The effect of ileal resection length on postoperative complications and prognosis in right colon cancer.

BACKGROUND: There is a lack of literature on the length of the terminal ileum to be resected in right hemicolectomy for colon cancer. Therefore, we aimed to determine the mean ileal loop length and the effect of this variation on postoperative complications and long-term oncological outcomes in patients who underwent right hemicolectomy. METHODS: Right hemicolectomy surgeries performed for colon cancer in a tertiary care hospital between January 2011 and December 2018 were retrospectively analyzed from a prospective database. Two patient groups were established based on the mean length of the resected ileum above and below 7 cm. The two groups were compared for clinicopathological data, postoperative complications, mortality, long-term overall survival (OS) and disease-free survival (DFS). The factors contributing to OS and DFS were analyzed. RESULTS: The study included 217 patients. Body mass index (BMI) values were significantly higher in the ileum resection length > 7 cm group (p = 0.009). Pathological N stage, tumor diameter, and number of metastatic lymph nodes were significantly higher in the ileum resection length > 7 cm group (p = 0.001, p = 0.001, and p = 0.026, respectively). There was no significant difference for postoperative complication and mortality rates between the two groups. The mean follow-up period was 61.2 months (2-120) in all patients. The total number of deaths was 29 (11.7%) while the 60-month OS was 83.5% and 50-month DFS was 81.8%. There was no significant difference between the groups in terms of OS and DFS rates (p > 0.05). CONCLUSIONS: Excessive resection of the distal ileum in right hemicolectomy does not provide any benefit in terms of prognosis and complications.The ileum resection length and values close to it in our study appear to be sufficient.

Perceptions and usage of traditional cigarettes, electronic cigarettes, and waterpipes among young and middle-aged adults in Iraq: A descriptive study.

Tobacco use poses significant public health concerns, linked to various mental and physical health outcomes. Iraq has a high prevalence of smoking, predominantly with traditional cigarettes, but there is also growing popularity of electronic cigarettes and waterpipes among younger and middle-aged adults. This study aims to explore the perceptions and usage of traditional cigarettes, electronic cigarettes, and waterpipes among this population in Iraq. A descriptive study was conducted among 402 young and middle-aged adults (50.25% females), aged between 18 and 45 years, with a mean age of 25.88 (SD = 7.27). For the data collection, an online questionnaire was developed utilizing distribution channels on common social networking platforms. The results showed that 41.79% of respondents have used traditional cigarettes, while 31.1% of participants reported that they use electronic cigarettes. Ninety-four per cent of respondents acknowledged that they use waterpipes. The results also indicated that a significant proportion believe that using electronic cigarettes is either much more harmful or more harmful than traditional cigarettes. Participants commonly perceived all three types of tobacco products as highly harmful, including secondhand smoke, addictive qualities, and popularity among peers. Additionally, significant differences in perceptions emerged between smokers and nonsmokers regarding electronic cigarettes and traditional cigarettes, although no such differences were observed for waterpipes. These findings contribute to understanding the attitudes toward different forms of tobacco use among respondents, highlighting the need for targeted interventions to address the perceived harm associated with tobacco products.

Investigating perceived core disaster competencies of nurses in Iran: A case study of northwest hospitals.

AIM: This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023. BACKGROUND: Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters. METHODOLOGY: This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%. RESULTS: The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05). CONCLUSIONS: The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters.

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.

Lymphocyte-to-C-reactive protein ratio as a new biomarker for predicting mortality and morbidity in Fournier's gangrene.

OBJECTIVE: The purpose of this study was to research the neutrophil-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), and Fournier's Gangrene Severity Index (FGSI) for predicting prognosis and mortality in patients with Fournier's gangrene (FG). MATERIAL AND METHODS: Patients diagnosed with FG and treated in a tertiary referral hospital in the period from January 2013 to June 2020 were reviewed. LCR, FGSI, and NLR values were calculated. RESULTS: Our series included a total of 41 patients. Of the patients, 78% survived and 21.9% (n = 9) died. Survivors were significantly younger than non-survivors (p = 0.009). Hospital costs were higher in non-survivors and close to statistical significance (p = 0.08). The ROC analysis revealed that the FGSI, LCR, and NLR parameters were significant in identifying survivors and non-survivors (AUC = 0.941 [0.870-1.000], p < 0.001; AUC = 0.747 [0.593-0.900], p = 0.025; and AUC = 0.724 [0.548-0.900], p = 0.042). CONCLUSION: A low LCR value can be used as a marker to assess mortality and disease severity in patients with Fournier's gangrene.

OBJETIVO: Investigar el cociente neutrófilos-linfocitos (CNL), el cociente linfocitos-proteína C reactiva (CLP) y el índice de gravedad de la gangrena de Fournier (IGGF) para predecir el pronóstico y la mortalidad en pacientes con gangrena de Fournier (GF). MÉTODO: Se revisaron los pacientes diagnosticados de GF y atendidos en un hospital de tercer nivel de referencia en el período de enero de 2013 a junio de 2020. Se calcularon los valores de CLP, IGGF y CNL. RESULTADOS: Nuestra serie incluyó 41 pacientes, de los cuales el 78% sobrevivieron y el 21.9% (n = 9) fallecieron. Los supervivientes eran significativamente más jóvenes que los no supervivientes (p = 0.009). Los costes hospitalarios fueron mayores en los no supervivientes y cercanos a la significación estadística (p = 0.08). El análisis ROC reveló que los parámetros IGGF, CLP y CNL fueron significativos para identificar supervivientes y no supervivientes (AUC: 0.941 [0.870-1.000], p < 0.001; AUC: 0.747 [0.593-0.900], p = 0.025; AUC: 0.724 [0.548-0.900], p = 0.042). CONCLUSIONES: Un valor bajo de CLP se puede utilizar como marcador para evaluar la mortalidad y la gravedad de la enfermedad en pacientes con GF.

Mediating roles of meaning in life and psychological flexibility in the relationships between occupational stress and job satisfaction, job performance, and psychological distress in teachers.

Employees may experience stress in the workplace for various reasons. Psychological strengths may help them to cope with emerging challenges and foster mental health and work productivity. This study examined the mediating roles of meaning in life and psychological flexibility in the relationships between perceived occupational stress and job satisfaction, job performance and psychological distress. This cross-section study included 554 teachers (56.0% males; Mage = 36.99 ± 7.88 years) at all school levels in Türkiye. The research data was collected through a convenience sampling method using an online survey. Participants completed self-report measures of meaning in life, psychological flexibility, perceived occupational stress, job satisfaction, job performance, and psychological distress. Pearson product-moment correlation and parallel mediation model using PROCESS macro (Model 4) were utilized to analyze the data. The results showed that perceived occupational stress had a significant effect on meaning in life, psychological flexibility, job satisfaction, job performance, and psychological distress. Also, meaning in life and psychological flexibility had significant effects on job satisfaction, job performance, and psychological distress. Furthermore, meaning in life and psychological flexibility partially mediated the relationships between occupational stress and job satisfaction, job performance, and psychological distress. These findings highlight the significance of considering meaning in life and psychological flexibility as crucial factors in mitigating the impact of occupational stress on employee mental health and work productivity. By focusing on enhancing employees' sense of meaning and their ability to adapt flexibly to workplace challenges, organizations can potentially create a better environment that fosters positive outcomes for both employees and the organization. However, the impact of occupational stress on job performance, job satisfaction and psychological distress may change over time. To address this concern, future research should test the model through a longitudinal study design.

Handmade Loop Versus Hem-o-Lok Clip in Closure of Appendiceal Stump During Laparoscopic Appendectomy: Limited Setting in a Peripheral University Hospital.

Background: Today, laparoscopy is frequently used in abdominal emergencies such as acute appendicitis. There are several techniques used to close the appendiceal stump during laparoscopic appendectomy. We aimed to compare the use of handmade loop and Hem-o-lok used to close the appendiceal stump in public hospitals where resources are limited, in terms of surgical outcomes and cost. Methods: Between January 2020 and December 2022, patients for whom handmade loops and Hem-o-loks were used to close the appendiceal stump during laparoscopic appendectomy in our clinic were included in the study. There were a total of 638 patients (mean age: 33 ± 13.5 years, 325 females and 313 males) in the patient cohort. Demographic and clinical data, duration of surgery, complications, hospital stay, pathology reports, mortality, and cost of supplies were compared between the two groups. Results: There were 308 patients in the handmade loop group (160 females, 148 males, mean age: 33.7 years, range: 18-85 years) and 330 patients in the Hem-o-lok group (166 females, 164 males, mean age: 32.5 years, range: 18-89 years). There was no significant difference between the two groups for American Society of Anesthesiologists score, duration of symptom, hospital stay, intensive care unit stay, preoperative laboratory values, histopathological results, mortality, and morbidity (P > .05). The mean operation time was 48.76 ± 16.16 minutes in the handmade loop group and 40.53 ± 11.63 minutes in the Hem-o-lok group (p = 0.001). In terms of cost, the cost per case of Hem-o-lok group was about 25.8 times as much as the group that used sutures ($31 versus $1.2). Conclusions: Both methods can be used safely in laparoscopic appendectomy. The use of Hem-o-lok has no advantage other than shortening the operation time. However, it is costlier. Especially in peripheral hospitals where resources are limited, closing the appendiceal stump using a handmade loop is an easy, safe, and cost-effective method.

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.

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.

Applications of multiphoton microscopy in imaging cerebral and retinal organoids.

Cerebral organoids, self-organizing structures with increased cellular diversity and longevity, have addressed shortcomings in mimicking human brain complexity and architecture. However, imaging intact organoids poses challenges due to size, cellular density, and light-scattering properties. Traditional one-photon microscopy faces limitations in resolution and contrast, especially for deep regions. Here, we first discuss the fundamentals of multiphoton microscopy (MPM) as a promising alternative, leveraging non-linear fluorophore excitation and longer wavelengths for improved imaging of live cerebral organoids. Then, we review recent applications of MPM in studying morphogenesis and differentiation, emphasizing its potential for overcoming limitations associated with other imaging techniques. Furthermore, our paper underscores the crucial role of cerebral organoids in providing insights into human-specific neurodevelopmental processes and neurological disorders, addressing the scarcity of human brain tissue for translational neuroscience. Ultimately, we envision using multimodal multiphoton microscopy for longitudinal imaging of intact cerebral organoids, propelling advancements in our understanding of neurodevelopment and related disorders.

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.

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.

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.

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.

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.

Mental health problems and help-seeking behaviours of Syrian refugee adolescents: mediating role of self-stigma.

BACKGROUND: Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey. METHODS: The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale. RESULTS: The findings revealed that stress (ß = 0.19, p < 0.01), anxiety (ß = 0.12, p < 0.05), and depression (ß = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (ß = -0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress - help-seeking [effect = -0.05, 95% confidence interval (CI) -0.11 to -0.01], anxiety - help-seeking (effect = -0.04, 95% CI -0.09 to -0.01)], and depression - help-seeking (effect = -0.05, 95% CI -0.12 to -0.01). CONCLUSIONS: Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

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 (ß = 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.

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.