The Mediating Role of Anxiety in the Relationship between Job Satisfaction and Psychosocial Functions of Nurses and Pediatricians in PICUs.

Background: Job satisfaction refers to an individual's overall attitude towards their job. It is influenced by various factors such as work environment, job role, work-life balance, compensation, anxiety, opportunities for growth and development. However, low levels of job satisfaction can have a significant impact on an individual's mental health and overall well-being. Objective: We contacted this study in order to assess the effect of PICU nurses' and pediatricians' job satisfaction on their psychosocial functioning and to examine the role of anxiety as a mediating factor in this relationship. Methods: A sample of 155 nurses and pediatricians at 7 University Hospitals in Greece has consented to participate in the study. Socio-demographic data, Hamilton Rating Scale for Anxiety, Minnesota Satisfaction Questionnaire -short form and a Brief Inventory of Psychosocial Functioning were used to evaluate anxiety, job satisfaction and psychosocial functions. Results: According to our results, participants with moderate or severe levels of anxiety showed moderate or low job satisfaction, while moderate or severe anxiety was also associated with low levels of participants' psychosocial functioning. Job satisfaction is a dynamic situation that is affected by the levels of anxiety of each worker in PICU. Conclusion: The presence of anxiety may be related to comorbid mental health disorders since it affects the psychosocial functions of the worker. We propose a longer rest period, a change of department in case an employee wishes it or shows symptoms of increased stress or another mental health disorder, regular assessments by mental health experts for all PICU's staff and support after a diagnosis of a mental health problem.

Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers.

Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.

The Involvement of Neonatal Intensive Care Unit and Other Perinatal Factors in Postpartum PTSD After Cesarean Section.

BACKGROUND: The experience of a neonate hospitalised in the Neonatal Intensive Care Unit (NICU) is an understandably traumatic experience for the parents, especially, for the mothers of neonates. This mental distress resulting from preterm birth and/or NICU hospitalisation can be understood as post-traumatic symptomatology, according to the Diagnostic and Statistical Manual-5 version. The aim of this study is to investigate the impact of the admission of a neonate to the NICU (from any reason) on the development of postpartum post-traumatic stress disorder (PTSD) in a sample of women after cesarean sections. MATERIAL AND METHODS: A total of 469 women who gave birth with cesarean section from July 2019 to June 2020 participated in this study, from the original sample of 490 women who consented to participate. Data were obtained from the researcher's socio-demographic questionnaire, the past traumatic Life Events Checklist, the perinatal stressor Criterion A, and the Post-Traumatic Stress Checklist from the Diagnostic and Statistical Manual-5 version. RESULTS: A percentage of 46.64% of sample experienced postpartum PTSD. Factors associated with PTSD were placenta previa type4, abruption, bleeding (ß = .07, p = .049), premature contractions (ß = .08, p = .039), heavy medical history or previous gynecological history and preeclampsia (ß = .08, p = .034), abnormal heart rate, premature rupture of membrane, premature contractions, infections (ß = .14, p = .004), life of child in danger (ß = .12, p = .025), complications involving child (ß = .15, p = .002), complications involving both (child and mother) (ß = .12, p = .011), traumatic cesarean section (ß = .041, p < .001) and prematurity (ß = .12, p = .022). CONCLUSIONS: Additional measures must be taken for mothers of children who have been admitted to the NICU with psychological support interventions and reassessment of their mental state.

Congenital Zika Syndrome and Disabilities of Feeding and Breastfeeding in Early Childhood: A Systematic Review.

BACKGROUND: The Zika virus outbreak has affected pregnant women and their infants. Affected infants develop microcephaly and other congenital malformations referred to as congenital Zika syndrome. The neurological manifestations of congenital Zika syndrome may result in some feeding disorders, including dysphagia, swallowing dysfunction and choking while feeding. The aim of this study was to assess the prevalence of feeding and breastfeeding difficulties in children with congenital Zika syndrome and to estimate the risk of developing feeding disabilities. METHODS: We searched PubMed, Google Scholar and Scopus for studies published from 2017 to 2021. From the total of 360 papers, reviews, systematic reviews, meta-analyses and publications in languages other than English were excluded. Therefore, the final sample of our study consisted of 11 articles about the feeding/breastfeeding difficulties of infants and children with congenital Zika syndrome. RESULTS: Infants and children with congenital Zika syndrome were likely to suffer from feeding difficulties at various levels, including breastfeeding. Dysphagia problems ranged from 17.9% to 70%, and nutritional and non-nutritive suckling of infants was also affected. CONCLUSIONS: In addition to continuing to investigate the neurodevelopment of affected children, future research should also focus on the severity of factors influencing the degree of dysphagia, as well as the impact of breastfeeding on the child's overall development.

The Relation between Birth with Cesarean Section and Posttraumatic Stress in Postpartum Women.

Objective: The aim of this study was to investigate the relation between cesarean section and postpartum posttraumatic stress disorder as well as the factors that contribute to the development of posttraumatic symptoms in mothers. Materials and methods: A sample of 538 women who gave birth with emergency and elective cesarean section in a University Hospital of Thessaly, Greece, have consented to participate in a two-phase prospective study. A socio-demographic questionnaire, the stressor Criterion A, the Life Events Checklist and the Posttraumatic Checklist of the fifth edition of the Diagnostic and Statistical Manual (DSM-5) were used to diagnose posttraumatic symptoms in Greek postpartum mothers. Results:Out of 538 mothers, 37.2% had an emergency cesarean section and the remaining 62.8% an elective one. Posttraumatic stress was seen in 26 (26%) of women with emergency surgery and three (3%) of those with elective surgery. The present study also found that the inclusion of a neonate to the NICU, complications during pregnancy and delivery, lack of breastfeeding and lack of support from the partner were strongly associated with the development of posttraumatic symptoms. Conclusions:The results of the current study indicate the need to take measures to reduce cesarean section rates and promote vaginal delivery. The high posttraumatic stress rates make it imperative to take additional measures for the mental health of women after cesarean section, especially in those with a traumatic birth experience.

The Involvement of Past Traumatic Life Events in the Development of Postpartum PTSD after Cesarean Delivery.

BACKGROUND: Although childbirth is considered a natural process, a high percentage of postpartum women consider it traumatic. Any previous traumatic event in a woman's life can be revived through a traumatic birth experience, especially after a complicated vaginal delivery or cesarean delivery. The purpose of this study was to clarify the relationship between previous traumatic life events and posttraumatic stress disorder (PTSD) in postpartum women after cesarean section and which specific events exerted the greatest influence. METHODS: A sample of 469 women who had undergone cesarean sections at a Greek university hospital consented to participate in this prospective study. Data from a medical/demographic questionnaire, life events checklist, perinatal stressor criterion A, and posttraumatic stress checklist were used to evaluate past traumatic life events and diagnose postpartum posttraumatic stress. RESULTS: Out of 469 women, 25.97% had PTSD and 11.5% a PTSD profile, while 2.7% had PTSD and 2.7% a PTSD profile. Also, it appeared that only specific direct exposure to a traumatic event and/or witnessing one were predictors of postpartum PTSD. CONCLUSIONS: This survey identified specific traumatic life events, psychiatric history, stressor perinatal criterion A, preterm birth, and emergency cesarean section as risk factors for the development of PTSD or a PTSD profile in women after cesarean delivery.

The Kind of Conception Affects the Kind of Cesarean Delivery in Primiparous Women.

BACKGROUND: So far, multiple factors have been found to be related to the IVF procedure, the most prevalent being extremes of maternal age, infections, previous gynecological history, infertility and others. Although women achieve the coveted pregnancy with the development of IVF technology, the rapid increase contributes to the increase of primary cesarean sections rates. OBJECTIVE: The aim of the study was to identify if the kind of conception affects the kind of cesarean delivery among primiparous women in Greece. METHODS: This cross-sectional observational study took place from September 2019 to February 2020 at the University Hospital of Larisa in Greece. One hundred and sixty-two primiparous women who underwent a cesarean section (c-section) after IVF (n=27) and natural conception (n=135) participated in the study. RESULTS: The mean age of the IVF and natural conception groups were 36.22 and 31.08 years, respectively. Nineteen (70.4%) women of the IVF group had a previous medical or gynecological history in contrast to 48 (35.6%) women of the natural conception group. Only 55.6% of the IVF group had a full-term pregnancy unlike 88.1% of women in the natural conception group. An elective c-section was performed in 18 (66.7%) of the women who conceived after IVF, as opposed to 45 (33.3%) of the women who conceived naturally. CONCLUSION: This cross-sectional study showed that IVF conception was associated with high rates of elective cesarean section as opposed to women with natural conception. The causes of c-sections must be evidence based because the primary cesarean delivery is a major factor contributing to increased c-section rates.

ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period.

BACKGROUND: The attention-deficit/hyperactivity disorder (ADHD) was initially considered a male disorder. As it has recently been shown, however, its presentation in girls is a topic of increasing scientific interest and research. There have been quite a few studies so far showing the differences in the symptoms between genders and the progression of the condition depending on the individual's profile. However, there are some special characteristics in the female gender, including neuropathology and hormonal factors, that play a decisive role in understating ADHD in women. Although it is known that the symptoms in ADHD girls are overshadowed by those of the impulsive and hyperactive boys, an effort was made in this study to highlight ADHD symptoms in women from childhood to menopause. OBJECTIVE: Taking into account the small but significant differences in the development of ADHD in women, this literature review aims at identifying the special characteristics of ADHD symptoms in all stages of a woman's life from childhood to menopause. Being aware of these signs is important to provide the best quality of health care in ADHD women. METHODS: A review of the literature was conducted through the databases on the occurrence of ADHD symptoms in girls, adolescents, women of childbearing age and women in menopause. RESULTS: ADHD and its comorbid disorders affect the female sex throughout its life. The hormonal fluctuations and transitional periods of life seem to influence the symptoms of ADHD more. CONCLUSION: Higher awareness is thus required by health professionals about ADHD behavioural characteristics in girls, adolescent girls and women in their productive period or in menopause to identify the special signs defining the disease, to treat them early and protect the women's mental health.

Congenital Zika Infection and the Risk of Neurodevelopmental, Neurological, and Urinary Track Disorders in Early Childhood. A Systematic Review.

It was late 2015 when Northeast Brazil noticed a worrying increase in neonates born with microcephaly and other congenital malformations. These abnormalities, characterized by an abnormally small head and often neurological impairment and later termed Congenital Zika Syndrome, describe the severity of neurodevelopmental and nephrological outcomes in early childhood, and the implication of microcephaly at birth. The purpose of the study was to describe the neurodevelopmental outcomes in children exposed to Zika virus during fetal life, with and without microcephaly at birth. The systematic review included research studies about the neurodevelopmental outcomes with and without microcephaly, as well as nephrological outcomes in early childhood. We searched PubMed, Crossref, PsycINFO, Scopus, and Google Scholar publications and selected 19 research articles published from 2018 to 2021. Most studies have linked the severity of microcephaly in childbirth to the neurodevelopmental and urinary outcomes in early childhood. However, most children without microcephaly at birth develop typically, while others may be at risk for language impairment.

Zika Virus and the Risk of Developing Microcephaly in Infants: A Systematic Review.

The global epidemic of Zika virus has been a major public health problem affecting pregnant women and their infants. Zika virus causes a viral disease transmitted to humans mainly by the infected Aedes mosquito bite. The infection is not severe in most cases; however, there is evidence that infection during pregnancy may be associated with fetal genetic abnormalities (including microcephaly). In addition to microcephaly and other malformations, some specific lesions in the central nervous system have been reported. The aim of this systematic review was to determine the risk of developing microcephaly in infants whose mothers were infected with Zika virus in pregnancy. Epidemiological studies and case reports were incorporated in our review, finally including 15 articles from an initial pool of 355 related papers. Most studies have linked maternal infection during pregnancy to the development of neonatal microcephaly. The period considered most dangerous is the first trimester and the beginning or the whole of the second trimester. In order to understand the relationship between Zika virus and microcephaly in infants, a cohort study will be able to estimate the time from the onset of Zika infection and the full spectrum of adverse pregnancy outcomes.