Couroupita guianensis bark decoction: From Amazonian medicine to the UHPLC-HRMS chemical profile and its role in inflammation processes and re-epithelialization.

ETHNOPHARMACOLOGICAL RELEVANCE: In the Amazon rainforest, the shamans of the Mayantuyacu site use the healing virtues of decoctions and teas from different parts of the Couroupita guianensis Aubl. (Lecythidaceae) trees as remedies in Ashaninka medicine. However, composition of the remedy and the underlying mechanism remain unclear. AIM OF THE STUDY: This study was designed to compare the metabolite profile of Couroupita guianensis bark decoction produced by Amazonian shamans with that obtained under standardised laboratory conditions and to investigate biological properties of both decoction and isolated constituents in skin wound healing process and inflammation. MATERIALS AND METHODS: The chemical analyses were carried out by Ultra-High-Performance Liquid Chromatography coupled with UV and High-Resolution Mass Spectrometry detectors (UHPLC-UV-HRMS). 1D and 2D-NMR experiments were performed to identify the main decoction constituents. The decoction and pure compound effect on keratinocyte migration was determined by the in vitro wound healing model; the mechanism of action was elucidated by western blot analysis. RESULTS: UHPLC-UV-HRMS analysis revealed the occurrence of polyphenolic compounds as catechins, ellagitannins and, notably, of unusual sulphated derivatives of ellagic acid isolated for the first time from Couroupita guianensis bark. A new natural sulphated molecule [4-(2″-O-sulphate- ß-D-glucuronopyranosyl) ellagic acid] was identified as the potential active compound responsible for the efficacy of bark decoction stimulating wound healing in human HaCaT keratinocytes. The molecular mechanism involved the induction of pro-migratory pathways mediated by ERK and AKT phosphorylation and the increase of MMP2 expression in HaCaT cells. At the same time, the treatment inhibited inflammation interfering with NFkB activation. CONCLUSION: Beyond identifying a new bioactive compound, the overall results scientifically validate the traditional use of Couroupita guianensis bark decoction as an anti-inflammatory remedy. Moreover, the beneficial effects on keratinocytes suggest promising therapeutic applications in skin diseases.

The medieval skincare routine according to the formulations of Madgistra Trotula and the Medical School of Salerno and its reflection on cosmetology of the third millennium.

BACKGROUND: Officinal plants, minerals, animal derivatives, and miscellaneous have always been used to treat and improve appearance despite the different aesthetic canons of a specific historical and cultural context. OBJECTIVE: The aim of this work was to make a critical comparison between medieval and modern dermocosmetics analyzing the works of Trotula de Ruggiero, a female doctor of the 11th century teaching and working inside the illustrious "Medical School of Salerno," who devoted particular attention to the promotion of female care, beauty, and well-being. METHODS: We applied the historical-critical method analyzing the Latin text and the nglish translation of the standardized corpus of the main Trotula medieval manuscript De Ornatu Mulierum with a multidisciplinary scientific approach ranging from botany to pharmaceutical chemistry and technology, pharmacology and pathology. RESULTS: We identified the medicinal plants, derivatives of animal origin and minerals used in the recipes of Trotula, highlighting their biological properties in the light of current scientific knowledge. A critical comparison between medieval and modern dermocosmetics is reported also taking into consideration the chemical, pharmaceutical, and technological literature. CONCLUSION: Beyond the obvious changes in the paradigms of cosmetology and the different beauty canons of Middle Age with respect to modern times, our results emphasize the attention of Trotula to female care, beauty and well-being as well as the extraordinary combination of tradition and modernity in her work.

Sleep Disturbances Rate among Medical and Allied Health Professions Students in Iran: Implications from a Systematic Review and Meta-Analysis of the Literature.

Medicine and healthcare professions are prestigious and valued careers and, at the same time, demanding, challenging, and arduous jobs. Medical and allied health professions students, experiencing a stressful academic and clinical workload, may suffer from sleep disturbances. In Iran, several studies have been conducted to explore the prevalence rate among medical and healthcare professions students. The aim of this systematic review and meta-analysis was to quantitatively and rigorously summarize the existing scholarly literature, providing the decision- and policy-makers and educators with an updated, evidence-based synthesis. Only studies utilizing a reliable psychometric instrument, such as the Pittsburgh sleep quality index (PSQI), were included, in order to have comparable measurements and estimates. Seventeen investigations were retained in the present systematic review and meta-analysis, totaling a sample of 3586 students. Studies were conducted between 2008 and 2018 and reported an overall rate of sleep disturbances of 58% (95% confidence interval or CI 45-70). No evidence of publication bias could be found, but formal analyses on determinants of sleep disturbances could not be run due to the dearth of information that could be extracted from studies. Poor sleep is highly prevalent among Iranian medical and healthcare professions students. Based on the limitations of the present study, high-quality investigations are urgently needed to better capture the determinants of poor sleep quality among medical and healthcare professions students, given the importance and the implications of such a topic.

Trans-cultural Adaptation and Validation of the "Teacher Job Satisfaction Scale" in Arabic Language Among Sports and Physical Education Teachers ("Teacher of Physical Education Job Satisfaction Inventory"-TPEJSI): Insights for Sports, Educational, and Occupational Psychology.

Background: Job satisfaction is largely associated with organizational aspects, including improved working environments, worker's well-being and more effective performance. There are many definitions regarding job satisfaction in the existing scholarly literature: it can be expressed as a positive emotional state, a positive impact of job-related experiences on individuals, and employees' perceptions regarding their jobs. Aims: No reliable scales in Arabic language to assess job satisfaction in the sports and physical education field exist.This study aimed to trans-culturally adapt and validate the Pepe's "Teacher Job Satisfaction Scale" 9 items (TJSS-9), creating the "Teacher of Physical Education Job Satisfaction Inventory" (TPEJSI) in Arabic language. This scale was administered to a Tunisian population of sports and physical education teachers and analyzed according to the Pepe's theoretical model. More in detail, this investigation systematically tested its factor structure, in terms of internal consistency/reliability, predictive validity, sensitivity and convergent validity. Methods: A total of 417 Tunisian teachers of sports and physical education participated voluntarily in this study. The sample comprised of 258 males and of 159 females. More in detail, 189 were teachers teaching in primary schools of physical education, 105 teaching in secondary schools, and 123 were university teachers. Both exploratory (EFA) and confirmatory (CFA) factor analyses were performed on random-split halves of the sample. Results: The three-dimensional alpha coefficients of the TPEJSI were all >0.80: for satisfaction with colleagues, alpha was 0.865; for satisfaction with parents, alpha was 0.856 and for satisfaction with students alpha was 0.860. The CFA fit indices were satisfactory. Conclusions: Given the good EFA factor loadings, the CFA fit indices, the correlation matrix, the sensitivity analysis, the convergent validity and the excellent internal consistency, it can be concluded that the TPEJSI is a good psychometric tool that can be used to quantitatively assess the job satisfaction level among teachers of sports and physical education in the Arabic-speaking world.

Trans-Cultural Validation of the "Academic Flow Scale" (Flow 4D 16) in Arabic Language: Insights for Occupational and Educational Psychology From an Exploratory Study.

Background: As an optimal psychological state, flow represents those moments when everything comes together for the performer. Flow is often associated with high levels of performance and is a positive psychological experience. Aim: Our study aimed to validate the "Academic Flow Scale" (Flow 4D 16) in Arabic language across Tunisian population, and to test its factor structure, in terms of internal consistency/reliability, predictive validity, and sensitivity. Methods: The population is composed of 320 students (139 men and 181 women) belonging to the University of Sfax, with a mean age of 22.26 years. The students voluntarily responded to the scale of academic flow (Flow 4D 16). Both exploratory (EFA) and confirmatory (CFA) factor analyses were performed. Results: The four-dimensional alpha coefficients of the Flow 4D 16 indicate an excellent internal consistency, respectively, of 0.902 (Cognitive), 0.959 (Time), 0.974 (Ego) and 0.960 (Well-being). The CFA fit indices were satisfactory. Conclusion: In summary, the 16-items model (original version) showed for all the indices an excellent fit to the theoretical model, confirming the four-dimensional factor structure among Tunisian student population.

A reliability and content analysis of Italian language anorexia nervosa-related websites.

OBJECTIVE: Internet represents a major source of information related to health issues, increasingly used by providers. Indeed, there are numerous websites concerning eating and weight disorders, such as anorexia nervosa. The aim of the current investigation was to systematically perform a reliability and content analysis of Italian language anorexia nervosa-related websites. METHODS: Reliability of the anorexia nervosa website pages was assessed using the Health on the Net Foundation Code of Conduct Standards (HonCode®) certification mark. A comprehensive content analysis (thematic cluster analysis, correspondence analysis of emerging themes and topics, density and degree-centrality analysis, and co-word analysis) was performed using the commercial software T-Lab. RESULTS: 402 unique website pages were included and analyzed in the current study. Statistically significant differences related to the accomplishment or less to the items of the HonCode® certificate mark were found for all items, except for confidentiality and webmaster/additional contact. From the thematic cluster analysis, four clusters were identified: namely, treatment (26.6%), vomiting (24.7%), weight (24.4%) and onset-age (24.3%). Treatment (in particular, cognitive-behavioral psychotherapy) was the most represented theme (with a frequency of 97.76%, recurring in 393 websites). Pro-ana content characterized 147 website pages (with a frequency of 36.57%). CONCLUSION: The quality of Italian language anorexia nervosa-related websites was rather moderate-poor, being generally inconsistent with the principles of the HonCode® certification mark. Therefore, physicians and health authorities should be aware of such findings to provide their patients with proper answers and education.

The efficacy of Crocus sativus (Saffron) versus placebo and Fluoxetine in treating depression: a systematic review and meta-analysis.

Background: Depression represents a serious public health concern, imposing a high burden, both in epidemiological and clinical terms. Crocus sativus (Saffron) is a herbal remedy that has anti-cancer, anti-oxidant, anti-inflammatory and anti-platelet properties. However, the exact mechanisms of Saffron in treating depression are not yet clear. This study was conducted to evaluate the effectiveness of Saffron versus placebo and Fluoxetine in the treatment of depressed patients. Methods: Different bibliographic thesauri, namely the Cochrane Library, Scopus, PubMed/MEDLINE, Centre for Reviews and Dissemination (CRD), EMBASE, and ISI/Web of Science (WoS) were searched up to May 2018. Effect sizes were computed as Standardized Mean Differences (SMD) with their 95% confidence interval (CI). To evaluate the heterogeneity among the studies, I2 test was carried out. Results: Eight studies were included. The SMD was -0.86 (95% CI: -1.73 to 0.00) concerning the comparison of Saffron with placebo. The SMD was found to be 0.11 (95% CI: -0.20 to 0.43) concerning the comparison of Saffron with Fluoxetine. In both sensitivity analyses, the results did not statistically change, confirming the stability of the findings. Conclusion: The findings of this study showed that Saffron administration was well comparable with Fluoxetine and placebo.

Development and Preliminary Validation of the "Teacher of Physical Education Burnout Inventory" (TPEBI) in Arabic Language: Insights for Sports and Occupational Psychology.

Background: Burnout is an inappropriate response to chronic work stress, leading to emotional exhaustion (EE), depersonalization (D), and low personal accomplishment (PA). Burnout can affect workers in the helping professions. To quantitatively assess the burnout level among teachers, Maslach has adapted the "Maslach Burnout Inventory" (MBI) to the educational environment (the so-called MBI Educators Survey version or MBI-ES). Among teachers, sports and physical education teachers may suffer from burnout due to high workload. Aims: No reliable psychometric tool in Arabic language exists that can be used to measure the burnout level among sports and physical education teachers. The objective of the present study was to develop a burnout measurement scale according to the Maslach's three-dimensional theoretical model for physical education teachers in Tunisia and to test its factor structure, in terms of internal consistency/reliability, predictive validity, and sensitivity. Methods: A total of 525 Tunisian teachers teaching in secondary schools from different Tunisian governorates volunteered to participate in this study. The sample comprised of 285 males (54.3%) and of 240 females (45.7%). More in detail, 327 were teachers of primary school of physical education (62.3%) and 198 teachers of secondary school (37.7%). Teachers were administered both the ad hoc developed "Teacher of Physical Education Burnout Inventory" (TPEBI) and the MBI-ES. Both exploratory [principal component analysis (PCA)] and confirmatory factor analyses (CFAs) were performed. Results: The Cronbach's alpha coefficients were excellent (0.93, 0.94, and 0.91 for EE, D, and PA, respectively). The correlation matrix indicated significant correlations between the TPEBI and MBI-ED dimensions. However, CFA fit indices were not completely satisfactory. Conclusion: Given the good PCA factor loadings, the correlation matrix, the sensitivity analysis, and the excellent internal consistency, it can be concluded that the TPEBI is a reliable psychometric tool that can be used to quantitatively assess the burnout level among teachers of physical education in the Arabic-speaking world. However, considering the CFA fit indices, further modifications to fully support the model are warranted.

Psychometric properties of the Brief Symptom Inventory in nomophobic subjects: insights from preliminary confirmatory factor, exploratory factor, and clustering analyses in a sample of healthy Italian volunteers.

BACKGROUND: The Brief Symptom Inventory (BSI), developed by Derogatis in 1975, represents an important standardized screening instrument that enables one to quantitatively assess psychological distress and psychiatric disorders. The BSI is a 53-item self-report scale, measuring nine dimensions that can be summed up to reflect three global indices, including the General Severity Index (GSI). In the era of new information and communication technologies, nomophobia ("no mobile phobia") is an emerging disorder, characterized by the fear of being out of mobile phone contact. Nothing is known, however, about the factor structure and reliability of the BSI in a population of nomophobic subjects. This study aimed at addressing this gap in knowledge. METHODS: A sample of 403 subjects aged 27.91±8.63 years (160 males, 39.7% of the entire sample, and 243 females, 60.3%), recruited via snowball sampling, volunteered to take part in the study. The Italian versions of the Nomophobia questionnaire and the BSI were administered. Exploratory factor analyses, confirmatory factor analyses, and clustering analysis were carried out together with correlation analysis, analysis of variance, and multivariate regression analysis. RESULTS: For each BSI subscale, scores were significantly higher than the norms. The nine subscales exhibited acceptable-to-good Cronbach's alpha coefficients, varying from 0.733 for psychoticism to 0.875 for depression. Overall, the reliability of the entire instrument proved to be excellent (alpha coefficient=0.972). Furthermore, all BSI subscales as well as BSI synthetic indexes correlated with nomophobia in a significant way. Stratifying the population according to the severity of nomophobia (mild, 206 individuals, 51.1% of the sample; moderate, 167 subjects, 41.4%; and severe, 30 individuals, 7.4%), the GSI score could distinguish (P<0.001) between mild and moderate (0.99±0.71 vs 1.32±0.81) and between mild and severe (0.99±0.71 vs 1.54±0.79) nomophobia, although not between moderate and severe nomophobia (P>0.05). Similar patterns could be found for the other subscales of the BSI. Finally, looking at the fit indexes, the second-order 9-factor model best fit the data compared with the Derogatis 1-factor model. CONCLUSION: The findings of our study show that the BSI is a reliable and valid instrument with acceptable psychometric properties, and can be administered to populations of nomophobic subjects.

The Relationship Between Nomophobia and Maladaptive Coping Styles in a Sample of Italian Young Adults: Insights and Implications From a Cross-Sectional Study.

BACKGROUND: Information technologies have become an integral part of the modern society; however, it is speculated that their overuse would result in addiction. Nomophobia refers to the irrational fear of being out of contact with virtual communication platforms. Generally, upon exposure to stress, humans adjust by employing cognitive mechanisms and behavioral efforts known as coping strategies. OBJECTIVE: The goal of the research was to explore coping styles implemented in subjects with nomophobia. METHODS: This was a cross-sectional study involving young adult participants (undergraduate students and younger subjects) who were recruited via an online survey using a snowball approach. The Italian version of the Nomophobia Questionnaire was administered to subjects. The measurement of coping styles was done using the 28-item Brief COPE questionnaire. Continuous data were computed as means and standard deviations, whereas categorical data were expressed as percentages, where appropriate. Correlation analysis was performed between the Nomophobia Questionnaire and Brief COPE scores. Multivariate regression analyses were conducted in order to shed light on the determinants of each coping style and its association with nomophobia. RESULTS: A total of 403 subjects took part in the study. Subjects with higher nomophobia scores responded when confronted with stress with behavioral disengagement (r=.16, P<.001), denial (r=.19, P<.001), self-blame (r=.12, P=.02), self-distraction (r=.22, P<.001), venting (r=.28, P<.001), use of emotional (r=.25, P<.001), and instrumental support (r=.16, P=.001). CONCLUSION: Nomophobia subjects adopt maladaptive coping strategies when confronted with stress. The acknowledgment of how nomophobia subjects react provides insight and introduces a focus for preventative and interventional measures in this population.

Psychometric evaluation of the Arabic version of the nomophobia questionnaire: confirmatory and exploratory factor analysis - implications from a pilot study in Kuwait among university students.

BACKGROUND: In the past decades, thanks to the widespread use of the new information and communication technologies, nomophobia has emerged as a contemporary psychological disorder. More in detail, it has been defined as the modern fear of feeling disconnected, being out of mobile phone contact, and being unable to access information and/or communicate with others. Few authors have used an Arabic version of the Nomophobia Questionnaire, even though its psychometric properties are not well known and have been poorly investigated from a formal rigorous standpoint. MATERIALS AND METHODS: Our research objective was to develop and validate the Arabic version, administering it to a sample of adolescents and young adults in a country characterized by a high mobile network coverage. A total of 512 subjects (aged 21.62±4.33 years, median 20 years), equally distributed between males and females, and based in Kuwait, volunteered to take part in the study. RESULTS: The confirmatory factor analysis did not show a completely satisfactory fitting with the original factor structure. The exploratory factor analysis showed that four factors had 57.24% variance. Overall Cronbach's alpha coefficient was 0.879. However, the coefficient increased from 0.645 to 0.849 with respect to the original factor structure. Scores (and mean scores) were 4.25±1.59 (21.23±7.95), 2.95±1.33 (17.68±7.97), 4.48±1.78 (8.96±3.56), and 4.98±1.52 (34.84±10.67) for factors I, II, III, and IV, respectively, whereas the overall score (and mean overall score) was 4.14±1.13 (82.71±22.68). CONCLUSION: In our sample, no subject (0.0%) was without nomophobia, with 92 (18.0%) and 288 individuals (56.2%) reporting mild and moderate nomophobia levels, respectively. Approximately a quarter of the recruited sample (132 subjects, 25.8%) had severe nomophobia level.

Cannabis Essential Oil: A Preliminary Study for the Evaluation of the Brain Effects.

We examined the effects of essential oil from legal (THC <0.2% w/v) hemp variety on the nervous system in 5 healthy volunteers. GC/EIMS and GC/FID analysis of the EO showed that the main components were myrcene and ß-caryophyllene. The experiment consisted of measuring autonomic nervous system (ANS) parameters; evaluations of the mood state; and electroencephalography (EEG) recording before treatment, during treatment, and after hemp inhalation periods as compared with control conditions. The results revealed decreased diastolic blood pressure, increased heart rate, and significant increased skin temperature. The subjects described themselves as more energetic, relaxed, and calm. The analysis EEG showed a significant increase in the mean frequency of alpha (8-13 Hz) and significant decreased mean frequency and relative power of beta 2 (18,5-30 Hz) waves. Moreover, an increased power, relative power, and amplitude of theta (4-8 Hz) and alpha brain waves activities and an increment in the delta wave (0,5-4 Hz) power and relative power was recorded in the posterior region of the brain. These results suggest that the brain wave activity and ANS are affected by the inhalation of the EO of Cannabis sativa suggesting a neuromodular activity in cases of stress, depression, and anxiety.

Effects of acculturation, coping strategies, locus of control, and self-efficacy on chronic pain: study of Chinese immigrant women in Italy - insights from a thematic field analysis.

Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon "cope and avoid" mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women's lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients.

Data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of immigrants in Genoa (Italy).

This article reports the data of the Modified Somatic Perception Questionnaire (MSPQ) administered to a sample of 143 immigrants accessing an outpatient clinic or the general practitioners offices in Genoa (Italy) compared with 186 Italian patients. For further details and for the interpretation of the data, the reader is referred to the original publication "Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants" by Bragazzi et al. (2014) [1].

Mindfulness-Based Stress Reduction Program on Chronic Low-Back Pain: A Study Investigating the Impact on Endocrine, Physical, and Psychologic Functioning.

OBJECTIVE: To explore the impact of the Mindfulness-Based Stress Reduction (MBSR) program on pain severity and endocrine, physical, and psychologic functioning in patients with chronic low-back pain (CLBP). METHODS: A total of 28 participants were enrolled in the study between January and June 2014; 17 participants were sequentially sampled for an 8-week MBSR program, and 11 were placed on a waitlist control group. Pain severity, quality of life (QOL), global psychologic functioning, and depression were assessed at baseline, at the end of treatment, and 4-5 months post-treatment for both groups. Morning and evening salivary cortisol was assessed at multiple time points in participants in the MBSR group. RESULTS: In comparison with baseline, evening cortisol release showed a significant increase post-treatment. Significant differences between groups were found in pain severity. Medium-to-large effect sizes were found for between-group differences in both pain severity and QOL. CONCLUSIONS: The cortisol increase in the MBSR group is a promising finding, in the context of CLBP hypocortisolism. Data show that the effects of the MBSR treatment may take time to surface. However, due to small sample size, decisive interpretation of findings is limited. Nevertheless, the MBSR program may show promise for CLBP and should be an avenue for further investigation through larger clinical trials within healthcare systems.

Ramadan Fasting and Patients with Cancer: State-of-the-Art and Future Prospects.

Ramadan fasting represents one of the five pillars of the Islam creed. Even though some subjects (among which patients) are exempted from observing this religious duty, they may be eager to share this particular moment of the year with their family and peers. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with cancer fasting in Ramadan and correctly advising them. Moreover, in a more interconnected and globalized society, in which more and more Muslim patients live in the Western countries, this topic is of high interest also for the general practitioner. For this purpose, we carried out a systematic review on the subject. Our main findings are that (1) very few studies have been carried out, addressing this issue, (2) evidence concerning quality of life and compliance to treatment is contrasting and scarce, and (3) generally speaking, few patients ask their physicians whether they can safely fast or not. For these reasons, further research should be performed, given the relevance and importance of this topic.