The Psychological Aspect of Polypharmacy in Patients with Chronic Diseases. A Case Control Study about The Impact of Polypharmacy Regime Amongst Patients in Kurdistan Region of Iraq.

Background:Patients on Polypharmacy regime due to having a chronic illness are at a higher risk of developing some form of negative psychological outcome as a result of their disease. This study aims to determine the impact of polypharmacy on the psychological aspects of a patient living with a chronic disease.Method:A case-control study conducted amongst patients in an outpatient clinic of an Internist (July 1st to September 1st, of 2021) in the city of Erbil, Iraq. Data was extracted from a self-assessed questioner. 200 participants were divided into polypharmacy (case group) and non-polypharmacy group (control group). Polypharmacy, being defined as the use of 5 or more medication which meant that participants in the case group must fit into these criteria. A ‘Hospital Anxiety and Depression Scale’ (HADS) was used to determine the presence of symptoms of depression and/or anxiety.Results:A totally of 200 patients were included in the study. Of these 100 participants were from the non-polypharmacy group while the remaining 100 were from the polypharmacy group. Of these, depression among non-polypharmacy group (control) participants were 11% while 76% were found to be non-cases of depression. Compared to that, 31% of the polypharmacy group had depression while 51% were non-cases for depression. Also. the prevalence of depression and anxiety was increasing with an increase in number of medications taken by the patients. Depression was present in 11% of patients who took 4 or less medications while the prevalence increased to 21.1%, 34.9% and 42.1% in patients who took five, six to eight, and more than nine medications, respectively.Conclusion: There is a significant link between polypharmacy and psychological distress in patients with chronic diseases with a focus on depression and anxiety. Healthcare providers can help in detecting polypharmacy and in providing recommendations for simplifying medication regimes and reducing the outcomes of chronic diseases. Trial registration: - This article doesn’t contain any health care intervention on human participants.

Perspective Chapter: Fallout from the Pandemic—A Social and Psychological Description of COVID-19 Related Traumatic Sequelae

Pandemics are not new phenomena in human history but in a globalised and interconnected planet the differential impact upon each generation may be distinctive. The concept of trauma has been widely discussed over the last 18 months with emphasis on a collective stress and distress but also in respect of those who are vulnerable to psychological adversity because of established prior mental health diagnoses. Much debate has centred on the impact of the pandemic on mental illness, both new and established, and this chapter will examine the utility of interpreting the psychological outcome at individual and societal level through the lens of collective trauma. At risk populations, such as healthcare workers and those recovering from infection will be a special focus of this chapter.

Psychological and Physical Health Outcomes in Adults With Craniosynostosis

Objectives Within current research, little is known about the long-term outcomes of craniosynostosis. A priority-setting exercise by UK charity Headlines Craniofacial Support identified 2 key questions in this area: (1) What are the long-term physical and psychological effects for individuals with syndromic and non-syndromic craniosynostosis? and (2) Are individuals with craniosynostosis likely to suffer from mental health difficulties, or are they more resilient? The aim of the current study was to conduct an initial investigation of these priority questions. Methods A comprehensive UK-wide survey consisting of 9 standardized psychological outcome measures and open-ended questions was distributed online. Thirty-six eligible adults (69.4% female) with a mean age of 30.8 years responded to the survey. Participants reported having single suture craniosynostosis (27.8%) or syndromic craniosynostosis (52.8%), with 19.4% being unsure of their diagnosis. Sample means were compared to published norms using independent samples t tests. Qualitative responses were analysed using inductive content analysis. Results Compared to the general population, participants reported significantly less favorable scores related to appearance concerns, attachment in adult relationships, anxiety, optimism, and resilience. Self-worth, depression, and social anxiety scores were similar to norms. Qualitative responses provided additional insight into participants’ satisfaction with appearance, physical health, medical treatment, employment, relationships, and recurrence risks. Few participants had accessed psychological support. Discussion This preliminary study illustrates the potential long-term implications for individuals with craniosynostosis. Improved treatment protocols are needed to address physical health concerns in adulthood, while dedicated psychological resources are necessary to promote emotional well-being, social confidence, and resilience.

Assessment Of Occupational Burnout And Its Correlates Among Medical Doctors in Nepal during COVID-19 pandemic: A cross-sectional study

Introduction: The current COVID-19 pandemic has increased emotional and physical toll on healthcare workers. The burnout among doctors could be another psychological outcome due to this. Considering the dearth of literature we planned this study with an aim to explore burnout and its correlates among medical doctors of Nepal. Material And Method: An online survey using a cross-sectional design and purposive sampling was conducted during the lock-down due to COVID-19 pandemic in Nepal. The tools used were basic proforma, Copenhagen Burn out Inventory (CBI) and Perceived Stress Scale (PSS). Descriptive and inferential statistical analysis (bivariate analysis followed by multiple linear regression) was performed with an objective to study prevalence of burnout and its correlates among the medical doctors. Results: The average age of participants was 30.44 years with the majority being male. All the study participants reported moderate to severe level of perceived stress. Around half of them reported moderate to high burnout. The multiple linear regression analyses showed that perceived stress, and working in surgical department were significant correlates for personal and work-related burnout among medical doctors. Additionally, being front-line worker was a significant correlate for client-related burnout. Conclusion: The burden and severity of burnout and perceived stress reported by the medical doctors during COVID-19 pandemic in the present study, suggests it to be an important mental health issue in Nepal. Suitable interventions for targeting this urgent issue of effectively reducing the burnout are warranted.

Efficacy of communication-based interventions on physicians and patients’ outcome: A meta-analysis of randomised controlled trials

Communication-based intervention on physicians are strongly linked to patient health improvement. We proceeded examine the efficiency of these programs interventions for relevant outcomes in patients life, along with study quality, publication bias and potential moderators. For this meta-analysis, we searched 2 databases, including: Web of Science and PubMed, using a comprehensive search strategy to identify the efficacy of the physician interventions on patient’s outcome studies in the literature, published from inception of 1965. Studies reporting means of health-related outcome in patients were included in the analyses. Studies quality was assessed with risk of bias tool. Meta-regression was used to explore heterogeneity of the year of published studies moderator and subgroup analysis was used to explore the medical specialty moderator. Of the 3,470 studies initially identified, 14 were eligible for inclusion. These studies had a large diversity of program interventions. The mean effect size representing the impact of communication intervention on patients physical and psychological health was not significant. The only significant mean effect was represented by psychological outcome. Significant associations were found between year of studies and general medicine specialization. In conclusion the impact of physicians’ intervention in not efficient on patients’ communication and medical outcome but it improves psychological health

Alpha activity neuromodulation induced by individual alpha-based neurofeedback learning in ecological context: a double-blind randomized study

The neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the link between brain activity and FB. We aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study. Forty-eight healthy participants were assigned to either NF (n = 25) or control (n = 23) group and performed alpha upregulation training (over 12 weeks) with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group. An increase of alpha activity across training sessions was observed in the NF group only (p < 0.001). This neuromodulation was selective in that there was no evidence for similar effects in the theta (4–8 Hz) and low beta (13–18 Hz) bands. While alpha upregulation was found in the NF group only, psychological outcome variables showed overall increased feeling of control, decreased anxiety level and increased relaxation feeling, without any significant difference between the NF and the control groups. This is interpreted in terms of learning context and placebo effects. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems.

Investigating Psychological Differences between Nurses and Other Healthcare Workers from Asia-Pacific Region during the Early Phase of the Coronavirus Disease 2019 (COVID-19): A Machine Learning Approach (Preprint)

BACKGROUND As the pandemic evolves, frontline work challenges continue to impose significant psychological impact on nurses. However, there is a lack of data how nurses fared compared to other healthcare workers in Asia-Pacific region. OBJECTIVE This study aims to investigate 1) psychological differences between nurses, doctor and non-medical healthcare workers, and 2) psychological outcome characteristics of nurses from different Asia-Pacific countries. METHODS Decision-tree type machine learning models (LIghtGBM, Gradientboost, and RandomForest) were adopted to predict psychological impact on nurses. The SHAP (SHapley Additive exPlanations) values of these models were extracted to identify the distinctive psychological distress characteristic. RESULTS Nurses had relatively higher percentages of normal or no-change in psychological distress symptoms relative to other healthcare workers (86.3% - 96.8% vs 80.7% - 92.3%). Among those without psychological symptoms, nurses constituted a higher proportion than doctors and non-medical healthcare workers (40.8%, 25.8%, and 33.4%, respectively). CONCLUSIONS Different contexts, cultures, and points in pandemic curve may have contributed to differing patterns of psychological outcomes amongst nurses in various Asia-Pacific countries. It is important that all healthcare workers practise self-care and render peer support to bolster psychological resilience for effective coping. CLINICALTRIAL Not applicable

A Protocol Study to Establish Psychological Outcomes From the Use of Wearables for Health and Fitness Monitoring

Background: The last few decades people have increasingly started to use technological tools for health and activity monitoring, such as tracking apps and wearables. The main assumption is that these tools are effective in reinforcing self-empowerment because they support better-informed lifestyle decision-making. However, experimental research assessing the effectiveness of the technological tools on such psychological outcomes is limited.Methods and Design: Three studies will be conducted. First, we will perform a systematic review to examine the experimental evidence on the effects of self-tracking apps on psychological outcome measurements. Second, we will conduct a longitudinal field experiment with a between subject design. Participants (N = 150) begin a 50-day exercise program, either with or without the aid of the self-tracking app Strava. Among those who use Strava, we vary between those who use all features and those who use a limited set of features. Participants complete questionnaires at baseline, at 10, 25, and 50 days, and provide details on what information has been tracked via the platform. Third, a subset of participants is interviewed to acquire additional qualitative data. The study will provide a rich set of data, enabling triangulation, and contextualization of the findings.Discussion: People increasingly engage in self-tracking whereby they use technological tools for health and activity monitoring, although the effects are still unknown. Considering the mixed results of the existing evidence, it is difficult to draw firm conclusions, showing more research is needed to develop a comprehensive understanding.Trial registration: Netherlands Trial registration: NL9402, received on 20 April 2021; https://www.trialregister.nl/trial/9402.

Parental Experiences in the Management of Children with Syndromic Craniofacial Diagnoses in Malaysia

INTRODUCTION: Patients with syndromic craniofacial diagnoses (SCD) require coordinated overall management and remain a parental challenge. This study assessed the parental experience and psychological outcome, as well as the evaluation of professional and community support, received in Malaysia. MATERIAL AND METHODS: The Craniofacial Experiences Questionnaire (CFEQ) was used to assess parents of SCD children registered with the Combined Oro-Craniomaxillofacial Clinic in University Malaya Medical Centre, Kuala Lumpur. RESULTS: Thirty parents participated in this study with their children’s age ranged from 2 months to 14 years old diagnosed with Apert, Crouzon, and Pfeiffer syndromes, as well as other SCD such as Goldenhar, Pierre Robin, and Nager. The majority of parents felt anxious whenever their child underwent an operation despite having positive perceptions of the outcome. Most respondents did not see the condition as handicap although 6.7% of parents were embarrassed by their child’s appearance. The majority of the respondents were worried about the financial implication, had to be occasionally absent from work due to their child’s regular appointments, and felt depressed while only a quarter of respondents socialised less and struggled to meet parenting needs. Most respondents received positive comments, were treated with respect, and obtained adequate support from both health professionals and the community with regards to their childcare. CONCLUSIONS: Although most parents were concerned about their children’s condition, only minimal social stigmatisation was noted. Parents were satisfied with the emotional and physical support received from healthcare professionals and the community. Understanding parental experience may contribute to the improvement of multidisciplinary syndromic craniofacial management.

Fear of COVID-19 pandemic (coronaphobia) amongst young adults in India

Background: The Novel Coronavirus disease has inherently brought a fear of uncertainty and continuity resulting in broad psychological effects on the mental health of the present generation. Although, few studies have tried to evaluate the degree of fear of COVID-19 but none has been done on young adults especially dental undergraduate healthcare providers so far. Hence, the present study aims to assess the fear of COVID-19 among young adults in India.Methods: A web based study was conducted on a sample of 309 dental undergraduate students of age group 18-25 years (young adults). The participants were asked for responding to a standardized online questionnaire prepared on google form that included the recently developed 7-item Fear of COVID-19 Scale (FCV-19S) to assess emotional fear reactions.Results: Overall mean fear score for the study population was 18.09+6.79. A significantly higher number of the study population reported low fear (56.6%). Age, place of residence, academic year, steady source of income and the students whose relative/friend got covid-19 depicted a significant difference based on the level of fear (p<0.05). Females and the students staying alone displayed higher levels of fear compared to their respective counterparts.Conclusions: Fear is a common psychological outcome during pandemics especially amongst healthcare providers as COVID-19 pandemic is a continuously evolving disease outbreak related to stress, disease contraction and dying. Thus, managing this fear in the young minds is imperative in order to reduce the psychological implications affecting their mental health due to the current COVID crisis.