Risk Perception and Protective Health Measure Regarding COVID-19 among Nepali Labour Migrants’ Returnee from India

Thousands of Nepali migrant workers returned home from India due to the impact of the COVID-19 pandemic. This cross-sectional study examines the association between risk perception and protective behaviour regarding COVID-19 in returnee migrant workers. The study used opportunistic sampling and 384 participants, based in a quarantine center on return from India, volunteered. Using the health belief model (HBM) as a theoretical framework, a structured interview questionnaire was designed and applied as the key data collection tool. Three health workers were interviewed face-to-face. The study showed that the perceived risk of COVID-19 among participants was medium to low. Participants perceived few barriers and had low self-efficacy levels compared to other constructs. This study further showed that participants were more likely to follow a range of protective health behaviours, but not found all. The study revealed a significant association between all risk perception constructs and protective behaviours (p=< 0.05). This study accordingly highlighted a significant relationship between the respondents’ risk perception level and protective health behaviours. The study envisaged that public awareness of risk to the people who returned from India is essential to increase risk perception during the outbreak

Neurovisceral phenotypes in the expression of psychiatric symptoms

This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brainbody mechanisms underlie individual differences in psychophysiological reactivity that can be important for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in 'emotional' brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity during postural change and as recently recognised factors causing vasodilatation (as noted post prandially, post exertion and with heat) is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiety