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"Tears Psychological aspects"
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Cry, baby : why our tears matter
\"One of our most private acts, weeping can forge connection. Tears may obscure our vision, but they can also bring great clarity. And in both literature and life, weeping often opens a door to transformation or even resurrection. But many of us have been taught to suppress our emotions and hide our tears. When writer Benjamin Perry realized he hadn't cried in more than ten years, he undertook an experiment: to cry every day. But he didn't anticipate how tears would bring him into deeper relationship with a world that's breaking. Cry, Baby explores humans' rich legacy of weeping--and why some of us stopped. With the keen gaze of a journalist and the vulnerability of a good friend, Perry explores the great paradoxes of our tears. Why do we cry? In societies marked by racism, sexism, and homophobia, who is allowed to cry--and who isn't? And if weeping tells us something fundamental about who we are, what do our tears say? Exploring the vast history, literature, physiology, psychology, and spirituality of crying, we can recognize our deepest hopes and longings, how we connect to others, and the social forces bent on keeping us from mourning. When faced with the private and sometimes unspeakable sorrows of daily life, not to mention existential threats like climate change and systemic racism, we cry for the world in which we long to live. As we reclaim our crying as a central part of being human, we not only care for ourselves and relearn how to express our vulnerable emotions; we also prophetically reimagine the future. Ultimately, weeping can bring us closer to each other and to the world we desire and deserve\"-- Publisher's description.
Book
The ocular symptoms and signs during the COVID-19 pandemic
The aim of this cohort study was to describe the change in ocular surface signs and symptoms before and during the COVID-19 pandemic, and to associate changes with potential pandemic-related events. First-visit patients from 2019 to 2021 were examined for corneal staining, lacrimal function and refraction. We assessed the presence of seven common ocular symptoms. Patients with glaucoma and macular disease were excluded. Dry eye (DE) was diagnosed according to the criteria of the Asia Dry Eye Society. The mean age of 3,907 participants was 59.6±18.6y and 63.8% were female. Mean age and the prevalence of diagnosed DE and shortened tear break-up time decreased from 2019 to 2021. The prevalence of eye fatigue, blurring and photophobia decreased in 2020. The prevalence of diagnosed DE did not increase among first-visit patients during the pandemic compared with 2019, despite many survey results suggesting that DE may have worsened due to frequent masking, increased screen time, mental stress, and depression under quarantine and social infection control. It might be considered however, that many elderly DE patients might have refrained from consulting an ophthalmologist and possibly delayed treatment of DE during the pandemic.
Journal Article
Association of problems, coping styles, and preferred online activity with depression, anxiety, and other psychological disorders in Turkish adolescents diagnosed with chronic kidney disease
Background
To assess depression, anxiety, and other psychological disorders in adolescents with chronic kidney disease (CKD) and determine the significant factors and the effect of digital media use on its scores among these patient groups.
Methods
The study was conducted as a cross-sectional study and included 84 adolescents with CKD and 68 healthy controls. The participants completed the Revised Child Anxiety and Depression Scale (RCADS). We recorded their age, gender, the most problematic issue in their lives, coping methods with problems, and online applications they prefer in their leisure time.
Results
Elevated rates (scores > 70) of separation anxiety, panic disorder, obsession, depression, total anxiety, and total depression scales were statistically higher in the CKD group. Separation anxiety, panic disorder, obsession, total anxiety, and total depression scales were higher in girls, and panic disorder, obsession, depression, total anxiety, and total depression scores were higher in younger ages in multivariate analysis. In the CKD group, family issues/problems increased panic disorder, obsession, depression, total anxiety, and total depression scales. Crying in tears/yelling response in children while facing a problem was associated with increased separation anxiety and social phobia rates. Also, preferring video applications was associated with separation anxiety and messaging applications with depression, total anxiety, and total depression.
Conclusions
Adolescents with CKD are at risk for depression, anxiety, obsession, and panic disorders. Also, crying in tears/yelling response may be at greater risk for anxiety among CKD adolescents. Early psychiatric evaluation and routine psychiatric follow-ups initiated early may improve the mental health of this vulnerable population.
Graphical Abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information
Journal Article
When animals cry: The effect of adding tears to animal expressions on human judgment
At a time of growing interest in and awareness about the relationships between humans and animals, it is of relevance to scientifically analyse the intrinsic nature of these interactions. Reactions to emotional tears show our extraordinary capacity for detecting micro-nuances when judging another human’s face. Regarding such behaviour, previous studies carried out in our laboratory have pointed to an adaptive function of emotional tears: i.e. their inhibitory influence on perceived aggressiveness. In the present work we aimed to further explore that hypothesis by extending our investigation from humans to animals, using pictures of five different animal faces (cat, dog, horse, chimpanzee, hamster) to which tears were added digitally. To this end, we conducted an online study of 403 participants recruited from different social networks and academic institutions. We questioned the participants about their perceptions of emotional intensity, aggressiveness and friendliness in the animal faces and analysed the comparisons they made between faces with and without tears. In addition, a latent variable referred to as “passion for animals” was measured using different indicators. By adding the results obtained in each species and breaking them down into different basic emotions, we found that the presence of tears was related to a higher absolute frequency of participants who perceived sadness, which endorsed our previous results obtained using images of humans. Regarding aggressiveness, the presence of tears favoured the perception of less aggressiveness. A structural equation model was also conducted to explore the relations among all the measured variables. The model confirmed that the presence of tears in the animal faces had a significant influence on the perception of higher emotional intensity and friendliness, and of lower aggressiveness.
Journal Article
Obstetric anal sphincter injury in adolescent mothers
Background
Obstetric anal sphincter injury (OASI) is a debilitating complication of vaginal delivery which has yet to receive ample attention in adolescents. The aim of this study was to describe risk for OASI in adolescent mothers compared to adults. We further attempted to compare risk factors for OASI between these two age groups.
Methods
We performed a retrospective cohort study between 2003 and 2019. Primiparous women who delivered vaginally, 21 years and younger were compared to women ages 26–35. Excluded were preterm, multifetal, non-vertex, cesarean deliveries as well as intrauterine fetal death. Rate of OASI as well as obstetric and labor characteristics of women with OASI, were compared between groups. Finally, risk factors were assessed for each group separately. Univariate and multivariate logistic regression model were performed.
Results
Final analysis was performed on 5113 nulliparous adolescents and 13,845 nulliparous in the 26–35 age group. Allocation to study groups was according to OASI – Sixty-seven adolescents (1.3%) had a 3rd or 4th degree perineal tear and were defined as the OASI group, while 5046 patients (98.7%) did not have such a tear. In the adult group, 199 out of 13,845 patients (1.4%) were diagnosed with OASI. Occurrence of OASI did not differ between groups (
p
= 0.510). Comparison of women with OASI in the adolescent group vs. adult group found differences with regard to operative vaginal delivery, (20.9% vs. 36.2%, respectively;
p
= 0.023) and meconium stained amniotic fluid (9.1% vs. 21.3%, respectively;
p
= 0.027).
Following multivariate analysis the only parameter independently associated with OASI in the adolescent age group was head circumference ≥ 90th percentile with an adjusted odds ratio of 3.08 (CI 1.48–6.38,
p
= 0.003). In the adult group the similar analysis revealed operative vaginal delivery (OR = 2.44, CI 1.72–3.47,
p
< 0.001) and a birthweight≥90th percentile (OR = 2.23, CI 1.19–4.18,
p
= 0.012) to be independent risk factors for OASI.
Conclusion
Adolescents have similar risk for OASI compared to adults but differ in risk factors leading to OASI. Head circumference ≥ 90th percentile was found to be associated with OASI in this age group.
Journal Article
Women’s experience with a first- and second-degree perineal tear and episiotomy – a qualitative study
Background
Perineal tears are associated with both physical- and psychological complications, and studies have found that women’s individual experience of the pain from the tear does not necessarily reflect the extent and severity of the tear. Women seem to experience a lack of consistency and sufficient follow up in the post-partum period related to perineal trauma. The aim of this study was to explore women’s experiences with first- and second- degree perineal tears and episiotomy in the post-partum period in an outpatient perineal clinic at a tertiary hospital in Norway.
Materials and methods
We conducted a qualitative study using individual semi-structured interviews, with women experiencing a follow-up of their perineal tear from an outpatient clinic. Participants were recruited from one tertiary hospital in Norway, and we conducted 18 individual interviews. All interviews were audio recorded, transcribed verbatim and analysed using systematic text condensation as described by Malterud.
Results
Three code groups and one overarching theme were identified. The overarching theme was that the women experienced a feeling of being left alone with the responsibility of both their physical and psychological needs regarding their perineal tear. The women described (I) lack of affirmation and emotional support, (II) lack of guidance on normal processes and (III) lack of systematic follow up of perineal tears.
Conclusion
The women in this study felt they were left alone with their perineal tear and did not receive support nor recognition from healthcare professionals regarding the challenges they faced. The physical and psychological consequences women experienced related to their perineal tear highlight the need for a more systematically and individually tailored care for women in the post-partum period, from both midwives and doctors.
Journal Article
A multi-centre quality improvement project to reduce the incidence of obstetric anal sphincter injury (OASI): study protocol
Background
Third and fourth degree perineal tears, or obstetric anal sphincter injuries (OASI), sustained during childbirth can result in anal incontinence and psychosocial problems which require ongoing treatment. Within the English National Health System (NHS) reported rates of OASI have gradually increased. In response, a care bundle was developed incorporating four elements: 1) antenatal information to women, 2) manual perineal protection during all vaginal births, 3) episiotomy to be performed with a 60° mediolateral angle at crowning (when clinically indicated) and 4) perineal examination (including per rectum) after childbirth. Implementation of the OASI Care Bundle is aided by a skills development module and an awareness campaign. The project is a collaboration between two national professional bodies, an NHS hospital trust and an academic institution.
Methods
Implementation of the OASI Care Bundle will be evaluated using a stepped-wedge design. From January 2017 sixteen maternity units across England, Wales and Scotland will participate in the study over a 15-month period, with sequential roll-out of the intervention in four blocks (regions) of four units. The primary clinical outcome is OASI rate. Regression analysis will adjust for differences in organisational characteristics and obstetric risk factors in women who gave birth before and after implementation of the care bundle. Focus group discussions and in-depth interviews with clinicians will evaluate the feasibility of integrating the care bundle into routine practice. Interviews with women will explore the acceptability of the intervention.
Discussion
This protocol outlines the evaluation of our quality improvement project which aims to prevent OASI using a bundle of evidence-based interventions that are each widely used in practice. The OASI project aims to 1) standardise practice to prevent OASI in a way that is acceptable to clinicians and women and 2) identify the barriers and enablers associated with upscaling interventions within maternity units. If found to be effective, feasible and acceptable, the OASI Care Bundle will be shared with a range of audiences using the communication channels available to the professional bodies.
Trial registration
The OASI Project was retrospectively registered on the
ISCTRN12143325
database date assigned 03/10/2017.
Journal Article
Thread-based assay for quantitative small molecule analysis of mice tear fluid by capillary electrophoresis
Tear fluid plays blood-like roles in the cornea, and changes in its chemical composition may be reflective of ocular surface disease pathogenesis. Studies of mice tears are limited by the small volume available for collection and difficulty in obtaining representative samples. Here, we establish a non-invasive assay for small volume analysis of small molecules in mice tears that requires no pre-treatment of mice. To the best of our knowledge, this is the first small molecule analysis of mice tears. Nanoliters of mice tears (70 ± 25 nL) was collected via a single insertion of phenol red thread in the corner of the eye without anesthesia to prevent any tear production alteration. The processing and elution of tear samples were optimized for minimal sample handling and dilution while maintaining high separation resolution. A capillary electrophoresis separation with light-emitting diode-induced fluorescence detection was developed for the analysis of primary amine-containing small molecules. The levels of arginine, alanine, aspartate, and glutamate after elution were in the micromolar range as seen in human tears. However, taurine and histamine levels were decreased and increased, respectively, compared to human tears, which may be indicative of restraint-induced emotional stress. No significant differences were seen for any of the small molecules between 20-week-old ND4 Swiss Webster females and 12-week-old CD-1 males (N = 3). The developed assay represents a means to assess the chemical composition of tear fluid in mouse models of human disease, which could significantly improve our understanding of ocular surface diseases.
Journal Article
An Investigation of the Psychosocial Outcomes of Dry Eye Disease Treatment in Children with Computer Vision Syndrome
Objectives: Computer vision syndrome (CVS) is a common disorder among children and is often associated with dry eye disease (DED). While researchers have shown a higher prevalence of psychopathology in older patients with DED, the impact of CVS-induced DED on the psychological state of children is not well known. This study aimed to evaluate psychological outcomes before and after DED treatment in pediatric patients with CVS-related DED. Materials and Methods: In this study, a total of 38 children (32 girls, 6 boys) with CVS-related DED were evaluated with the Schirmer test, tear break-up time (TBUT), ocular surface disease index (OSDI), and Oxford grading scale at the time of diagnosis and after treatment with artificial tear drops. Additionally, quality of life (QoL) and anxiety and depression symptoms were assessed using self-report scales for children. Results: The mean age and mean daily screen exposure of the patients were 13.95[+ or -]2.42 years and 5.65[+ or -]2.31 hours, respectively. After treatment, TBUT and Schirmer test values of the patients increased significantly, while OSDI values decreased (p<0.001 for all). The anxiety and depression scores of the patients decreased, while QoL functionality scores increased (p<0.05 for all) following treatment. There were significant correlations between Schirmer test values and anxiety scores (r = -0.32, p = 0.045) and QoL total scores (r = 0.38, p = 0.016). Conclusion: Enhanced QoL and decreased anxiety and depression scores were associated with improved Schirmer test results, indicating that appropriate DED treatment may mitigate the psychosocial effects of CVS-related DED in pediatric patients. Keywords: Dry eye disease, computer vision syndrome, children, quality of life, anxiety, depression
Journal Article
Preoperative and Postoperative Kinesiophobia Influences Postoperative Outcome Measures Following Anterior Cruciate Ligament Reconstruction: A Prospective Study
The anterior cruciate ligament (ACL) is the most injured ligament of the knee, and the treatment of choice is usually ACL reconstruction. Kinesiophobia refers to an irrational and paralyzing fear of movement caused by the feeling of being prone to injury or reinjury. The aim of the present study is to evaluate the relationship between preoperative and postoperative kinesiophobia with postoperative outcomes of ACL-R evaluated through SF-36, ACL-RSI, KOOS, and OKS scores. Included patients all underwent ACL reconstruction. The preoperative TSK-13 questionnaire and six-month postoperative TSK-13, ACL-RSI, SF-36, KOOS, and OKS questionnaires were assessed in included patients. Normal distribution was assessed using the Shapiro–Wilk test. The study included 50 patients who filled out the questionnaires at the 6-month postoperative follow-up. Correlations between preoperative TSK-13 and postoperative outcome measures revealed a low–moderate negative correlation between preoperative TSK-13 and SF-36 PCS at 6-month follow-up. Correlations between postoperative TSK-13 and postoperative outcome measures revealed a high negative correlation between preoperative TSK-13 and ACL-RSI, KOOS Symptoms, KOOS Pain, KOOS ADL, and OKS at 6-month follow-up. Preoperative and postoperative kinesiophobia were found to influence postoperative ACL-R outcomes negatively, more specifically an increase in kinesiophobia showed a statistically significant correlation with worse postoperative SF-36 PCS scores in patients.
Journal Article