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Fear of stinging insects in relation to state anxiety and trait anxiety in a group of patients with hymenoptera venom allergy undergoing immunotherapy.
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Fear of stinging insects in relation to state anxiety and trait anxiety in a group of patients with hymenoptera venom allergy undergoing immunotherapy.

Postepy Dermatol Alergol. 2019 Aug;36(4):472-477

Authors: Woźniewicz A, Szynkiewicz E, Pałgan K, Graczyk M, Dowbór-Dzwonka A, Bartuzi Z

Abstract
Introduction: The level of fear of hymenoptera associated with stinging or envenomation may depend on situational factors and on trait anxiety characteristic of each patient.
Aim: To assess the relationship between fear of stinging insects on the one hand and state anxiety and trait anxiety on the other in a group of patients with hymenoptera venom allergy.
Material and methods: The study was conducted by the Department of Allergy, Clinical Immunology and Internal Diseases, Dr J. Biziel University Hospital No. 2 in Bydgoszcz, Poland. A total of 114 patients (71 women (63%) and 43 men (37%)) with hymenoptera venom allergy undergoing immunotherapy participated in the study. The State-Trait Anxiety Inventory (STAI) and a dedicated scale developed by the authors for this study were used.
Results: State anxiety was found to significantly (p < 0.05) correlate with anxiety in the present moment (R = 0.247), in a situation of real danger (appearance of an insect) (R = 0.223) and during the spring and summer seasons (R = 0.278). Trait anxiety was found to significantly (p < 0.05) correlate with anxiety before immunotherapy (R = 0.261), in the present moment (R = 0.257), in a situation of real danger (appearance of an insect) (R = 0.254), and after an insect sting (R = 0.236). These were also weak correlations. The correlation between trait anxiety and anxiety during the spring and summer seasons was moderate (R = 0.331).
Conclusions: The levels of trait and state anxiety are associated with the magnitude of the fear of the danger. Respondents showed a higher level of anxiety in a situation of danger and after an insect sting.

PMID: 31616224 [PubMed]



A systematic review of qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa.
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A systematic review of qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa.

BMC Public Health. 2019 Oct 15;19(1):1289

Authors: Njau B, Covin C, Lisasi E, Damian D, Mushi D, Boulle A, Mathews C

Abstract
BACKGROUND: More than 40% of adults in Sub-Saharan Africa are unaware of their HIV status. HIV self-testing (HIVST) is a novel approach with a potential to increase uptake of HIV testing and linkage to care for people who test HIV positive. We explored HIV stakeholder's perceptions about factors that enable or deter the uptake of HIV self-testing and experiences of self-testing of adult users in Africa.
METHODS: This systematic review of qualitative evidence included articles on qualitative studies published or made available between January 1998 to February 2018 on perspectives of key stakeholders, including HIV policymakers, HIV experts, health care providers, and adult men and women (18 years and above) about factors that enable or deter the uptake of HIV self-testing and experiences of self-testing among adult users. We searched CINAHL, MEDLINE in Pubmed, EMBASE, AJOL, PsycINFO, Social Science Citation Index (SSCI), and Web of Science for articles in English on HIVST with qualitative data from different African countries.
RESULTS: In total, 258 papers were retrieved, and only nine (9) studies conducted in 5 African countries were eligible and included in this synthesis. Perceived facilitators of the uptake of HIVST were autonomy and self-empowerment, privacy, confidentiality, convenience, opportunity to test, including couples HIV testing, and ease of use. The perceived barriers included the cost of buying self-test kits, perceived unreliability of test results, low literacy, fear and anxiety of a positive test result, and potential psychological and social harms. HIV stakeholder's concerns about HIVST included human right issues, lack of linkage to care, lack of face-to-face counseling, lack of regulatory and quality assurance systems, and quality of self-test kits. Actual HIVST users expressed preference of oral-fluid self-testing because of ease of use, and that it is less invasive and painless compared to finger-stick/whole blood-based HIV tests. Lack of clear instructions on how to use self-test kits, and existing different products of HIVST increases rates of user errors.
CONCLUSIONS: Overcoming factors that may deter HIV testing, and HIVST, in particular, is complex and challenging, but it has important implications for HIV stakeholders, HIVST users, and public health in general. Research is warranted to explore the actual practices related to HIVST among different populations in Africa.

PMID: 31615461 [PubMed - in process]



Acupuncture modulates stress response by the mTOR signaling pathway in a rat post-traumatic stress disorder model.
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Acupuncture modulates stress response by the mTOR signaling pathway in a rat post-traumatic stress disorder model.

Sci Rep. 2018 08 08;8(1):11864

Authors: Oh JY, Kim YK, Kim SN, Lee B, Jang JH, Kwon S, Park HJ

Abstract
Post-traumatic stress disorder (PTSD) is a psychiatric disease that can form following exposure to a traumatic event. Acupuncture has been proposed as a beneficial treatment for PTSD, but the underlying mechanisms remain unclear. The present study investigated whether acupuncture improves depression- and anxiety-like behaviors induced using a single prolonged stress (SPS) as a PTSD rat model. In addition, we investigated whether the effects were mediated by increased mTOR activity and its downstream signaling components, which contribute to protein synthesis required for synaptic plasticity in the hippocampus. We found that acupuncture at HT8 significantly alleviated both depression- and anxiety-like behaviors induced by SPS in rats, as assessed by the forced swimming, elevated plus maze, and open field tests; this alleviation was blocked by rapamycin. The effects of acupuncture were equivalent to those exerted by fluoxetine. Acupuncture regulated protein translation in the mTOR signaling pathway and enhanced the activation of synaptic proteins, PSD95, Syn1, and GluR1 in the hippocampus. These results suggest that acupuncture exerts antidepressant and anxiolytic effects on PTSD-related symptoms by increasing protein synthesis required for synaptic plasticity via the mTOR pathway in the hippocampus. Acupuncture may be a promising treatment for patients with PTSD and play a role as an alternative PTSD treatment.

PMID: 30089868 [PubMed - indexed for MEDLINE]



Transcutaneous vagus nerve stimulation and extinction of prepared fear: A conceptual non-replication.
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Transcutaneous vagus nerve stimulation and extinction of prepared fear: A conceptual non-replication.

Sci Rep. 2018 07 31;8(1):11471

Authors: Burger AM, Van Diest I, van der Does W, Hysaj M, Thayer JF, Brosschot JF, Verkuil B

Abstract
Transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) may accelerate fear extinction in healthy humans. Here, we aimed to investigate this hypothesis in healthy young participants in a prepared learning paradigm, using spider pictures as conditioned stimuli. After a fear conditioning phase, participants were randomly allocated to receive tVNS (final N = 42) or sham stimulation (final N = 43) during an extinction phase. Conditioned fear was assessed using US expectancy ratings, skin conductance and fear potentiated startle responses. After successful fear acquisition, participants in both groups showed a reduction of fear over the course of the extinction phase. There were no between-group differences in extinction rates for physiological indices of fear. Contrary to previous findings, participants in the tVNS condition also did not show accelerated declarative extinction learning. Participants in the tVNS condition did have lower initial US expectancy ratings for the CS- trials than those who received sham stimulation, which may indicate an enhanced processing of safety cues due to tVNS. In conclusion, the expected accelerated extinction due to tVNS was not observed. The results from this study call for more research on the optimal tVNS stimulation intensity settings.

PMID: 30065275 [PubMed - indexed for MEDLINE]



Experiences of returning to work and maintaining work 7 to 8 years after a stroke: a qualitative interview study in Sweden.
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Experiences of returning to work and maintaining work 7 to 8 years after a stroke: a qualitative interview study in Sweden.

BMJ Open. 2018 07 16;8(7):e021182

Authors: Palstam A, Törnbom M, Sunnerhagen KS

Abstract
OBJECTIVE: To explore how persons experienced return to work (RTW) and their work situation 7 to 8 years after a stroke.
DESIGN: An explorative qualitative design with individual interviews. The data analysis was inductive thematic and three researchers collaborated during the analysis process.
PARTICIPANTS: The study population included five women and eight men who had a stroke during 2009-2010, received care at the Sahlgrenska University Hospital in Gothenburg, Sweden and RTW after stroke and it was a heterogenic sample based on age, occupation, stroke severity and time to RTW.
RESULTS: The analysis led to four themes; motivated and RTW while struggling with impairments, mixed feelings in the RTW process, still at work though restricted and social support for a sustainable work situation. The themes revealed that participants were motivated to RTW while struggling with impairments. The RTW process evoked mixed feelings of worry and grief over lost functions but also acceptance and gratitude for being able to work. Although maintaining work 7 to 8 years after experiencing a stroke, most were restricted in some way. Fatigue and cognitive impairments meant having to set limits, omit work tasks and rest at work, but also rest during free time and refraining from social activities in order to manage work. Participants avoided work-related stress if they could because of aggravated symptoms and/or fear of a new stroke. Support from supervisors and colleagues was often crucial for a sustainable work situation.
CONCLUSION: Maintaining work can be a continuous struggle with invisible impairments many years after a stroke. Strategies for managing work are dependent on each individual work situation, where support and understanding at work seem to be crucial for a sustainable work situation.

PMID: 30012785 [PubMed - indexed for MEDLINE]



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