Comparison of stress, anxiety and depression levels of health, education and security sector employees: The effect of psychological resilience

This study compared the stress, anxiety and depression levels in employees working in the health, education and security sectors. The study also investigated the effect of psychological resilience on stress, anxiety, and depression levels and whether the stress, anxiety, depression and psychological resilience levels of employees differ according to occupational and demographic variables. In this cross-sectional study, 1222 employees participated, comprising 50.8% from the health sector, 37.7% from education, and 11.5% from security. Data were collected using the Stress, Anxiety, and Depression Scale-21 and the Brief Resilience Scale. The study revealed varying rates of severe stress (49.1%), anxiety (74.0%), and depression (53.2%) among participants. Health employees experienced higher stress (52.1%), anxiety (77.0%), and depression (58%) rates compared to those in education (46.4%, 72.4%, and 48.4%) and security sectors (44.3%, 66.4%, and 48.5%). Health employees exhibited higher stress, anxiety, and depression levels, signifying a significant difference. Furthermore, the research identified psychological resilience as a crucial predictor of stress, anxiety, and depression. Additionally, these mental health issues were more prevalent among younger individuals with less work experience, females, private sector employees, singles, and those without children. The findings of the study showed that the level of stress, anxiety and depression was high in employees working in all three sectors (health, education and security), but mental problems were more common in health employees. The fact that psychological resilience is a significant predictor of stress, anxiety and depression levels indicates that this factor should be taken into account.

Global prevalence of sexual dysfunction in cardiovascular patients: a systematic review and meta-analysis

BACKGROUND

Sexual dysfunction poses a significant challenge for patients with cardiac conditions. Concerning the prevalence of sexual disorders in cardiovascular patients, several seminal studies conducted in various regions of the world have provided diverse facts and figures pertaining to sexual dysfunction among cardiovascular patients. Therefore, the present study aimed to analyze, summarize, and integrate the findings of seminal studies on the effect of underlying factors and estimate the global rate of sexual disorders in cardiovascular patients.

METHODS

The present systematic review and meta-analysis included studies conducted in 2003-2023. To find the relevant published academic papers, SID, MagIran, PubMed, Scopus, Web of Science (WOS), and Google Scholar databases were searched for keywords using MeSH/Emtree until January 14, 2023. The GRADEpro software was used to evaluate the quality of evidence. The heterogeneity of studies was checked using the I2 index.

RESULTS

An initial number of 2122 studies were found in the first search. Following a precise screening process based on predefined inclusion criteria, a total of 17 studies were deemed suitable for inclusion in the meta-analysis. The global prevalence of sexual disorders in cardiovascular patients was estimated at 62.6% (95% CI: 49.8-73.8%). As the results of the meta-regression showed that as the sample size increased, there was a significant decrease in the overall prevalence of sexual disorders among cardiovascular patients. Additionally, as the study years progressed, both age and JBI score exhibited an upward trend.

CONCLUSION

The present findings showed a high prevalence of sexual disorders among cardiovascular patients. Therefore, it is recommended that experts and health policymakers enhance their focus on effectively preventing and controlling these disorders. Besides the evidence achieved very low certainty, it is important for the treatment team to prioritize the sexual relations of cardiovascular patients and focus on improving their sexual function. This should be seen as an essential aspect of their overall recovery process.

The characterization of plant derived-carbon dots and its responses on chlorophyll a fluorescence kinetics, radical accumulation in guard cells, cellular redox state and antioxidant system in chromium stressed-Lactuca sativa

Based on their chemical structure and catalytic features, carbon dots (CDs) demonstrate great advantages for agricultural systems. The improvements in growth, photosynthesis, nutrient assimilation and resistance are provided by CDs treatments under control or adverse conditions. However, there is no data on how CDs can enhance the tolerance against chromium toxicity on gas exchange, photosynthetic machinery and ROS-based membrane functionality. The present study was conducted to evaluate the impacts of the different concentrations of orange peel derived-carbon dots (50-100-200-500 mg L-1 CD) on growth, chlorophyll fluorescence, phenomenological fluxes between photosystems, photosynthetic performance, ROS accumulation and antioxidant system under chromium stress (Cr, 100 μM chromium (VI) oxide) in Lactuca sativa. CDs removed the Cr-reduced changes in growth (RGR), water content (RWC) and proline (Pro) content. Compared to stress, CD exposures caused an alleviation in carbon assimilation rate, stomatal conductance, transpiration rate, carboxylation efficiency, chlorophyll fluorescence (Fv/Fm) and potential photochemical efficiency (Fv/Fo). Cr toxicity disrupted the energy fluxes (ABS/RC, TRo/RC, ETo/RC and DIo/RC), quantum yields and, efficiency (ΨEo and φRo), dissipation of energy (DIo/RC) and performance index (PIABS and PItotal). An amelioration in these parameters was provided by CD addition to Cr-applied plants. Stressed plants had high activities of superoxide dismutase (SOD), peroxidase (POX) and ascorbate peroxidase (APX), which could not prevent the increase of H2O2 and lipid peroxidation (TBARS content). While all CDs induced SOD and catalase (CAT) in response to stress, POX and enzyme/non-enzymes related to ascorbate-glutathione (AsA-GSH) cycle (APX, monodehydroascorbate reductase (MDHAR) and dehydroascorbate reductase (DHAR), the contents of AsA and, GSH) were activated by 50-100-200 mg L-1 CD. CDs were able to protect the AsA regeneration, GSH/GSSG and GSH redox status. The decreases in H2O2 content might be attributed to the increased activity of glutathione peroxidase (GPX). Therefore, all CD applications minimized the Cr stress-based disturbances (TBARS content) by controlling ROS accumulation, antioxidant system and photosynthetic machinery. In conclusion, CDs have the potential to be used as a biocompatible inducer in removing the adverse effects of Cr stress in lettuce plants.

Author Correction: The clinical significance and diagnostic value of serum Dickkopf1 and CKAP4 levels in patients with gastric cancer: a prospective study

Correction to: Eur Rev Med Pharmacol Sci 2023; 27 (20): 10031-10040-DOI: 10.26355/eurrev_202310_34183-PMID: 37916373-published online on October 27, 2023. After publication, the authors found a mistake in Table I. Under Table I, the following sentence "HR: hazard ratio. CI: confidence interval. SCC: squamous cell carcinoma. FIGO: International Federation of Gynecology and Obstetrics. DFS: disease-free survival. OS: overall survival. p<0.05 and p<0.01 values were accepted for the significance level of the test" has been mistakenly inserted and must be removed. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/34183.

Hair dehydroepiandrosterone sulfate as biomarker of employees' well-being? A longitudinal investigation of support, resilience, and work engagement during COVID-19 pandemic

Introduction

Building on the motivational process of the job demands-resources (JD-R) theory, in the current research we investigated the longitudinal association between supervisor support/resilience as job/personal resources, work engagement (WE) and hair dehydroepiandrosterone sulfate, or DHEA(S), as a possible biomarker of employees' well-being.

Methods

In the context of the COVID-19 pandemic, 122 workers completed two self-report questionnaires (i.e., psychological data): the former at Time 1 (T1) and the latter three months afterwards, at Time 2 (T2). Participants also collected a strand of hair (i.e., biological data) at T2.

Results

Results from path analysis showed that both SS and resilience at T1 were positively related to WE at T2, which, in its turn, was positively related to hair DHEA(S) at T2. Both SS and resilience at T1 had a positive indirect effect on hair DHEA(S) at T2 through WE at T2, which fully mediated the association between job/personal resources and hair DHEA(S).

Discussion

Overall, results are consistent with the motivational process of the JD-R. Furthermore, this study provides preliminary evidence for the role of hair DHEA(S) as a biomarker of WE, a type of work-related subjective well-being that plays a central role in the motivational process of the JD-R, leading to favorable personal and organizational outcomes. Finally, the article outlines practical implications for organizations and professionals to foster WE within the workplace.

Positive childhood experiences as predictors of anxiety and depression in a large sample from Turkey

BACKGROUND

Positive childhood experiences positively influence one's adult life, while the absence of such positive experiences can potentially yield mental health problems throughout the lifespan.

OBJECTIVE

This study aimed to investigate the role of positive childhood experiences on depression and anxiety levels.

PARTICIPANTS AND SETTING

3090 (2059 women) young adults participated in this research. They ranged in age between 18 and 68 years (M = 28.78, SD = 9.44) and completed the self-report measures including the Positive Childhood Experiences Scale, Beck Depression and Anxiety Scales and Personal Information Forms.

METHOD

A cross-sectional research design was used to collect the data through social media platforms. We conducted a regression analysis to examine how positive childhood experiences contribute to depression and anxiety.

RESULTS

The results of correlation analysis indicated that positive childhood experiences were significantly negatively related to depression and anxiety. Regression analysis revealed that positive childhood experiences explained a significant amount of variance in the prediction of depression (10 %) and anxiety (8 %) after controlling for demographic factors.

CONCLUSIONS

The results suggest that the frequency of positive experiences lived during childhood might significantly reduce anxiety and depression, and positive childhood experiences might positively affect them.

How COVID-19 prevention burnout impacts emotional symptoms among Chinese college students: A moderated mediation model

The current study investigated the relationship between COVID-19 prevention burnout and emotional symptoms (depression and anxiety) among 1,837 Chinese college students and the underlying mechanisms. Results from moderated mediation analysis revealed that the association between COVID-19 prevention burnout and emotional symptoms was mediated by psychological inflexibility (β = 0.20, 95%CI = [0.10, 0.19]). Also, COVID-19 prevention burnout's direct and indirect effects on emotional symptoms were more substantial for students with high susceptibility to emotional contagion than those with low susceptibility. These findings contribute to understanding how COVID-19 prevention burnout relates to emotional symptoms and provide a new perspective for interventions promoting students' psychological flexibility, particularly those with higher susceptibility to emotional contagion.

Patients' sense of security from clinical factors in Iran: a cross-sectional study

BACKGROUND

One of the clinical responsibilities and goals of hospitals is to provide patients with comfort and security. The present study aims to assess patients' sense of security among patients in Iranian hospitals.

METHODS

The present research employed a cross-sectional design. The sample consisted of 830 patients visiting public, private, and social security hospitals in Mazandaran in the North of Iran. The required data were collected using a questionnaire developed by the researcher of this study.This questionnaire consisted of 4 dimensions:nursing, medical, advanced facilities and patient rights. The participants were selected using a proportional stratified random sampling method. Exploratory factor analysis, confirmatory factor analysis, descriptive statistics, and ANOVA were used for data analysis using SPSS version 22.

RESULTS

The mean scores of patients' sense of security in social security, private, and public hospitals were 4.16 ± 0.89, 3.78 ± 0.67, and 3.60 ± 0.89, respectively. Medical factors with a mean and standard deviation of 3.92 ± 0.76, advanced facilities and equipment with 3.89 ± 0.89, nursing factors with 3.87 ± 0.73, and patient rights with 3.71 ± 0.90 were the highest to the lowest scores, respectively. The results showed that the type of hospital significantly affected the mean dimensions of security (p < 0.05).

CONCLUSIONS

The study revealed variations in the sense of securityacross the sampled hospitals. Particularly, the sense of security attributed to the patient rights factors was lower than other factors. Therefore, to enhance the sense of security for patients, it is recommended to focus on staff training and fostering a culturethat emphasizes obtaining informed consent, demonstrating respect for the patient, and introducing the medical team to the patient before initiating any treatment.

The role of social media literacy in infodemic management: a systematic review

Background

The term infodemic refers to the proliferation of both accurate and inaccurate information that creates a challenge in identifying trustworthy and credible sources. Among the strategies employed to mitigate the impact of the infodemic, social media literacy has emerged as a significant and effective approach. This systematic review examines the role of social media literacy in the management of the infodemic.

Methods

Six databases, including SID, Magiran, Scopus, PubMed, Google Scholar and Web of Science were systematically searched using relevant keywords. We included the relevant publications between 2012 and 2023 in our analysis. To ensure a qualitative assessment of the studies, we used the STROBE and AMSTAR checklists as evaluation tools. The Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used for the design of this review study. Finally, we organized the studies into groups based on similarities and retrieved and analyzed evidence pertaining to the challenges and opportunities identified.

Results

Eleven papers were included in this study after reviewing the retrieved studies. Five of them examined the effect of social media literacy and health literacy on acceptance of health behaviors. Four studies investigated the role of media literacy in managing misinformation and fake news related to health. Two studies focused on infodemic management and promoting citizen engagement during health crises. Results showed that health-related infodemics are derived from the users' lack of media knowledge, distrust of government service systems, local influencers and peers, rapid circulation of information through mass media messages, weakness of solutions proposed by health care providers, failure to pay attention to the needs of the audience, vertical management, and inconsistency of published messages.

Conclusion

The findings of this study highlight the importance of increasing social media literacy among the general public as a recognized strategy for managing the infodemic. Consequently, it is recommended that relevant organizations and institutions, such as the Ministry of Health, develop targeted training programs to effectively address this need.

Validation of a Turkish Translation of the Perceived Occupational Stress Scale and Measurement Invariance Across Turkish and Italian Workers

Introduction

Measuring and understanding perceived occupational stress is crucial for understanding workers' experiences of stress in the workplace and its potential implications on mental health outcomes and job performance. However, there is a scarcity of brief measures containing relevant items focused solely on occupational stress, suitable for integration with risk assessment tools for work-related stress. This study aimed to validate the Perceived Occupational Stress (POS) scale in Turkish and examined its measurement invariance across Turkish and Italian samples.

Methods

The participants included 350 Turkish teachers (55.7% male) and 160 Italian workers (60.6% female).

Results

The results showed a single-factor structure explaining 69.61% of the total variance for the POS. The internal consistency was found to be high in both samples. The results also indicated that the factor structure of the POS was equivalent across the two groups, supporting measurement invariance.

Conclusion

Overall, the POS demonstrated solid measurement properties, including validated factor structure, internal reliability, and measurement invariance.

Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample

There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.

The Mediating Role of Procrastination in the Relationship between Fear of Missing Out and Internet Addiction in University Students

This study aims to examine the potential mediating role of procrastination in the relationship between fear of missing out and internet addiction. Employing a cross-sectional research design, this study utilized a paper-pencil form to collect data from 315 students (65.4% undergraduate and 66.3% females) between 18 and 32 (Mage = 22.43; SD = 3.81) studying at a state university in Türkiye. Data were collected through the convenience sampling method. The study was designed as a survey model. This design was tested via mediation analysis. The participants completed self-report assessments using the Fear of Missing Out Scale (FoMOs), General Procrastination Scale (GPS-9), and Young Internet Addiction Scale (short form). The findings showed that FoMO had a significant positive direct effect on both procrastination (R2 = 0.13) and internet addiction (R2 = 0.33). Procrastination also had a significant positive direct effect on internet addiction (R2 = 0.34). Additionally, procrastination mediated the relationship between the fear of missing out and internet addiction (β = 0.156, p < 0.001). These findings not only extend the scope of existing research but also hold practical implications for the development of sustainable interventions. It is believed that the findings will contribute to the consideration of procrastination when preparing psychoeducation or group guidance programs for internet addiction. These interventions can effectively address the process through which fear of missing out leads to internet addiction by considering the significant role of procrastination in students. Findings typically suggest that procrastination behavior is a key factor in explaining the association between FoMO and internet addiction.

Challenging experiences of the elderly with heart failure in the COVID-19 pandemic: a phenomenological study in Iran

BACKGROUND

Patients with heart failure (HF), especially the elderly, faced many challenges during the COVID-19 pandemic, which need to be explored. The present study aimed to analyse the challenging experiences facing the elderly with heart failure during the pandemic in Iran. To achieve this aim, a qualitative approach to research was employed.

METHODS

The present qualitative research employed a phenomenological approach to study 12 elderly with heart failure visiting Imam Ali Hospital during the COVID-19 pandemic in Kermanshah, Iran. The data collection occurred between August 5, 2022, and November 21, 2022. The participants were selected through a purposive sampling method and interviewed using a semi-structured interview. MAXQDA10 software was used for data organisation and the Colizzi analytical technique for data analysis. Guba and Lincoln's criteria were also used to evaluate the trustworthiness of the qualitative research.

RESULTS

A total of two categories, 8 subcategories, and 110 primary codes were extracted from the data. The two categories were challenges and coping strategies. The former included the sub-categories of economic issues, fear, anxiety, and fear of death; limited access to health care; quarantine issues; disruption of family life; and medication non-adherence. The subcategories of the latter were faith in God, social support, and self-care behaviors.

CONCLUSIONS

The present study revealed the challenges experienced and the coping strategies employed by elderly patients with heart failure during the pandemic in Iran. A knowledge of these challenges and experiences during the COVID-19 pandemic can raise healthcare workers' awareness of the elderly patients' strategies used to cope with the virus.

Analysis of ethical considerations of COVID‑19 vaccination: lessons for future

BACKGROUND

Since the beginning of the COVID-19 pandemic, different countries sought to manufacture and supply effective vaccines to control the disease and prevent and protect public health in society. The implementation of vaccination has created many ethical dilemmas for humans, which must be recognized and resolved. Therefore, the present study was conducted to analyze the ethical considerations in vaccination against COVID-19 from the perspective of service providers.

METHODS

The present qualitative research was conducted in 2022 in the north of Iran. The participants included 23 health workers with at least five years of work experience and members of the COVID-19 vaccination team. The data were initially collected through systematic semi-structured interviews, then snowball sampling and finally continued until data saturation. The next steps were transcription of interviews, identification of meaning units, coding, categorization based on similarity and symmetry, extraction of themes and the analysis of themes through content analysis.

RESULTS

The analysis of participants' experiences led to the extraction of five main categories of themes and fifteen sub-categories of the ethical considerations of COVID-19 vaccination. Safe and standard vaccine production, vaccine supply, fairness, respect for autonomy, and accountability were the main categories. The subcategories included compliance with scientific and ethical procedures, effectiveness and profitability of vaccine, absence of severe adverse effects, allocation of resources for vaccine supply, vaccine availability, diversity and comprehensiveness of alternative vaccines, vaccination prioritization, prioritization of the vulnerable populations of society, autonomy of patient (equal rights), autonomy of community, autonomy of service providers, reporting correct information, reporting vaccine side effects, public trust and acceptance.

CONCLUSION

The health system managers should be adequately prepared to solve the ethical problems posed by COVID-19 vaccination. Therefore, it is recommended to avoid haste in vaccination and pay more attention to vaccination safety standards, provide sufficient resources for a comprehensive vaccine supply, pay close attention to collective interests versus individual interests, and meet community needs.

General work stress and suicide cognitions in health-care workers: mediating effect of hopelessness and job satisfaction

Individuals with a satisfactory level of job satisfaction are much less likely to feel hopeless about their future and are more likely to perform efficiently in the workplace. General work stress (i.e., the work-related stress subjectively experienced) is a significant predictor of suicide cognitions. Furthermore, it has been posited that satisfaction and hope are fundamental to life from an existential perspective. We, therefore, tested a hypothetical model of general work stress, suicide cognitions, hopelessness, and job satisfaction. The data were collected from 416 health-care workers through a convenience sampling method. The mediation analysis results revealed significant negative and positive relationships among general work stress, suicide conceptions, hopelessness, and job satisfaction. The findings indicate that hopelessness and job satisfaction have a parallel mediating effect in the relationship between general work stress and suicide cognitions. The result of the study is of great importance, which suggests that interventions to alleviate hopelessness and work stress and to boost the job satisfaction of medical staff may help prevent suicide cognitions.

Meaning in Life and Loneliness as Mediators between COVID-19 Anxiety and Life Satisfaction in the Post-Pandemic among the General Population in Turkey: A Serial Mediation Model

The COVID-19 pandemic has impacted global society, leading to negative well-being and mental health outcomes. However, little is known about how COVID-19-related anxiety affects life satisfaction through psychological factors. This study examined the mediating roles of meaning in life and loneliness in the relationship between COVID-19 anxiety and life satisfaction in 333 Turkish general population (59.2% females; Mage = 33.9 ± 7.8). Participants completed measures of COVID-19 anxiety, life satisfaction, meaning in life, and loneliness. The results showed that COVID-19 anxiety predicted meaning in life, loneliness, and life satisfaction. Meaning in life predicted loneliness and life satisfaction, while loneliness predicted life satisfaction. Serial mediation analysis revealed that COVID-19 anxiety predicts life satisfaction through meaning in life and loneliness, even after controlling for age and gender. These findings contribute to our understanding of the underlying mechanisms between COVID-19 anxiety and life satisfaction, with implications for future research and practice.

Wanna Bet? Investigating the Factors Related to Adolescent and Young Adult Gambling

For many adolescents and young adults, gambling can represent an attractive and exciting form of entertainment, a way to take risks and explore new experiences. However, gambling also poses a significant risk for this age group. Research suggests that adolescents and young adults are particularly vulnerable to the negative consequences of gambling, including addiction, financial difficulties, and mental health issues. This paper aims to critically examine data on adolescent and young adult gambling, focusing on the risk factors associated with gambling behavior. A total of 326 subjects (Mage = 19.01; SD =2.72), of whom 65.5% were female, completed a protocol containing a demographic sheet, the Lie/Bet Questionnaire, the Seven Domains Addiction Scale (7DAS), a subscale of the Addictive Behavior Questionnaire and the Coping Inventory for Stressful Situations (CISS). Specifically, we explored the impact of sociodemographic, environmental, psychological, and cognitive factors on adolescent and young adult gambling behavior. Clinical implications and future directions are discussed.

The clinical significance and diagnostic value of serum Dickkopf1 and CKAP4 levels in patients with gastric cancer: a prospective study

OBJECTIVE

Gastric cancer is diagnosed at an advanced stage in most patients, and the prognosis is poor. Novel biochemical markers of high diagnostic value for the detection of the disease are therefore important. Dickkopf1 (DKK1) and cytoskeleton-associated protein 4 (CKAP4) have been extensively studied as biomarkers in cancer patients.

PATIENTS AND METHODS

Serum DKK1 and CKAP4 levels in 58 patients with gastric cancer and 41 healthy controls were examined using an ELISA kit in this prospective study. The patients were subdivided into groups based on pathological TNM staging and histological grades. Serum levels of both proteins in the patients with gastric cancer were measured preoperatively, 10 and 30 days after surgery.

RESULTS

Serum DKK1 and CKAP4 levels were significantly higher in the gastric cancer group compared to the healthy controls (p<0.05). Serum levels of both proteins increased in line with the pathological stage and histological grade of the gastric cancer. Serum CKAP4 and DKK1 levels decreased after surgical resection. Both serum levels also decreased significantly on day 30 after surgery compared to day 10 (p<0.05). Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) positivity rates were below 20% in the gastric cancer group, while the diagnostic value (sensitivity and specificity) of serum CKAP-4 and DKK1 exceeded 80%.

CONCLUSIONS

DKK1 and CKAP4 are biomarkers of high diagnostic value that can be used to diagnose and predict the severity of gastric cancer. These proteins can also be employed for disease monitoring after surgical resection. The diagnostic value of these proteins is higher than that of biomarkers such as CEA and CA19-9, which are routinely used in clinical practice.

Psychological state and predictors of psychiatric morbidity in COVID-19 patients six weeks after discharge

To be able to detect possible psychological distress and long-term deterioration caused by COVID-19, following the patient, who has recovered, is crucial. Therefore, this study (i); aims to examine the ongoing fear-loss of control, the rate of anxiety, depression, and post-traumatic stress disorder levels following the 6th week after discharge; (ii) to examine the effect of post-traumatic stress disorder on anxiety, and depression and (iii) within the same context to reveal the developmental markers of psychiatric morbidity and the risk group. The study includes 180 patients who were hospitalized with COVID-19 diagnosis. Sociodemographic Data Form, the Hospital Anxiety Depression Scale and the Impact of Event Scale-Revised were used in the current study. High rates of symptoms of anxiety, depression, and PTSD were reported by the inpatients, as more than one-third scored above the anxiety and depression cut-off scores of borderline abnormal and abnormal. Also, 37.22 % of the participants reported the likely presence of PTSD symptoms. Anxiety and depression were significantly positively related to the symptoms of PTSD. The results suggest that there is psychiatric morbidity in anxiety, depression, and post-traumatic stress disorder and that especially posttraumatic stress poses a risk for other psychopathologies.

The mediating role of outgroup perspective-taking in the relationship of the sense of global social responsibility with negative stereotypes and intergroup anxiety

Existing literature has extensively explored attitudes toward refugees; however, to the best of our knowledge, no study has specifically examined the relationship between the sense of global social responsibility and attitudes toward refugees. Therefore, this study investigated the mediating role of outgroup perspective-taking in the relationship of the sense of global social responsibility with negative stereotypes and intergroup anxiety. The data for this study were collected from a sample of 325 participants, with 53.5% males, aged between 18 and 47 years (Mage = 28.90 ± 7.08). The findings revealed that the sense of global social responsibility was positively related to outgroup perspective-taking and inversely related to negative stereotypes and intergroup anxiety. Also, perspective-taking exhibited negative relationships with negative stereotypes and intergroup anxiety. Mediation analyses showed that the sense of global social responsibility not only directly influenced the reduction of negative stereotypes and intergroup anxiety but also indirectly affected these attitudes through increased outgroup perspective-taking. These findings contribute to a deeper understanding of the underlying mechanisms that can effectively mitigate negative attitudes toward refugees. Findings also highlighted the potential of the sense of global social responsibility and outgroup perspective-taking in designing intervention programs aimed at reducing negative attitudes toward outgroup members, including refugees.

Nurse burnout before and during the COVID-19 pandemic: a systematic comparative review

Introduction

This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The specific objective was to compare nurse burnout scores in terms of emotional exhaustion, depersonalization, and personal accomplishment.

Methods

A comprehensive search was conducted for studies on nurses' burnout using the MBI published between 1994 and 2022. In total, 19 studies conducted prior to the pandemic and 16 studies conducted during the pandemic were included and compared using the criteria from the Joanna Briggs Institute Critical Appraisal Tool.

Results

Surprisingly, the results indicated that nurses' burnout scores did not differ significantly before (N = 59,111) and during (N = 18,629) the pandemic. The difference observed was qualitative rather than quantitative.

Discussion

The outbreak of the COVID-19 pandemic exacerbated an already critical situation, and while COVID-19 may serve as an additional triggering factor for staff mental illness, it cannot solely explain the observed burnout levels. These findings underscore the need for long-term clinical and preventive psychological interventions, suggesting that psychological resources should not be limited to emergencies but extended to address the ongoing challenges faced by nurses.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=399628, identifier: CRD42023399628.

Expressing emotions, rejection sensitivity, and attachment in patients with fibromyalgia

Objectives

This study aimed to examine emotional awareness, control of emotions, and the childhood attachment process in fibromyalgia patients.

Patients and methods

The observational study was conducted with 117 participants (14 males, 103 females; mean age: 43.9±9.0 years; range, 22 to 64 years) between February 20, 2022, and May 20, 2022. Sixty-one patients and 56 healthy control subjects filled out a form including sociodemographic data, such as age, sex, occupation, and educational status. In addition, the participants answered the Expressing Emotions Scale, Rejection Sensitivity Scale, and Experiences in Close Relationships Scale.

Results

In our study, Expressing Emotions Scale scores are significantly higher in the healthy control group than in the patient group (p<0.05). Rejection Sensitivity Scale scores are significantly higher in the patient group than in the healthy control group (p<0.05). In the Experiences in Close Relationships Scale, a significant difference was determined between the patient and control groups in the avoidant attachment subdimension (p<0.05). Similarly, a significant difference was observed between both groups in terms of the anxiety attachment subdimension (p<0.05).

Conclusion

The ability to express emotions is lower and avoidant and anxious attachment rates are higher in fibromyalgia patients.

Fear of COVID-19, intolerance of uncertainty, psychological capital, and positive future expectations: Tests of mediating relationships with healthcare workers

COVID-19 has a profound impact on the mental health of healthcare workers, especially those combatting the disease. The current study examined the mediating role of psychological capital in the relationship between fear of COVID-19 and intolerance of uncertainty and positive future expectations in healthcare workers during the pandemic. 310 healthcare workers (51.9 % males, Mage = 34.2 ± 7.6) completed measures of fear of COVID-19, psychological capital, intolerance of uncertainty, and positive future expectations The results showed that fear of COVID-19 had a significant negative predictive impact on psychological capital and a significant positive predictive impact on intolerance of uncertainty. Psychological capital had a significant negative predictive impact on intolerance of uncertainty and a significant positive predictive impact on positive future expectations. Most importantly, the results indicated that psychological capital mediated the association of fear of COVID-19 with intolerance of uncertainty and positive future expectations. The results improve our understanding of the role of psychological capital in the relationship between fear of COVID-19 and intolerance of uncertainty and positive future expectations. Also, results have possible wider implications for equipping healthcare workers with the psychological tools to cope with stressors, including those linked to public health threats such as pandemics.

[Sources used to obtain information on COVID-19 and its impact on mental health.]

With the rise of COVID-19, the society has had the need to search for information about the pandemic and the sources used to obtain information have been very diverse, with a greater predominance of social media, traditional media and consultation with loved ones. In addition, an excess of information has been observed in the media that made access and understanding difficult, as well as a constant concern and anxiety about health that caused a need to search excessively or repeatedly for information on health and disease. This information was not always endorsed by the scientific community and during the pandemic there has been the spread of misinformation, fake news and conspiracy theories about COVID-19 disseminated, mainly through social media. In this sense, both the knowledge and the beliefs apprehended have been able to impact the mental health of the population.

Resilience and Extrinsic Motivation as Mediators in the Relationship between Fear of Failure and Burnout

Athletes with fear of failure are at risk of developing the symptoms of a wide range of psychological problems, including burnout. Understanding the risks and protective factors of athletes' psychological health is an essential step in tailoring strategies and interventions to promote athletes' psychological and mental health. This study examined the mediating roles of resilience and extrinsic motivation in the relationship between fear of failure and burnout among Turkish athletes. The study included 335 young athletes (93.4% males) whose ages ranged from 18 to 55 years (M = 24.95, SD = 8.22). Participants completed the self-reported measures of fear of failure, resilience, extrinsic motivation, and burnout. The analysis revealed that fear of failure had significant predictive effects on resilience, extrinsic motivation, and burnout. Resilience and extrinsic motivation also had significant predictive effects on burnout. The mediation analysis results showed that both resilience and extrinsic motivation partially mediated the effect of fear of failure on athlete burnout. The findings of the study provide a better insight into the underlying mechanisms between fear of failure and athlete burnout by considering resilience and extrinsic motivation as mediators. These results suggest that the adverse impact of fear of failure on athlete burnout can be mitigated by cultivating resilience and hindering extrinsic motivation.

Role of echocardiography on early diagnosis of atrial remodelling and fibrosis in elite athletes

There is emerging data indicating that long-standing vigorous exercise may be associated with atrial structural remodelling. This remodelling process is may be the cause of the increasing frequency of atrial arrythmias in athletes. Early diagnosis of atrial remodelling by atrial imaging could have a role in management of atrial arrythmias in elite athletes. In this study we aimed to diagnose early phases of atrial remodelling in elite athletes. Two groups of athletes including professional weight lifters (n = 33), professional marathoners (n = 32) and sedentary participants (n = 30) were enrolled. We also studied patients who received cardiotoxic chemotherapy (n = 10) for comparison. Serum TGF-beta level as a marker of fibrosis was measured. Both left atrial (LA) 3D volume and strain values were analysed. There was a positive correlation between serum TGF-beta levels and LA volumes and negative correlation between TGF-beta levels and strain values. TGF-beta levels were higher among chemotherapy and weight lifter groups, compared to control and marathoner groups [mean 0.57 ± 0.3 and 0.55 ± 0.2 vs. 0.45 ± 0.2 and 0.47 ± 0.2, respectively, p = 0.005]. LA volumes were higher among chemotherapy and weight lifter groups [median 33 (26-38) and 31 (23-36) respectively, p = 0.005], and strain values were lower in these two groups [mean 20.3 ± 2.5 and 24.6 ± 4.5, respectively, p < 0.005] compared to control and marathoner groups. Total exercise volume was higher in weight lifter group compared to marathoners [13,780 (2496-36,400) vs. 4732 (780-44928), respectively, p = 0.001]. There wasn't any difference between any group regarding left ventricular systolic and diastolic functions. Vigorous exercise causes atrial remodelling and fibrosis in elite athletes. Strength exercise carries higher risk for atrial fibrosis than endurance exercise. Burden of exercise is correlated with the severity of cardiac fibrosis. Echocardiographic evaluation of the left atrium and TGF-beta levels may help to detect subclinical cardiac remodelling and fibrosis.

Treatment options in primary mediastinal B cell lymphoma patients, retrospective multicentric analysis; a Turkısh oncology group study

Introduction and Aim

Primary mediastinal B-cell lymphomas (PMBL) are aggressive B- cell lymphomas. Although the initial treatment models vary in PMBL, appropriate treatment methods are not known. We aim to show real-life data on health outcomes in adult patients with PMBL who received various type of chemoimmunotherapies in Turkey.

Method

We analyzed the data of 61 patients who received treatments for PMBL from 2010 to 2020. The overall response rate (ORR), overall survival (OS) and progression-free survival (PFS) of the patients were evaluated.

Results

61 patients were observed in this study. The mean age of the study group was 38.4 ± 13.5 years. From among them, 49.2% of the patients were female (n = 30). For first-line therapy, 33 of them had received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen (54%). Twenty-five patients had received rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH-R) regimen. The ORR was 77%. The median OS and PFS were as follows: 25 months (95% CI: 20.4-29.4) and 13 months (95% CI: 8.6-17.3), respectively. The OS and PFS at 12 months were 91.3% and 50%, respectively. The OS and PFS at five years were 64.9% and 36.7%, respectively. Median follow-up time period was 20 months (IQR 8.5-38.5).

Conclusion

R-CHOP and DA-EPOCH-R showed good results in PMBL. These remain one of the best determined systemic treatment options for first-line therapy. Also, the treatment was associated with good efficacy and tolerability.

Fear of COVID-19, Resilience, and Future Anxiety: Psychometric Properties of the Turkish Version of the Dark Future Scale

The COVID-19 pandemic has brought many disruptions to individuals’ everyday lives and caused wide-ranging, drastic effects on their well-being, mental health, and physical health. This study sought to validate the Dark Future Scale (DFS) and examine its reliability and validity in Turkish. The present study also examined the relationship between fear of COVID-19, dark future anxiety, and resilience during the COVID-19 pandemic in Turkey. Four hundred and eighty-nine Turkish athletes (mean age = 23.08 ± 6.64) completed measures on fear, anxiety, resilience, and demographic information. Exploratory and confirmatory factor analyses revealed that the DFS had a one-factor solution with good reliability. Fear of COVID-19 significantly predicted resilience and future anxiety. Furthermore, resilience significantly predicted anxiety and mediated the effect of fear of COVID-19 on future anxiety. The findings have important implications for improving mental health and developing the resiliency of athletes during public health crises such as the COVID-19 pandemic.

Efficiency rating of SG Diagnostics COVID-19 antigen rapid test kit

Aim: Rapid detection is crucial in complementing vaccination to reduce transmission of SARS-CoV-2. Materials & methods: Nasopharyngeal swabs (n = 213) and oropharyngeal swabs (n = 98) were tested. with the antigen rapid test kit. Results: Overall sensitivity (97.96%), specificity (100.00%) and coincidence rate (98.71%) were high, which translated into a positive predictive value of 100.00% and a negative predictive value of 96.64%. Conclusion: Antigen rapid tests have a great potential for screening in different settings to deliver results with high sensitivity and specificity.

Fear of COVID-19, death depression and death anxiety: Religious coping as a mediator

The COVID-19 pandemic has affected the well-being and mental health of populations worldwide. This study sought to examine whether religious coping mediated the relationship between COVID-19-related fear and death distress. We administered an online survey to 390 adult participants (66.15% females; Mage = 30.85 ± 10.19 years) across Turkey. Participants completed a series of questionnaires measuring the fear they had experienced during the COVID-19 pandemic, their levels of religious coping and their levels of death anxiety and depression. Our findings revealed that (a) fear of COVID-19 was associated with positive religious coping, negative religious coping, death anxiety and death distress; (b) negative religious coping was associated with death anxiety and depression and (c) negative religious coping mediated the relationship between fear of COVID-19 and death anxiety and depression. These results highlight the detrimental effect of negative religious coping in increasing the adverse effect of the COVID-19 fear on death depression.

Mediating effect of work stress in the relationship between fear of COVID-19 and nurses' organizational and professional turnover intentions

Nursing is one of the most stressful and high-risk professions. It is important to identify the psychological problems experienced by nurses during the COVID-19 pandemic and examine the relationship between these problems to devise measures that can properly address them. This study examined mediating effect of work stress in the relationship between fear of COVID-19 and nurses' organizational and professional turnover intentions. Using a cross-sectional research design, this study was conducted on 486 nurses working in seven hospitals in Turkey. The mean age of the participants was 35.24 ± 6.81 and 59.9 % of them were women. The Fear of COVID-19 Scale, the General Work Stress Scale, and the Turnover Intention Scale were used to collect data. A mediation model showed that fear of COVID-19 was positively associated with work stress and organizational and professional turnover intentions. The model also revealed that work stress was positively associated with organizational and professional turnover intentions. Furthermore, the results demonstrated that fear of COVID-19 did not only have a direct effect on organizational and professional turnover intentions but also had an indirect effect on it via increased work stress. Findings improve our understanding of the role of work stress in the relationship between fear of COVID-19 and organizational and professional turnover intentions. The findings are fruitful for tailoring and implementing intervention programs to reduce the adverse psychological impacts of COVID-19 on nurses.

Fear of COVID-19, Coronavirus Anxiety, COVID-19 Burnout, and Resilience: Examining Psychometric Properties of COVID-19 Burnout Scale in Urdu

This research examined the associations between resilience, fear of COVID-19, coronavirus anxiety and COVID-19 burnout. The study also aimed to validate the COVID-19 Burnout Scale (COVID-19-BS) in Urdu. Participants included 812 Pakistani young adults (55.7% males; mean _age 26.4 ± 8.7 years). Results supported a one-factor solution for the COVID-19-BS with high reliability. Mediation analysis showed that resilience mediated the relationships between fear of COVID-19 and coronavirus anxiety with COVID-19 burnout. The study provided preliminary evidence that fear of COVID-19 and coronavirus anxiety might be significant risk factors for burnout among the Pakistani general population, and resilience might mitigate the impacts of these factors.

Mediating and moderating effects of cognitive flexibility in the relationship between social media addiction and phubbing

Presently, social media is widely used worldwide among different populations. Therefore, phubbing rapidly became a popular phenomenon in our daily life. However, little is known about the underlying mechanism and interaction between social media use and phubbing. Therefore, this research examines the mediating and moderating role of cognitive flexibility in the association between social media addiction and phubbing. Participants were 385 university students (280 females) studying at a state university in eastern Turkey and completed the self-reported measures of cognitive flexibility, social media addiction, and phubbing. The results showed that cognitive flexibility mediated and moderated the effect of social media addiction on phubbing. These findings may contribute to the discussion around the psychological consequences of using social media alongside increasing awareness about factors affecting and explaining the association between social media use and phubbing, which have important implications for research and practice.

Validation and Psychometric Properties of the Turkish Version of the Riverside Eudaimonia Scale

The Riverside Eudaimonia Scale (RES) has been recently developed to measure psychological measures of eudaimonia. Currently, there is no evidence regarding its psychometric properties in Turkish. Therefore, this study, for the first time, examined the validation and psychometric properties of the Turkish version of the RES. Participants included 336 undergraduate students from a public university in Turkey. The results showed good internal consistency of the RES suggesting a good measure to assess eudaimonic flourishing. Exploratory and confirmatory factor analyses yielded a one-factor structure as a good fit with strong reliability evidence. The results indicated that the RES was correlated with life satisfaction and flourishing, and the RES explained a significant amount of variance in the prediction of life satisfaction and flourishing after controlling for age and gender. The results suggest that the RES has sound psychometric properties, is culturally and linguistically acceptable, and is equally fruitful in measuring eudaimonic flourishing in Turkish population.

Satisfaction With Life Among Vaccinated Turkish People

Abstract. Introduction: Past research has shown that psychological and behavioral factors, including anxiety, fear, and preventive behaviors, are related to well-being outcomes during the COVID-19 pandemic. Yet little is known about the simultaneous effects of those factors in predicting satisfaction with life among vaccinated people. Methods: This cross-sectional study is among the first to examine whether COVID-19 anxiety, fear of COVID-19, and preventive behaviors predicted satisfaction with life among the vaccinated general public in Turkey. Participants were 1,017 Turkish adults (69.71% female; mean age = 36.28, SD = 10.83 years) who completed online self-reported questionnaires. Results: Results showed that increased levels of anxiety and fear of COVID-19 significantly predicted reduced satisfaction with life over and above the effects of sociodemographic and clinical factors. Discussion: The findings suggest the importance of tailoring and implementing interventions focusing on the improvement of the well-being of people during the pandemic.

Understanding the effect of fear of COVID-19 on COVID-19 burnout and job satisfaction: a mediation model of psychological capital

Healthcare professionals are more at risk than others of being affected by the negative psychological consequences of COVID-19. Therefore, it is necessary to determine the factors protecting healthcare professionals from the negative psychological consequences of the pandemic. The purpose of the present study is to examine the mediating role of psychological capital in the relationship of fear of COVID-19 with COVID-19 burnout and job satisfaction among Turkish healthcare professionals. Participants included 313 healthcare professionals (52.7% females) ranged in age between 22 and 59 years (mean age = 34.41 ± 6.59) and completed measures of fear of COVID-19, psychological capital, job satisfaction and burnout. A mediation model indicated that fear of COVID-19 was negatively associated with psychological capital and job satisfaction but positively associated with COVID-19 burnout. The model also indicated that psychological capital was negatively associated with COVID-19 burnout and positively associated with job satisfaction. Additionally, psychological capital mitigated the effect of fear of COVID-19 on COVID-19 burnout. Finally, the results indicated that fear of COVID-19 did not only have a direct effect on reduced job satisfaction but also had an indirect effect on it through increased psychological capital. Findings elucidate our understanding of the role of psychological capital in the relationship between fear of COVID-19 and COVID-19 burnout and job satisfaction. The results are useful for developing and implementing intervention programs to reduce the negative psychological effects of COVID-19 on healthcare professionals.

A longitudinal study of depression, anxiety, and stress among Indians during COVID-19 pandemic

The COVID-19 has caused significant public health chaos. Whether infected or uninfected, people have reported significant mental health issues during the COVID-19 pandemic. The present study explored symptoms of depression, anxiety, and stress of uninfected people with the disease over three time periods. A total of 132 participants took part in all the three phases. Data at Time 1 and Time 2 were collected during the national lockdown with 1 month apart, while data at Time 3 were collected immediately once the lockdown was uplifted in India. Participants completed the Depression, Anxiety and Stress Scale-21 online. The results indicated that despite an increase in the average number of COVID-19 cases, depression, anxiety, and stress symptoms decreased over time with the lowest level once the lockdown was ended. These results suggest that the restrictions implemented during the national lockdown led to distress, and not an increase in COVID-19 cases per se.

Family Communication and Psychological Distress in the Era of COVID-19 Pandemic: Mediating Role of Coping

This study aims to examine the association between family communication and psychological distress with coping as a potential mediator. The study also developed and validated the Family Communication Scale (FCS) in the context of COVID-19 pandemic. Participants (n = 658; 74.9% female) were general public ranged in age between 18 and 58 years (mean age = 26.38, SD = 10.01). The results showed that family communication directly influenced psychological distress and indirectly influenced through approach coping. However, avoidant coping was not directly associated with psychological distress, nor did it mediate the association between family communication and psychological distress. The findings suggest that people, who have better family communication, highly engage in approach coping which in turn leads to better psychological health in face of adversity. The findings have important empirical and theoretical implications.

Association of Serum Interleukin-17 and Interleukin-23 Levels with Disease Activity, Function, Mobility, Enthesitis Index in Patients with Ankylosing Spondylitis

Aim: More and more studies have demonstrated that the interleukin (IL)-23/IL-17 axis is highly associated with immune dysfunction and activated autoimmune inflammation. The purposes of this study were to determine the serum levels of IL-17 and IL-23 in ankylosing spondylitis (AS) patients compared with healthy controls and evaluate these cytokine levels based on disease-related characteristics. Material and Methods: Eighty-six consecutive AS patients and 70 sex and age-matched healthy controls were included in the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), ASDAS-C reactive protein, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index, the Bath Ankylosing Spondylitis Metrology Index (BASMI), the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and Achilles pain VAS scores were recorded. Serum IL-17 and IL-23 levels were examined by enzyme-linked immunosorbent assay. Results: The serum levels of IL-17, IL-23 and CRP as well as ESR values were significantly increased in AS patients compared with controls (1.94 vs. 0.28 pg/mL p ˂ 0.001; 82.9 vs. 44.3 pg/mL p ˂ 0.001; 0.48 vs. 0.30 mg/dL, p=0.001; 12±13.9 vs. 8±6.8 mm/h, p=0.003, respectively). In AS patients, serum IL-17 levels were significantly correlated with the ASDAS-ESR and ASDAS-CRP (r=0.244, p=0.024; r=0.258, p=0.017), but not with ESR, CRP, BASDAI, function, mobility, quality of life, enthesitis index or Achilles pain scores (all p>0.05). Serum IL-23 levels demonstrated a significant correlation with Achilles pain VAS, but not with other disease-related parameters (all p>0.05). Conclusions: AS patients had increased serum IL-17 and IL-23 levels compared with healthy controls, and serum IL-17 levels were associated with disease activity. Our study results support the hypothesis that the IL17/23 pathway plays an important role in the pathogenesis of AS.

Fear of COVID-19 and Smartphone Addiction Among Turkish Adolescents: Mitigating Role of Resilience

The objective of the present study is to examine the mediating effect of resilience on the association between fear of COVID-19 and smartphone addiction in the era of COVID-19. Participants included 508 Turkish adolescents (53.9% girls; M = 17.78 ± 1.11 years) attending high schools or supplementary schools and completed measures of fear of COVID-19, smartphone addiction, and resilience. Girls reported higher scores on fear of COVID-19 and smartphone addiction and lower scores on resilience than their peers. Findings indicated that fear of COVID-19 significantly predicted resilience and smartphone addiction. Resilience also significantly predicted smartphone addiction. Mediation analysis showed that resilience partially mediated the relationship of fear of COVID-19 with smartphone addiction. Overall, current results suggest that high levels of fear of COVID-19 fuel the development of smartphone symptoms through reduced resilience. The fear of the COVID-19-smartphone addiction association appeared to be partially explained through resilience.

Effect of Blood Groups on Clinical Presentations and Treatment Outcomes in Immune Thrombotic Thrombocytopenic Purpura Patients with Severe ADAMTS13 Deficiency: A Multi-Center Experience

Introduction

Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy caused by accumulation of ultra-large von Willebrand factor (vWF) due to the significantly reduced activity ADAMTS13. Limited studies have been published examining the blood group as an epidemiological factor that can contribute to development of TTP. It has been suggested that due to low vWF levels, the distribution of the "O" blood group among TTP patients may be lower than anticipated compared to the blood group distribution rates in the normal population. The aim of this study was to explore the relationship between blood groups and the clinical outcome of immune TTP (iTTP).

Methods

Thirty patients with iTTP with severe ADAMTS13 deficiency were enrolled. Data collection commenced in January 2011 and was completed by June 2020. It was analyzed whether there was a difference between the blood groups in terms of frequency of iTTP, response to treatment, frequency of relapse, and clinical and laboratory results.

Results and Conclusions

The distribution of group "A" among patients with iTTP was higher than expected. Although not statistically significant, patients with blood group "O" required more TPE for the treatment and relapse rate was statistically higher than other blood groups. Mortality rate in all patients was 6.7%. Although blood group "A" is a risk factor for iTTP, the frequency of relapse is higher in the blood group "O."

Personal growth initiative moderates the mediating effect of COVID-19 preventive behaviors between fear of COVID-19 and satisfaction with life

This study focused on a moderated mediation model. First, it determined the mediating effect of COVID-19 preventive behaviors between fear of COVID-19 and satisfaction with life. Next, it examined whether personal growth initiative moderated the mediation effect. The study comprised 461 Pakistani university students (52% men and 48% women) between 18 and 35 years (M = 24.66, SD = 3.51). Results indicated that higher levels of fear of COVID-19 were linked to greater adherence to COVID-19 preventive behaviors, which in turn were related to higher levels of satisfaction with life (mediation model). With regard to the hypothesized moderated mediation model, results showed that personal growth initiative moderated the mediating path from fear of COVID-19 to satisfaction with life and from COVID-19 preventive behaviours to satisfaction with life. Further, results suggested that fear of COVID-19 and COVID-19 preventive behaviours had stronger effects on satisfaction with life when personal growth initiative was high, but not when it was low or moderate. It was therefore concluded that personal growth initiative may play a protective role in buffering the negative effect of higher levels of fear of COVID-19 on satisfaction with life and an enabling role in strengthening the relationship between COVID-19 preventive behaviors and satisfaction with life. Theoretical contribution and practical implications of the results are discussed as well as the study limitations and future research prospects.

Associations among resilience, hope, social support, feeling belongingness, satisfaction with life, and flourishing among Syrian minority refugees

To date, research on refugee mental health has mainly focused on understanding the absence of psychopathology rather than on their well-being and associated positive aspects. The aim of this study was to examine the role of resilience, hope, belongingness, and social support in predicting satisfaction with life and flourishing among 361 minority Syrian refugees living in Iraq (age range = 18-60 years, mean = 32.57, SD = 10.05). Participants completed the Brief Resilience Scale, Adult Hope Scale, Multidimensional Scale of Perceived Social Support Scale, General Belongingness Scale, Satisfaction With Life Scale, and Flourishing Scale. Males reported significantly higher levels of resilience, belongingness, and flourishing compared to females. Demographic variables (age, gender, and economic level), resilience, hope, belongingness, and social support were correlated with life satisfaction and flourishing scores. While controlling for sociodemographic characteristics, resilience and hope were associated with life satisfaction and flourishing scores. However, belongingness and social support were only associated with flourishing scores. The findings suggest that equipping refugees with positive psychological resources could promote increased levels of life satisfaction and flourishing and thus enhance preventive psychosocial programs.

Evaluation of Surgical Margins with Intraoperative Frozen Section in Patients Undergoing Breast-Conserving Surgery: Our clinical experience

Background: Breast cancer is the second most common cancer in women. Breast-conserving surgery (BCS) has increasingly been applied to eligible patients. One of the most important points in BCS is to provide clean surgical margins. In this study, it is aimed to share the re-excision results of those having positive surgical margins in intra-operative evaluation among BCS patients, and to discuss the intra-operative evaluation in the light of the literature. MATERIALS AND METHODS:The data (patient files, surgery notes and pathology reports) of 203 patients who had undergone BCS for breast cancer between January 2016 and January 2022 and whose excision materials had been evaluated with intra-operative frozen sections in terms of surgical margins, were scanned retrospectively. Absence of ink on tumoral cells (“no ink on tumor”) for invasive ductal carcinoma (IDC), and a margin width of ≥ 2mm for ductal carcinoma in situ (DCIS) were considered as a clean surgical margin.RESULTS: Median age was 51 years (range, 22-75). There were reportedly 27 with positive surgical margins, five of whom with positive margins in re-excision. Second re-excision specimens of all these 5 cases (18.5%) had been reported to have no positive surgical margins. No patients had been reported to require a second re-excision or mastectomy.CONCLUSION: Intraoperative surgical margin assessment eliminates the need for repetitive surgery. We recommend routine application of intra-operative surgical margin assessment.

Testing the Career Construction Model of Adaptation in a Sample of Afghanistan’s Working Adults: A Longitudinal Study

This study tested the Career Construction Model of Adaptation (CCMA) in a sample of Afghanistan’s working adults amid the COVID-19 pandemic. The measures of adaptation were applied at three time points, that is, positive orientation toward future (adaptive readiness) at Time 1, career adaptability (adaptability resources) and competence need satisfaction at work (adapting responses) at Time 2, and meaningful work (adaptation result) at Time 3. Testing the model through Structural Equation Modeling (SEM) indicated that the indirect effect of positive orientation toward future at Time 1 on meaningful work at Time 3 via the combination of career adaptability and competence need satisfaction at work at Time 2 was significant and positive. Results support Afghan employees’ career construction over time. Theoretical contribution of the results and strategies for assisting Afghan employees in crafting their careers in the current political situation are discussed. Study limitations and prospects for future research are also discussed.

The Association of Achilles Sonoelastography Findings with Disease Activity, Functional Status and Enthesitis Index in Patients with Axial Spondyloarthritis

Background Sonoelastography (SE) is a new ultrasound (US)-based technique able to assess tissue elasticity. Using conventional US, it is sometimes difficult or even impossible to distinguish pathologic tissue because it often presents with the same echogenicity as the surrounding healthy tissue. This study aimed to evaluate SE findings in Achilles tendons of patients with axial spondyloarthritis (axSpA) and to assess how these findings are associated with disease-related parameters.

Material and Methods Sixty-four consecutive patients (37 men, 27 women; mean age 39.7 years; range 20–65 years) with axSpA and 30 sex and age-matched healthy controls were enrolled in the study. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index were recorded. All participants underwent an SE examination of the Achilles tendon and measurement of the strain index (SI).

Results The mean right and left SI were significantly higher in axSpA patients than in controls (2.96±0.94 vs. 1.90±0.45; p<0.001; 2.95±0.95 vs. 1.92±0.48, p<0.001, respectively). In axSpA patients, both right and left SI were significantly correlated with the BASDAI, BASFI and SPARCC enthesitis indices, but not with ESR or CRP.

Conclusion AxSpA patients had an increased SI compared with healthy subjects and these values were associated with disease activity, functional capacity and the enthesitis index. SE may be a useful tool for the evaluation of Achilles tendons in patients with axSpA.