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This study aimed to identify the psychological and social effects of distance education from the viewpoints of students’ guardians in Jordan. The study sample comprised 1206 guardians, of whom 71% have completed their undergraduate studies or a higher level. Furthermore, 62% of participants aged more than 35 years. Results also indicated that 34% of participants have children studying in primary education, 21.9% have children studying in primary and secondary education, and 13.4% have children studying in all levels of education. The researchers developed the ‘psychological and social effects of distance education’ scale. After being measured, the scale was electronically sent to the study sample. Findings showed that the psychological and social effects of distance education on guardians were significant. Moreover, students’ level of social activity was moderate, they have become less active, and their use of social media sites has increased. In addition, results indicated that the psychological and social impact significantly differs in terms of parents’ level of education. Results also showed that the psychological and social effects of distance education on students’ guardians do not differ in terms of the number of schoolchildren. Instead, all guardians, with any number of schoolchildren, were negatively affected.

Toxic leadership (TL) is a prevalent phenomenon within South African schools, yet is vastly under-studied. Abuse by leaders has a detrimental effect on the well-being of teachers, which may create barriers in the learning and teaching process. This study sought to assess the experience of educators who work under toxic leaders as well as the impact of toxic leadership on the psychological well-being of educators under principals/ heads of department, who hold a toxic leadership style, within in a South African context. This was done by conducting a scoping review, using the updated 2020 JBI methodology. The key words used in the review were: “toxic leadership”, “workplace bullying”, “teachers/educators”, “schools” and “South Africa”. From these key words approximately 1904 studies appeared. Further filtering, using BOOLEAN operators, was applied to these studies. Relevant studies, as well as their reference lists, were then screened. From these screened studies, 12 were applicable to the current review. This review found that there are a number of recurring psychological effects of toxic leadership in schools across South Africa, with the most common being stress, feelings of powerlessness, isolation, loss of self-confidence, humiliation, low morale, depression, and hopelessness. The study also found that common experiences of teachers under toxic leaders were that abusive superiors were overbearing and over-controlling of the victims, that the victims’ personal (social and familial relationships) lives were negatively affected by the abuse they experienced, and that victims experienced public humiliation. Furthermore, victims were excluded from conversations and/or events, because individuals who were the favourites were given preference in these situations. Additionally, the common experiences reported by victims were being threatened, being the subject of malicious rumours, being ignored or given “silent treatment” and being verbally abused (e.g. swearing and insults). A number of gaps and limitations were identified, a primary limitation being the fact that the construct of TL was not sufficiently investigated in schools. Consequently, the present study’s reviewers needed to use workplace bullying, and other proxies of toxic leadership, to identify suitable studies.

Introduction Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can cause a physiological or psychological burden to the patients. At present, most of the studies done on PWS are focused on the treatment rather than the quality of life and psychological effects of the disease. Material and methods A comprehensive literature search was done in MEDLINE using PubMed database, Embase®, and Cochrane. All observational studies were included in this review. Results A total of 17 relevant articles with 2,135 PWS patients were included in this review. There were 36 measurement tools used to assess the quality of life and the psychological effects among PWS patients. The results showed that patients with facial PWS had a significant negative effect on their quality of life and had also suffered from psychological disabilities. The PWS lesion tends to worsen with age and may cause further adaptation problems towards the social environment, especially in children. Conclusion Early treatment, psychological assistance, and patient support are the key management in improving the quality of life of patients with PWS. Quality of life must be regularly assessed together with the improvement of treatment.

Background: Hereditary angioedema (HAE) attacks can be provoked with psychological factors. The aim of this study was to assess the effects of anxiety, depression and stress related to COVID-19 pandemic on disease activity of HAE patients during the quarantine period (QP) and the return to normal period (RTNP). Methods: This prospective study was conducted between March 2020 and September 2020 in four allergy centres. Demographic, clinical features and mental health status were evaluated in QP (from March to the beginning of June) and RTNP (from June to the beginning of September) was applied by the government. The 10-point visual analogue scale (VAS10) was used to define the severity of HAE attacks. Depression-Anxiety- Stress Scale-21 (DASS-21) and Fear of Covid-19 (FC-19) scales were performed to assess mental health status. Results: 139 HAE patients were included in the study. In QP, median attack numbers and median VAS10 scores were 5 (min-max: 0-45) and 6 (min-max: 0-10), respectively. HAE attack numbers, DASS-21 stress, anxiety, depression and total DASS-21 scores, as well as FC-19 scores were higher in QP than RTNP (p= 0.001, p 0.05). Conclusions: This study revealed that the restriction measures during Covid-19 outbreak causes an increase in the number of HAE attacks in relation to anxiety, depression, stress and fear of Covid-19 pandemic. Therefore, it is important to provide psychological support to HAE patients during the pandemic.

Background SARS-CoV-2 infection in the pediatric age group has a milder course than in adults, but in some cases even children may present with severe forms or develop long-term consequences. The aim of this study was to analyze the clinical features, long-term effects, lifestyle changes and psychological effects of SARS-CoV-2 infection in a pediatric sample of the Italian population. Methods We conducted a telephone survey among 3075 children infected with SARS-CoV-2 in the Latina Local Health Authority. Outcomes included: clinical features of infection, long-term symptoms, lifestyle changes and emotional symptoms during the illness. The information obtained was automatically linked to a spreadsheet and analyzed. Results One thousand four hundred thirteen children agreed to participate in the study; the mean age was 112.8 ± 21.9 months. Children were infected mainly inside familial clusters (59.6%; n = 842); 99% (n = 1399) of children were asymptomatic or exhibited mild symptoms. 20% (n = 259) of children experienced long-term symptoms; risk factors were: older age, higher body mass index and longer duration of infection. Throughout the period of infection, children spent most of the time on devices like tv-video, social media and mobile phone for non-educational activities. 58.8% (n = 620) of parents expressed a negative opinion about distance learning. Finally, we observed that 49,6% (n = 532) of children experienced psychological symptoms during quarantine period. Conclusion Despite a lower susceptibility to COVID-19 in children, it is important to keep the focus high in children, both because of the possible long symptoms after infection and the impact on a children’s mental and physical health due to pandemic. We believe that the return to school or other extracurricular activities are important to correct some of the risk factors for the long COVID syndrome, as obesity, and to limit the cultural damage generated by distance learning and psychological effects related to restrictive measures.

Introduction: Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies globally. Living with a stoma has potential to impair the patient’s quality of life, often with associated negative psychological effects. Objective: To evaluate the quality of life among intestinal stoma patients under Mulago National Referral Hospital (MNRH), with emphasis on psychological effects and effects on family-social interactions. Methodology: A cross-sectional study carried out at surgical outpatient clinics of MNRH between January and June 2018. Data was collected using Stoma-QOL questionnaire, PHQ-9 and GAD-7 from 51 participants who had lived with intestinal stomas for at least a month. Results: Of the 51 participants, male: female ratio was 4:1 and aged 18-84 years (mean age 44.04+18.47 years). 76.5% had colostomy; 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+ 17.04. Only about a quarter (24%) of participants had Stoma-QOL scores >70 (best). Most patients exhibited negative psy- chological effects (anxiety-100%, concerns about changed body image - 96.1% and depression - 88.4%). Conclusion: Most participants had low levels of stoma-related quality of life, suffered negative psychological effects and exhibited limited social interactions. This calls for efforts to support Stoma patients adapt beter life. Keywords: Stoma; Quality of Life (Stoma-QOL); Psychological effects; Patient Health Questionnaire (PHQ-9); General- ized Anxiety Questionnaire (GAD-7).

Walid Al-Zyoud,1 Thelal Oweis,2 Haytham Al-Thawabih,3 Fawwaz Al-Saqqar,2 Akeel Al-Kazwini,1 Fawzi Al-Hammouri4 1School of Applied Medical Sciences, German Jordanian University, Amman, Jordan; 2School of Basic Sciences and Humanities, German Jordanian University, Amman, Jordan; 3School of Applied Humanities and Languages, German Jordanian University, Amman, Jordan; 4Specialty Hospital Amman, Amman, JordanCorrespondence: Walid Al-ZyoudGerman Jordanian University, Amman Madaba Street, P.O. Box 35247, Amman, 11180, JordanTel +962 6 429 4401Fax +962 6 430 0215Email Walid.AlZyoud@gju.edu.joPurpose: The COVID-19 pandemic has affected physician–patient communication (PPC) in multiple ways. This study aims to report on the impact of physician–patient communication (PPC) skills on COVID-19 patients’ psychology in Jordan.Sample and Methods: In this study, two questionnaires were designed. The first questionnaire targeted physicians, with 72 responses, and the second questionnaire targeted patients, with 248 responses. Both questionnaires contained common sections covering nine aspects of communication such as empathy, honesty, optimism, simple and deliberateness.Results: This study found that the psychological effect of physicians’ positive communication skills on COVID-19 patients is significant. There were almost statistical agreement between physicians’ and patients’ questionnaire responses that the physicians’ communication skills have positively affected the patients’ psychological status; all patients’ responses confirmed this finding.Conclusion: Based on this study’s findings, appropriate and continuous training will advance physicians’ communication skills in the form of exercises that could be as simple as class- or lecture-based activities, or using technology-based learning. Using a protocol or handbook to guide such communication is another essential strategy to enhance physician–patient communication (PPC). The study recommends that physicians must be aware that PPC skills required may vary depending on whether they are dealing with a pandemic or non-pandemic situation. Generally, appropriate or positive communication skills are considered one of the main factors effecting patients’ psychological responses to their diagnosis.Keywords: psychological effects, communication skills, COVID-19, pandemic, physicians and patients

Studies discovered that humans spent around 80% of our time indoor and this phenomenon is deteriorating our health physically and psychologically. Thus, it is important to study the effects of different interior designs on our emotions. The previous studies and researches done on interior spaces are mostly focusing on measurable physical attributes of interior whereas the psychological relationships between interior design criteria and human emotions have not been well studied. Therefore, this research paper aims to determine the suitable interior space for youngsters from different backgrounds in terms of spatial quality and materiality. In this paper, 4 types of commonly-used materials in Malaysia, namely Timber, Concrete, Bricks and Stones are selected to be studied and analyzed based on the respondents’ preferences and perceptions of warmness or coolness of materials. The results showed that there is no distinctive relationship between respondents’ preferences to materials and their educational backgrounds but respondents of different races showed different degree of acceptance towards different finishing materials. The paper proof the respondents prefer to have warm-feeling materials such as timber and bricks for their home design as compared to cold-feeling materials such as concrete and stones. The results will serve as a material-selection guideline for designers.

This paper conducts quantitative research on the influence of the COVID-19 pandemic on the adaptation to digital learning environments (DLE) of a group of 908 university professors. We compared the perceptions of participants who were digital natives (born before 1980) with those of digital immigrants (born after 1980). For this purpose, a validated survey was used and the obtained responses statistically analyzed. The results show a negative correlation between pandemic stress and the digital competence of professors and their adaptation skills to digital environments, which although weak for both of the two groups compared are stronger for digital immigrants. Both self-confidence and digital competence show a positive influence on the perception of adaptation of skills to DLE, and this is weaker in digital natives. Gaps were identified by gender and area of knowledge of the participants; consequently, the need to carry out training actions for university faculty on skills linked to their digital competence in teaching is clear.

Background: COVID-19 pandemic changes the lifestyle and inducted negative emotions. People living with chronic disease (PLWCD) are the frailest social category, both for the risk of severe COVID-19 illness and for the pandemic impact on the continuum of care. Aim of this study was to analyze coping strategies and resilience in people living with HIV (PLWH) compared to people living with oncological diseases (PLWOD) during COVID-19 pandemic. Methods: In this observational study based on the administration of an anonymous questionnaire, we explored the emotional experience, the clinical and demographic factors linked to a COVID-19-related stress syndrome, the patient’s perception about the adequacy of clinical and psychological undertaking from the hospital and the level of resilience through a validated resilience scale. We performed a Kruskal-Wallis and a chi-squared test to compare the characteristics between PLWH and PLWOD and a linear regression to assess the factors associated to higher resilience. Results: We analyzed 324 questionnaires (PLWH n=167, PLWOD n=157). There were no significant differences in prevalence of psychological distress, anxiety, and fear among the whole cohort; however, PLWOD were calmer (p=0.039), less troubled (p=0.014), and more serene (p=0.026) than PLWH. Moreover, PLWH smoked more (pp=0.003) and thus gained more weight (p=0.013) than PLWOD. 62% of patients didn’t have more feelings of solitude than usual (p=0.130) and 71,3% continued to take pleasure from their activities (p=0.511). No differences in resilience were found between the groups, however in the whole cohort lower levels of resilience were found in patients that were unemployed (-3.52; 95% CI = [-6.68 -0.35]; p=0.029), with history of psychological disorders (-2.18; 95% CI = [-3.17 -1.18]; pppConclusions: PLWCD had high level of resilience, preserved in general their psychological well-being, and activated adaptive coping during the pandemic. However, PLWH showed higher distress than PLWOD according to comparable resilience score. Patients with psychological problems, feelings of anger and concern deserve more attention as they show lower levels of resilience.

Environmental issues and health-benefitting design strategies have raised interest in natural and renewable building materials, resulting in an increased focus on the use of wood in built environment. The influence of wooden materials on measured and perceived indoor environment quality (IEQ) has gained attention during the past few decades, with a growing number of studies having explored the issue. This review was conducted to examine and summarise the body of research on the influence of wooden interior materials on IEQ, with an emphasis on the following themes: emissions of chemical compounds, moisture buffering of indoor air, antibacterial effects, acoustics, and psychological and physiological effects. This review found that wooden interior materials exert mainly positive or neutral effects on IEQ, such as moderating humidity fluctuations of indoor air, inducing positive feelings in occupants, and inhibiting certain bacteria. Negative effects on IEQ are limited to volatile organic compounds emitted from wood. The odour thresholds of some aldehydes and terpenes are low enough to affect the perceived IEQ. Additionally, concentrations of formaldehyde and acrolein may under certain conditions cause adverse health effects. Further studies are needed to better understand these phenomena and take advantage of the beneficial effects while hindering the unpleasant ones.

This study evaluated whether the consumption of locally produced food without additives might have a positive effect on known risk factors for non-communicable diseases (NCDs) such as hypertension, and levels of fasting glucose and visceral adipose tissue (VAT). Attention was focused on various types of cheese, sausages, fresh pasta, pastries, biscuits and chocolate without additives to make them palatable and durable for transport.Healthy volunteers were randomized to purchase the foods under study from either local producers not using additives (group 1) or supermarkets (group 2). At baseline and after 6 months, both groups underwent evaluation for weight, blood pressure, VAT, serum sodium, potassium, fasting glucose, insulin, C-peptide and creatinine levels, and also the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI-II) by examiners blinded to group allocation. At baseline, the state part of the STAI and Wechsler Adult Intelligence Scale IV were also performed, and body mass index, HOMA index and estimated glomerular filtration rate calculated.Data for 159 subjects (89 in group 1, 70 in group 2) were analyzed. Baseline evaluations did not differ between groups. At 6 months, HOMA scores and fasting glucose levels were lower in group 1 than in group 2 (P0.01). Also, in group 1, VAT (P=0.006), systolic blood pressure (P=0.001) and BDI-II score (P=0.0005) were decreased, whereas serum fasting glucose (P=0.04) and C-peptide (P=0.03) levels, and diastolic blood pressure (P=0.02), were increased in group 2.Consumption of the locally produced food under study improved some of the major risk factors for NCDs after 6 months.

Introduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic. Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated. Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6\%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4\%). The routine medical follow-up was interrupted in 61.4\% and the medication was discontinued in 14\% of the patients. Approximately 25\% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4\% lost their jobs. Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored.

En el último año las agresiones al colectivo de lesbianas, gays, bisexuales y transgénero (LGTB) han aumentado más de un 50%, lo que conlleva graves secuelas psicológicas para este tipo de personas. La mayoría de la comunidad LGTB (40%) está formada por personas bisexuales, y tienen un mayor riesgo de sufrir problemas de salud mental que lesbianas y gays. Por este motivo, se decidió que el objetivo de este trabajo sería realizar una revisión bibliográfica de los estudios que analizan el impacto de la bifobia en la salud mental de las personas bisexuales. Se revisaron los artículos realizados entre el año 2010 y 2020, utilizando las bases de datos APA PsycArticles, APA PsyInfo, Psicodoc y Pubmed. Tras realizar un cribado, fueron 13 los artículos que cumplieron los criterios de inclusión. Los resultados obtenidos indican que la bifobia afecta de forma negativa a la salud mental y al bienestar, genera síntomas de trauma y lleva a una mayor estigmatización de las personas bisexuales. También afecta la visibilidad, haciendo que muchas personas bisexuales oculten su identidad por miedo a sufrir discriminación. In the last year, aggressions against lesbian, gay, bisexual and transgender community (LGTB) have increased by more than 50%, which entails serious psychological consequences for this type of people. The majority of the LGTB community (40%) is made up of bisexual people, and they have a higher risk of suffering mental health problems than lesbians and gays. For this reason, it was decided that the aim of this work would be to conduct a literature review of studies analyzing the impact of biphobia on the mental health of bisexual people. Articles conducted between 2010 and 2020 were reviewed, using the APA PsycArticles, APA PsyInfo, Psicodoc and Pubmed databases. After screening, 13 articles met the inclusion criteria. Biphobia negatively affects the mental health and well-being of bisexual people, generates symptoms of trauma and leads to further stigmatization of bisexuality. It also affects bisexual visibility, causing many bisexual people to hide their identity out of fear of discrimination.

Background Family caregivers of patients receiving hemodialysis experience physical and psychological disorders. They are unfortunately neglected. The aim of this study was to explain the psychological consequences for family caregivers of patients receiving hemodialysis. Methods This qualitative inductive conventional content analysis research approach was conducted in Tehran, Iran. Nineteen hemodialysis patient caregivers were enrolled via purposive sampling. Data collection was conducted through in-depth and semi-structured interviews until reaching data saturation. All interviews were recorded, transcribed, imported into the Open Code Software, and analyzed using the Graneheim and Lundman methods. Results The results included two main categories: (1) threats to the psychological integrity; (2) development of capabilities. The first main category comprised the sub-categories of “care-related negative feelings and emotions,” care-related stress and its behavioral impacts on care, “psychological disorders arising from care provision,” and “impaired quality and quantity of sleep.” The second main category comprised of the sub-categories of “care-related positive feelings and emotions” and “coping strategies.” Conclusions The present study showed that though caring for hemodialysis patients threatens the caregiver’s psychological integrity, it provides the opportunity of development capabilities.

Objectives As specialists of the upper airway, otolaryngologists are at high risk for COVID-19 transmission. N95 and half-face respirator (HFR) masks are commonly worn, each with advantages in functionality and comfort. In this study, physiologic and psychological parameters of prolonged N95 vs HFR wear were compared. Study Design Prospective crossover cohort study. Setting Single academic tertiary care hospital. Methods A prospective crossover cohort study was performed. Healthy otolaryngology trainees and medical students (N = 23) participated and wore N95 and HFR masks continuously for 3 hours each on separate days. Various measures were analyzed: vitals, spirometry variables, scores on the State-Trait Anxiety Inventory and HIT-6 (Headache Impact Test–6), distress, and “difficulty being understood.” Results The average age was 26.3 years (SD, 3.42). There were no significant differences in vital signs and spirometry variables between N95 and HFR wear. N95 wear was associated with decreases in oxygen saturation of approximately 1.09% more than with HFRs (95% CI, 0.105-2.077). State-Trait Anxiety Inventory scores increased more with HFR wear when compared with mean changes with N95 wear (95% CI, 1.350-8.741). There were no significant differences in HIT-6 scores or distress levels between masks. The proportions of participants reporting difficulty being understood was significantly higher with HFRs. Conclusions Oxygen saturation decreases with prolonged N95 wear, but anxiety and difficulty being understood are greater with HFR wear. Although HFRs have less resistance to gas exchange, N95 respirators may produce less anxiety and distress in clinical situations. Further studies are warranted to evaluate the clinical significance of these differences. Level of Evidence 2.

The purpose of this study is to investigate the effect of forest conservation activities on the physical and psychological wellbeing of participants. The experiment was conducted in a forest near an urban area and involved 61 participants (average age: 22.5 ± 1.8). The participants selected one of three activities (pruning, stacking cut branches, and removing vines) in the forest conservation program. The effects of these activities on the musculoskeletal system were assessed using the Ovako Working Posture Assessment System (OWAS); the physical intensity of the activities was evaluated using heart rate data. The psychological evaluation measurement indexes used the Positive and Negative Affect Schedule, Rosenberg Self-Esteem scale, World Health Organization Quality of Life assessment instrument, and the Perceived Restorativeness Scale. As a result of the OWAS assessment, forest conservation activities were found to be action categories 1 and 2, which were less burdensome to the musculoskeletal system. All forestry activities were found to be light levels of physical intensity. Psychological evaluation of the participants revealed that positive emotions such as self-esteem, quality of life, and perceived restorativeness increased significantly, whereas negative emotions decreased significantly. This forest conservation program, that involved low-intensity activities which were less burdensome to the musculoskeletal system, had positive physical and psychological effects on the local residents who participated.

The Coronavirus Disease 2019 (COVID-19) epidemic broke out from Wuhan in Hubei province, China, spread nationwide and then gradually developed into other countries in the world. The implementation of unprecedented strict isolation measures has affected many aspects of people's lives and posed a challenge to psychological health. To explore whether people isolated for 14 days due to having contact with COVID-19 patients had more psychosocial problems. We conducted an online survey from February 29 to March 10, 2020. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and coping style were assessed by the Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder Scale (GAD-7), Impact of Event Scale-Revised (IES-R), and Simplified Coping Style Questionnaire-20-Chinese Version. This study included 1,315 isolated respondents in Hubei province (58.5% located in Wuhan). 69.3% respondents isolated at home, 30.7% respondents isolated at centralized quarantined spot. Of all respondents, 66.8% reported depressive symptoms, 49.7% reported anxiety symptoms, 89.0% reported PTSD symptoms. The Cronbach α of the IES-R, PHQ-9, GAD-7, and total SCSQ-20 were 0.935, 0.847, 0.843, and 0.888, respectively. Persons who isolated at home were associated with a lower risk of PTSD, depressive and anxiety symptoms (P < 0.01). People who knew someone to have COVID-19 were associated with severe symptoms of PTSD symptoms (P = 0.001). As for coping style, higher level of passive coping style was associated with severe symptoms of PTSD, depression and anxiety (P < 0.001). Our findings identify that person isolated during the COVID-19 epidemic was associated with high proportion of depression, anxiety, and PTSD symptoms. Public health officials should be aware of and prepared to take necessary measures.

Although unmanned aerial vehicle (UAV) operators avoid exposure to many physical risks, they may be susceptible to the same psychological threats as conventional aircraft pilots in the field. This thesis analyzes case studies involving experiences of UAV operators suffering from posttraumatic stress disorder (PTSD) with the intent to increase understanding of the psychological threats associated with piloting unmanned systems. Mitigation strategies found to combat PTSD include workload restructure, strategic counseling, and cortisol testing and therapy. Psychological distress that leads to PTSD can be prevented when conditions are structured with containment, intervention, and prevention in mind. Following the Government Accountability Office recommendations and applying scientific treatments and therapies, the U.S. Armed Forces has a chance to gain traction against its operator shortages without causing psychological distress to its personnel. Captain, United States Marine Corps Approved for public release. Distribution is unlimited.

Traumatic brain injury (TBI) is known as “silent epidemic” because of lack of knowledge about it and its delayed symptoms of memory and cognitive problems. The incidence is approximately 1.4 million per year in the United States, and in the developing countries, it is approximately 341 per 100,000. In the United States, the annual productivity loss due to TBI and its delayed effects is more than $56 billion. TBIs occur mainly due to traffic accidents and falls. All the age groups are affected, but the rates are higher in men than in women. The causes vary as per the age groups as traumas affect mainly children and elderly, and traffic accidents and violence affect more of adolescents and young adults. Data from various studies indicate wide variation in the incidence and prevalence of psychiatric disorders after TBI, but they are definitely higher as compared with general population. We also noted different psychiatric disorders in post head injury cases during follow-up at our university hospital, which included depression, behavioral disorders, cognitive disorders, memory impairment, anxiety disorders, stress-related headache, vertigo, irritability and sleep disorders, etc. Therefore, this review was undertaken to assess the psychosocial impact of brain injury on an individual.

The burden of disability among survivors and the socio-economic impact of snakebite have not been adequately researched. We reviewed original research articles, case reports and small case series relating to chronic physical, mental and psycho-social disability and economic burden of snakebite. Both physical and psychological health problems seem common in snakebite survivors and can lead to disability and loss of productivity. Chronic physical health effects, musculoskeletal disability being the commonest, can be largely attributed to limited and delayed access to optimal treatment of acute envenoming. The economic burden is considerable, and includes health system costs, out-of-pocket expenditure and opportunity costs, with regional variations. Health systems should be more responsive to needs and circumstances of bite victims, and a more holistic approach should be developed in the treatment of snakebite which incorporates the management of chronic health effects., Graphical abstract Image 1, Highlights • Limited attention has been paid to chronic disability and the socio-economic impact of snakebite. • Physical and psychological health problems occur in snakebite survivors leading to disability and loss of productivity. • Chronic health effects can be largely attributed to limited and delayed access to optimal treatment of acute envenoming. • Economic burden includes health system costs, out-of-pocket expenditure and opportunity costs. • Health systems should be responsive to needs and circumstances of bite victims including care of chronic health effects.

Introduction: Several studies reported that traditional Chinese mind-body exercises showed beneficial effects on improving anxiety and depression of patients with low back pain (LBP) in recent years. However, the effects of traditional Chinese mind-body exercises on improving psychological disorders of patients with LBP remain controversial. Most previous reviews only focused on the effects of traditional Chinese mind-body exercises for LBP on pain and dysfunction. Therefore, the present systematic review and meta-analysis will be conducted to evaluate the evidence on psychological effects of traditional Chinese mind-body exercises for LBP. Methods and analysis: The electronic databases (PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, China Knowledge Resource Integrated Database, and Wanfang Data) will be searched. The search will include all documents from their inception to February 2021. The Physiotherapy Evidence Database scale will be used for quality assessment of eligible studies. Risk of bias of eligible studies will also be assessed by Cochrane tool. The meta-analysis will be conducted using the Review Manager Version 5.3 software. The Higgins I2 statistic will be performed to examine for heterogeneity. The subgroup analysis will be conducted based on different types of traditional Chinese mind-body exercises, different intervention time, and different outcomes. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation. Ethics and dissemination: No ethical statement will be required for the performance of this review and meta-analysis. The results of this review will be published in an international peer-reviewed journal. INPLASY registration number: INPLASY202130075.

Background Whole-body electromyostimulation (WB-EMS) training is used in popular and health sports to improve muscular performance. Little is known about the possible psychological effects of WB-EMS training. The aim of the study is therefore to investigate the possible psychological effects of WB-EMS training on subjective well-being, relaxation, mood, and perceived stress. Materials and Methods Twenty-five healthy subjects underwent conventional WB-EMS training and Sham training (without the application of electrical stimulation) as part of a randomized, controlled pilot study in a crossover design. Subjective well-being and subjective relaxation were assessed using visual analog scales, the current state of mood was assessed with Multidimensional Mood State Questionnaires (MDBF), and the current level of stress was assessed with Recovery–Stress Questionnaires/Erholungs-Belastungs-Fragebögen (RESTQEBF) before and after training. Results WB-EMS training has a statistically significant positive effect on subjective well-being and subjective relaxation, as well as on the awake subscale of the MDBF. No significant main effect of sequence and no interaction effects were found. Also, compared to a Sham training session, a single WB-EMS training session had no significant effect on mood, nervousness, or the current level of stress. Conclusion Besides physiological effects, WB-EMS might also have a strong psychological impact. WB-EMS could be beneficial for people who, due to their limitations, have problems training on a regular basis and with adequate training intensity. Trial Registration German Clinical Trials Register, DRKS00012583, 22 June 2017.

March 2020 has seen thousands of people across the globe have been infected with coronavirus disease 2019 (COVID-19). Apart from that, the pandemic has affected the learning of billions of students worldwide. As a result, educational institutions throughout the world have turned to online learning using online platforms. Online platforms not only cater to virtual learning, but the students will also have unrestricted access to their social media accounts and online games. Due to this situation, there has been an increase in violence and hate online, which includes bullying. The study reviewed articles to identify cyberbullying victimization during COVID-19. Articles published during COVID-19 pandemic from January 2020 to April 2021 were identified for review. The article search was conducted in April 2020 using the search engine on the National Centre for Biotechnology and Information (NCB) website and Google Scholar. Nineteen articles were chosen as being appropriate for the study's scope. The review highlights the presence and the psychological effects of cyberbullying during COVID-19. The current preventive measure in place is the legal measures. However, the legal measures are found not to be effective in combating cyberbullying.

The current study provides data about the immediate risk perceptions and psychological effects of the COVID-19 pandemic among Italian participants. A sample of 980 volunteers answered a web-based survey which aimed to investigate the many facets of risk perceptions connected to COVID-19 (health, work, institutional-economy, interpersonal and psychological), and risk-related variables such as perceived knowledge, news seeking, perceived control, perceived efficacy of containment measures, and affective states. Socio-demographic characteristics were also collected. Results showed that although levels of general concern are relatively high among Italians, risk perceptions are highest with regards to the institutional-economy and work, and lowest concerning health. COVID-19 has been also estimated to be the least likely cause of death. Cognitive and affective risk-related variables contributed to explain the several risk perception domains differently. COVID-19 perceived knowledge did not affect any risk perception while the perceived control decreased health risk likelihood. The other risk-related variables amplified risk perceptions: News seeking increased work and institutional-economy risk; perceived efficacy of containment measures increased almost all perceived risks; negative affective states of fear, anger and sadness increased health risk; anxiety increased health, interpersonal and psychological risks, and uncertainty increased work, institutional-economy, interpersonal and psychological risk perceptions. Finally, positive affective states increased health risk perception. Socio-psychological implications are discussed.

Having to listen to the devastating daily news brought by COVID-19 since the first case was reported on 23rd January 2020 in Nepal, it has pushed the country into various crises. The issue of psychological health has been overlooked during this crisis.COVID-19 has sabotaged the psychological health of general people and more importantly medical students. It has disrupted the academics and clinical rotations of medical education. The prospect of being the future health care personnel without adequate training has destroyed the confidence and aspiration andin addition, joining the frontline against this type of deadly virus with little preparedness has instilled fear and uncertainty among them. So, concerning the context, this article focuses on the psychological effects faced by medical students and some ways to overcome this issue. Keywords: psychological effects;medical students;COVID-19.

Psychological manifestations such as depression and suicidal ideation are commonly caused by poorly controlled pain, anxiety, and sleep deprivation in intensive care unit (ICU) patients. We are concerned that previous analgesic and sedative techniques administered as single-medication approaches are outdated and inadequate. It is imperative that ICU practitioners are knowledgeable in multimodal approaches to pain and sedation in high acuity settings. We have shown that appropriate combinations of ketamine and fentanyl are effective, and if further supplementation is needed, we utilize additional pharmacological agents in low doses and regional techniques that ultimately lower the overall opioid consumption. We acknowledge that a variety of medication supplementations tailored to the patient's clinical needs and nature of surgery improves a patient's outcome in ICU and overall quality of life.

Background Flow is an optimal psychological state when people engage in a training task, and it is a theory explaining the absorbed state. Objective To investigate the additional effect of flow on attention deficits for chronic patients after traumatic brain injury. Methods Twenty patients were randomly assigned to the flow group (n = 10) or the control group. Patients performed a video game task, one inducing flow (flow group) and the other not (control group) for 4 weeks, and they were assessed with the flow state scale for occupational tasks (FSSOT) regularly and neuropsychological tests at baseline, after intervention, and at 4 weeks after intervention (follow-up). Results Although both groups significantly improved their attentional function after intervention, patients in the flow group tended to show more improvement of attention. The effect size of the neuropsychological test of attention was positive, and its value was small to medium. There was a significant positive correlation between improvement of attention and the FSSOT score. Conclusions Attention training with induction of the flow was associated with greater improvement of attention. The results of this study may provide provisional evidence of the effectiveness of rehabilitation considering the patient's psychological state.

Aims Psychosocial factors increase risk for incident heart disease and poor prognosis. In patients with an implantable cardioverter-defibrillator (ICD), negative emotions have been associated with increased mortality risk, although the association with ventricular arrhythmias (VAs) is less consistent. Anger has been linked to incident ICD shocks, but no prospective study has examined the association of anger (state and trait) with mortality or VAs in the ICD population. In a consecutively recruited cohort of first-time ICD patients, we examined the association of state and trait anger with 7-year mortality risk and time to first VA. Methods and results A consecutive cohort of patients implanted with a first-time ICD (n = 388; 80% men) between 2003 and 2010 completed the State-Trait Anger Scale and were followed for 7 years. Outcomes were mortality and time to first appropriate ICD therapy. State anger at the time of implant was associated with increased mortality risk in adjusted analyses, with a 1-point increase in score on the state anger measures associated with a 5% [hazard ratio 1.05; 95% confidence interval 1.01–1.09; P = 0.015] increased 7-year mortality risk. We found no statistically significant differences in mortality risk for trait anger, nor an effect for state or trait anger on time to first treated VA (all ps > 0.05). Conclusion This is the first study to examine the association of state and trait anger with long-term clinical outcomes in ICD patients. Evaluating anger reduction strategies in newly implanted ICD patients, such as self-regulation or mindfulness techniques, may be warranted for reducing mortality risk.

The world has been severely challenged by the Coronavirus Disease (COVID-19) outbreak since the early 2020s. Worldwide, there have been more than 66 million cases of infection and over 3,880,450 deaths caused by this highly contagious disease. All sections of the population including those who are affected, those who are not affected and those who have recovered from this disease, are suffering physiologically, psychologically or psychophysiologically. In this paper we briefly discuss the consequences of COVID-19 on physiological, psychological and psychophysiological vulnerability. We also attempt to provide evidence in support of exercise management as a prevention strategy for improving and minimizing the physiological, psychological and psychophysiological effects of COVID-19. Moderate exercise including walking, yoga and tai-chi to name but a few exercise regimes are critical in preventing COVID-19 and its complications. Governments, public health authorities and the general population should maintain physical activity during the COVID-19 pandemic to prevent additional physical and mental distress.

BACKGROUND The aim of the study is to assess the psychological and general scholastic performances of the children with type 1 diabetes. MATERIALS AND METHODS Study design is a hospital-based cross-sectional study. 42 children of age 1-15 years were enrolled for the study. Data collected from the records and from direct interviews of parents and children. Analysis were done based on CPMS and SDQ scoring system. Statistics was done using SPSS software and Student’s t-test was used for comparison. RESULTS Most of the children showed average school performance and reduction in school performance was noticed with advancing age. Psychological effects were experienced by all children and its severity increased with age. CONCLUSION Children with type 1 diabetes experience psychological stress due to the chronic nature of the illness. Financial constraints add to the stress. Severe stress was seen in older children and in girls. Regular follow up and counseling reduces the severity of stress.

Research question What are the main research interests among patients of assisted reproductive technologies (ART)? Design Cross-sectional study consisting of an anonymous online survey sent to 2112 patients from eight centres in four countries in 2018. Patients were asked to identify research questions relevant to them in the field of infertility and ART. Answers were categorized into topics and ranked by frequency. A long list of the top 30 research topics was extracted from the aggregate results, from which a short list of the top 10 research topics was created. Ten research questions were finally formulated. Results A total of 945 responses were analysed. Main interests were side-effects, success rates, infertility prevention and emotional support. The 10 research questions were: 1. What are the side-effects of drugs used in ART treatments? (51.6%). 2. What are the most effective methods to cope with infertility from the psychological point of view? (35.7%). 3. What effects could diet have on fertility? (25.9%). 4. What are ART success rates per clinical profile? (24.8%). 5. Are there some habits and lifestyle factors that could prevent infertility? (20.0%). 6. What are the long-term risks associated with ART in mother and child? (18.5%). 7. Are alternative therapies such as acupuncture, yoga and meditation effective to treat/prevent infertility? (18.5%). 8. What is the impact of exercise on fertility? (15.4%). 9. How does oocyte quantity and quality affect fertility? (9.5%). 10. What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%). Conclusions Researchers and clinicians should keep in mind that, in addition to success rates and safety, patients greatly value research into causes, prevention and emotional aspects of infertility.

This case study explores the relationship of a same-sex couple to analyse whether long term effects of homophobic bullying can be identified within it and in what shape or form. This study tries to shed light into a research void around the treatment of same-sex couples that have experiences of homophobic bullying within one or several of their life stages. Este estudio de caso explora la relación de una pareja del mismo sexo para analizar si los efectos a largo plazo del acoso homofóbico pueden identificarse dentro de la relación y en qué forma. Este estudio intenta arrojar luz sobre un vacío de investigación en torno al tratamiento de parejas del mismo sexo que han vivido experiencias de acoso homofóbico a lo largo de alguna o de varias etapas de su vida. Aquest estudi de cas explora la relació d'una parella del mateix sexe per analitzar si els efectes a llarg termini de l'assetjament homofòbic poden identificar-se dins de la relació i en quina forma. Aquest estudi intenta fer llum sobre un buit d'investigació al voltant del tractament de parelles del mateix sexe que han viscut experiències d'assetjament homofòbic al llarg d'alguna o de diverses etapes de la seva vida.

A study of the psychological effects of prolonged intubation on PTSD patients.

Introduction: The COVID-19 pandemic has exacted an appreciable burden on health systems globally including adverse psychological impacts on health workers. This study sought to assess COVID-19-related fear, depression, anxiety and stress among hospital staff, potential factors that may help reduce its psychological effects and their personal coping strategies. The study will help to highlight the psychological impact of COVID-19 on Ghanaian health workers and indirectly serve as a needs assessment survey for input to support affected staff and the broader health system. Methods: A cross-sectional survey was conducted among health workers in three hospitals in the Ashanti Region of Ghana from 11 July 2020 to 12 August 2020. Demographic data and scores from the validated DASS-21 and Fear of COVID-19 scales and two other scales developed de novo were entered from 272 self-administered questionnaires and analyzed for means, frequencies and proportions. Fisher’s exact test analysis was done to ascertain associations between selected independent variables and depression, anxiety, stress and fear. Parametric and non-parametric tests were used to compare the mean and median scores of the outcome variables across the three study hospitals. Results and conclusion: Over 40% of respondents had fear while 21.1%, 27.8% and 8.2% had depression, anxiety and stress, respectively. Positive attitudes from colleagues and the government’s tax-free salary relief were some factors said to reduce the psychological effects while over half of participants indicated praying more often as a coping strategy. There is a need for the health system to recognize the presence of these adverse psychological effects in health workers and take pragmatic steps to address them.

The aim of the article is to consider the psychological characteristics of involvement of youth in extremist community through the Internet. Methods. The theoretical analysis and modeling were used as the main methods. Results. The Internet is described as a means and space of psychological influence on young people, which can be both positive and negative. Absorption of teenagers, boys and young men, in a virtual space essentially converts their activity and, as a result, transform the leading activity, which in turn leads to different mental tumors. Three main effects from the exposure of the Internet are found out: «the effect of the goals of drift», mythology and «the effect of excitement»; their impact on the individual in each age periods is noted. Consideration of the main motivational reasons, taking into account the specifics of building human interaction with the environment made it possible to identify and describe the main types of behavioural patterns exhibited by young people on the Internet. The degree of activity of young people in the network is described from the perspective of integrated strategies of behaviour: information blocking, changes in the distance, control, transformations. Risk groups of users, the most susceptible to extremist manipulations are designated. «Vulnerability areas» of representatives of each group are summarized and described; a step-by-step algorithm of victims’ involvement in extremist communities by recruiters is described. Scientific novelty of the present study consists in discussion of one of the most acute problems of the present – the changed conditions of a growing and socialization of younger generation; constant stay in network virtual space is an integral part of today’s existence, wherein unformed and immature person is very vulnerable to the influence of extremist content. To prevent the increased potential threat of involvement of young people in destructive, asocial and criminal activity, the authors suggest to draw close attention and to subject to the purposeful attacks of extremist communities. Detailed studying of social and psychological features of network behaviour of youth being affected by the dangerous content will help to provide well-timed prophylaxis of extremist moods among young people. Practical significance. The materials of the research can be used to identify and effectively prevent the influence of extremist groups on young Internet users.

Highligths • Physicians may be psycologically affected in the battle against the Covid19 pandemics • The mental wellbeing of healthcare workers need to be taken into consideration • Women, young and less experienced people are in the high-risk group • The excessive workload and inadequate logistic support may increase the perception of risk, Aim To investigate anxiety, stress, and depression levels of physicians during the Covid-19 outbreak and explored associated factors in both clinical and general site. Methods An online survey is conducted to asses psychological responses of healthcare workers and related factors during Covid-19 outbreak. It is consisted of three subsections covering the following areas: 1) sociodemographic data 2) information on individuals` working condition 3) Depression Anxiety and Stress Scale-21 (DAS-21). Results Of all 442 participants, 286 (64.7%) had symptoms of depression, 224 (51.6%) anxiety, and 182 (41.2%) stress. Being female, young, and single, having less work experience, working in frontline were associated with higher scores, whereas having a child was associated with lower scores in each subscale. Factors found to be associated with higher DAS-21 total scores in frontline workers were as follows: increased weekly working hours, increased number of Covid-19 patients cared for, lower level of support from peers and supervisors, lower logistic support, and lower feelings of competence during Covid-19 related tasks. Conclusions Our findings highlight the factors which need to be taken into consideration to protect the mental wellbeing of doctors while fighting with a disaster that has major impacts on society worldwide.

Background: COVID-19 and associated lockdown have had some detrimental effects on the health care professionals. With the maximum fear of getting infected and further transmitting the infection, dentists are suffering from the psychological meltdown along with the physical changes due to altered lifestyle. Aim and Objectives: To evaluate the psychological and physical effects of COVID-19 and consequential lockdown on dentists and to understand the possible reasons for the problems they were facing amidst lockdown due to the changes in their lifestyle. Settings and Design: A questionnaire-based survey to evaluate disaster mental health and analysis of musculoskeletal symptoms was designed and sent to the various groups of dentists. A total of 453 respondents completed the survey. Materials and Method: Cluster sampling method was used and the dentists were segregated into four groups. The responses were evaluated for Post-traumatic stress disorder, Depression, Anxiety and Pain or discomfort. Statistical Analysis: Chi Square test was applied to statistically assess the association of responses. Results: Out of 453 respondents 65.1% were females and 34.9% were males. Based on profession, 23% were academicians, 18.8% private practitioners, 16.8% post-graduate students and 41.5% undergraduates. Females were significantly affected and showed a tendency towards Post traumatic stress disease (PTSD) and potential depression along with pain and discomfort. All the three groups except undergraduate students showed potential symptoms. Conclusion: COVID-19 and the lockdown exhibited significant psychological and physical effects on the dentists. Counselling centers or helplines/portals need to be set up to avoid any grave consequences and untoward losses.

Objetivo: determinar si existe relación entre el estrés percibido y la calidad de sueño en las enfermeras de los turnos nocturno y rotativo de la empresa social del Estado Hospital San Rafael de Facatativá. Metodología: estudio transversal con alcance correlacional donde se evaluó el estrés percibido y la calidad de sueño por medio de la escala de estrés percibido - versión 14 y el índice de calidad de sueño de Pittsburg -versión colombiana, respectivamente, en una muestra de 98 enfermeras que cumplieron con los criterios de inclusión. Resultados: se presentó una prevalencia del 72,45% de estrés percibido y del 79,59% de mala calidad de sueño; entre estas dos variables se halló una correlación baja (r=0,258; p=0,010). Se puede asegurar con un 95% de confianza que mientras una variable aumenta, la otra también lo hace, queriendo decir que a mayor puntaje en la escala de estrés percibido, mayor puntaje en el índice de calidad de sueño de Pittsburgh, lo que sugiere que el nivel de estrés es un factor que tiene relación directamente proporcional con el sueño, es decir, entre mayor estrés, peor calidad de sueño. Conclusiones: se concluye que sí existe relación entre el estrés percibido y la calidad de sueño, lo cual evidencia, por un lado, que en las enfermeras a mayor estrés, peor calidad de sueño, y por otro, que a peor calidad de sueño, mayor estrés. Objective: To determine if there is a relationship between perceived stress and sleep quality in nurses in the night and rotating shifts of the social enterprise of the State Hospital San Rafael of Facatativá. Methodology: cross-sectional study with a correlational scope where the perceived stress was assessed through the Perceived Stress Scale, Version 14, and sleep quality using the Pittsburg Sleep Quality Index, Colombian Version, in a sample of 98 nurses who met the inclusion criteria. Results: a prevalence of 72.45% of perceived stress and 79.59% of poor sleep quality were perceived; there was a low correlation between these two variables (r= 0.258; p=0.010). It can be ensured with 95% of confidence that when one variable increases, the other one does the same; this means that higher stress level in the perceived stress scale implies a higher score in the Pittsburgh Sleep Quality Index, which suggests that stress level is a factor that has direct proportionality with sleep; so, higher stress level is equal to worse sleep quality. Conclusions: It is concluded that there is a relationship between perceived stress and sleep quality, showing that, the greater the stress in the nurses, the worse the quality of sleep, and conversely, the worse the quality of sleep, the greater the stress.

Background Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia. Methods A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models. Result A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p

The current study aims at analysing the perception and opinions of people exposed to Wind Turbine (WT) noise. Noise measurements were carried out in a wind farm in the north of Portugal. Data were analysed and crossed with the answers to a survey applied in four nearby villages. Although the noise levels were generally low, it was found that the direct visibility of the WT makes people feel more annoyed and also more sensitive to noise. Finally, it seems that the economic interests that exposed people may have in WT did not significantly affect their annoyance. Noise annoyance perception rather seems to be related to specific aspects, such as the general opinion of people about wind power generation.

Background Current Alzheimer’s disease (AD) research initiatives focus on cognitively healthy individuals with biomarkers that are associated with the development of AD. It is unclear whether biomarker results should be returned to research participants and what the psychological, behavioral and social effects of disclosure are. This systematic review therefore examines the psychological, behavioral and social effects of disclosing genetic and nongenetic AD-related biomarkers to cognitively healthy research participants. Methods We performed a systematic literature search in eight scientific databases. Three independent reviewers screened the identified records and selected relevant articles. Results extracted from the included articles were aggregated and presented per effect group. Results Fourteen studies met the inclusion criteria and were included in the data synthesis. None of the identified studies examined the effects of disclosing nongenetic biomarkers. All studies but one concerned the disclosure of APOE genotype and were conducted in the USA. Study populations consisted largely of cognitively healthy first-degree relatives of AD patients. In this group, disclosure of an increased risk was not associated with anxiety, depression or changes in perceived risk in relation to family history. Disclosure of an increased risk did lead to an increase in specific test-related distress levels, health-related behavior changes and long-term care insurance uptake and possibly diminished memory functioning. Conclusion In cognitively healthy research participants with a first-degree relative with AD, disclosure of APOE ε4-positivity does not lead to elevated anxiety and depression levels, but does increase test-related distress and results in behavior changes concerning insurance and health. We did not find studies reporting the effects of disclosing nongenetic biomarkers and only one study included people without a family history of AD. Empirical studies on the effects of disclosing nongenetic biomarkers and of disclosure to persons without a family history of AD are urgently needed. Trial registration PROSPERO international prospective register for systematic reviews CRD42016035388. Registered 19 February 2016.

It has been 30years since the worst accident in the history of the nuclear era occurred at the Chernobyl power plant in Ukraine close to densely populated urban areas. To date, epidemiological studies reported increased long-term risks of leukemia, cardiovascular diseases, and cataracts among cleanup workers and of thyroid cancer and non-malignant diseases in those exposed as children and adolescents. Mental health effects were the most significant public health consequence of the accident in the three most contaminated countries of Ukraine, Belarus, and the Russian Federation. Timely and clear communication with affected populations emerged as one of the main lessons in the aftermath of the Chernobyl nuclear accident.

It has been 30 years since the worst accident in the history of the nuclear era occurred at the Chernobyl power plant in Ukraine close to densely populated urban areas. To date, epidemiological studies reported increased long-term risks of leukemia, cardiovascular diseases, and cataracts among cleanup workers and of thyroid cancer and non-malignant diseases in those exposed as children and adolescents. Mental health effects were the most significant public health consequence of the accident in the three most contaminated countries of Ukraine, Belarus, and the Russian Federation. Timely and clear communication with affected populations emerged as one of the main lessons in the aftermath of the Chernobyl nuclear accident.

194-198 В статье представлена инновационная технология образовательной системы, основанная на субъектно-ориентированном подходе. В работе раскрывается сравнение традиционных и инновационных методов преподавательской деятельности, а также проводится анализ данных систем на основе качественных показателей. Статья направлена на совершенствование технологий субъектно-ориентированного подхода к студентам вуза. The paper presents the innovative technology of educational system, based on subject-oriented approach. In this text we consider the comparison of traditional and innovative methods of teaching, as well as an analysis of these systems on the basis of quality indicators. This article aimed at improving the technologies of subject-oriented approach to the students.

194-198 В статье представлена инновационная технология образовательной системы, основанная на субъектно-ориентированном подходе. В работе раскрывается сравнение традиционных и инновационных методов преподавательской деятельности, а также проводится анализ данных систем на основе качественных показателей. Статья направлена на совершенствование технологий субъектно-ориентированного подхода к студентам вуза. The paper presents the innovative technology of educational system, based on subject-oriented approach. In this text we consider the comparison of traditional and innovative methods of teaching, as well as an analysis of these systems on the basis of quality indicators. This article aimed at improving the technologies of subject-oriented approach to the students.

Currently, there is a paucity of studies evaluating the adverse health effects of benzene exposure in children or clinical findings of those children who have been exposed. However, emerging studies show that benzene exposure can cause deleterious health effects in children. The objective of this study was to evaluate and summarize published studies on the adverse health effects of benzene exposure in children. More than 77 articles were examined and only the articles that dealt with adverse health effects on pediatric populations were included in the study. The evaluation of those studies provided current understanding of the health effects of benzene exposure in children. Findings from the currently available studies reveal that benzene exposure is associated with abnormalities in hematologic, hepatic, respiratory, and pulmonary functions in children. Published studies clearly support the need for further assessment of the potential adverse effects of benzene exposure in children, and clinical and laboratory findings of these children.

This work deals with the relationship between induced abortion and mental health with a special focus on the area of political controversy. This article explores the historical background of the abortion and its legislative implications in Europe with special reference to Bosnia and Herzegovina. This work is based on etnographich, analitical and historical aproaches. It explains abortion in medical terms and analyzes the psychological effects of the abortion. This is a significant and challanging topic for those who find themselves facing the moral dilemma of whether or not to terminate a pregnancy. Problems of controversy are numerous. Is abortion a murder or not? Is fetus a person or not? When it becomes the one if ever till the birth? If abortion is not morally wrong, that doesn't mean that it's right to have an abortion. If abortion is morally wrong, that doesn't mean that it is always impermissible to have an abortion. The comon dilema is whether having an abortion is less wrong than the alternatives. These are some of the questions this paper deals with.

Three-dimensional displays provide an unambiguous visual representation of the spatial structure of natural scenes and computer-generated virtual environments and thus have proven substantial advantages over conventional displays in remote guidance and inspection tasks and in application fields such as medical imagery and architectural and molecular modelling. Recent years have seen increasing efforts to extend 3D technologies into the domain of image communications. These efforts received support from human factors studies indicating that 3D displays are highly appreciated by prospective users of image communications systems for their enhanced psychological effects (telepresence and communicative presence). On the other hand, these studies have revealed heavy technological requirements that must be met in order to avoid visible image distortions and increased visual strain.