Metabolic, neuroendocrine and behavioral effects of social defeat in male and female mice using the chronic non-discriminatory social defeat stress model

Stress-related disorders predominately affect females, yet preclinical models of chronic stress exclusively use males especially in models where social stressors are studied. Here, we implemented a 21-day novel social defeat paradigm in which a female and male C57 intruder are simultaneously placed in the cage of a territorial, resident CD-1 male mouse, and the resident proceeds to attack both intruders. Mice were given access to a regular laboratory diet, high in carbohydrates, and a palatable diet, high in fat. Chronic social defeat stress using this paradigm resulted in increased caloric intake in male and female mice, with the effects being more pronounced in females. We observed sex differences in high fat diet intake in response to stress, which was correlated with higher levels of plasma ghrelin observed in female mice but not male mice. Furthermore, females exposed to chronic stress displayed changes in growth hormone secretatogue receptor (ghsr) and neuropeptide-y (npy) expression in the arcuate nucleus of the hypothalamus, potentially increasing ghrelin sensitivity and inducing changes in diet choice and caloric intake. Behavioral results show that females tended to spend more time interacting during the social interaction test, compared to males who displayed higher vigilance towards the stranger mouse. Overall, our results highlight unique neurometabolic alterations in female mice in response to stress that is not present in male mice and may be important for coping with chronic stress and sustaining reproductive function.

Caregivers' perception of the role of the socio-environment on their extremely preterm child's well-being

PURPOSE

The purpose of this qualitative descriptive study was to explore primary caregivers' perception of how social-environmental characteristics, and their own role as primary caregivers, affected their extremely preterm adolescent's well-being.

METHODS

Participants were 20 mothers who identified as the primary caregiver of an adolescent born extremely prematurely (<28 weeks gestation) enrolled in the ELGAN cohort study. Data was collected through individual interviews and was analyzed using inductive content analysis.

RESULTS

A total of three themes, and five subthemes, were identified. The two main themes were "familial impact to health and well-being," and "contributors and barriers at the community level." This study described specific familial and community contributors to child and caregiver well-being, including: the importance of advocacy, participating in community activities, and social and familial support networks.

CONCLUSIONS

Overall, while there are individual level characteristics that contribute to well-being, a support structure at the family and community level is essential to children born extremely prematurely, and their mother's, well-being.

PRACTICE IMPLICATIONS

Healthcare providers caring for these families should understand that not only are extremely preterm youth affected by prematurity, but caregivers are also deeply impacted. Therefore, it is essential that maternal and family care is emphasized by nurses and healthcare providers.

Emotional Response and Behavioral Coping Associated with Experienced and Media Discrimination Among Asians and Asian Americans in the United States

This paper examined how sources (experienced and media) and forms (overt and subtle) of discrimination were associated with emotional response and behavioral coping among Asians and Asian Americans during the COVID-19 pandemic. Data were collected in June 2020 from 249 Asian and Asian American adults living in 20 U.S. states. We used hierarchical regression for data analysis, controlling for age, gender, and the length of residence in the U.S. Results showed that experienced discrimination, especially in the overt form, was associated with both emotional responses (i.e., emotional distress and vigilance) and behavioral coping (i.e., using avoidant behavior to protect oneself). Media discrimination was associated only with emotional response. The relationship between experienced discrimination and emotional response was less pronounced among those who frequently observed discrimination in the media. Notably, subtle discrimination through personal experience or media exposure was positively associated with behavioral coping. The results suggest the need to address the rising anti-Asian acts with more initiatives in policy and practice, with special attention paid to the parallel influences from personal experience and media exposure to violence.

Spiritual Coping of Emergency Department Nurses and Emergency Medical Services Staff During the COVID-19 Pandemic in Iran: An Exploratory Study

Emergency department (ED) nurses and emergency medical services (EMS) staff have been recently exposed to high levels of stress due to the new Coronavirus (COVID-19) pandemic. This increased stress level may influence the physical and mental health of ED nurses and EMS staff and the quality of caregiving to the patients. A spiritual coping approach is one of the most commonly used strategies to help healthcare workers manage stressful events or situations. This study explores the spiritual coping (positive or negative) among ED nurses and EMS staff during the COVID-19 pandemic. A descriptive cross-sectional study was performed on 494 ED/EMS nurses in Ardabil Province in the northwest of Iran, using a convenience sampling method. The spiritual coping questionnaire (SCQ) was used to assess spiritual coping in the subjects. The results of this study showed that ED nurses and EMS staff generally used positive spiritual coping methods to reduce stress during the COVID-19 pandemic. Multiple linear regression indicated that workplace (β = 0.22, p < 0.001), service location (β = 0.16, p < 0.001), and type of employment (β = - 0.13, p = 0.012) were significant predictors of positive spiritual coping, and older age (β = 0.13, p = 0.045), overtime work (β = 0.12, p = 0.01), and marital status (β = - 0.12, p = 0.021) were predictors of negative spiritual coping. Our findings indicated that positive religious behavior was the main spiritual coping strategy used by healthcare workers. The findings could help emergency nurse managers to propose future strategies to minimize stress based on the use of spiritual coping strategies and provide time and facilities to pray.

Explaining stress coping behaviors in patients with multiple sclerosis based on the PRECEDE model: a qualitative directed content analysis

BACKGROUND

Stress can be regarded as one of the consequences of Multiple Sclerosis (MS) and a factor in exacerbating or recurring the symptoms resulting from the disease. This study aimed to explain the stress coping behaviors in patients with MS based on the PRECEDE model.

METHODS

This study is a qualitative directed content analysis research based on the PRECEDE model. Data were obtained through in-depth semi-structured interviews with 26 patients with MS, who were selected using a purposive sampling and maximum diversity in terms of gender, age, education, marital status, and employment. Data collection continued until the saturation occurred. Simultaneously, collected data were analyzed using a qualitative directed content analysis method.

RESULTS

Data analysis led to the identification of 11 sub-categories. Of these, 10 sub-categories were assigned to three categories of predisposing factors (awareness, attitude, self-efficacy, and perceived severity), enabling factors (existence of resources, access to resources, skills of using resources, and educational preferences), and reinforcing factors (social support, important others and behavioral consequences). The social comparison category was a new category identified from the analysis of interviews.

CONCLUSIONS

Based on the results, individual, environmental and social factors play a role in the stress of these patients. Designing programs that lead to their empowerment and improvements in the environmental and social conditions can be effective in controlling stress in these patients. Based on the results, planners can adopt the most appropriate strategies to change these determinants, help reduce stress, and promote the psychological standard of living in these patients.

Power of Religious Beliefs and Coping with Cancer: Opinions of Iranian Parents

Childhood cancer as a stressful event has many consequences for both the parents and their children. The aim of the study was to assess the coping strategies used by Iranian parents of children with cancer. The present study was conducted through convenience sampling with the participation of 205 parents with at least one child with cancer referred to the oncology ward, in the southeast of Iran. The Coping Health Inventory for Parents was used to measure parental coping strategies. Results showed that the highest and the lowest mean coping score belonged to the dimensions of social support and medical factors, respectively. Briefly, "Belief in God" and "Gratefulness for his Blessings" were the most helpful coping strategies among parents. Based on results of this study, it seems necessary for nurses to be aware of all aspects of human existence, including religion and spirituality as strong sources of power for parents to adapt with the illness of their child. Also, providing interventions to teach effective coping skills to parents may reduce their distress and improve their quality of life.

Coping during COVID-19: a mixed methods study of older cancer survivors

PURPOSE

Older cancer survivors are among the most vulnerable to the negative effects of COVID-19 and may need specific survivorship supports that are unavailable/restricted during the pandemic. The objective of this study was to explore how older adults (≥ 60 years) who were recently (≤ 12 months) discharged from the care of their cancer team were coping during the pandemic.

METHODS

We used a convergent mixed method design (QUAL+quan). Quantitative data were collected using the Brief-COPE questionnaire. Qualitative data were collected using telephone interviews to explore experiences and strategies for coping with cancer-related concerns.

RESULTS

The mean sample age (n = 30) was 72.1 years (SD 5.8, range 63-83) of whom 57% identified as female. Participants' Brief-COPE responses indicated that they commonly used acceptance (n = 29, 96.7%), self-distraction (n = 28, 93.3%), and taking action (n = 28, 93.3%) coping strategies. Through our descriptive thematic analysis, we identified three themes: (1) drawing on lived experiences, (2) redeploying coping strategies, and (3) complications of cancer survivorship in a pandemic. Participants' coping strategies were rooted in experiences with cancer, other illnesses, life, and work. Using these strategies during the pandemic was not new-they were redeployed and repurposed-although using them during the pandemic was sometimes complicated. These data were converged to maximize interpretation of the findings.

CONCLUSIONS

Study findings may inform the development or enhancement of cancer and non-cancer resources to support coping, particularly using remote delivery methods within and beyond the pandemic. Clinicians can engage a strengths-based approach to support older cancer survivors as they draw from their experiences, which contain a repository of potential coping skills.

Older Adults' Experiences and Adaptation Strategies during the Midst of COVID-19 Crisis: A Qualitative Instrumental Case Study

BACKGROUND

This study aimed to validate one of the propositions of the Need-Threat Internal Resiliency Theory.

METHODS

This study used an instrumental case study of five participants to qualitatively explore older adults' experiences and adapting strategies during the coronavirus disease 2019 (COVID-19) crisis. We selected participants based on parameters and conducted in-depth interviews of 15-30 minutes. The transcribed responses were then analyzed using a phenomenological holistic description.

RESULTS

Five major themes emerged to explain and describe the various experiences of coping with COVID-19, known as internal resiliency, developed by the older adult participants in response to the perceived threat from this crisis.

CONCLUSION

These findings showed that older adult participants had established internal resiliency in response to changes caused by the COVID-19 crisis, resulting in adaptation and coping with the situation, consistent with one proposition of the Need-Threat Internal Resiliency Theory.

Investigating relationships among coping, personal growth, and life satisfaction among individuals with physical disabilities

Background: It is well-documented that active coping strategies can lead to better positive adjustment and psycho-social outcomes among individuals with disabilities and illnesses. However, little information exists related to exploring how coping is related to health benefits such as personal growth and life satisfaction in an international context. Thus, this study examined how the use of coping strategies is associated with personal growth and life satisfaction among individuals with physical disabilities in non-Western settings.

Methods: In this cross-sectional study, we employed a nonprobability methodology, purposivesampling, to recruit 351 participants who adults over the age of 18 living with a physicaldisability and currently enrolled in the Korean Disability Association. A hierarchical linearregression analysis was conducted to determine which types of coping strategies predictedpersonal growth and life satisfaction, while controlling for the effects of the demographicvariables (i.e., gender and age).

Results: With regard to personal growth, problem-solving coping strategy (β = 0.663, P < 0.001,95% CI [0.51, 0.70]) was the strongest predictor, followed by avoidance coping strategy(β = -0.263, P < 0.001, 95% CI [-0.37, -0.20]). As for life satisfaction, problem-solving copingstrategy (β = 0.268, P < 0.001, 95% CI [0.18, 0.70]) was the strongest predictor, followed bysocial support seeking coping strategy (β = 0.264, P < 0.001, 95% CI [-0.19, 0.10]).

Conclusion: Our study suggests that problem-focused and social support coping strategies playimportant roles in improving the personal growth and life satisfaction among Korean individualswith physical disabilities. This study provides implications for health professionals seeking waysto facilitate the personal growth and enhance the life satisfaction of individuals with physicaldisabilities.

Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

OBJECTIVES

To evaluate the effects of a patient-centered intervention including the cumulative-complexity model on quality of life related to health, coping behaviors, pain, self-perceived occupational performance and activity levels.

STUDY DESIGN

Randomized controlled trial. Forty-four women with a clinical diagnosis of chronic pelvic pain were randomized into two groups. Patients in the experimental group (n = 22) were included in a patient-centered intervention that involved relevant activities proposed by participants. Patients in the control group (n = 22) received a leaflet with information about chronic pelvic pain, physical activity, fear of movement, false beliefs, active lifestyle and behavioral advice.

MAIN OUTCOME MEASURES

The primary outcome measures were health-related quality of life assessed with the EuroQol-5D and coping behavior using the Coping Strategies Questionnaires. Secondary outcomes included severity of pain using a Visual Analogue Scale, self-perception of occupational performance using the Canadian Occupational Performance Measure and physical activity levels assessed by the International Physical Activity Questionnaire.

RESULTS

An analysis of variance with repeated measures showed, in the experimental group compared with the control group, significantly greater improvement from baseline to post-intervention in health-related quality of life (EuroQol-5D Visual Analog Scale values of 70.06 ± 16.44 vs. 57.38 ± 16.40, p = 0.026) and coping behavior (adaptive coping 113.00 ± 31.89 vs. 83.24 ± 16.69, p = 0.002). Pain, self-perception of performance and physical activity levels also significantly improved.

CONCLUSIONS

A patient-centered intervention considering the workload of patients and their capacity for performing health behaviors provides benefits regarding quality of life and coping behavior. Additionally, pain, self-perceived performance of relevant tasks and physical activity levels improved.

Mechanisms of Racial Health Disparities: Evidence on Coping and Cortisol from MIDUS II

OBJECTIVE

Blunted patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress response system dysregulation, are implicated in poor health outcomes and racial health disparities. It is unknown how coping-an important, but understudied, component of the stress-health disparities relationship-relates to these biological mechanisms of health.

METHODS

This study investigated relationships, including racial differences, between 12 coping strategies and early-day cortisol changes (diurnal cortisol slopes from peak to before lunch) among 700 35-85-year-old Black and White male participants in the National Survey of Midlife Development in the United States (MIDUS) II. Cognitive-oriented (e.g., positive reinterpretation, denial, religious/spiritual) and behavioral (e.g., stress eating, substance use) coping strategies were examined.

RESULTS

Overall, Black and White men used similar coping strategies. Most coping strategies were not associated with men's cortisol slopes. Religious/spiritual coping was associated with steeper (more robust) cortisol slopes among White (b = - 0.004, t = - 3.28, p = 0.001) but not Black men. Drug use was associated with steeper cortisol slopes among Black (b = - 0.095, t = - 2.87, p = 0.004) but not White men.

CONCLUSIONS

This exploratory study increases our understanding of relationships between coping and stress-related biological mechanisms underlying racial health disparities among men in later life. With some notable exceptions, men's coping strategies were not associated with their diurnal cortisol slopes. This suggests that the coping strategies currently used by older Black and White men may not be important factors, as determinants or intervention targets, in disparities in diurnal cortisol slopes and associated health outcomes among men in this age group.

Coping behaviors and depressive status in individuals with type 2 diabetes mellitus

OBJECTIVE

Type 2 diabetes mellitus (T2DM) is associated with a high prevalence of depression, which is influenced by personality traits and coping style. However, these psychological factors have not been well studied in individuals with T2DM. The association between coping behaviors and the reported levels of depressive symptoms was examined in individuals with T2DM.

METHODS

The subjects were 435 T2DM patients (mean age 63.1 ± 12.6 years). Depressive status, personality traits and coping behaviors were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Brief Scale for Coping Profile (BSCP). Lifestyle factors and glycated hemoglobin A1c (HbA1c) levels in the patients were also included in the analyses.

RESULTS

Among the 435 subjects with T2DM, 130 (29.9%) exhibited possible depression, and 68 (15.6%) displayed probable depression. After adjustment for confounders, logistic and multiple regression analyses revealed that certain coping profile scores, such as Changing one's point of view, Emotional expression involving others and Avoidance and suppression, were consistently and significantly associated with the presence and severity of depression. No relationship was found between depression and HbA1c.

CONCLUSION

These findings indicate that Maladaptive emotion-focused coping strategies, such as Emotional expression involving others and Avoidance and suppression, are protective factors and that Adaptive emotion-focused coping, such as Changing one's point of view, is a risk factor for depression in T2DM patients. Psychological intervention focusing on the coping profile may reduce depressive symptoms. Additional studies are needed to examine the relationships between psychological factors and depressive symptoms using a longitudinal study design.

Workplace bullying in risk and safety professionals

INTRODUCTION

Previous research demonstrates that workplace bullying impacts the welfare of victimized employees, with further consequences for the organization and profession. There is, however, a paucity of information relating to the bullying directed at risk and safety professionals. The present study was conducted to address this issue.

METHOD

Risk and safety professionals (N=420) completed the Negative Acts Questionnaire - Revised and Brief Cope, and reported the extent to which they had been pressured to make or amend a risk or safety based decision.

RESULTS

Those experiencing workplace bullying were more likely to engage in a range of coping behaviors, with exposure to work-related and personal bullying particularly influential. Workplace bullying also predicted pressure to make or change a risk or safety based decision. Work related and physically intimidating bullying were particularly important for this aspect of professional practice.

CONCLUSIONS

Findings are discussed with regard to current practice and the support available to risk and safety professionals.

PRACTICAL APPLICATIONS

Risk and safety professionals require additional support in relation to workplace bullying and specifically guidance to resist pressure to make or change a risk or safety based decision.

A qualitative study on coping behaviors and influencing factors among mothers in Japan raising children under three years old while experiencing physical and mental subjective symptoms

BACKGROUND

No studies illustrating the coping behaviors of mothers experiencing physical and mental subjective symptoms, or the factors that contribute to these behaviors, have been investigated. Therefore, the present study sought to develop a conceptual framework on the coping behaviors and contributing factors of mothers experiencing physical and mental subjective symptoms.

METHODS

This qualitative study involved theoretical sampling and semi-structured interviews of mothers who were raising children under 3 years of age in Japan and had experienced physical and mental subjective symptoms since giving birth. Women who were pregnant, required regular medical exams, or had difficulty communicating in Japanese were excluded. All mothers were recruited via personal contacts, snowball sampling, and posters at a community center and nursery schools. Analysis was conducted using the constant comparative method. The interview data were extracted in contextual units based on analytical themes, and concepts were generated. Relationships between concepts were investigated and categorized. To confirm theoretical saturation and ensure the validity of the data, a study supervisor was appointed, four qualitative researchers examined the results, and the interview respondents underwent member checking.

RESULTS

There were a total of 21 participants. Thirteen categories were created from 29 concepts identified from the analytical theme "What do mothers do when raising children under 3 years of age while experiencing physical and mental subjective symptoms?" While experiencing subjective symptoms, mothers raising children under 3 years of age tended to lead a child-centric lifestyle and were hesitant to visit the doctor, not only because of typical reasons such as time and costs, but also because of factors related to their child. Some circumstances occurring while experiencing physical and mental subjective symptoms led mothers to put their own needs first and attempt to cope on their own as much as possible. As a result, most mothers would only visit a doctor after becoming seriously ill.

CONCLUSION

Mothers raising children under 3 years of age in Japan tend to put their own needs on hold when experiencing subjective symptoms. As a result, they attempt to cope on their own and, at times, only visit a doctor after becoming seriously ill.

Coping strategies of nursing students for dealing with stress in clinical setting: A qualitative study

Background

Nursing students in the clinical setting experience a high level of stress. The understanding of people involved in nursing education, from coping strategies of nursing students with clinical stress, is highly important for any kind of planning in this field.

Objective

To explore the coping strategies of Iranian nursing students with stress in a clinical setting.

Methods

This qualitative content analysis study was carried out with twenty nursing students who were selected using purposive sampling at the Razi nursing and midwifery school in Kerman, in Iran during a ten-month period in 2016. Data were collected using semi-structured face to face interviews, and analyzed through Graneheim and Lundman's qualitative content analysis method.

Results

"Seeking well-being" as the main theme and three categories of "Active confrontation with stress", "mastering the mind and body" and "avoidance" were obtained from data analysis.

Conclusion

The exploration of nursing students' experiences of coping with clinical stressors, increases students' awareness of their coping strategy. The academic authorities in recognizing the coping strategies of students with stress in clinical setting, can provide necessary training on effective coping strategies for students.

Occupational health management system: A study of expatriate construction professionals

Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a systems view of health management.

Psychological aspects of diabetes care: Effecting behavioral change in patients

Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient’s psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM.

Coping behaviours in recent abstinence attempt in opioid dependent subjects

Failure of coping machanisms in handling urges when exposed to high risk situations has been posited as one of the factors associated with relapse of drug use. In the present study there has been an attempt to study the coping mechanisms used by opioid dependent subjects in a recent abstinence attempt. The sample consisted of 100 opioid dependent subjects admitted to the deaddiction centre at A.I.I.M.S. New Delhi. The subjects should have had an abstinence longer than a month's period in the 1 year prior to the study. The coping behaviours were assessed by a semistructured interview schedule based on the coping behaviors inventory of Litmen et al, (1981). The results indicate that a wide variety of cognitive and behavioural startegies are used by subjects to handle temptations when exposed to high risk situations. On an average each subject used 7.4. behaviours. Behavioural strategies were commonly employed and they were: keeping away from users, keeping in company of nonusers, working harder, avoiding places associated with use, etc. In understanding the determinants of the coping mechanisms it was seen that family type determined the use of following behaviours viz, being better off without drugs, thinking of mess resulting from drugs and saying J am well and wish to stay so. Route of drug use was important determinant for using the mechanism i.e., realizing effects on health to keep off the urges in high risk situations.