Mediating role of stressful life events between sleep chronotype and depressive mood in adolescents / 中国学校卫生

Objective@#A longitudinal mediating model was designed to explore the relationship between sleep chronotype and depressive mood with stressful life events as the mediating variable, so as to provide reference basis for preventing depression in adolescents.@*Methods@#From March (T1) to October (T2) 2022, the Munich Chronotype Questionnaire, and Adolescent Self-rating Life Events Checklist and Center for Epidemiologic Studies Depression Scale were administered in 1 251 middle school students in the first and second grades of a middle school in Meishan, Sichuan Province for a follow up study. Two wave of date on sleep time type, stressful life events, and depressive moods were collected.@*Results@#At T1, the detection rate of depressive mood was 22.5% in adolescents but 27.0% at T2.At the same time point, there were significant positive correlations between chronotype, stressful life events and depressive mood ( r=0.06-0.69, P <0.05). Cross lagged model results showed that early sleep chronotype could significantly predict later depressive mood ( β=0.53, P <0.05), and early depressive mood could significantly predict later sleep chronotype ( β=0.01, P <0.01). Longitudinal mediation model analysis showed that T1 sleep chronotype not only directly affected T2 depressive mood (direct effect value=1.421, 95% CI =0.985- 1.858 , P <0.01), but also affect T2 depressive mood through the partial mediating effects of T2 stressful life events (indirect effect value=1.268, 95% CI =0.810-1.726, P <0.05). Although T1 depressive mood was a direct predictor of T2 sleep chronotype (direct effect value=0.025, 95% CI =0.017-0.032), it was not a direct predictor of T2 sleep chronotype by partial intermediate action of T2 stressful life events (indirect effect value=-0.001, 95% CI = -0.006- 0.004, P >0.05).@*Conclusions@#Sleep chronotype can not only directly predict depressive mood of adolescents, but also indirectly affect depressive mood of adolescents through the longitudinal mediating effect of stressful life events. To prevent depression and improve mental health in this population, adolescents should develop the habit of early sleep schedule, and improve their ability to cope with stressful life events.

Dificuldades experienciadas no cotidiano dos adolescentes em ambiente escolar: gatilhos para o surgimento do sofrimento mental / Difficulties experienced in the daily life of adolescents in the school environment: triggers for the emergency of mental suffering / Dificultades vivendas en el cotidiano de los adolescentes en el ámbito escolar: desencadenantes de la emergencia del sufrimiento mental

A adolescência é um período de experimentação e autodescoberta marcada por inúmeras transformações. Estas transformações quando associada a outras condições em que o adolescente não consegue lidar, podem culminar em depressão. Diante disso, este estudo tem por objetivo analisar, por meio dos discursos, saberes e experiências dos adolescentes acerca das dificuldades vivenciadas no cotidiano que levam ao sofrimento mental. Trata-se de estudo descritivo, com abordagem qualitativa, mediado pela pesquisa- ação. Participaram do estudo dezessete adolescentes estudantes da Escola Técnica localizada na Paraíba, estado do Nordeste do Brasil. Para proceder à ordenação e organização dos dados empíricos, produzidos nas entrevistas semiestruturadas, recorreu- se ao processo metodológico do Discurso do Sujeito Coletivo. O estudo teve início após a aprovação pelo Comitê de Ética em Pesquisa. Considerou-se três temáticas: obstáculos no vivenciar do ambiente escolar como geradoras de angústias nos adolescentes, desestrutura nas relações familiares no surgimento do sofrimento mental e o bullying velado nas brincadeiras. Foi possível identificar problemáticas pertinentes à depressão, também possibilitou a discussão e análise sobre saberes e experiências dos adolescentes acerca das dificuldades vivenciadas no cotidiano que levam ao sofrimento mental. Ainda, oportunizou o compartilhamento das experiências vividas e um maior conhecimento sobre a relação desses adolescentes com os motivos pelos quais surge esse estresse psicológico.

Adolescence is a period of experimentation and self-discovery marked by numerous transformations. These transformations, when associated with other conditions that the teenager cannot deal with, can culminate in depression. Therefore, this study aims to analyze, through the speeches, knowledge and experiences of adolescents about the difficulties experienced in everyday life that lead to mental suffering. This is a descriptive study, with a qualitative approach, mediated by action research. Seventeen adolescent students from the Technical School located in Paraíba, in the Northeast of Brazil, participated in the study. To order and organize the empirical data produced in the semi- structured interviews, the methodological process of the Discourse of the Collective Subject was used. The study began after approval by the Research Ethics Committee. Three themes were considered: obstacles in experiencing the school environment as generators of anguish in adolescents, disruption of family relationships in the emergence of mental suffering and veiled bullying in games. It was possible to identify issues related to depression, also enabling the discussion and analysis of knowledge and experiences of adolescents about the difficulties experienced in everyday life that lead to mental suffering. Still, it provided opportunities for sharing experiences and greater knowledge about the relationship of these adolescents with the reasons why this psychological stress arises.

La adolescencia es un período de experimentación y autodescubrimiento marcado por numerosas transformaciones. Estas transformaciones, cuando se asocian a otras condiciones que el adolescente no puede afrontar, pueden culminar en depresión. Por lo tanto, este estudio tiene como objetivo analizar, a través de los discursos, los conocimientos y experiencias de los adolescentes sobre las dificultades vividas en la vida cotidiana que conducen al sufrimiento mental. Se trata de un estudio descriptivo, con abordaje cualitativo, mediado por la investigación acción. Participaron del estudio diecisiete adolescentes estudiantes de la Escuela Técnica ubicada en Paraíba, en el Nordeste de Brasil. Para ordenar y organizar los datos empíricos producidos en las entrevistas semiestructuradas se utilizó el proceso metodológico del Discurso del Sujeto Colectivo. El estudio se inició después de la aprobación por el Comité de Ética en Investigación. Se consideraron tres temas: obstáculos en la vivencia del ambiente escolar como generador de angustia en los adolescentes, ruptura de las relaciones familiares en la aparición del sufrimiento psíquico y acoso velado en los juegos. Fue posible identificar cuestiones relacionadas con la depresión, posibilitando también la discusión y el análisis de saberes y experiencias de los adolescentes sobre las dificultades vividas en el cotidiano que conducen al sufrimiento psíquico. Aún así, brindó oportunidades para compartir experiencias y un mayor conocimiento sobre la relación de estos adolescentes con las causas por las que surge este estrés psicológico.

Correlation between self-health management, adaptation, and perceived stress among nursing interns in medical school / 中国学校卫生

Objective@#To explore health self-management, adaptation, and perceived stress among nursing interns in medical colleges and universities under the normal prevention and control of COVID-19, and to provide a scientific basis for the health management of practice nursing students.@*Methods@#Medical colleges in the Inner Mongolia region were selected to study 263 nursing student interns by cluster random sampling. The survey was conducted using the Health Self-Management Ability Assessment Scale, the Chinese College Students Adjustment Scale and the Perceived Stress Scale.@*Results@#The total score of health self-management ability of nursing students during internship was (138.31±20.13). The total score of health self-management ability of nursing students with different educational backgrounds and different residence places was statistically significant ( F/t =3.51, 2.46, P < 0.05 ); the total adaptive score was (3.17±0.72); during the epidemic, the total score of perceived stress was (11.52±2.79), and the difference in the total score of perceived stress among nursing students with different educational backgrounds was statistically significant ( t=4.05, P <0.05). Pearson analysis showed that there was a significant negative correlation between health self-management ability, adaptation, and perceived stress among nursing students during the epidemic period ( r =-0.31, -0.35, P <0.01).@*Conclusion@#There was a close relationship between perceived stress of nursing students and health self-management and adaptation; the educators in medical colleges should actively explore strategies to improve the health self-management ability and adaptation level of nursing students to enhance the psychological adjustment ability of nursing students to maintain good physical and mental health.

Associations between psychosocial stress in early and middle adolescence with emotional and behavioral problems one year later / 中国学校卫生

Objective@#This study explored the predictive effects of psychological stress in early and middle puberty on subsequent emotional and behavioral problems.@*Methods@#A cohort of 911 boys and girls from primary and secondary schools in Chongqing was studied. Psychological stress was measured in early and middle adolescence, and the levels of emotional and behavioral problems were determined in one year follow up. Logistic regression analysis was used to analyze the effects of psychological stress in early and middle adolescence on subsequent emotional and behavioral problems.@*Results@#The average psychological stress score in early and middle adolescence was (27.96±24.95), and the average scores of internalized and externalized behavioral problems and overall problems one year later were (8.21±8.46)(6.21±5.87) and (37.90±24.68) respectively. When grouped by gender, these scores, as well as the detection rate of anxiety and depression, withdrawal, physical discomfort, thinking problems, internalization problems and overall problems, were higher in girls than boys( t/Z =-6.38，-5.63，-6.06，-3.74，-6.80，-5.47， χ 2=15.88，12.01，3.92，6.64，24.67，15.88， P <0.05). Logistic regression showed that the psychological stress scale score was a risk factor for internalized and externalized behavioral problems and overall problems( P <0.05).@*Conclusion@#Psychological stress levels in early and middle puberty have a positive predictive effect on emotional and behavioral problems in the following year.

Evaluation of early postoperative psychological pain in patients with esophageal cancer and analysis on its influential factors / 中国基层医药

Objective:To investigate early postoperative psychological pain in patients with esophageal cancer and analyze its influential factors, providing evidence for developing accurate psychological management plan during the perioperative period of esophageal cancer.Methods:A cross-sectional study was conducted on the demographic data, disease data, and psychological pain screening management tool (Distress Management Screening Measurement of patients with esophageal cancer who received treatment in Chifeng Municipal Hospital between January 2019 and January 2021 with a self-designed general data questionnaire.Results:The average score of the distress thermometer was 4.5 ± 0.8 points among the 106 patients with esophageal cancer in the early postoperative stage. DT score was < 4 points in 40 patients (37.7%) and it was ≥ 4 points in 66 patients (62.3%). Univariate analysis revealed that in the general data questionnaire, education level, hospital expense, smoking history, and operation methods were the influential factors of early postoperative esophageal cancer ( χ2 = 7.87, 9.56, 12.65, 7.03, all P < 0.05). In the list of psychological pain-related problems, fatigue, depression, pain, sleep, breathing, eating, and child care were the influential factors of early postoperative physiological pain in patients with esophageal cancer ( χ2 = 48.18, 64.19, 42.17, 27.14, 36.13, 35.01, 8.01, all P < 0.05). Multivariate regression analysis showed that in the general data questionnaire, education level, hospital expense, smoking history, and operation methods were the influential factors of early postoperative esophageal cancer ( χ2 = 14.71, 8.31, 13.56, 6.47, all P < 0.05). In the list of psychological pain-related problems, fatigue, depression, pain, breathing, and eating were the influential factors of early postoperative physiological pain in patients with esophageal cancer ( χ2 = 5.45, 3.91, 4.89, 3.96, 4.00, all P < 0.05). Conclusion:The incidence of early postoperative psychological pain is high in patients with esophageal cancer. The main influential factor of psychological factors are physical problems, while the influential factors emotional problems, education level, hospital expense, smoking history, and operation methods cannot be ignored.

Efficacy of Doula delivery combined with painless delivery and its effects on pregnancy outcome / 中国基层医药

Objective:To investigate the efficacy of Doula delivery combined with painless delivery and its effects on pregnancy outcome.Methods:A total of 150 parturient women who underwent delivery in the First People's Hospital of Yongkang from June 2019 to June 2020 were included in this study. They were randomly assigned to undergo either conventional delivery (control group, n = 75) or Doula delivery combined with painless delivery (observation group, n = 75). Analgesic effect, mode of delivery, duration of labor and pregnancy outcome as well as mood score before and after intervention were compared between the two groups. Results:Total analgesia-effective rate in the observation group was significantly higher than that in the control group [100.00% (75/75) vs. 65.33% (49/75), χ2 = 31.45, P < 0.05]. Vaginal delivery rate in the observation group was significantly higher than that in the control group [84.00% (63/75) vs. 66.67% (50/75), χ2 = 6.60, P < 0.05]. The length of the first stage of labor, the second stage of labor, the third stage of labor and total labor length in the observation group were (398.42 ± 35.41) minutes, (43.65 ± 5.78) minutes, (8.36 ± 1.08) minutes and (450.87 ± 37.98) minutes, which were significantly shorter than those in the control group [(543.21 ± 47.87) minutes, (76.73 ± 16.56) minutes, (9.76 ± 1.23) minutes, (629.34 ± 45.26) minutes, t = 21.05, 16.33, 7.40, 26.15, all P < 0.05]. The incidence of neonatal asphyxia, fetal distress and postpartum hemorrhage in the observation group were [1.33% (1/75), 2.67% (2/75) and 2.67% (2/75), respectively, which were significantly lower than those in the control group [13.33% (10/75), 17.33% (13/75), 18.67% (14/75), χ2 = 7.94, 8.96, 10.07, all P < 0.05]. Self-rating Anxiety Scale score and Self-Rating Depression Scale score in the observation group were (43.25 ± 4.28) points and (40.28 ± 3.45) points, which were significantly lower than those in the control group [(52.12 ± 3.95) points, (47.79 ± 3.72) points, t = 13.18, 12.81, both P < 0.05). Conclusion:Doula delivery combined with painless delivery can relieve women's emotional changes, alleviate pain, shorten labor duration, and improve pregnancy outcomes.

Predictive effects of psychological stress in early and middle puberty on adolescent health risk behaviors / 中国学校卫生

Objective@#To explore whether psychological stress in early and mid puberty is predictive of adolescent healthrisk behaviors.@*Methods@#In April 2018, a total of 1 046 primary and secondary school students from grade 5 to 8 were recruited through purposive sampling. The basic information and psychological stress of the respondents were collected by questionnaire and physical examination. In addition, self reports of health risk behaviors were collected in October 2018. Logistic multiple regression analysis was used to analyze the relationship between psychological stress and health risk behaviors of adolescents.@*Results@#The reported health risk behaviors of the surveyed adolescents ranking from high to low were unreasonable physical activity (62.05%), food preferences (24.76%), fighting (21.03%), suicidal ideation (17.02%), ideation of running away from home (9.85%), low mood (8.80%), smoking (4.21%), drinking (3.73%), gambling (3.63%) and internet addiction (3.06%). Logistic multiple regression analysis showed that the high level of psychological stress was a risk factor for fighting ( OR =1.02, 95% CI =1.01-1.03), suicidal ideation ( OR =1.02, 95% CI =1.01-1.03), low mood ( OR =1.02, 95% CI =1.01-1.03), ideation of running away from home ( OR =1.02, 95% CI =1.01-1.03), unreasonable physical activity ( OR =1.01, 95% CI =1.00-1.02), smoking ( OR =1.02, 95% CI = 1.00-1.03), internet addiction ( OR =1.02, 95% CI =1.00-1.03), food preferences ( OR =1.01, 95% CI = 1.00-1.02) and gambling ( OR =1.02, 95% CI =1.01-1.04)( P <0.05).@*Conclusion@#Unreasonable physical activity and food preferences are most common health risk behaviors among adolescents. Psychological stress during early to middle puberty is predictive of adolescent health risk behaviors.

Associations between psychosocial stress in early and middle adolescence with emotional and behavioral problems one year later / 中国学校卫生

Objective@#This study explored the predictive effects of psychological stress in early and middle puberty on subsequent emotional and behavioral problems.@*Methods@#A cohort of 911 boys and girls from primary and secondary schools in Chongqing was studied. Psychological stress was measured in early and middle adolescence, and the levels of emotional and behavioral problems were determined in one year follow up. Logistic regression analysis was used to analyze the effects of psychological stress in early and middle adolescence on subsequent emotional and behavioral problems.@*Results@#The average psychological stress score in early and middle adolescence was (27.96±24.95), and the average scores of internalized and externalized behavioral problems and overall problems one year later were (8.21±8.46)(6.21±5.87) and (37.90±24.68) respectively. When grouped by gender, these scores, as well as the detection rate of anxiety and depression, withdrawal, physical discomfort, thinking problems, internalization problems and overall problems, were higher in girls than boys (t/Z=-6.38，-5.63，-6.06，-3.74，-6.80，-5.47， χ 2=15.88，12.01，3.92，6.64，24.67，15.88， P <0.05). Logistic regression showed that the psychological stress scale score was a risk factor for internalized and externalized behavioral problems and overall problems( P <0.05).@*Conclusion@#Psychological stress levels in early and middle puberty have a positive predictive effect on emotional and behavioral problems in the following year.

Palliative professionals: stressors imposed on the team in the death and dying process / Profesionales de cuidados paliativos: estresores impuestos al equipo en el proceso de muerte y morir / Profissionais paliativistas: estressores impostos à equipe no processo de morte e morrer

ABSTRACT Objective: to know the multidisciplinary palliative care team's perception about stressors in the death and dying process. Method: a qualitative, exploratory-descriptive study, carried out from the perspective of Betty Neuman's theory. Data were collected using online semi-structured interview with nine palliative professionals from two health institutions between February and November 2020. Results: a grid of analysis composed of the three Neuman System Models was organized, i.e., environment, person and health, emerging the categories: Self-perception for care in death and dying; Communication between team, patient and family - minimizing stress in palliative care; Personal and professional stressors and health structure. Conclusion: the main stressor source referred to communication as an intrateam relationship and with patient and family. The pandemic was considered as a potential impact of relational and communication difficulties, and the fragility of health management support was linked to palliative multidisciplinary teams.

RESUMEN Objetivo: conocer la percepción del equipo multidisciplinario de cuidados paliativos sobre los estresores en el proceso de muerte y morir. Método: enfoque cualitativo, exploratorio-descriptivo desde la perspectiva de la teoría de Betty Neuman. Los datos fueron recolectados a través de entrevistas semiestructuradas en modalidad remota y con nueve profesionales paliativos de dos instituciones de salud entre febrero y noviembre de 2020. Resultados: se organizó una tabla de análisis compuesta por los tres Modelos de los Sistemas de Neuman, es decir, ambiente, persona y salud, emergiendo las categorías: Autopercepción para el cuidado en la muerte y el morir; Comunicación entre equipo, paciente y familia - minimizando el estrés en cuidados paliativos; Estresores personales y profesionales y la estructura de salud. Conclusión: la principal fuente de estrés se refirió a la comunicación como relación intra-equipo y relación con el paciente y la familia. Se consideró la pandemia como una potencial imposición de dificultades relacionales y comunicativas, y se vinculó la fragilidad del apoyo a la gestión en salud con el equipo paliativo multidisciplinario.

RESUMO Objetivo: conhecer a percepção da equipe multiprofissional de cuidados paliativos acerca dos estressores no processo de morte e morrer. Método: abordagem qualitativa, exploratório-descritiva sob a perspectiva da teoria de Betty Neuman. Dados coletados por entrevista semiestruturada na modalidade remota e com nove profissionais paliativistas de duas instituições de saúde entre fevereiro e novembro de 2020. Resultados: organizou-se uma grelha de análise composta dos três Modelos de Sistemas de Neuman, ou seja, ambiente, pessoa e saúde, emergindo as categorias: Percepção de si para o cuidado na morte e no morrer; Comunicação entre equipe, paciente e família - minimizando o estresse em cuidados paliativos; Estressores pessoal e profissional e a estrutura de saúde. Conclusão: a principal fonte estressora se referiu à comunicação enquanto relacionamento intraequipe, e desse com o paciente e família. Considerou-se a pandemia como potencial impositor das dificuldades relacionais e comunicacionais, e a fragilidade do suporte da gestão em saúde foi vinculada à equipe multiprofissional paliativista.

Family relationship and psychological stress response of college students in Shanghai under the COVID-19 epidemic / 中国学校卫生

Objective@#To investigate the association between the family relationship of college students in Shanghai and the psychological stress response under the COVID-19 epidemic.@*Methods@#Totally 904 college students from universities in Shanghai were investigated with questionnaire of FACESII-CV and IES-R.@*Results@#The score of family relationship intimacy was(61.32±6.29), the score of family relationship adaptability was(43.30±5.83), the score of psychological stress was(30.77±7.33), the score of internal dimension，avoidance, high alertness were(11.63±2.53)(11.69±2.64)(7.45±2.33). About 77.5%(701) and 17.3%(156) of college students showed mild and moderate stress reactions. Three dimensional scores of psychological stress response and two dimensional scores of family relationship differed significantly by age, grade, family income and parental education(P<0.01). Moreover, family relationship intimacy and adaptability scores showed negative associations with intrusive symptoms, avoidance symptoms, and high alert symptom dimension scores(P<0.05).@*Conclusion@#College students showed mild psychological stress under the COVID 19 epidemic with intrusion and avoidance symptoms as the most common. The intimacy and adaptability of family relationships are negatively associated with psychological stress response of college students under the epidemic. High-quality family relationships can reduce the psychological impact and adverse effects of the new crown epidemic on college students.

Relationships among psychological stress, achievement motivation and psychological capital in college students / 中国学校卫生

Objective@#This study explored the relationships among psychological stress, achievement motivation and psychological capital in college students to provide a reference for improving the level of psychological capital in college students.@*Methods@#A multi stage stratified cluster sampling method was used to select 9 940 college students from ten universities in Anhui Province. The achievement motivation scale (AMS), psychological stress scale (SRQ-20) and psychological capital scale (PPQ) were applied. The moderating effect of the questionnaire was analyzed with χ 2 tests, Spearman rank correlation and stratified regression.@*Results@#Statistical differences were found in psychological stress according to major, whether students leader, family economic status and whether students had left behind experience ( χ 2=15.50, 10.25, 28.61, 25.55, P <0.05). The rank correlation results indicated that psychological stress was negatively correlated with the pursuit of success ( r =-0.27) and four dimensions of self efficacy,optimism,hope and resilence in psychological capital ( r =-0.43, -0.41,-0.36,-0.45)( P <0.05), and was positively correlated with the avoidance of failure ( r =0.25, P <0.05). The stratified regression model indicated that psychological stress in the dimensions of college students achievement motivation (pursuit of success: β =0.02, Δ R 2=0.01, P <0.01; failure avoidance: β = 0.03 , Δ R 2=0.01, P <0.01) played a moderating role in the relationship between psychological capital and psychological capital.@*Conclusion@#Being female, senior students, low household economic status, and left behind experience are associated with more psychological stress among college students. Psychological stress is correlated with achievement motivation and psychological capital, and has a moderating effect on the relationship between achievement motivation and psychological capital.

Predictive effect of psychological stress in early puberty on subsequent anxiety and depression / 中国学校卫生

Objective@#Longitudinal data were used in this study to examine the predictive effects of psychological stress in early puberty on subsequent anxiety and depression symptoms.@*Methods@#Objects from a puberty cohort of 998 children from 4 primary schools in Chongqing were included. Psychological stress was measured during their early puberty, and anxiety and depression were followed up after 4 years. Multiple linear regression was used to analyze the influence of psychological stress on anxiety and depression level in their middle puberty.@*Results@#The average score of psychological stress during early puberty was (34.79±24.78), and scores of anxiety and depression were (11.20±10.89) and (12.06±6.69), respectively, with detection rates of 14.03% and 15.63%. Girls had higher anxiety and depression scores than boys(F=51.58,5.48，P<0.05). The depression scores of children with different parents’ educational levelsand perceived parental relationship were different(F=6.74, 7.38, 10.49, P<0.05). The results of multiple linear regression showed that girls(β=4.38), higher psychological stress(β=0.13), older age (β=0.89) were risk factors for higher anxiety level. Children with higher psychological stress(β=0.05), older age(β=0.57), perceived worse parents’ relationship(β=1.19), lower maternal education (β=-1.00) had higher depression scores(P<0.05).@*Conclusion@#The psychological stress level, and age during early puberty had a positive predictive effect on anxiety and depression after 4 years. Simultaneously, girls were more prone to anxiety, and poor parental relationship and low maternal literacy were risk factors for children’s depression.

Validation of the Brazilian Version of the Screening Tool for Psychosocial Distress (Stop-D) for Cardiac Patients

Distress has a potentiating effect on complications of heart disease. Early identification of distress and psychosocial management could help patients to deal with the disease and improve their quality of life. However, in Brazil, there is no specific instrument for evaluation of distress in cardiac patients. Objectives: To describe the validation process of the Screening Tool for Psychosocial Distress (STOP-D) for the Brazilian population. Methods: Cross-sectional, observational study with a quantitative approach. A total of 144 patients (including outpatients and inpatients) were interviewed at the waiting room of the outpatient cardiology clinic or in cardiology wards. Sociodemographic and clinical data were collected, and distress was assessed using two instruments - the Brazilian version of the STOP-D and the Hospital Anxiety and Depression Scale (HADS). First, we performed an exploratory factor analysis and analysis of the accuracy of the STOP-D score by the receiver operating characteristic (ROC) curvet. Results: The factorability analysis of the correlation matrix did not detect any factor that made the factorial solution unfeasible. The instrument showed a single-factor nature, confirmed by the criterion of eigenvalues, with an 85% accuracy in predicting distress. A cut-off point of 15.5 was chosen for distress using the ROC curve. Conclusions: The Brazilian version of the STOP-D is an adequate instrument for the screening of heart disease patient for distress. It can be easily used by any health professional and would contribute to the promotion of a comprehensive support to cardiac patients

Ideal Cardiovascular Health and Job Strain: A Cross-Sectional Study from the Amazon Basin / Saúde Cardiovascular Ideal e Estresse no Trabalho: Um Estudo Transversal da Amazônia Brasileira

Abstract Background: Ideal Cardiovascular (CV) Health is characterized by four ideal lifestyle parameters and absence of cardiovascular risk factors. The prevalence of ideal CV health in the Amazon Basin and the influence of job strain on CV health in this setting are uncertain. Objective: To evaluate the prevalence of ideal CV health and its relationship with job strain in a secluded area from a developing country. Methods: Job strain was evaluated in 478 employees from an university in the Amazon Basin by a questionnaire that classified participants as passive, active, low or high strain, according to the demand-control model. CV health was evaluated using the American Heart Association 7 health factors (diet, physical activity, body mass index (BMI), smoking, hypertension, diabetes and hypercholesterolemia). Participants were classified as having ideal, intermediate or poor CV health. The level of significance was set at p < 0.05. Results: The mean age was 44.3 ± 12 years, 65% were men, and 35% were faculty. No participant fulfilled the criteria for ideal CV health. Intermediate CV health was found in 44 (9%) and poor in 434 (91%) individuals. Considering low strain as a reference group, individuals classified as high strain, active and passive had a non-significant (p > 0.05) increase in the chances of having poor CV health. When adjusting for possible confounders, high job strain was associated with poor BMI (> 30 kg/m2), (OR 2.11, 95%CI 1.06-4.22; p = 0.034) and poor diet (OR 2.31, 95% CI 1.29-4.13; p = 0.005). Conclusion: Job strain was not associated with cardiovascular health, but high job strain was related to obesity and poor diet. Given the high prevalence of poor CV health and lack of participants with ideal CV health, policies focusing on health education and lifestyle interventions are paramount to this population.

Resumo Fundamento: Saúde cardiovascular (CV) ideal é caracterizada por quatro parâmetros de estilo de vida ideal e ausência de fatores de risco CV. A prevalência da saúde CV ideal na Bacia Amazônica e sua relação com estresse no trabalho é desconhecida. Objetivo: Avaliar a prevalência da saúde CV ideal e sua relação com o estresse no trabalho em uma área isolada de um país em desenvolvimento. Métodos: O estresse no trabalho foi avaliado em 478 funcionários de uma universidade na Bacia Amazônica através de um questionário validado que classificou os participantes como passivos, ativos, baixa tensão ou alta tensão no trabalho, de acordo com o modelo de demanda e controle. A saúde CV foi avaliada usando os 7 parâmetros usados pela American Heart Association (dieta, atividade física, IMC, tabagismo, hipertensão, diabetes e hipercolesterolemia). Os participantes foram classificados em saúde CV ideal, intermediária ou ruim. O nível de significância adotado foi de 5% (p < 0,05). Resultados: A idade média foi de 44,3 ± 12 anos, 65% eram homens e 35% eram professores. Nenhum participante preencheu os critérios de saúde CV ideal. A saúde CV intermediária foi encontrada em 44 (9%) e ruim em 434 (91%) dos entrevistados. Considerando a baixa tensão como grupo de referência, indivíduos classificados como de alta tensão, ativos e passivos tiveram um aumento não significativo (p > 0,05) nas chances de ter saúde CV ruim. Ao ajustar para possíveis fatores de confusão, a alta tensão no trabalho foi associada à obesidade (IMC > 30 kg/m2): OR 2,11 (IC 95% 1,06-4,22; p = 0,034) e dieta inadequada: OR 2,31 (IC 95%: 1,29-4,13 p = 0,005). Conclusão: Não houve associação entre saúde CV e estresse no trabalho, mas a obesidade e a má alimentação foram relacionadas à alta tensão. Dada a alta prevalência de saúde CV ruim e ausência de participantes com saúde CV ideal, as políticas voltadas para a educação em saúde e as intervenções de estilo de vida são primordiais para essa população.

Long-term effects of early life stress on neurodevelopment / 中华围产医学杂志

Early life stress can have long-term effects on human health.Both prenatal and postnatal stress exposure affect offspring's neurodevelopment,and increase the risk of emotional disorders and cognitive and behavioral abnormalities.However,these effects are gender and species specific and individualized with intergenerational influence.Many factors,including neurobiological responses,such as glucocorticoid,brainderived neurotrophic factors,glutamate and gamma-aminobutyric acid,neuroimmune network function as well as epigenetic regulation of key functional genes in stress response,play important roles in the long-term effects of early life stress on neurodevelopment.Various postnatal environment can alleviate the neurological and behavioral abnormalities induced by stress.Therefore,the risk of long-term effects may be reduced along with environment optimization.

The role of neuropsychiatric factors in the occurrence of psoriasis / 中华皮肤科杂志

Considerable evidence has indicated that psychological factors,such as anxiety,nervousness and mental stress,can induce or exacerbate psoriasis and affect therapeutic effects to a certain degree,suggesting that psychological factors may play an important role in the occurrence of psoriasis.Current researches on neuropsychiatry-related pathogenesis of psoriasis mainly include two aspects:on the one hand,acting as stressors,psychological factors can activate the following two neuroendocrine systems,including hypothalamic-pituitary-adrenocortical axis and sympathetic-adrenal medullary system;on the other hand,neuropeptides and nerve growth factors induce in vivo neurogenic inflammation.Neuropsychiatric factors may participate in the occurrence of psoriasis through the above pathways.

The esophageal expression of fibrotic cytokines and NADPH oxidase in stress induced esophageal fibrosis and its significance / 中国医师杂志

Objective To detect the expression levels of collagen1 (colla-1),transforming growth factor-β1 (TGF-β1),a-smooth muscle actin (α-SMA) and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX-4) in mouse esophagus submitted to chronic restraint stress (CRS),in order to discuss stress-induced esophageal fibrosis and the role of oxidative stress.Methods 20 male Kunming mice were randomly divided into two groups,CRS and normal control (NC).The mice in CRS group were submitted to 2 h per day of restraint stress using home-made device for a period of 14 days,and the mice in both group were treated the same at rest of the time.Fibrotic changes of esophageal tissue were observed using Masson staining.The expression levels of NOX-4 and related fibrotic cytokines in esophageal tissues were detected by several methods such as immunohistochemistry,enzyme-linked immunosorbent assay (ELISA) and realtime polymerase chain reaction (qRT-PCR).Results Body weight in CRS group was significantly lower than NC group (8.75 ± 1.69 vs 12.69 ± 3.16),with statistically significant difference (t =3.11,P ＜ 0.05).Masson staining revealed that CRS mice showed distinct fibrosis of epithelial interstitium,while there was no distinct changes observed in NC mice.Immunohistochemical staining revealed intense staining for NOX-4 in epithelial,mucosal and submucosal layers of esophagi in CRS mice.ELISA showed that the serum level of NOX-4 in CRS mice was higher than NC mice (1.442 ± 0.05 vs 0.449 ± 0.08),with statistically significant difference (t =-27.32,P ＜ 0.01).Real-time PCR results showed that the expression of colla-1,TGF-β1,α-SMA and NOX-4 in CRS mice were as (2.443 ±0.36,2.78 ±0.13,2.244 ±0.18,2.448 ±0.440) times higher than NC mice,with statistically significant difference (t =-11.19,-38.86,-19.90,-10.37,P ＜ 0.01).Conclusions Fibrotic cytokines such as colla-1,TGF-β1 and α-SMA may participate in formation of stress induced esophageal fibrosis,and oxidative stress may play crucial role in the process of esophageal fibrosis.

Prevention and nursing care of relocation stress of family members of patients transferred from ICU / 中华护理杂志

To summarize the causes of relocation stress in family members of patients transferred from ICU.Based on muhidisciplinary collaboration,stress prevention before transfer and stress intervention after transfer were implemented.For thirty family members of patients in our group,their level of relocation stress 7d after transfer was low.

The status and its influencing factors of job stressors in postpartum nurses with the second-child / 中华护理杂志

Objective To investigate the status and its influencing factors of job stressors in postpartum nurses with the second-child.Methods A total of 127 postpartum nurses with the second-child from 18 tertiary general hospitals in Beijing were investigated with general information questionnaire and the Nurse Stressor Scale.Results The scores of the Nurse Stressor Scale of postpartum nurses with the second-child were 487.99±209.37,mainly for the stressors of nature of nursing work,work load and family.Nature of the department,length of second-child maternity leave,satisfaction of income,appropriate adjustment and care of the department according to work position were the independent contributing factors(P＜0.05).Conclusion The scores of the Nurse Stressor Scale of postpartum nurses with the second-child were in the middle level.Measures should be taken to ensure the length of the second-child maternity leave,arrange suitable work posts,raise salary,and give full care and support to postpartum nurses with the second-child in order to reduce their stress level.