Risultati per: Incontinenza urinaria da stress o mista

Introduction
Diagnosis and treatment represent distressing experiences for the families of children with cancer. Psychosocial challenges are faced by these families in China because of limited health services and resources for psychosocial oncology care. Effective interventions tailored to the knowledge level and cultural values of this population are needed. The goal of this study is to evaluate a smartphone-based care support (SBCS) programme for the families of children with cancer in China.

Methods and analysis
A parallel randomised controlled trial will be conducted to examine the efficacy of an evidence-based and culturally tailored SBCS programme for the families of children with cancer in China. A total of 180 families will be recruited. The intervention will consist of an introduction session and four main sessions and will be conducted sequentially on a single weekend day. Participating families will be included in the intervention group. The post-traumatic stress and quality of life of families will be evaluated at baseline, during the intervention, immediately after the intervention, and 2 and 6 months after the intervention.

Ethics and dissemination
Ethical approval for this protocol has been obtained from the Nursing and Behavioural Medicine Research Ethics Review Committee, Xiangya School of Nursing, Central South University (Protocol #: E2020125). The findings of the trial will be disseminated through conference presentations and publications in peer-reviewed journals.

Trial registration number
ChiCTR2000040510.

Introduction
Postoperative imaging after neurosurgical interventions is usually performed in the first 72 hours after surgery to provide an accurate assessment of postoperative resection status. Patient frequently report that early postoperative examination after craniotomy for tumour and vascular procedures is associated with distress, exertion, nausea and pain. Delayed postoperative imaging (between 36 and 72 hours postoperatively) may have an advantage regarding psychological and physical stress compared with early imaging. The goal of this study is to evaluate and determine the optimal time frame for postoperative imaging with MRI and CT in terms of medical and neuroradiological implications and patient’s subjective stress level.

Methods and analysis
Data will be prospectively collected from all patients aged 18–80 years who receive postoperative MRI or CT imaging following a craniotomy for resection of a cerebral tumour (benign and malignant) or vascular surgery. Participants have to complete questionnaires containing visual analogue scores (VAS) for headache and nausea, Body Part Discomfort score and a single question addressing subjective preference of timing of postoperative imaging after craniotomy. The primary endpoint of the study is the difference in subjective stress due to imaging studies after craniotomy, measured just before and after postoperative MRI or CT with the above-mentioned instruments. Subjective stress is defined as a combination of the scores VAS pain, VAS nausea and 0.5* Body Part Discomfort core.
This study determines whether proper timing of postoperative imaging can improve patient satisfaction and reduce pain, stress and discomfort caused by postoperative imaging. Factors causing additional postoperative stress are likely responsible for delayed recovery of neurosurgical patients.

Ethics and dissemination
The institutional review board (Kantonale Ethikkommission Zürich) approved this study on 4 August 2020 under case number BASEC 2020–01590. The authors are planning to publish the data of this study in a peer-reviewed paper. After database closure, the data will be exported to the local data repository (Zurich Open Repository and Archive) of the University of Zurich. The sponsor (LR) and the project leader (MR.G) will make the final decision on the publication of the results. The data that support the findings of this study are available on request from the corresponding author LT. The data are not publicly available due to privacy/ethical restrictions.

Trial registration number
NCT05112575; ClinicalTrials.gov.

Introduction
In traumatic brain injury (TBI) patients, inflammatory processes and oxidative stress have been linked to the development of neurodegenerative diseases, disability, increased rate of muscle catabolism, malnutrition, hospital stay and mortality. Previous in vitro and in vivo studies have shown that trehalose can decrease inflammatory and oxidative factors. Therefore, the present study was designed to evaluate the effect of oral trehalose consumption on this marker in critically ill TBI patients at intensive care unit (ICU).

Methods and analysis
This study is a pilot randomised, prospective and double-blind clinical trial. The study sample size is of 20 (10 patients in each group) TBI patients aged 18–65 years at ICU. Randomisation is performed by permuted block randomisation method. The allocation ratio is 1:1. An intervention group will receive 30 g of trehalose instead, as a part of the carbohydrate of daily bolus enteral feeding and the control group will receive standard isocaloric hospital bolus enteral feeding for 12 days. The inflammatory factors (C reactive protein, interleukin 6) and oxidative stress markers (glutathione, malondialdehyde, superoxide dismutase, pro-oxidant–antioxidant balance, total antioxidant capacity) will be measured at the baseline, at the 6th day, and at the end of the study (12th day). Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, Nutrition Risk in the Critically ill scores, 28-day mortality, anthropometric assessments and the clinical and nutritional status will be measured. Each patient’s nutritional needs will be calculated individually. The statistical analysis would be based on the intention to treat.

Ethics and dissemination
The vice-chancellor of the research centre of Mashhad University of Medical Sciences is sponsoring this study. IR.MUMS.MEDICAL.REC.1400.113.

Trial registration number
Iranian Registry of Clinical Trials (IRCT) Id: IRCT20210508051223N1, Registration date: 26 July 2021.

Introduction
The mental health status of nurses affects not only their well-being but also the organisational outcomes and the quality of patient care. Hence, stress management strategies are critical as a universal prevention measure that address an entire population and are not directed at a specific risk group to maintain nurses’ mental health in the workplace. No systematic review or meta-analysis has been conducted to evaluate the effect of cognitive–behavioural therapy (CBT) that specifically focuses on universal prevention. Therefore, the aim of this study is to examine the effectiveness that is reported in published randomised controlled trial (RCT) studies.

Methods and analysis
This systematic review and meta-analysis will analyse published studies selected from electronic databases (ie, Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, Web of Science and the Japan Medical Abstracts Society). The inclusion criteria for studies are that they (1) were conducted to assess the effect of CBT on the mental health of nurses as a universal prevention, (2) used an RCT design and (3) provided sufficient results (sample sizes, means and SD) to estimate the pooled effect sizes with 95% CIs. Studies will be excluded if they only targeted nurses who had been screened as being at high risk in terms of their mental health and indicated that they required the prevention. The methodological quality of the included studies will be assessed using the Cochrane Collaboration’s risk of bias tool.

Ethics and dissemination
Ethical approval is not required because this study is based on information obtained from previous studies. The results and findings of this study will be submitted for publication in a peer-reviewed international scientific journal. Results from this study will be helpful when implementing CBT strategies for nurses as a universal preventative measure in the workplace and for managing stress-related outcomes.

PROSPERO registration number
CRD42020152837.

Objective
This study was designed to explore the impact of occupational hazards and occupational stress on job burn-out among factory workers and miners. This study also aimed to provide a scientific basis for the prevention and control of job burn-out among factory workers and miners.

Design
A cross-sectional study based on the factory Workers and Miners of Urumqi, Xinjiang. Demographic biases, that is, confounding factors, were eliminated by the propensity score-matched analysis method.

Participants
An electronic questionnaire was used to survey 7500 eligible factory workers and miners in Urumqi, the capital of Xinjiang, and 7315 complete questionnaires were returned.

Primary outcome measures
A general demographic questionnaire, the Effort–Reward Imbalance (ERI) and the Chinese Maslach Burnout Inventory.

Results
The total rate of burn-out was 86.5%. Noise (OR 1.34, 95% CI 1.09 to 1.64) and ERI (OR 2.16, 95% CI 1.78 to 2.61) were the risk factors for job burn-out among factory workers and miners (p

This meta-analysis uses peripheral biological matrices and central nervous system markers to examine the association of nucleic acid damage from oxidative stress with psychiatric disorders in adults.

Objective
Test whether Sudarshan Kriya Yoga (SKY) was non-inferior to cognitive processing therapy (CPT) for treating symptoms of post-traumatic stress disorder (PTSD) among veterans via a parallel randomised controlled non-inferiority trial.

Setting
Outpatient Veterans Affairs healthcare centre.

Participants
85 veterans (75 men, 61% white, mean age 56.9) with symptoms of PTSD participated between October 2015 and March 2020: 59 participants completed the study.

Interventions
SKY emphasises breathing routines and was delivered in group format in a 15-hour workshop followed by two 1-hour sessions per week for 5 weeks. CPT is an individual psychotherapy which emphasises shifting cognitive appraisals and was delivered in two 1-hour sessions per week for 6 weeks.

Measures
The primary outcome measure was the PTSD Checklist-Civilian Version (PCL-C). The secondary measures were the Beck Depression Inventory-II (BDI-II) and Positive and Negative Affect Scale (PANAS).

Results
Mean PCL-C at baseline was 56.5 (±12.6). Intent-to-treat analyses showed that PCL-C scores were reduced at 6 weeks (end of treatment) relative to baseline (SKY, –5.6, d=0.41, n=41: CPT, –6.8, d=0.58, n=44). The between-treatment difference in change scores was within the non-inferiority margin of 10 points (–1.2, 95% CI –5.7 to 3.3), suggesting SKY was not inferior to CPT. SKY was also non-inferior at 1-month (CPT–SKY: –2.1, 95% CI –6.9 to 2.8) and 1-year (CPT–SKY: –1.8, 95% CI –6.6 to 2.9) assessments. SKY was also non-inferior to CPT on the BDI-II and PANAS at end of treatment and 1 month, but SKY was inferior to CPT on both BDI-II and PANAS at 1 year. Dropout rates were similar (SKY, 27%, CPT, 34%: OR=1.36, 95% CI 0.51 to 3.62, p=0.54).

Conclusions
SKY may be non-inferior to CPT for treating symptoms of PTSD and merits further consideration as a treatment for PTSD.

Trial registration number
NCT02366403.

Objectives
Limited research has focused on the association between work stress and health behaviours in Asian countries. We aimed to explore the effect of work stress on two health behaviours among employees aged 45 years or above in two countries with ageing populations, Korea and Japan.

Design
A cross-sectional study.

Setting
This secondary data analysis was conducted on baseline data from the Korean Longitudinal Study of Aging (KLoSA, 2006) and the Japanese Study of Aging and Retirement (JSTAR, 2007 and 2009).

Participants
Included in the analytical sample were 4982 responders without missing data aged 45 years or older who reported work positions and hours (KLoSA n=3478, JSTAR n=1504).

Main outcome measures
Work stress was represented by the short version of the effort-reward imbalance (ERI) model. We used logistic regression and multinomial logistic regression to investigate the association between work stress and smoking (binary current smoking) and between work stress and drinking (categorical volume of alcohol). Socioeconomic and work-related characteristics were taken into consideration, and we examined the potential interaction between ERI and gender.

Results
Work stress as measured by ERI ratio was significantly associated with both smoking and drinking in the KLoSA analysis; after the model was fully adjusted, ORs were 1.45 (95% CI 1.17 to 1.80) and 1.44 (95% CI 1.09 to 1.90), respectively. In analysis of the data from JSTAR, the ERI ratio was associated with smoking (OR 1.37, 95% CI 1.01 to 1.89) but not with drinking. No statistically significant interaction was found between ERI and gender in any model (p=0.82 in KLoSA data and p=0.19 in JSTAR data).

Conclusions
Statistically significant associations were found between work stress and both smoking and drinking behaviours in Korea and between work stress and smoking in Japan. Government integration of effort-reward balance programmes and health promotion programmes could effectively promote population health in these two Asian countries.

Introduction
Measures to mitigate the COVID-19 outbreak in the migrant worker dormitories in Singapore included lockdown and isolation of residents for prolonged periods. In this paper, we explore efforts to ease tensions and support mental health under these conditions.

Methods
Case study of dormitory residents under lockdown from April to August 2020 comprises a nested mixed-method approach using an online questionnaire (n=175) and semistructured interviews (n=23) of migrant workers sampled from the survey (August to September 2020). Logistic regression models were used to analyse survey data. Semistructured interviews were analysed using applied thematic analysis.

Results
Survey and interview data showed that mental health was largely protected despite initial rising tensions over restrictions during lockdown. Sources of tension negatively affecting low stress responses included job related worries, OR=0.07 (95% CI 0.03 to 0.18, p

Objectives
To find predictors of burn-out in a cohort of rescuers.

Design
Cross-sectional study.

Setting
Republican Rescue Squad (N=105) and Republican Mudslide Rescue Service under the Ministry of Emergency Situations (N=480) in Almaty, Kazakhstan.

Participants
In total, we included 268 (80% men, median age 38 (IQR 22) years) rescuers from both organisations.

Primary and secondary outcome measures
We offered a questionnaire to rescuers, which included Maslach Burnout Inventory, quantifying emotional exhaustion (EX), cynicism (CY) and professional efficacy (PE) along with fatigue, stress and health-related quality of life (HRQL) tools.

Results
Lower scores of HRQL (Physical Component Score (PCS) beta –0.04 (95% CI –0.06 to –0.02); Mental Component Score beta –0.03 (95% CI –0.05 to –0.01)), higher fatigue (Fatigue Severity Scale (FSS) score beta 0.03 (95% CI 0.03 to 0.04)) and stress (Perceived Stress Score-10 beta 0.04 (95% CI 0.02 to 0.06)) independently predicted greater EX. Lower PCS (beta –0.03 (95% CI –0.06 to –0.01)) and FSS (beta 0.02 (95% CI 0.01 to 0.03)) could predict more CY burn-out. In addition to stress, higher education (beta 0.86 (95% CI 0.40 to 1.32)) was positively associated with lower burn-out severity in PE domain.

Conclusions
Fatigue, stress and HRQL were associated with burn-out in rescuers. Addressing these predictors may help guide further interventions to reduce occupational burn-out.

Aim
To investigate experiences of stress, feelings of safety, trust in healthcare staff and perceptions of the severity of a SARS-CoV-2 infection among inpatients discharged from Valais Hospital, Switzerland, during the COVID-19 pandemic’s first wave.

Methods
Discharged patients aged 18 years or more (n=4665), hospitalised between 28 February and 11 May 2020, whether they had been infected by SARS-CoV-2 or not, were asked to complete a self-reporting questionnaire, as were their informal caregivers, if available (n=866). Participants answered questions from Cohen’s Perceived Stress Scale (PSS) (0=no stress, 40=severe stress), Krajewska-Kułak et al’s Trust in Nurses Scale and Anderson and Dedrick’s Trust in Physician Scale (10=no trust, 50=complete trust), the severity of a SARS-CoV-2 infection (1=not serious, 5=very serious), as well as questions on their perceived feelings of safety (0=not safe, 10=extremely safe).

Results
Of our 1341 respondents, 141 had been infected with SARS-CoV-2. Median PSS score was 24 (IQR1–3=19–29), median trust in healthcare staff was 33 (IQR1–3=31–36), median perceived severity of a SARS-CoV-2 infection was 4 (IQR1–3=3–4) and the median feelings of safety score was 8 (IQR1–3=8–10). Significant differences were found between males and females for PSS scores (p

Objective
This study aims to determine the burden and factors associated with perceived stress in the Pakistani population amidst the COVID-19 pandemic.

Setting
A web-based cross-sectional survey was conducted from April to August 2020.

Population
This survey was broadcasted on the web using a Google form link and 1654 Pakistani residents had completed this survey. Individuals belonging to any province, city, village, or district of Pakistan irrespective of any age, having internet access and a link of Google form, with English/Urdu competency, consent to participate, and currently residing in Pakistan were eligible to participate.

Outcome measure
Perceived stress was measured using a validated tool of perceived stress scale-10. Multiple ordinal regression was used, and an adjusted OR along with a 95% CI are reported.

Results
The mean score of perceived stress was 19.32 (SD ±6.67). Most of the participants screened positive for moderate (69%) and high levels (14%) of stress, respectively. The odds of high-perceived stress among severely anxious participants were 44.67 (95% CI: 21.33 to 93.53) times than participants with no/minimal generalised anxiety during the complete lockdown. However, the odds of high levels of perceived stress among moderately anxious respondents were 15.79 (95% CI: 10.19 to 24.28) times compared with participants with no/minimal anxiety during the smart lockdown.

Conclusion
This study evidence that the pandemic was highly distressing for the Pakistani population causing the maximum level of perceived stress in more than half of the population. Adequate and timely interventions are needed before high-stress levels culminate into psychological disorders.

Objective
This study aimed to assess the prevalence of depression, anxiety and stress, associated factors and stress-coping strategies among traffic police officers in Kathmandu, Nepal.

Design
Cross-sectional survey.

Setting
Kathmandu Valley, Nepal.

Participants
A total of 300 traffic police officers working under the different traffic units of Kathmandu Valley for at least 6 months were recruited via a simple random sampling procedure.

Primary outcome measures
State of depression, anxiety and stress among traffic police officers based on the Depression, Anxiety and Stress Scale.

Secondary outcome measures
Coping strategies under stressful conditions based on the Coping Orientation to Problems Experienced Inventory (Brief-COPE) tool.

Results
Altogether 124 (41.3%) traffic police officers had symptoms of depression, 141 (47%) had anxiety symptoms and 132 (44%) had symptoms of stress. Smoking was significantly associated with an increased likelihood of experiencing symptoms of depression (adjusted OR (AOR): 10.7, 95% CI: 4.8 to 23.6), anxiety (AOR: 7.1, 95% CI: 3.4 to 14.9) and stress (AOR: 6.8, 95% CI: 3.3 to 14.1). Similarly, longer working hours was significantly associated with higher odds of experiencing symptoms of depression (AOR: 3.4, 95% CI: 1.8 to 6.4), anxiety (AOR: 2.3, 95% CI: 1.3 to 3.9) and stress (AOR: 1.9, 95% CI: 1.1 to 3.4), and lack of physical exercise was associated with an increased likelihood of exhibiting depressive symptoms (AOR: 2.3, 95% CI: 1.1 to 4.7). Participants in this study used positive coping strategies more than negative coping strategies.

Conclusion
Our study found a high prevalence of depression, anxiety and stress symptoms among traffic police officers in Kathmandu Valley, Nepal. Smoking and longer working hours were associated with an increased likelihood of experiencing symptoms of depression, anxiety and stress, and lack of physical exercise was associated with an increased likelihood of depressive symptoms.

Stroke, Ahead of Print. Background:Individuals with sickle cell anemia have heightened risk of stroke and cognitive dysfunction. Given its high prevalence globally, whether sickle cell trait (SCT) is a risk factor for neurological injury has been of interest; however, data have been limited. We hypothesized that young, healthy adults with SCT would show normal cerebrovascular structure and hemodynamic function.Methods:As a case-control study, young adults with (N=25, cases) and without SCT (N=24, controls) underwent brain magnetic resonance imaging to quantify brain volume, microstructural integrity (fractional anisotropy), silent cerebral infarcts (SCI), intracranial stenosis, and aneurysms. Pseudocontinuous arterial spin labeling and asymmetric spin echo sequences measured cerebral blood flow and oxygen extraction fraction, respectively, from which cerebral metabolic oxygen demand was calculated. Imaging metrics were compared between SCT cases and controls. SCI volume was correlated with baseline characteristics.Results:Compared with controls, adults with SCT demonstrated similar normalized brain volumes (SCT 0.80 versus control 0.81,P=0.41), white matter fractional anisotropy (SCT 0.41 versus control 0.43,P=0.37), cerebral blood flow (SCT 62.04 versus control, 61.16 mL/min/100 g,P=0.67), oxygen extraction fraction (SCT 0.27 versus control 0.27,P=0.31), and cerebral metabolic oxygen demand (SCT 2.71 versus control 2.70 mL/min/100 g,P=0.96). One per cohort had an intracranial aneurysm. None had intracranial stenosis. The SCT cases and controls showed similar prevalence and volume of SCIs; however, in the subset of participants with SCIs, the SCT cases had greater SCI volume versus controls (0.29 versus 0.07 mL,P=0.008). Of baseline characteristics, creatinine was mildly elevated in the SCT cohort (0.9 versus 0.8 mg/dL,P=0.053) and correlated with SCI volume (ρ=0.49,P=0.032). In the SCT cohort, SCI distribution was similar to that of young adults with sickle cell anemia.Conclusions:Adults with SCT showed normal cerebrovascular structure and hemodynamic function. These findings suggest that healthy individuals with SCT are unlikely to be at increased risk for early or accelerated ischemic brain injury.

BackgroundThe study aimed to investigate whether a bystander’s emotional stress state affects DA-CPR in OHCA. The primary outcome was time from recognition of OHCA by the medical dispatcher until first chest compression delivered. Secondarily, we investigated time from recognition of OHCA until initiation of CPR-instructions as well as quality of DA-CPR instructions according to the caller’s emotional stress state.MethodThe study was a retrospective and observational study of OHCA emergency call recordings from the Capital Region of Denmark. Callers were evaluated by five raters using a simplified emotional content and cooperation score (ECCS).Results894 call were included of which 250 callers were registered as emotional stressed. We found a significantly longer time from recognition of OHCA until first chest compression delivered in the emotional stressed callers vs. the not emotional stressed callers (65 s vs.38 s; P < 0.001). There was no significant difference in time from recognition of OHCA until initiation of CPR-instructions (P = 0.12). Furthermore, there was a significant higher incidence of the medical dispatcher being assertive and encouraging when instructing, and of the medical dispatcher instructing on speed and depth of chest compressions in calls with an emotional stressed caller (P = 0.006, P < 0.001 and P < 0.001).ConclusionThe emotional stressed callers had a significantly longer time from recognition of OHCA by the medical dispatcher until first chest compression was delivered. In addition, the quality of DA-CPR instructions given was significantly higher in the emotional stressed group.Conflict of interestNone.FundingNone.

Concluso il progetto pilota messo a punto da Maior-Ama in collaborazione con l’Asl di Teramo per ridurre stress, ansia e burnout