Nurse Stress Associated with Delirium Care in Intensive Care Units: A Cross-Sectional Study

Background and Objectives: Delirium is highly prevalent in Intensive Care Units (ICUs). While prior studies have identified hyperactive and hyperalert behaviors as major stressors for nurses caring for delirious patients, limited research exists on ICU nurses’ stress specifically related to delirium care. This study aims to investigate the stress experienced by ICU nurses in China when managing patients with delirium. Methods: This cross-sectional survey was conducted in China from January to February 2023. A total of 243 ICU nurses participated by completing an online survey that included the Personal Information Questionnaire and the Strain of Caring for Delirium Index (SCDI). Although 260 responses were initially collected, 29 invalid questionnaires were excluded, resulting in a final sample size of 243 valid responses. The SCDI scale demonstrated reliable internal consistency, with Cronbach’s α coefficients of 0.744, 0.812, 0.778, and 0.920 across its four subscales. Results: The survey results indicated that hypoactive delirium behaviors were perceived as the most significant stressors when caring for delirious patients. Among the behaviors, “noisy/yelling” was identified as the most challenging, whereas “pulling at tubes, dressings” was rated as the least challenging. No significant associations were found between demographic factors and stress levels. Conclusion: This study sheds light on the stress levels ICU nurses experience when caring for delirious patients, particularly in relation to hypoactive behaviors. Based on these findings, it is recommended that nurse managers implement stress management strategies and provide targeted delirium-related care training to better support ICU nurses and enhance the quality of delirium care.

Perceived stress among staff in Saudi Arabian dental colleges before and after an accreditation process: A cross-sectional study

BACKGROUND Accreditation processes are extensively employed to guarantee the quality of higher education institutions.However,this process can potentially generate a stressful atmosphere for staff,thus impacting their ability to perform optimally under pressure.AIM To examine the knowledge of the National Commission for Academic Assessment and Accreditation(NCAAA)and its effects on perceived stress among dental college staff before and after the program accreditation process.METHODS The present cross-sectional questionnaire-based study included 300 employees from three dental colleges.The same employees had to fill out the questionnaire 1 mo after the NCAAA process.RESULTS Approximately 51.33%of the included employees believed that NCAAA is essential to attract quality students to join the program before and after the program.A total of 44.67%felt that their stress was high before,and 31.33%had low stress levels before and after NCAAA.These findings were statistically significant(P≤0.05).CONCLUSION NCAAA raised the prestige of the institution and specific programmes and increased prospects to attract better students,staff,and money,according to the employees.In addition to their needed teaching,research,and other service responsibilities,this work requires a tremendous amount of faculty effort and may cause them stress.

Peer pressure and academic stress among junior high school students:a cross-sectional study

Objective:The objective of the study was to explore the connection between peer pressure and academic stress among junior high school students.Methods:This descriptive correlational study was conducted to investigate the link between perceived peer pressure and academic stress.The study involved a total of 525 adolescents,aged 14-19 years,drawn from 6 public junior high schools(PJHS)in Padang,Indonesia,using purposive sampling.Academic stress and perceived peer pressure were assessed using the Educational Stress Scale for Adolescents(ESSA)and the Perceived Peer Pressure Scale(PPPS).Results:The findings indicated significant variations in stress levels among students in different grade levels(7th,8th,and 9th grades)(P<0.05),while there were no noteworthy differences in peer pressure across these grade levels(P>0.05).Additionally,there was a positive correlation observed between perceived peer pressure and academic stress(r=0.14,P<0.05).Furthermore,multiple regression analyses,incorporating demographic variables and perceived peer pressure as independent factors,yielded statistically significant results(adjusted R^(2)=0.082,F=4.33,P<0.001).Notably,peer pressure had a direct impact on academic stress among adolescents,with class level and parents’educational background mediating the relationship between academic stress and adolescent behavioral problems.Conclusions:These findings underscore the importance of addressing both external and internal factors at the individual,family,school,and societal levels to enhance adolescents’psychological resilience and mitigate problem behaviors.

Optimization Design of the Multi-Layer Cross-Sectional Layout of An Umbilical Based on the GA-GLM

Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components directly affects manufacturing,operation and storage performances of the umbilical.For the multi-layer cross-sectional layout design of the umbilical,a quantifiable multi-objective optimization model is established according to the operation and storage requirements.Considering the manufacturing factors,the multi-layering strategy based on contact point identification is introduced for a great number of functional components.Then,the GA-GLM global optimization algorithm is proposed combining the genetic algorithm and the generalized multiplier method,and the selection operator of the genetic algorithm is improved based on the steepest descent method.Genetic algorithm is used to find the optimal solution in the global space,which can converge from any initial layout to the feasible layout solution.The feasible layout solution is taken as the initial value of the generalized multiplier method for fast and accurate solution.Finally,taking umbilicals with a great number of components as examples,the results show that the cross-sectional performance of the umbilical obtained by optimization algorithm is better and the solution efficiency is higher.Meanwhile,the multi-layering strategy is effective and feasible.The design method proposed in this paper can quickly obtain the optimal multi-layer cross-sectional layout,which replaces the manual design,and provides useful reference and guidance for the umbilical industry.

Association between triglyceride-glucose index and colorectal polyps:A retrospective cross-sectional study

BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.

Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic:A multicenter cross-sectional study

BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.

Brain region-specific roles of brain-derived neurotrophic factor in social stress-induced depressive-like behavior

Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.

Association between Residential Greenness and Cardiometabolic Risk Factors among Adults in Rural Xinjiang Uygur Autonomous Region,China:A Cross-Sectional Study

Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.

Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

An Analysis of the Lifestyle and Mental Health Status of Adult People Living in Dhaka City: A Cross-Sectional Study in Post COVID-19 Era

Introduction: The Novel Coronavirus or COVID-19 affected all the megacities of the world and made the mental health and lifestyle of people paralyzed. According to different studies, such difficulties were different in scale in different cities depending on the demographic attributes of the people. This phenomenon has created the essence of the current study to examine the health conditions in terms of their mental health, lifestyle, and demographic attributes during and immediate past of the COVID-19 era. Method: It was a cross-sectional study covering the people of Dhaka City Corporation. For this purpose, a multistage sampling method was applied, under which the respondents were selected randomly and a self-administered structured questionnaire was used to collect data. The questionnaire was developed based on the DASS 21, as it was suitable to measure the components of mental health in the form of depression, anxiety, and stress. Descriptive analysis and cross-tabulation were applied to find out the association between dependent and independent variables, whereas, a chi-square test was performed to examine the hypothesis. Finally, multivariate analysis was done to find out the risk factors. Three logistic regression models were developed for three dependent variables. Result: The findings of the analysis revealed that the lifestyle of people had severely influenced the components of their mental health conditions during and immediate past of COVID-19 in the Dhaka City Corporation, which varies to some extent depending on the demographic attributes of those. Conclusion: The above findings are statistically significant enough to conclude about the essence of taking preventive measures regarding mental health issues in the future. However, the limitations of this study-keeping it within the urban areas and the educated people, have also created the venue for future researchers to move with their research endeavors in the rural areas nationwide and thus generalize the results.

Patterns of Infertility and Abortion in Saudi Arabia: A Cross-Sectional Study

Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.

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.

Cross-sectional study of traumatic stress disorder in frontline nurses 6 mo after the outbreak of the COVID-19 in Wuhan

BACKGROUND Frontline nurses in Wuhan directly fighting severe acute respiratory syndrome coronavirus-2 diseases are at a high risk of infection and are extremely susceptible to psychological stress,especially due to the global coronavirus disease 2019(COVID-19)pandemic.The psychological after-effects of this public health emergency on frontline nurses will last for years.AIM To assess factors influencing post-traumatic stress disorder(PTSD)among frontline nurses in Wuhan 6 mo after the COVID-19 pandemic began.METHODS A total of 757 frontline nurses from five hospitals in Wuhan,China,participated in an online survey from July 27 to August 13,2020.This cross-sectional online study used a demographic information questionnaire,the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders,the Connor-Davidson Resilience Scale,and the Patient Health Questionnaire-4.The chisquare test and logistic regression were used to analyze the association of demographics,COVID-19-related variables,and PTSD.Logistic regression was also conducted to investigate which variables were associated with PTSD outcomes.RESULTS A total of 13.5%,24.3%,and 21.4%of the frontline nurses showed symptoms of PTSD,depression,and anxiety,respectively.The multivariate logistic regression analysis showed that the following factors were strongly associated with PTSD:Having a relative,friend,or colleague who died of COVID-19;experiencing stigma;or having psychological assistance needs,depressive symptoms or anxiety.Showing resilience and receiving praise after the COVID-19 outbreak were protective factors.CONCLUSION Frontline nurses still experienced PTSD(13.5%)six months after the COVID-19 outbreak began.Peer support,social support,official recognition,reward mechanisms,exercise,better sleep,and timely provision of information(such as vaccine research progress)by the government via social media,and adequate protective supplies could mitigate the level of PTSD among nurses responding to COVID-19.Stigmatization,depression,and anxiety might be associated with a greater risk of PTSD among nurses.

A Cross-Sectional Study on The Prevalence of Anemia in Maintenance Hemodialysis and Peritoneal Dialysis Patients and Its Related Factors

Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.

The Relationship between Eating Disorders and Stress among Medical Undergraduate: A Cross-Sectional Study

Introduction: Eating disorders are compulsive behaviours that can consume a person’s life to the point of becoming life threatening. Medical college can be a very stressful time and previous studies had found that stress could be a main factor leading to higher risk of eating disorder. We aimed to determine the association between stress and eating disorders among undergraduate medical students. Methods: A cross-sectional study was conducted among 320 respondents comprises of Year 3, 4 and 5 medical students in private medical college in Malaysia, assessed using self-administered questionnaires which consist of social demographic data, EAT-26 and Cohen Perceived Stress Scale. The response rate of this study was 77.4%. Results: With regards to EAT-26, 11.0% of medical students were at risk of developing eating disorder and from this students who have obese BMI status (25%) had 3.9 times more likely to develop eating disorder (95% CI: 1.4 - 10.9). There was significant association between those with unsatisfactory social relationship with friends and peers (OR 2.5, 95% CI 1.0 - 5.9;p value 0.035) and risk of developing eating disorders (OR 3.9, 95% CI 1.4 - 10.9;p value 0.007). For Cohen Perceived Stress Scale (CPSS), 75.5% of the respondents were having high stress level. There was no significant association between stress and the risk of eating disorders with OR 1.0, 95% CI: 0.6 - 1.7;p value 0.887. Conclusion: Majority of medical undergraduates were under stressed and there was a risky trend toward eating disorders in medical. However, based on our results it did not portray any significant association between stress and risk of developing eating disorders. Nevertheless, it should not be completely neglected. It is important to increase the awareness of medical undergraduates regarding eating disorders and its complications.

Correlation between the rock mass properties and maximum horizontal stress:A case study of overcoring stress measurements

Understanding the mechanical properties of the lithologies is crucial to accurately determine the horizontal stress magnitude.To investigate the correlation between the rock mass properties and maximum horizontal stress,the three-dimensional(3D)stress tensors at 89 measuring points determined using an improved overcoring technique in nine mines in China were adopted,a newly defined characteristic parameter C_(ERP)was proposed as an indicator for evaluating the structural properties of rock masses,and a fuzzy relation matrix was established using the information distribution method.The results indicate that both the vertical stress and horizontal stress exhibit a good linear growth relationship with depth.There is no remarkable correlation between the elastic modulus,Poisson's ratio and depth,and the distribution of data points is scattered and messy.Moreover,there is no obvious relationship between the rock quality designation(RQD)and depth.The maximum horizontal stress σ_(H) is a function of rock properties,showing a certain linear relationship with the C_(ERP)at the same depth.In addition,the overall change trend of σ_(H) determined by the established fuzzy identification method is to increase with the increase of C_(ERP).The fuzzy identification method also demonstrates a relatively detailed local relationship betweenσ_H and C_(ERP),and the predicted curve rises in a fluctuating way,which is in accord well with the measured stress data.

Dip2a regulates stress susceptibility in the basolateral amygdala

Dysregulation of neurotransmitter metabolism in the central nervous system contributes to mood disorders such as depression, anxiety, and post–traumatic stress disorder. Monoamines and amino acids are important types of neurotransmitters. Our previous results have shown that disco-interacting protein 2 homolog A(Dip2a) knockout mice exhibit brain development disorders and abnormal amino acid metabolism in serum. This suggests that DIP2A is involved in the metabolism of amino acid–associated neurotransmitters. Therefore, we performed targeted neurotransmitter metabolomics analysis and found that Dip2a deficiency caused abnormal metabolism of tryptophan and thyroxine in the basolateral amygdala and medial prefrontal cortex. In addition, acute restraint stress induced a decrease in 5-hydroxytryptamine in the basolateral amygdala. Additionally, Dip2a was abundantly expressed in excitatory neurons of the basolateral amygdala, and deletion of Dip2a in these neurons resulted in hopelessness-like behavior in the tail suspension test. Altogether, these findings demonstrate that DIP2A in the basolateral amygdala may be involved in the regulation of stress susceptibility. This provides critical evidence implicating a role of DIP2A in affective disorders.

Acquired sensorineural hearing loss,oxidative stress,and microRNAs

Hearing loss is the third leading cause of human disability.Age-related hearing loss,one type of acquired sensorineural hearing loss,is largely responsible for this escalating global health burden.Noise-induced,ototoxic,and idiopathic sudden sensorineural are other less common types of acquired hearing loss.The etiology of these conditions is complex and multi-fa ctorial involving an interplay of genetic and environmental factors.Oxidative stress has recently been proposed as a likely linking cause in most types of acquired sensorineural hearing loss.Short non-coding RNA sequences known as microRNAs(miRNAs)have increasingly been shown to play a role in cellular hypoxia and oxidative stress responses including promoting an apoptotic response.Sensory hair cell death is a central histopathological finding in sensorineural hearing loss.As these cells do not regenerate in humans,it underlies the irreversibility of human age-related hearing loss.Ovid EMBASE,Ovid MEDLINE,Web of Science Core Collection,and ClinicalTrials.gov databases over the period August 1,2018 to July 31,2023 were searched with"hearing loss,""hypoxamiRs,""hypoxia,""microRNAs,""ischemia,"and"oxidative stress"text words for English language primary study publications or registered clinical trials.Registe red clinical trials known to the senior author we re also assessed.A total of 222studies were thus identified.After excluding duplicates,editorials,retra ctions,secondary research studies,and non-English language articles,39 primary studies and clinical trials underwent full-text screening.This resulted in 11 animal,in vitro,and/or human subject journal articles and 8 registered clinical trial database entries which form the basis of this narrative review.MiRNAs miR-34a and miR-29b levels increase with age in mice.These miRNAs were demonstrated in human neuroblastoma and murine cochlear cell lines to target Sirtuin 1/peroxisome proliferato r-activated receptor gamma coactivator-1-alpha(SIRT1/P GC-1α),SIRT1p53,and SIRT1/hypoxia-inducible factor 1-alpha signaling pathways resulting in increased apoptosis.Furthermore,hypoxia and oxidative stress had a similar adve rse apoptotic effect,which was inhibited by resve ratrol and a myocardial inhibitorassociated transcript,a miR-29b competing endogenous mRNA.Gentamicin reduced miR-182-5p levels and increased cochlear oxidative stress and cell death in mice-an effect that was corrected by inner ear stem cell-derived exosomes.There is ongoing work seeking to determine if these findings can be effectively translated to humans.

Prediction of Perceived Stress of Hong Kong Nursing Students with Coping Behaviors over Clinical Practicum: A Cross-Sectional Study

Nursing students are facing more and more stress in their course of study especially in clinical practicum. The study aimed to predict nursing students’ stress level in clinical practicum with coping behaviors. It was a retrospective cross-sectional study conducting in a self-financing institution in Hong Kong. Nursing students who were studying the pre-registration baccalaureate nursing program and completed all the practicum blocks were recruited. Those who had extended the study and failed any of the practicum blocks were excluded. Convenience sampling was used to recruit subjects. Participants were required to fill out the demographic sheet, COPE Inventory and Assessment of Stress among Nursing Students scale during lecture at the commencement of a semester. The whole data collection lasted for 30 minutes. Stepwise multiple regression was used to do the modeling with p-value being set at 0.05. 131 eligible nursing students were recruited with about half of female students. The regression model accounted for 50% of the variance in the perceived stress level. Gender, focus on and venting of emo-tions, restraint, use of emotional social support and denial were positively associated with perceived stress level (R squared = 0.52, p = 0.001). It is to conclude that nurse educators can refer to the findings to screen out students with higher risk of being overwhelmed by clinical learning and ineffective coping. Proactive measures should be taken to prevent poor health outcomes.

A Cross-Sectional Study of the Causes, Effects and Management Strategies for Stress and Burnout among Nurses in the Fako Division, Cameroon

Introduction: Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses who work in ED are front line providers of immediate medical care needed to stabilize patients. With the known critical shortage of health workforce in Cameroon, nurses are overloaded with work and often experience stress and burnout. Aim: This study aimed at determining the causes, effects and management strategies of stress and burnout among nurses working in the ED in hospitals in the Fako Division, Cameroon. Methods: This study was a descriptive cross-sectional study. The sample consisted of seventy nurses from five different hospitals. A purposive sampling technique was used and data was analyzed using SPSS version 16.0. Data was collected using a structured questionnaire developed from the International Stress Management Scale. Results: The highest reported cause of stress in this study was heavy workload (12.88%) and the least was no experience in handling the challenges of the department. The leading reported effect of stress was the development of musculoskeletal disorders such as joint and back pain (16.48%) and the least effect was contemplating quitting the profession (5.99%). The major management strategy used was humour (8.27%), while the least was crying out stress to feel relieved (2.18%). Conclusion: The major cause of stress and burnout among nurses in our study setting was heavy workload, which mostly results in joint and back pain. Moreover, humour was the prime management strategy for stress and burnout among nurses in the emergency department in the study setting. Thus more nurses should be employed and the working conditions of nurses improved to reduce the workload in the study hospitals.