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The achievement of integrated care requires innovative, cross-sectoral and interdisciplinary collaboration in relation to workforce capacity and capability. Such collaboration can be furthered by collaborative, participatory health research in which people in the field under study and university researchers co-produce knowledge across different epistemologies and institutional contexts. However, co-producing knowledge across different knowledge forms and institutions faces challenges rooted in tensions. The tensions arise in the complex relational work which collaboration across disciplines and institutions necessitates. This paper is based on the assumption that critical, reflexive analysis of these tensions can further develop innovative collaboration and, in so doing, enhance workforce capacity and capability in relation to integrated care. Our research question is as follows: In collaborative research practices across institutions, how do different knowledge forms come into play, what tensions arise and with what implications for the enhancement of workforce capacity and capability in relation to integrated care?" We address this question through critical, reflexive analysis of a collective research project designed to enhance workforce capacity and capability, and more specifically, the recruitment and retention of nurses. The main collaborative research partners are junior and senior researchers from the Region Zealand and Roskilde University, including professors, associate professors, Ph.D. students and a Postdoc. The collective project consists of the following collaborative, participatory sub-projects: 1) conflict de-escalation in hospitals (Ph.D.) 2) nurses' workplace environment and satisfaction (Ph.D.) 3) nurses' choice of specialisation (Postdoc). Theoretically, our analysis draws on dialogic communication theory, Foucauldian poststructuralist theory and Bennett and Brunner (2020: 2)'s concept of a 'buffer zone': a "dynamic, contextual space and set of practices necessary to undertake collaborative research within contemporary, complex arrangements". Using the methods of discourse analysis, we analyse the following data: advertisements for the doctoral and postdoctoral posts; policy documents about the recruitment and retention of nurses; audio recordings of meetings between the collaborative research partners; email correspondence between the partners. The analysis provides insight into the tensions that arise in struggles for legitimacy across conflicting understandings of "co-production" and "intended outcomes". One main tension arises between an orientation towards outcomes designed to generate innovative solutions to complex problems and an orientation towards processes designed to provide a strong foundation for dialogic learning across difference. An orientation towards outcomes carries the risks of overly instrumentalizing co-production and reproducing the existing hierarchy of power and knowledge. An orientation towards research processes of dialogic learning and caring can face difficulties in meeting the criteria for "evidence" that dominate the practice and research fields and finding a constructive course of action leading to practice change. In conclusion, we expand on how the approach to critical-reflexive analysis illustrated in the paper represents a strategy for furthering the innovative collaboration, which enhances workforce capability and capacity and is at the core of people-centred integrated care. [ABSTRACT FROM AUTHOR]

The article discusses International Psychoanalytical Association (IPA) Congress Buenos Aires 2017: Intimacy, primitive communication, the psychoanalytic communication panel held in 2017 which was presented by Anna Ferruta, Ema Ponce de León and Régine Prat and chaired by René Roussillon. Topics discussed include tension allows an encounter directed by an imperative of proximity and empathic authenticity while maintaining a differentiation of subjects and exasperated reaction of young people.

Introduction: Depression, a worldwide spread mental health issue, entails enduring emotions of sadness, and a diminished interest in previously enjoyable activities. It can lead to physiological changes in the body contributing to cardiovascular problems. Chronic stress associated with depression can lead to increased levels of cortisol, having adverse effects on the cardiovascular system, as increased inflammation and arterial damage, potentially leading to a myocardial infarction. Case Report: This paper presents the case of a 51-year-old active male pacient without any major cardiovascular risk factors. He presented an important episode of depression in the recent past and reported a high stress level at his job. He was admitted in the Emergency Room with important retrosternal started 3 hours prior the admission. Upon investigations, the ECG revealed a 2-5 mm ST elevation in V1-V6, D1, aVL territories sugessting an antero-extensive ST-elevation myocardial infarction (STEMI). Transthoracic echography showed a left ventricular ejection fraction of 25-30%. Coronarography highlighted a distal occlusion in the left coronary artery, prompting angioplasty with two active pharmaceutical stents. The circumflex artery was passed by a balance middle weight guidewire (BMW guide) and the pre-stenosis dilatation was performed with a 1.5/15 balloon, resulting in the revascularization of the left anterior descending and the circumflex arteries. The left ventriculary artery and the left anterior descending artery were angioplastied with pharmaceutical active Onyx 3.5/30 stent. Proximal optimisation technique (POT) was executed on the left ventricular artery with a NC 5/15 mm balloon, followed by kissing with the left ventriculary artery and circumflex artery balloons with good angiographic outcomes. During the procedure the patient experienced an episode of ventricular tachycardia requiring electrical cardioversion. Under double antiplatelet, anticoagulant, beta-blocker, statine, antialdosteronic, diuretic therapy, the patient showed satisfactory progress in the intensive care unit with no recurrence of angina or arrhythmias. Discussions : Similarly, in the military context, a soldier may face significant stressors. These can lead to mental health issues, including depression, which can have implications for cardiovascular health. The demanding nature of military service, combined with exposure to high-stress environments, result in physiological changes similar to those seen in depression, potentially increasing the risk of cardiovascular events like myocardial infarction. Conclusions: By acknowledging the relationship between stress, depression, and cardiovascular health, healthcare providers can optimize outcomes and improve overall quality of life for individuals affected by these conditions, whether in civilian or military populations. [ABSTRACT FROM AUTHOR]

Background: Stress can cause a significant impact on social and occupational participation to the extent that is significant clinically. This study thus aims to verify any correlation among self-reported mindfulness, perceived stress, and psychological well-being among individuals in intimacy versus isolation (19-40 years) and generativity versus stagnation (40-65 years) stage of Erick Erikson's classification of development. Objectives: (1) To measure psychological well-being, mindfulness, and perceived stress in people from the two developmental stages. (2) To study the correlation between psychological factors (the six dimensions of psychological well-being and mindfulness) with stress in each group. (3) To compare between these two developmental stages and the relationship between psychological factors and stress. Study Design: This is a cross-sectional study. Methods: Males and females belonging to intimacy versus isolation (19-40 years) and generativity versus stagnation (40-65 years) stage of Erick Erikson's classification of development were included in the study. Paper-based version of perceived stress scale, mindful attention awareness scale (MAAS), and Ryff's psychological well-being scale were administered. The scores of perceived stress scale, MAAS, and Ryff's psychological well-being were compared. Results: individuals belonging to the intimacy versus isolation stage showed higher scores on stress and lower scores on mindfulness as compared to individuals in generativity versus stagnation (40-65 years) stage of development. Conclusions: Individuals who are more mindful experience less stress. Thus, practicing mindfulness can help deal with stress. [ABSTRACT FROM AUTHOR]

Background Suicide is serious health issue and frequently one of the leading causes of death around the world. Suicidal behavior has three stages—ideation, attempt and completion. Since suicide ideation (SI) predicts attempt, it is an important indicator that has been extensively investigated. Studies have found childhood trauma and various forms of stress as robust risk factors for suicide ideation and behavior. However, to our knowledge, there has not been a direct comparison of childhood trauma and stress that would determine if one has a greater effect on current SI than the other. For our study, the goal is to identify whether childhood trauma affects current ideation in people that are presently experiencing stress. Methods A total of 163 participants were selected from an existing schizophrenia database. All were previously interviewed and completed the Childhood Trauma Questionnaire (CTQ), the Columbia-Suicide Severity Rating Scale (CSSRS), and the Holmes and Rahe Stress Scale (HR) during a one-time cross-sectional assessment. The CSSRS was administered for scoring suicidal ideation in the last month. The CTQ was administered to assess the history of childhood trauma and HR was used to assess stressful life events in the last three months. Data analysis was performed to assess whether the presence of traumatic experiences in childhood and current stress interact in conferring risk for current suicidal ideation. Results There was no significant interaction (p>0.05) between childhood trauma and recent stress in conferring risk for current suicidal ideation. Discussion Even though, we could not prove any additive effect of childhood trauma and recent stressful events in conferring risk for current suicidal ideation in our sample, the development of predictive algorithms that combine proximal and distal stressful events can improve the assessment of psychotic patients at risk of suicide. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Growing evidence indicates that individual differences in attachment style are related to health outcomes. The present study extends this literature by examining whether attachment anxiety in both mothers and fathers predicts maternal health the year following the birth of a child in a sample of 698 low-income, racially diverse couples. We hypothesized that maternal perceptions of partner responsiveness would mediate these associations. Maternal allostatic load, a measure of cumulative wear-and-tear on the body due to stress, was used as an indicator of maternal health. Maternal biomarkers (blood pressure, adiposity, blood metabolites, inflammation, and diurnal cortisol) were scored using clinical or top-quartile cutoffs to compute an allostatic load index. Attachment anxiety and perceived partner responsiveness were assessed in interviews. Path models were used to test indirect associations between mother and father attachment anxiety and maternal allostatic load through perceived partner responsiveness. We found that higher mother and father attachment anxiety were each independently and indirectly associated with higher maternal allostatic load through lower maternal perceptions of partner responsiveness. These findings highlight the need to consider both relationship and partner factors in understanding maternal health. [ABSTRACT FROM AUTHOR]

Prior studies using exploratory factor analysis provide evidence that negative symptoms are best conceptualized as 2 dimensions reflecting diminished motivation and expression. However, the 2-dimensional model has yet to be evaluated using more complex mathematical techniques capable of testing structure. In the current study, network analysis was applied to evaluate the latent structure of negative symptoms using a community-detection algorithm. Two studies were conducted that included outpatients with schizophrenia (SZ; Study 1: n = 201; Study 2: n = 912) who were rated on the Brief Negative Symptom Scale (BNSS). In both studies, network analysis indicated that the 13 BNSS items divided into 6 negative symptom domains consisting of anhedonia, avolition, asociality, blunted affect, alogia, and lack of normal distress. Separation of these domains was statistically significant with reference to a null model of randomized networks. There has been a recent trend toward conceptualizing the latent structure of negative symptoms in relation to 2 distinct dimensions reflecting diminished expression and motivation. However, the current results obtained using network analysis suggest that the 2-dimensional conceptualization is not complex enough to capture the nature of the negative symptom construct. Similar to recent confirmatory factor analysis studies, network analysis revealed that the latent structure of negative symptom is best conceptualized in relation to the 5 domains identified in the 2005 National Institute of Mental Health consensus development conference (anhedonia, avolition, asociality, blunted affect, and alogia) and potentially a sixth domain consisting of lack of normal distress. Findings have implications for identifying pathophysiological mechanisms and targeted treatments. [ABSTRACT FROM AUTHOR]

Background: Many studies conducted in this area shows that parents of children with disabilities experience a higher level of stress compared to children with typical development (Sanders and Morgan, 1997). Objectives: The primary aim of the study is to determine the amount of stress among parents of children with different types of developmental disabilities and to assess the need of stress management among parents of children with special needs. Methods: Consent from parents was taken; Parental Stress Scale was administered on 140 parents in the language of their choice: English, Hindi, and Marathi. Study Design: This was a cross-sectional survey. Results: There was a statistically nonsignificant difference seen for the values between the groups (P > 0.05) of different developmental disabilities for total Parental Stress Scale also there was no significant correlation between the age of the parents and level of stress. We also found a statistically highly significant difference for the values between the groups (P < 0.01) for age of the child, with higher values in group children with disabilities. Conclusion: Parents with special needs children are at more risk of stress and it is very important to address the stress and timely refer it for stress management and in severe cases, it should be referred to the psychiatric clinic. [ABSTRACT FROM AUTHOR]

Purpose The purpose of the study is to examine the differences in family caregivers' burden based on the usage of caring device such as bed for preventing bedsore, wheelchair, electric wheelchair etc., and the predictive factors (caregiver age, educational level, daily care time, satisfaction on interactive relationship between caregiver and care-recipient, and perceived stress) of care burden in informal caregivers of people with disability in Korea. Methods A cross-sectional survey study design was used through either telephone interview or self-report using Google form with family caregivers of people with severe disability. Data were collected from December, 2021 to Feb. 2022. A convenience sample of 103 family caregivers were included if they were giving care to people with severe disability who were older than 19 years old and had disability level 1-3, and needed lots of help from others, demonstrating difficulties in performing ADLs by themselves. Measurements were included Zarit Burden Interview- Korean version (Lee et al., 2004; Zarit et al., 1980), Barthel ADL Index (Collin et al., 1988, Kim et al., 2004), and Korean version of perceived stress scale (Hong et al., 2016). Data were analyzed using Pearson's correlation and hierarchical moderated regression analysis. Results and Discussion Mean age and educational level of the participants were 51.39 years old (SD = 8.64, range = 19 - 72) and 14.37 year (SD = 2.52, range = 6 - 20), respectively. Family members using care objects were significantly low on care burden (t = 3.32, p = .001). Longer daily care time (r=.37, p<.001), lower satisfaction on interactive relationship (r=-.28, p<.001), and higher stress (r=.58, p<.001) were related to higher care burden. With hierarchical multiple regression, perceived stress (Beta = .49, p = .000) was the strongest predictor on caregiver burden, followed by satisfaction on interactive relationship (Beta = -.19, p = .000). Although the variable of usage care device predicted on care burden significantly, it was not that strong predictor on care burden. Future research is suggested to increase sample size, and use detail questions on types of care device and care technology including care robot. Considering in increases in number of disabled older adults, it would be necessary to develop and apply technologies in caring based on personal needs. [ABSTRACT FROM AUTHOR]

Copyright of Academic Emergency Medicine is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings. [ABSTRACT FROM AUTHOR]

As a consequence, stress-induced illnesses are further on the rise and new advances in the field of stress research are dearly needed. The authors propose that the stress response is continuously fine-tuned by neuronal activity, shaping the diversity of stress responses based on prior experience. [Extracted from the article]

Background The context of coronavirus on higher education caused upsetting consequences on students' lives. The restrictions on social mobility and the consequent reduction of interpersonal contacts brought them unprecedented stressful situations. The extent and quality of adaptation to these situations, due to the uniqueness of each person's resources, needs to be early known preventing eventual and serious psychological disorders. This study aimed to assess stress, anxiety, and depression among undergraduate students from both Santarém and Leiria Polytechnic Institutes. Methods A descriptive cross-sectional correlational study was performed in the period immediately after the first lockdown. Participants were 775 students (females = 73.5%), aged between 17 and 55 years. All of them completed measures of the Depression Anxiety and Stress Scale-21 (DASS-21; in the Portuguese version EADS, by Pais-Ribeiro, Honrado e Leal, 2004). Collected data were analyzed with IBM SPSS Statistics for Windows software, Version 27.0. Results According to DASS-21 scoring instructions (Lovibond & Lovibond, 1995), results showed that most participants had experienced a normal level of depression (72.5%), anxiety (79.7%) and stress (87.6%). However, about 4.7% and 1.8% of respondents, respectively, report a severe or extremely severe level of anxiety or depression. We also found significant differences for the three dimensions in terms of polytechnic institute attended, gender, age categories, and marital status. Conclusions The findings suggest that higher education institutions must understand this phenomenon experienced and develop strategies for improving students' mental health, especially in vulnerable groups. The importance of a transdisciplinary approach is emphasized and the involvement of all educational stakeholders is encouraged. [ABSTRACT FROM AUTHOR]

Background Suicide is the leading cause of premature death among those with schizophrenia (Palmer, Pankratz, & Bostwick, 2005). However, it is unclear what places someone at high risk of suicide. Given the difficulties of living with schizophrenia, many individuals rely on family for assistance with housing, food, and other critical needs (National Alliance on Mental Illness, 2018). Moreover, family members are often individuals' sole source of emotional support (Awad & Voruganti, 2008). Thus, family members are vital to the lives and functioning of those with schizophrenia. Indeed, greater family cohesion has been associated with lower psychiatric symptom severity in patients with schizophrenia (Weisman, Rosales, Kymalainen, & Armesto, 2005). Similarly, perceived family cohesion was found to be protective against suicidal attempts in non-clinical samples (Borowsky, Ireland, & Resnick, 2001). However, no research has assessed the relationship between suicidal ideation and family cohesion in schizophrenia. Additionally, given how disabling schizophrenia can be, becoming aware of one's limitations may be dismaying and lead to suicidal ideation. Crumlish and colleagues (2005) found that greater insight at 6 months predicted suicide attempts in individuals with schizophrenia 4 years later. Therefore, the present study assesses whether patient's perceptions of family cohesion and cognitive insight are associated with suicidal ideation. It is hypothesized that lower levels of family cohesion and greater insight will predict greater endorsement of suicidal ideation, and these effects will be mediated by depression, anxiety, and stress. Methods Individuals with schizophrenia (N = 120) were assessed using the family cohesion index (FC) of the Family Environment Scale (Moos & Moos, 1994), the suicidal ideation (SI) item (1–7 Likert rating) from the Brief Psychiatric Rating Scale (Ventura, Lukoff, Nuechterlein, Liberman, Green, & Shaner, 1993), Beck's Cognitive Insight Scale (CI; Beck, et al. 2004), and the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995). Participants were, on average, 40.3 years old (SD = 15.75), male (62.5%), and Hispanic (48.3%, Caucasian=17.5%, Black=27.5%, Other=2.5%, missing=4.2%). Results As expected, significant relationships were found between SI and FC (r = -.22, p =.02), SI and CI (r =.26, p =.02), SI and DASS (r =.43, p <.001), and FC and DASS (r = -.41, p <.001). CI was not significantly correlated with DASS (r =.17, p =.15) nor FC (r =.12, p =.33). A mediation model was assessed in which SI was regressed on FC and DASS and DASS was regressed on FC. Additionally, SI was regressed on CI. Increases in observed DASS (depression: b =.02, SE =.004, p <.001), cognitive insight (b =.06, SE =.02, p =.02), and decreases in family cohesion (b = -.14, SE =.06, p =.02) were all significantly associated with a greater likelihood of suicidal ideation. Moreover, a Sobel test of mediation revealed a significant indirect effect from FC to SI, through DASS (Sobel = 3.24, SE =.03, p =.001). Discussion Family cohesion may be protective for individuals with schizophrenia, or, stated differently, weaker family cohesion may be a stressor, exacerbating suicidal ideation through increased depression, anxiety, and stress. Insight also played an important role, with more insightful individuals endorsing greater suicidal ideation. Individuals who are more aware of their disorder and limitations are at greater risk for suicidal ideation. It is important to note that both insight and family cohesion independently predicted suicidal ideation. Study findings suggest that interventions aimed at increasing family cohesion and revamping detrimental attributions resulting from greater insight may be warranted. [ABSTRACT FROM AUTHOR]

Background: In lower to middle income countries (LMIC), the influences of environmental stress on neurobiological processes involved in the development of schizophrenia is of great importance. High levels of stress may contribute to an increased burden of schizophrenia, including profound functional impairment and disability, decreased productivity, and even elevated mortality. Stress in Schizophrenia has been associated with behavioral disturbances such as maladaptive coping styles as well as well-established physiological abnormalities in sensorimotor gating in the form of abnormal startle responses. In turn, childhood trauma exposure is known to affect physiological stress responses. Indeed, we have found childhood trauma to be associated with both white matter and hippocampal changes in schizophrenia. Few studies, however, have explored the relationship between Childhood trauma and stress responses in schizophrenia. In recent years Virtual Reality (VR) has undergone a resurgence as a viable method for studying fear related physiological stress responses in an ecologically valid manner. Here we aim to investigate the potential relationship between abnormal physiological stress responses in schizophrenia with early life adversity. Methods: Physiological response data were collected while participants completed a VR paradigm based on the Trier stress test, a well-established social stressor that reliably elicits a stress response in participants in VR and HPA axis attenuation in schizophrenia. Data were also collected in a fear of heights environment, not associated with abnormalities in schizophrenia. Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). HPA axis stress responses during the course of the task were assessed using saliva cortisol samples collected at key points during the paradigms. Results: Preliminary data of both the social anxiety and fear of heights scenario will be presented. We will focus specifically on the viability of using VR in a LMIC context. Discussion: VR could prove to be a cost-effective tool to explore the relationship between childhood trauma, stress sensitivity and schizophrenia. [ABSTRACT FROM AUTHOR]