Search Results (101)

Background/Objectives: Given the heterogeneous nature of long COVID, its treatment and management remain challenging. This study aimed to investigate whether poor pre-pandemic sleep quality, its deterioration during the peak of the pandemic, and circadian preference increase the risk of long COVID symptoms. Methods: An online survey was conducted between 9 October and 12 December 2022, with 384 participants who had recovered from COVID-19 at least three months prior to data collection. Participants were categorized based on the presence of at least one long COVID symptom. Logistic regression models assessed associations between sleep-related variables and long COVID symptoms. Results: Participants with long COVID symptoms reported significantly poorer sleep quality, higher perceived stress, greater somatic and cognitive pre-sleep arousal, and elevated levels of post-traumatic stress symptoms, anxiety, depression, and aggression. Fatigue (39.8%) and memory problems (37.0%) were the most common long COVID symptoms. Sleep deterioration during the pandemic peak was reported by 34.6% of respondents. Pre-pandemic poor sleep quality, its deterioration during the pandemic, and poor sleep at the time of the survey were all significantly associated with long COVID. An extreme morning chronotype consistently predicted long COVID symptoms across all models, while an extreme evening chronotype was predictive only when accounting for sleep quality changes during the pandemic. COVID-19 frequency, severity, financial impact, and somatic pre-sleep arousal were significant predictors in all models. Conclusions: Poor sleep quality before the pandemic and its worsening during the pandemic peak are associated with a higher likelihood of long COVID symptoms. These findings underscore the need to monitor sleep health during pandemics and similar global events to help identify at-risk individuals and mitigate long-term health consequences, with important clinical and societal implications. Full article

Background: It is common for patients with eating disorders (ED) to report traumatic experiences early in their lifetime. The objective of this study was to explore the presence and types of traumatic events and the comorbidity with Post-Traumatic Stress Disorder (PTSD) in a sample of adolescents with severe ED. Method: A total of 118 adolescents treated at our Eating Disorders Day Care Hospital (EDDCH) were systematically evaluated for depressive symptoms, disordered eating, early traumatic experiences, and presence of PTSD. Likewise, various clinical variables were collected including comorbidities, age upon ED diagnosis, number of hospital admissions, presence of non-suicidal self-injury, and suicide attempts. Results: Seventy-seven (65.3%) of adolescents of the total sample reported exposure to four or more traumatic events (bullying, psychological abuse, and sexual abuse being the most common). Fifty-seven of them (48.3% of the total sample) scored significantly high in PTSD assessment. Patients with ED and comorbid PTSD (PTSD+) presented higher disordered eating (p < 0.001) and depressive symptoms (p < 0.001) and also a higher prevalence of both non-suicidal self-injury (p = 0.031) and suicide attempts (p = 0.004). The depressive symptoms, measured with the CDI, emerged as an independent predictor of belonging to the PTSD+ group, explaining 22.9% of the variance. Conclusions: It is imperative to systematically screen adolescents with severe ED for traumatic events and PTSD, especially in patients presenting with more depressive symptoms and suicidal or non-suicidal self-injury behaviours, since this subset of patients could be at a higher risk of PTSD. Offering specific psychotherapeutic care targeting PTSD and/or posttraumatic symptoms in addition to the ED standard of care could arguably improve the prognosis of the ED in comorbid patients. Full article

Post-traumatic stress disorder (PTSD) is a complex, debilitating condition prevalent among military personnel exposed to traumatic events, necessitating biomarkers for early detection and intervention. Using data from the Millennium Cohort Study, the largest and longest-running military health study initiated in 2001, our objective was to identify specific microRNA (miRNA) expression patterns associated with distinct PTSD symptom trajectories among service members and veterans and assess their potential for predicting resilience and symptom severity. We analyzed 1052 serum samples obtained from the Department of Defense Serum Repository and linked with survey data collected at baseline and across three follow-up waves (2001–2011), using miRNA sequencing and statistical modeling. Our analysis identified five PTSD trajectories—resilient, pre-existing, new-onset moderate, new-onset severe, and adaptive—and revealed significant dysregulation of three key miRNAs (miR-182-5p, miR-9-5p, miR-204-5p) in participants with PTSD compared to resilient individuals. These miRNAs, which inhibit brain-derived neurotrophic factor (BDNF) and target pathways like NFκB, Notch, and TGF-alpha, were associated with neuronal plasticity, inflammation, and tissue repair, reflecting PTSD pathophysiology. These findings suggest that miRNA profiles could serve as biomarkers for early identification of PTSD risk and resilience, guiding targeted interventions to improve long-term health outcomes for military personnel. Full article

This sought seeks to find and examine the main stress factors and psychosocial settings that affect ambulance staff, looking at the larger problem of how these stressors impact their mental well-being and work satisfaction. The research collected data from a field survey that identified and assessed stress factors, as well as qualitative insights from interviews that examined staff perceptions of complex work conditions in emergency services. Important findings show that high-stress situations, like dealing with traumatic events, long hours, and insufficient support, are linked to higher anxiety and burnout in ambulance workers. Moreover, the study points out important features of the work environment, such as workplace relationships and organizational culture, that can either reduce or increase stress. These findings are important, as they could guide healthcare policies that seek to improve the well-being of emergency service workers, which is crucial for maintaining a strong and effective workforce in pre-hospital care. By stressing the urgent need for effective approaches and supportive work structures, this research can have wider implications for healthcare, indicating that tackling the psychosocial issues faced by ambulance staff is crucial not just for their own well-being but also for the overall quality of emergency medical services. Full article

Background: Refugees often experience multiple traumatic events due to persecution, conflict, and displacement, which can result in poor mental health outcomes. Objective: The current study examined whether coping and resilience mediate the relationship between traumatic experience(s) and mental health outcomes and whether these indirect effects were moderated by age, gender, and refugee camp duration. Method: A cross-sectional, correlational study design was employed. Data were collected from 14 July 2019 to 28 August 2019. A sample of 414 adolescent refugees from two refugee camps in the Gambella regional state of Ethiopia were selected using proportional stratified sampling and simple random sampling techniques. Participants completed a self-reported questionnaire. Data were analysed using Structural Equation Modelling for hypotheses testing causal models. Results: Coping and resilience fully mediated the relationship between traumatic experience and mental health among adolescent refugees. Refugee camp duration as a moderator factor weakens the positive relationship between traumatic experiences and mental health outcomes. Conclusions: This study highlights the critical importance of comprehensive intervention strategies that strengthen adolescent refugee personal, family, social, and community level coping and resilience abilities within refugee camps setting. The findings also strongly suggested that early intervention in refugee camps could protect adolescent refugees from possible psychological distress and maintain adolescents’ mental health and well-being within refugee camps. Full article

Background: This study investigates the medium-term psychosocial impacts of the 2021 floods in Belgium, which caused fatalities and considerable infrastructural damage. Given similar events’ significant impacts on psychosocial well-being, this study seeks to answer three questions: whether there are medium-term (two years and further) effects on residents’ psychosocial well-being, whether demographic variables influence these effects, and how flood exposure impacts psychosocial well-being. Methods: We collected data in affected municipalities through an online survey, assessing demographic variables (e.g., age, gender, education, SES), flood exposure (e.g., being physically hurt, being faced with financial difficulties), and psychosocial well-being, employing two validated instruments for quantitative evaluation: the RAND-36 and the Traumatic Exposure Severity Scale (TESS). Results: The sample included 114 participants, with 54% reporting a deterioration in their psychosocial well-being after the floods. Additionally, over 50% mentioned the psychosocial impact of the floods. SES was the only significant demographic variable impacting psychosocial well-being, with lower SES linked to higher deterioration. Financial difficulties generated by the floods were the only considerable exposure factor. Furthermore, 22% discussed being unhappy with the organized response measures. Due to the sample size, confounding effects could not be checked. Conclusions: This study found a medium-term effect of the 2021 floods on psychosocial well-being, highlighting the need for policy adaptations focused on post-disaster psychosocial support. With lower SES and financial difficulties as risk factors, one needs to design policies tailored to these vulnerable groups. With climate change expected to increase flood events, context-specific policies are essential to boost resilience. Full article

This study analyzes the award-winning documentary film Searching for Rodakis, directed by Kerem Soyyilmaz, produced in 2023. The aim of this study is the historic comprehension and analysis of this filmic narrative in the field of social–semiotic literacy and its utilization in historical studies for approaching issues of conflict in modern history, otherness, collective experience and trauma, and collective memory. The research material is the documentary Searching for Rodakis (produced by Denmark, Turkey 2023; screenplay/director, Kerem Soyyilmaz; duration, 57’), which received the following awards: Adana Golden Boll FF 2023 Turkey | Best Documentary, Thessaloniki International Doc. Festival 2023 Greece, Greek Film Festival Los Angeles 2023 USA, and Istanbul Documentary Days 2023 Turkey. As regards the historic context, the year of production, 2023, coincides with the 100th anniversary of the signing of the Treaty of Lausanne, where Turkey’s current borders were set and the “population exchange” legally sealed, i.e., the violent expulsion of 400,000 Muslims, citizens of Greece, many of whom spoke only Greek, and 200,000 Orthodox citizens of Turkey, who in the majority spoke Turkish. At the same time, the Treaty of Lausanne ratified and finalized the expulsion of approximately one million Orthodox who were forced to leave the Ottoman Empire, as well as 120,000 Muslims who had fled Greece since the beginning of the Balkan Wars (1912–1913). About two million people were deported and lost their citizenship and property, in the context of “national homogeneity” (which connotes an ethnic cleansing), with the official states ignoring the criticisms of lawyers and academics who spoke of violations of constitutional rights. Mohammedan Greeks, estimated at around 190,000 as early as 1914, based on ecclesiastical statistics in the Pontus region, did not receive attention from the provisions of the Treaty of Lausanne, even though linguistically and culturally (origin, customs, culture and traditions) they did not differ in any way from the Orthodox Greeks. In Turkey, there was general indifference to the thousands of desperate people who arrived, with the exception of a few academics and the Lausanne Exchange Foundation. The filmic scenario is as follows: as a Greek tombstone of unknown origin is discovered underneath the floorboards in an old village house in Turkey, an almost forgotten story from the country’s creation unravels—the forced population exchange between Greece and Turkey in 1923. The engraved Greek letters tell of a woman, Chrysoula Rodaki, who died in 1887. Thus the search for her descendants begins. It leads director Kerem Soyyilmaz to local archives, where his own family’s role in history is laid bare; to abandoned ghost towns, and through the memories of older villagers—all while Soyyilmaz meets massive support for his quest from Greeks on the other side of the border. The stone becomes a portal to the past—and for a while, the trauma becomes redeemed when the previous owners of the village house return. Searching for Rodakis is a movie that reconnects people, culture, and the stories that were discarded in order to build a strong, nationalist state—told through the director’s personal experiences. The research questions, as they arise from the cinematographic material itself, are as follows: How is the historical memory of traumatic events of the previous century, such as the exchange of populations according the Treaty of Lausanne, recorded in the cinematographic narrative? What are the historical sources? To what extent did the origin, ethnicity, and geographical location of the narrators as participants influence the preservation of historical memory and the historical research? What are the criteria of the approach of the creator, and what are the criteria of the participants? Methodologically, we apply historic and socio-semiotic analyses in the field of public and digital history. The results: The types of historical sources found in filmic public discourse include the oral narration of testimonies, of experiences and of memories, as well as the director’s historical research in state archives, the material cultural objects, and the director’s digital research. Thus, historic thematic categories occur, such as the specific persons and actions in Turkey/Greece, actions on-site and in online research, and the types of historical sources, such as oral testimonies, research in archives, and objects of material culture. Sub-themes such as childhood, localities and kinship also emerge. These cinematic recordings of biographical oral narratives as historical and sociological material help us understand the political ideologies of the specific period, between the years 1919 and 1923. The multimodal film material is analyzed to provide testimonies of oral and digital history; it is utilized to approach the historical reality of “otherness”, seeking dialogue in cross-border history in order to identify differences, but above all the historic and cultural similarities against sterile stereotypes. The historic era and the historic geography of the Greek and Turkish national histories concern us for research and teaching purposes a hundred years after the Treaty of Lausanne which set the official borders of the countries. Full article

Background/Objectives: A person-under-train (PUT) incident is a traumatic event for train drivers that can result in serious health consequences. This systematic review aimed to identify and synthesize evidence on these health effects, including post-traumatic stress disorder (PTSD), sickness absence (SA), and other related mental health outcomes. Methods: Following the PECO scheme, we searched the PubMed, Web of Science, and Embase databases for studies published between 1980 and 2021. We included cross-sectional, case–control, prospective, and interventional studies focusing on train drivers exposed to PUT incidents. Data synthesis followed PRISMA guidelines, with quality appraisal using the Downs and Black checklist. Results: The search was conducted on 22 September 2022, resulting in 3673 records. Nine studies were included, involving a total of 3425 participants. PTSD prevalence ranged from 0% to 55.3%, depending on study design and timing of data collection. Risk factors included repeated exposure, lack of social support, and proximity to the victim. SA varied widely, with durations ranging from 1 day to over 6 months. Drivers frequently reported depression, somatoform disorders, and other long-term psychological impacts. Conclusions: PUT incidents significantly affect the mental health of train drivers and their ability to return to work, frequently leading to extended sickness absence. The timely identification of at-risk individuals and the implementation of best-practice interventions could mitigate long-term effects. Future research should explore standardized follow-up periods to improve comparability. Full article

There is limited information regarding factors related to education workers’ responses to traumatic stress during the COVID-19 pandemic. The study goal was to determine whether personal factors, behaviours that mitigate viral spread, and work-related factors were associated with post-traumatic symptoms. This observational study, embedded within a cohort study, recruited Ontario education workers from February 2021 to June 2023. Exposure data were collected at enrollment and updated annually. Participants completed the Impact of Event Scale (IES) at withdrawal/study completion. Modified Poisson regression was used to build hierarchical models of dichotomized IES scores (≥26: moderate/severe post-traumatic symptoms). Of the 1518 education workers who submitted an IES between September 2022 and December 2023, the incidence rate ratio of IES scores ≥26 was significantly higher among participants who usually/always wore a mask at work (1.48; 95% confidence interval 1.23, 1.79), usually/always practiced physical distancing (1.31; 1.06, 1.62), lived in larger households (1.06; 1.01, 1.12), and reported poor/fair/good health (1.27; 1.11, 1.46). However, models accounted for little of the variance in IES scores, suggesting the need for future studies to collect data on other factors associated with the development of PTSD, such as pre-existing mental health challenges. Early identification of those experiencing traumatic stress and the implementation of stress reduction strategies are needed to ensure the ongoing health of education workers. Full article

(1) Background: Hip fractures are highly prevalent traumatic events with significant functional consequences, particularly among the older population. These fractures are associated with increased mortality, postoperative complications, and functional dependence. Medical and nutritional factors such as malnutrition and sarcopenia are crucial for predicting functional outcomes and mortality in these patients. This study aimed to assess the nutritional status, vitamin D levels, and sarcopenia, as well as their relationship with mortality, mean hospital stay, and 30-day-readmission rate, in patients with hip fracture who underwent surgery in a rural hospital setting. (2) Methods: A longitudinal retrospective study involving 124 patients who underwent hip fracture surgery in 2021 was conducted. Sociodemographic, surgical, and nutritional data, including vitamin D, albumin, and blood urea nitrogen (BUN) levels, were collected. (3) Results: The average age of the sample was 89.1 years, with a postoperative 30-day-mortality rate of 8.1% and an average hospital stay of 10.4 days. Vitamin D deficiency was present in 79.7% of patients, and a high prevalence of malnutrition was indicated by low albumin and elevated BUN levels. Elevated BUN levels and low vitamin D levels were associated with higher mortality. (4) Conclusions: Adequate nutritional assessment in patients with hip fracture is vital for identifying the risks of complications and mortality. Understanding the current nutritional status and its associated complications will aid in developing strategies to improve health and reduce complications in the future. Full article

Background: There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability. Methods: Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training. Results: Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement. Conclusions: The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations. Full article

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21–77 years). The study predictors were sociodemographic characteristics, occupational status, factors related to the work environment, COVID-19-related adverse events, and lifetime traumatic events. The poor mental health outcomes that were considered were depersonalization/derealization, anxiety, depression, and somatization symptoms. Results: The main predictors of poor mental health outcomes were sleeping less than six hours per night, inadequate protective equipment measures, female gender, personal and familiar infection, living alone, working as a nurse, and working in a COVID-19 ward. Healthcare workers in 2021 reported experiencing more serious accidents and stressful events than those of the first wave. Depressive symptoms and COVID-19-related adverse events were higher in the second pandemic outbreak than in the first. Conclusions: Preventive strategies against poor mental health outcomes should be particularly focused on female nurses who live alone, work in areas with high infection rates, and have experienced the COVID-19 infection personally or who are close to people that have experienced the infection. Full article

Objectives: Facial fractures and associated traumatic brain injuries represent a worldwide public health concern. Therefore, we aimed to determine the pattern of brain injury accompanying facial fractures by comparing adult patients with and without facial fractures in terms of demographic, clinical, and imaging features. Methods: This single-center, retrospective study included 492 polytrauma patients presenting at our emergency department from January 2019 to July 2023, which were divided in two groups: with facial fractures (FF) and without facial fractures (non-FF). The following data were collected: age, sex, mechanism of trauma (road traffic accident, fall, and other causes), Glasgow Coma Scale (GCS), the evolution of the patient (admitted to a medical ward or intensive care unit, neurosurgery performed, death), and imaging features of the injury. Data were analyzed using descriptive tests, Chi-square tests, and regression analyses. A p-value less than 0.05 was considered statistically significant. Results: In the FF group, there were 79% (n = 102) men and 21% (n = 27) women, with a mean age of 45 ± 17 years, while in the non-FF group, there were 70% (n = 253) men and 30% (n = 110) women, with a mean age 46 ± 17 years. There was a significant association between brain injuries and facial fractures (p < 0.001, AOR 1.7). The most frequent facial fracture affected the zygoma bone in 28.1% (n = 67) cases. The most frequent brain injury associated with FF was subdural hematoma 23.4% (n = 44), and in the non-FF group, the most common head injury was intraparenchymal hematoma 29% (n = 73); Conclusions: Both groups shared similarities regarding gender, age, cause of traumatic event, and outcome but had significant differences in association with brain injuries, ICU admission, and clinical status. Full article

In this article, I propose a collaborative preaching model for healing collective trauma. It begins with the preaching context of a society in the grip of collective trauma after a traumatic event. Taking the May 1998 tragedy in Jakarta, Indonesia, as a case study and employing descriptive, historical, and analytical methods, this study argues that the Church is called to respond to collective trauma in its ministries as part of God’s mission. The research focuses specifically on the ministry of preaching and explores theories of trauma-aware preaching to affirm that preaching can indeed be a medium for healing collective trauma. I then present a collaborative preaching model for collective trauma healing by integrating a conversational preaching approach with the local Indonesian traditions of gotong-royong and musyawarah-mufakat. Full article

Individuals have different rumination patterns after experiencing traumatic events in different cultural backgrounds and situations. This study aimed to explore the experience of Chinese young and middle-aged patients with acute coronary syndrome (ACS) to understand the content and nature of their rumination. Sixteen participants were selected using the purposive sampling method in the First Affiliated Hospital of Soochow University from May 2023 to December 2023. Data were collected using semi-structured interviews and analyzed using Colaizzi’s seven-step phenomenological method. The participants went through two successive stages: non-adaptive rumination and adaptive rumination. During the initial admission phase, all the participants experienced varying degrees of non-adaptive rumination. Non-adaptive rumination included four sub-themes: worry or anxiety of daily activities and medical therapy (37.50%), fear of unpredictable outcomes and death (37.50%), sadness of maladjustment (25.00%), and remorse of carelessness (12.50%). During the period of stable condition and pre-discharge, the participants received health education and gradually all transitioned to adaptive rumination. Adaptive rumination included four sub-themes: tracing of disease processes (100%), enhancement of disease cognition (81.25%), improvement of health awareness (62.50%), and adjustment of lifestyle cognition (100%). In conclusion, although the Chinese young and middle-aged patients with ACS experienced negative emotions after a traumatic cardiac event, they gradually made positive changes, and optimism and information support played important roles in this transition. The results of this study provide a fundamental understanding of rumination experiences in Chinese young and middle-aged patients with ACS and provide new data for healthcare providers when designing intervention programs to enhance post-traumatic growth in these patients. Full article