BACKGROUND:Among healthcare personnel, longitudinal studies have shown high levels of stress before, during and after the pandemic. The aim of this study was to examine the relationship between stress, psychological resilience, and sense of coherence in healthcare professionals. SUBJECTS AND METHODS:In total, 203 healthcare professionals (63 physicians and 140 nurses) completed the Perceived Stress Scale (PSS), the Brief Resilience Scale (BRS), and the Sense of Coherence Questionnaire (SOC-13). The age, sex, and profession of the participants were recorded. RESULTS:Women exhibited higher levels of perceived stress compared to males (18.450 ± 7.232 vs. 15.116 ± 5.662, t-test p < 0.05), as well as lower scores on the sense of coherence scale (57.525 ± 13.716 vs. 65.535 ± 12.481, t-test p < 0.05). No differences were observed with respect to profession. High levels of stress were recorded in 12.3% of workers and moderate values in 58.7%. The PSS demonstrated a negative correlation with both the SOC-13 and the BRS. The BRS showed a positive correlation with the SOC-13 (Pearson p < 0.01). Age showed no significant correlation. Linear regression analysis indicated that 49% of the variance in PSS was explained by SOC-13 and 3% by BRS. We subsequently investigated the hypothesis that the BRS may function as a mediator in the relationship between SOC-13 and PSS. Mediation analysis revealed that the BRS acts as a mediator in the relationship between SOC-13 and PSS. The indirect effect of BRS was statistically significant [b = -0.0770, 95% CI (-0.1312, -0.0216), p ≤ 0.01]. Furthermore, even in the presence of BRS mediation, the direct effect of SOC-13 on PSS remained significant [b = -0.2796, 95% CI (-0.3450, -0.2142), p ≤ 0.001]. CONCLUSIONS:High rates of stress, particularly in women healthcare professionals, appear to be intrinsically associated with the healthcare profession. It is likely that sense of coherence and psychological resilience can reduce stress, with resilience acting as a mediator.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition commonly caused by prolonged exposure to harmful particles or gases. The literature on COPD patients is rich in reports of psychological symptoms such as anxiety and depression, which often co-occur with the physical manifestations of the disease. The primary aim of this study was to investigate the role of the sense of coherence and family support in depressive symptomatology among patients with COPD. A total of 143 patients (107 men and 32 women) participated, completing the Beck Depression Inventory (BDI), the Sense of Coherence-13 scale (SOC), and the Family Support Scale (FSS). Among the participants, 46.8% exhibited no depressive symptoms (BDI≤9), 29.5% had mild symptoms (BDI 10–15), 16.5% had moderate symptoms (BDI 16–23), and 7.2% had severe depressive symptoms (BDI≥24). Multiple regression analysis revealed that SOC accounted for 35.2% of the variance in BDI scores, with FSS contributing an additional 3.6%. Mediation analysis was conducted with BDI as the outcome variable, FSS as the mediator, and SOC as the predictor. The analysis confirmed the mediating role of family support in the SOC–BDI relationship, with the model explaining 10.3% of the variance in depressive symptoms. Based on these findings, future studies may benefit from exploring interventions that enhance perceived family support in COPD patients.

Background: Post-traumatic growth (PTG) refers to positive psychological changes resulting from the struggle with highly challenging or traumatic life events. Psychosocial interventions have demonstrated efficacy in promoting psychological well-being in the aftermath of traumatic experiences. Cognitive Behavioral Therapy (CBT) is among the most extensively studied such interventions, aligning with the PTG model's prerequisites for growth. Objective: The aim of this systematic review was to assess the efficacy of CBT and CBT-based interventions in promoting PTG. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Scopus, and Google Scholar databases from inception to December 2024. Eligibility criteria included: (a) the inclusion of a CBT or CBT-based intervention, (b) measurement of PTG using the Post-Traumatic Growth Inventory (PTGI), (c) study participants having experienced traumatic life events, and (d) articles written in English. Risk of bias was assessed independently by two reviewers. Due to the heterogeneity of included studies, a qualitative narrative synthesis approach was adopted. Risk of bias was assessed using the RoB-2 tool for RCTs, ROBINS-1 for quasi-experimental studies and Newcastle-Ottawa scale for cohort studies. Certainty of evidence, assessed using the GRADE framework, is considered low. Results: A total of 19 studies were included (13 randomized controlled trials, 3 quasi-experimental, and 3 longitudinal studies). While traditional CBT produced mixed results in fostering PTG, CBT-based therapeutic protocols-particularly those explicitly designed to target PTG or incorporating structured cognitive-emotional techniques-demonstrated more consistent benefits. Limitations of the included studies include measurement of PTG as a secondary outcome, small sample sizes, and the presence of confounding variables. Conclusions: Further high-quality, multicenter randomized controlled trials with standardized protocols are needed to clarify the role of CBT in promoting growth after trauma.

Sleep is not a passive state of rest but a biologically active process essential for cognitive function, immune regulation, emotional homeostasis, and metabolic integrity [...]

Background: The nursing profession is recognized as a high-risk occupation, with the emotional toll on healthcare workers reaching a critical point. A complex interplay of anger and cynicism, often stemming from systemic pressures and chronic moral injury, seems to increasingly affect nurses' professional and personal lives. This psychological strain does not end when the shift ends; rather, it often manifests as insomnia and nightmare distress, creating a vicious cycle of exhaustion and emotional instability. This article explores how anger, cynical distrust, nightmare distress and insomnia are interrelated and jeopardize the well-being of nursing staff and what these "invisible" symptoms reveal about the current state of healthcare by confirming their prevalence rates. Methods: This cross-sectional study was conducted online in October 2025 and included 441 hospital nurses who completed the Dimensions of Anger Reactions-5 (DAR-5), the 8-item Cynical Distrust scale (CDS-8), the Nightmare Distress Questionnaire (NDQ) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of anger, nightmare distress and insomnia were 41.5%, 6.6%, and 62.1%, respectively. Based on the CDS-8 scores, a notable proportion (20.9%) of nurses fell within the highest quartile of CDS-8 scores (CDS-8 > 29), indicating relatively elevated cynical distrust within this sample; this threshold is sample-derived and does not correspond to a validated clinical cut-off. Hierarchical multiple regression analysis indicated that the DAR-5 explained 22.1% of the variance in AIS, while an additional 10.2% was explained by NDQ and another 1.5% by the CDS-8. Both cynical distrust and nightmare distress displayed a chain mediation pattern in the association between anger and insomnia; however, given the cross-sectional design, the temporal order of these variables cannot be confirmed. Conclusions: Anger exhibited significant direct and indirect associations with insomnia, with cynical distrust and nightmare distress acting as serial mediators in this cross-sectional model. Findings from this cross-sectional study tentatively suggest that future intervention efforts targeting insomnia in nurses might benefit from addressing anger alongside nightmare distress and cynical attitudes; however, experimental studies are needed to confirm whether such interventions would be effective.

BACKGROUND/OBJECTIVES:Primary aldosteronism (PA), the leading cause of secondary hypertension, results from autonomous aldosterone hypersecretion. It is characterized by increased extracellular volume, elevated cardiac output, and greater arterial stiffness compared with essential hypertension, reflecting aldosterone-mediated hemodynamic dysregulation. The prevalence and morbidity of PA are increasingly acknowledged; however, PA continues to be underdiagnosed because of limited screening and diagnostic complexity. METHODS:A narrative review was conducted using PubMed (2015-2025), with terms targeting PA epidemiology, excluding treatment-focused studies. From 971 articles, 133 relevant studies (original research studies, reviews, meta-analyses) were included, addressing prevalence, risk factors, comorbidities, genetics, and diagnostic issues. RESULTS:PA prevalence in hypertensive populations is 5-10%, rising to 17.8% in young-onset and 20-30% in resistant hypertension. Screening indications include resistant/severe hypertension, hypokalemia, adrenal incidentaloma, young-onset disease, obstructive sleep apnea (59.8% comorbidity in hypertensive PA), and familial history, while a link may exist with papillary thyroid cancer. The aldosterone-renin ratio (ARR) is the primary screening tool, limited by assay variability and confounders (e.g., sodium intake). Confirmatory testing (such as with the saline infusion test) is often challenging to perform in routine practice. Adrenal venous sampling (AVS) is useful for subtyping unilateral (aldosterone-producing adenoma; APA; ~35-50%) vs. bilateral (idiopathic hyperaldosteronism; IHA) disease, despite technical challenges. Somatic mutations (e.g., KCNJ5, more frequent in Asians) and rare familial forms drive PA. Complications include cardiovascular events (Major Adverse Cardiovascular Events; MACE: 13.6% at 5.8 years), stroke, renal impairment (decreased eGFR, proteinuria), metabolic disorders (diabetes, obesity), and novel associations (vertebral fractures, renal stones, normal-tension glaucoma). Psychiatric comorbidities (depression/anxiety in 30-70% of patients) have been associated with central mineralocorticoid receptor effects, with sleep disturbances being prominent in females. Subclinical PA predicts hypertension and arterial stiffness. CONCLUSION:Improved screening protocols, standardized ARR cutoffs, and advanced imaging and genetic analyses are needed to enhance PA detection. Future research should validate cost-effective screening and clarify psychiatric-metabolic links for optimized management.

Background/Objectives: Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support potentially affects inflammatory and metabolic biomarkers. The aim of this study was to determine the interrelations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of outpatients with schizophrenia. Importantly, this study sought to elucidate the effect of perceived family support on inflammatory processes among patients with schizophrenia. Methods: In this cross-sectional correlation study, 206 outpatients with schizophrenia in clinical remission completed a standardized self-report questionnaire that assessed family support (Family Support Scale-FSS). Sociodemographic, clinical and laboratory data were also recorded. Results: Among the participants, 49.5% had detectable CRP values (≥0.11 mg/dL), whereas 14.6% had positive CRP levels (>0.6 mg/dL). There was a significant difference in CRP levels among the different BMI groups (normal weight/overweight vs. obese). For obese patients, the crude odds ratios (ORs) for detectable and positive CRP values were 1.980 (95% confidence interval (CI) [1.056, 3.713]) and 27.818 (95% CI [6.300, 122.838]), respectively. Significant positive correlations were observed among CRP, BMI and illness duration, while scores on the FSS were negatively associated with these variables. The results of binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds, and with each unit increase in family support leading to an 8.6% (95% CI [0.018, 0.15]) decrease. A moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on the BMI value, but only for obese patients did the protective effect of family support significantly decrease the magnitude of the risk of having positive CRP (b = -0.1972, SE = 0.053, OR = 0.821, p = 0.000, 95% CI [-0.3010, -0.0934]). Conclusions: The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications, inflammatory processes have already been established. Increased perceived family support seems to protect against inflammation and, notably, the association between low perceived family support and increased inflammation is even stronger. Establishing the role of family involvement during the treatment of patients with schizophrenia through inflammatory processes is a novelty of this study, emphasizing the need to incorporate family therapy into psychiatric treatment plans. However, primary interventions are considered necessary for patients with schizophrenia in order to maintain their BMI within normal limits and avoid the subsequent nosological sequelae.

A recent article highlighted the hepatic benefits of intermittent fasting, particularly during Ramadan. However, the rising use of glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists (RAs) is altering public behavior, leading to decreased interest in diet and exercise. With a focus on hepatic health, we analyzed global search trends using Google Trends™ data from January 1, 2022 to December 31, 2024, focusing on the keywords "fasting", "intermittent fasting", "diet", "nutrition", "liver", Semaglutide ("Ozempic"™, the most widely known GLP-1 RA) and Tirzepatide ("Mounjaro"™, a newer dual GLP-1 and GIP RA). Search interest for "intermittent fasting" and "diet" showed a significant decline over time (Spearman's rho: -0.582 and -0.605, respectively, both P < 0.001), while interest in "fasting" and "nutrition" remained stable. Search interest for Semaglutide, Tirzepatide, "fasting and liver", "diet and liver" and Semaglutide and "liver" increased (Spearman's rho: +0.914, +0.936, +0.369, +0.297 and +0.808, respectively, all P < 0.001). These findings suggest a trend of shifting away from traditional dieting toward broader health concerns, likely influenced by the increasing use of GLP-1/GIP RAs.

Recent studies indicate that nurses experienced high levels of occupational burnout and insomnia during and after the pandemic and highlight resilience as a crucial competence for overcoming adversity. The aim of this study was to assess occupational burnout, insomnia, and psychological resilience and to explore their interrelations among Greek nurses 14 months after the official ending of the pandemic which was declared in May 2023. The study was conducted online in July 2024 and included 380 nurses currently working in Greek hospitals, who completed the Copenhagen Burnout Inventory (CBI), the Athens Insomnia Scale (AIS), and the Brief Resilience Scale (BRS). Overall, 56.1% of the nurses exhibited insomnia symptoms and 46.8% displayed signs of occupational burnout. Low resilience scores were observed in 26.3%. Multiple regression analysis indicated that CBI explained 34.4% of the variance in the AIS scores, while an additional 3% was explained by the BRS. Mediation analysis revealed that resilience operates protectively as a negative mediator in the relationship between burnout and insomnia. In conclusion, one year after the end of the pandemic the levels of occupational burnout and insomnia among nurses remain high, whereas psychological resilience seems to be retained at moderate levels. Consequently, there is an urgent need to regularly monitor for risk of burnout and insomnia and to implement resilience-building strategies for nurses to combat burnout and improve insomnia symptoms.

Background/Objectives: Several studies have reported alarming rates of mental health issues and sleep problems among nurses even in the post-pandemic era. The objective was to investigate the prevalence of stress, anxiety and depressive symptoms, burnout and insomnia among nurses in Greece one year after the end of the pandemic and to construct a mediation model evaluating the impact of stress on insomnia, the chain mediating roles of depressive symptoms and burnout, as well as the moderating role of anxiety symptoms in the model. Methods: This cross-sectional study was conducted online in July 2024 and included 380 hospital nurses who completed the Depression Anxiety Stress Scale (DASS-21), the Copenhagen Burnout Inventory (CBI) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of stress, anxiety and depressive symptoms, burnout and insomnia were 33.9% with 95% confidence interval (CI): [0.292, 0.390], 33.3% (95% CI: [0.284, 0.381]), 35% (95% CI: [0.302, 0.400]), 46.8% (95% CI: [0.399, 0.502]) and 56.1% (95% CI: [0.509, 0.611]), respectively. Multiple regression analysis indicated that the Depression subscale of the DASS-21 explained 40.6% of the variance in the AIS, while an additional 7.6% was explained by the CBI and another 1.3% rate by the Stress subscale of the DASS-21. Mediation analysis revealed that stress affected insomnia both directly and indirectly through the chain mediating roles of depressive symptoms and burnout. Anxiety symptoms moderated the chain mediation path by enhancing the negative impact of stress on depressive symptoms. Conclusions: The proposed moderated chain mediation model introduces certain factors influencing insomnia and explains how changes in any one of these factors effectuate changes in the other factors, offering insights for individualized interventions.

Transgender individuals often undergo gender-affirming hormonal therapy (GAHT) to align their physical characteristics with their gender identity, which introduces unique challenges in the management of critically ill patients. In the setting of critical illness, the interactions between GAHT and the body's endocrine response are complex. GAHT can influence the hypothalamic-pituitary-adrenal axis, sex hormone levels, and metabolic parameters, potentially complicating the clinical picture. For example, estrogen therapy in transgender women increases the risk of venous thromboembolism, which is further exacerbated by the immobility and hypercoagulable state often present in critically ill patients. Testosterone therapy in transgender men can lead to erythrocytosis, increasing the risk of thromboembolic events during critical illness. The potential for drug interactions, particularly with medications used in the intensive care unit, also requires careful consideration. Monitoring hormone levels and adjusting GAHT in the acute setting are crucial, although evidence-based guidelines are lacking. The need for individualized care and vigilant monitoring of endocrine and metabolic parameters is paramount to improve outcomes in this vulnerable population.

Introduction: The pandemic has led to notable psychological challenges among healthcare professionals, including nurses. Objective: Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience. Methods: Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected. Results: The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship. Conclusions: Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.

Introduction: Nurses seem to be persistently experiencing intense psychological repercussions, even after the official conclusion of the COVID-19 pandemic. In this cross-sectional study conducted after the end of the pandemic crisis, from 1 June 2023 to 30 June 2023, we evaluated the levels and explored the associations between anger, insomnia, and resilience among Greek nurses. Methods: A total of 441 nurses participated in an online survey and were invited to state their work experience, gender, and age and to complete the self-report measures of the Dimensions of Anger Reactions-5 (DAR-5), the Athens Insomnia Scale (AIS), and the Brief Resilience Scale (BRS). Results: Overall, 62.1% of the participants presented with positive scores on the AIS, and 41.5% displayed positive values on the DAR-5 scale, whereas 24.9% demonstrated scores indicative of low resilience on the BRS. A regression analysis revealed that 23.5% of the variance in the AIS scores can be attributed to the DAR-5 scores and 3% to the BRS scores. A mediation analysis confirmed the protective role of resilience, contributing as a negative mediator in the DAR-5 and AIS relationship. Conclusions: Screening for insomnia symptoms and anger issues among nurses after the end of the pandemic and implementing appropriate interventions is considered imperative to avoid long-term health consequences.

Recent studies indicate that nurses experienced higher levels of occupational burnout and insomnia during the pandemic compared to other healthcare professionals. The aim of this study was to assess occupational burnout, insomnia, and psychological resilience and to explore their interrelations among nurses in Greece in the post-pandemic era. The study was conducted online in July 2024 and included 380 nurses currently working in Greek hospitals, who completed the Copenhagen Burnout Inventory (CBI), the Athens Insomnia Scale (AIS), and the Brief Resilience Scale (BRS). Overall, 56.1% of the nurses exhibited insomnia symptoms and 46.8% displayed signs of occupational burnout. Low resilience scores were observed in 26.3%. Female nurses had a higher mean burnout score compared to their male counterparts. Multiple regression analysis indicated that CBI Total explained 34.4% of the variance in the AIS scores, with an additional 3% explained by BRS. Mediation analysis further revealed that resilience operates protectively as a negative mediator in the relationship between burnout and insomnia. In conclusion, the levels of occupational burnout and insomnia among nurses remain high one year after the end of the pandemic and consequently there is an urgent need to enhance the support for nurses to protect them from adverse physical and psychological effects.

Numerous investigations have consistently underscored the impact of societal stigma on the well-being of transgender individuals. The primary objective of the current research is to translate and adapt the Attitudes Toward Transgendered Individuals Scale into the Greek language. This scale specifically assesses stigma, excluding components such as discreteness and violence, and is tailored to evaluate individuals within the general populace. Employing confirmatory factor analysis (CFA) and assessing gender metric equivalence, the analyses yielded highly favorable outcomes, demonstrating excellent scale fit, reliability, and construct validity, reflecting the robustness of the adapted tool for the Greek population.

The coronavirus pandemic (COVID-19) is a global health crisis with a particular emotional and physical impact on health professionals, especially nurses. The aim of this study was to investigate the prevalence of anxiety, depression and fatigue and their possible relationships among nurses during the pandemic. The study population consisted of nurses from five tertiary-level public hospitals in Athens who completed the Fatigue Assessment Scale (FAS), Beck Depression Inventory (BDI) and State–Trait Anxiety Inventory (STAI) questionnaires. Gender, age and years of work experience were recorded. The study was conducted from mid-November to mid-December 2021. The sample included 404 nurses (69 males and 335 females) with a mean age of 42.88 years (SD = 10.90) and 17.96 (SD = 12.00) years of work experience. Symptoms of fatigue were noted in 60.4% of participants, while 39.7% had symptoms of depression, 60.1% had abnormal scores on state anxiety and 46.8% on trait anxiety, with females showing higher scores on all scales (p < 0.05). High positive correlations (p < 0.01) were found between the FAS, BDI, State Anxiety and Trait Anxiety scales. Regression analysis showed that 51.7% of the variance in FAS scores can be explained by trait anxiety, an additional 6.2% by the BDI and 1.2% by state anxiety. Mediation analysis showed that state anxiety and BDI mediate the relationship between trait anxiety and FAS. Finally, BDI was found to exert a moderating role in the relationship between trait anxiety and fatigue. In conclusion, our study showed that nurses continue to experience high rates of anxiety, depression and fatigue. The variation in fatigue appears to be significantly dependent on trait anxiety. Depressive symptomatology and state anxiety exert a parallel positive mediation on the relationship between trait anxiety and fatigue, with depression exhibiting a moderating role in this relationship.

We conducted an analysis of internet search trends spanning from January 2022 to June 2023 in the ten most populous Muslim countries. Our study focused on key terms, including the prominent GLP1 analog "ozempic™", as well as "diet", "exercise", and "diabetes". The findings revealed a substantial increase in searches for the GLP1 analog in eight countries. Concurrently, searches for "diet" and "exercise" predominantly exhibited a decline in nine and four countries, respectively. Notably, searches for "diabetes" displayed positive trends in only two countries. These patterns indicate a growing reliance on pharmaceutical interventions for managing diabetes and weight, often to the detriment of diet and exercise. Healthcare professionals and clinicians in Muslim countries should emphasize the importance of maintaining dietary and exercise regimens for patients with diabetes, even during the observance of Ramadan.

During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration, or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism, and medical mistrust among nurses, as there are no relevant studies in the literature. This study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item "Cynical Distrust" scale, and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used: one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. In total, 387 nurses (66 men and 321 women) participated in this study. Nurses showed statistically greater hesitancy toward the COVID-19 vaccine compared to hesitancy toward the influenza vaccine. The variation in vaccine hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions, and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between the Cynical Distrust Scale and total vaccine hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of the Cynical Distrust Scale on total vaccine hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting anti-systemic views of mistrust in the medical system.

Introduction:Anger is considered as one of the basic human emotions, constituting the affective component of aggression. In the first year of the pandemic, the intense pressure on healthcare workers resulted in the deterioration of their psychosocial problems. Objective:The aim of this study is to investigate the relationship between family support, anger, and aggression. Methods:The present study included physicians and nurses who completed an online survey of Dimensions of Anger Reactions-5 (DAR-5), a Brief Aggression Questionnaire (BAQ) and a Family Support Scale (FSS). Before completing the questionnaires, participants were asked to state their gender, years of work, age, and profession. Results:Fifty-three men and 190 women participated in the study. Almost one-third of the participants had a positive score on the DAR-5 scale. Male participants displayed lower DAR-5 scores compared to women. Female participants displayed lower FSS scores compared to men, but higher scores when compared with earlier measures. Regression showed that 15.2% of the variance in BAQ scores can be explained by DAR-5 scores, with an additional 3.8% explained by FSS scores, while an additional 2.3% is explained by years of working experience. Mediation analysis highlighted the role of family support as a negative mediator in the DAR-5 and BAQ relationship. Conclusion:During the first year of the pandemic, there was an increase in the sense of family support among female health workers. One-third of the participants displayed increased anger scores. Family support acts as a mediator by preventing anger derailing into aggression. In healthcare worker support programs, it seems necessary to entail a specific section on anger management.

BACKGROUND:Recent publications from several countries have reported that more young people (mainly girls) are experiencing precocious puberty (PP)/menarche during the coronavirus disease 2019 pandemic compared to the past. This variation is attributed to the stress of confinement, lack of exercise, obesity and disturbed sleep patterns. A common feature of the relevant papers, however, is the small number of reported cases of PP. Studies have shown that searches for diseases on the internet also reflect to some extent the epidemiology of these diseases.AIM:To estimate, through internet searches for PP, any changes in the epidemiology of PP.METHODS:We assessed in Google Trends searches for 21 PP-related terms in English internationally (which practically dwarf searches in other languages), in the years 2017-2021. Additionally, we assessed local searches for selected terms, in English and local languages, in countries where a rise in PP has been reported. Searches were collected in Relative Search Volumes format and analyzed using Kendall's Tau test, with a statistical significance threshold of P < 0.05.RESULTS:Internationally, searches for three PP-related terms showed no noticeable change over the study period, while searches for eight terms showed a decrease. An increase was found over time in searches for nine PP-related terms. Of the 17 searches in English and local languages, in countries where a rise in PP has been reported, 5 showed a significant increase over time.CONCLUSION:Over the study period, more than half of the search terms showed little change or declined. The discrepancy between internet searches for PP and the reported increase in the literature is striking. It would be expected that a true increase in the incidence of PP would also be aptly reflected in Google trends. If our findings are valid, the literature may have been biased. The known secular trend of decreasing age of puberty may also have played a role.