Depression and Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator in Women.

INTRODUCTION: Cardiovascular disease remains a major cause of morbidity and premature mortality worldwide. The aim of the present study was to investigate the association of atherosclerotic cardiovascular disease (ASCVD) risk estimator with depression in women undergoing cardiological evaluation. MATERIAL AND METHOD: Three hundred women undergoing cardiological evaluation completed the Zung Self-Rating Depression Scale (ZSDS) questionnaire which included women's characteristics. RESULTS: A percentage of 57.4% of our participants exhibited ASCVD risk <5%; while the 18.3% had ASCVD risk between 5% and 7.4%, the 18.3% between 7.5% and 20%, and the remaining 6% > 20%. In terms of depression, 50% of the women had a score of less than 38 (median), according to Zung scale and mean score was 38.4. In addition, 25% of women had a score below 32. These scores indicate low levels of depression in women. Statistically significant higher rates of depression were found in women who were not involved with physical activities (p = 0.030). CONCLUSIONS: The negative impact of depression on the ASCVD risk could potentially be prevented by modifying individuals' behavior with regard to their engagement in physical activity.

Quality of Life in Patients Receiving Medical Cannabis.

INTRODUCTION: Medical cannabis has been used to relieve the symptoms of people with various chronic diseases. Despite of this, it has been stigmatized, even after its legalization in many countries. AIM: The purpose of this study was to investigate the quality of life of patients receiving medical cannabis. MATERIAL AND METHOD: One hundred patients receiving medical cannabis were given (a) a socio-demographic and clinical questionnaire, and (b) the SF-36 Health Survey scale for assessing quality of life. RESULTS: The majority of our patients who received medical cannabis to treat their neurological disorders (58%) reported decrease in their symptoms (96%), better energy and vitality (68%), ability to perform their professional duties (88%), and an improvement in sleeping and appetite (79% and 71%, respectively) after receiving medical cannabis. Our participants exhibited very few restrictions in activities due to emotional difficulties, a moderate general health status as well as moderate vitality and energy. Participants, who reported a longer period of receiving medical cannabis, reported statistically significant more energy and vitality (p = 0.000), but also better mental (p = 0.000) and general health status (p = 0.001). Furthermore, the majority of patients have disclosed medical cannabis use to their family members (85%) and enjoyed their support (93%), but they haven't revealed their medication treatment to their social environment (81%). CONCLUSIONS: Appropriate knowledge could significantly help health professionals in the field of planning and implementation of personalized nursing care in order to achieve optimal therapeutic outcomes.

Anxiety and Depression in Parents of Children Undergoing Hematopoietic Stem Cell Transplant (HSCT).

Hematopoietic stem cell transplantation (HSCT) is a well-established therapy tool for several malignant and non-malignant diseases. Parents of children undergoing HSCT experience physiological distress for various reasons such as intensive caregiving, potential complications, and medically intensive process. The purpose of this study was to explore anxiety/depression in parents of children who underwent HSCT and the associated self-reported characteristics. METHOD AND MATERIAL: In the present study were enrolled 100 parents of children who underwent HSCT. Data were collected by the completion of the "Hospital Anxiety and Depression Scale (HADs)," which also included parents' characteristics. The statistical significance level was p < 0.05. RESULTS: Of the 100 participants, 81% and 64% of parents experienced anxiety and depression, respectively, based on HADs scores. A statistically significant association was observed between parental anxiety and gender (p = 0.017), frequency of visiting the hospitalized child (p = 0.023), whether they desired family members to remain in hospital (p = 0.033), as well as with the need for participation in daily care (p = 0.023), for help based on personal needs (p = 0.026), for scheduled meetings with parents having same problems (p = 0.006), for contact with hospital after discharge (p = 0.035), and for written information (p = 0.044). In terms of depression, a statistically significant association was observed with difficulties during the hospital stay (p = 0.034), whether they desired other family members to remain in hospital (p = 0.009), as well as with the need for opportunities or time for questions (p = 0.004), for scheduled meetings with parents having the same problems (p = 0.026), and for contact with hospital after discharge (p = 0.038). CONCLUSION: Anxiety and depression were associated with possibility of family members to remain in the hospital as well as with the need for scheduled meetings with parents having the same problems and for contact after hospital discharge. Based on the findings presented, it is suggested that understanding parents' needs and perceptions is fundamental to the development of appropriate interventions that address their worries.

Coping Strategies in Greek Parents of Children with Cancer.

INTRODUCTION: Childhood cancer is a life-threatening, chronic condition and treatment may extent for several years. The diagnosis of cancer in children could stress intensely their parents. AIM: To explore coping strategies utilized by Greek parents who have children with cancer. MATERIAL AND METHODS: Eighty-five parents of children with cancer, admitted for treatment at the in-patient unit of a Paediatric Hospital in Athens completed a questionnaire with demographic and their children's disease related characteristics and the Family Crisis Oriented Personal Evaluation Scale. RESULTS: Sixty mothers (70.6%) and 25 fathers (29.4%) completed the questionnaire. A percentage of 29.4% of the parents included in this study considered themselves anxious. Elementary or secondary school graduates scored higher in Seeking Spiritual Support (p = 0.013). Stay-at-home or unemployed parents scored lower in the subscale of Passive Appraisal (p = 0.012). Parents who were very well informed tended to exhibit more frequently passive appraisal behavior (p = 0.004). Parents whose child had Hodgkin's lymphoma scored higher in the subscale of Acquiring Social Support (p = 0.034). Statistical significance was found between parent's strategies of Seeking Spiritual Support and the gender (girls) (p = 0.036), as well as the treatment problems (p = 0.008) of hospitalized children. CONCLUSIONS: This study may help health professionals understand Greek families' coping strategies when they have a child with cancer. Appropriate knowledge could significantly help them in the field of planning and implementation of personalized care in order to achieve optimal therapeutic outcomes.

Perceived Social Support in Parents of Hospitalized Children During COVID-19.

It was March 2020 when the World Health Organization declared a global pandemic due to the spread of a virus known as SARS-CoV-2, which started in Wuhan (China) and spread across the world. From that time onward, all governments took specific measures to minimize virus outspread. Human beings faced several challenges in each aspect of life mainly the more vulnerable ones, such as parents with sick children who encountered not only with hospitalization but also with the negative effects posed by pandemic. PURPOSE: Purpose of this study was to explore levels of perceived social support and the associated factors in parents of hospitalized children. METHOD AND MATERIAL: In the study were enrolled 110 parents (30 fathers and 80 mothers) of hospitalized children. Data were collected by the completion of "The Multidimensional Scale of Perceived Social Support (MSPSS)," which included patients' self-reported characteristics. The statistical significance level was p < 0.05. RESULTS: From the 110 participants, 50% scored over 22, 22, and 20 (median) in support from significant ones, family, and friends, respectively. In addition, 25% of parents scored above 25, 25, and 24, respectively. With respect to the possible range of scores (4-28), these values indicate high levels of social support. Statistically significant higher levels of support from significant ones were experienced by parents who desired to be COVID-19 vaccinated (p = 0.019) and had a person at home belonging to a vulnerable group (p = 0.001). In terms of support from family, statistically significantly higher levels had parents who had been COVID-19 vaccinated (p = 0.003), who had not experienced family conflicts during pandemic (p = 0.026), and those who had a person at home belonging to a vulnerable group (p = 0.001). Regarding support from friends, statistically significant levels were experienced by parents who wished to be vaccinated (p = 0.012) and who had not experienced family conflicts during pandemic (p = 0.050). CONCLUSION: Through this unprecedented global health issue, levels of support remained high. Vaccination, having a vulnerable person at home, and intra-family conflicts were associated with support. A better understanding of support in parents with hospitalized children may help in the planning of rational and cost-effective interventions.

The Effect of Psychological Resilience and Coping Strategies on Mental Health of Nurses.

INTRODUCTION: Nursing professional is considered to be stressful with impact on nurses' mental health. AIM: The aim of this study was to investigate the effect of coping strategies and psychological resilience on anxiety and depression among nurses. METHODS: In this descriptive and cross-sectional study, 378 nurses from two hospitals (a general and a psychiatric) in Greece completed the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2), the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and the Ways of Coping Questionnaire for evaluating the depression, anxiety, psychological resilience, and coping strategies, respectively. The study was carried out between October and December of 2019. Statistical analysis was performed with JASP version 0.14.01 and significance for all statistical tests was set at 0.05 or less. RESULTS: Psychological resilience was significantly correlated with anxiety (r = -0.127, p = 0.014), Positive approach (r = -0.466, p<0.001), Seeking social support (r = -0.228, p < 0.001), Avoidance/Escape (r = -0.121, p = 0.020). Anxiety was positively correlated with Seeking social support (r = -0.112, p = 0.030), Prayer/Daydream (r = -0.132, p = 0.030), Avoidance/Escape (r = -0.164, p < 0.001), and Assertive problem solving (r =-0.195, p < 0.0010). Psychological resilience, Avoidance, and Assertive problem-solving were significant predictors of increasing of anxiety (ß = -0.128, p = 0.013, ß = 0.130, p = 0.027, ß = 0.131, p = 0.020, respectively). Avoidance (ß = 0.209, p < 0.001) and age (ß = 0.208, p = 0.029) were significant predictors of depression. CONCLUSIONS: Psychological resilience and coping strategies have a significant effect on nurses' mental health.

Investigation of Nurses' Wellbeing towards Errors in Clinical Practice-The Role of Resilience.

Background and Objectives: The fatigue, stress, and burnout of nurses lead to them frequently making mistakes, which have a negative impact not only on the safety of the patients but also on their psychology. The ability to bounce back from mistakes is crucial for nurses. Nursing staff members' physical and mental health, particularly their depression, is far from ideal, and this ill health is directly correlated with the frequency of self-reported medical errors. The nurses' mental and physical health are also positively correlated with their perception of wellness support at work. This cross-sectional study aimed to investigate the status of nurses' mental and physical health regarding clinical errors and the impact of resilience on coping with these situations. Materials and Methods: A total of 364 healthcare professionals participated in this research; 87.5% of them were females and 12.5% of them were males. Most of the participants were 22-35 years old. The median number of years of employment was nine. Clinical nurses anonymously and voluntarily completed a special structured questionnaire that included questions from different validated tools in order to assess their state of physical and mental wellbeing after events of stress and errors made during their practice. Results: In total, 49.4% of the nurses had made an error on their own, and 73.2% had witnessed an error that someone else had made. At the time of the error, 29.9% of the participants were in charge of more than 20 patients, while 28.9% were responsible for a maximum of three patients. Participants who were 36-45 years old had more resilience (p = 0.049) and experienced fewer negative emotions than participants who were 22-35 years old. The participants who mentioned more positive feelings according to their mental state had greater resilience (p > 0.001). Conclusions: Errors were likely to happen during clinical practice due to nurses' negative experiences. The level of resilience among the nursing population was found to play a very important role not only in making mistakes but also in coping with errors during their daily routine. Wellness and prevention must be given top priority in all healthcare systems across the country in order to promote nurses' optimal health and wellbeing, raise the standard of care, and reduce the likelihood of expensive, avoidable medical errors. Healthcare administrations should promote prevention programs for stress occurrence in order to support nurses' wellbeing maintenance.

Assessing the Respect of Children's Rights in Pediatric Hospitals.

Background and Objectives: In 1989, the United Nations (UN) General Assembly adopted the United Nations Convention on the Rights of the Child (UNCRC), with a considerable number of the Articles of the Convention being related to the health status of children. Therefore, adhering to and assessing the implementation of the rights of children during hospitalization is a very important step towards child protection. Herein, we attempt to highlight the depth of knowledge of employees working in children's hospitals with regard to children's rights as well as the degree of adherence to the UNCRC with respect to hospitalized children. Material and Methods: The target group included all healthcare professionals working in the various general pediatric clinics of the three Children's Hospitals of the Athens metropolitan area in Greece. We conducted a cross-sectional study, with data collection carried out in February and March 2020, using a structured questionnaire consisting of 46 questions which was handed out to all personnel. For the analysis, we used the IBM SPSS 21.0. Results: A total of 251 individuals participated in the study (physicians 20%, nurses 72%, and other employees 8%). A total of 54.5% of health professionals did not know what the UNCRC is, and 59.6% of them were not even aware that their hospital had rules and a bioethical committee related to clinical research involving children. Lack of awareness or trust of health professionals is also observed for other procedures or supervisory measures such as abuse protocols, complaint control, admission control, etc. With regard to the health system, there are shortcomings or weaknesses in (a) procedures followed with regard to respect for gender and privacy, (b) information on basic services provided by pediatric hospitals (such as recreation, education and free meals during hospitalization), (c) the logistical infrastructure (such as recreational facilities and facilities for the disabled), (d) the possibility of recording complaints, and (e) hospitalizations that were not necessary. A difference emerged concerning the nurses' responses between the three hospitals, with nurses participating in relevant seminars held in one of the hospitals being significantly more informed. Conclusions: The majority of healthcare personnel seem unaware of basic principles with respect to children's rights during hospitalization as well as relevant procedures and supervisory measures. Moreover, obvious weaknesses of the health system exist with respect to procedures, services, infrastructure, and complaint recording. There is a need for improved education of health professionals with respect to the implementation of children's rights in pediatric hospitals.

Association of University Students' COVID-19 Vaccination Intention with Behaviors toward Protection and Perceptions Regarding the Pandemic.

Background and Objectives: The COVID-19 pandemic is a serious global health problem. Vaccination is suggested to be one of the most efficacious precautionary measures, in combination with other protective behaviors. The purpose of this study was to explore the association of students' intention to get vaccinated about COVID-19 with protection behaviors and perceptions about the pandemic. Material and Methods: The study sample included 1920 university students who electronically completed two validated questionnaires anonymously and voluntarily from December 2020 to January 2021. Results: Results of the multiple linear regression analysis showed that as the perceived general risk was getting lower, the number of protective behaviors significantly diminished (p < 0.001). Additionally, respondents who believed that they had minor or no personal risk had undertaken significantly fewer preventing behaviors in comparison with participants who thought they had major personal risk (p = 0.006). However, the experience of respondents with people having COVID-19 had statistically significant association with undertaking more preventing behaviors (p = 0.004). Lower general perception of risk had statistically significant association with lower determination to obtain the vaccines of COVID-19 (p < 0.001). Personally knowing someone who had the coronavirus and undertaking more behavioral changes due to the coronavirus situation were significantly related to greater determination to obtain the vaccines of COVID-19 (p = 0.005 and p < 0.001, respectively). Conclusions: The results of this study can provide universities with the appropriate information about the improvement of COVID-19 vaccination strategies.

Factors Affecting Anxiety and Depression in Caregivers of Hemodialysis Patients.

Anxiety and depression have high levels in caregivers of patients on hemodialysis and are strongly associated with demographic factors. The aim of this study was to evaluate the factors affecting anxiety and depression in caregivers of hemodialysis patients. Four hundred and fourteen (414) caregivers (98 males and 316 females) participated in this study. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels. Multiple linear regression was performed to estimate the factors being independently associated with Beck Depression Inventory and State-Trait Anxiety Inventory. From a total of 414 participants, 125 (30.2%) had depression and 215 (52%) had anxiety. The median age of respondents was 54.34 (43.9-66.28) years, with half of the sample's age ranging from 43.9 to 66.28 (IQR). Depression and anxiety were significantly associated with parents or siblings, low level of education, increased caregivers' age, retirement, poor financial condition, having children, and comorbidities. In this study, a significant proportion of caregivers were found to have high levels of depression and anxiety. Thus, a formal screening can contribute to early diagnosis and treatment of depression and anxiety in caregivers of patients on hemodialysis.

Adults' Stress Response to Unexpected Oral and Arithmetic Tasks in Supine Position.

To study the autonomic nervous system (ANS) and hypothalamus pituitary adrenal axis (HPA) response before and after mental stress test in healthy adolescents and adults, is the aim of this study. Twenty healthy adults (aged 23-46 years) entered the Trier Social Stress Test (TSST), after informed consent signing. The procedure was modified: (a) the participants' position was supine as ANS system changes were to be assessed, (b) the interviewers were entering and departing from the session room. Salivary cortisol (marker of HPA axis response) samples were collected at the end of the baseline and 20 min after TSST. ANS of the heart was measured with CNS Task Force Monitor in supine position and was recorded during relaxation (15 min) and after TSST. The sympathovagal balance (LF/HF ratio) for each phase was computed. Evaluations were conducted with R. The HPA axis disturbance between baseline and 20 min after TSST was significant (g = 0.545 [0.092, 0.999]) and in adolescents (whereas, the mean intervals of the sinus rhythm RR parameter were found largely changed (g = 0.834 [0.340, 1.327]). The sympathovagal balance component of heart rate variability LF/HF ratio was founded unchanged (g = 0.215 [-0.211, 0.641]). RR changes were not correlated to salivary cortisol concentrations at any phase. Mean RRIs and salivary cortisol levels were significantly increased, although HPA axis showed medium size effect. However, the systems effectively counterbalance the perturbation, since the LF/HF ratio does not change. Our findings suggest further research in stress effect on HPA and ANS cross-talk and dynamics.

Depression in diabetic foot ulcer: Associated factors and the impact of perceived social support and anxiety on depression.

Diabetic foot ulcer (DFU) exerts a heavy physical and emotional burden on patients with diabetes mellitus. The purpose of the present study was to explore the impact of anxiety and perceived social support on depression of DFU patients well as patients' characteristics associated with depression. The sample of the study consisted of 180 DFU patients. Data collected by the completion of "Self-rating Depression/Anxiety Scale- Zung" (SDS/SAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients had moderate levels of anxiety and depression (median: 36, 42, respectively) and high levels of perceived social support from their significant ones, their family and friends (median: 24, 24, 17, respectively). After multiple regression factors that were found to have an impact on depression after taking into account all other factors, were patient's age of above 70 years, patient's anxiety and the social support they received from their significant ones. More specifically, patients aged above 70 years had 9.51 points higher depression than patients aged <50 years of age (ß = 9.51, 95% CI: [0.76, 18.25], P = .034). Moreover, one point increase in patient's anxiety score indicated an increase of 0.71 points in patient's depression (ß = 0.71, 95% CI: [0.43, 1.00], P = .001). On the contrary, one point increase in patient's social support from their significant ones indicated a decrease of 1.52 points in patient's depression (ß = -1.52, 95% CI: [-0.25, -2.79], P = .020). Clinically, a better understanding of factors having an impact on depression on DFU may provide an essential in planning cost effective interventions.

Factors Associated with Hemodialysis Machine Dependency.

INTRODUCTION: Hemodialysis is one of major stresses in patients' daily lives since there is no other path for life maintenance but to accept the machine and its' related rules. PURPOSE: of this study was to explore factors associated with dependency on dialysis machine as reported by the patients. MATERIAL AND METHODS: The sample of the study included 250 patients undergoing hemodialysis. For data collection a questionnaire specially designed for the needs of the research was used. More specifically, socio-demographic and clinical characteristics as well as several other self-reported variables were collected. RESULTS: Of the 250 participants, 53.2% was men while 65.2% was aged over 60 years. The study showed that 44% of the patients reported that their life depended very much on hemodialysis machine. Statistically significant association was observed between dependency on dialysis machine as reported by the patients and gender (p=0.030), education (p=0.022), job (p=0.001) and place of residence (p=0.001). Additionally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and the degree of information about their problem (p=0.001) and whether patients reported adherence to treatment guidelines (p=0.001) or followed the proposed diet (p=0.001). Finally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and relations with nursing staff (p=0.001), whether patients had noticed change in body image (p=0.001), whether they faced difficulties in social (p=0.001) and family environment (p=0.030), whether they hid their problem (p=0.006), whether they needed help in daily activities (p=0.001) and whether their lifestyle had changed (p=0.001). CONCLUSIONS: Socio-demographic and clinical characteristics as well as hemodialysis patients' beliefs are associated with machine dependency. This study contributed in outlining factors affecting dependency on dialysis machine, thus reinforcing multidisciplinary health care teams to develop interventions in order to address hemodialysis patients' needs.

Prevention and Treatment of Oral Mucositis in Pediatric Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND/AIM: Oral mucositis (OM) is a common and serious side effect of cancer treatment. The incidence of chemotherapy-induced OM in pediatric patients can reach up to 91.5% and has a major impact on patients' quality of life. The aim of the study was to assess the efficacy of current interventions and agents for the management of OM in children undergoing chemo/radiotherapy or hematopoietic stem cell transplantation (HSCT). MATERIALS AND METHODS: A systematic search of randomized controlled trials (RCTs) was conducted in the MEDLINE and Scopus databases from January 2000 until March 2023. Thirty-four randomized studies meeting the inclusion criteria were identified and five RCTs investigating the efficacy of Low Level Laser Therapy (LLLT) intervention or the agent honey were included in the meta-analysis. RESULTS: The meta-analysis of two RCTs indicated that topical application of honey on oral mucosa was effective in shortening the mean duration of hospital stay in children with severe OM (MD=-4.33, p=0.002). However, LLLT was not found to be effective for the prevention or treatment of OM grade ≥II (RR=0.99, p=0.99). Moreover, the therapeutic application of LLLT did not show significant benefit for lower risk of OM grade ≥II (RR=0.48, p=0.58). CONCLUSION: Various interventions and agents were examined in the present study for the management of OM. Honey could be a promising candidate for the treatment of OM in pediatric patients. Further high-quality RCTs are required to enhance our findings.

Investigation of Internalized Weight-Related Stigma: Progression to Dietary Addiction and the Role of Stress.

INTRODUCTION: Internalizing weight stigma can lead to the development of dietary addiction, as individuals seek food as a coping mechanism for the emotional distress caused by stigma. The influence of stress exacerbates this dynamic, encouraging the reliance on food as a stress-coping strategy. METHODS: Electronic questionnaires were completed in a special electronic form through an online platform. The Two-Factor Weight Bias Internalization Scale (WBIS-2F), the Yale Food Addiction Scale (YFAS), the Depression Anxiety Stress Scale-21 (DASS-21), Positive and Negative Affect Schedule (PANAS), the Life Orientation Test (LOT), the Brief Resilience Scale (BRS) were used at this study to examine the prevalence of Internal Weight Stigma (IWS) among adults in Greece, evaluate the degrees of stress/anxiety, food addiction, mental resilience, emotions, and positive life perspectives within this group, and explore the correlations between stress/anxiety, mental resilience, optimistic life attitudes, and both IWS and food addiction. RESULTS: 376 participants completed the questionnaire. The average BMI of the participants was 26.3 kg/m2 (SD = 5.9 kg/m2). Almost half of the participants (46.8%) fell within the normal weight range (18.5 ≤ BMI ≤ 24.9), while 28.2% were classified as overweight and 21.0% as obese. Interestingly, a significant majority (63.1%) perceived themselves as heavier than the normal weight range suggests. Most participants demonstrated typical levels of depression, anxiety, and stress, with percentages of 67.3%, 64.9%, and 71.3%, respectively. Resilience exhibited positive associations with optimism and positive emotions while displaying negative connections with depression, anxiety, stress, and negative emotions. Additionally, individuals with greater optimism reported fewer symptoms of despair, anxiety, and stress. CONCLUSION: The research highlights the intricate dimensions of mental well-being, emphasizing the need for a holistic comprehension encompassing demographic, psychological, and societal factors. The results indicate potential strategies for intervention to boost resilience, and optimism, and tackle issues such as food addiction, underscoring the significance of fostering a positive body image and self-esteem.

Factors Associated With Anxiety and Depression in Persons With Epilepsy (PWE).

INTRODUCTION: Epilepsy is a common neurological disease that is associated with increased morbidity and mortality globally. Persons with epilepsy (PWE) experience a heavy emotional burden mainly due to social stigmatization and limited opportunities in life. The purpose of this study was to explore factors associated with anxiety and depression in PWE. MATERIAL AND METHODS: In the present cross-sectional study, we enrolled 100 PWE who visited outpatient settings in a public hospital for scheduled follow-up. Data collection was carried out by the completion of the Hospital Anxiety and Depression Scale (HADS), which included participants' characteristics. The statistical significance level was p < 0.05. RESULTS: Of the 100 participants, the majority were women (65%), below 50 years old (62%), and single (40%). In terms of mental comorbidity, 58% and 48% experienced anxiety and depression, respectively. A statistically significant association was observed between anxiety and age (p = 0.002). Furthermore, a statistically significant association was observed between depression and gender (p = 0.044), age (p = 0.001), marital status (p = 0.036), educational level (p = 0.003), job (p = 0.025), residency (p = 0.041), and whether they went out at night (p = 0.009). CONCLUSION: Identifying factors associated with anxiety and depression is essential for PWE to receive appropriate support.

The Impact of the COVID-19 Pandemic on Childhood Obesity: A Review.

The coronavirus disease 2019 (COVID-19) pandemic has changed many families' eating habits and lifestyles. The main aim of this study was to investigate the association between COVID-19 and childhood obesity across the scientific literature. Literature reviews have shown that the current COVID-19 pandemic may play a major negative role in the global fight against childhood obesity. School closures, changes in routine, loss of structure, and loss of control were negatively associated with childhood obesity during the COVID-19 period. In addition, physical inactivity, irregular sleep, increased smartphone/TV screen time, and sedentary life may have played a significant negative role in social distress among children and adolescents. It has been argued that school closures during the pandemic have the potential to increase the prevalence of childhood obesity. Finally, family violence was predicted to increase during the pandemic, putting already vulnerable children at increased risk. The pandemic caused significant morbidity and mortality, straining healthcare systems, shutting down economies, and closing school districts. Pandemic future planning should involve stakeholders, including governments, schools, and families, who should make every effort to minimize the impact of the COVID-19 outbreak on childhood obesity.

Measuring Importance of Physical Self-Care Behavior in Patients with Heart Failure: Validation and Reliability Analysis of 14-item IPSC Scale.

INTRODUCTION: Heart failure (HF) is a complex clinical syndrome associated with increased disability, morbidity and mortality globally. HF is characterized by recurrent exacerbations and a high rate of hospital readmissions. Self-care is a crucial component of treatment. The way patients assess the importance of self-care may shed light on planning effective individualized interventions. The aim of this study was to conduct a validity and reliability analysis of the new 14-item IPSC scale, which measures how important HF patients consider their physical self-care behavior (IPSC, Importance of Physical Self-Care). MATERIAL AND METHODS: The 14-item IPSC scale was created by the researchers to explore how important HF patients consider their physical self-care behavior. The validation of the IPSC scale included face and content validity, construct validity, internal consistency, repeatability and discriminant validity. Patients' characteristics were also included. RESULTS: In the present study, 52 hospitalized HF patients were enrolled, of whom 55.8% were female, 34.6% above 70 years old, 48.1% of NYHA class III and 32.7% suffered this illness from 6 to 10 years. The total IPSC score had a possible range of 14-56, with higher scores indicating a low importance of self-care. The descriptive statistics in the IPSC scale showed a mean score of 27.9 ± 4.9 and a median score of 29, indicating that HF patients evaluated self-care behavior as moderately important. All items were found to be statistically significantly correlated with total scale scores (p ≤ 0.05), with correlation coefficients rho > 0.250, indicating moderate to strong correlations and meaning that all items are important in the calculation of the final score (construct validity). The internal consistency of the items that constituted the total score was found to be high (Cronbach's a > 0.7). Furthermore, it was found that scores had high repeatability (p ≤ 0.001 and ICCs > 0.7). Regarding discriminant validity, a statistically significant association was observed between the importance of physical self-care behavior and both years suffering the illness (p = 0.007) and the NYHA class (p = 0.030). CONCLUSION: The 14-item IPSC scale is a reliable instrument that help nurses in clinical settings to gain a better and prompt understanding of the importance which patients invest in their physical self-care behavior.

Body Image, Social Physique Anxiety Levels and Self-Esteem among Adults Participating in Physical Activity Programs.

(1) Background: individuals may benefit from being involved in physical and athletic activities in order to improve their body appearance and promote their physical and mental health. This study aimed to investigate body image, body mass index (BMI) characteristics, social physique anxiety, self-esteem and possible correlations between the above factors. (2) Methods: 245 adults engaged in training programs in gyms, as well as in track and field, football and basketball athletic activities completed (a) a sociodemographic questionnaire which recorded their BMI values and utilized the (b) Body-Esteem Scale for Adolescents and Adults, (c) the Social Physique Anxiety Scale and (d) the Rosenberg Self-Esteem Scale. (3) Results: Females and individuals with higher BMI reported statistically significant lower body-esteem and greater social physique anxiety levels compared to males and individuals with lower BMI, respectively (p < 0.05). A total of 25.3% of our participants were labeled as "overweight", while 20.4% had been overweight in the past. Significant differences were reported between body-esteem and social physique anxiety levels (p < 0.001); age (p = 0.001); BMI value (p < 0.001) and never having a problem with body weight (p = 0.008). Additionally, individuals with lower body-esteem and greater social physique anxiety levels presented lower global self-esteem (p < 0.001). (4) Conclusions: individuals' engagement in physical activity promotes physical as well as mental well-being, contributing to an improved quality of life, which may be the most important issue for health care professionals.