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Purpose: The purpose of this study is to explore how adolescents and their parents/guardians communicate about mental health in order to generate ideas for potential interventions that seek to improve parent-adolescent communication. Methods: Twenty adolescents aged 12 to 19 with a history of depression and/or anxiety were recruited from an adolescent and young adult medical clinic affiliated with an academic medical center in Pittsburgh, PA. Adolescent participants were asked to enroll in the study alongside one parent or guardian. Following enrollment, both adolescents and their parents/guardians completed a survey including a Barriers to Adolescents Seeking Help Scale and Parent-Adolescent Communication Scale. Two sample t-tests were performed to determine if a significant difference existed between overall adolescent and parent/guardian scores. Separate, semi-structured interviews were conducted in person and via Zoom for both adolescents and parents/guardians. Interviews were transcribed verbatim and separate, data-driven codebooks for adolescents and parents/guardians were developed based upon themes that emerged after initial read-through of interview transcripts. Qualitative data was analyzed via template analysis. Double coding was utilized for half of the adolescent and parent/guardian interviews and Cohen's Kappa scores were calculated for each code;the average score was 0.90, indicating substantial agreement. The rest of the interviews were coded by one coder. Results: Qualitative analysis revealed themes concerning adolescents' reluctance to communicate with parents about mental health, including fear of judgement, apprehension about parents' dismissal or misinterpretation of mental health symptoms, and worry about burdening parents. Additionally, a theme of adolescents' preference for communicating with peers was identified, often due to shared experiences. Several themes were identified that promoted parent-adolescent communication, including the disclosure of familial mental health conditions, which led to greater mutual understanding, as well as reduced mental health stigma: "She [mother] talks to me about her own mental health, which makes me feel comfortable talking to her about mine”. Psychotherapy was described by both parents and adolescents as promoting the development of more effective communication strategies. A theme of increased communication about mental health during the COVID-19 pandemic was found, many times due to a greater amount of family time. Both parents and adolescents indicated that an established, trusting relationship was critical to the success of a conversation about mental health. Quantitative analysis revealed that parents reported a significantly higher quality of communication with their child (79.80, p = 0.04) than adolescents reported with their parent (71.75). Additionally, parents reported significantly lower barriers to help seeking (18.60, p = 0.002) than adolescents (24.00). Conclusions: The themes identified in this study lend insight into how communication between parents and adolescents about mental health might be improved and provide targets for potential educational interventions. Anti-stigma campaigns directed at parents may assist in disclosure of familial mental health history and assist in diminishing adolescents' apprehension of parents' dismissal or misinterpretation of mental health symptoms. For parents and adolescents with poor communication, targeted combined psychotherapy sessions can be encouraged as a means to facilitate conversation about mental health and establish trust. Sources of Support: National Institute of Mental Health K23MH111922
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Introduction: Nursing and midwifery staff members are at high risk of mental disorders. Depression, anxiety, and insomnia are commonly reported symptoms among healthcare professionals during the COVID-19 pandemic. Chronic insomnia leads to lower quality of life, worse professional performance and deterioration of cognitive function. Moreover, it increases the risk of metabolic and cardiovascular diseases. Material and methods: The study included 235 nurses (n =133) and midwives (n =102). The diagnostic methods included a descriptive and demographic questionnaire, The General Health Questionnaire (GHQ-28), The Pittsburgh Sleep Quality Index (PSQI), and The Insomnia Severity Index (ISI). The study was conducted using an online survey. Results: There are no statistically significant intergroup differences in terms of mental state, sleep quality and the insomnia level in the groups of nurses and midwives. 9% of subjects used psychological support and revealed lower assessment of their mental health, poorer sleep quality and the higher insomnia rate. The stable mental health of nurses and midwives positively correlated with the sleep quality and negatively with the insomnia level. 63% of study participants assessed their sleep quality as low. The symptoms of clinical insomnia were present in 35% of subjects. Conclusions: Insomnia is a serious health problem for nursing and midwifery staff during the COVID-19 pandemic. The implementation of preventive programmes focused on medical workers' mental health should be a priority in prevention of long-term consequences of sleep problems and insomnia.
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Background and objectives: This paper reviews Australia's take-up of digital mental health interventions, including some specific reference to their application in relation to employment. Use of these interventions in Australia was already significant. Under COVID-19 they have exploded. The Australian experience offers useful lessons for European and other countries, and these are summarised. Methods: This paper presents a narrative review of key texts, resources, policies and reports, from government and other sources. It also presents data reflecting the take-up of digital mental health services and the employment of people with a mental illness in Australia. Results: We present data showing the explosion in uptake of digital mental health services. There is very limited evidence about the impact of these services in improving employment outcomes for people with a mental illness in Australia. The Government has moved to make them a permanent feature of mental health care, in addition to traditional face-to-face care. Conclusion: Key lessons emerge from the Australian experience, including the need for target clarity;the importance of blending digital services into broader frameworks of mental health care;the need for quality and safety standards to be developed and applied to digital services;and the need for better evaluation of the outcomes of digital interventions in the workplace. The digital mental health genie is out of the bottle. New capacity for evaluation of the outcomes of digital mental health services is vital to ensure value and quality of such investments. © 2022 Asociación Universitaria de Zaragoza para el Progreso de la Psiquiatría y la Salud Mental
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Objective: While there are several studies that have focused on the role of face masks in preventing airborne transmission of SARS-CoV-2, few data are available on their effects on physiological measures, and no study has examined their effects on blood pressure (BP). The purpose of our study was to investigate the effect of surgical masks on BP in drug-treated hypertensive patients who had a routine follow-up visit to a university hospital outpatient hypertension clinic. Design and method: The study included already treated hypertensive patients aged > 18 years, while the exclusion criteria were atrial fibrillation or any other arrhythmia affecting the BP measurement, an arm circumference > 42 cm, mental disorders, Parkinson disease, pregnancy, intolerance to the BP measurement method, or unwillingness to participate. A new surgical mask was provided to all participants to replace the face mask that was already in use. After the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa. Results: A total number of 265 patients were included in the study. Among the participants, 115 were women (43.4%), the mean age was 62 ± 12 years, and the mean office BP was 134 ± 15 / 81 ± 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 ± 15 mmHg) and mask-off unattended systolic BP (132 ± 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 ± 13 mmHg) and mask-off unattended diastolic BP (76 ± 13 mmHg) (P = 0.32). Moreover, there was no difference in the heart rate (mask-on first, 69 ± 11 bpm;mask-off first, 69 ± 11 bpm, P = 0.7). Conclusions: Common surgical masks do not affect systolic/diastolic BP levels during unattended BP measurements in treated hypertensive patients.
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Introduction: The level of post-traumatic stress symptoms (PTSS) associated with the early stages of the COVID-19 outbreak, stress, anxiety, and depressive symptoms was assessed. Risk factors for mental health in the Polish population have been identified. Material and methods: Nine hundred and twenty-six respondents completed a set of questionnaires consisting of questions concerning COVID-19, PTSS related to the COVID-19 outbreak (Impact of Event Scale-Revised, IES-R), and their mental health status (Depression, Anxiety and Stress Scale, DASS-21). Results: Most respondents reported severe PTSS related to the COVID-19 outbreak (44.06%), the normal intensity of depressive symptoms (52.38%), anxiety symptoms (56.05%), and stress (56.48%). Almost 20% of Polish respondents were characterized by a severe or extremely severe level of stress, anxiety, or depressive symptoms. Every seventh respondent reported an extremely severe level of depressive symptoms. Female gender, parental status, having a relationship, at least a two-person household were associated with higher PTSS or DASS-21 subscales. A few physical symptoms, a medical visit, quarantine, negative health evaluation, chronic diseases, knowledge about the increase in the number of infected people or deaths were associated with higher levels of PTSS. Some of the precautions and the need for additional information on COVID-19, the certainty of a high COVID-19 contracting probability or of a low survival rate, and concerns about the loved ones were associated with higher PTSS. Conclusions: The indicated risk factors can be used for developing psychological interventions to improve mental health. It is necessary to conduct qualitative research on the psychological reasons for the occurrence of mental symptoms during the pandemic.
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Inequalities in health care exist in many countries in the world. In 2008 the then UK Secretary of State for Health commissioned the Marmot review, ‘Fair Society, Healthy Lives', to propose strategies to address health inequalities in the UK. Most of Marmot's proposals were not acted upon and in 2020, 10 years after the initial recommendations were published, Marmot found that there had been no improvement and some things were worse. In diabetes care inequalities are widespread, impacting on prevention, treatment, access to technology, screening for complications, risk of complications, morbidity and mortality. Ethnicity is a major risk factor, starkly demonstrated by the increased COVID-19 related mortality in people from minority ethnic groups with diabetes. Disadvantaged groups include, but are not limited to, those with social deprivation, intellectual and physical disabilities and severe mental illness. The decision to shelve the long-awaited white paper on tackling health inequalities, taken recently by the last Secretary of State for Health amid protests from a coalition of medical organisations, makes it unlikely that the government will take the actions proposed by Marmot. In the absence of a national strategy, responsibility to recognise and address inequalities in diabetes care falls on health care professionals, in teams and as individuals. Copyright © 2023 John Wiley & Sons.
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Anorexia nervosa is the mental disorder with the highest mortality and is often associated with a chronic course. During the corona pandemic the number of patients in need of treatment significantly increased, especially for affected patients in childhood. In addition, there is an increasing prevalence of atypical anorexia nervosa characterized by normal or overweight but with similar somatic or psychiatric symptoms. The prevalence of anorexia nervosa in males is probably underestimated because clinicians are not well informed about its characteristics in the male sex. Somatic consequences of anorexia nervosa are mostly starvation-induced and can affect many organs. Depressive symptoms, anxiety and obsessive-compulsive disorders are the most frequent psychiatric comorbid disorders or sequelae. Besides an important genetic disposition, further biological risk factors are discussed for the etiology of anorexia nervosa. Treatment consists of somatic stabilization, achievement of a healthy body weight and psychotherapy. The parents should always be integrated into the treatment of children and adolescents with anorexia nervosa. Weight stabilization and its adjustment to growth are essential for a positive long-term outcome. The new concept of anorexia nervosa as a metabo-psychiatric disorder is associated with the hope of new research and treatment strategies.
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Introduction Lactococcus garvieae, a zoonotic pathogen, may rarely infect humans through the consumption of fish. Documented manifestations of L. garvieae infection in humans include infective endocarditis, prosthetic joint infections, liver abscesses, peritoneal dialysis-associated peritonitis, osteomyelitis, meningitis, infective spondylodiscitis, acalculous cholecystitis, and urinary tract infection. Case report An 87-year-old female was hospitalized for coffee-ground emesis secondary to acute gastritis after eating cooked fish. One week after her discharge, she developed new-onset confusion and was returned to the hospital. Chest computed tomography revealed total consolidation of the left lung and a multiloculated left pleural effusion. The patient required intubation and direct admission to the intensive care unit. Pleural fluid and blood cultures grew L. garvieae, which was susceptible to ceftriaxone, penicillin, and vancomycin. Despite intensive antibiotic therapy and supportive care for thirteen days, the patient remained in irreversibl e shock, and the family opted for comfort care. Conclusions Heretofore unreported, this case demonstrates that L. garvieae can cause bronchopneumonia and empyema. Copyright © GERMS 2022.
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Background: Deterioration in the mental health of healthcare workers during and after pandemics have been established. Ongoing health worker shortages and burnout previous to COVID19 and the aggressive transmission of the virus has intensified these mental health issues. Community pharmacists and technicians, who serve on the frontline and who are heavily relied upon during pandemics, are no exception. Purpose(s): The purpose of this study is primarily to understand the immensity of the mental health problems faced in community pharmacy settings and highlight the legal and policy structures that may be easing or exacerbating these incidences in the United States of America. Method(s): Exploratory research that includes a rapid review of existing literature, current news articles and professional organisation publications is used to map out the problem. Result(s): Little research has been conducted on the unique role that pharmacists and technicians occupy during a pandemic, and how, if at all, they may experience different types, or severities, of mental health problems. However, technological advancements have allowed for various interventions and resources. Conclusion(s): This research will help to better understand mental health problems faced in community pharmacy settings, highlight available resources, and discern existing legal and policy structures. Moreover, it could be used to guide future studies on how to address and mitigate specific factors that exacerbate the mental health problems and the need for policy changes to accommodate these incidences.
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Background: Mental health problems significantly increased worldwide during the coronavirus (COVID-19) pandemic. At the early stage of the outbreak, the government of Madhya Pradesh imposed lockdown and quarantine approaches to prevent the spread of the virus, which impacted people's daily life and health. The COVID-19 pandemic has also affected people's economic status, healthcare facilities and other lifestyle factors in Madhya Pradesh. Aim(s): The aim of the study to assess the impact of the COVID-19 pandemic on mental health among the population of Madhya Pradesh. Methods and Materials: An online cross-sectional survey was conducted among 500 individuals of central India, aged between 15 and 65 years from the duration of 15 April to 10 May 2020. After obtaining electronic consent, thesurvey was conducted assessing individual's sociodemographic profiles and psychometric measures. Result(s): The prevalence of loneliness, depression, anxiety and sleep disturbance was estimated at 71% (mild: 32%, moderate: 29%, severe: 10%), 38% (mild: 24%, moderate: 11%, severe: 3%), 64% (mild: 30%, moderate: 17%, severe: 17%) and 73% (mild: 50%, moderate: 18%, severe: 5%), respectively. Conclusion(s): A large portion of respondents reported mental health problems during the COVID-19 pandemic in Madhya Pradesh. The present study suggests longitudinal assessments of mental health among Madhya Pradesh people to determine the gravity of the problem during and after the pandemic. Appropriate supportive programmes and interventional approaches would address mental health problems in Madhya Pradesh during the COVID-19 pandemic. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Guduchi (Tinospora cordifolia) is an essential drug of the Ayurvedic medicine system used in different Ayurvedic formulations to treat a variety of ailments. Guduchi is a member of the Menispermaceae family and is widely produced in tropical and sub-tropical countries such as India, Sri Lanka, China, Myanmar, Philippines, South Africa, Thailand, Bangladesh, and several south-east Asian continents such as Indonesia, Malaysia. All parts of Guduchi have nutritional value and medicinal importance, including the roots, stem, bark, and leaves. A different class of phytochemicals like alkaloids, glycosides, aliphatic compounds, diterpenoids, sesquiterpenoids, phenolic compounds, steroid and polysaccharides, etc., are found in Guduchi. Tinosporaside, tinosporine, magnosporine, berberine, choline, Jatrorrhizine, palmatine, beberine, giloin, giloinsterol, and other beneficial biomarkers are present in this herb. Guduchi is used to treat cold, fever, headache, jaundice, digestive disorder, among other things, and it shows several proven pharmacological activities such as anti-oxidant, anti-inflammatory, antidiabetic, immunomodulatory activity, anti-toxic, hepatoprotective, anticancer, cardioprotective activity, radioprotective, antimicrobial, anti-stress, anti-HIV and many more. This review article majorly highlights the phytochemical present in Guduchi, analytical works and pharmacological activities of Guduchi. Copyright © 2022 are reserved by International Journal of Pharmaceutical Sciences and Research.
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COVID-19 pandemics reactivated interest in the relationship between mental diseases and infectious factors. In this narrative review, such association for tuberculosis, syphilis, toxoplasmosis, influenza, and COVID-19 was discussed. A connection between tuberculosis and melancholia was postulated for several centuries. In the 1950s, an anti-tuberculosis drug, iproniazid, was found to exert an antidepressant effect. In the 20th century, it was demonstrated that psychiatric disturbances connected with syphilis can be treated by an inoculation of malaria, which initiated immunotherapy. Increased frequency of Toxoplasma gondii infections in psychiatric illnesses was found and higher risk of the illnesses following the infection in pregnancy. A more frequent incidence of schizophrenia in persons born during the influenza pandemic in the second half of the 20th century was evidenced. Mental disturbances can result from an ancient infection of the human genome by retroviruses. Infection during pregnancy can increase their risk in later life. Pathogenic can be also an infection in adult life. COVID-19 causes significant early and late consequences for mental health. Two-year pandemics observation brought data on the therapeutic action of psychotropic drugs on SARS-CoV-2. Despite previous data on the antiviral action of lithium, a significant effect of this ion of the prevalence and course on the COVID-19 was not confirmed. Copyright © 2022 Polish Psychiatric Association. All rights reserved.
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Background Multisystem involvement of Covid-19 has been known since beginning of the pandemic. Multisystem after-effects or sequelae of covid-19 have been noted and the term 'long Covid' encompasses these signs and symptoms. This leads to prolonged morbidity which have not been adequately addressed by Covid guidelines.The primary aim of our study was to know the spectrum of different sequelae patients have endured after recovery from acute Covid-19 and study their impact on their quality of life. Methods It was a longitudinal observational study of a cohort of 146 patients who recovered from Covid-19 illness. Patients were enrolled within a week of their onset of Covid symptoms and were followed up monthly for a duration of 6 months with a detailed clinical and investigational pulmonary, cardiac, neurological and psychiatric assessment anda final follow-up after a year. Impact on quality of life was assessed using EQ-5D-3L questionnaire. Those lost to follow up were excluded from the analysis. Results 120/146 patients qualified for final analysis. Pulmonary sequelae (40%) were the majority among the patients, followed by psychiatric (25%), neurological (21.7%) and opportunistic infections (5.8%). 4/120 died within a year. 62/120 patients documented worsening in quality of life. Sequelae like pulmonary fibrosis, PTSD had the worst impact on the quality of life.95% severe, 54.5% moderate and 25% mild Covid patients reported deterioration in QoL score respectively. Conclusion Study indicates health related consequences from Covid-19 extend far beyond acute infection andmake significant impact on their quality of life, regardless of the severity of the disease. Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
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The arrival of COVID-19 pandemic led to a much-publicized mental health crisis for American youth. A subgroup of those youth particularly affected were transgender and gender diverse (TGD) children and adolescents. Yet, a psychoanalytic eye cast on these youth revealed not a crisis, but a dialectic: from a relational and intrapsychic perspective, it was the best of times and the worst of times for TGD young people. This article applies Winnicott's concepts of mirroring and the author's constructs of the true gender self, false gender self, and gender creativity to information gleaned from survey studies and clinical observation. These data were then used to analyze why some TGD children and adolescents experienced the shutdown phase of the pandemic as an opportunity to consolidate their gender self, while others experienced the shutdown as a significant environmental impingement and threat to their gender self and overall well-being. Copyright © 2023 American Psychological Association
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Purpose of Study:We aimed to evaluate the incidence of acute myocardial infarction (AMI) in New Orleans in the sixteen years after Hurricane Katrina. Methods Used: This was a single-center, retrospective study performed at Tulane University Health Sciences Center of patients admitted for AMI during two years prior to Hurricane Katrina and sixteen years after Hurricane Katrina. The pre-Katrina and post-Katrina cohorts were compared according to pre-specified demographic and clinical data. Summary of Results: In the sixteen-year post-Katrina period, there were 3696 admissions for AMI out of a total census of 128 276 (2.9%) compared to 150 admissions out of a census of 21 079 (0.7%) in the pre-Katrina group (p < 0.0001). The post-Katrina group had a higher prevalence of known coronary artery disease (CAD) (43.8% vs. 30.7%, p < 0.0001), diabetes mellitus (40.7% vs. 28.7%, p < 0.002), hypertension (80.1% vs. 74.0%, p < 0.05), hyperlipidemia (54.2% vs. 44.7%, p < 0.0001), smoking (54.2% vs. 39.3%, p < 0.0002), drug abuse (18.7% vs. 6.7%, p < 0.0002), and psychiatric disease (15.3% vs. 6.7%, p < 0.0004). The post-Katrina group was more often prescribed aspirin (49.6% vs. 31.3%, p < 0.0001), betablocker (46.9% vs. 34.0%, p < 0.004), ACE inhibitor or ARB (51.9% vs. 36.0%, p < 0.0004), and statin (52.6% vs. 28.0%, p < 0.0001) but with higher medication nonadherence (15.8% vs. 7.3%, p < 0.0001). The post- Katrina patients were also more likely to be unemployed (75.6% vs 22.7%, p < 0.0001) and non-married (56.3% vs. 52.7%, p < 0.0001). Rates of STEMI were lower in the post-Katrina group (29.1% vs 42.0%, p < 0.002). There was no significant difference in terms of sex, being uninsured, or prior coronary artery bypass grafting. Four patients were COVID positive in the post-Katrina cohort. Conclusion(s): There was a fourfold increase in the incidence of AMI sixteen years after Hurricane Katrina. Prevalent psychosocial, behavioral, and traditional CAD risk factors were significantly higher among the post- Katrina group. These findings will continue to add to the growing body of literature demonstrating the adverse cardiovascular outcomes that occur after a natural disaster. Despite this, further research is required to explain the underlying mechanisms to help mitigate future cardiac morbidity. This study will help enable cardiovascular clinicians to further understand the needs and dynamic changes that can occur following natural disasters. Copyright © 2023 Southern Society for Clinical Investigation.
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Objective: This study aimed to investigate behavioral, emotional problems and fatigue in adolescents after COVID-19 infection. Also, we examined relationships between baseline inflammation levels, fatigue, and the current behavioral and emotional problems of adolescents. Material(s) and Method(s): A total of 110 adolescents (56 boys, 50.9%, mean age 14.72 years) and their parents were included in the study. Psychiatric assessments of the adolescents were performed 7.31+/-2.35 months after discharge from hospital. Behavioral and emotional problems was assessed using the Child Behavior Checklist (CBCL) 6-18 parent-rated questionnaire. Result(s): We collected baseline inflammatory markers including C-reactive protein (CRP), the neutrophil/lymphocyte ratio (NLR), the monocyte/lymphocyte ratio (MLR), and the systemic immune-inflammation index (SII). The proportions of adolescents that were in the clinical range in at least one behavioral and emotional domain were as follows: 44.5% in the entire sample, 35.7% in boys, and 53.7% in girls. Thought problems were the most common problems in the entire sample (25.5%). The rates of internalizing and externalizing symptoms were 33.6% and 16.4%, respectively. Somatic and attention symptoms were more frequent in females than in males. Inflammatory marker levels did not correlate with behavioral and emotional scores. Fatigue symptoms were determined in 36.4% of all adolescents. We found that somatic and attention problems are more common in fatigued adolescents. Conclusion(s): Our findings demonstrated that screening for behavioral, emotional problems, and fatigue in adolescents with COVID-19 infection is necessary. Future studies with a follow-up design are needed to determine whether a relationship exists between behavioral, emotional problems and baseline inflammation levels after COVID-19 infection. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.