Search Results for: Nelle donne lo stress danneggia la salute dell’intestino

Un portale per informare genitori su rischi ambientali precoci

Proiettato ‘Diamanti’. La cineterapia per alleviare i sintomi

Proiettato ‘Diamanti’. La cineterapia per alleviare i sintomi

Introduction
Referrals for gender-affirming healthcare services have surged in recent decades, presumably driven by increased visibility, acceptance and reduced barriers to care. Despite these advances, transgender and gender-diverse individuals continue to face significant mental health challenges, including elevated rates of anxiety, depression as well as high prevalence of autistic traits. Gender-affirming hormonal treatment (GAHT) has been suggested to improve mental health and quality of life (QoL) among transgender individuals; however, the short- and long-term treatment effects of GAHT are not yet fully understood. Therefore, this study aims to establish a comprehensive cohort of transgender individuals at the Centre for Gender Identity (CGI), Aalborg University Hospital, Denmark, to enhance understanding and treatment outcomes.

Methods and analysis
The Transgender Cohort (TraCK) will recruit participants from February 14, 2024, with recruitment occurring continuously alongside yearly follow-up. This single-centre cohort study will include both retrospective and prospective data collection. Transgender individuals referred to CGI will be invited to participate in the study via the Danish digital mail system called e-Boks. Participants must provide informed consent and complete a baseline questionnaire. Data will be collected from self-reported questionnaires and medical records across multiple specialists. Self-reported questionnaires include WHO-Quality of Life BREF, Eating Disorders Examination Questionnaire, Autism Spectrum Quotient, Transgender Congruence Scale, and Gender Minority Stress and Resilience Measure. Medical records will provide information on demographics, mental health, physical health, and gender-affirming treatment details. Data will be managed using REDCap, ensuring compliance with GDPR and the National Data Protection Act.

Ethics and dissemination
While recognising the potential privacy risks associated with data collection, the study considers these outweighed by the benefits of advancing knowledge on gender diversity and the impacts of gender-affirming care. The North Jutland Region Ethics Committee reviewed the project, determining no formal approval was needed, but it was registered and approved (no. F2024-012) by the North Jutland Region. Findings will be disseminated through peer-reviewed journals, conferences, and accessible reports for participants.

Registration details
This study is registered with the North Jutland Region (no. F2024-012). Recruitment and data collection began on February 14, 2024, and will continue alongside yearly follow-up. Keywords Transgender individuals, transgender and gender-diverse, transgender cohort, transgender health, transgender research, cohort study, gender-affirming care.

‘Impatto sulla salute degli operatori e sulla qualità delle cure’

Introduction
Sepsis is a common condition with significant morbidity, mortality and annual costs of care in the billions of dollars. Despite innumerable studies on the causes of, and therapies for, sepsis, the mortality rate has not changed substantially in the last 20 years. Treatments remain generic, with current guidelines recommending the same approach for all patients, regardless of the litany of differences that exist at baseline. Moreover, the blanket administration of 30 cc/kg of intravenous fluid (IVF) to all patients is recognised as being directly harmful to some. Patient-level heterogeneity in prior sepsis trials is recognised as a substantial contributor to all these problems, yet no prior investigation has attempted to identify volume-informed septic phenotypes, a necessary first step towards precision care.

Methods and analysis
Predicated on prior studies demonstrating detectability of organ-level congestion, we hypothesise that central venous hypertension (1) is deleterious to the function of the lungs, liver, kidneys and vascular endothelium; (2) is worsened by cardiac dysfunction and IVF administration; and (3) contributes to adverse organ-specific and overall outcomes. Beginning in the emergency department, cardiac function will be assessed with echocardiography while congestion in the lungs and kidneys will be assessed using previously validated sonographic markers of congestion. Biomarkers for each organ will be collected concurrently, thereby increasing the fidelity of our phenotypic profiles by pairing indicators of macroscopic and microscopic stress and dysfunction. Data will also be collected at 24 hours and 7 days (or discharge, whichever comes first) after presentation. Classical and machine learning approaches will be used to analyse our large data stream and develop a rule-based system to identify distinct subpopulations of patients with sepsis who have greater risk/likelihood of both organ-specific and overall adverse outcomes.

Ethics and dissemination
This project has been approved by the Wayne State University Institutional Review Board, with patient enrolment beginning in April 2024. Findings will be reported and disseminated via conference presentations and open-access publications.

Introduction
The medical profession is facing an unprecedented crisis. Reasons for this are complex and multifactorial; however, rising rates of burnout will undoubtedly contribute to problems with recruitment and retention. Chronic workplace stress, whereby there are insufficient resources available to meet the demands doctors face, is a contributor to burnout. There are a wide variety of available self-report measures for stress, with heart rate variability (HRV) shown to be a biomarker of stress and recovery in doctors. We aim to triangulate continuous HRV measurements with validated self-report measures and qualitative data to better understand the patterns of stress and recovery.

Methods and analysis
This study has a sequential explanatory mixed-methods design. Participants will be recruited from multiple sites within National Health Service (NHS) Grampian. Initially, participants will complete a suite of validated scales, including the Maslach Burnout Inventory for Medical Personnel, the Resilience Scale for Adults and the Interpersonal, Community, Occupational, Physical, Psychological (ICOPPE) well-being scale. Following this, participants will undertake seven consecutive days of ecological momentary assessment of real-time demands, resources and fatigue, alongside 7 days of continuous ambulatory assessment of HRV via Firstbeat Bodyguard 3 chest-worn monitors. Participants will be provided with a summary report following their study period. If 40 participants are recruited within the recruitment timeframe, multilevel modelling will be used to analyse data; otherwise, N-of-1 statistical techniques will be used. Following initial analysis of the quantitative data, participants of interest will be invited to take part in semistructured interviews, which will be thematically analysed and presented alongside the quantitative data.

Ethics and dissemination
This study was approved by the University of Aberdeen, School of Medicine, Medical Sciences and Nutrition ethics review board (ref. 3389193) and the NHS Grampian research and development team. Results will be disseminated in international peer-reviewed journals.

Trial registration number
NCT06721312.

Rapporto Iss su equità e salute regionale, ancora ampi i divari

Basic scienceSensing pain in the gut: new insights into enterochromaffin cells Touhara K, Rossen N, Deng F et al Topological segregation of stress sensors along the gut crypt-villus axis. Nature 2025; 640(8059): 732-742. doi: 10.1038/s41586-024-08581-9. The gut barrier is monitored by enterochromaffin (EC) cells, epithelial sensory enteroendocrine cells which release serotonin in response to stimuli. TRPA1 (transient receptor potential cation channel, subfamily A, member 1—also known as the wasabi receptor), which detects electrophilic irritants, is present in the crypts. TRPM2 (transient receptor potential cation channel, subfamily M, member 2), which measures oxidative stress, is in the villi. The EC-pain circuit is not well understood. Touhara et al used a new mouse model to study this. Serotonin receptors were labelled in a way that fluorescence intensity increased after serotonin release. Tonic (low-level) serotonin release was observed in crypts where TRPA1 was expressed. This activated metabotropic 5-HT4 (5-hydroxytryptamine receptor…

Polemica sul ddl di FdI. Gli psichiatri: valuteremo ma fermi su Basaglia

All’Asl To5 progetto prevenzione coinvolgendo adulti e bambini

Appuntamento sabato e domenica in Piazza della Libertà

Introduction
Cervical cancer is a major global health issue. The standard treatment for locally advanced disease involves radiochemotherapy followed by uterovaginal brachytherapy (UBT). UBT requires several days of hospitalisation and strict bed rest. UBT often induces pain, anxiety, stress, distress and a decline in physical capacity during and after treatment. Previous research suggests that non-pharmacological interventions, such as yoga, may help alleviate these issues. However, few studies have specifically evaluated their effectiveness in reducing stress during UBT. Furthermore, patient education has been shown to facilitate autonomous practice and to improve patient empowerment. This study aims to evaluate the impact of the KYOCOL protocol, which integrates both a physiotherapy-yoga intervention and an educational programme, on perceived stress and its correlates in patients undergoing UBT.

Methods and analysis
KYOCOL is an ongoing randomised, prospective trial carried out in three French comprehensive cancer centres, using a quantitative approach complemented by a qualitative component. Eighty patients are planned to be randomised (1:1) into a control arm (standard care) or an intervention arm. In the intervention arm, patients will be educated and supervised by a trained physiotherapist in a physiotherapy-yoga programme and will then perform daily autonomous sessions during UBT and for up to 15 days post-treatment. The primary objective is to assess the impact of the KYOCOL intervention compared with standard care during UBT, on perceived stress 15 days post-UBT, using the 10-item Perceived Stress Scale. Secondary objectives include evaluating the safety of the intervention, its effects on stress, pain and fatigue during UBT, and patient adherence to the programme. Qualitative analyses based on semistructured interview surveys will be conducted to gather valuable information and analyse in depth patients’ experiences with the intervention and UBT.

Ethics and dissemination
This study was approved by the French ethics committee (Comité de Protection des Personnes Ouest V, reference number 2023-A01491-44) on 22 February 2024 and will be carried out in accordance with the good clinical practice guidelines and the Declaration of Helsinki. The results will be shared with patients and healthcare professionals and published in a peer-reviewed journal.

Trial registration number
NCT06263283.

Objectives
This study aimed to compare the perceptions of quality of life (QoL) and mental health among medical students and their peers in other university courses in Brazil through a cross-sectional analysis. We hypothesised that medical students face greater psychological challenges due to the demanding nature of their academic workload. Previous studies have indicated that medical training is associated with a decline in empathy and an increase in stress and anxiety, particularly during the clinical phase, when students face greater exposure to patient care and emotionally demanding experiences. These factors contribute to decreased psychological well-being, highlighting the need for targeted interventions in medical education. To address these challenges, this study investigates the specific impact of medical education on students’ mental health and QoL, aiming to identify potential structural changes that could mitigate these negative outcomes.

Design
A cross-sectional study was conducted in private higher education institutions in Brazil.

Setting
Data were collected online via the QuestionPro platform in August 2024, encompassing 32 units located across 14 states and 4 geographic regions in Brazil.

Participants
The sample included 10 844 students, 33.7% of whom were enrolled in medicine and 66.3% in other fields (administration, agronomy, agribusiness, systems analysis and development, architecture, architecture and urbanism, biomedicine, computer science, accounting, economics, social communication/advertising and propaganda, law, physical education, nursing, civil engineering, computer engineering, production engineering, electrical engineering, mechatronics engineering, aesthetics and cosmics, pharmacy, physics, physiotherapy, speech, speech therapy, environmental management, commercial management, human resources management, financial management, history, Portuguese-English literature, logistics, marketing, mathematics, veterinary medicine, nutrition, dentistry, pedagogy, management processes, psychology, advertising and propaganda, computer networks, social work, information systems and theology). The inclusion criterion was as follows: regularly enrolled students. The exclusion criteria were refusal to provide consent and incomplete questionnaires.
The margin of error, calculated as 0.9 percentage points at a 95% CI, was based on a population of 74 684 students enrolled in the private institutions participating in the study.

Primary and secondary outcomes
Primary outcomes included QoL assessment via the WHOQOL-Brief Version and a customised questionnaire developed by the researchers. This questionnaire evaluated variables such as inclusion, accessibility, sports practices, adaptation and satisfaction with undergraduate training. Secondary outcomes assessed factors such as risky substance use, academic satisfaction and mental health conditions, including symptoms of anxiety and depression.

Results
Medical students exhibited significant declines in physical QoL (64.5–57.1, p

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