Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic Surgery: Comparing Three Concentrations of Ropivacaine

Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.Approaches: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R0.2%, R0.3%, and R0.4%; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30 ml.Outcomes: Groups R0.2%, R0.3%, and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (p < 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R0.2% group (p < 0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions [physical comfort (p = 0.585)] did not vary greatly between Groups R0.3% and R0.4% (p > 0.05 for all contrasts). Groups R0.2%, R0.3%, and R0.4% showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 h when compared with the Group C (p < 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in NRS score AUC at rest and on movement in 48 h when compared with the R0.2% group (p < 0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48 h, did not vary greatly between the Group R0.3% and R0.4% (p > 0.05 for all contrasts).Conclusion: In this study it was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.Clinicaltrials.gov Registration:https://clinicaltrials.gov/, identifier ChiCTR2100046254.

Diagnosis concealment is associated with psychosocial outcomes in persons with multiple sclerosis

Persons with multiple sclerosis (pwMS) frequently conceal their diagnosis, fearing professional and personal repercussions of disclosing. Associations of concealment behavior and expected consequences of disclosure with psychosocial outcomes were examined in 90 pwMS who completed validated self-report measures of diagnosis concealment, loneliness, social support, and self-efficacy. More frequent concealment was related to worse loneliness ( rp = 0.213, p = 0.045) and lower social support ( rp = −0.211, p = 0.047), controlling for depression. Higher anticipated negative consequences of disclosure were associated with worse loneliness ( rp = 0.263, p = 0.013), lower social support ( rp = −0.338, p < 0.001), and lower self-efficacy ( rp = −0.350, p < 0.001). Findings hold implications for the development of psychological support strategies addressing concealment/disclosure issues and their psychosocial consequences.

Breast cancer: role of psychological support and the effectiveness of treatment

Background. Breast cancer is the most frequently diagnosed and life-threatening cancer in women worldwide. Since the disease diagnosis and treatment have improved greatly over time, quality of life has become an important outcome measure in breast cancer clinical investigations. The goal of the study was to analyze quality of life in women with breast cancer and to conduct a meta-analysis of data indicating the need for psychological support aimed at improving the quality of life in breast cancer patients. Material and methods. The study involved 186 women who were diagnosed with breast cancer no earlier than 6 months from the date of the survey. All patients had a luminal type of tumor. To study the quality of life of women with breast cancer, the sf-36 (36-item short-Form Health survey) questionnaire recommended by the international protocol was used. Results. Comparative analysis of standardized indicators of the quality of life indicats that the quality of life of women with breast cancer is significantly lower than that of women from the population (p<0.05). This result requires attention from both social/psychological services and physicians, due to the fact that the general indicator of the quality of life is associated with the prognosis of survival. The essence of providing psychological support to women with breast cancer is not only to alleviate their moral and psychological suffering, but also to enhance the effect of treatment and, as a result, increase survival. The authors come to the conclusion that it is necessary to include psychological rehabilitation programs in the protocol for treating women with breast cancer to enhance the effect of treatment, improve the quality of life.

Prevalence and correlates of depression and anxiety among Chinese international students in US colleges during the COVID-19 pandemic: a cross-sectional study

Previous studies showed that the COVID-19 outbreak increased the levels of depression and anxiety in heterogeneous populations. This study examines the prevalence of depression and anxiety among Chinese international students enrolled in US universities during the COVID-19 pandemic and identifies the associated factors, including habits, social and psychological support, sleep quality, and remote learning. Participants were recruited with snowball sampling through 21 Chinese international student associations in US universities. The survey consisted of demographic questions, the Social Support Rating Scale (SSRS), the Insomnia Severity Index (ISI), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 (GAD-7), and self-constructed questions on academic performance, financial concerns, use of social media, physical exercise, and psychological support. Cut-off scores of 10 were used for both PHQ-9 and GAD-7 to determine the binary outcomes of depression and anxiety, respectively. Bivariant analyses and multivariable logistic regression analyses were performed to identify the associated factors. Among 1881 participants, we found a prevalence of depression at 24.5% and that of anxiety at 20.7%. Multiple correlates—including recent exposure to traumatic event(s), pandemic-related financial concerns, workload, social support, remote learning, willingness to seek professional help, and sleep quality—were identified. It is critical for future studies to further investigate this student population and for universities to provide more flexible learning options and more access to psychological services.

Features of volitional self-regulation of convicts preparing for parole

Modern society is characterized by a large number of emergencies or situations, under the influence of which a person activates special mechanisms that help not only adapt in society, but also adapt to any situation that has arisen, often a conflict-gene. One of the internal resources that allows a person to overcome difficult, stressful situations in modern society is the volitional sphere of the personality. It seems that the study of the volitional sphere of convicts can become the basis for psychological support of convicts to imprisonment at all stages of serving their sentences, contribute to the development and implementation of effective programs to prepare for parole. The purpose of the study was to study the features of the volitional sphere of convicts preparing for parole. According to the results of the study, it was possible to establish that convicts preparing for parole, serving sentences in a strict regime colony to a greater extent, are characterized by a superficial attitude to affairs, a tendency to take thoughtless risks, weak volitional processes, unwillingness to apply physical and mental efforts, emotional instability and severe anxiety, which probably increases the likelihood of committing repeated crimes. At the same time, convicts preparing for parole, serving sentences in a settlement colony, are largely characterized by the ability to control their emotions and show initiative and perseverance when making a responsible decision. It seems that, to a sufficient degree, self-confidence frees from the fear of the unknown, increases the readiness to accept the new, the unexpected, and, as a rule, is combined with freedom of opinion, a tendency to innovation.

BASICS OF A PERSONALIZED APPROACH TO MEDICAL AND PSYCHOLOGICAL SUPPORT OF CARDIAC SURGERY PATIENTS

The concept of a personalized approach is becoming more and more popular in modern medicine. Today it is often understood as a multidisciplinary approach designed to improve therapeutic options, as well as help diagnose diseases at an early stage. In a cardiac surgery clinic, such an approach can take into account not only biological, but also psychological risk factors for the disease, especially its history, clinical condition, mental and psychological status to create an individual route within the framework of medical and psychological support for the patient at the stages of treatment and rehabilitation. The aim of the work was to develop, based on the analysis of the literature and the authors' own work experience, the organizational and psychological foundations for the implementation of a personalized approach in medical and psychological support of cardiac patients. The fundamental principles of support in the work include the following: the principle of accessibility, the principle of openness, the principle of continuity, the principle of complexity, the principle of integrativity, the principle of differentiation, the principle of variability, the principle of participativeness, the principle of awareness, the principle of prevention. In the process of medical and psychological support of cardiac surgical patients within the framework of a personalized approach, the most optimal was the identification of the following clinical stages, different in duration and content, corresponding to the periods of outpatient and inpatient treatment and rehabilitation of patients: preoperative outpatient, preoperative inpatient, early postoperative, postoperative inpatient, postoperative rehabilitation and rehabilitation outpatient stages. For each of the clinical stages of medical and psychological support, a differentiation of goals, objectives, duration and expected results of the impact was carried out, which makes it possible to personalize the programs for accompanying a cardiac patient and individualize the route for each patient, taking into account the specificity and relevance of the influence of biologi cal, psychological and social factors.

Identification of alcohol use disorders among women in the Republic of Khakassia

The article presents results of a regional project to prevent and reduce the prevalence of alcohol consumption among women in the Republic of Khakassia (Eastern Siberia, Russian Federation). In addition to the main preventive goal of reducing alcohol consumption among groups of women covered by the project, there was an objective to conduct screening using the AUDIT test and provide motivational counseling in case of identifying alcohol-related problems. 691 women took part in screening, among them 202 at enterprises of the Republic of Khakassia, and 489 when seeking social/psychological support to the Khakass Republican Branch of the Russian Red Cross, as well as to local branches of the Red Cross in other cities of the Republic of Khakassia. Levels of risk related to alcohol use were identified, based on the results of the screening the studied groups of women. Depending on the risk level, three types of socio-psychological interventions were carried out: informing about harmful consequences of alcohol use and the need to maintain a healthy lifestyle; motivational counseling; motivating women for treatment of dependency.Majority of women who were screened at workplaces were more likely to use alcohol with low risk (78.2%), much smaller proportion of women had risky alcohol consumption (14.4%), alcohol consumption with harmful consequences (2.5%) or signs of alcohol dependency (2.0%). Among women who applied for social and psychological support to branches of the Russian Red Cross, prevalence of low-risk use was lower (43.4%), and risky alcohol use (31.3%), alcohol use with harmful consequences (10.6%) or signs of alcohol dependency (14.5%) were significantly higher.