Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study.

BACKGROUND: Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. OBJECTIVE: This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. METHODS: This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. RESULTS: Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. CONCLUSIONS: This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. TRIAL REGISTRATION: OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51298.

Microporous Hydroxyapatite-Based Ceramics Alter the Physiology of Endothelial Cells through Physical and Chemical Cues.

Incorporation of silicate ions in calcium phosphate ceramics (CPC) and modification of their multiscale architecture are two strategies for improving the vascularization of scaffolds for bone regenerative medicine. The response of endothelial cells, actors for vascularization, to the chemical and physical cues of biomaterial surfaces is little documented, although essential. We aimed to characterize in vitro the response of an endothelial cell line, C166, cultivated on the surface CPCs varying either in terms of their chemistry (pure versus silicon-doped HA) or their microstructure (dense versus microporous). Adhesion, metabolic activity, and proliferation were significantly altered on microporous ceramics, but the secretion of the pro-angiogenic VEGF-A increased from 262 to 386 pg/mL on porous compared to dense silicon-doped HA ceramics after 168 h. A tubulogenesis assay was set up directly on the ceramics. Two configurations were designed for discriminating the influence of the chemistry from that of the surface physical properties. The formation of tubule-like structures was qualitatively more frequent on dense ceramics. Microporous ceramics induced calcium depletion in the culture medium (from 2 down to 0.5 mmol/L), which is deleterious for C166. Importantly, this effect might be associated with the in vitro static cell culture. No influence of silicon doping of HA on C166 behavior was detected.

Assessing effectiveness of heart rate variability biofeedback to mitigate mental health symptoms: a pilot study.

Introduction: The increasing burden on mental health has become a worldwide concern especially due to its substantial negative social and economic impact. The implementation of prevention actions and psychological interventions is crucial to mitigate these consequences, and evidence supporting its effectiveness would facilitate a more assertive response. Heart rate variability biofeedback (HRV-BF) has been proposed as a potential intervention to improve mental wellbeing through mechanisms in autonomic functioning. The aim of this study is to propose and evaluate the validity of an objective procedure to assess the effectiveness of a HRV-BF protocol in mitigating mental health symptoms in a sample of frontline HCWs (healthcare workers) who worked in the COVID-19 pandemic. Methods: A prospective experimental study applying a HRV-BF protocol was conducted with 21 frontline healthcare workers in 5 weekly sessions. For PRE-POST intervention comparisons, two different approaches were used to evaluate mental health status: applying (a) gold-standard psychometric questionnaires and (b) electrophysiological multiparametric models for chronic and acute stress assessment. Results: After HRV-BF intervention, psychometric questionnaires showed a reduction in mental health symptoms and stress perception. The electrophysiological multiparametric also showed a reduction in chronic stress levels, while the acute stress levels were similar in PRE and POST conditions. A significant reduction in respiratory rate and an increase in some heart rate variability parameters, such as SDNN, LFn, and LF/HF ratio, were also observed after intervention. Conclusion: Our findings suggest that a 5-session HRV-BF protocol is an effective intervention for reducing stress and other mental health symptoms among frontline HCWs who worked during the COVID-19 pandemic. The electrophysiological multiparametric models provide relevant information about the current mental health state, being useful for objectively evaluating the effectiveness of stress-reducing interventions. Further research could replicate the proposed procedure to confirm its feasibility for different samples and specific interventions.

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic.

Background and objective: The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up. Material and methods: A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2). Results: Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up. Conclusion: Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.

Antecedentes y objetivo: La pandemia Covid-19 sigue desafiando a los sistemas sanitarios, exponiendo al personal asistencial a estresores físicos y psicológicos. Actualmente, varios estudios han demostrado el impacto catastrófico en la salud mental del personal asistencial durante la primera etapa de la pandemia, pero pocos han considerado el seguimiento de los síntomas. El presente estudio examina el efecto de la pandemia en la salud mental del personal sanitario de primera línea a los 6 meses de seguimiento. Material y métodos: Se evaluó psicológicamente a 141 trabajadores sanitarios de primera línea de 2 hospitales terciarios al inicio del estudio (julio-noviembre, 2020) y a los 6 meses (enero-mayo, 2021) mediante pruebas psicométricas para el estrés agudo (VASS, PSS-10, PCL-5), la ansiedad (STAI) y la depresión (PHQ-2). Resultados: En general, se observó un empeoramiento de la salud mental entre las 2 evaluaciones psicológicas, especialmente en depresión y predisposición a percibir las situaciones como una amenaza. La salud mental del personal de enfermería empeoró con el tiempo, mientras que los médicos mejoraron. La reducción de la jornada laboral y el aumento del ejercicio físico mejoraron la salud mental. Las mujeres y el personal de enfermería fueron los más afectados por el malestar psicológico al inicio y a los 6 meses de seguimiento. Conclusión: Jornadas laborales reducidas, períodos de descanso adecuados, ejercicio físico y estrategias de intervención eficientes son de suma importancia para prevenir, controlar y reducir el malestar psicológico entre el personal sanitario ante escenarios críticos como la pandemia actual.

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic

Background and objectiveThe Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up.Material and methodsA total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2)ResultsOverall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up.ConclusionReduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic. (AU)

Antecedentes y objetivoLa pandemia Covid-19 sigue desafiando a los sistemas sanitarios, exponiendo al personal asistencial a estresores físicos y psicológicos. Actualmente, varios estudios han demostrado el impacto catastrófico en la salud mental del personal asistencial durante la primera etapa de la pandemia, pero pocos han considerado el seguimiento de los síntomas. El presente estudio examina el efecto de la pandemia en la salud mental del personal sanitario de primera línea a los 6 meses de seguimiento.Material y métodosSe evaluó psicológicamente a 141 trabajadores sanitarios de primera línea de 2 hospitales terciarios al inicio del estudio (julio-noviembre, 2020) y a los 6 meses (enero-mayo, 2021) mediante pruebas psicométricas para el estrés agudo (VASS, PSS-10, PCL-5), la ansiedad (STAI) y la depresión (PHQ-2).ResultadosEn general, se observó un empeoramiento de la salud mental entre las 2 evaluaciones psicológicas, especialmente en depresión y predisposición a percibir las situaciones como una amenaza. La salud mental del personal de enfermería empeoró con el tiempo, mientras que los médicos mejoraron. La reducción de la jornada laboral y el aumento del ejercicio físico mejoraron la salud mental. Las mujeres y el personal de enfermería fueron los más afectados por el malestar psicológico al inicio y a los 6 meses de seguimiento.ConclusiónJornadas laborales reducidas, períodos de descanso adecuados, ejercicio físico y estrategias de intervención eficientes son de suma importancia para prevenir, controlar y reducir el malestar psicológico entre el personal sanitario ante escenarios críticos como la pandemia actual. (AU)

Dental and maxillofacial manifestations of Steinert's myotonic dystrophy: A retrospective case series and therapeutic investigation.

This retrospective study was performed to analyse the facial features and occlusal anomalies in 18 patients with Steinert's myotonic dystrophy (MD1). Medical and surgical management issues noted in this study may contribute to clinical decision-making. This series included 18 patients with MD1 who presented for maxillofacial consultations. For all patients, the following characteristics were assessed: sex, age, intellectual ability, oral condition, initial assessment of the occlusion and facial aspect. In total, 11 of 18 patients underwent surgery (10 achieved occlusion modification, whereas one did not). amongst patients who underwent surgery and achieved occlusion modification, six had stable class I results and four had unstable results or exhibited a slight degradation. Facial muscles play an important role in craniomaxillofacial development and facial aspects. A high prevalence of malocclusions is present in patients with MD1. Orthodontics and orthognathic surgery can improve the quality of life for affected patients. However, the long-term results of these treatments may be disappointing, and relapse can occur in patients with the most severe disease. Aspects of disease to consider while planning for surgery include oral health, risks of instability and relapse, and risks involving anaesthesia.

Dealing with Emotional Vulnerability and Anxiety in Nurses from High-Risk Units-A Multicenter Study.

Compassion fatigue and anxiety derived from continued exposure to trauma and death greatly impact nurses' quality of care and quality of life, increasing their desire to leave work. The aim of the study is to assess compassion fatigue and anxiety prevalence and their association with secondary variables. A multicenter, cross-sectional study in nurses from four high-risk units, Emergency, Intensive Care, Oncology, and Pediatrics, was carried out in 14 hospitals in Catalonia (Spain) between 2015 and 2016. The primary endpoints were compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress), which were assessed by Professional Quality of Life (ProQOL), and anxiety, assessed with the State-Trait Anxiety Inventory (STAI). Multivariable logistic regression analyzed the association of sociodemographic, training, working, and psychological factors. Of a total of 1302 nurses, 18.6% presented low compassion satisfaction; 19.7%, high burnout; and 36.4%, high secondary traumatic stress. Trait anxiety scored high in 7.2%. Although compassion satisfaction was present, it did not protect sufficiently against the high level of compassion fatigue or anxiety present in nurses in all centers. The working conditions in the units and variables showed a strong association with nurses' desire to leave. This corroborates the global challenge of healthcare professionals' shortage. Participants expressed the need for better training in emotional management.

COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months.

OBJECTIVE: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. METHOD: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. RESULTS: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. CONCLUSIONS: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.

Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola, salud mental a los 4 meses y seguimiento a los 9 meses / COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months

Objetivo: Determinar el impacto que ha tenido la pandemia COVID-19 en profesionales sanitarios, en términos de cambios laborales y de salud mental. Método: 1)Estudio transversal y 2) estudio longitudinal prospectivo sobre profesionales de la salud que trabajaron de forma directa con pacientes afectados por la pandemia COVID-19 durante el periodo comprendido entre marzo-junio de 2020 en un hospital de tercer nivel de Barcelona. Se recogieron datos basales (julio-noviembre de 2020) y de seguimiento (noviembre de 2020-marzo de 2021). Se recogieron datos relacionados con el puesto de trabajo y hábitos tóxicos con cuestionarios ad hoc, y de estrés percibido, estrés postraumático, depresión y ansiedad mediante cuestionarios validados. Resultados: En el grupo basal (estudio transversal) participaron 90 profesionales, 76% enfermeras. Más de un tercio estuvo de baja o tomó fármacos para gestionar el estrés. La mitad de los fumadores aumentó el consumo de tabaco, y uno de cada 5 aumentó el consumo de alcohol. Se asocia de forma significativa el cambio de turno habitual con la depresión, el perfil profesional con la ansiedad, y el estrés percibido con la edad. En el estudio longitudinal, el grupo de seguimiento (n=64) muestra niveles elevados de estrés y ansiedad, que se mantienen o incluso aumentan en el tiempo de forma significativa. Conclusiones: Los cambios estructurales acontecidos en el hospital durante la primera ola de la pandemia por la COVID-19 tuvieron un fuerte impacto en los profesionales, presentando muchos de ellos un aumento en los hábitos tóxicos, así como una salud mental alterada que se mantiene en el tiempo.(AU)

Objective: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. Method: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. Results: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n=64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. Conclusions: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.(AU)

[COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months]. / Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola, salud mental a los 4 meses y seguimiento a los 9 meses.

Objective: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. Method: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. Results: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. Conclusions: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.

Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic.

BACKGROUND AND OBJECTIVE: The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up. MATERIAL AND METHODS: A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2) RESULTS: Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up. CONCLUSION: Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.

Mental health assessment of Spanish healthcare workers during the SARS-CoV-2 pandemic. A cross-sectional study.

INTRODUCTION: The SARS-CoV-2 outbreak is posing unprecedented care scenarios, increasing the psychological distress among healthcare workers while reducing the efficiency of health systems. This work evaluated the psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers of two tertiary hospitals. MATERIAL AND METHODS: Healthcare workers were recruited from the medical units designated for the care of Covid-19 patients. The psychological assessment consisted of an individual, face-to-face session where gold-standard psychometric tests were administered to assess stress (VASS & PSS-10), anxiety (STAI), depression (PHQ-2) and posttraumatic stress disorder (PCL-5). Regression models were also fitted to identify predictors of psychological distress. RESULTS: Overall, almost 13% of healthcare workers showed severe anxiety, while more than 26% had high levels of perceived stress. More than 23% presented severe posttraumatic stress symptoms, and another 13% had PHQ-2 scores equal to or above 3, compatible with Major Depressive Disorder (MDD) diagnosis, respectively. Women, stress-related medication, overworking, performing in Covid-19 wards, and substance abuse were risk factors for increased psychological distress. Instead, practising exercise reduced the burden. CONCLUSION: This study outlines the severe psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers. The stress, depression and anxiety levels found were similar to those reported in similar works but much higher than in Wuhan healthcare workers. Knowledge of risk factors for increased psychological distress may help to develop comprehensive intervention strategies to prevent, control and reduce the mental health exacerbation of healthcare workers, thereby maintaining the effectiveness of health systems in critical scenarios.

Psychosomatic response to acute emotional stress in healthy students.

The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.

A Comparative Study of a Novel Postural Garment Versus Exercise for Women with Nonspecific Cervical Pain: A Randomized Cross-over Trial.

STUDY DESIGN: Randomized cross-over study. OBJECTIVE: The aim of this study was to compare exercise, the criterion standard, to the postural garment PosturePlusForce in the management of nonspecific cervical pain in women. We also analyzed both interventions with regards to baseline posture, use of pharmacological pain relievers, compliance, and comfort. SUMMARY OF BACKGROUND DATA: The prevalence of neck pain has increased during the last decade, preferentially affecting women. Those suffering from this condition may manifest a decrease in quality of life and inability to work. Consistent recommendations highlight the importance of exercise and posture for neck pain improvement. METHODS: A total of 32 female health care professionals with cervical pain (≥3 on the visual analogue scale) entered the trial. Participants were allocated to either performing exercises or wearing the postural garment. The cross-over between interventions was separated by a 3-month washout period. Primary outcomes included pain intensity and posture. Secondary outcomes comprised cervical pain-related disability, psychological factors, physical activity, global perceived effect of treatment, and garment comfort. Treatment compliance, medication use, and adverse events were also recorded. RESULTS: Both interventions showed a significant improvement in pain in subjects with an adherence >60%. However, in participants with dorsal hyperkyphosis (>45°), the garment demonstrated a greater reduction in pain than exercise (P = 0.019). Additionally, those wearing the garment needed fewer pain relievers than those performing exercises (P = 0.007). Compliance was >50% for both interventions and comfort was contingent on season. CONCLUSION: In our study, PosturePlusForce showed, at least, a similar effect on pain to exercise, although those with dorsal hyperkyphosis exhibited a greater reduction in pain and related variables with the garment. Pain relievers were less required by those wearing PosturePlusForce than by those performing the exercises.Level of Evidence: 1.

Design and validation of an electrophysiological based tool to assess chronic stress. Case study: burnout syndrome in caregivers.

Caregiver burnout syndrome is an increasingly seen condition, although the subjective nature of self-administered psychometric tests and the lack of a consensual diagnostic tool might hinder a proper diagnosis. The availability of objective psychosomatic measures of stress might facilitate the early diagnosis and clinical management of these patients. For this reason, the aim of this work was to develop a quantitative tool to evaluate the stress level of caregivers in a noninvasive and repeatable manner. An observational, controlled, matched study was designed including a group of 38 principal caregivers of chronic patients and a control group of 38 non-caregivers. Psychometric, biochemical, and electrophysiological data were analyzed along with sociodemographic data. A quantitative chronic stress reference scale (CSRs) was constructed based on the weighted contribution of several psychometric and biochemical variables and afterwards, a predictive psychosomatic model (ESBSm) correlated with CSRs was elaborated from extracted variables of several electrophysiological signals monitored for 10 min. The resulting CSR scale shows a high power to discriminate caregivers from the control group while the ESBSm shows a 79% correlation with the CSR scale validated through a 5-fold process. Therefore, the results demonstrate that the ESBS model is an objective and validated tool to diagnose the degree of stress linked to burnout in caregivers of chronic patients from a 10-min session of noninvasive monitoring with a reliability equivalent to the questionnaires currently used to quantify stress in caregivers.

Emotional impact and compassion fatigue in oncology nurses: Results of a multicentre study.

PURPOSE: To assess the prevalence of Compassion Satisfaction, Compassion Fatigue (Burnout and Secondary Traumatic Stress) and anxiety in oncology nurses and the association with demographics, training, work-related conditions, and psychological factors. METHOD: A multicentre, cross-sectional study in 8 selected hospitals in Catalonia (Spain) involving oncology nurses. Primary outcomes were Compassion Satisfaction and Compassion Fatigue (Burnout/Secondary Traumatic Stress), evaluated with the Professional Quality of Life questionnaire v.IV, and anxiety, evaluated with the State-Trait Anxiety Inventory. RESULTS: Of 297 participants, 18.2% (95% confidence interval [CI]:16.1-20.3) presented low Compassion Satisfaction; 20.2% (95% CI:18.0-22.4), high burnout; and 37.4% (95% CI:34.8-40.0), high Secondary Traumatic Stress. Trait and State Anxiety were high in 5.4% (95% CI:4.2-6.6) and 8.1% (95% CI:6.6-9.6) of participants, respectively. Nurses' desire to leave the unit was associated with high burnout (adjusted odds ratio [ORa] 3.7, 95% CI:1.9-7.5) and Secondary Traumatic Stress (ORa 3.2, 95% CI:1.9-5.3), while the desire to leave the profession was related to high State Anxiety (ORa 12.5, 95% CI:4.6-33.7). Most participants (96.9%) were interested in receiving emotional management training. CONCLUSIONS: Continuous demands on oncology nurses' empathy can lead them to experience compassion fatigue, anxiety and a desire to leave the profession. The first study carried out with Spanish oncology nurses shows Compassion Fatigue is highly prevalent. This is related to nurses' desire to change units, leave their profession and has negative implications on staff satisfaction and quality of care. This problem justifies institutions support strategies for these professionals.

The effect of functional circuit training on physical frailty in frail older adults: a randomized controlled trial.

The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (± SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p < .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.

Measuring balance, lower extremity strength and gait in the elderly: construct validation of an instrument.

The purpose of the study was to determine the degree to which scores of a modified version of the 'Timed Get Up and Go' test (TGUG) were associated with other measures of functional performance. Thirty-seven community-dwelling older women (72.3+/-5.5 years) volunteered to participate. Subjects were assessed when performing the modified TGUG test. Correlations between the performance-oriented mobility assessment (POMA), single-leg balance, five chair rises, fast and normal gait speed, knee extension and flexion strength, and the modified TGUG were conducted. Total time to perform the modified TGUG test was significantly correlated with normal and fast gait speed (p<0.05). The Pearson correlation coefficients were -0.841 and -0.748, respectively. The time needed to perform several tasks of the modified TGUG test significantly correlated with five chair rises, and with right knee extensor strength (p<0.05). Points obtained in the assessment questionnaire correlated significantly to points obtained in the POMA scale (p<0.05). The Pearson correlation coefficient was 0.795. Based on the strength of the correlations obtained between components of the modified TGUG and the comparison tests, concurrent, criterion validity of the modified TGUG has been established.