The causative factors of psychological distress and mental ill-health among ICU nurses during the pandemic.

The coronavirus disease (COVID-19) pandemic had a global impact on health systems and health professionals. Nurses, particularly those working in intensive care units (ICUs), held a central critical role in the care of COVID-19 patients, facing numerous challenges in the delivery of care, leading to significant psychological and mental health issues. This article reports on findings from a qualitative narrative review of the literature related to psychological ill-being and mental health of ICU nurses' during the pandemic. Four key themes emerged: (1) isolation (2) workload (3) clinical preparedness and lack of protocols and (4) fear.

Comparative familial aggregation of bipolar disorder in patients with bipolar I and bipolar II disorders.

OBJECTIVE: We sought to quantify the prevalence and differential prevalence of a bipolar disorder among family members of patients with a bipolar I or II disorder. METHODS: The sample comprised 1165 bipolar and 1041 unipolar patients, with the former then sub-typed as having either a bipolar I or II condition. Family history data was obtained via an online self-report tool. RESULTS: Prevalence of a family member having a bipolar disorder (of either sub-type) was distinctive (36.8%). Patients with a bipolar I disorder reported a slightly higher family history (41.2%) compared to patients with a bipolar II disorder (36.3%), and with both significantly higher than the rate of bipolar disorder in family members of unipolar depressed patients (18.5%). CONCLUSIONS: Findings support the view that bipolar disorder is heritable. The comparable rates in the two bipolar sub-types support the positioning of bipolar II disorder as a valid condition with strong genetic underpinnings.

Clinical Characteristics Associated With Treatment-Resistant Bipolar Disorder.

There has been limited consideration and empirical studies on treatment-resistant bipolar disorder (TRBD). This exploratory study was designed to identify factors contributing to TRBD in patients with a bipolar (I or II) disorder. Patients were categorized with "low," "medium," or "high" levels of treatment resistance based on a) the total number of psychiatric medications received and, for a second analysis, b) the number of mood stabilizer medications received. The study identified a number of factors associated with TRBD, such as being female and older and having an older age at illness onset, a higher incidences of family depression, less likelihood of being in paid employment, a higher number of lifetime stressors, medical conditions and comorbid anxiety disorders, a different personality and temperament profile, and more regular use of benzodiazepines. There were few factors associated with TRBD when defined by number of mood stabilizers trialed. Potential explanations for these findings were explored.

Parenting Behaviors, Parent Heart Rate Variability, and Their Associations with Adolescent Heart Rate Variability.

Adolescence is a potentially important time in the development of emotion regulation and parenting behaviors may play a role. We examined associations among parenting behaviors, parent resting heart rate variability, adolescent resting heart rate variability and parenting behaviors as moderators of the association between parent and adolescent resting heart rate variability. Ninety-seven youth (11-17 years; 49.5 % female; 34 % African American, 37.1 % Euro-American, 22.6 % other/mixed ethnic background, and 7.2 % Hispanic) and their parents (n = 81) completed a physiological assessment and questionnaires assessing parenting behaviors. Inconsistent discipline and corporal punishment were negatively associated with adolescent resting heart rate variability, while positive parenting and parental involvement were positively associated. Inconsistent discipline and parental involvement moderated the relationship between parent and adolescent resting heart rate variability. The findings provide evidence for a role of parenting behaviors in shaping the development of adolescent resting heart rate variability with inconsistent discipline and parental involvement potentially influencing the entrainment of resting heart rate variability in parents and their children.

Trends in the diagnosis of bipolar disorder: Has the story changed?

OBJECTIVE: A recent study reported an 8% increase in bipolar diagnoses in public and community mental health services in New South Wales from 2003 to 2014, an increase interpreted by the authors as reflecting increasing diagnostic boundaries of bipolar disorder, and bipolar II in particular. If valid, we would expect an increase in hospital admissions for hypomania as well as for mania and so analysed a relevant dataset to test that hypothesis. METHODS: Data were examined for 27,255 individuals hospitalised in NSW psychiatric hospitals over a 14-year period (2000-2014) for ICD-10 diagnosed mania or hypomania and with analyses examining rates of hospitalisation/per year for both mania and for hypomania. RESULTS: While overall admissions for mania and hypomania increased over the study period by 16.4%, admissions for mania increased by 31.0% and admissions for hypomania actually decreased by 32.1%. CONCLUSION: The increased rate in admissions of those with a bipolar disorder appears to reflect a trend over more than four decades. The hypothesis that any increase in the diagnostic boundaries of bipolar II disorder would be associated with an increase in hospitalisation rates was rejected, with the converse trend being identified.

Agreement in Youth-Parent Perceptions of Parenting Behaviors: A Case for Testing Measurement Invariance in Reporter Discrepancy Research.

While conventional wisdom suggests that parents and their adolescent offspring will often disagree, the nature of discrepancies in informant reports of parenting behaviors is still unclear. This article suggests testing measurement invariance in an effort to clarify if discrepancies in informant scores reflect true differences in perspectives on the same construct, or if the instrument is simply not measuring the same construct across parents and youth. The study provides an example by examining invariance and discrepancy across child, adolescent, and parent reports on the Alabama Parenting Questionnaire. The sample for this study was 255 youth (51.4 % male) aged 6-17 years (M age  = 12.3 years) and an accompanying parent. A five-factor model of the measure was found to provide approximately equivalent measurement across four participant groups (children under 12 years, adolescents aged 12-18 years, and parents of each group, respectively). Latent mean levels of reported parenting constructs varied greatly across informants. Age moderated the association between reports of two subscales, Parental Involvement and Positive Parenting, such that adolescents were more consistent with parents. The findings highlight the utility of testing measurement invariance across informants prior to evaluating differences in their reports, and demonstrate the benefits of considering invariance in the larger conversation over informant discrepancies.

Developmental differences in the linkages between anxiety control beliefs and posttraumatic stress in youth.

BACKGROUND: Anxiety control beliefs have emerged as a trans-diagnostic risk factor for anxiety disorders and a potential mechanism of change in cognitive and behavioral therapies. The purpose of this study was to examine the association between anxiety control beliefs and anxiety disorder symptoms following exposure to hurricanes in youth and test a developmental hypothesis about those associations. METHODS: A large school-based sample of (N = 1048) children and adolescents with a history of exposure to natural disaster were assessed with the short form of the Anxiety Control Questionnaire for Children (ACQ-C), symptom measures (PTSD and generalized anxiety disorder symptoms) and level of disaster exposure. Developmental differences in the association between ACQ-C scores and symptoms were tested, as well as the ACQ-C's ability to assess symptoms beyond level of exposure. RESULTS: ACQ-C scores were associated with symptoms beyond level of exposure, but age moderated the strength of the association. Modeling the interaction suggested that the ACQ-C short had incremental validity beyond hurricane exposure in youth over 12 years. CONCLUSIONS: Findings extend previous work to a novel population of youth and add to the developmental understanding of the role of anxiety control beliefs in anxiety regulation. Age differences in the linkages between anxiety control and symptoms is consistent with a developmental model where low perceived control exhibited by younger children may be less indicative of problems with anxiety but may instead be related to normal cognitive development.

Health care providers' perspectives on a weekly text-messaging intervention to engage HIV-positive persons in care (WelTel BC1).

Though evidence shows that Mobile health (mHealth) interventions can improve adherence and viral load in HIV-positive persons, few have studied the health care providers' (HCP) perspective. We conducted a prospective mixed methods pilot study using the WelTel intervention wherein HIV-positive participants (n = 25) received weekly interactive text messages for 6 months. Text message response rate and topic data were collected to illustrate the HCP experience. The aim of this study is to explore intervention acceptability and feasibility from the HCP perspective through a baseline focus group and end of study interviews with HCP impacted by the intervention. Interview data were thematically coded using the Technology Acceptance Model. HCPs identified that the WelTel intervention engaged patients in building relationships, while organizing and streamlining existing mHealth efforts and dealing with privacy issues. HCPs recognized that although workload would augment initially, intervention benefits were many, and went beyond simply improving HIV viral load.

Determinants of Treatment-Resistant Depression: The Salience of Benzodiazepines.

Treatment-resistant depression (TRD) lacks consensus regarding its definition, despite being common in clinical practice. This study was designed to identify factors contributing to TRD in patients diagnosed with a major depressive disorder. Patients were grouped into "low," "medium," and "high" treatment-resistant (TR) groups based on the number of medications that had been prescribed for their depression. We identified a number of factors linked to TRD. The high TR group was generally older, had a longer depressive episode duration, a higher number of comorbid medical and anxiety disorders, a lower education, and were less likely to be in full-time employment. They also reported less trait irritability and were more likely to view medication as being a contributor to their current depression. Some differences between non-melancholic and melancholic subsets were evident and point to the benefits in research on TRD analyzing the two diagnostic groups separately. The most striking finding was benzodiazepine use, which was significantly more common in the high TR group and within both the melancholic and non-melancholic subsets. Some potential explanations for this finding are offered.

Fitting anxious emotion-focused intervention into the ecology of schools: results from a test anxiety program evaluation.

Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.

The impact of being newly diagnosed with a bipolar disorder and the short-term outcome of disorder-specific management.

OBJECTIVES: The aim of the study was to determine the impact of a first-time diagnosis of bipolar disorder in patients previously generally managed as having a unipolar disorder, and to quantify the impact of disorder-specific management strategies for such newly diagnosed patients over the following three months. METHODS: A total of 157 patients receiving a diagnosis of bipolar disorder for the first time by a psychiatrist at a specialist depression clinic completed a research interview and questionnaires, with 106 (68%) also completing 12-week quantitative and qualitative evaluations. Assessing psychiatrists undertook baseline and follow-up assessments recording management changes, reactions to the diagnosis and global changes in functioning over time. RESULTS: The majority of patients had a positive response to receiving a diagnosis of bipolar disorder, and most implemented a number of clinician-suggested bipolar management strategies. Patients showed improvement on five of the six self-report measures over the three-month study period. Multivariate analyses quantified lamotrigine as making the most distinctive contribution to 'improver' status, particularly for the bipolar II disorder subset. CONCLUSIONS: Results are encouraging in identifying a generally positive acceptance of a diagnosis of bipolar disorder, improved outcome following the introduction of diagnostic-specific management components, and a distinctive contribution of lamotrigine to improved three-month outcome.

The Lived Experience of Play and How It Relates to Psychological Wellbeing: An Interpretive Phenomenological Analysis (IPA) Study Amongst Undergraduate Students from Medicine, Nursing, and Allied Health Professions' Programmes in the United Kingdom.

Current literature acknowledges that undergraduate students undertaking programmes in medicine, nursing, and allied health professions experience occupational stress which presents as a detriment to mental health, psychological wellbeing (PWB), and burnout. Strategies to improve the wellbeing of students have been slow to embed and have had limited impact, indeed the issue of declining wellbeing amongst this group is escalating. Studies from the business literature suggest that organisations that foster a playful environment reap benefits in terms of employee wellbeing. This interpretive phenomenological analysis (IPA) study explored the lived experiences of play amongst undergraduate students from medicine, nursing, and allied health professions' programmes in the clinical practice setting. The resultant findings offer some unique empirical insights into the types of play that the students engaged in, ranging from informal banter with peers and patients to artful, sophisticated, cocreated play. The study also revealed insights about the factors which facilitate play, notably the "big personalities" on the ward. The factors which limited play are related to the tension between being a health professional and the enactment of play as well as hierarchical factors. Crucially, the study found that the practice of play induced key hedonic and eudaimonic PWB benefits to the students, ranging from positive affect to improved relationships, a sense of meaning, and a positive learning environment, offering original empirical insights. These findings have not been observed previously and shine a conceptual light on a previously unknown phenomenon.

Morphological profiling in human neural progenitor cells classifies hits in a pilot drug screen for Alzheimer's disease.

Alzheimer's disease accounts for 60-70% of dementia cases. Current treatments are inadequate and there is a need to develop new approaches to drug discovery. Recently, in cancer, morphological profiling has been used in combination with high-throughput screening of small-molecule libraries in human cells in vitro. To test feasibility of this approach for Alzheimer's disease, we developed a cell morphology-based drug screen centred on the risk gene, SORL1 (which encodes the protein SORLA). Increased Alzheimer's disease risk has been repeatedly linked to variants in SORL1, particularly those conferring loss or decreased expression of SORLA, and lower SORL1 levels are observed in post-mortem brain samples from individuals with Alzheimer's disease. Consistent with its role in the endolysosomal pathway, SORL1 deletion is associated with enlarged endosomes in neural progenitor cells and neurons. We, therefore, hypothesized that multi-parametric, image-based cell phenotyping would identify features characteristic of SORL1 deletion. An automated morphological profiling method (Cell Painting) was adapted to neural progenitor cells and used to determine the phenotypic response of SORL1-/- neural progenitor cells to treatment with compounds from a small internationally approved drug library (TargetMol, 330 compounds). We detected distinct phenotypic signatures for SORL1-/- neural progenitor cells compared to isogenic wild-type controls. Furthermore, we identified 16 compounds (representing 14 drugs) that reversed the mutant morphological signatures in neural progenitor cells derived from three SORL1-/- induced pluripotent stem cell sub-clones. Network pharmacology analysis revealed the 16 compounds belonged to five mechanistic groups: 20S proteasome, aldehyde dehydrogenase, topoisomerase I and II, and DNA synthesis inhibitors. Enrichment analysis identified DNA synthesis/damage/repair, proteases/proteasome and metabolism as key pathways/biological processes. Prediction of novel targets revealed enrichment in pathways associated with neural cell function and Alzheimer's disease. Overall, this work suggests that (i) a quantitative phenotypic metric can distinguish induced pluripotent stem cell-derived SORL1-/- neural progenitor cells from isogenic wild-type controls and (ii) phenotypic screening combined with multi-parametric high-content image analysis is a viable option for drug repurposing and discovery in this human neural cell model of Alzheimer's disease.

Beyond the baby blues: perspectives of women diagnosed with a mood disorder on children, pregnancy and medication.

OBJECTIVE: The aim of this study was to explore the views of women diagnosed with a mood disorder about children, medication and pregnancy. METHOD: Female patients from the Black Dog Institute were invited to complete a questionnaire regarding their views about pregnancy, children and medication during pregnancy. Diagnostic groupings were derived by assessing DSM-IV criteria for mood disorders. Unipolar and bipolar patient responses were analysed to determine any differences between groups. RESULTS: Women with bipolar disorder were more concerned than those with a unipolar condition about the impact pregnancy would have on their mood, as well as the potential for their offspring to inherit a mood condition. Both groups of women expressed concerns regarding the child-rearing environment, and stated that knowing the risk their child could have of developing a mood disorder would encourage them to be more vigilant parents. CONCLUSION: While both groups were concerned about the environment in which they would raise their child and wanted to be vigilant parents, women diagnosed with a bipolar condition expressed stronger opinions regarding the impact that their pregnancy could have on their mood disorder, and passing the mood disorder onto their children.

Assessing Sustainability Priorities of U.S. Food Hub Managers: Results from a National Survey.

Food hubs have emerged as innovative alternatives to the conventional United States food system. As aggregators of small local farms, food hubs hold the potential to transform food production, distribution, and consumption, while fostering environmental sustainability and social equity. However, assessing their contributions to environmental sustainability and social equity is challenging due to the diverse structures and practices of U.S. food hubs. This study presents the findings of a national survey of food hub managers conducted in 2022 to assess the sustainability objectives and practices of food hubs across the United States. Our survey questions were designed based on a comprehensive framework of social and environmental sustainability criteria. Our results reveal that food hubs make valuable contributions in supporting small producers and providing healthy local food options. However, there is room for improvement in their environmental sustainability practices, as they only meet 47% of the defined environmental sustainability goals. Addressing food insecurity is a high priority for food hubs, although not their top priority, and many offer fresh food access to low-income households. Food hubs also contribute to environmental sustainability by reducing food transportation, promoting healthy food production methods, and minimizing waste. While food hubs meet 67% of the defined social sustainability goals, there are opportunities for improvement in reaching important institutional stakeholders and enhancing consumer education on healthy nutrition and lifestyles. Expanding technical assistance for farmers is also critical. By addressing these opportunities for improvement, food hubs can drive progress towards a more resilient and equitable food system in the United States.

A cautionary note on the use of N-acetylcysteine as a reactive oxygen species antagonist to assess copper mediated cell death.

A new form of cell death has recently been proposed involving copper-induced cell death, termed cuproptosis. This new form of cell death has been widely studied in relation to a novel class of copper ionophores, including elesclomol and disulfiram. However, the exact mechanism leading to cell death remains contentious. The oldest and most widely accepted biological mechanism is that the accumulated intracellular copper leads to excessive build-up of reactive oxygen species and that this is what ultimately leads to cell death. Most of this evidence is largely based on studies using N-acetylcysteine (NAC), an antioxidant, to relieve the oxidative stress and prevent cell death. However, here we have demonstrated using inductively coupled mass-spectrometry, that NAC pretreatment significantly reduces intracellular copper uptake triggered by the ionophores, elesclomol and disulfiram, suggesting that reduction in copper uptake, rather than the antioxidant activity of NAC, is responsible for the diminished cell death. We present further data showing that key mediators of reactive oxygen species are not upregulated in response to elesclomol treatment, and further that sensitivity of cancer cell lines to reactive oxygen species does not correlate with sensitivity to these copper ionophores. Our findings are in line with several recent studies proposing the mechanism of cuproptosis is instead via copper mediated aggregation of proteins, resulting in proteotoxic stress leading to cell death. Overall, it is vital to disseminate this key piece of information regarding NAC's activity on copper uptake since new research attributing the effect of NAC on copper ionophore activity to quenching of reactive oxygen species is being published regularly and our studies suggest their conclusions may be misleading.

What to Look for in Relationships: Development, inter-rater reliability, and initial validity estimates for a young child-caregiver relationship assessment.

Introduction: Observational assessments are important for understanding a range of behaviors and emotions in the young child-caregiver relationship. This paper provides initial data on a multidimensional assessment for professionals who work with young children and their caregivers, the What to Look for in Relationships (WLR). The WLR was designed to assist providers in evaluating strengths and areas for improvement in five areas of young child-caregiver relationship dimensions. This paper reports on the development, interrater reliability, initial convergent and discriminant validity, and incremental utility of the scales. Methods: Data were collected from caregiver-child dyads, who participated in a semi-structured observational caregiver-child interaction session as part of a clinic evaluation for relationship-based therapeutic services for young children in child protection. Recorded interactions were coded using the WLR scales with 146 interactions coded by at least two independent observers for interrater reliability analyses. Results: The scales showed adequate internal consistency, good inter-rater reliability, strong convergent associations with a single dimension measure (i.e., the Parent-Infant Relationship Global Assessment Scale; PIR-GAS) and discriminated those in the clinical range from those with adaptive functioning on the PIR-GAS. Discussion: This study provides initial support for the usefulness of the WLR scales for assessing dimensions of caregiver-child relationships during early childhood that may be useful targets of intervention.

Undergraduate nursing students' experiences of online education: A cross-sectional survey.

During the coronavirus pandemic, UK Academics were required to adjust their learning and teaching environment and pedagogical approaches, with little guidance or time. Feelings of frustration and uncertainty around student engagement were commonplace across Higher Education Institutions. This was heightened in professionally regulated courses, such as nursing. The shift to online learning created a situation where academics were frequently faced with a 'sea of black screens' and unable to ascertain student engagement. This study investigated undergraduate nursing students' experience of online education during the COVID-19 pandemic. An anonymous survey was distributed to each year of the undergraduate nursing programme and data subsequently analysed. Responses from 54 students revealed that engagement varied between different year groups. There were significant differences between those with pre-COVID (traditional face-to-face) teaching experience (years 2 and 3) and those without (year 1) in regard to self-reported engagement with online learning. The findings from this study revealed some powerful and emotional insights into the experience of online learning amongst UK students undertaking an undergraduate nursing programme during the COVID-19 pandemic.

Is T.V. traumatic for all youths? The role of preexisting posttraumatic-stress symptoms in the link between disaster coverage and stress.

In youths, watching T.V. coverage of a disaster is associated with traumatic-stress symptoms. However, the role of predisaster symptoms in this link has not been addressed. In this study, urban-school youths who had experienced both Hurricanes Katrina and Gustav (N = 141; grades 4-8) were assessed 12 months and 6 months before Gustav and then 1 month after Gustav. The amount of T.V. viewing was associated with post-Gustav stress symptoms, controlling for pre-Gustav symptoms. However, pre-Gustav stress symptoms interacted with T.V. viewing in predicting post-Gustav symptoms such that for youths with higher preexisting symptoms, there was a stronger association between T.V. viewing and level of post-Gustav symptoms. The results advance the literature on the role of media coverage in stress reactions by showing that preexisting symptoms can be an important component of identifying which children are likely to be most negatively affected by TV coverage.

Identification, sequencing and molecular analysis of Chp4, a novel chlamydiaphage of Chlamydophila abortus belonging to the family Microviridae.

Members of the family Microviridae have been identified in a number of chlamydial species infecting humans (phage CPAR39 in Chlamydophila pneumoniae), other mammals (φCPG1 in Chlamydophila caviae, Chp2 in Chlamydophila abortus and Chp3 in Chlamydophila pecorum) and birds (Chp1 in Chlamydophila psittaci). This study describes the identification and genome sequencing of Chp4, an icosahedral, 4530 bp, ssDNA phage in C. abortus. Chp4 is predicted to contain eight ORFs, six of which could be assigned putative functions based on sequence similarity to characterized bacteriophage. Gene order and content were highly conserved amongst chlamydiaphage, with the highest sequence variability occurring in the IN5 and INS variable regions of the VP1 major coat protein, which has been associated with host cell recognition and binding. Phylogenetic analysis of VP1 indicated that Chp4 is a member of the Chlamydiamicrovirus, and is most closely related to phage φCPG1 and CPAR39.