Low self-reported stress despite immune-physiological changes in paramedics during rescue operations

"You treat your stress by doing what you're supposed to do": a qualitative inquiry into emotion regulation of paramedics and paramedic students in critical incidents

BACKGROUND

Emergency medical services (EMS) are among the professions with a high degree of responsibility and the frequency of critical situations. Existing research is largely quantitative and provides little insight into the specifics of critical incidents and the emotion regulation strategies used to manage them. Furthermore, little is known about the process by which an experienced paramedic is equipped with emotion regulation resources in the profession.

METHOD

In this study, we interviewed 12 experienced paramedics (at least 4 years of practice) and 10 urgent medical care students about the most intense acute stressors they encounter and the emotion regulation that these stressors trigger.

RESULTS

Psychological distancing, attention management, cognitive framing and interpersonal self-regulation were used by both groups as means of emotion regulation. Identification with the professional role is a key aspect of maintaining a sense of psychological distance. A balance between distance and connectedness is sought. It is not so easy for paramedic trainees to achieve a sense of psychological distance from patients and relatives, and their attention may shift from the situation to themselves, leading to greater anxiety.

CONCLUSION

Emotions and emotion regulation are taboo subjects in paramedic community, but greater awareness of them might be beneficial in psychological adaptation to work.

Green Spaces with Fewer People Improve Self-Reported Affective Experience and Mood

Calm and quiet green spaces provide health benefits for urban residents. Yet as cities become more densely populated, increasing public users to green spaces may reduce or moderate these benefits. We examine how increased pedestrian density in a green street changes self-reported wellbeing. We use a between subject experimental design that added public users as confederates in randomly selected periods over three weeks. We collect data on mood and affective response from pedestrians moving through the green street (n = 504), with and without our public user treatment in randomly selected periods. Mood and affective response are improved when experiencing the green street with fewer people. We find that an increased number of public users in the green space has a negative effect on mood, especially among women. We provide experimental evidence that self-reported wellbeing in urban green spaces depends on social context, and that there are gender inequities associated with changes in affective response. Although we only measure immediate impacts, our results imply that the health benefits of green spaces may be limited by the total number of users. This research contributes additional evidence that greener cities are also healthier cities, but that the benefits may not be equally shared between women and men and will depend on the social context of use.

Metabolomics Based on Peripheral Blood Mononuclear Cells to Dissect the Mechanisms of Chaigui Granules for Treating Depression

Chaigui granules were a traditional Chinese medicine (TCM) preparation with antidepressant effects derived from a famous antidepressant prescription. It was of great significance to clarify the antidepressant mechanism of Chaigui granules for the clinical application of this drug. In this study, a chronic unpredictable mild stress (CUMS) depression model was successfully established, and behavioral indicators were used to evaluate the antidepressant effect. Second, the CD4+, CD8+, and CD4+/CD8+ levels were detected in peripheral blood. Meanwhile, the amount of inflammatory cytokines was determined in serum. Correspondingly, LC/MS-based peripheral blood mononuclear cell (PBMC) metabolomics was used to investigate vital metabolic pathways participating in the antidepressive effects of Chaigui granules. Finally, bioinformatics technology was further employed to discover the potential antidepressant mechanism of Chaigui granules regulating the immune system. The results suggested that the administration of Chaigui granules significantly improved CUMS-induced depressive symptoms. Chaigui granules could improve immune function by regulating T lymphocyte subsets, increasing anti-inflammatory cytokine levels of IL-2 and IL-10, and reducing pro-inflammatory cytokine levels of TNF-α, IL-1β, and IL-6. In addition, metabolomics results of PBMCs showed that Chaigui granules improved 14 of the 25 potential biomarkers induced by CUMS. Metabolic pathway analyses indicated that purine metabolism was the critical metabolic pathway regulated by Chaigui granules. Furthermore, correlation analysis indicated that 13 key biomarkers were related to immune-related indicators. The metabolite-gene network of 13 key biomarkers was investigated by using bioinformatics. The investigation showed that 10 targets (5'-nucleotidase ecto; 5'-nucleotidase, cytosolic IB; 5'-nucleotidase, cytosolic II; etc.), mainly belong to the purine metabolism, might be potential targets for Chaigui granules to exert their antidepressant effects by improving immune function impairment. Together, our results suggested that Chaigui granules might exert antidepressant effects by improving immune function and regulating the purine metabolic pathway in PBMCs. This work used PBMCs metabolomics as an entry point to study the antidepressant mechanism of Chaigui granules, which provided a new way to elucidate the mechanism of a traditional Chinese medicine prescription.