Relationship between preoperative psychological stress and shortterm prognosis in elderly patients with femoral neck fracture

BACKGROUND Older adults are at high risk of femoral neck fractures(FNFs).Elderly patients face and adapt to significant psychological burdens,resulting in different degrees of psychological stress response.Total hip replacement is the preferred treatment for FNF in elderly patients;however,some patients have poor postoperative prognoses,and the underlying mechanism is unknown.We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress.AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF.METHODS In this retrospective analysis,the baseline data,preoperative 90-item Symptom Checklist score,and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected.We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score.RESULTS Anxiety,depression,garden classification of FNF,cause of fracture,FNF reduction quality,and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF(P<0.05).The areas under the curve for anxiety,depression,and length of hospital stay were 0.742,0.854,and 0.749,respectively.The sensitivities of anxiety,depression,garden classification of FNF,and prediction of the cause of fracture were 0.857,0.786,0.821,and 0.821,respectively.The specificities of depression,FNF quality reduction,and length of hospital stay were the highest at 0.880,0.783,and 0.761,respectively.Anxiety,depression,and somatization scores correlated moderately with Harris scores(r=-0.523,-0.625,and-0.554;all P<0.001).CONCLUSION Preoperative anxiety,depression,and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.

Advances in the Study of Psychological Stress and Eating Behavior in Children and Adolescents

With the rapid development and change in society,children and adolescents are facing more and more psychological pressure,which comes not only from academic performance and interpersonal relationships but also from family environment,social expectations and other aspects.Psychological stress not only affects the mental health of children and adolescents but is also closely related to their eating behavior.Therefore,exploring the relationship between psychological stress and eating behaviors is of great significance in promoting the physical and mental health development of children and adolescents.Based on this,the study reviewed the research progress on the relationship between psychological stress and eating behavior of children and adolescents in recent years.The relationships between psychological stress and general eating behaviors,abnormal eating behaviors and eating disorders were successively reviewed,and the related physiological mechanisms were explored with a view to providing a scientific basis for mental health education and eating behavior intervention for children and adolescents.

Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients

BACKGROUND The degree of psychological stress and the difficulty and efficacy of laparoscopic surgery differ in patients with pelvic abscesses after different durations of antiinfection treatment.AIM To compare and analyse the effects of different durations of anti-infective therapy on patients’preoperative psychological stress level and the clinical efficacy of laparoscopic surgery in patients with pelvic abscesses to offer a reference for the selection of therapy plans.METHODS A total of 100 patients with pelvic abscesses who were admitted to the Department of Gynecology of Suzhou Ninth Hospital affiliated to Soochow University(Suzhou Ninth People's Hospital)from January 2018 to December 2022 were retrospectively enrolled.According to the different durations of antiinfective therapy,they were divided into Group S(50 patients,received antiinfective therapy for 24-48 h)and Group L(50 patients,received anti-infective therapy for 48-96 h).Baseline data,state-trait anxiety score at admission and before surgery,self-rating anxiety scale(SAS)+self-rating depression scale(SDS)score,surgery time,adhesion grading score,intraoperative blood loss,presence or absence of intraoperative intestinal injury,ureteral injury or bladder injury,postoperative body temperature,length of hospital stay,and presence or absence of recurrence within 3 mo after surgery,chronic pelvic pain,incision infection,dysmenorrhea,menstrual disorder or intestinal obstruction were compared between the S group and the L group.RESULTS There was no significant difference in the background data between the S group and the L group(P<0.05).There was no significant difference in the state-trait anxiety score or SAS+SDS score between the S group and the L group on admission(P<0.05).The state-trait anxiety score and SAS+SDS score of the S group were lower than those of Group L after receiving different durations of anti-infective therapy(P<0.05).There was no significant difference in the incidence of intestinal,ureteral or bladder injury between the S group and the L group(P<0.05).The surgery time of Group S was shorter than that of Group L,and the adhesion score and intraoperative blood loss volume were lower than those of Group L(P<0.05).There was no significant difference in the incidence of incision infection,dysmenorrhea,menstrual disorder or intestinal obstruction between the S group and the L group(P<0.05).The postoperative body temperature of Group S was lower than that of Group L(P<0.05),and the hospital stay was shorter than that of Group L(P<0.05).The incidences of recurrence and chronic pelvic pain within 3 mo after surgery were lower than that of Group L(P<0.05).CONCLUSION Twenty-four to forty-eight hours of anti-infective therapy is better than 48-96 h of anti-infective therapy for patients with pelvic abscesses because the degree of psychological stress is lower,which is more conducive to achieving better outcomes after laparoscopic surgery.

Fang-Xia-Dihuang decoction inhibits breast cancer progression induced by psychological stress via down-regulation of PI3K/AKT and JAK2/STAT3 pathways:An in vivo and a network pharmacology assessment

Background:The development and prognosis of breast cancer are intricately linked to psychological stress.In addition,depression is the most common psychological comorbidity among breast cancer survivors,and reportedly,Fang-Xia-Dihuang decoction(FXDH)can effectively manage depression in such patients.However,its pharmacological and molecular mechanisms remain obscure.Methods:Public databases were used for obtaining active components and related targets.Main active components were further verified by ultra-high-performance liquid chromatography-high-resolution mass spectrometry(UPLC-HRMS).Protein–protein interaction and enrichment analyses were taken to predict potential hub targets and related pathways.Molecule docking was used to understand the interactions between main compounds and hub targets.In addition,an animal model of breast cancer combined with depression was established to evaluate the intervention effect of FXDH and verify the pathways screened by network pharmacology.Results:174 active components of FXDH and 163 intersection targets of FXDH,breast cancer,and depression were identified.Quercetin,methyl ferulate,luteolin,ferulaldehyde,wogonin,and diincarvilone were identified as the principal active components of FXDH.Protein–protein interaction and KEGG enrichment analyses revealed that the phosphoinositide-3-kinase–protein kinase B(PI3K/AKT)and Janus kinase/signal transducer and activator of transcription(JAK2/STAT3)signaling pathways played a crucial role in mediating the efficacy of FXDH for inhibiting breast cancer progression induced by depression.In addition,in vivo experiments revealed that FXDH ameliorated depression-like behavior in mice and inhibited excessive tumor growth in mice with breast cancer and depression.FXDH treatment downregulated the expression of epinephrine,PI3K,AKT,STAT3,and JAK2 compared with the control treatment(p<0.05).Molecular docking verified the relationship between the six primary components of FXDH and the three most important targets,including phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3CA),AKT,and STAT3.Conclusion:This study provides a scientific basis to support the clinical application of FXDH for improving depression-like behavior and inhibiting breast cancer progression promoted by chronic stress.The therapeutic effects FXDH may be closely related to the PI3K/AKT and JAK2/STAT3 pathways.This finding helps better understand the regulatory mechanisms underlying the efficacy of FXDH.

Impact of psychological stress on irritable bowel syndrome

Psychological stress is an important factor for the development of irritable bowel syndrome(IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stresssensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary.

Effects of psychological stress on small intestinal motility and expression of cholecystokinin and vasoactive intestinal polypeptide in plasma and small intestine in mice

AIM: To investigate the effects of psychological stress on small intestinal motility and expression of cholecystokinin (CCK) and vasoactive intestinal polypeptide (VIP) in plasma and small intestine, and to explore the relationship between small intestinal motor disorders and gastrointestinal hormones under psychological stress. METHODS: Thirty-six mice were randomly divided into psychological stress group and control group. A mouse model with psychological stress was established by housing the mice with a hungry cat in separate layers of a two-layer cage. A semi-solid colored marker (carbon-ink) was used for monitoring small intestinal transit. CCK and VIP levels in plasma and small intestine in mice were measured by radioimmunoassay (RIA). RESULTS: Small intestinal transit was inhibited (52.18±19.15% vs70.19±17.79%, P<0.01) in mice after psychological stress, compared to the controls. Small intestinal CCK levels in psychological stress mice were significantly lower than those in the control group (0.75±0.53 μg/g vs1.98±1.17 μg/g, P<0.01), whereas plasma CCK concentrations were not different between the groups. VIP levels in small intestine were significantly higher in psychological stress mice than those in the control group (8.45±1.09 μg/g vs7.03±2.36 μg/g, P<0.01), while there was no significant difference in plasma VIP levels between the two groups. CONCLUSION: Psychological stress inhibits the small intestinal transit, probably by down-regulating CCK and up-regulating VIP expression in small intestine.

Effect of psychological stress on gastric motility assessed by electrical bio-impedance

AIM:To evaluate gastric motility using electrical bioimpedance(EBI) and gastric changes as a result of stress induced by psychological tests.METHODS:A group of 57 healthy women,aged 40-60 years,was recruited,and a clinical history and physical examination were performed.The women were free from severe anxiety,chronic or acute stress,severe depression,mental diseases and conditions that affect gastric activity.The women were evaluated under fasting conditions,and using a four-electrode configuration,the gastric signals were obtained through a BIOPAC MP-150 system.The volunteers were evaluated using the following paradigm:basal state,recording during the Stroop Test,intermediate resting period,recording during the Raven Test,and a final resting period.We analyzed the relative areas of the frequency spectrum:A1(1-2 cpm),A2(2-4 cpm),A3(4-8 cpm),and A4(8-12 cpm),as well as the median of area A2 + A3.The data were analyzed by an autoregressive method using a Butterworth filter with MatLab and Origin.Analysis of variance(ANOVA) and Friedman ANOVA(for nonparametric variables) were performed;in addition,pairs of groups were compared using the T dependent and Wilcoxon T tests.RESULTS:The results of the main values of area A2 were not significantly different comparing the five steps of the experimental paradigm.Nevertheless,there was a tendency of this A2 region to decrease during the stress tests,with recuperation at the final resting step.When an extended gastric region was considered(1-4 cpm),significant differences with the psychological stress tests were present(F = 3.85,P = 0.005).The A3 region also showed significant changes when the stress psychological tests were administered(F = 7.25,P < 0.001).These differences were influenced by the changes in the adjacent gastric region of A2.The parameter that we proposed in previous studies for the evaluation of gastric motility by electrical bio-impedance(EBI) was the median of the area under the region from 2 to 8 cpm(A2 + A3).The mean values of these frequencies(median of the A2 + A3 area) with the stress test showed significant changes(F = 5.5,P < 0.001).The results of the WilcoxonT test for the A4 area parameter,which is influenced by the breathing response,changed significantly during the Raven stress test(P < 0.05).CONCLUSION:We confirm that the gastric response to acute psychological stress can be evaluated by short-term EBI.

Effects of psychological stress on small intestinal motility and bacteria and mucosa in mice

AIM: To investigate the effects of psychological stress on small intestinal motility and bacteria and mucosa in mice, and to explore the relationship between small intestinal dysfunction and small intestinal motility and bacteria and mucosa under psychological stress. METHODS: Sixty mice were randomly divided into psychological stress group and control group. Each group were subdivided into small intestinal motility group (n= 10), bacteria group (n = 10), and D-xylose administered to stomach group (n= 10). An animal model with psychological stress was established housing the mice with a hungry cat in separate layers of a two-layer cage. A semi-solid colored marker (carbon-ink) was used for monitoring small intestinal transit. The proximal small intestine was harvested under sterile condition and processed for quantitation for aerobes (Escherichia coli) and anaerobes (Lactobacilli). The quantitation of bacteria was expressed as Iog10(colony forming units/g). D-xylose levels in plasma were measured for estimating trie damage of small intestinal mucosa. RESULTS: Small intestinal transit was inhibited (39.80±9.50% vs 58.79±11.47%,P<0.01) in mice after psychological stress, compared with the controls. Psychological stress resulted in quantitative alterations in the aerobes (E.coli). There was an increase in the number of E coli in the proximal small intestinal flora (1.78±0.30 log10(CFU/g) vs 1.37±0.21 log10(CFU/g), P<0.01), and there was decrease in relative proportion of Lactobacilli and E.coli of stressed mice (0.53±0.63 vs 1.14±1.07,P<0.05), while there was no significant difference in the anaerobes (Lactobacilli) between the two groups (2.31±0.70 log10 (CFU/g) vs 2.44±0.37 log10(CFU/g), P>0.05). D-xylose concentrations in plasma in psychological stress mice were significantly higher than those in the control group (2.90±0.89 mmol/L vs 0.97±0.33 mmol/L, P<0.01). CONCLUSION: Small intestinal dysfunction under psychological stress may be related to the small intestinal motility disorder and dysbacteriosis and the damage of mucosa probably caused by psychological stress.

Serotonin regulates brain-derived neurotrophic factor expression in select brain regions during acute psychological stress

Previous studies suggest that serotonin （5-HT） might interact with brain-derived neurotrophic factor （BDNF） during the stress response. However, the relationship between 5-HT and BDNF expression under purely psychological stress is unclear. In this study, one hour before psychological stress exposure, the 5-HT1A receptor agonist 8-OH-DPAT or antagonist MDL73005, or the 5-HT2A receptor agonist DOI or antagonist ketanserin were administered to rats exposed to psychological stress. Immunohistochemistry and in situ hybridization revealed that after psychological stress, with the exception of the ventral tegmental area, BDNF protein and mRNA expression levels were higher in the 5-HT1A and the 5-HT2A receptor agonist groups compared with the solvent control no-stress or psychological stress group in the CA1 and CA3 of the hippocampus, prefrontal cortex, central amygdaloid nucleus, dorsomedial hypothalamic nucleus, dentate gyrus, shell of the nucleus accumbens and the midbrain periaqueductal gray. There was no significant difference between the two agonist groups. In contrast, after stress exposure, BDNF protein and mRNA expression levels were lower in the 5-HT1A and 5-HT2A receptor antagonist groups than in the solvent control non-stress group, with the exception of the ventral tegmental area. Our findings suggest that 5-HT regulates BDNF expression in a rat model of acute psychological stress.

Psychological stress and long-term blood pressure variability of military young males:The cardiorespiratory fitness and hospitalization events in armed forces study

BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psychological stress with long-term BPV in young male humans.METHODS We prospectively examined the association of chronic psychological stress with long-term BPV in 1112 healthy military males,averaged 32.2 years from the cardiorespiratory fitness and hospitalization events in armed forces study in Taiwan.Psychological stress was quantitatively evaluated with the Brief Symptom Rating Scale(BSRS-5),from the least symptom of 0 to the most severe of 20,and the five components of anxiety,insomnia,depression,interpersonal sensitivity,and hostility(the severity score in each component from 0 to 4).Longterm BPV was assessed by standard deviation(SD)for systolic and diastolic blood pressure(SBP and DBP),and average real variability(ARV),defined as the average absolute difference between successive measurements of SBP or DBP,across four visits in the study period from 2012 to 2018(2012-14,2014-15,2015-16,and 2016-18).RESULTS The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP,SDDBP,ARVSBP,and ARVDBP after adjusting for all the covariates[β(SE):-0.022(0.024),-0.023(0.026),-0.001(0.018),and 0.001(0.020),respectively;P>0.05 for all].In addition,there were also no correlations between each component of the BSRS score and the long-term BPV indexes.CONCLUSION Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young male humans.

CHANGES OF PSYCHOLOGICAL STRESS STATE AND THE EFFECT OF ACPUNCTURE INTERVENTION IN ARMED ANTI-TERRORISM POLICEMEN

Objective:To observe psychological changes of the armed policemen under stress state and the effect of acupuncture intervention for exploring possible measures in raising the armed policemen's capability in dealing with the suddenly-occurred accidents. Methods: In the first part of the study for observing psychological changes, a total of 90 volunteer armed policemen participating in anti-terrorism maneuver were randomly and evenly divided into anti-chemical weapon group, flight reconnaissance group and hostage-rescuing group. 30 logistic personals were selected to form control group. Symptom Checklist-90 (SCL-90) questionnaire was used to assess the psychological state of these anti-terrorism policemen. In the second part of the study for observing the effect of acupuncture, 60 policemen with anxiety and depression who were determined by Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were randomly and evenly divided into non-acupuncture and acupuncture groups, and other 30 policemen with normal psychological state were selected to form control group. Two weeks before anti-terrorism maneuver, participants of acupuncture group were asked to receive continuous acupuncture treatment of bilateral Neiguan (内关 PC 6) and Zusanli (足三里 ST 36), once daily, 15 min every time. Results:Comparison among the first 4 groups displayed that the total scores, scores of body feeling reactions, interpersonal relation, depression, anxiety, terror, and psychological problems of flight reconnaissance and hostage-rescuing groups were significantly higher than those of control group (P<0.05-0.01), suggesting that the psychological stress pressure was strongest in flight reconnaissance policemen and secondary in hostage-rescuing policemen, followed by anti-chemical weapon policemen. Following administration of acupuncture intervention, scores of both SDS and SAS in acupuncture group were considerably lower than those of non-acupuncture group (P< 0.01), showing that acupuncture intervention could reduce psychological stress reactions in the armed policemen undergoing anti-terrorism exercise. Conclusion: Before anti-terrorism exercise,neerly all the armed policemen have different degrees of psychological problems, while acupuncture intervention can improve their psychological state.

Adolescents’perceived stress of COVID-19 and self-compassion in Saudi Arabia:A cross-sectional study

Objectives Worldwide,the COVID-19 pandemic has significantly impacted mental health challenges for adolescent populations.The current study aims to examine the levels of perceived stress of COVID-19 and self-compassion and their relationship among adolescents in Saudi Arabia.Methods This study employed a cross-sectional online survey of adolescents from secondary schools in Asir,Saudi Arabia.Instruments that we distributed online included the modified Perceived Stress Scale(PSS-10)and the Self-Compassion Scale(SCS),in addition to demographic and health-related questions.A total of 500 adolescents completed the survey.Results Adolescents in the study reported an average moderate perceived stress level of 18.6(SD=6.67)and an average moderate self-compassion level of 3.22(SD=0.53).A significant correlation is also found between the two variables(r=−0.460,P<0.001).This negative correlation indicates that lower levels of perceived stress are significantly correlated with higher levels of self-compassion.Conclusion The study results show that the perceived stress of COVID-19 is inversely correlated with self-compassion in Saudi adolescents.Further research is needed to explore how to enhance adolescents’self-compassion.School nurses’role should be given full play in this area.

Study on the Relationship between Mental Health Literacy and Psychological Symptoms of University Students: Mediating Effect of Grit

Background:The occurrence of mental health symptoms is higher in individuals aged between 18 and 24 years than in other age groups.Mental health literacy is derived from health literacy,and focuses on the knowledge,attitudes,and competencies that individuals need to acquire to manage their own health effectively.Low mental health literacy is associated with poorer mental health.Grit is also a known protective factor against mental disorders.Despite a heightened focus on mental health literacy and grit as important factors for decreasing mental health symptoms,knowledge of the effect of mental health literacy and grit on mental health symptoms is very limited.This study aimed to evaluate the relationship between mental health literacy and psychological symptoms and the mediating effect of grit on these relationships.Methods:This cross-sectional descriptive study used survey data from 178 university students in Korea.Data were collected between March and May 2022.The SPSS PROCESS macro(Model 4)was used to analyze the data.Results:Mental health literacy was not directly associated with psychological symptoms.However,an indirect pathway was observed between mental health literacy,depression,and anxiety,through grit.Conclusion:Mental health literacy affects psychological symptoms through grit.Therefore,to improve the mental health of university students,it is necessary to develop programs that increase mental health literacy and grit.

Comparative study on ghrelin level change and its related factors in hypertensive elders with psychological distress

Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress.Methods A total of 300 elders,who were screened with Hamilton Anxiety Scale(HAMA),Hamilton Rating Scale for Depression(HAMD),and the Symptom Checklist-90(SCL-90)for psychological stress and somato-psychological manifestations respectively,were divided into hypertension group(n=148)and non-hypertension group(n=152).Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day.Results The incidences of anxiety and depression were 27.7% and 11.7%,respectively,in all the enrolled elders.However,the rates of psychological distress,particularly anxiety,were significantly higher in the hypertensive elders than in the non-hypertensive ones(43.2% vs.12.5%).Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level,and the latter two were negatively correlated with each other.Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level,which then adversely affects blood pressure in elders with psychological distress.Therefore,ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.

Role of ghrelin in cognitive impairment of hypertensive elders with chronic psychological distress

Objective:To investigate ghrelin level change in combination with psychological stress in the hypertensive old people with cognitive impairment and to explore its effect as well as possible mechanism.Methods:The study population of 300 elders was divided into 2 groups,148 with hypertension and 152 non-hypertension,who were screened for psychological distress and cognition function,and had blood drawn to measure plasma levels of ghrelin and total cortisol on the same day.Results:The rates of anxiety and cognitive impairment were higher in the hypertension elders,which were negatively correlated with plasma ghrelin level,resulted from chronic cortisol response to anxiety.Conclusion:Chronic plasma cortisol increase to long-term anxiety leads a reduce in ghrelin level which then adversely affects blood pressure and cognitive function in old people.So measuring ghrelin of elders may be a diagnostic tool to predict cognitive development and ghrelin may be a selective antihypertensive medicine for cognitive impairment elders with or without chronic psychological stress.

The association of salivary alpha-amylase, heart rate variability, and psychological stress on objectively measured sleep behaviors among college students

Objective:This study aimed to evaluate sleep behaviors among college students,to assess salivary alpha-amylase(sAA)and heart rate variability(HRV)in association with stress,and to investigate sleep-related factors including sAA,HRV,and stress among them.Methods:Saliva samples for sAA assessment and HRV measurements in the supine position were taken between 3 PM and 6 PM.The level of prolonged psychological stress for the previous week was evaluated using the Korean version of the Global Assessment of Recent Stress(GARS-K),and sleep behaviors were assessed using an actigraphy device.Results:A total of 86 healthy college students participated in this study.Sleep behaviors of the college students were not good,with 84%sleep efficiency(SE)and 62.7 min wake after sleep onset(WASO).The average sAA level was 65.8 U/mL in the participants.Although neither the sAA level nor HRV indices were significantly correlated with prolonged psychological stress,decreased normalized high frequency(nHF)on HRV was independently associated with a higher level of stress when adjusted for age and sex.Higher stress(r=-0.276,P=0.011)and lower sAA(r=0.266,P=0.030)had significant correlations with shorter time in bed;however,it was sAA that was independently associated with time in bed(β=0.244,p=0.044).Decreased nHF(β=0.245,P=0.027)and higher body mass index(BMI)(β=-0.224,P=0.043)were independently related to and poorer SE.Conclusions:Poor sleep behaviors were associated with decreased parasympathetic activity,a physiological change to psychological stress,rather than with psychological stress itself among college students.Thus,sAA and HRV should be considered as significant factors for impaired sleep behaviors in relation to psychological stress.

Psychological Stress and Nursing Intervention of Sick Children

Holistic nursing is guided by modern nursing concept and framed by nursing procedures, providing high quality nursing according to patients’ psychological, physiological, social and cultural needs. To develop holistic nursing in pediatrics is to develop nursing services for the purpose of satisfying the various clinical needs and psychological nursing of children. It is of great significance to establish holistic nursing concept, provide high quality nursing service for hospitalized children, and take targeted psychological intervention to alleviate their adverse psychological stress, which can improve treatment compliance and clinical efficacy, and shorten the length of hospital stay. In this paper, scientific and effective psychological nursing stress intervention means are used to improve the psychological anti-stress level of hospitalized children, and nursing intervention means are put forward, contribute to the maintenance of children’s mental health and the development of children’s mental health work and also to provide a theoretical basis for the intervention and treatment of children with psychological stress.

Investigation of possible relationship between atopic dermatitis and salivary biomarkers,stress,and sleep disorders

Atopic dermatitis(AD)is a chronic,relapsing,multifactorial inflammatory disease with genetic,environmental,and immunological characteristics.The quality of life and sleep of patients and their families are affected by AD,which triggers stress,described as one of the factors that worsens AD.Salivary biomarkers such as cortisol,alpha-amylase,chromogranin A,and melatonin have been associated with stress and sleep disturbances.Therefore,the evaluation of stress and sleep disorders using salivary biomarkers in AD patients is important.This review aims to describe the possible relationship between atopic dermatitis and stress,sleep disorders,and salivary biomarkers,seeking to contribute to better understanding and clinical management of AD.This descriptive study is characterized as a narrative literature review.A literature search was conducted of studies published in English and Portuguese between January 2012 and October 2022 that are available in electronic media from various databases,such as Scientific Electronic Library Online,Latin American and Caribbean Literature on Health Sciences,and PubMed.AD is associated with different degrees of impact on the lives of individuals who present with the disease.Psychological stress may induce changes in saliva composition and worsen AD;at the same time,the severity of the disease may be associated with emotional impact.Further studies are needed to assess and correlate AD severity,stress,and sleep disturbances with salivary biomarkers in order to better understand this association.

Association of psychological stress with wives’hypertension across over 10 million Chinese married female population aged 20-49 years

Background:Psychological stress has been reported to be a potential risk factor for hypertension among females,but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women.We examined the associations between stress within the family and hypertension among married women.Methods:Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects(NFPCP)across 31 provinces in China in 2016 and 2017.Perceived stress of wives or husbands was measured with a 5-point Likert-type scale,and assessed from three domains:work/life-related stress,economic stress,and overall stress.Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.Results:Of 10,027,644 couples,261,098(2.60%)women had hypertension.The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women(P_(for trend)<0.001).Compared with non-stressed participants,female participants with the highest stress themselves were at a greater risk of hypertension,with adjusted odds ratio(OR)of 1.31(95%confidence interval[CI]:1.25-1.37);and compared with participants whose husbands had no stress,those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24(95%CI:1.20-1.29).Moreover,compared with non-stressed status for both couples,only-wife-stressed,only-husband-stressed,and both-stressed couples were found to be significantly associated with increased risks of wives’hypertension,with adjusted ORs of 1.28(95%CI:1.25-1.31),1.19(95%CI:1.17-1.21),and 1.28(95%CI:1.26-1.31),respectively.Conclusion:Moderate to severe stress in both spouses might be associated with female hypertension prevalence,which highlights the importance of paying attention to the psychological stresses of couples within the family.

Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.