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However, no interaction effects were found for externalizing problems. The findings underline the burden of exposure to violence by teachers and the importance of mental health for children's social functioning. Knowledge about interrelations can be applied in interventions to effectively reduce violence by teachers toward students.RATIONALE Androgens are potentially beneficial in asthma, but androgen receptor (AR) has not been studied in human airways. OBJECTIVES To measure whether AR and its ligands are associated with human asthma outcomes. METHODS We compared AR expression to lung function, symptom scores and fractional of exhaled nitric oxide (FENO) in adults enrolled in the Severe Asthma Research Program (SARP). Further, asthma exacerbations, and emergency department (ED) visits were also evaluated in the SARP, with validation studies in the Cleveland Clinic Health System (CCHS) and the National Health and Nutrition Examination Survey (NHANES). MEASUREMENTS AND MAIN RESULTS In SARP (n=128), AR gene expression from bronchoscopic epithelial brushings was positively correlated with FEV1/FVC ratio (R2=0.135, p=0.0002) and total AQLQ score (R2=0.056, p=0.016); and was negatively associated with FENO (R2=0.178, p=9.8e-06) and NOS2 gene expression (R2=0.281, p=1.2e-10). In SARP (n=1,659), CCHS (n=32,527) and NHANES (n=2,629), women had more asthma exacerbations and ED visits than men. Levels of the AR ligand precursor dehydroepiandrosterone sulfate (DHEA-S) correlated positively with FEV1 in both women and men. CONCLUSIONS Higher AR expression in bronchial epithelial cells, and higher androgen levels, are associated with better lung function, fewer symptoms and lower FENO in human asthma. The role of androgens should be considered in asthma management.Purpose Encountering patients with chest pain iscommon for Registered Nurses (RNs) in Emergency Medical Services (EMS) who are responsible for the patient's medical and nursing care . From a lifeworld perspective, bodily illness is related to existential suffering, requiring knowledge to asses the situation from a holistic perspective . The aim of this study is to describe the caring approach when RNs encounter patients with chest pain.Methods A phenomenological methodology to capture RNs' lived experiences was chosen. Seven qualitative in-depth interviews were conducted at three ambulance stations in Sweden.Results The essence of the caring approach while encountering patients with chest pain comprises two constituents; "trust based on confidence and competence" and "the collegial striving towards the best possible care". Trust is two-parted; trust in oneself, and striving towards gaining the patient's trust . Competence and experience when combined, develop into confidence especially in stressful situations. The caring approach is nurtured in a well-functioning collegial team.Conclusions This study contributes to understanding the caring approach based on the specific patient's lifeworld in holistic EMS care. By trusting oneself, the patient, and one's colleague, RNs in EMS shift focus from medical-orientated care to a holistic lifeworld caring approach. . Ruboxistaurin chemical structure More research is needed on trust as a phenomenon in EMS, both from caregivers' and patients' perspectives.Objectives A prospective longitudinal single-centre study to assess the mental health impact of COVID-19 on nurses working in the frontline during the first wave of COVID-19 hospitalizations in Belgium, 2020.Patients and Methods The study was performed between April 1st and 30 June 2020. Nurses who were actively and daily involved in the care of COVID-19 patients on selected intensive care units (ICU) and non-ICU wards were included. Depression, somatization, anxiety and distress scores were calculated using the Four-Dimensional Symptom Questionnaire (4DSQ). The Impact of Event Scale-Revised (IES-R) and Brief-COPE questionnaires were used to assess respectively the psychological impact and coping strategies. Participants were asked to fill in the questionnaire at the start of inclusion, 4 weeks later and 8 weeks later.Results In total, 39/42 included nurses participated in the study. 4DSQ results showed low rates of depression, anxiety and somatization with a declining trend over time. Distress scores however were high throughout the study period. A past history of stress symptoms was significantly associated with higher distress scores at the inclusion and one month follow-up. As major psychological impact, more participants experienced 'intrusion' compared to 'avoidance' specifically among nurses working on ICU. In 10% of participants, IES-R-scores were predictive for post-traumatic stress disorder.Conclusion Healthcare workers dealing with COVID-19 patients during the pandemic reported high and enduring distress scores and experienced a major impact on mental health, especially when employed at ICU. These results highlight the importance of psychological support and proper long-term follow-up to mitigate this impact.
Anecdotal reports have proposed that diet might influence the occurrence of seizures.

Our objectives were to assess nutritional status in a sample of patients with epilepsy and to investigate the impact of nutrition on epilepsy control.

One hundred and fifty patients with epilepsy participated in the study. To assess nutritional status, sociodemographic characteristics, anthropometric measurements, dietary food intake, and 24-hour food intake were evaluated. Patients answered questions using a food frequency questionnaire.

In patients with epilepsy, there was insufficient intake of water, fiber, potassium, magnesium and some vitamins (C, E, B12, folate and niacin); suboptimal intake of calories, zinc, calcium, and some vitamins (A, B1 and B6); optimal intake of total fats; and over-intake of proteins, carbohydrates, phosphorus, iron, sodium, and vitamins D and B2. Moreover, there was a statistically significant difference between patients with controlled versus uncontrolled seizures regarding frequency of vegetable intake and percentage of caloric intake from the recommended dietary allowance. Stepwise logistic regression indicated that those with low intake of vegetables had a 2.3 times higher likelihood of uncontrolled seizure occurrence compared to those with a high intake of vegetables per week. Also, those with optimal caloric intake were 80% less likely to have uncontrolled seizures than those with too much caloric intake.

Macro- and micronutrient intake were unbalanced in patients with epilepsy. Patients who consumed too many calories and too few vegetables were more likely to have improper seizure control.
Macro- and micronutrient intake were unbalanced in patients with epilepsy. Patients who consumed too many calories and too few vegetables were more likely to have improper seizure control.
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