The Affective Dynamics of Everyday Digital Life: Opening Computational Possibility.

Up to now, there was no way to observe and track the affective impacts of the massive amount of complex visual stimuli that people encounter "in the wild" during their many hours of digital life. In this paper, we propose and illustrate how recent advances in AI-trained ensembles of deep neural networks-can be deployed on new data streams that are long sequences of screenshots of study participants' smartphones obtained unobtrusively during everyday life. We obtained affective valence and arousal ratings of hundreds of images drawn from existing picture repositories often used in psychological studies, and a new screenshot repository chronicling individuals' everyday digital life from both N = 832 adults and an affect computation model (Parry & Vuong, 2021). Results and analysis suggest that (a) our sample rates images similarly to other samples used in psychological studies, (b) the affect computation model is able to assign valence and arousal ratings similarly to humans, and (c) the resulting computational pipeline can be deployed at scale to obtain detailed maps of the affective space individuals travel through on their smartphones. Leveraging innovative methods for tracking the emotional content individuals encounter on their smartphones, we open the possibility for large-scale studies of how the affective dynamics of everyday digital life shape individuals' moment-to-moment experiences and well-being. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-023-00202-4.

Fertility Preservation in Children and Adolescents during Oncological Treatment-A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers.

Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents' beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.

Risk factors for relapse or recurrence in women with bipolar disorder and recurrent major depressive disorder in the perinatal period: a systematic review.

It is well known that the perinatal period supposes a considerable risk of relapse for women with bipolar disorder (BD) and recurrent major depressive disorder (rMDD), with the consequences that this entails. Therefore, the authors sought to provide a critical appraisal of the evidence related to specific risk factors for this population with the aim of improving the prevention of relapses during pregnancy and postpartum. The authors conducted a systematic review assessing 18 original studies that provided data on risk factors for relapse or recurrence of BD and/or rMDD in the perinatal period (pregnancy and postpartum). Recurrences of BD and rMDD are more frequent in the postpartum period than in pregnancy, with the first 4-6 weeks postpartum being especially complicated. In addition, women with BD type I are at higher risk than those with BD type II and rMDD, and the most frequent presentation of perinatal episodes of both disorders is a major depressive episode. Other risk factors consistently repeated were early age of onset of illnesses, severity criteria, primiparity, abrupt discontinuation of treatment, and personal or family history of perinatal affective episodes. This review shows that there are common and different risk factors according to the type of disorder and to perinatal timing (pregnancy or postpartum) that should be known for an adequate prevention of relapses.

Treating postpartum affective and/or anxiety disorders in a mother-baby day hospital: preliminary results.

INTRODUCTION: Women experiencing perinatal mental-health illness have unique needs. The present study analyzes preliminary data about the effectiveness of MBDH in treating postpartum women with affective and anxiety disorders. METHODS: We analysed 33 mothers with affective and/or anxiety disorders treated at the MBDH with their babies between March 2018 and December 2019. All women were assessed at admission, discharge and three months after discharge. Outcomes included symptoms of depression (EPDS) and anxiety (STAI-S), mother-infant bonding (PBQ) and functional impairment (HoNOs). We also assessed the clinical significance of changes in patients' scores on these scales and patient satisfaction. RESULTS: At discharge, no patients still met the full criteria for the main diagnosis. Between admission and discharge, symptoms of depression and anxiety, mother-infant bonding, functional impairment and autonomy in caring for babies improved significantly. These gains were maintained at three months follow-up. Patient satisfaction was high. CONCLUSIONS: These preliminary results suggest that multidisciplinary intervention for postpartum women with affective or anxiety disorders at the MBDH improves maternal psychopathology, mother-infant bonding and mothers' ability to care for their babies. MBDHs are a promising approach for delivering specialised perinatal mental-health care for mother-baby dyads.

Mother-baby day hospital (MBDH) could be an adequate device for women with perinatal mental disordersMultidisciplinary intervention is effective for treating postpartum anxiety and depressive disorders.Interventions at MBHD improve mother-infant bonding and mothers' ability to care for their babies.Further research is needed to assess the effectiveness at long term not only on maternal health also on child neurodevelopment.

Ultra-high-speed liquid chromatography combined with mass spectrometry detection analytical methods for the determination of nitrosamine drug substance-related impurities.

In the present study, five simple, feasible, and sensitive Ultra-high-speed liquid chromatography combined with mass spectrometry detection methods, using electrospray ionization are proposed. These methods were developed and validated for the determination of four different nitrosamine drug substance-related impurities-N-nitrosoacebutolol, N-nitrosobisoprolol, N-nitrosometoprolol, and N-nitrososotalol-in five beta blockers active pharmaceutical ingredients-acebutolol HCl, bisoprolol fumarate, metoprolol tartrate, metoprolol succinate, and sotalol HCl. The proposed methods were validated as per regulatory guidelines. Acquity HSS T3 (3.0 × 100 mm, 1.8 µm) column and formic acid 0.1% in water combined with methanol or acetonitrile were used for chromatographic separation in all methods. The limit of detection and the limit of quantification were found to be in the range of 0.02-1.2 and 2-20 parts per billion, respectively. The accuracy and precision of the five methods have been demonstrated in the working range of each one, giving values of recovery within the range of 64.1%-113.3%, and the regression coefficients (R) were found to be in the range of 0.9978-0.9999. These methods could be used for controlling nitrosamine drug substance-related impurities content for beta blockers drug substances batches manufactured at Moehs group.

Anxiety Connected with Pelvic Ultrasound in Adolescents and Their Caregivers: Comparison of Transabdominal and Transrectal Approaches.

STUDY OBJECTIVE: Transabdominal ultrasound (TAUS) is usually the first approach for diagnosis of reproductive tract complaints in all adolescents. However, there are instances when transrectal ultrasound (TRUS) is more feasible. Although TRUS is considered more invasive and distressing, evidence-based data are lacking. The aim of this study was to evaluate the level of anxiety in adolescents subjected to TAUS and TRUS and in their caregivers. METHODS: In this cross-sectional study, data were prospectively gathered using 2 instruments: the adult or child version of the State and Trait Anxiety Inventory (STAI or STAIC) and a self-developed survey. RESULTS: TAUS and TRUS are connected with high-level anxiety in patients and moderate anxiety in caregivers, as measured by the STAI/STAIC questionnaires. TRUS-related anxiety, fear, discomfort, and pain in adolescents are significantly higher compared with TAUS. The TRUS-related anxiety of caregivers, as well as the parent-estimated fear, discomfort, and pain of adolescents, is significantly higher compared with TAUS. Anticipated pain connected to TRUS is significantly higher than the post-exam, actually experienced pain. Pain and shame are the main reasons for adolescent anxiety connected with TRUS, whereas shame and unknown experience contribute to TAUS-related anxiety. CONCLUSION: Given the high level of anxiety associated with both exams, additional support should be provided to patients scheduled for any pelvic ultrasound exam. Given the even higher level of adolescent anxiety related to TRUS, specialists should be encouraged to train in TAUS and make efforts to begin with this approach. Because increased caregiver anxiety could adversely affect a child's reactions, anxiety-reducing interventions should be oriented toward the caregivers as well as the patients.

Concentrations of Selected Adipocytokines in the Blood Plasma in Proximal Suspensory Desmopathy of Horses, with a Focus on Their Physical Activity-A Pilot Study.

Chronic tendon and ligament diseases are commonly encountered in both athletic humans and animals, especially horses. Distal limb diseases, including suspensory ligament (SL) pathology due to anatomical, histological, and biomechanical properties, can be considered a model for tendon and ligament pathologies in humans. The appropriate selection of therapy is often crucial in optimising the healing process. One decisive factor influencing the possibility of returning to pre-disease training levels appears to be the utilisation of physical activity, including controlled movement, during the rehabilitation process. In the pathogenesis of musculoskeletal diseases and rehabilitation, adipocytokines play diverse roles. However, it is unclear what significance they hold in horses and in specific disease entities as well as the consequences of their mutual interactions. Recent studies indicate that in the pathogenesis of diseases with varied aetiologies in humans, their value varies at different stages, resulting in a diverse response to treatment. The results of this study demonstrate lower resistin concentrations in the venous blood plasma of horses with proximal suspensory desmopathy (PSD), while higher levels were observed in regularly trained and paddocked animals. The horses investigated in this study showed higher concentrations of resistin and IL-8, particularly in paddocked horses as well as in the working group of horses. The results suggest that these concentrations, including resistin in blood plasma, may be clinically significant. This attempt to explore the aetiopathogenesis of the processes occurring in the area of the proximal attachment of the suspensory ligament may optimise the procedures for the treatment and rehabilitation of horses.

A manikin or human simulator-development of a tool for measuring students' perception.

Background: Education with the use of medical simulation may involve the use of two modalities: manikins or standardized patients (SPs) to meet specific learning objectives. We have collected students' opinions about the two modalities which can be helpful in planning and evaluating the curriculum process. Although reviews or comparisons of student opinions appear in the literature, it is difficult to find a scale that would be based on a comparison of specific effects that can be obtained in the educational process. In order to fill this gap, an attempt was made to construct a questionnaire. Methods: An experimental version of a questionnaire measuring the final-year students' (273) opinions about the effectiveness of both simulation techniques has been designed on the basis of semi-structured interviews. They were conducted with 14 final-year students excluded from the subsequently analyzed cohort. The scale has been completed, tested and validated. Results: The authors developed a 33-statement questionnaire which contain two scales: teaching medicine with the manikins and with the SPs. Two factors were identified for each scale: Doctor-patient relationship and practical aspects. The scales can be used complementary or separately, as the article reports independent statistics for each scale. The Cronbach's alpha coefficient for the manikin scale is 0.721 and for the SP scale is 0.758. Conclusions: The questionnaire may be applied to medical students to identify their opinions about using manikins and SPs in teaching. It may have an important impact for planning curriculum and implementing particular modalities in accordance with the intended learning objectives.

The Importance of Immunological Disorders in the Pathogenesis of Lichen Sclerosus in Pediatric Patients: A Systematic Review.

Lichen sclerosus (LS) is defined as a chronic mucocutaneous inflammatory disease with a localization predominantly to the anus and genitals (vulvar sclerosus (VLS)). Pediatric lichen sclerosus (LS) is a chronic inflammatory skin condition with predilection for the anogenital area that if untreated can lead to scarring. Vulvar LS is characterized by two peaks in incidence: it occurs in prepubertal girls and in postmenopausal women. To date, several mechanisms and risk factors have been proposed in the pathogenesis of pediatric vulvar LS; however, the etiology of this condition is still not fully understood and constitutes a challenge for scientists and clinicians. The presented research aimed to systematically review the existing literature on the pathogenesis of pediatric LS and to identify possible underlying autoimmune mechanisms and molecular networks. The clinical presentation of pediatric lichen sclerosus and available treatment modalities are also presented to acquaint a broader audience with this underdiagnosed and undertreated condition. As a result of our review, we discuss several potential mechanisms, molecules, and pathways that have been recognized in this disease. The purpose of our review was also to summarize what we can induce in further studies, which will ultimately help to identify the mechanism responsible for the disease and aid in the development of new, more effective treatment strategies for diagnosis and treatment by clinicians and researchers.

Personality traits as a risk factor for postpartum depression: A systematic review and meta-analysis.

BACKGROUND: Certain personality traits increase vulnerability to depression, but the evidence linking personality and postpartum depression (PPD) is less robust. This systematic review aimed to identify personality traits that increase the risk of PPD. METHODS: We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, Scopus, CINAHL, and Cochrane, following the PRISMA guidelines for reporting. We carried out a meta-analysis on the association between neuroticism and PPD. RESULTS: A total of 34 studies were analyzed. Of these, 31 considered at least one trait associated with PPD; 10 studies considered at least one trait not associated with PPD. The meta-analysis included 13 studies, concluding that neuroticism was associated with PPD (OR: 1.37; 95%CI: 1.22-1.53; p<0.001). LIMITATIONS: Study design and approach to personality assessment influence results. Prospective longitudinal studies of persons with no prior history of mood disorder would provide stronger evidence about whether particular personality traits predict PPD. Most studies reviewed used self-report measures to assess personality. Study design and approach to personality assessment influence results, and indications of publication bias were found. CONCLUSIONS: Neuroticism is the personality trait most widely studied in relation to PPD. Our meta-analysis found this trait is strongly related with PPD. Moreover, vulnerable personality style and trait anxiety are also associated with PPD. Screening for these traits might help identify women at risk, improving prevention, early detection, and possibly treatment.

Hybrid simulation of pediatric gynecologic examination: a mix-methods study of learners' attitudes and factors affecting learning.

BACKGROUND: Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low. That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution. METHODS: The study aimed to investigate learners' attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP (simulated patient)-voice model in the HFS environment and the factors connected to learners' attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS). The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). RESULTS: Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient's emotions, physical realism of the simulation, and technical issues. CONCLUSIONS: Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.

The role of emotional intelligence in attitudes towards elderly patients - Comparative study of medical students from rural and urban areas.

INTRODUCTION: Medical care in geriatrics has its own specificity, and in order to build a successful doctor-patient relationship it is important while studying medicine to learn some functioning aspects of this age group. OBJECTIVE: The aim of this study is to explore and describe the role of emotional intelligence in the attitudes of medical students towards elderly patients, taking into account their the place of residence. The place of residence has an impact on social relations and socialization, which could effect with disparities in behaviour towards elderly patients. MATERIAL AND METHODS: Medical University of Lublin students from rural (N=71; M=23.44 SD=1.80) and urban (N=87; M=23.34; SD=1.38) areas took part in the study. Emotional Intelligence Questionnaire (INTE) and Attitude Towards Elderly Patients Questionnaire (ATEP) were used. RESULTS: There are statistically significant differences between medical students from rural and urban areas in their attitude towards elderly patients (p=0.001), but no differences were observed between rural and urban residents in terms of emotional intelligence (general result, action factor and cognitive factor). Positive correlations were observed between action factor (r=0.322), cognitive factor (r=0.311) and general INTE result (r=0.358) and attitude towards elderly patients in the group of medical students from rural area. CONCLUSIONS: Medical students from rural areas are characterized by a more positive attitude towards elderly patients than medical students from urban areas. The predictors of attitudes towards elderly patients are the cognitive factor of emotional intelligence and the place of residence of medical students. The results give the opportunity to design a well-developed programme of a geriatric course which could be matched to the personal predispositions of students.

Obstetric complications in bipolar disorder: Psychiatric factors and the risk of caesarean section.

Bipolar Disorder (BD) is a chronic psychiatric condition with somatic morbidity that requires continuous mood stabilizing treatment to prevent relapses. Pregnant women with BD have shown an increased rate of caesarean section (C-Section) in comparison with women without BD. Because specific differentiated profiles between mothers with BD that require C-Section and those that do not require C-Section have not been largely discussed, we aim to explore the risk factors associated with the type of delivery in pregnant women with BD. A prospective cohort study was conducted at the Perinatal Mental Health Unit. 100 pregnant women with BD were followed throughout their pregnancy by obstetric and psychiatric services at the same hospital. The cohort was developed in order to compare psychiatric and obstetric outcomes between women with BD that required C-Section (N = 40) versus women that did not require C-Section (N = 60). Final regression models showed an increased risk for obstetric complications during labour (OR 4,52, 95% CI 1,66-12,29), higher rates of hypothyroidism (OR 3,73, 95% CI 1,04-13,73) and treatment with lithium + antidepressant (OR 4,24, 95% CI 1,34-13,40) amongst the C-Section group when compared to the non-C-Section group. In our sample, women with BD treated with lithium plus antidepressant, with hypothyroidism and without obstetric complications have a 70,5% probability of C-Section. In conclusion, psychopharmacology and thyroid function might help understanding which women with BD will have more probability of C-Section. The implementation of more targeted interventions in selected patients might be useful to avoid complications during delivery.

Changes of post-operative peripheral blood dendritic cells in patients undergoing laparoscopy.

INTRODUCTION: Surgical intervention affects local and systemic immune responses, especially in obese individuals. Many studies have attempted to evaluate immunological response to surgical trauma. Surgery changes the quantity and phenotype of circulating blood dendritic cells (DCs), including a decrease of total DCs post-operatively. The study aimed to evaluate the percentage and changes of myeloid, lymphoid DCs, and myeloid to lymphoid DCs ratio in obese and normal weight patients undergoing laparoscopy. MATERIAL AND METHODS: The study enrolled asymptomatic patients with gallstones, who underwent laparoscopic cholecystectomy. Blood samples were obtained before the surgery as well as 24 and 48 hours after the surgery. Cells were collected using a FACSCalibur flow cytometry, and phenotypes were analyzed with CellQuest software. RESULTS: No statistically significant differences were observed between obese and normal-weighted patients in all studied time periods, except for the myeloid to lymphoid DCs ratio assessed at 48-post-operative hour. The myeloid DCs percentage increased significantly in the post-operative period within both studied groups. The percentage of lymphoid DCs increased significantly in obese patients in all studied time periods. CONCLUSIONS: Laparoscopy induces immunomodulation, such as changes of myeloid and lymphoid dendritic cells, especially in obese patients. We describe new findings, in which minimally invasive surgical trauma promotes the increase of percentage of circulating DCs in the early post-operative period.

CD44, TGM2 and EpCAM as novel plasma markers in endometrial cancer diagnosis.

BACKGROUND: Endometrial cancer (EC) is the most common malignancy of the female reproductive tract. Despite years of research, the accurate screening strategy is still not available in this disease and it is usually diagnosed only after the clinical signs are present. The recent technological advances in analytical methodologies enabled detection of multiple molecules in one, small sample of biological materials. Such approach was undertaken in the presented study. METHODS: Concentrations of aldehyde dehydrogenase 1 family, member A1 (ALDH1A1), carbonic anhydrase IX (CA9), CD44, epithelial cell adhesion molecule (EpCAM), hepsin, kallikrein-6, mesothelin, midkine, neural cell adhesion molecule L1 (L1CAM), and transglutaminase 2 (TGM2) were measured using MAGPIX®System in plasma samples of 45 EC, 20 healthy controls and 11 patients with endometriosis. RESULTS: Significantly increased concentration in EC as compared to healthy controls were found in case of CD44 (p <  0.001), EpCAM (p = 0.033) and TGM2 (p <  0.001). EpCAM and mesothelin concentrations differed based on FIGO stages. Regression analysis revealed marker panels with high accuracy in detection of EC. The highest AUC 0.937 was attributed to the 3-marker panel of CD44/TGM2/EpCAM (84% sensitivity, 100% specificity), FIGO IA samples were discriminated from more advanced stages of EC with the mesothelin/grade 1 model featuring AUC of 0.911 (95.24% sensitivity, 78.26% specificity). CONCLUSIONS: Novel plasma biomarkers presenting good accuracy in diagnosing EC were found with TGM2 reported for the first time as plasma marker. It was also revealed that endometriosis may share similarities in the pattern of markers alterations characteristic for EC.

Interactions between microRNA-200 family and Sestrin proteins in endometrial cancer cell lines and their significance to anoikis.

In the present study, we intend to determine whether Sestrin proteins 1, 2, and 3 (SESN1-3) are targets of microRNA-200 family (miR-200) in endometrial cancer (EC) Ishikawa, AN3CA, KLE, and RL 95-2 cell lines and to investigate how these potential interactions influence anoikis resistance of EC cell lines. The luciferase reporter assay, qRT-PCR, and western blotting assays were used to verify whether SESN1-3 are direct targets of miR-200. Moreover, the anoikis assay and transient transfections of miR-200 mimics or inhibitors into EC cell lines were performed to evaluate the modulatory role of miR-200 and SESN proteins on anoikis resistance. We demonstrated that SESN2 protein is a direct target of mir-141 in KLE and RL-95-2 EC cell lines and the functional interaction of miR-141 and SESN2 protein has a downstream effect on anoikis resistance and SESN2 expression level in Ishikawa and AN3CA cell lines. Moreover, we have shown that SESN3 protein is a direct target of miR-200b, miR-200c, and miR-429 in Ishikawa, AN3CA, and KLE cell lines. Our results show that manipulation of miR-200b, miR-200c, and miR-429 expression patterns also has an influence on anoikis resistance in EC cell lines. In conclusion, we identified new interactions between miR-200 and the oxidative stress response SESN proteins that affect anoikis resistance in human EC cells.

Obstetric complications in bipolar disorder: The role of mental health disorders in the risk of caesarean section.

BACKGROUND: Women with Bipolar Disorder (BD) during pregnancy present a negative impact on them and their babies' health. Caesarean Section (C-Section) is an intervention to reduce complications associated with childbirth, but it also has risks, including maternal infections, anaesthetic and psychological complications. There are few studies that analyse the C-Section rates in women with BD compared to the general population. METHODS: A case-control study was conducted in a general university hospital. 100 pregnant women with BD matched with 100 controls without psychiatric illness who were attending the same hospital at delivery. We compared obstetrical outcomes during pregnancy, Pre/During Labour, onset of labour and mode of delivery specifying the type of C-Section. RESULTS: Rate of C-Section was significantly higher in BD group compared to the control group (OR=2, 95% CI 1,4-1,6). Case group had more somatic illness (SI) without treatment (P<, 001). BD (P=,021), primiparity (P=, 003), obstetric complications during pregnancy (P<, 001), obstetric complications during labour (P<,001), and SI with and without treatment (P<,001 and P=,007, respectively) were higher in women that required C- section. CONCLUSION: Women with Bipolar Disorder have near two-fold increased risk of C-section than women without Bipolar Disorder of similar age, gestational age and parity. Somatic illness was more prevalent in BD group that required C-section and this relation probably is related to high probability of having somatic comorbidities in patients with BD.

Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study.

BACKGROUND: Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course. METHOD: This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE). RESULTS: Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission. LIMITATIONS: Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed. CONCLUSIONS: Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.

Self-reported occupational blood exposure among paramedics in Poland: a pilot study.

Introduction. Paramedics are at risk of occupational blood exposure, increased by the immediacy of provided treatment. However, the issue has not been acknowledged to date by any research in Europe. Methods. This research aimed at assessing occupational blood exposure among paramedics in Poland. Respondents represented 21 Polish medical institutions. Their participation was voluntary and anonymous. Paramedics were provided with a self-directed job-specific questionnaire adapted to Polish conditions from an original US version. Results. 118 paramedics participated in the study from institutions constituting the National Emergency Medical System in Poland; including ambulance crews, Helicopter Emergency Medical Services and emergency department employees. Occupational exposure was reported by 18.64% of respondents and the main route of exposure was needlestick events. Conclusions. There is a further need to improve education among paramedics concerning the threat of being infected with blood-borne pathogens through all existing routes. Our findings point to the problem as being hidden and considered a shameful issue.