaires to a structured clinical interview to determine the discriminative abilities.

Expanding the social lens: A quantitative study of the developmental theory of embodiment

The developmental theory of embodiment (DTE) is a research-based theory of social factors that shape the experience of embodiment, a construct that is strongly correlated with body esteem and body appreciation. The DTE is anchored in prospective and retrospective qualitative research studies with cisgender girls and women of diverse backgrounds. This paper describes the first comprehensive quantitative study of factors in the social environment the DTE delineates as shaping the experience of embodiment involving a cross-sectional design, among 412 cisgender women. The 13 quantitative social factors correlated positively with the Experience of Embodiment Scale and accounted together for over 60% of its score variance. The findings of significant positive correlations between all social factors and of a large shared variance amongst these factors in a simultaneous multiple regression predicting the experience of embodiment are in line with the DTE and with a multi-level model of causality central to public health perspectives, whereby social structures and positions, such as those related to gender, shape multiple lower-level protective and risk factors. Future studies of the theory should include prospective designs with samples of varied backgrounds along different dimensions of social location.

Multicentre evaluation of anxiety and mood among collegiate student athletes with concussion

Objectives

Mental health problems are a premorbid and postinjury concern among college student athletes. Clinical phenotypes of anxiety and mood disruption are prevalent following mild traumatic brain injury, including concussion, a common sports injury. This work examined whether concussed student athletes with a history of mental health problems and higher symptoms of anxiety and mood disruption at baseline were more likely to have higher postinjury reports of mood and anxiety as well as prolonged resolution of postconcussive symptoms to near-baseline measures.

Methods

This was a retrospective cohort study of a multi-institutional database of standardised baseline and postinjury assessments among college student athletes. Anxiety/mood evaluation data among varsity college athletes from four institutions over 1 year were measured and compared at baseline and postconcussion recovery using descriptive statistics and multilevel/mixed-effects analysis.

Results

Data from 2248 student athletes were analysed, with 40.6% reporting at least one symptom of anxiety and/or mood disruption at baseline. Of the 150 distinct concussions, 94.7% reported symptoms of anxiety/mood disruption during recovery (recovery time=0-96 days). Higher anxiety/mood scores at baseline were significantly associated with higher scores following concussion (p<0.001). Recovery trajectories of anxiety/mood scores showed different patterns by sex and prolonged recovery.

Conclusion

Symptoms of anxiety and mood disruption are common at baseline among college student athletes. These students are at higher risk for symptomatology following injury, representing a screening cohort that may benefit from early counselling. Almost all student athletes will experience symptoms of anxiety and/or mood disruption following concussion.

Associations between health problems and athlete burnout: a cohort study in 210 adolescent elite athletes

Objectives

We studied associations between the burden of health problems and athlete burnout in a population of athletes from Norwegian Sport Academy High Schools.

Methods

This is a mixed prospective/retrospective cohort study. We included 210 athletes, 135 boys and 75 girls, from endurance, technical and team sports. We used the Oslo Sports Trauma Centres Questionnaire for Health Problems to collect 124 weeks of health data. During the first 26 weeks, athletes reported the health data prospectively using a smartphone app. For the following 98 weeks, we collected health data by interviewing athletes at the end of their third year in Sport Academy High School. At the time of the interview, the athletes also completed a web-based questionnaire, including the Athlete Burnout Questionnaire and covering social relations in sports and school, coach relations and living conditions.

Results

A greater burden of health problems was associated with a higher score for athlete burnout (B: 0.16, 95% CI 0.09 to 0.22, p<0.001). In a multivariable model, this was true for both illnesses (B: 0.21, 95% CI 0.10 to 0.32, p<0.001), acute injuries (B: 0.16, 95% CI 0.04 to 0.27, p=0.007) and overuse injuries (B: 0.10, 95% CI 0.002 to 0.18, p=0.011). This was also true in gender and sports category subgroups. The coach having a high influence on training week was associated with a lower score for athlete burnout.

Conclusion

A greater burden of health problems was associated with greater symptoms of athlete burnout in athletes attending Sport Academy High Schools.

Van Gilder-Pierce

Due to lack of mental healthcare facilities in rural areas, the population often resorts to private practice practitioners to address their need for mental health services. Dr. Taryn S. Van Gilder-Pierce and her husband, Dr. William D. Pierce founded their private practice in Yankton, SD in 2001. She has more than 25 years of training and experience treating individuals, married couples, families, and groups in rural South Dakota. The interview delves into the challenges faced by early career professionals in building a practice in remote areas and extends into the room for expansion within the field of rural mental health provision of services.

Should All Minimal Access Surgery Be Robot-Assisted? A Systematic Review into the Musculoskeletal and Cognitive Demands of Laparoscopic and Robot-Assisted Laparoscopic Surgery

BACKGROUND

Surgeons are among the most at risk of work-related musculoskeletal health decline because of the physical demands of surgery, which is also associated with cognitive fatigue. Minimally invasive surgery offers excellent benefits to patients but the impact of robotic or laparoscopic surgery on surgeon well-being is less well understood. This work examined the musculoskeletal and cognitive demands of robot-assisted versus standard laparoscopic surgery.

METHODS

Medline, Embase and Cochrane databases were systematically searched for 'Muscle strain' AND 'musculoskeletal fatigue' AND 'occupational diseases' OR 'cognitive fatigue' AND 'mental fatigue' OR 'standard laparoscopic surgery' AND 'robot-assisted laparoscopic surgery'. Primary outcomes measured were electromyographic (EMG) activity for musculoskeletal fatigue and questionnaires (NASA-TLX, SMEQ, or Borg CR-10) for cognitive fatigue. A systematic review was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) Guidelines. The study was preregistered on Prospero ID: CRD42020184881.

RESULTS

Two hundred and ninety-eight original titles were identified. Ten studies that were all observational studies were included in the systematic review. EMG activity was consistently lower in robotic than in laparoscopic surgery in the erector spinae and flexor digitorum muscles but higher in the trapezius muscle. This was associated with significantly lower cognitive load in robotic than laparoscopic surgery in 7 of 10 studies.

CONCLUSIONS

Evidence suggests a reduction in musculoskeletal demands during robotic surgery in muscles excluding the trapezius, and this is associated with most studies reporting a reduced cognitive load. Robotic surgery appears to have less negative cognitive and musculoskeletal impact on surgeons compared to laparoscopic surgery.

Assessment of dropout rates in the preclinical years and contributing factors: a study on one Thai medical school

BACKGROUND

The highest dropout rate for medical students is during the preclinical years of education. Several studies have reported possible contributing factors, however, studies regarding the dropout rate from medical education among Thai medical students and its associated factors are still lacking. This study aimed to identify the prevalence of dropout from medical education within the preclinical period and its associated factors among Thai medical students.

METHODS

We collected data from preclinical medical students who entered one medical school in Bangkok, Thailand, between 2017-2019. Demographic data, admission program, pre-admission mental health status assessed by the Thai Mental Health Indicator 66, mental health records from the faculty-based counseling services, and academic achievement were extracted. Data were reported in a descriptive fashion. We analyzed the association between dropout and these factors by robust Poisson regression.

RESULTS

In total, 914 students were recruited. Dropout was only 1.5%, which was lower than the previous studies. Regression analysis showed a significant association between dropout and mental health problems [Prevalence ratio (PR) 58.20, 95%CI 13.72- 246.95] but not admission program [PR 0.32, 95%CI 0.09 - 1.16] or failing examinations [PR 0.59, 95%CI 0.18 - 1.90]. However, other contributing factors such as financial status, family problems, medical illness, and students' motivation, were not evaluated in this study.

CONCLUSIONS

Mental health problems during medical education were associated with dropout after adjusting for other confounding variables. Further longitudinal studies are needed to identify the impacts of academic failure on dropout in higher clinical years.

Associations between mental and physical conditions in children and adolescents: An umbrella review

We mapped the evidence on the type and strength of associations between a broad range of mental and physical conditions in children and adolescents, by carrying out an umbrella review, i.e., a quantitative synthesis of previous systematic reviews and meta-analyses. We also assessed to which extent the links between mental and physical conditions vary across disorders or, by contrast, are transdiagnostic. Based on a pre-established protocol, we retained 45 systematic reviews/meta-analyses, encompassing around 12.5 million of participants. In analyses limited to the most rigorous estimates, we found evidence for the following associations: ADHD-asthma, ADHD-obesity, and depression-asthma. A transdiagnostic association was confirmed between asthma and anxiety/ASD/depression/bipolar disorder, between obesity and ADHD/ASD/depression, and between dermatitis and ASD/ADHD. We conclude that obesity and allergic conditions are likely to be associated with mental disorders in children and adolescents. Our results can help clinicians explore potential links between mental and physical conditions in children/adolescent and provide a road map for future studies aimed at shading light on the underlying factors.

Eco-crisis and mental health of children and young people: Do child mental health professionals have a role?

Child mental health professionals have an extremely important role to play in their distinct roles as clinicians, therapists, researchers, policy makers, advocates, preventative public health professionals and service developers pertaining to eco-crisis in the child and adolescent populations. This article provides examples of how this can be done.

Health conditions among retired professional footballers: a scoping review

Objective

To conduct a scoping review providing an overview of the health conditions occuring in retired male and female professional footballers, with an emphasis on musculoskeletal, mental, neurocognitive, cardiovascular and reproductive health conditions.

Methods

In January 2022, a comprehensive systematic literature search in three databases (MEDLINE via PubMed, SPORTDiscus via EBSCOhost and EMBASE) was conducted for common health conditions among retired male and female professional footballers. Primary research studies (full text available online) which described the incidence or prevalence of a health condition (musculoskeletal, mental, neurocognitive, cardiovascular, reproductive) among retired male and female professional footballers were included for review. Case reports, qualitative research and grey literature were omitted.

Results

In total, 917 eligible articles were identified from the databases, with 41 meeting the eligibility criteria. Osteoarthritis of the hip, knee and ankle were found to be common among retired professional footballers. Mental health symptoms (eg, anxiety, depression) are experienced by retired male and female professional footballers. The incidence of neurocognitive disease appears to be higher among retired male professional footballers than among matched controls. There is very limited evidence examining the presence of health conditions in retired female professional footballers.

Conclusion

Osteoarthritis of the lower limb, musculoskeletal pain and mental health symptoms are common among retired professional footballers. Knowledge about the occurrence and timing of musculoskeletal, mental health and neurocognitive conditions among retired professional footballers can be used by a wide range of stakeholders to proactively intervene during and after a player’s career to mitigate risk.

Improving young pig welfare on-farm: The Five Domains Model

Considering welfare through the "neonatal and nursery pig perspective" is an exciting approach, and one that resonates with consumers. Overlaying this with the Five Domains Model, as we suggest in this review, points to practical on-farm improvements that provide each pig the opportunity to experience positive mental states. The Five Domains Model is broken into physical and functional states, that includes Domain 1 Nutrition, Domain 2 Physical Environment, Domain 3 Health and, Domain 4 Behavioral Interaction, and Domain 5 Mental State. The Five Domains Model can build on the breadth and depth of swine welfare science to highlight opportunities to improve welfare on-farm. In Domain 1 management of increasingly large litters is considered, with examples of sow vs. artificial rearing, colostrum quality and quantity, and creep feed management strategies. Efforts can result in positive mental states such as feeling full and content and the ability to experience pleasure of drinking and food tastes/smells. Domain 2 considers space complexity and access to key resources, along with thermal and physical amenities, to promote feelings of physical comfort. Domain 3 considers pig health in three broad, yet inter-linking categories, (a) congenital and hereditary health, (b) environmental pathogen load and, (c) colostrum quality and quantity, and its effect on the microbiome. Improvements can result in a pig that displays vitality and feels healthy. Domain 4 provides the pig opportunities to express its rich behavioral repertoire, specifically positive social interactions, play, and exploration. These efforts can result in pigs feeling calm, safe, comfortable, having companionship, engaged, interested and rewarded. In conclusion, using the Five Domains Model can highlight numerous opportunities to improve current and future housing and management through the "neonatal and nursery pig perspective" with a focus on inducing positive mental states that can result in improved quality of life and welfare state.

Children in the Blind Spot of Social Medical Concerns: Supporting Children with Mentally Ill Parents in Korea

Children whose parents have mental disorders are more likely to be vulnerable and exposed to an environment where they may not be cared for by parents or guardians in Korea. Particularly, young children often develop mental disorders or maladaptive behaviors. This study aimed to implement a structured program to enhance the resilience of school-aged children whose parents have mental disorders and to analyze its effectiveness through a single-group pretest-posttest experimental design. The Korean Child Personality Inventory for Self-Report self-resilience and clinical scales were used, and daily behavioral observation logs showed decreases in psychosis scores among all children, anxiety scores among girls, and somatization and physical development among boys. Self-efficacy, social competency, and acceptance toward families increased. Therefore, the improvement of resilience and clinical symptoms was confirmed through this program, suggesting it should be expanded and developed in local community healthcare sites to help support children with mentally ill parents.

A systematic review of questionnaires assessing the psychological impact of COVID-19

The COVID-19 pandemic has led to a number of complications in everyday life, greatly affecting public health. Estimating its impact on mental health constitutes a priority issue. The current study aims to summarize the scales that have been specifically developed for this reason and are not adaptations of already existing scales. A comprehensive search was conducted by two reviewers during the period 28/09/2020-30/09-2020 in the following databases: PubMed, ScienceDirect, ScieLo, Mendeley, Google Scholar. A quality appraisal of the identified scales was made by three reviewers using the COSMIN checklist for methodological issues and the Terwee criteria for measurement properties. Our search strategy yielded a total of 855 results. Of these, 832 articles were excluded according to exclusion criteria, 23 were assessed for eligibility and 10 were finally included. These are presented in the text with additional useful information found separately. The identified scales tended to be quite short and examine stress, anxiety or fear. All studies were cross-sectional and the majority was conducted online. Most of them had a good Cronbach value (> 0.80) and adequate fit indices. It is however noted that the evaluation of their quality may be untimely due to relevant lack of data.

Nonesterified Fatty Acids and Hospitalizations Among Older Adults: The Cardiovascular Health Study

BACKGROUND

We sought to determine associations between total serum concentrations of nonesterified fatty acids (NEFAs) and incident total and cause-specific hospitalizations in a community-living cohort of older adults.

METHODS

We included 4715 participants in the Cardiovascular Health Study who had fasting total serum NEFA measured at the 1992/1993 clinic visit and were followed for a median of 12 years. We identified all inpatient admissions requiring at least an overnight hospitalization and used primary diagnostic codes to categorize cause-specific hospitalizations. We used Cox proportional hazards regression models to determine associations with time-to-first hospitalization and Poisson regression for the rate ratios (RRs) of hospitalizations and days hospitalized.

RESULTS

We identified 21 339 hospitalizations during follow-up. In fully adjusted models, higher total NEFAs were significantly associated with higher risk of incident hospitalization (hazard ratio [HR] per SD [0.2 mEq/L] = 1.07, 95% confidence interval [CI] = 1.03-1.10, p < .001), number of hospitalizations (RR per SD = 1.04, 95% CI = 1.01-1.07, p = .01), and total number of days hospitalized (RR per SD = 1.06, 95% CI = 1.01-1.10, p = .01). Among hospitalization subtypes, higher NEFA was associated with higher likelihood of mental, neurologic, respiratory, and musculoskeletal causes of hospitalization. Among specific causes of hospitalization, higher NEFA was associated with diabetes, pneumonia, and gastrointestinal hemorrhage.

CONCLUSIONS

Higher fasting total serum NEFAs are associated with a broad array of causes of hospitalization among older adults. While some of these were expected, our results illustrate a possible utility of NEFAs as biomarkers for risk of hospitalization, and total days hospitalized, in older adults. Further research is needed to determine whether interventions based on NEFAs might be feasible.

Light-intensity physical activity and mental ill health: a systematic review of observational studies in the general population

Background

Most of theevidence has focused on examining the influence of moderate-to-vigorous intensity physical activity on mental health, but he role of light intensity physical activity (LIPA) is less understood. The purpose of this systematic review was to assess the relationship between time spent in LIPA and mental ill health across the lifespan.

Methods

Data were obtained from online databases (Medline, Embase, Scopus, PsychInfo and CINAHL). The search and collection of eligible studies was conducted up to May 28, 2020. Observational studies conducted in the general population and reporting on the association between LIPA (1.6–2.9 metabolic equivalents; either self-reported or device-based measured) and mental ill health were included.

Results

Twenty-two studies were included in the review (16 cross-sectional and 6 longitudinal). In older adults (≥ 65 years) and adults (18–64 years), the evidence examining the relationship between LIPA and depressive symptoms is mixed. Data on anxiety, psychological distress and overall mental health are scarce, and results are inconclusive. There is no evidence suggesting favorable associations between LIPA and anxiety in college students. Finally, very limited data was found in adolescents (11–17 years) (n = 2 studies) and children (6–10 years) (n = 2 studies), but the evidence suggests that LIPA does not influence mental health outcomes in these age groups.

Conclusions

This review provided mostly cross-sectional evidence indicating that LIPA may not be associated with mental health outcomes across age groups. Future research efforts employing prospective research designs are warranted to better understand the role of LIPA on mental ill health across age groups.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01196-7.

Mental health consequences during alerting situations and recovering to a new normal of coronavirus epidemic in 2019: a cross-sectional study based on the affected population

Background

As a major virus outbreak in the twenty-first century, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented hazards to mental health globally.

Methods

We performed a cross-sectional study based on the results of an online survey. The survey was conducted 1 month after the outbreak (February 18–29, 2020) and repeated at the time of resuming activity (April 8–14, 2020). The 15-item Death Anxiety Scale (T-DAS) was used to assess the degree of death anxiety, and the Chinese version of PTSD checklist-civilian version (PCL-C), for PTSD symptom clusters. Through convenient sampling, a total of 7678 cases were collected.

Results

Our findings showed that even after the lockdown was lifted, the prevalence of the symptoms of post-traumatic stress disorder (PTSD) and death anxiety remained significantly high in the general population affected by the outbreak. Regression model analysis showed that PTSD was significantly associated with age > 50 years, contact history/living community, poor health status of participants, past traumatic experience (PTE), and medical occupation. Moreover, death anxiety mediated the relationship between life-threatening PTE and PTSD, indicating that reducing death anxiety could buffer the negative effects of PTE on PTSD.

Conclusions

Despite the lifting of the lockdown, long-term adverse psychological effects remain in the affected general population. The management of mental health after major public health events is important, and high-risk groups such as the elderly and healthcare workers should receive targeted interventions. In addition, the study suggests that methods for alleviating death anxiety must be included in plans to manage the psychological impact of public health emergencies.

Health-related quality-of-life improvement after hallux valgus corrective surgery

BACKGROUND

Hallux valgus is a common forefoot deformity that affects function of foot and quality of life (QoL). This study aims to identify factors associated with clinically important improvements in QoL after hallux valgus corrective surgery.

METHODS

A retrospective analysis on 591 cases of hallux valgus corrective surgery performed between 2007 and 2013 was conducted. Patients' preoperative and 2-year postoperative Physical Component Score (PCS) and Mental Component Score (MCS) were compared to identify the presence of clinically significant improvements in patient-reported QoL. A multiple logistic regression model was developed through a stepwise variable-selection model building approach. Age, BMI, preoperative patient reported outcome score, PCS, MCS, pain score, gender, side of surgery, type of surgery, and presence of lesser toe deformities or metatarsalgia were considered.

RESULTS

Median PCS significantly improved from 49 to 53 (p < 0.001), and median MCS remained at 56 (p = 0.724). Age, preoperative MCS and PCS were independent predictors for significant improvements of PCS at 2-year postoperatively.

CONCLUSION

Three groups of patients were more likely to have significant QoL improvements after hallux valgus corrective surgery. These were the younger patients, those with better preoperative mental health or those with poorer preoperative physical health.

LEVEL OF EVIDENCE

III.

The effects of COVID-19 restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities

BACKGROUND

COVID-19 has caused unprecedented restrictions, significantly affecting the most vulnerable groups in society, such as those with a disability.

OBJECTIVE

The aim of the study was to investigate the effects of COVID-19 lockdown restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities.

METHODS

The study was a cross-sectional design. Parents/carers completed an electronic survey in the UK between June-July 2020 on behalf of their child. Through Likert scales and free-text questions, the survey asked about physical activity levels and mental health during lockdown compared to before, access to specialist facilities and equipment to aid with physical activity, and the short- and long-term concerns around ongoing lockdown restrictions.

RESULTS

Generally, respondents reported negative effects of lockdown restrictions, with 61% reporting a reduction in physical activity levels and over 90% reporting a negative impact on mental health (including poorer behaviour, mood, fitness and social and learning regression). Many respondents cited a lack of access to specialist facilities, therapies and equipment as reasons for this, and raised concerns about the long-term effects of this lack of access on their child's mental health and physical activity levels.

CONCLUSIONS

The survey highlights the negative impact of the COVID-19 lockdown on the physical activity levels and mental health of children and young adults with disabilities and highlights the importance of addressing the needs of the disabled community as restrictions are eased.

A Strategic Plan for Strengthening America's Families: A Brief from the Coalition of Behavioral Science Organizations

Despite significant progress in research on the treatment and prevention of psychological, behavioral, and health problems, the translation of this knowledge into population-wide benefit remains limited. This paper reviews the state of America’s children and families, highlighting the influence of stressful contextual and social conditions on child and family well-being and the concentration of disadvantage in numerous neighborhoods and communities throughout the nation. It then briefly reviews the progress that has been made in pinpointing policies that can reduce stressful contextual conditions such as poverty, discrimination, and the marketing of unhealthful foods and substances. It also describes numerous family and school interventions that have proven benefit in preventing psychological and behavioral problems as diverse as tobacco, alcohol, and other drug use; depression; antisocial behavior; academic failure; obesity prevention; and early childbearing. We argue that progress in translating existing knowledge into widespread benefit will require a nationwide effort to intervene comprehensively in neighborhoods and communities of concentrated disadvantage. We present a strategic plan for how such an effort could be organized. The first step in this organizing would be the creation of a broad and diverse coalition of organizations concerned with advancing public health and well-being. Such a coalition could increase public support both for the policies needed to focus on these disadvantaged areas and the research needed to incrementally improve our ability to help these areas.

The physical and mental burden of dry eye disease: A large population-based study investigating the relationship with health-related quality of life and its determinants

PURPOSE

This large cross-sectional population-based study investigated the relationship between dry eye disease (DED) and health-related quality of life (HR-QoL).

METHODS

Dry eye and HR-QoL were assessed in 78,165 participants (19-94 yrs, 59.2% female) from the Dutch population-based Lifelines cohort, using the WHS and the SF36 questionnaire, respectively. Logistic regression was used to assess the relationship between DED and below median Physical Component Summary (PCS) and Mental Component Summary (MCS) score, corrected for age, sex, education, BMI, and 52 comorbidities.

RESULTS

Overall, 8.9% of participants had DED. Participants with DED had an increased risk of low PCS (OR 1.54 (95% CI 1.46-1.62)) and MCS scores (OR 1.39 (95% CI 1.32-1.46)), corrected for age and sex. This risk remained significant after correction for comorbidities (P < 0.0005). Increasing DED symptom frequency was associated with decreasing HR-QoL (P < 0.0005). Undiagnosed DED subjects had a significantly increased risk of low mental HR-QoL with increasing dry eye symptoms compared to diagnosed subjects (P < 0.0005). Compared to allergic conjunctivitis, glaucoma, macular degeneration and retinal detachment, DED showed the highest risk of low HR-QoL. Compared to other common systemic and chronic disorders, such as depression, rheumatoid arthritis, and COPD, DED was distinctive by having a substantial reduction in both PCS and MCS.

CONCLUSION

DED is associated with substantial reductions in both physical and mental HR-QoL, also after correction for associated comorbidities. Not having a diagnosis is associated with worse mental HR-QoL in subjects with severe DED. Our results underline the importance of recognizing dry eye as a serious disorder.

Gulf Coast Residents

Repeated exposure to hurricanes and tropical storms likely impacts the mental and physical health of populations living along the U.S. Gulf Coast. In this study, the self-rated physical and mental health of residents in the U.S. Gulf Coast was estimated and factors associated with differences in self-rated health were identified. The 12-item Short Form Health Survey (SF-12) was administered online to a sample of 3030 residents of the U.S. Gulf Coast in December 2017. Responses were scored to calculate mental component summary scores and physical component summary scores. Multiple linear regression models were fitted to identify predictors of self-rated health among the residents. Residents of U.S. Gulf Coast States have poorer self-rated physical and mental health compared to the U.S. population. Women and respondents reporting higher perception of flood risk had worse self-rated mental health, while hurricane evacuees, adults of at least 25 years of age, those with self-reported hurricane damage, and respondents reporting higher perception of surge risk had worse self-rated physical health. Residents of U.S. Gulf Coast States have poorer self-rated health compared to national standards. These findings may have practical implications for hurricane-associated physical and mental health services planning and delivery.

Religiosity and stigma toward patients with mental illness among undergraduate university students

There is a dearth of research that investigates the relationship between religiosity and stigma of mental illnesses by the context of Jordanian culture. So, this study aimed to describe the relationship between religiosity and stigma against mental illnesses as described by undergraduate university students in Jordan. This study design was descriptive correlations study among 338 University Students, undergraduate students in Jordan. The findings indicate there is a significant correlation (r = - 0.154, p < 0.05) between stigma toward patient with mental illnesses and religiosity. The higher religiosity score is associated with more negativity toward stigma of patient with mental illnesses. Also, the findings indicated there was a significant difference between medical and non-medical student's specialty area and stigma toward patients with mental illnesses (t = 111.14, p = 0.01). Non-medical students reported more stigma for patients with mental illnesses. Stigma against patient with mental illnesses should be addressed at different levels. Cultural competency curriculum should be established for medical and non-medical students to assure more acceptance attitudes and avoidance of stigma against patients with mental illnesses.

A Survey of Residents/Fellows, Program Directors, and Faculty About Telepsychiatry: Clinical Experience, Interest, and Views/Concerns

The effectiveness of telepsychiatry video for clinical care is well established, and clinician and psychiatry resident interest in it is growing—particularly in light of the COVID-19 impact. Still, few residency programs in the United States have core curricula, rotations/electives available, and competencies, and many faculty have no experience. A survey was sent via national organization listserves for residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience and interest, and views/concerns, using Likert-like and yes/no questions. Descriptive statistics and other analyses compared the groups to assess impact of clinical experience on interest and views/concerns. Respondents (N = 270) have limited clinical experience with telepsychiatry (46% none), with trainees having less than others, and yet, most were very interested or interested in it (68%). Trainees (N = 123) have concerns about being prepared for future practice. Clinical experience with video in the range of 6–20 h appears to dramatically increase interest and reduce concerns, though less time has a positive effect. Respondents have concerns about connectivity, medico-legal issues, and clinical effectiveness (e.g., diverse populations, psychosis, and emergencies) with telepsychiatry. More research is needed to assess current clinical and curricular experience, interest, and concerns. Additional curricular interventions during residency and fellowship training could build skills and confidence, if this is feasible, and the benefits outweigh the costs.

Evaluation of the cognitive impairments and depressive symptoms in patients with Parkinson's disease: A case-control study from Iran

BACKGROUND

Parkinson's disease is a progressive neurodegenerative disease and the second most common neurological disease in the world, which usually affects people mainly in later years of life. Cognitive impairments and depressive symptoms are important symptoms in these patients that are associated with a poor prognosis. The study will focus on the original data regarding the cognitive impairments and depressive symptoms in patients with Parkinson's disease and control group.

METHODS

In a case-control study, a total of 100 Parkinson's patients who were hospitalized in Rouhani Hospital and 200 non-Parkinson's people (control group) from Amirkola Health and aging project (AHAP) Marras et al., Babol, Iran were enrolled between September 2019 to February 2020. Data were collected by simple random sampling. Data were collected using a four-part questionnaire, including demographic characteristics, Unified Parkinson Disease Rating Scale (UPDRS), Modified Hoehn and Yahr staging Scale (MHYSS), Mini-M ental State Examination (MMSE) and Geriatric Depression Scale (GDS). P-value less than 0.05 was considered as significant RESULTS: A total of 300 persons were enrolled in the study. The mean age of Parkinson's patients and non-Parkinson's people was 70.34 ± 7.76 and 70.87 ± 7.59 years, respectively. The mean MMSE score in Parkinson's and non-Parkinson's people was 24.80 ± 4.53 and 25.40 ± 3.1, respectively (p = 0.182). The mean GDS score in Parkinson's and non-Parkinson's people was 7.06 ± 4.06 and 4.31 ± 3.47, respectively (p = 0.001). There was a statistically significant relationship between depressive symptoms and cognitive impairments with disease severity (p = 0.022 and p = 0.012, respectively). In addition, variables, such as age and the education level were associated with cognitive impairments (p = 0.001 and p = 0.021, respectively), but these variables were not significantly associated with depressive symptoms (p = 0.843 and p = 0.411, respectively). There was a significant relationship between depressive symptoms and cognitive impairment in Parkinson's patients and the control group (p = 0.001 and p = 0.003, respectively).

CONCLUSIONS

Cognitive impairments and depressive symptoms were significantly associated with an increase in the severity of Parkinson's disease, and also, depressive symptoms in Parkinson's patients was associated with an increase in cognitive impairments.

A Survey Comparing Adult and Child Psychiatry Trainees, Faculty, and Program Directors' Perspectives About Telepsychiatry: Implications for Clinical Care and Training

Telepsychiatry’s effectiveness is well established, and interest in it is growing, despite few residency/fellowship core curricula and rotations. A link to a cross-sectional survey was sent via national organization listservs for psychiatry residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience, and views/concerns about telepsychiatry. Descriptive statistics and other analyses compared groups to assess the impact of amount clinical experience and psychiatric specialty (general vs. child and adolescent psychiatry), on interest, and views/concerns about the practice of telepsychiatry. All respondents (N = 270; child psychiatry N = 89) have limited clinical experience with telepsychiatry (46% overall; 49% of non-child had none versus 40% child). Trainees (N = 123; child N = 43) expressed less interest than others. All respondents expressed worry about ability to do a physical exam, connectivity, medico-legal issues, and fit for diverse populations. Child respondents expressed less concern than others, but they reported more worry about loss of nonverbal cues. Clinical experience with telepsychiatry in the range of 6–20 h appears to build interest and allay concerns, though 1–5 h also may have a positive impact. More research is needed to assess clinical experience, interest, and concerns for adult and child psychiatry trainees and clinicians. Replicable, curricular interventions appear to be indicated.

Medical unfitness for work at sea: causes and incidence rate over a 12-year period in France

Background

The purposes of the study were first to determine the incidence rate of medical unfitness for work at sea among French seafarers, second to identify the conditions (diseases or accidents) causing such incapacity so as to set up prevention measures where possible and third to ascertain whether there were any overrepresentations of diseases according to category of unfit seafarers (fishers, merchant seafarers, shellfish farmers and professional sailors).

Methods

An exhaustive, observational, descriptive, retrospective epidemiological and nosological study was carried out based on the medical coding of files stored in the Aesculapius® national database, which registers all medical data regarding seafarers presenting at the French seafarers’ health services. The increasing rate of permanent medical unfitness for work at sea was calculated in relation to the annual number of registered seafarers. A 12-year span was chosen in an attempt to ascertain the different sociodemographic categories associated with incapacity.

Results

In all, 2392 seafarers were declared unfit for work at sea. This represents a permanent medical unfitness for work at sea incidence rate of below 1% for all French seafarers examined for medical fitness between 2005 and 2016.

The average age of the population of unfit seafarers was 48. The average time spent at sea before being declared unfit for work at sea was 15.5 years. Sixty-seven percent of the seafarers declared unfit had been working in the fishing sector.

The main reasons for deciding permanent unfitness for work at sea were: rheumatological conditions associated specifically with the spine; injuries relating to accidents or other external causes, mostly affecting the upper limbs; mental and behavioural disorders, including mood disorders and particularly addictions; and diseases of the circulatory system, namely coronopathies. The incidence rate of medical unfitness for work at sea was seen to increase between 2005 and 2016, but a decrease due to the dilution effect was noted in 2015.

Conclusions

Permanent unfitness seldom occurs among French professional seafarers. Prevention measures must be focused on musculoskeletal disorders, psychiatric affections and coronary conditions as well as on combatting maritime accidents, especially in the professional fishing sector, where such affections and accidents are overrepresented.

Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status

BACKGROUND

Suboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss the feasibility of improving health status and preventing diseases according to PPPM concepts in Chinese nurses.

METHODS

A cross-sectional study was conducted with the cluster sampling method among 9793 registered nurses in Foshan city, China. SHS was evaluated with the Suboptimal Health Status Questionnaire-25 (SHSQ-25). Meanwhile, the PS of depression and anxiety were evaluated with Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) self-assessment questionnaires. The relationship between PS and SHS in Chinese nurses was subsequently analyzed.

RESULTS

Among the 9793 participants, 6107 nurses were included in the final analysis. The prevalence of SHS in the participants was 74.21% (4532/6107) while the symptoms of depression and anxiety were 47.62% (2908/6107) and 24.59% (1502/6107) respectively. The prevalence of SHS in the participants with depression and anxiety was significantly higher than those without the symptoms of depression (83.3% vs 16.7%, P < 0.001) and anxiety (94.2% vs 5.8%, P < 0.0001). The ratio of exercise habit was significantly lower than that of non-exercise habit (68.8% vs 78.4%, P < 0.001) in SHS group.

CONCLUSIONS

There is a high prevalence of SHS and PS in Chinese nurses. PS in Chinese nurses are associated with SHS. Physical exercise is a protective factor for SHS and PS so that the exercise should be strongly recommended as a valuable preventive measure well in the agreement with PPPM philosophy. Along with SDS and SAS, SHSQ-25 should also be highly recommended and applied as a novel predictive/preventive tool for the health measures from the perspectives of PPPM in view of susceptible population and individual screening, the predisposition to chronic disease preventing, personalization of intervention, and the ideal health state restoring.

Psychological stress in heart failure: a potentially actionable disease modifier

Psychological stress is common in patients with heart failure, due in part to the complexities of effective disease self-management and progressively worsening functional limitations, including frequent symptom exacerbations and hospitalizations. Emerging evidence suggests that heart failure patients who experience higher levels of stress may have a more burdensome disease course, with diminished quality of life and increased risk for adverse events, and that multiple behavioral and pathophysiological pathways are involved. Furthermore, the reduced quality of life associated with heart failure can serve as a life stressor for many patients. The purpose of this review is to summarize the current state of the science concerning psychological stress in patients with heart failure and to discuss potential pathways responsible for the observed effects. Key knowledge gaps are also outlined, including the need to understand patterns of exposure to various heart failure-related and daily life stressors and their associated effects on heart failure symptoms and pathophysiology, to identify patient subgroups at increased risk for stress exposure and disease-related consequences, and the effect of stress specifically for patients who have heart failure with preserved ejection fraction. Stress is a potentially modifiable factor, and addressing these gaps and advancing the science of stress in heart failure is likely to yield important insights about actionable pathways for improving patient quality of life and outcomes.

Associations between fitness, physical activity and mental health in a community sample of young British adolescents: baseline data from the Fit to Study trial

OBJECTIVES

To examine relationships between fitness, physical activity and psychosocial problems among English secondary school pupils and to explore how components of physically active lifestyles are associated with mental health and well-being.

METHODS

A total of 7385 participants aged 11-13 took a fitness test and completed self-reported measures of physical activity, attitudes to activity, psychosocial problems and self-esteem during the Fit to Study trial. Multilevel regression, which modelled school-level cluster effects, estimated relationships between activity, fitness and psychosocial problems; canonical correlation analysis (CCA) explored modes of covariation between active lifestyle and mental health variables. Models were adjusted for covariates of sex, free school meal status, age, and time and location of assessments.

RESULTS

Higher fitness was linked with fewer internalising problems (β=-0.23; 95% CI -0.26 to -0.21; p<0.001). More activity was also related to fewer internalising symptoms (β=-0.24; 95% CI -0.27 to -0.20; p<0.001); the relationship between activity and internalising problems was significantly stronger for boys than for girls. Fitness and activity were also favourably related to externalising symptoms, with smaller effect sizes. One significant CCA mode, with a canonical correlation of 0.52 (p=0.001), was characterised high cross-loadings for positive attitudes to activity (0.46) and habitual activity (0.42) among lifestyle variables; and for physical and global self-esteem (0.47 and 0.42) among mental health variables.

CONCLUSION

Model-based and data-driven analysis methods indicate fitness as well as physical activity are linked to adolescent mental health. If effect direction is established, fitness monitoring could complement physical activity measurement when tracking public health.

Patient and service-level factors affecting length of inpatient stay in an acute mental health service: a retrospective case cohort study

BACKGROUND

The NHS Mental Health Implementation Plan aims to reduce length of inpatient psychiatric stays to a maximum of 32 days, yet provides little guidance on how to achieve this. Previous studies have attempted to analyse factors influencing length of stay in mental health units, focussing mostly on patient factors. These models fail to sufficiently explain the variation in duration of inpatient stay. We assess how the type of service delivered by a trust, in addition to patient factors, influences length of stay.

METHODS

We conducted a retrospective case cohort study in a large inner-city NHS mental health trust for all admissions in a 1 month period. Data was gathered from electronic notes of 105 patients. Descriptive univariate and bivariate analyses were conducted on the data, with multiple regression analysis conducted on statistically significant data.

RESULTS

Short-stay assessment ward admission significantly reduced length of stay. Patients under outpatients or under care co-ordination, admitted through Mental Health Act assessment and formally detained all had longer length of stay. Out of area admissions, locum Consultant care, changing Responsible Clinician and ward transfers all led to longer length of stay. Factors indicating more severe illness such as increased observation level and polypharmacy, as well as diagnoses of psychosis or bipolar disorder were associated with longer duration of stay. Discharges requiring referral to accommodation or rehabilitation led to longer stays. The most significant factors that influenced length of stay were higher observation levels, diagnosis of psychotic illness or bipolar, and discharge to rehabilitation placement. The final model, taking into account all these factors, was able to account for 59.6% of the variability in length of stay.

CONCLUSIONS

The study backs up existing literature which shows patient-factors have an influence on length of stay. The study also demonstrates that service-level factors have an impact on the duration of stay. This data may be used to inform further studies which may aid provision of inpatient and community services in the future.

Safety analysis of work zone complexity with respect to driver characteristics - A simulator study employing performance and gaze measures

Driving is a complex task that consists of several physical (motor-related) and physiological (biological changes within the body) processes occurring simultaneously. The complexity of the task depends on several factors, but this research focuses on work zone configurations and their effect on driver performance and gaze behavior. The increase in work zone fatalities in the United States between 2015 and 2018 coupled with the limited literature of driver behavior in these complex environments requires a more comprehensive study. Given the nature of these crashes, typically lane departures, gaze behavior provided an additional physiological dimension to the present research. A framework that comprises of the interactions between driver characteristics, mental workload, and situation awareness, with longitudinal control, lateral control, and gaze behavior is proposed. Crash analysis and a simulator study with 90 participants were carried out to investigate the performance and gaze-based changes with respect to various work zone configurations. Distracted driving was also studied by including a secondary task. The results showed a significant interaction between the longitudinal control and the standard deviation of horizontal gaze position in predicting lateral control. Also, significant differences in lateral control and horizontal gaze variations were observed between genders. Female drivers showed lower lateral position deviations and lower horizontal gaze variability. This was a key finding given the inherently higher number of work zone crashes involving male drivers. Placing work zone barriers further away, by up to one meter from pavement edges, could significantly decrease mental workload and improve safety in work zones.

Factors associated with good health among older persons who received a preventive home visit: a cross-sectional study

Background

The ageing population is increasing worldwide, and this trend is bringing challenges both for the older person and for society. In order to meet the challenges a comprehensive approach is needed involving both health promotion and risk prevention. The preventive home visit is a public health intervention used around the world with the purpose of promoting health and preventing risk among older persons. However, most preventive home visits are focused on questions asking about risks. In order to strengthen the health promotion perspective during the preventive home visits, factors associated with good health need to be identified. The aim of this study was therefore to determine which factors were associated with good self-rated health among older persons who received preventive home visit.

Methods

This was a register study with a cross-sectional design, including older persons (≥75 years old), living in their own homes, and that had received preventive home visit. Data were collected during a period of 9 months, in two municipalities in the south of Sweden. A questionnaire covered mental, physical and lifestyle factors were used at home visit. Binary logistic regression was used to analyse the data.

Results

In total, 619 older persons were included in the study; 55.4% were women, and the mean age was 80.6 years (standard deviation 2.2 years). The following items were significantly associated with good health (after adjustment for age and gender): being able to do things that make one feel valuable, having no physical problems affecting participation in social activities, not feeling sad, not having reduced energy, and not having impaired endurance.

Conclusions

The main conclusion of this study is that questions focusing on risks could be seen from a health promotion perspective and could thus be turned into assets with a positive impact on older persons’ health. Furthermore, the mental and physical factors identified in the results as associated with good health have implications for the person’s ability to feel valuable and participate in social activities. The results suggest that issues regarding both health promotion as well as risk prevention must be brought up during the preventive home visit.

Minority stress and health: A grounded theory exploration among men who have sex with men in China and implications for health research and interventions

RATIONALE

Men who have sex with men (MSM) in China are disproportionately affected by HIV and mental health issues. Although predominately western-based research suggests a minority stress perspective to explain health disparities, how Chinese MSM experience stress related to being a sexual minority and how such experiences affect their health have not been carefully examined.

OBJECTIVE

This study was a qualitative investigation of how stress related to sexuality (e.g., stigma, discrimination, and oppression) are experienced among MSM in China and how these experiences affect their psychological and behavioral health.

METHOD

In-depth, semi-structured interviews were conducted with 24 MSM in China. Grounded theory was employed to guide data analysis.

RESULTS

Six categories emerged, which included: A Family-Oriented, Heteronormative Culture, Interpersonal Rejections and Marginalization, Internalization of Stigma, the Psychological Impact of Minority Stress, Impact on HIV-related Behavioral Health, and Coping. A conceptual model was developed, which illustrated relationships among categories and described sources, processes, and impact of minority stress among MSM in China. Cultural, social, and internalized sources of minority stress were shown to have detrimental effects on participants' psychological health and HIV-related behavioral health. Various coping strategies shared the purpose of navigating well-being in one's direct environment and in the larger culture.

CONCLUSIONS

Findings demonstrate the relevance of minority stress in behavioral health among Chinese MSM as well as the need to conceptualize minority stress within MSM's sociocultural context. HIV prevention efforts may benefit from a contextualized understanding of minority stress and addressing minority stress in a culturally congruent, community-centered fashion.

Adverse childhood experiences and mental health: Comparing the link in rural and urban men who have sex with men

BACKGROUND

Research shows individuals experiencing adverse childhood experiences (ACEs) as well as identifying as a man who has sex with other men (MSM) are at an increased risk for mental health issues. Less has been studied, however, on ACEs in MSM; with even fewer studies investigating non-urban (e.g., rural/small town/suburban) MSM, as most research features urban samples. This is problematic due to studies showing that rurality can influence the behavior of MSM. The current study comparatively investigates the impact of ACEs on the mental health of rural/small town/suburban and urban MSM.

METHODS

Participants included 156 MSM residing in Oklahoma. Linear regression was used to test the association between ACEs' and mental health (anxiety, depressive symptoms, and loneliness). Split-sample regressions were conducted on rural/small town/suburban and urban MSM.

RESULTS

ACEs were associated with all three mental health outcomes in the full sample. However, ACEs were significantly linked to anxiety and depressive symptoms only in urban MSM.

LIMITATIONS

Limitations include a smaller sample size with limited racial/ethnic variations.

CONCLUSIONS

Results suggest that living in an urban environment may amplify the risks of ACEs, rural/small town/suburban MSM may acquire outside, unique support networks which work to limit the effect of ACEs, or that rural/small town/suburban MSM may manifest the effects of ACEs differently (or a combination of the three). Trauma-informed programming has been shown to effectively reduce mental health issues, yet consideration is generally not given with regards to rurality. Future programming and research should consider rurality/urbanity as influential factor.

Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance

Background

Therapeutic alliance is a core part of the nursing role and key to the attainment of positive outcomes for people utilising mental health care services. However, these relationships are sometimes difficult to develop and sustain, and nursing staff would arguably benefit from evidence-based support to foster more positive relationships.

Objectives

We aimed to collate and critique papers reporting on interventions targeted at improving the nurse–patient therapeutic alliance in mental health care settings.

Design

Systematic literature review.

Data sources

The online databases of Excerpta Medica database (Embase), PsycINFO, Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched, eligible full text paper references lists reviewed for additional works and a forward citation search conducted.

Review methods

Original journal articles in English language were included where they reported on interventions targeting the nurse–patient therapeutic relationship and included a measure of alliance. Data were extracted using a pre-determined extraction form and inter-rater reliability evaluations were conducted. Information pertaining to design, participants, interventions and findings was collated. The papers were subject to quality assessment.

Results

Relatively few eligible papers (n = 8) were identified, highlighting the limitations of the evidence base in this area. A range of interventions were tested, drawing on diverse theoretical and procedural underpinnings. Only half of the studies reported statistically significant results and were largely weak in methodological quality.

Conclusions

The evidence base for methods to support nursing staff to develop and maintain good therapeutic relationships is poor, despite this being a key aspect of the nursing role and a major contributor to positive outcomes for service users. We reflect on why this might be and make specific recommendations for the development of a stronger evidence base, with the hope that this paper serves as a catalyst for a renewed research agenda into interventions that support good therapeutic relationships that serve both staff and patients.

International consensus statement on the psychosocial and policy-related approaches to mental health awareness programmes in sport

Background

Research focused on mental health in sport has revealed a need to develop evidence-supported mental health practices that are sensitive to sport culture, particularly for non-elite athletes. A consensus statement was produced to assist effective mental health awareness in sport and guide programme implementation in this rapidly emerging field.

Method

The AGREE Reporting Checklist 2016 was used in two international expert consultation meetings, followed by two online surveys. Experts from 10 countries and over 30 organisations contributed.

Results

Six objectives were agreed: (1) to define mental health awareness and service implementation constructs for inclusion in programmes delivered in sporting environments; (2) to identify the need to develop and use valid measures that are developmentally appropriate for use in intervention studies with sporting populations, including measures of mental health that quantify symptom severity but also consider causal and mediating factors that go beyond pathology (ie, well-being and optimisation); (3) to provide guidance on the selection of appropriate models to inform intervention design, implementation and evaluation; (4) to determine minimal competencies of training for those involved in sport to support mental health, those experiencing mental illness and when to refer to mental health professionals; (5) to provide evidence-based guidance for selecting mental health awareness and implementation programmes in sport that acknowledge diversity and are quality assured; and (6) to identify the need for administrators, parents, officials, coaches, athletes and workers to establish important roles in the promotion of mental health in various sports settings.

Conclusion

This article presents a consensus statement on recommended psychosocial and policy-related approaches to mental health awareness programmes in sport.

Building Mental Health Research Capacity in Kenya: A South - North Collaboration

This paper describes a mental health capacity-building partnership between the University of Nairobi (UON) and the University of Washington (UW) that was built upon a foundational 30-year HIV/AIDS research training collaboration between the two institutions. With funding from the US National Institute of Mental Health Medical Education Program Initiative (MEPI), UW and UON faculty collaborated to develop and offer a series of workshops in research methods, grant writing, and manuscript publication for UON faculty and post-graduate students committed to mental health research. UON and UW scientists provided ongoing mentorship to UON trainees through Skype and email. Three active thematic research groups emerged that focused on maternal and child mental health, gender-based violence, and HIV-related substance abuse. Challenges to conducting mental health research in Kenya included limited resources to support research activities, heavy teaching responsibilities, clinical duties, and administrative demands on senior faculty, and stigmatization of mental health conditions, treatment, and research within Kenyan society. The partnership yielded a number of accomplishments: a body of published papers and presentations at national and international meetings on Kenyan mental health topics, the institution of systematic mental health data collection in rural clinics, funded research proposals, and a mental health research resource centre. We highlight lessons learned for future mental health research capacity-building initiatives.

A scoping review

Background

Use of physical restraint is a common practice in mental healthcare, but is controversial due to risk of physical and psychological harm to patients and creating ethical dilemmas for care providers. Post-incident review (PIR), that involve patient and care providers after restraints, have been deployed to prevent harm and to reduce restraint use. However, this intervention has an unclear scientific knowledge base. Thus, the aim of this scoping review was to explore the current knowledge of PIR and to assess to what extent PIR can minimize restraint-related use and harm, support care providers in handling professional and ethical dilemmas, and improve the quality of care in mental healthcare.

Methods

Systematic searches in the MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Science databases were carried out. The search terms were derived from the population, intervention and settings.

Results

Twelve studies were included, six quantitative, four qualitative and two mixed methods. The studies were from Sweden, United Kingdom, Canada and United States. The studies’ design and quality varied, and PIR s’ were conducted differently. Five studies explored PIR s’ as a separate intervention after restraint use, in the other studies, PIR s’ were described as one of several components in restraint reduction programs. Outcomes seemed promising, but no significant outcome were related to using PIR alone. Patients and care providers reported PIR to: 1) be an opportunity to review restraint events, they would not have had otherwise, and 2) promote patients’ personal recovery processes, and 3) stimulate professional reflection on organizational development and care.

Conclusion

Scientific literature directly addressing PIR s’ after restraint use is lacking. However, results indicate that PIR may contribute to more professional and ethical practice regarding restraint promotion and the way restraint is executed. The practice of PIR varied, so a specific manual cannot be recommended. More research on PIR use and consequences is needed, especially PIR’s potential to contribute to restraint prevention in mental healthcare.

The Relationship between the Duration of Playing Gadget and Mental Emotional State of Elementary School Students

BACKGROUND:

Technology has provided a type of facility in the world that currently makes the world like a virtual globe. One of the technologies currently used by humans is gadgets. Generally, children and adolescents nowadays often use gadget excessively. They use it excessively which may affect their social and emotional functions.

AIM:

This study aims to determine the relationship between the duration of playing gadget and mental-emotional state of elementary school students.

METHODS:

This study uses Strength and Difficulties Questionnaire (SDQ) which contains 25 questions that can be used for children aged 8 to 16 years. This research was conducted in August 2018 with fourth-grade students of Public Elementary School and Private Elementary School Medan as respondents. This study uses a cross-sectional study method with the chi-square test as a statistical hypothesis test. The number of respondents in this study was 103 students consist of 73 students of Public Elementary School and 30 students of Private Elementary School Medan.

RESULTS:

The results of this study found a relationship between the duration of playing gadgets on mental-emotional at elementary school students with a probability value of 0.0001 (p < 0.05) and the relationship between the frequency of using gadgets and mental-emotional with a probability value of 0.001 (p < 0.05).

CONCLUSIONS:

There is a significant relationship between mental emotional and the duration of playing gadgets and the frequency of using gadgets elementary school students.