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Research suggests mask-wearing can increase struggles with social anxiety

People who struggle with social anxiety might experience increased distress related to mask-wearing during and even after the COVID-19 pandemic.

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People who struggle with social anxiety might experience increased distress related to mask-wearing during and even after the COVID-19 pandemic.

A paper authored by researchers from the University of Waterloo’s Department of Psychology and Centre for Mental Health Research and Treatment also has implications for those who haven’t necessarily suffered from social anxiety in the past.

“The adverse effects of the COVID-19 pandemic on mental health outcomes, including anxiety and depression, have been well-documented,” said David Moscovitch, professor of clinical psychology and co-author of the paper. “However, little is known about effects of increased mask-wearing on social interactions, social anxiety, or overall mental health.

“It is also possible that many people who didn’t struggle with social anxiety before the pandemic may find themselves feeling more anxious than usual as we emerge out of the pandemic and into a more uncertain future — especially within social situations where our social skills are rusty and the new rules for social engagement are yet to be written.”

Social anxiety is characterized by negative self-perception and fear that one’s appearance or behaviour will fail to conform with social expectations and norms. Social anxiety disorder is an extreme manifestation that affects up to 13 per cent of the population.

The researchers reviewed existing literature addressing three factors that they hypothesized might contribute to social anxiety associated with mask-wearing: hypersensitivity to social norms, bias in the detection of social and emotional facial cues, and propensity for self-concealment as a form of safety behaviour.

“We found that mask-wearing by people with social anxiety is likely to be influenced by their perception of social norms and expectations, which may or may not be consistent with public-health guidelines and can vary widely by region and context,” said Sidney Saint, an undergraduate psychology student at Waterloo and lead author of the paper.

The paper also highlights that people with social anxiety have difficulty detecting ambiguous social cues and are likely to interpret them negatively. These individuals also tend to worry about sounding incomprehensible or awkward. “We believe that both issues are likely to be magnified during interactions with masks,” Saint said.

Another highlighted impact is that masks can function as a type of self-concealment strategy that enables people with social anxiety to hide their self-perceived flaws. Therefore, the desire for self-concealment may motivate their use of masks over and above their desire to protect themselves from contagion. “Due to their self-concealing function, masks may be difficult for some people to discard even when mask-wearing is no longer required by public health mandates,” Saint said.

In addition to contributing insights to guide clinicians toward effective assessment and treatment, the paper shows that people with social anxiety may be particularly vulnerable to periods of norm transitions where expectations for mask-wearing are in flux or become a matter of personal choice.

The study, Effects of mask-wearing on social anxiety: an exploratory review, is available online and will be published in the journal Anxiety, Stress, & Coping.

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5 Steps for women to reduce their risk of COPD

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

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If you’re a woman who tries to stay healthy, you may exercise several times per week, watch what you eat and get 7-9 hours of sleep each night. But are you listening to your lungs?

Chronic obstructive pulmonary disease (COPD), a leading cause of disability and death in the United States, takes an especially heavy toll on women. You may think problems like shortness of breath, frequent coughs or wheezing are just signs of getting older, but it’s important to pay attention to these symptoms and discuss them with your doctor.

COPD is a serious lung disease that causes breathing problems and worsens over time. It has often been considered a man’s disease. Yet more women than men have been diagnosed with COPD in the past decade, and over the past 20 years more women have died from it, according to the US Centers for Disease Control and Prevention.

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

Don’t Smoke

You probably already know cigarette smoking is harmful  but did you know that women may be more vulnerable to the effects of smoking? Women who smoke tend to get COPD at younger ages and with less cigarettes smoked than men. COPD is the leading cause of death among U.S. women smokers.

If you do smoke, it’s never too late to quit.

If you thought vaping was a healthy alternative to smoking, think again. Researchers are still learning about the long-term health effects of e-cigarettes, but they may contain as many, if not more, harmful chemicals than tobacco cigarettes.

Avoid Pollutants

Among people with COPD who have never smoked, most are women. Women may be more vulnerable to indoor and outdoor air pollution. Women’s smaller lungs and airways mean the same amount of inhaled pollutants may cause more damage.

Working in places like nail salons, hair salons or dry cleaners can expose you to harmful chemicals. If you’re exposed to chemical fumes at your job, talk to your employer about ways to limit exposure. Better ventilation and wearing a mask can help.

Stay Current on Vaccines

People at risk for COPD are more likely to have serious problems resulting from some vaccine-preventable diseases. Ask a health care provider about getting vaccinated against the flu, pneumococcal disease and COVID-19.

Talk to Your Doctor About COPD

Women with COPD tend to be diagnosed later than men when the disease is more severe and treatments are less effective. If you think you could be at risk, or you are having symptoms, bring it up with your health care provider. Treatment can ease symptoms and improve your ability to exercise.

Learn More to Breathe Better

Find more information on COPD from NHLBI’s Learn More Breathe Better program at copd.nhlbi.nih.gov.

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2 Steps to save a life

“By equipping people with Hands-Only CPR training, we are empowering them to spring into action if a loved one needs help, as the majority of cardiac arrests occur at home.”

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More than 350,000 sudden cardiac arrests occur annually outside hospital settings. However, a hands-on emergency intervention like cardiopulmonary resuscitation (CPR), especially if performed immediately, can double or triple a cardiac arrest victim’s chance of survival.

According to the American Heart Association, 70% of cardiac arrests – electrical malfunctions in the heart that cause an irregular heartbeat (arrhythmia) and disrupt the flow of blood to the brain, lungs and other organs – occur at home, but often family and friends who witness a child, spouse, parent or friend going into cardiac arrest hesitate to perform potentially lifesaving CPR for fear of making the situation worse.

“By equipping people with Hands-Only CPR training, we are empowering them to spring into action if a loved one needs help, as the majority of cardiac arrests occur at home,” said Dr. Anezi Uzendu, M.D., interventional cardiologist and American Heart Association volunteer.

As part of its Hands-Only CPR campaign, nationally supported by the Elevance Health Foundation, the American Heart Association aims to increase awareness about the importance of bystander CPR and offers these two simple steps:

1.      Call 911.
2.      Push hard and fast in the center of the chest of the individual experiencing cardiac arrest.

Using the beat of a familiar song with 100-120 beats per minute, such as “Stayin’ Alive” by the Bee Gees, can help you stay on pace with the necessary compressions.

“Being able to efficiently perform Hands-Only CPR in the moment can mean the difference between life and death, and by following these two simple steps we can increase someone’s chance of survival from cardiac arrest,” said Shantanu Agrawal, M.D., board certified emergency medicine doctor and chief health officer at Elevance Health. “As a longstanding supporter of the American Heart Association, we remain focused on working together to improve health inequities in our communities by expanding access to training and increasing the number of people who learn and feel confident performing Hands-Only CPR to save lives.”

To find more information, watch a livestream video demonstration of Hands-Only CPR or download a first aid smartphone app, visit heart.org/CPR.

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What you eat could contribute to your menstrual cramps

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

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Despite the fact that menstrual pain (dysmenorrhea) is the leading cause of school absences for adolescent girls, few girls seek treatment. An analysis of relevant studies suggests that diet may be a key contributor, specifically diets high in meat, oil, sugar, salt, and coffee, which have been shown to cause inflammation.

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

This analysis was designed to study the effect of diet on menstrual pain and identify which foods contribute to it and which can reduce it. Research was conducted through a literature review that found multiple studies that examined dietary patterns that resulted in menstrual pain. In general terms, these studies found that diets high in omega-6 fatty acids promote inflammation and foods high in omega-3 fatty acids reduce it. The muscles in the uterus contract because of prostaglandins, which are active in inflammatory responses. When measuring the Dietary Inflammatory Index, it was found that those on a vegan diet (that excluded animal fat) had the lowest rates of inflammation.

“Researching the effects of diet on menstrual pain started as a search to remedy the pain I personally experienced; I wanted to understand the science behind the association. Learning about different foods that increase and decrease inflammation, which subsequently increase or reduce menstrual pain, revealed that diet is one of the many contributors to health outcomes that is often overlooked. I am hopeful that this research can help those who menstruate reduce the pain they experience and shed light on the importance of holistic treatment options,” says Serah Sannoh, lead author of the poster presentation from Rutgers University.

“Since menstrual pain is a leading cause of school absenteeism for adolescent girls, it’s important to explore options that can minimize the pain. Something like diet modification could be a relatively simple solution that could provide substantial relief for them,” said Dr. Stephanie Faubion, NAMS medical director.

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