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1.
Womens Health (Lond) ; 17: 17455065211042190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465268

RESUMO

OBJECTIVES: The COVID-19 pandemic has caused considerable stress throughout the world. Little is known about how postpartum women who gave birth during the early months of the pandemic were impacted. The purpose of this study was to explore and describe the associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during the early months of the COVID-19 pandemic. METHODS: Postpartum women over the age of 18 years who gave birth in the US hospitals between March and July of 2020 and spoke English completed a survey about their experiences. Demographic and health variables were measured via self-report. Stress was measured using the Perceived Stress Scale-10. Mastery was measured with the Pearlin Mastery Scale. Resilience was measured with the Connor-Davidson Resilience Scale-2. RESULTS: This study included 885 women. Participants had higher stress and lower resilience relative to pre-pandemic norms. Participants had high levels of depression, anxiety, and stress. Women who had an infant admitted to the neonatal intensive care unit had more stress. Income, full-time employment, and partnered relationships were associated with lower stress. Resilience and mastery were related to lower stress, depression, and anxiety. Black, Indigenous, or People of Color women showed higher stress and lower resiliency. Single women were likely to report lower levels of mastery than partnered women. CONCLUSION: Stress, depression, and anxiety were high in postpartum women in this study. Income, partnered relationships, and employment security, along with protective traits such as mastery and resilience, may reduce the impact of stress on postpartum women in a pandemic. Care models should be modified to support women during a pandemic. Health disparities exist in postpartum stress. Future interventions should focus on building resiliency and mastery and ensuring appropriate resources are available to postpartum women in a pandemic.


Assuntos
COVID-19/epidemiologia , Pandemias , Período Pós-Parto/psicologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Gravidez , Fatores de Proteção , Angústia Psicológica , Resiliência Psicológica , Fatores de Risco , SARS-CoV-2 , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
2.
BMC Psychiatry ; 21(1): 445, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34496823

RESUMO

BACKGROUND: The risk of depression has risen in the general population during the COVID-19 epidemic. This study was conducted to explore risk and protective factors associated with depression among the general population uninfected by COVID-19. METHODS: A cross-sectional study was conducted with 1,500 representative South Korean citizens aged 19-65 years through an anonymous online survey. Depression was defined as a Patient Health Questionnaire-9 score of 10 or higher. Other questionnaires included one measuring psycho-behavioural and social changes, and stress, due to COVID-19, a six-item version of the Gratitude Questionnaire (GQ-6), and a three-item version of the UCLA loneliness scale. RESULTS: Of the 1492 participants not infected by COVID-19, 312 (20.9%) exhibited depression. Multiple logistic regression analysis revealed that depression was positively associated with COVID-19-related stress and psycho-behavioural variables such as disturbances in eating and sleeping, younger age, smoking, underlying mental illness, and loneliness scale scores. In contrast, exercise three or more times per week and GQ-6 scale scores were inversely associated with depression. CONCLUSION: During the COVID-19 pandemic, maintaining daily routines including eating, sleeping, and regular exercise and focusing on gratitude may be important for the prevention of depression. In addition, more attention should be paid to vulnerable populations, including young people, those with mental illnesses, and smokers, who might be more susceptible to depression.


Assuntos
COVID-19 , Pandemias , Adolescente , Ansiedade , Estudos Transversais , Depressão/epidemiologia , Humanos , Saúde Mental , Fatores de Proteção , República da Coreia/epidemiologia , SARS-CoV-2
3.
An. psicol ; 37(2): 189-201, mayo-sept. 2021. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-202543

RESUMO

El objetivo principal de este trabajo fue revisar el estado de la investigación psicopatológica del duelo complicado en población adulta de España. Una búsqueda sistemática en PsycINFO, PsycArticles, PTSDpubs y PSICODOC identificó 13 estudios en los que, en conjunto, se había evaluado a 1,655 adultos. Los resultados de esta revisión ponen de manifiesto que no existe consenso en el diagnóstico de duelo complicado, en el uso de instrumentos de detección ni en los factores de riesgo y protección del duelo complicado. La prevalencia media ponderada basada en 6 de los estudios revisados fue de 21,53%. Tomando en consideración el tipo de instrumento de medida del duelo utilizado, se obtuvo una prevalencia de 7,67-10,68% en aquellos estudios que utilizaban instrumentos diagnósticos y de 28,77% en los instrumentos sintomáticos. Los resultados indican que el duelo complicado se relaciona con: un menor nivel socioeconómico y situación laboral desfavorable, la pérdida de un hijo o cónyuge, menor edad del fallecido, vulnerabilidad psicológica previa, consumo de psicofármacos y comorbilidad con otros trastornos. El apoyo social, los cuidados paliativos, las estrategias de afrontamiento centradas en el problema, el empleo de actividades agradables y la trascendencia o espiritualidad se presentan como factores protectores


The main objective of this research was to review the status of the psychopathological research of complicated grief in adult population of Spain, specifically the prevalence and risk factors. A systematic review of PsycINFO, PsycArticles, PTSDpubs, and PSICODOC databases identified 12 studies in which, overall, 1.627 adults had been evaluated. The results of this review show that there is no consensus about the diagnosis of complicated grief, the use of detection instruments, or the risk and protective factors for complicated grief. The weighted mean prevalence based on 6 of the reviewed studies was 21.53%. Taking into account the type of grief measurement used, a prevalence of 7.67 - 10.68% was obtained in those studies that used diagnostic instruments, and 28.77% in those using symptomatic instruments. The results indicate that complicated grief is related to: a lower socioeconomic level and unfavorable work situation, the loss of a child or spouse, younger age of the deceased, previous psychological vulnerability, the use of psychotropic medication, and comorbidity with other disorders. Social support, palliative care, problem-centered coping strategies, the use of pleasant activities, and transcendence or spirituality are shown as protective factors


Assuntos
Humanos , Adulto , Pesar , Fatores de Proteção , Transtornos de Adaptação/epidemiologia , Transtornos de Adaptação/diagnóstico , Fatores de Risco , Prevalência , Transtornos de Adaptação/psicologia , Fatores de Tempo , Espanha/epidemiologia
4.
Law Hum Behav ; 45(3): 179-196, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351202

RESUMO

OBJECTIVES: There are currently 1,308,327 immigrants in removal proceedings, over 80% of whom are Latinx (TRAC, 2021b). This study examined the relation among putative protective markers (i.e. social support, religious support, and legal support) and the emotional and physical well-being of Latinx individuals facing removal proceedings. HYPOTHESES: We hypothesized that increased social support, religious support, and legal support would buffer the negative relations between hopelessness, poor self-efficacy, and well-being measures (depression, anxiety, stress, mental well-being, somatic symptoms, and physical well-being). METHOD: Participants (N = 157; 31.2% men, M age = 33.4 years) had an active immigration court case in Texas and completed a demographic questionnaire, the Beck Hopelessness Scale, General Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, Multi-Faith Religious Support Scale, Depression, Anxiety, Stress Scale-21, Patient Health Questionnaire-15, and Short Form Health Survey-12. RESULTS: Higher levels of hopelessness and poor self-efficacy were associated with more negative well-being outcomes, while social support was associated with more positive well-being outcomes. Contrary to hypotheses, religious support and legal support served as risk markers independently, while legal support interacted with hopelessness, such that decreased legal support was associated with higher mental well-being at lower levels of hopelessness and interacted with poor self-efficacy, such that increased legal support was associated with poorer mental well-being at lower levels of self-efficacy. All effect sizes were small (rsp2 = .04 to .16). CONCLUSIONS: Targeting hopelessness and poor self-efficacy while promoting social support may help mental health professionals improve the well-being of immigrants in removal proceedings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Deportação , Hispano-Americanos/legislação & jurisprudência , Hispano-Americanos/psicologia , Saúde Mental , Imigrantes Indocumentados/legislação & jurisprudência , Imigrantes Indocumentados/psicologia , Adulto , Idoso , Feminino , Esperança , Humanos , Serviços Jurídicos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Psicometria/instrumentação , Fatores de Risco , Autoeficácia , Apoio Social , Inquéritos e Questionários , Texas/etnologia
5.
Nutrients ; 13(8)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34445014

RESUMO

The maternal diet can potentially influence the life-course health of the child. A poor-quality maternal diet creates nutrient deficiencies and affects immune-metabolic regulation during pregnancy. The nutrient-based overall dietary quality can be assessed using the Nutrient-Rich Food Index 9.3 (NRF9.3), which measures adherence to the national reference daily values of nutrient intake. Pro- and anti-inflammatory nutrient intake can be assessed using the energy-adjusted dietary inflammatory index (E-DII), a comprehensive index of diet-derived inflammatory capacity. Using these indices, we assessed the overall dietary quality and inflammatory potential of pregnant women during mid-gestation in an urban area of Japan (n = 108) and found that there was a strong inverse correlation between the NRF9.3 and E-DII scores. Comparison of the scores among the tertiles of NRF9.3 or E-DII indicated that dietary fiber, vitamin C, vitamin A, and magnesium mainly contributed to the variability of both indices. Intake of vegetables and fruits was positively associated with high NRF9.3 scores and negatively associated with high E-DII scores, after adjustment for maternal age, pre-pregnancy body mass index, and educational level. Consistent with the previous studies that used dietary pattern analysis, this study also demonstrated that vegetables and fruits were the food groups chiefly associated with high dietary quality and low inflammatory potential among pregnant Japanese women.


Assuntos
Dieta Saudável , Inflamação/prevenção & controle , Fenômenos Fisiológicos da Nutrição Materna , Avaliação Nutricional , Estado Nutricional , Valor Nutritivo , Recomendações Nutricionais , Adulto , Registros de Dieta , Dieta Saudável/efeitos adversos , Ingestão de Energia , Feminino , Frutas , Humanos , Inflamação/etiologia , Inflamação/fisiopatologia , Estudos Prospectivos , Fatores de Proteção , Medição de Risco , Fatores de Risco , Tóquio , Verduras
6.
Health Psychol ; 40(7): 428-438, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34435794

RESUMO

OBJECTIVE: This study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic in Italy by specifically looking at the psychosocial response of children/adolescents with neurodevelopmental disabilities (NDD) and their parents, and explored which factors could potentially contribute to increasing or mitigating stress-related behaviors in children/adolescents as well as their parents' stress. METHOD: An online anonymous survey was designed to investigate family demographic characteristics, COVID-19 outbreak and restriction-related variables, children/adolescents' behavioral regulation problems, parental stress, and resilience. Data were collected from 1,472 parents (83.1% mothers) of 1632 NDD children/adolescents (33.7% females). RESULTS: Compared to pre-emergency, parents reported a significant increase in their children's behavioral regulation problems: Anxious/depressed behavior, Attention problems, and Aggressive behavior (p < .001), and they reported feeling more Overwhelmed and Burdened (p < .001) as parents but less Unfulfilled, Numbness, Devastated, and Angry (p < .001). A hierarchical stepwise regression analysis revealed that both behavioral regulation problems in NDD children/adolescents and parental stress are-at least partially-buffered by resilience factors in parents (Perception of self, Planned future, Family cohesion). CONCLUSIONS: Results showed that behavioral regulation problems in children/adolescents with NDD and parental stress increased. However, parental resilience can act as a protective factor, counterbalancing parental difficulties in the care of their NDD children during the emergency. Identifying risk and protective factors impacting the psychosocial response ofchildren/adolescents with NDD and their parents is essential to implement appropriate support interventions both for parents and children/adolescents with NDD during the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
COVID-19/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Pandemias , Pais/psicologia , Resiliência Psicológica , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Fatores de Proteção , SARS-CoV-2
7.
Artigo em Inglês | MEDLINE | ID: mdl-34444297

RESUMO

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS based on the insights and lived experiences of racially and ethnically diverse, older gbMSM. Applying a community-based participatory research approach that included the meaningful involvement of older gbMSM living with HIV/AIDS in different roles (i.e., advisory committee member, collaborator, peer researcher, and participant), the study recruited and included forty-one older gbMSM living with HIV/AIDS from Ontario, Canada, in confidential, semi-structured interviews. Utilizing thematic analysis, we identified three major themes from the participant interviews as factors that fostered the resilience of older gbMSM to HIV/AIDS and helped to address HIV/AIDS health disparities: (1) established protective factors, (2) behavioral protective factors, and (3) controversial protective factors. This paper argues for the importance of valuing and capitalizing on these protective factors in the conceptualization and development of interventions, services, and programs that are dedicated to fostering resilience to HIV/AIDS.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Bissexualidade , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Ontário/epidemiologia , Fatores de Proteção
8.
Artigo em Inglês | MEDLINE | ID: mdl-34444358

RESUMO

Prior research has found that Black and Latinx communities in the U.S. face significant disparities that impact both preparedness for severe weather events and the support received after a disaster has occurred. In the current study, we examined key risk and protective factors that impacted mental health among 221 Black and Latinx adult respondents exposed to the 2-3 March 2020 nocturnal tornado outbreak in the U.S. state of Tennessee. Key factors that adversely affected mental health among participants were encountering barriers for receiving tornado warning alerts and tornado-related exposure. Key factors that served a protective mechanism against adverse mental health included having access to physical resources, supportive relationships, and adaptive coping skills. These findings may assist National Weather Service (NWS) personnel, emergency managers, and mental health providers with the development of policies and practices to address barriers and promote protective strategies for future nocturnal tornado events.


Assuntos
Desastres , Tornados , Adulto , Humanos , Saúde Mental , Fatores de Proteção , Tempo (Meteorologia)
9.
Behav Ther ; 52(5): 1114-1122, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34452666

RESUMO

Acquired capability for suicide is associated with increased suicide risk and behaviors, but little research has examined factors that may qualify this relationship. Body investment is proposed as one such factor, as it may engage self-preservation instincts and serve as a buffer to capability for suicide. It was expected that facets of body investment (body feelings, body care, comfort with touch, and body protection) would moderate the relationship between acquired capability for suicide and suicide attempts. The current study included a sample of 1,150 undergraduate students with a mean age of 19.74 (3.44). The majority of the sample identified as female (71%) and White/Caucasian (78%). Participants completed self-report measures of body investment (Body Investment Scale [BIS]), acquired capability (Acquired Capability for Suicide Scale [ACSS]), suicide thoughts and attempt history (Self-Harm Behavior Questionnaire [SHBQ]), and demographic information. Four moderation analyses were run using the PROCESS macro; one for each body investment subscale. All facets of body investment showed significant moderation except for body care. Acquired capability was significantly associated with suicide attempts when body feelings, comfort with touch, and body protection were low, but not when they were high. Results indicate that fostering aspects of body investment may be important for suicide prevention.


Assuntos
Comportamento Autodestrutivo , Tentativa de Suicídio , Feminino , Humanos , Fatores de Proteção , Ideação Suicida , Inquéritos e Questionários
10.
Behav Ther ; 52(5): 1213-1225, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34452674

RESUMO

Over 48,000 people died by suicide in 2018 in the United States, and more than 25 times that number attempted suicide. Research on suicide has focused much more on risk factors and adverse outcomes than on protective factors and more healthy functioning. Consequently, little is known regarding relatively positive long-term psychological adaptation among people who attempt suicide and survive. We recommend inquiry into the phenomenon of long-term well-being after nonfatal suicide attempts, and we explain how this inquiry complements traditional risk research by (a) providing a more comprehensive understanding of the sequelae of suicide attempts, (b) identifying protective factors for potential use in interventions and prevention, and (c) contributing to knowledge and public education that reduce the stigma associated with suicide-related behaviors.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Humanos , Fatores de Proteção , Fatores de Risco , Estados Unidos/epidemiologia
11.
Bioengineered ; 12(1): 4054-4069, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34369278

RESUMO

During the pandemic of the coronavirus disease 2019, there exist quite a few studies on angiotensin-converting enzyme 2 (ACE2) and SARS-CoV-2 infection, while little is known about ACE2 in hepatocellular carcinoma (HCC). The detailed mechanism among ACE2 and HCC still remains unclear, which needs to be further investigated. In the current study with a total of 6,926 samples, ACE2 expression was downregulated in HCC compared with non-HCC samples (standardized mean difference = -0.41). With the area under the curve of summary receiver operating characteristic = 0.82, ACE2 expression showed a better ability to differentiate HCC from non-HCC. The mRNA expression of ACE2 was related to the age, alpha-fetoprotein levels and cirrhosis of HCC patients, and it was identified as a protected factor for HCC patients via Kaplan-Meier survival, Cox regression analyses. The potential molecular mechanism of ACE2 may be relevant to catabolic and cell division. In all, decreasing ACE2 expression can be seen in HCC, and its protective role for HCC patients and underlying mechanisms were explored in the study.


Assuntos
Enzima de Conversão de Angiotensina 2/genética , Carcinoma Hepatocelular/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Proteínas de Neoplasias/genética , Receptores Virais/genética , alfa-Fetoproteínas/genética , Fatores Etários , Idoso , Enzima de Conversão de Angiotensina 2/metabolismo , Área Sob a Curva , COVID-19/virologia , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Bases de Dados Genéticas , Conjuntos de Dados como Assunto , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/mortalidade , Cirrose Hepática/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/classificação , Proteínas de Neoplasias/metabolismo , Fatores de Proteção , Mapeamento de Interação de Proteínas , Curva ROC , Receptores Virais/metabolismo , SARS-CoV-2/patogenicidade , Análise de Sobrevida , alfa-Fetoproteínas/metabolismo
12.
Nutrients ; 13(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34371901

RESUMO

BACKGROUND: Burnout is an undesirable mental condition, which may have a negative impact on individuals' health and work ability. This study aimed to evaluate the relationship between diet and burnout symptoms among female public sector employees. METHODS: A cross-sectional study was conducted in 2015 among 630 female employees from 10 municipal work units of the city of Pori, Finland. Burnout symptoms were assessed with the Bergen Burnout Indicator (BBI). The consumption of food items was determined using the food frequency questionnaire (FFQ). The main food groups were categorized into healthy and unhealthy foods based on the Nordic Nutrition Recommendations for a healthy and balanced diet. RESULTS: In multivariate linear regression analysis, consumption of healthy food items had an inverse relationship with the severity of burnout symptoms independently of age, education years, physical activity, and depressive symptoms. De-tailed analysis revealed that subjects with lower BBI score consumed more often low-fat dairy produce, vegetables, fruit and berries, vegetable food, and white meat. CONCLUSIONS: Frequent consumption of healthy food items is associated with low level of burnout symptoms. Our results emphasize the importance of diverse and balanced healthy diet to promote work well-being.


Assuntos
Esgotamento Profissional/prevenção & controle , Dieta Saudável , Saúde do Trabalhador , Setor Público , Comportamento de Redução do Risco , Saúde da Mulher , Adulto , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/epidemiologia , Estudos Transversais , Feminino , Finlândia/epidemiologia , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Valor Nutritivo , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Fatores Sexuais
13.
Cien Saude Colet ; 26(8): 3031-3040, 2021 Aug.
Artigo em Português | MEDLINE | ID: mdl-34378695

RESUMO

Mothers of children with CZS face exceptional challenges caring for their offspring. Due to this reality, the availability of social support can function as an important protective factor. In this respect, this study aimed to evaluate the role of informal and formal social support in mental health, parental self-efficacy and satisfaction in the life of mothers of children with CZS. A total of 69 mothers of children with CZS (M = 26.4 years; SD = 6.23) living in the state of Ceará, Brazil participated in this study. They filled out the Social Support Satisfaction Scale, General Health Questionnaire, Parental Self-efficacy Scale and Satisfaction with Life Scale. The results show that the greater perception of informal social support significantly enables better mental health and satisfaction with life levels. In addition, access to formal social support significantly enables enhanced perception of parental self-efficacy. The results observed with the mothers of children with CZS are consistent with those reported in other studies with mothers of children with chronic conditions, pointing out that formal and informal social support have different effects on mental health, parental self-efficacy, and satisfaction with life, even controlling the effect of sociodemographic variables.


Assuntos
Infecção por Zika virus , Zika virus , Brasil , Criança , Feminino , Humanos , Mães , Fatores de Proteção , Apoio Social
14.
Artigo em Inglês | MEDLINE | ID: mdl-34360488

RESUMO

There seems to be a broad consensus that there is a positive correlation between resilience and sport performance. However, different studies show divergent results on the role played by certain variables in this relationship. This study aimed to analyze the possible relationships between resilience levels and the practiced sport according to gender, age, and competitive level of the athletes in 1047 competitive athletes from five different sports (handball, basketball, volleyball, athletics, and judo). Resilience was assessed with the Spanish version of the Brief Resilience Scale (BRS). Results of independent samples t-tests or analysis of variance (ANOVA) showed no significant differences on the level of resilience according to the practiced sport or the competitive level. However, the analyses of covariance (ANCOVA) showed that they were related to the gender and age of the athletes, being higher in males than in females, and there was a positive correlation with age. These results seem to suggest the convenience of using differentiated strategies, according to gender and age, when working on all those protective factors that could allow the athlete to perform better when facing adversity in the competitive environment.


Assuntos
Basquetebol , Artes Marciais , Voleibol , Atletas , Feminino , Humanos , Masculino , Fatores de Proteção
15.
Transl Psychiatry ; 11(1): 392, 2021 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-34282129

RESUMO

The COVID-19 pandemic and resulting measures can be regarded as a global stressor. Cross-sectional studies showed rather negative impacts on people's mental health, while longitudinal studies considering pre-lockdown data are still scarce. The present study investigated the impact of COVID-19 related lockdown measures in a longitudinal German sample, assessed since 2017. During lockdown, 523 participants completed additional weekly online questionnaires on e.g., mental health, COVID-19-related and general stressor exposure. Predictors for and distinct trajectories of mental health outcomes were determined, using multilevel models and latent growth mixture models, respectively. Positive pandemic appraisal, social support, and adaptive cognitive emotion regulation were positively, whereas perceived stress, daily hassles, and feeling lonely negatively related to mental health outcomes in the entire sample. Three subgroups ("recovered," 9.0%; "resilient," 82.6%; "delayed dysfunction," 8.4%) with different mental health responses to initial lockdown measures were identified. Subgroups differed in perceived stress and COVID-19-specific positive appraisal. Although most participants remained mentally healthy, as observed in the resilient group, we also observed inter-individual differences. Participants' psychological state deteriorated over time in the delayed dysfunction group, putting them at risk for mental disorder development. Consequently, health services should especially identify and allocate resources to vulnerable individuals.


Assuntos
COVID-19 , Saúde Mental , Controle de Doenças Transmissíveis , Estudos Transversais , Alemanha/epidemiologia , Humanos , Pandemias , Fatores de Proteção , SARS-CoV-2
16.
Transl Psychiatry ; 11(1): 359, 2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34226500

RESUMO

Posttraumatic stress (PTS), depressive symptoms (DS), and musculoskeletal pain (MSP) are common sequelae of trauma exposure. Although these adverse posttraumatic neuropsychiatric sequelae (APNS) are often studied separately, clinical comorbidity is high. In a cohort of European American motor vehicle collision (MVC) trauma survivors (n = 781), substantial PTS (≥33, IES-R), DS (≥26, CES-D), and MSP (≥4, 0-10 NRS) were identified via a 6-month survey. Genetic risk was estimated using polygenic risk scores (PRSs) calculated from the largest available GWAS datasets of PTSD, MDD, and back pain. We then assessed comorbidity and genetic risk influence for developing chronic PTS, DS, and MSP after MVC. Secondary analyses explored whether common social determinants of health ameliorate genetic vulnerability. We found that 6 months after MVC, nearly half 357/781 (46%) of the participants had substantial PTS, DS, and/or MSP, and overlap was common (PTS + MSP (23%), DS + MSP (18%), PTS + DS (12%)). Genetic risk predicted post-MVC outcomes. PTSD-PRSs predicted PTS and DS (R2 = 2.21% and 2.77%, padj < 0.01), MDD-PRSs predicted DS and MSP (R2 = 1.89%, padj < 0.01) and 0.79%, padj < 0.05), and back pain-PRS predicted MSP (R2 = 1.49%, padj < 0.01). Individuals in the highest quintile of PTSD-PRSs had 2.8 and 3.5 times the odds of developing PTS and DS vs. the lowest quintile (95% CI = 1.39-5.75 and 1.58-7.76). Among these high-risk individuals, those living in non-disadvantaged neighborhoods and with college education had 47% (p = 0.048) and 52% (p = 0.04) less risk of developing PTS, and those with high social support had 60% (p = 0.008) less risk of developing DS. Overall, genetic factors influence the risk of APNS after MVC, genetic risk of distinct APNS are overlapping, and specific social determinants greatly augment genetic risk of APNS development after MVC.


Assuntos
Dor Crônica , Transtornos de Estresse Pós-Traumáticos , Dor Crônica/genética , Depressão , Humanos , Veículos Automotores , Fatores de Proteção , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/genética
17.
Front Endocrinol (Lausanne) ; 12: 665134, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34248841

RESUMO

Introduction: Neuropilin-1(NRP1) is a cofactor that enhances SARS-CoV-2 coronavirus cell infectivity when co-expressed with angiotensin-converting enzyme 2(ACE2). The Renin-Angiotensin System (RAS) is activated in type 2 diabetes (T2D); therefore, the aim of this study was to determine if hypoglycaemia-induced stress in T2D would potentiate serum NRP1(sNRP1) levels, reflecting an increased risk for SARS-CoV-2 infection. Methods: A case-control study of aged-matched T2D (n = 23) and control (n = 23) subjects who underwent a hyperinsulinemic clamp over 1-hour to hypoglycemia(<40mg/dl) with subsequent timecourse of 4-hours and 24-hours. Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement determined RAS-related proteins: renin (REN), angiotensinogen (AGT), ACE2, soluble NRP1(sNRP1), NRP1 ligands (Vascular endothelial growth factor, VEGF and Class 3 Semaphorins, SEM3A) and NRP1 proteolytic enzyme (A Disintegrin and Metalloproteinase 9, ADAM9). Results: Baseline RAS overactivity was present with REN elevated and AGT decreased in T2D (p<0.05); ACE2 was unchanged. Baseline sNRP1, VEGF and ADAM9 did not differ between T2D and controls and remained unchanged in response to hypoglycaemia. However, 4-hours post-hypoglycemia, sNRP1, VEGF and ADAM9 were elevated in T2D(p<0.05). SEMA3A was not different at baseline; at hypoglycemia, SEMA3A decreased in controls only. Post-hypoglycemia, SEMA3A levels were higher in T2D versus controls. sNRP1 did not correlate with ACE2, REN or AGT. T2D subjects stratified according to ACE inhibitor (ACEi) therapies showed no difference in sNRP1 levels at either glucose normalization or hypoglycaemia. Conclusion: Hypoglycemia potentiated both plasma sNRP1 level elevation and its ligands VEGF and SEMA3A, likely through an ADAM9-mediated mechanism that was not associated with RAS overactivity or ACEi therapy; however, whether this is protective or promotes increased risk for SARS-CoV-2 infection in T2D is unclear. Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT03102801.


Assuntos
Proteínas ADAM/metabolismo , Enzima de Conversão de Angiotensina 2/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Hipoglicemia/metabolismo , Proteínas de Membrana/metabolismo , Neuropilina-1/metabolismo , Semaforina-3A/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Idoso , Angiotensinas/metabolismo , COVID-19 , Feminino , Técnica Clamp de Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Renina/metabolismo , Fatores de Risco , SARS-CoV-2
18.
Med Hypotheses ; 153: 110641, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34256245

RESUMO

While previous viral pandemics showed that pregnancy was a risk factor for susceptibility and adverse outcomes, current evidence is conflicting whether SARS-CoV-2 infection during pregnancy is more severe than in the general population, with relatively low maternal and fetal/neonatal mortality rates. SARS-CoV-2 is known to enter host cells via the ACE-2 receptors, competitively occupying their binding sites. In theory, viral invasion can lead to a reduction in available ACE-2 receptors and consequently an unbalanced regulation between the ACE-AngII-AT1 axis and the ACE-2-Ang-(1-7)-MAS axis, thus enhancing pathological vasoconstriction, fibrosis, inflammation and thrombotic processes. We hypothesize that the normal pregnant state of highly expressed ACE-2 receptors leads to higher Ang-(1-7) levels and consequently more vasodilation and anti-inflammatory response to SARS-COV-2 infection. We suggest that this up-regulation of ACE-2 receptors in human gestation may actually be clinically protective and propose a potential research line to investigate this hypothesis, which may lead to future novel therapeutics.


Assuntos
COVID-19 , SARS-CoV-2 , Feminino , Humanos , Recém-Nascido , Pandemias , Gravidez , Fatores de Proteção , Fatores de Risco
20.
Ann Clin Transl Neurol ; 8(8): 1738-1744, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34240579

RESUMO

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39-3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18-0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon.


Assuntos
Anticorpos Monoclonais Humanizados/farmacologia , COVID-19/fisiopatologia , Fatores Imunológicos/farmacologia , Interferons/farmacologia , Esclerose Múltipla/tratamento farmacológico , Rituximab/farmacologia , Adulto , Anticorpos Monoclonais Humanizados/efeitos adversos , COVID-19/epidemiologia , Feminino , França/epidemiologia , Humanos , Fatores Imunológicos/efeitos adversos , Interferons/efeitos adversos , Itália/epidemiologia , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Análise Multivariada , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco , Rituximab/efeitos adversos , Índice de Gravidade de Doença
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