Anaemia and the development of depressive symptoms following acute coronary syndrome: longitudinal clinical observational study

OBJECTIVE: Depressive symptoms are common following acute coronary syndrome (ACS) and predict subsequent cardiovascular morbidity. Depression in acute cardiac patients appears to be independent of clinical disease severity and other cardiovascular measures. One factor that has not been considered previously is anaemia, which is associated with fatigue and adverse cardiac outcomes. This study assessed the relationship between anaemia on admission and depressive symptoms following ACS. DESIGN: Longitudinal clinical observational study. SETTING: Coronary care unit. PATIENTS: 223 patients with documented ACS. MAIN OUTCOME MEASURES: Depressive symptoms measured with the Beck Depression Inventory 3 weeks after admission. RESULTS: Anaemia was defined with WHO criteria and was present in 30 (13.5%) patients. Anaemia predicted raised depression scores 3 weeks later independently of age, gender, marital status, educational attainment, smoking, Global Registry of Acute Cardiac Events (GRACE) risk scores, negative mood in hospital and history of depression (p=0.003). The odds of a Beck Depression Inventory score ≥10 among anaemic patients were 4.03 (95% CIs 1.48 to 11.00), adjusted for covariates. Sensitivity analyses indicated that effects were also present when haemoglobin was analysed as a continuous measure. Anaemia also predicted major adverse cardiac events over the subsequent 12 months. CONCLUSIONS: Anaemia appears to contribute to depression following ACS and is associated with future cardiac morbidity. Studies evaluating the effects of anaemia management will help delineate the role of this pathway more precisely

Cyberbullying and cyberstalking victimisation among university students: A narrative systematic review.

With the increasing use of information and communication technology, university students are more vulnerable to cyberbullying and cyberstalking than ever before. While prior research has mostly addressed these adverse behaviours separately, the convergence of these phenomena in the education and lives of university students suggests the need to explore them within a more holistic framework. This study presents a narrative systematic review (NSR) that focuses on university students (undergraduate and postgraduate) as victims. Out of 7,518 papers screened, only 61 were eligible for the review, resulting in a comprehensive and critical overview of the risks and protective factors associated with cyberbullying and cyberstalking among university students. The analysis of the review metadata sheds light on the factors that contribute to victims’ adverse experiences and explores best practices and intervention strategies for supporting them. The analysis revealed Corresponding author:Anna Bussu, School of Law, Criminology and Policing, Edge Hill University, St Helens Road, Ormskirk, Lancashire L39 4QP, UK. Email: [email protected]/02697580241257217International Review of Victimology X(X)Bussu et al.research-article2024Original Manuscript2 International Review of Victimology 00(0)more research on cyberbullying rather than cyberstalking among university students. Certain risk factors have emerged as particularly relevant, such as underestimation of cyberbehaviour and risky behaviour among victims, along with considerations of gender, age, mental health, personality, and previous face-to-face victimisations. The most significant consequences include negative emotions and psychological vulnerabilities. Self-conscious behaviour and seeking support from family and friends are considered as the most common protective factors. There is a need for academic institutions to engage actively in preventing cyberbullying and cyberstalking through evidence based programmes. Overall, there is a gap in our understanding of the effectiveness of policies and programmes at the university level

Cyberbullying and Cyberstalking victimisation among university students: A Narrative Systematic Review

With the increasing use of information and communication technology, university students are more vulnerable to cyberbullying and cyberstalking than ever before. While prior research has mostly addressed these adverse behaviours separately, the convergence of these phenomena in the education and lives of university students suggests the need to explore them within a more holistic framework. This study presents a Narrative Systematic Review (NSR) that focuses on university students (undergraduate and postgraduate) as victims. Out of 7,518 papers screened, only 61 wereeligible for the review, resulting in a comprehensive and critical overview of the risks and protective factors associated with cyberbullying and cyberstalking among university students. The analysis of the review metadata sheds light on the factors that contribute to victims' adverseexperiences and explores best practices and intervention strategies for supporting them. The analysis revealed more research on cyberbullying rather than cyberstalking among university students. Certain risk factors have emerged as particularly relevant, such as underestimation of cyberbehaviour and risky behaviour among victims, along with considerations of gender, age, mental health, personality, and previous face-to-face victimisations. The most significant consequences include negative emotions and psychological vulnerabilities. Self-conscious behaviour and seeking support from family and friends are considered the most common protective factors. There is a need for academic institutions to engage actively in preventing cyberbullying and cyberstalking through evidence-based programs. Overall, there is a gap in our understanding of the effectiveness of policies and programs at the university level

Fear of dying and inflammation following acute coronary syndrome

Aims Many patients are afraid of dying during acute coronary syndrome (ACS), but the origins and biological correlates of these emotional responses are poorly understood. This study evaluated the prevalence of fear of dying, associations with inflammatory responses during ACS, and later heart rate variability (HRV) and cortisol secretion. Methods and results Two hundred and eight patients admitted with clinically verified ACS rated their fear of dying on interview in hospital. Plasma tumour necrosis factor (TNF)α was recorded on admission, and HRV and salivary cortisol were assessed 3 weeks later. Intense distress and fear of dying was experienced by 21.7%, with moderate levels in 66.1% patients. Fear of dying was more common in younger, lower socioeconomic status, and unmarried patients. It was positively associated with plasma TNFα on admission after controlling for sociodemographic factors, clinical risk, and pain intensity (adjusted odds = 4.67, 95% C.I. 1.66-12.65). TNFα was associated with reduced HRV 3 weeks later, adjusting for clinical and sociodemographic factors and medication (P = 0.019), while fear of dying was associated with reduced cortisol output (P = 0.004). Conclusions Intense distress and fear of dying and heightened inflammation may be related manifestations of an acute biobehavioural response to severe cardiac injury, and have implications for prognostically significant biological risk processe

A Headset Method for Measuring the Visual Temporal Discrimination Threshold in Cervical Dystonia

Background: The visual temporal discrimination threshold (TDT) is the shortest time interval at which one can determine two stimuli to be asynchronous and meets criteria for a valid endophenotype in adult‐onset idiopathic focal dystonia, a poorly penetrant disorder. Temporal discrimination is assessed in the hospital laboratory; in unaffected relatives of multiplex adult‐onset dystonia patients distance from the hospital is a barrier to data acquisition. We devised a portable headset method for visual temporal discrimination determination and our aim was to validate this portable tool against the traditional laboratory‐based method in a group of patients and in a large cohort of healthy controls. Methods: Visual TDTs were examined in two groups 1) in 96 healthy control participants divided by age and gender, and 2) in 33 cervical dystonia patients, using two methods of data acquisition, the traditional table‐top laboratory‐based system, and the novel portable headset method. The order of assessment was randomized in the control group. The results obtained by each technique were compared. Results: Visual temporal discrimination in healthy control participants demonstrated similar age and gender effects by the headset method as found by the table‐top examination. There were no significant differences between visual TDTs obtained using the two methods, both for the control participants and for the cervical dystonia patients. Bland–Altman testing showed good concordance between the two methods in both patients and in controls. Discussion: The portable headset device is a reliable and accurate method for visual temporal discrimination testing for use outside the laboratory, and will facilitate increased TDT data collection outside of the hospital setting. This is of particular importance in multiplex families where data collection in all available members of the pedigree is important for exome sequencing studies

Comparison of frailty screening instruments in the emergency department

Early identification of frailty through targeted screening can facilitate the delivery of comprehensive geriatric assessment (CGA) and may improve outcomes for older inpatients. As several instruments are available, we aimed to investigate which is the most accurate and reliable in the Emergency Department (ED). We compared the ability of three validated, short, frailty screening instruments to identify frailty in a large University Hospital ED. Consecutive patients aged ≥70 attending ED were screened using the Clinical Frailty Scale (CFS), Identification of Seniors at Risk Tool (ISAR), and the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 item questionnaire (PRISMA-7). An independent CGA using a battery of assessments determined each patient’s frailty status. Of the 280 patients screened, complete data were available for 265, with a median age of 79 (interquartile ±9); 54% were female. The median CFS score was 4/9 (±2), ISAR 3/6 (±2), and PRISMA-7 was 3/7 (±3). Based upon the CGA, 58% were frail and the most accurate instrument for separating frail from non-frail was the PRISMA-7 (AUC 0.88; 95% CI:0.83–0.93) followed by the CFS (AUC 0.83; 95% CI:0.77–0.88), and the ISAR (AUC 0.78; 95% CI:0.71–0.84). The PRISMA-7 was statistically significantly more accurate than the ISAR (p = 0.008) but not the CFS (p = 0.15). Screening for frailty in the ED with a selection of short screening instruments, but particularly the PRISMA-7, is reliable and accurate