Fatigue and depression influence the prevalence of anxiety in patients with multiple sclerosis.

BACKGROUND: There is scarce information in Middle-Eastern Europe regarding the prevalence of anxiety in patients with multiple sclerosis (pwMS) and its association with different clinical-demographic factors. OBJECTIVE: We aimed to determine the prevalence of anxiety in Hungarian MS patients and to analyze associated factors. MATERIALS AND METHODS: We evaluated 260 PwMS with the STAI-5 anxiety questionnaire. Fatigue (FIS), depression (BDI-II) and cognition (BICAMS) were also measured. Patients underwent standard neurological evaluations to evaluate Expanded Disability Status Scale (EDSS), and also measured the fine motor skills of the hand with the 9-hole peg test (9HPT), and the walking distance with the 25-foot walking test (T25FW). RESULTS: We identified 23.1% (N = 60) of the patients with anxiety (only state, trait or both forms concurrently). According to our two univariate, multivariable logistic regression analysis, fatigue and depression are strongly associated with both state and trait anxiety. In the absence of fatigue, the odds of trait anxiety are 82% lower (OR: 0.18; 95% CI: 0.06-0.53; p = 0.002), while in the case of pwMS without depression, the odds are reduced by 81% (OR: 0.19; CI95%= 0.07-0.51, p = 0.001). This association with fatigue (OR: 0.33; CI95%= 0.13-0.85, p = 0.021) and depression (OR: 0.14; CI95%=0.06-0.35; p < 0.001) can also be statistically verified on state anxiety. Importantly, a significant association with state anxiety was found in SPSM patients as well (OR: 34.94; CI95%=2.55-479.61; p = 0.008). CONCLUSIONS: Anxiety was strongly associated with fatigue, depression, and secondary progressive disease form. These results emphasize the burden of psychiatric morbidity in pwMS.

Anxiety in couples undergoing IVF: evidence from E-Freeze randomised controlled trial.

STUDY QUESTION: What are the risk factors and impacts of anxiety in women and men in heterosexual couples undergoing IVF as part of a randomised trial, with a delay in embryo transfer in one arm? SUMMARY ANSWER: Duration of infertility, ethnicity, and male partner's anxiety levels were associated with women's anxiety at the start of treatment, while initial anxiety score, partner's anxiety score at embryo transfer, ethnicity, and clinic location were associated with women's anxiety levels at embryo transfer; although women undergoing IVF were more anxious than their partners for slightly different reasons, their self-reported state anxiety was not associated with achieving clinical pregnancy, nor with switching from delayed frozen embryo transfer to fresh embryo transfer in an IVF trial. WHAT IS KNOWN ALREADY: Use of IVF treatment continues to rise and patients undergoing IVF are anxious. Participating in a randomised controlled trial (RCT) with uncertainty of arm randomisation might increase their anxiety, while a delay in treatment may add further to anxiety. STUDY DESIGN SIZE DURATION: A mixed methods study was conducted using data from the multi-centre E-Freeze RCT cohort conducted across 13 clinics in the UK from 2016 to 2019. A regression analysis on anxiety scores of couples undergoing the IVF trial and a qualitative analysis of participant questionnaires were performed. PARTICIPANTS/MATERIALS SETTING METHODS: Six hundred and four couples participating in the E-Freeze trial, who had at least one useable State-Trait Anxiety Inventory (STAI) State Anxiety subscale (STAI-S) standardised self-report questionnaire for at least one of the partners, were included in the study. STAI-S scores were measured at consent for trial (T1) and again at embryo transfer (T2). Linear and log-binomial regression were used to explore the association between characteristics and STAI-S scores, and the associations between STAI-S scores and non-compliance and clinical pregnancy, respectively. Responses to the open text question were qualitatively analysed inductively using content analysis. MAIN RESULTS AND THE ROLE OF CHANCE: Women's STAI-S scores at T1 (consent) were associated with their ethnicity, duration of infertility, and their male partner's STAI-S score at T1. Women's STAI-S scores at T2 (embryo transfer) were associated with their ethnicity, location of fertility clinic, their STAI-S score at consent, and their male partner's STAI-S score at embryo transfer. The adjusted coefficient (95% CI) for women's STAI-S scores at T2 was -4.75 (-7.29, -2.20, P < 0.001) for ethnic minority versus White, -2.87 (-4.85, -0.89, P = 0.005) for Scotland versus England, 0.47 (0.37, 0.56, P < 0.001) for each point increase in their own score at T1, and 0.30 (0.21, 0.40, P < 0.001) for each point increase in their male partner's score at T2. On average, women had higher STAI-S scores than men at both time points, and a larger increase of scores between the two time points. However, women's STAI-S scores were not associated with either non-compliance with trial allocation in the 'freeze-all' trial arm, or with chances of pregnancy. Both partners, but particularly women, described feeling anxious about the outcome of IVF, with women carrying the added worry of believing that feeling stressed might itself affect the outcome. Participants highlighted the important role of support from staff in helping them to manage their anxiety. LIMITATIONS REASONS FOR CAUTION: Data were not available on education level or social support, which might influence anxiety scores. Men's baseline characteristics were not collected. WIDER IMPLICATIONS OF THE FINDINGS: Identifying couples at increased risk of emotional distress may be improved by using standardised anxiety measures at the start of the fertility treatment. Women can be reassured that their self-reported state anxiety does not affect their chances of achieving clinical pregnancy through IVF, and this may help to reduce anxiety levels. The psychological wellbeing and experiences of couples undergoing IVF could be supported by patient-centred care: making information about the whole process of treatment and choices available to both partners in accessible formats; ensuring interactions with staff are kind and supportive; and acknowledging and addressing the different concerns of women undergoing IVF and their partners. STUDY FUNDING/COMPETING INTERESTS: This study was an NIHR HTA (National Institute for Health and Care Research Health Technology Assessment) funded study. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: ISRCTN registry: ISRCTN61225414.

A pilot study exploring the effectiveness of binaural beats at reducing anxiety associated with cadaveric dissection.

This study explored the effects of a novel intervention, binaural beats (BB), on anxiety levels of anatomy students during cadaveric dissections and its impact on the learning environment. The study was quasi-experimental, employing a purposive sampling strategy. State (SA) and trait (TA) anxiety levels were measured using the State-Trait Anxiety Inventory during two routine dissection sessions. SA was measured at three time points: at the start, after a 3-min control (silence)/intervention (10 Hz BB) session, and at the end of the dissection. A post-study survey was distributed to the participants to obtain qualitative feedback on their perceptions of BB use during cadaveric dissections. Thirteen female students participated in this study (mean age 19.62 ± 0.65 years). Both control and intervention measures significantly reduced SA levels, with BB demonstrating a greater effect size (Hedges' g = 0.98 for intervention vs. 0.76 for control). SA decreased significantly after the BB intervention (t(12) = 3.78, p = 0.003) and remained low throughout the session, in contrast to the control session, where the reduction post-measure was not sustained (t(12) = -0.64, p = 0.54). Feedback from the post-study survey indicated that most students found the BB intervention effective in reducing their anxiety levels before the dissection. The BB intervention was effective in reducing and maintaining students' SA levels during dissection. Students reported positive experiences with BB. Further investigations are warranted to determine whether the findings of this study can be generalized to larger and more heterogeneous populations.

Pre and post-competitive anxiety and self-confidence and their relationship with technical-tactical performance in high-level men's padel players.

Introduction: This study aimed to analyze the variations in pre- and post-competitive anxiety and self-confidence considering match outcomes, the performance according to the result and the correlation among performance and psychological variables. Methods: The sample consisted on 12 matches in which 11 high-level padel players from Finland (top 24) voluntarily participated. CSAI-2R and STAI-S were used to assess psychological variables and technical-tactical performance was evaluated by a certified padel coach. Results: Losing players presented higher cognitive (p = .004), somatic (p = .020) and state (p = .001) anxiety and lower selfconfidence (p = .014), and winning players showed higher state anxiety (p = .022), after than before the matches. Post-match, winning players exhibited higher self-confidence (p = .015) than losing players. Winning players made more winners (p = .010) than losing players. There are direct correlations between unforced errors and post-state anxiety (p = .015), unforced errors and state anxiety (p = .009) and winners and cognitive anxiety (p = .033), in winning players; between generators of forced error and post-cognitive anxiety (p = .034), forced errors and cognitive anxiety in losing players (p = .001). There are indirect correlations between forced errors and pre-cognitive anxiety (p = .009), winners and somatic anxiety (p = .046), unforced errors and state anxiety (p = .042) in losing players. Discussion: The outcomes imply the need for intervention programs to equip players, especially those facing defeat, with tools for anxiety management and self-confidence enhancement. Likewise, coaches are advised to incorporate exercises that promote the occurrence of winners.

Enhancing Working Memory and Reducing Anxiety in University Students: A Neurofeedback Approach.

(1) Background: Neurofeedback training (NFT) has emerged as a promising approach for enhancing cognitive functions and reducing anxiety, yet its specific impact on university student populations requires further investigation. This study aims to examine the effects of NFT on working memory improvement and anxiety reduction within this demographic. (2) Methods: A total of forty healthy university student volunteers were randomized into two groups: an experimental group that received NFT and a control group. The NFT protocol was administered using a 14-channel Emotiv Epoc X headset (EMOTIV, Inc., San Francisco, CA 94102, USA) and BrainViz software version Brain Visualizer 1.1 (EMOTIV, Inc., San Francisco, CA 94102, USA), focusing on the alpha frequency band to target improvements in working memory and reductions in anxiety. Assessment tools, including the Corsi Block and Memory Span tests for working memory and the State-Trait Anxiety Inventory-2 (STAI-2) for anxiety, were applied pre- and post-intervention. (3) Results: The findings indicated an increase in alpha wave amplitude in the experimental group from the second day of NFT, with statistically significant differences observed on days 2 (p < 0.05) and 8 (p < 0.01). Contrary to expectations based on the previous literature, the study did not observe a concurrent positive impact on working memory. Nonetheless, a significant reduction in state anxiety levels was recorded in the experimental group (p < 0.001), corroborating NFT's potential for anxiety management. (4) Conclusions: While these results suggest some potential of the technique in enhancing neural efficiency, the variability across different days highlights the need for further investigation to fully ascertain its effectiveness. The study confirms the beneficial impact of NFT on reducing state anxiety among university students, underscoring its value in psychological and cognitive performance enhancement. Despite the lack of observed improvements in working memory, these results highlight the need for continued exploration of NFT applications across different populations and settings, emphasizing its potential utility in educational and therapeutic contexts.

Clinical Evaluation of Effectiveness and Safety of Combined Use of Dietary Supplements Amberen® and Smart B® in Women with Climacteric Syndrome in Perimenopause.

INTRODUCTION: Perimenopause is a time of transition in a woman's life that links her reproductive years to the cessation of ovulation, or menopause. For many women, this time is characterized by a variety of physiological and lifestyle changes, including increasing irregularity in menstrual bleeding, frequency and severity of vasomotor symptoms, etc. Therapies evaluated specifically for the perimenopausal women are very limited. This study aimed to evaluate the effectiveness and safety of Amberen® (a succinate-based non-hormonal supplement) combined with a Smart B® (vitamin B) complex in women with typical (without complications) mild to moderate climacteric syndrome during perimenopause. METHODS: Women up to 50 years of age, in perimenopause, with vasomotor and psychosomatic symptoms of the climacteric syndrome were enrolled for the study. The trial was randomized, double-blinded, placebo-controlled, comparative, and prospective. RESULTS: A total of 106 participants were enrolled in the trial and, per protocol, 105 completed the trial. We observed statistically significant improvements in most of the Greene Climacteric Scale symptoms, State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), and Well-being, Activity, and Mood (WAM) scores. The intervention was well tolerated with few adverse effects reported to be mild and transient. CONCLUSION: The use of this dietary supplement is safe and eliminates or improves vasomotor and psychosomatic symptoms of climacteric symptoms in perimenopausal women: it improves sleep and cognitive abilities, lowers depression and anxiety, improves mood and well-being, and positively affects quality of life. GOV IDENTIFIER: NCT03897738.

Association Between Pandemic-Related Maternal Perinatal Anxiety and Early Postpartum Breastfeeding Success.

BACKGROUND AND OBJECTIVES: Prior studies have shown conflicting results on the impact of maternal anxiety on breastfeeding initiation and success. Furthermore, a substantial increase in maternal anxiety levels was shown in response to the COVID-19 pandemic. In this study, we aimed to investigate the relationship between maternal perinatal anxiety induced by the COVID-19 pandemic and early breastfeeding outcomes. MATERIALS AND METHODS: This cross-sectional study was conducted in two regional maternity hospitals, involving 220 first-time pregnant patients with a gestational age of ≥37 weeks. All patients had no current diagnosis of COVID-19 and no cases of COVID-19 in their close environment at the time of admission. At 24-48 hours postpartum or at the time of discharge, three following scoring systems were employed: the Coronavirus Anxiety Scale (CAS), the State-Trait Anxiety Inventory (STAI), and the LATCH (short for latch, audible swallowing, type of nipple, comfort, and hold) score. A LATCH score of ≥8 was chosen as the cutoff point for defining successful breastfeeding performance. Spearman's rank correlation was used to evaluate relationships between the CAS, STAI scores, maternal and infant factors, and LATCH scores. RESULTS: There were no differences in baseline characteristics between groups categorized as successful and unsuccessful in breastfeeding initiation. The mean total STAI score was 86.3±13.2, the CAS score was 1.07±1.91, and the LATCH score was 8.42±1.7. Although there was an increase in State-Trait Anxiety Inventory-State Anxiety (STAI-S) scores compared to State-Trait Anxiety Inventory-Trait Anxiety (STAI-T) scores, and the STAI-S score and CAS score were higher in the unsuccessful group, these differences did not reach statistical significance (p = 0.22 and 0.16, respectively). When we evaluated the correlation of the LATCH score with STAI total, STAI-S and STAI-T scores, CAS score, and maternal and infant factors, only the type of delivery showed a significant correlation with the LATCH score (p = 0.008). CONCLUSIONS: Early postpartum breastfeeding efficiency, as measured by the LATCH score, was only correlated with the type of delivery. No significant correlation was found between pandemic-related maternal perinatal anxiety and early postpartum breastfeeding success.

Trait-anxiety and glial-related neuroinflammation of the amygdala and its associated regions in Alzheimer's disease: A significant correlation.

Background: Positron emission tomography, which assesses the binding of translocator protein radiotracers, 11C-DPA-713, may be a sensitive method for determining glial-mediated neuroinflammation levels. This study investigated the relationship between regional 11C-DPA713 binding potential (BPND) and anxiety in patients with Alzheimer's disease (AD) continuum. Methods: Nineteen patients with AD continuum determined to be amyloid-/p-tau 181-positive via cerebrospinal fluid analysis were included in this cross-sectional study (mild cognitive impairment [MCI, n = 5] and AD [n = 14]). Anxiety was evaluated using the State-Trait Anxiety Inventory (STAI). A whole-brain voxel-based analysis was performed to examine the relationship between 11C-DPA-713-BPND values at each voxel and the STAI score. Stepwise multiple regression analysis was performed to determine the predictors of STAI scores using independent variables, including 11C-DPA-713-BPND values within significant clusters. 11C-DPA-713-BPND values were compared between patients with AD continuum with low-to-moderate and high STAI scores. Results: Voxel-based analysis revealed a positive correlation between trait anxiety severity and 11C-DPA713-BPND values in the centromedial amygdala and the left inferior occipital area [P < 0.001 (uncorrected) at the voxel-level]. 11C-DPA713-BPND values in these regions were a strong predictor of the STAI trait anxiety score. Specifically, patients with AD continuum and high trait anxiety had increased 11C-DPA713-BPND values in these regions. Conclusions: The amygdala-occipital lobe circuit influences the control of emotional generation, and disruption of this network by AD pathology-induced inflammation may contribute to the expression of anxiety. Our findings suggest that suppression of inflammation can help effectively treat anxiety by attenuating damage to the amygdala and its associated areas.

Effectiveness of WeChat-assisted preoperative education to reduce perioperative anxiety in breast cancer patients: a prospective randomized controlled study protocol.

BACKGROUND: Breast cancer is the most prevalent cancer among women globally, and surgical procedures continue to be the primary treatment. However, over 50% of patients experience preoperative anxiety due to the unknown and fear associated with surgery. Although drug therapy is commonly used to address this anxiety, its side effects have led to a heated debate regarding its effectiveness. Consequently, non-pharmacological therapies, such as preoperative education, have emerged as an alternative approach to alleviate anxiety. WeChat, a widely popular social media platform, offers a public platform that can potentially be utilized for effective preoperative education. This study aims to evaluate the use of WeChat public platform as a tool for preoperative education in patients undergoing breast surgery. METHODS: This is a prospective, randomized, and controlled trial will involve 392 adult women scheduled for breast cancer resection. Participants will be randomly assigned to either the WeChat education group or the regular group. In addition to regular preoperative visits, the WeChat education group will also watch science videos through the WeChat public platform. The regular group will only receive education from ward nurses during preoperative visits. The primary outcome measure will be the incidence of preoperative anxiety, defined by scores of the State Anxiety Inventory (SAI) exceeding 40 points. Secondary outcome measures include the incidence of severe anxiety (SAI > 44) on the day before surgery, incidence of anxiety 72 h after surgery, incidence of severe anxiety 72 h after surgery, NRS scores for pain at rest and during activity 24, 48, and 72 h after surgery, incidence of nausea and vomiting within 24 h after surgery, subjective sleep score at 1 week postoperatively, quality of life QoR-15 scores at 1 and 3 months postoperatively, incidence of chronic pain at 3 months postoperatively, bowel function recovery, length of hospital stay, and hospitalization expenses. DISCUSSION: This is the first clinical trial to investigate the use of WeChat public platform for delivering preoperative education on perioperative anxiety in breast cancer patients. By utilizing the renowned WeChat public platform, our study aims to improve patient outcomes by providing video education that explains the disease, surgery, and anesthesia in a more accessible manner, thereby reducing the incidence of perioperative anxiety. If our hypothesis is confirmed, this non-pharmacological approach can be universally acknowledged as a cost-effective and practical method in clinical care. Its application can also be extended to other medical fields beyond breast cancer. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05291494. Registered on 29 December 2021.

Stress responses in surgical trainees during simulation-based training courses in laparoscopy.

BACKGROUND: Simulation-based training courses in laparoscopy have become a fundamental part of surgical training programs. Surgical skills in laparoscopy are challenging to master, and training in these skills induces stress responses in trainees. There is limited data on trainees' stress levels, the stress responses related to training on different laparoscopic simulators, and how previous experiences influence trainees' stress response during a course. This study investigates physiologic, endocrine and self-reported stress responses during simulation-based surgical skills training in a course setting. METHODS: We conducted a prospective observational study of trainees attending basic laparoscopic skills training courses at a national training centre. During the three-day course, participants trained on different laparoscopic simulators: Two box-trainers (the D-box and P.O.P. trainer) and a virtual reality simulator (LAPMentor™). Participants' stress responses were examined through heart rate variability (HRV), saliva cortisol, and the State Trait Anxiety Inventory-6 (STAI-6). The correlation between previous laparoscopic experiences and stress response measurements was explored. RESULTS: Twenty-four surgical trainees were included in the study. Compared to resting conditions, stress measures were significantly higher during simulation-training activity (the D-box (SDNN = 58.5 ± 23.4; LF/HF-ratio = 4.58 ± 2.71; STAI-6 = 12.3 ± 3.9, P < 0.05), the P.O.P trainer (SDNN = 55.7 ± 7.4; RMSSD = 32.4 ± 17.1; STAI-6 = 12.1 ± 3.9, P < 0.05), and the LAPMentor™ (SDNN = 59.1 ± 18.5; RMSSD = 34.3 ± 19.7; LF/HF-ratio = 4.71 ± 2.64; STAI-6 = 9.9 ± 3.0, P < 0.05)). A significant difference in endocrine stress response was seen for the simulation-training activity on the D-box (saliva cortisol: 3.48 ± 1.92, P < 0.05), however, no significant differences were observed between the three simulators. A moderate correlation between surgical experience, and physiologic and endocrine stress response was observed (RMSSD: r=-0.31; SDNN: r=-0.42; SD2/SD1 ratio: r = 0.29; Saliva cortisol: r = 0.46; P < 0.05), and a negative moderate correlation to self-reported stress (r=-0.42, P < 0.05). CONCLUSION: Trainees have a significant higher stress response during simulation-training compared to resting conditions, with no difference in stress response between the simulators. Significantly higher cortisol levels were observed on the D-box, indicating that simulation tasks with time pressure stress participants the most. Trainees with more surgical experience are associated with higher physiologic stress measures, but lower self-reported stress scores, demonstrating that surgical experience influences trainees' stress response during simulation-based skills training courses.

Position and ranking influence in padel: somatic anxiety and self-confidence increase in competition for left-side and higher-ranked players when compared to pressure training.

This study aimed to analyze the differences in the precompetitive anxiety and self-confidence according to the side of play, the ranking and the match outcome, under different competitive scenarios, in high level men's padel players from Finland who trained under pressure prior to the competition. 10 men's padel players (28.60 (4.17) years old) from the highest category participated in the research. The CSAI-2R (Competitive State Anxiety Inventory-2 Revised) and STAI-S (State-Trait Anxiety Inventory - State) questionnaires were used and descriptive and inferential analyzes were performed, including Mann-Whitney's U tests. The findings illuminate that, across the player spectrum, somatic anxiety and self-confidence levels are higher before competition compared to training matches. This trend holds true for left-side, higher-ranked and match winning players. Even lower-ranked players exhibit heightened self-confidence preceding competitions. These insights offer valuable considerations for players, coaches, and sports psychologists, fostering a deeper understanding of the intricate interplay between pressure training, competition, and the athlete's psychological landscape.

The effect of informative video before the procedure on anxiety levels in patients who will have ureteral stent removal under local anesthesia.

OBJECTIVE: Our objective was to assess the impact of video-animated information on the anxiety levels of patients undergoing ureteral stent removal under local anesthesia. METHOD: The study was designed as a randomized prospective trial. The one group received only verbal and written information before the surgery, while the other group received video-animated information in addition to the written and verbal instructions. The patients' anxiety levels were assessed using the STAI-S and STAI-T questionnaires, while their pain scores were evaluated using VAS scores. Tolerability and satisfaction scores were also evaluated on a 5-point Likert scale. RESULTS: The video-group (Group 1) consisted of 74 patients, while the non-video group (Group 2) consisted of 82 patients. The mean pre-information STAI-T score was 34.4 ±â€¯3.7 in Group 1 and 35.2 ±â€¯3 in the Group 2 (p = 0.113). In the video group, pre-information STAI-S scores was 34.8 ±â€¯3.3 and post-information STAI-S scores was 33.8 ±â€¯3 (p < 0.001). In the non-video group, pre-information STAI-S score was 35.6 ±â€¯2.6 and post-information STAI-S score was 35.5 ±â€¯2.7 (p = 0.260). The mean VAS score of Group 1 is 5.7 ±â€¯1.2 and Group 2 is 5.7 ±â€¯1.4 (p = 0.608). The mean tolerability scores of Group 1 and Group 2 were 3.7 ±â€¯0.9 and 2.7 ±â€¯1, respectively. The mean satisfaction scores of Group 1 and Group 2 were 4.1 ±â€¯0.9 and 2.6 ±â€¯1, respectively. Both tolerability score and satisfaction score improved statistically significantly after video information (p < 0.001). CONCLUSION: Providing video-animated information in addition to written and verbal information before removing the ureteral stent reduces patients' preoperative anxiety. Furthermore, patient tolerance and satisfaction are higher when informative videos are included.

A Longitudinal Study of the Influence of the COVID-19 Pandemic on Anxiety and Stress among Medical University Students.

(1) Background: The COVID-19 pandemic was declared an international health emergency by the World Health Organization. The dramatic, widespread transmission of the virus, high mortality, and lack of specific drugs caused the development of panic attacks and anxiety. Healthcare professionals, including medical students, were challenged to provide medical care to patients in need, often exposing themselves to the virus. (2) Methods: This study aimed to assess anxiety and stress levels in medical students, both at the beginning and after the end of the COVID-19 pandemic. The STAI and PSS-10 questionnaires were used. (3) Results: This study showed a decrease in anxiety levels among medical students after the end of the COVID-19 pandemic. In both 2020 and 2022, female students were found to experience higher stress levels than male students. Anxiety levels were similar among students of different medical-related faculties. (4) Conclusions: The COVID-19 pandemic caused stress and anxiety among medical students, which decreased throughout the duration of the pandemic.

Total Antioxidant Capacity of Saliva and Its Correlation with pH Levels among Dental Students under Different Stressful Conditions.

(1) Background: This cross-sectional study conducted at the Faculty of Dental Medicine, Timisoara, Romania, between December 2022 and February 2023 aims to assess salivary total antioxidant capacity and pH levels in dental students experiencing non-stressful and stressful situations and explore potential correlations between these factors. (2) Methods: Saliva samples were collected during two different periods: before an Oral Health course and before the Oral Health exam, under stressful conditions. Ethical principles were followed, and informed consent was obtained. Data on age, gender, health status, drug use, smoking habits, and anxiety levels were recorded. Saliva was collected using the draining method and pH was measured using indicator paper strips. Total antioxidant capacity (TAC) was determined using a commercial assay kit. Statistical analysis involved descriptive statistics, Student's t-test to compare pH and TAC between study groups, and Pearson's correlation coefficient to analyze the correlation between salivary pH and TAC within each group, with p < 0.05 indicating significance. (3) Results: This study involved 80 participants, comprising 26 males and 54 females, all enrolled in the 5th year of the Oral Health course, with ages ranging from 20 to 53 and a mean age of 23.62 (±4.19) years. Pearson's correlation results show a statistically significant negative relationship between the STAI test and TAC during the stress-free period (-0.02 **, N = 80, p < 0.01). (4) Conclusions: There are variations in saliva's antioxidant capacity in response to different stress conditions. Dental students experienced a higher level of stress before academic assessments compared to the non-stress period during the course.

Precompetitive anxiety and self-confidence during the 2023 Finnish Padel championship in high level men's players.

The aim of the current study was to assess precompetitive anxiety and self-confidence in high level men's padel players from Finland. Twenty eight men's padel players from the highest category participated in the research (87.5% of the target population). The CSAI-2R (Competitive State Anxiety Inventory-2 Revised) and STAI-S (State-Trait Anxiety Inventory - State) questionnaires were used and descriptive and inferential analyzes were performed, including the Kruskal Wallis's H and Mann-Whitney's U tests. The results show that seeded players presented lower levels of cognitive anxiety (η2 = 0.111). Moreover, losers of first round presented more state anxiety than winners (η2 = 0.302). Before the first match, state anxiety was higher than prior to the second match (η2 = 0.148). Furthermore, lower ranked players of first round, compared to second, presented more state anxiety and somatic anxiety (η2 = 0.487 and η2 = 0.277, respectively). However, according to the results obtained, self-confidence was not affected by any of the variables analyzed (ranking, seed, result or round). These findings may be of great interest to players, coaches and sports psychologists, as they allow an enhanced comprehension of the player's level of anxiety and self-confidence.

Effects of music on the preoperative and intraoperative anxiety through the assessment of pupil size and vital signs (blood pressure, respiratory, and pulse rates) among cataract surgery patients at UNTH-Enugu.

Background/Aim: To examine how music can impact preoperative and intraoperative anxiety via assessment of physiological markers such as pupil size, blood pressure, pulse rate, and respiratory rate. Methods: This is a randomized interventional study of individuals aged 50 years and above who were scheduled for and undergoing cataract surgery under regional anesthesia, with music (test group) randomly matched with similar individuals undergoing the same procedure but without music (control group). The surgeries were performed in the operating theater of the Department of Ophthalmology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu. Using a systematic random sampling method, a total of 98 patients were grouped into two. Both groups completed the State-Trait Anxiety Inventory (STAI) questionnaire at baseline, immediately upon entrance into the preoperative room and 5 min after intervention. Relevant study indices (blood pressure, pulse, respiratory rate, and pupil diameter) were measured and recorded, and these served as baseline parameters. The STAI questionnaire was then administered. Results were analyzed using the SPSS version 20 and analysis of variance was used to compare means of variables measured at baseline, preoperative before intervention, and preoperative after intervention. Categorical variables were compared using the Chi-square test. Student's t-test was used to analyze the continuous variables. Results: Our analysis, using the multiple linear regression, showed that music has an effect on preoperative anxiety and intraoperative anxiety by positively affecting the blood pressure, pulse rate, respiratory rate, and pupil diameter (P ≤ 0.001). Conclusion: Music reduces preoperative and intraoperative anxiety evidenced by its effect on the physiological biomarkers.

Situaciones de violencia por parte de pacientes percibidos por personal de enfermería en un hospital público Corrientes capital 2021 / Situations of violence by patients received by nursing personnel in a public hospital Corrientes capital 2021

Describir las situaciones de violencia por parte de los pacientes percibidas por el personal de enfermería en una institución de salud pública de Corrientes capital durante 2021. Metodología: Estudio observacional, descriptivo, transversal. Muestreo de tipo consecutivo. La población personal de enfermería asistencial de un hospital. Variables: edad, género, instrucción, antigüedad laboral, área de trabajo, turno, identifcación de maltrato físico, verbal y asedio sexual, principal modo de actuar e impacto frente a situaciones de violencia. Recolección de datos mediante cuestionario Google Forms con consentimiento informado anónimo, que fue validado por prueba piloto. Análisis con Microsof Excel y Epidat 4.1. Resultados: Población estudiada 115 trabajadores de enfermería; 69,57% mujeres; rango etario 22-56 años, promedio 35,5 años. Formación: 58,26% enfermeros, 22,61% licenciados en enfermería y 19,13% auxiliares en enfermería. Turno: 37,39% mañana, 30,43% tarde, 17,39% noche y 14,78% rotativo. Área laboral: cuidados intensivos 27,83%, clínica médica 21,74%, clínica quirúrgica 15,65%, emergencias 15,65%, consultorios 10,43%, coronaria 8,70%. De los entrevistados, 89,56% había percibido algún tipo de violencia, de estos 61,17% estaba entre 22 y 38 años. La percepción de violencia mostró que 92,53% eran enfermeros, 88,46% licenciados y 81,81% auxiliares de enfermería. Los tipos de violencia identificados fueron maltrato verbal en el 86,09%, maltrato físico en el 72,17% y asedio sexual en el 24,35%. El principal género afectado por los hechos violentos fue el femenino y el turno de trabajo con mayor identificación de situaciones violentas fue el de la mañana. En cuanto a los modos de proceder para comunicar a la institución las situaciones vividas, el 66,96% lo reportaron a un superior Los hechos de violencia según área de trabajo se reportaron por 80% de los de unidad coronaria, 84,38% de unidad de cuidados intensivos, 88,89% de emergencias, 92% de clínica médica, 94,44% de clínica quirúrgica y 100% de consultorios externos. Conclusión: La violencia hacia enfermería está presente en el hospital y afecta más a las mujeres. La forma más frecuente es la verbal, seguida de la física y del asedio sexual. En general frente a las agresiones optan por no hacer nada[AU]

To describe the situations of violence by patients perceived by the nursing staff in a public health institution in Corrientes capital during 2021. Methodology: Observational, descriptive, cross-sectional study. Consecutive type sampling. Te nursing staff population of a hospital. Variables: age, gender, education, job seniority, work area, shif, identifcation of physical, verbal and sexual abuse, main mode of action and impact in situations of violence. Data collection through Google Forms questionnaire with anonymous informed consent, which was validated by pilot test. Analysis with Microsof Excel and Epidat 4.1.Results: Population studied 115 nursing workers; 69.57% women; age range 22-56 years, average 35.5 years. Training: 58.26% nurses, 22.61% nursing graduates and 19.13% nursing assistants. Shif: 37.39% morning, 30.43% afernoon, 17.39% night and 14.78% rotating. Work area: intensive care 27.83%, medical clinic 21.74%, surgical clinic 15.65%, emergencies 15.65%, doctor's ofces 10.43%, coronary 8.70%. Of those interviewed, 89.56% had perceived some type of violence, of these 61.17% were between 22 and 38 years old. Te perception of violence showed that 92.53% were nurses, 88.46% licensed and 81.81% nursing assistants. Te types of violence identifed were verbal abuse in 86.09%, physical abuse in 72.17% and sexual harassment in 24.35%. Te main gender affected by violent acts was female, and the work shif with the highest identifcation of violent situations was the morning shif. Regarding the ways of proceeding to communicate the situations experienced to the institution, 66.96% reported it to a superior Te acts of violence according to work area were reported by 80% of those in the coronary unit, 84.38% of intensive care unit, 88.89% emergencies, 92% medical clinic, 94.44% surgical clinic and 100% outpatient clinics. Conclusion: Violence towards nursing is present in the hospital and affects women more. Te most frequent form is verbal, followed by physical and sexual harassment. In general, when faced with aggression, they choose to do nothing[AU]

Descrever as situações de violência por pacientes percebidas pela equipe de enfermagem em uma instituição pública de saúde da capital Corrientes durante o ano de 2021. Metodologia: Estudo observacional, descritivo, transversal. Amostragem do tipo consecutivo. A população da equipe de enfermagem de um hospital. Variáveis: idade, sexo, escolaridade, tempo de serviço, área de atuação, turno, identifcação de abuso físico, verbal e sexual, principal forma de atuação e impacto em situações de violência. Coleta de dados por meio de questionário Google Forms com consentimento informado anônimo, que foi validado por teste piloto. Análise com Microsof Excel e Epidat 4.1. Resultados: População estudada 115 trabalhadores de enfermagem; 69,57% mulheres; faixa etária de 22 a 56 anos, média de 35,5 anos. Formação: 58,26% enfermeiros, 22,61% graduados em enfermagem e 19,13% auxiliares de enfermagem. Turno: 37,39% matutino, 30,43% tarde, 17,39% noturno e 14,78% rotativo. Área de atuação: terapia intensiva 27,83%, clínica médica 21,74%, clínica cirúrgica 15,65%, emergências 15,65%, clínicas 10,43%, coronariana 8,70%. Dos entrevistados, 89,56% já perceberam algum tipo de violência, destes 61,17% tinham entre 22 e 38 anos. A percepção da violência mostrou que 92,53% eram enfermeiros, 88,46% licenciados e 81,81% auxiliares de enfermagem. Os tipos de violência identifcados foram abuso verbal em 86,09%, abuso físico em 72,17% e assédio sexual em 24,35%. O principal gênero acometido por atos violentos foi o feminino, e o turno de trabalho com maior identifcação de situações de violência foi o turno da manhã. Em relação às formas de proceder para comunicar as situações vivenciadas à instituição, 66,96% relataram a um superior Os atos de violência por área de trabalho foram relatados por 80% daqueles na unidade coronariana, 84,38% na unidade de terapia intensiva, 88,89% emergências, 92% clínica médica, 94,44% clínica cirúrgica e 100% ambulatório. Conclusão: A violência contra a enfermagem está presente no hospital e atinge mais as mulheres. A forma mais frequente é a verbal, seguida do assédio físico e sexual. Em geral, diante da agressão, optam por não fazer nada[AU]

Cognitive Performances: The Role of Digit Ratio (D2:D4) With a Protective Factor for Anxiety.

This study aimed to identify a possible correlation between the D2:D4 ratio and state and/or trait anxiety in adult healthy subjects and, if so, whether it exists any difference between men and women. In addition, we also wanted to observe whether there is a relationship between participants' age and state and/or trait anxiety. The research involved 125 subjects of both sexes, who were calculated the D2:D4 ratio and were administered the self-assessment questionnaire State-Trait Anxiety Inventory (STAI-Y). Results show that there are positive significant correlations between the D2:D4 ratio and score at state anxiety and trait anxiety, in the total sample. However, if men are examined separately from women, it can be observed that only men have a statistically significant relationship between D2:D4 ratios and state anxiety and trait anxiety. Moreover, about possible relations between the age of participants and state and trait anxiety, a significant negative relationship was observed, without differences between men and women. However, only subjects with a D2:D4 ratio ≥ 1, without differences between men and women, showed a statistically significant negative linear correlation between their age and their state and trait anxiety. The present data allow us to conclude that a low D2:D4 ratio (<1) represents a protective factor against anxiety in both men and women and that this protection seems likely to act throughout life.

Evidencias psicométricas del inventario ansiedad estado-rasgo: IDARE en universitarios de Lima en tiempos de COVID-19 / Psychometric evidence of the state-Trait anxiety inventory: IDARE In University Students from Lima in times of Covid-19

Resumen 420 universitarios de Psicología y Derecho fueron evaluados con el objetivo de actualizar las evidencias psicométricas del Inventario ansiedad estado-rasgo: IDARE en tiempos de pandemia por COVID-19. La muestra estuvo compuesta por hombres y mujeres, siendo mayor el grupo de mujeres, con un rango de edad de entre 18 a 57 años. Las pruebas de validación con jueces expertos permiten obtener una "V" de Aiken mayor a 0.80, y los valores de la prueba binomial fueron significativos con una p <.05. Las pruebas de análisis discriminativo ítem-test obtuvieron puntajes para todo el Inventario que van entre 0.334 a 0.679, eliminando el ítem 34 por no cumplir los criterios esperados. Para la validez convergente, su correlación con el Cuestionario CASO A30 obtuvo para A-E una "r" de .320 y para A-R de .522; ambas con una p <.05. La validez de constructo fue evaluada mediante el análisis factorial exploratorio y confirmatorio, hallándose 4 escalas independientes: ansiedad estado, bienestar estado, ansiedad rasgo y bienestar rasgo. La confiabilidad se obtuvo calculando el coeficiente alfa de Cronbach = 0.86 y el coeficiente omega de McDonald = 0.89. Asimismo, en la confiabilidad por mitades de Guttman encontraron valores entre 0.76 a 0.89. Se establecieron baremos por sexo y por edad para la población total. La prevalencia de la ansiedad en universitarios de Lima fue de 29.4 %, se aproxima a los datos de China y Colombia, pero es más alta que en Inglaterra, todos en tiempos de COVID-19.

Abstract 420 university students of Psychology and Law were evaluated in order to update the psychometric evidence of the State Anxiety Inventory - trait: STAI in times of the COVID-19 pandemic. The sample consisted of men and women, the group of women being the largest, with an age range between 18 to 57 years old. The validation tests with expert judges allow obtaining an Aiken "V" greater than 0.80 and the values of the binomial test were significant with a p <.05. The item-test discriminative analysis tests obtained scores for the entire Inventory ranging from 0.334 to 0.679, with item 34 eliminated for not meeting the expected criteria. For convergent validity, its correlation with the CASE A30 questionnaire obtained for A-E an "r" of .320 and for A-R of .522, both with a p <.05. The construct validity was evaluated by means of the exploratory and confirmatory factor analysis, finding 4 independent scales: state anxiety, state well-being, trait anxiety and trait well-being. Reliability was obtained by calculating Cronbach's Alpha coefficient = 0.86 and McDonald's Omega coefficient = 0.89. Likewise, in the reliability by Guttman halves, values between 0.76 and 0.89 were found. Scales were established by sex and by age for the total population. The prevalence of anxiety in university students in Lima was 29.4 %, which is close to the data from China and Colombia, but it is higher than in England all in the time of COVID-19.

Resumo Foram avaliados 420 universitários de Psicologia e Direito para atualização das evidências psicométricas do Inventário de Ansiedade do Estado - traço: IDARE em tempos de pandemia do COVID-19. A amostra foi composta por homens e mulheres, sendo o maior grupo de mulheres, com faixa etária entre 18 e 57 anos. Os testes de validação com juízes especialistas permitiram obter um Aiken "V" maior que 0.80 e os valores do teste binomial foram significativos com p <0.05. Os testes de análise discriminativa do teste item-teste obtiveram escores para todo o Inventário variando de 0.334 a 0.679, sendo o item 34 eliminado por não atender aos critérios esperados. Para a validade convergente, sua correlação com o questionário CASE A30 obteve para A-E um "r" de .320 e para A-R de .522, ambos com p <0.05. A validade de construto foi avaliada por meio da análise fatorial exploratória e confirmatória, encontrando 4 escalas independentes: ansiedade-estado, bem-estar-estado, ansiedade-traço e bem-estar-traço. A confiabilidade foi obtida calculando o coeficiente alfa de Cronbach = 0.86 e o coeficiente ômega de McDonald = 0.89. Da mesma forma, na confiabilidade pelas metades de Guttman, foram encontrados valores entre 0.76 e 0.89. As escalas foram estabelecidas por sexo e por idade para a população total. A prevalência de ansiedade em estudantes universitários em Lima foi de 29.4 %, o que se aproxima dos dados da China e da Colômbia, mas é mais alta do que na Inglaterra durante toda a época de COVID-19.

Quality of Life and Anxiety in Patients with First Diagnosed Non-Muscle Invasive Bladder Cancer Who Receive Adjuvant Bladder Therapy.

BACKGROUND: Bladder cancer (BC) is one of the most common malignancies (4.5%of all newly diagnosed cases worldwide). Most of the new BC cases are diagnosed as non-muscle invasive BC (NMIBC), needing continuous follow up after primary endoscopic therapy. Adjuvant bladder therapy with chemo- or immuno- agents, apart from the initial diagnosis, the strict surveillance program and the risk of recurrence, may have a major impact on the patients' physical and mental health. OBJECTIVE: We evaluated anxiety and quality of life (QoL) in patients who underwent surgery for NMIBC and followed a bladder instillation programme. METHODS: This is a prospective analysis of patients with histopathologically confirmed NMIBCs. Eligible were all adult patients with a single or multiple NMIBCs who underwent a transurethral tumor resection and followed a therapy with either BCG or Epirubicin instillations. The SF-36 questionnaire Physical and Mental health aspects were used for QoL assessment. Similarly, the STAI-Y was introduced for the state (STAI-Y1) and trait anxiety (STAI-Y2) evaluation. RESULTS: 117 eligible patients were screened, with 108 entering finally the study; 9 patients were excluded due to disease recurrence. 17 patients (15.7%) received Epirubicin (Ta-T1, Low Grade tumors), whereas 91 patients (84.3%) received BCG (T1, High Grade). Regarding SF-36 Physical a 6 months decrease was followed by an improvement at 12 months (p = 0.008). Similarly, an increase of the SF-36 Mental health score was identified (p = 0.03). In contrast to STAI-Y2 scores (p = 0.945), a long-term reduction of the state anxiety was identified (p = 0.001). Preoperative SF-36 Physical was inversely correlated with age (p = 0.029), while absence of alcohol was associated with lower mental health (p = 0.003). Overall, patient characteristics, habits and the administered treatment did not affect the postoperative QoL and anxiety. CONCLUSION: Patient QoL and anxiety improved during follow up. Still, further larger scale studies are required to support our findings.