Academic Burnout, Family Functionality, Perceived Social Support and Coping among Graduate Students during the COVID-19 Pandemic.

Academic burnout and the COVID-19 pandemic have greatly impacted the academic life and mental health of graduate students. This study aims to address the mental health issue in graduate students by relating it to family functionality, perceived social support, and coping with academic burnout during the COVID-19 pandemic. Data were gathered from a cross-sectional study with 519 graduate students across universities in Hungary and other European countries. The Copenhagen Burnout Inventory Student, Family APGAR Index, the brief form of the Perceived Social Support Questionnaire, and the Brief Resilient Coping Scale were used to measure academic burnout, family functionality, perceived social support, and coping, respectively. Structural equations modeling was used for statistical analysis. The results revealed a negative effect of family functionality, perceived social support, and coping on academic burnout. The inverse relationship between perceived social support and the Copenhagen Burnout Inventory was identified, and mediated by coping and family functionality. These findings may offer patterns and predictors for future graduate students and higher-education institutions to identify outside factors that are implicated in academic burnout, especially in outbreaks such as the COVID-19 pandemic.

Academic burnout among master and doctoral students during the COVID-19 pandemic.

The COVID-19 outbreak has had an immense impact on academic life and public health. Graduate students had experienced obligatory curfews and quarantines due to the COVID-19 outbreak directly impacting their mental health and triggering academic burnout. In this cross-sectional study, we address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic. A total of 519 graduate students from master's and Ph.D./DLA degrees across universities in Hungary and other European countries participated in this study. The Copenhagen burnout inventory student version was used to evaluate burnout syndrome as an outcome. Our findings displayed burnout significantly lower among graduate students who had good sleep quality, receive high levels of support from their university, and were satisfied with how their university dealt with the pandemic. The excessive consumption of alcohol, the use of antidepressants, being single, and thinking about dropping out showed as predictive factors of burnout. The results add to emergent evidence on the impact of the COVID-19 pandemic on mental health and the predicted factors of academic burnout among master and doctoral students.

The D allele of angiotensin-converting enzyme gene is associated with a worse autonomic heart control in community-based older adults.

The relationship between the Renin-Angiotensin-Aldosterone System (RAAS) and modulation of the Autonomic Nervous System (ANS) is reported as complex and bidirectional. Thus, the present study aimed to compare autonomous heart control, through symbolic analysis parameters, in the older adults carrying different ACE I/D gene polymorphisms (rs4646994). Two hundred four older adults comprised the study population and were grouped according to the ACE I/D gene polymorphism: II + ID genotype and DD genotype. Successive RR intervals were recorded along 5 min and analyzed with Symbolic Analysis (SA) method. 0 V%, 1 V% and 2 V% patterns were quantified and compared between groups. A linear mixed model analysis was used to determine between-group differences in symbolic analysis parameters (0 V%, 1 V% and 2 V%), taken groups as fixed factor and sex, use of ACE inhibitors and Angiotensin II receptor type I blockers as random factors. The Bayesian analysis was carried out to check the magnitude of the evidence. The results of this study indicate that older adults carrying the DD genotype have statistically greater sympathetic modulation (0 V%) and poor sympathovagal balance (1 V%), but the Bayesian analysis indicate only an anecdotal effect. Sympathetic predominance is recognized a worrying condition, since may predisposes to cardiovascular risk.

Hyperuricemia is associated with sympathovagal imbalance in older adults.

PURPOSE: This study aimed to compare heart rate variability (HRV) parameters obtained through symbolic analysis (SA), between older adults with and without hyperuricemia. METHODS: This is a cross-sectional study including 202 community-dwelling old adults, which was clinically stratified as with or without hyperuricemia, according to the cutoff point of serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men. Successive RR intervals were recorded along 5 min and analyzed with SA method. 0 V%, 1 V% and 2 V% patterns were quantified and compared between groups. Comparisons were carried out through parametric or nonparametric tests, according to the data distribution characteristics, evaluated by Kolmogorov-Smirnov test. The significance level was set as p ≤ 0.05 for all statistical procedures. RESULTS: The prevalence of hyperuricemia was 67.8 %, and the hyperuricemic older adults exhibited significant higher values for V0% and lower values for V2% parameters when compared to normouricemic older adults. CONCLUSION: These results suggesting a sympathovagal imbalance in hyperuricemic older adults, characterized by greater sympathetic predominance (0 V%) and lower vagal modulation (2 V%) at rest conditions.

Improving the comprehension of sarcopenic state determinants: An multivariate approach involving hormonal, nutritional, lifestyle and genetic variables.

It is known that sarcopenia is a multifaceted phenomenon, which involves genetic, nutritional, hormonal and living habits aspects. Then, an integrated analysis, as a multivariate approach, could improve the comprehension about the determinants of sarcopenic state in old adults. The present study aimed to investigate the interaction among serum vitamin D, daily caloric and protein intake, lifestyle habits, ACE I/D gene polymorphism and sarcopenic state in community-dwelling old adults. One hundred one community-dwelling old adults were clinically stratified as sarcopenic or non-sarcopenic. Serum vitamin D, daily caloric and protein intake, lifestyle habits (smoking, physical activity level and sedentary behavior) and ACE I/D gene polymorphism were recorded. A multivariate logistic regression technique was applied to investigate the interaction among the selected independent variables and the sarcopenic state. The independent variables age, smoking, serum Vitamin D and ACE I/D polymorphism achieved the statistical criteria to be inserted in the multivariate analysis. After a stepwise procedure from the multivariate logistic regression, the variables age, serum Vitamin D and ACE I/D polymorphism remained, together, in the final model. Sarcopenic state was significantly associated to older age, II-genotype and low serum Vitamin D in old adults from 60 years old.

Sarcopenia is associated to an impaired autonomic heart rate modulation in community-dwelling old adults.

PURPOSE: The aims of this study were to compare the autonomic heart control parameters from sarcopenic and non-sarcopenic community-dwelling elders. METHODS: This is a cross-sectional study including 76 community-dwelling old adults, which was clinically stratified as sarcopenic or non-sarcopenic, according to the current recommendations. They were submitted to 5-min recordings of successive RR intervals. The analysis of the RR intervals variability was carried out in time (mean RR, RMSSD, pNN50, SDNN and triangular index) and frequency domains (LFnu, HFnu and LF/HF ratio), and with nonlinear methods (SD1, SD2, and D2). The parameters of autonomic heart rate modulation (AHRM) were adjusted for potential confounders: sex, diabetes, beta-blockers use, cardiovascular disease, body mass index and physical activity level, smoking habit. Normality of the data was tested by Kolmogorov-Smirnov test and, since most variables did not exhibit a normal distribution the Mann-Whitney test was used to compare the parameters of AHRM. The significance level was set as p ≤ 0.05 and all statistical procedures were performed with SPSS®. RESULTS: Adjusted parameters of AHRM obtained from time domain and nonlinear methods were significantly different between sarcopenic and non-sarcopenic elders (p < 0.05), while parameters obtained from frequency domain analysis did not were different between groups (p > 0.05). CONCLUSION: Sarcopenic old adults exhibited lower parasympathetic-associated modulation, suggesting a poor cardioprotection associated to this condition.

Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults.

The angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism has been widely reported as being associated with hypertension; however, most studies do not consider environmental/behavioral factors. This study aimed to investigate the relationship among angiotensin-converting enzyme insertion/deletion gene polymorphism, environmental/behavioral factors, and hypertension in community-dwelling elderly individuals. All community-dwelling older adults from Aiquara, Bahia, Brazil, were invited to take part in this study. After exclusions, 234 elderly participants were submitted to a data collection, which included sociodemographics, lifestyle and health status questionnaires, clinical assessment, and blood withdrawal. From the blood samples, the gene polymorphism was identified through polymerase chain reaction and patients grouped as II or D allele carriers (ID and DD genotypes). Hypertension was defined by self-report of the condition and confirmed by antihypertensive drug treatment. Chi-square test was used to identify differences in the proportions distributed between groups of each dependent variable (ie, genotype, diagnosis of hypertension, and blood pressure state from medicated patients with hypertension). The prevalence of hypertension was 59.3% and was associated with diabetes mellitus and obesity, but not with angiotensin-converting enzyme insertion/deletion gene polymorphism. However, carriers of the II genotype, a salt-sensitivity genotype, exhibited a significantly greater estimated sodium intake. In addition, among medicated elderly patients with hypertension, II genotype carriers exhibited poor blood pressure control, despite similar antihypertensive drug treatment in D allele carriers, while exhibiting a greater estimated sodium intake. Our results provide new evidence regarding the interaction of genetic and environmental/behavioral factors in the genesis of hypertension among elderly patients, as well as in blood pressure control in medicated elderly patients with hypertension.

Determinants of Stroke in Brazil: A Cross-Sectional Multivariate Approach from the National Health Survey.

OBJECTIVE: The objective of this study was to investigate the association between biological-health, socioeconomics, and behavioral determinants and stroke by evaluating the risk of stroke in the presence of each or all determinants grouped in a multivariate model. METHODS: This study is a transversal secondary data analysis of the Brazilian National Health Survey, released by the Brazilian Institute of Geography and Statistics. The prevalence, prevalence ratios, and confidence intervals were calculated for the main outcome. A multivariate regression model was applied, with the stroke as outcome and all other variables with a P value of .20 or lower in the univariate analysis included as explanatory variables to adjust for potential confounders and effect modifiers. RESULTS: The mean age was 43.3 ± 16.6 years, ranging from 18 to 101 years. The prevalence of hypertension was 21.4%, and with regard to lifestyle habits, it was observed that 20.0% had smoked but stopped and 29.7% practiced physical activity in the last 30 days. The regression model showed that the odds ratio in the final model was weighted, with low schooling, smoking habit, overweight, low physical activity practice, diabetes, and hypertension being significantly associated with stroke. CONCLUSION: The multivariate model showed that the chance of stroke is high, both combined or isolated.

The smoking habit negatively influences autonomic heart control in community-dwelling elderly adults.

OBJECTIVE: The present study aimed to analyze the influence of smoking on heart autonomic control in elderly adults who did and did not smoke. METHODS: In a population-based study, all community-dwelling elderly adults (≥60 years old) from Aiquara, Bahia, Brazil, were invited to participate in the study. Two-hundred-thirty-two (232) elderly adults provided information about their smoking habits and underwent 5-min recordings of successive RR intervals. Analysis of the variability of the RR intervals was performed in time and frequency domains and with nonlinear methods. The HAC parameters were adjusted for the following potential confounders: age, sex, diabetes, beta-blocker use, cardiovascular disease, body mass index and physical activity level. After exclusions, 210 elderly adults were divided into 2 groups, nonsmokers or those who stopped smoking (NSMOK [n=190]) and current smokers (SMOK [n=20]). Owing to the absence of a normal distribution, the Mann-Whitney test was used for group comparisons. RESULTS: For unadjusted HAC parameters, a significant difference was observed (p<0.05) between groups for the following parameters in the time domain: CV_RR; SDNN; RMSSD; pNN50; triangular index TINN; and nonlinear parameters SD1, SD2 and D2. All of the adjusted HAC parameters (including the Mean RR and frequency domain parameters) were significantly different between the groups. CONCLUSION: Together, the HAC parameters indicated a higher variability of successive RR intervals in NSMOK elderly adults. Notwithstanding, adjustment of the HAC parameters was an important step to improve data analysis. These results indicate an impaired sympathovagal balance on the heart of elderly adult smokers.

Relationship between diabetes mellitus and heart rate variability in community-dwelling elders.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is one of the most common non-communicable diseases (NCDs) and may influence the autonomic nervous system. This study aims to analyze the autonomic control, through heart rate variability (HRV), from community-dwelling elders with (DM+) and without diabetes mellitus (DM-). MATERIALS AND METHODS: This cross-sectional study, in which 205 elders (≥ 60 years old), from the urban area of Aiquara municipality gave their written consent to participate. HRV data was collected through a Polar RS800CX monitor with a 5-min initial record at rest, followed by the command to quickly stand up. RESULTS: The mean age was 71 years (SD, 7.32). The population was mostly made up of women 121 (59%), with low or no schooling 123 (60%), and low income 166 (81%). HRV analysis in a frequency domain showed no difference when comparing the two groups of DM+ and DM-. Henceforth in a time domain, the rMSSD showed a median value of 16.09 (interquartile range, 9.91-30.68); pNN50 median of 0.79 (interquartile range, 0.00-6.62), with a statistical significance between the group of DM+ and DM-. CONCLUSIONS: There is a difference between the studied groups principally in what concerns the time domain, which reflects the parasympathetic activity, suggesting that elders with diabetes mellitus may have a worse parasympathetic control.

The D allele of angiotensin-converting enzyme gene is associated with greater hemodynamic response to resistance exercises.

HYPOTHESIS/INTRODUCTION: The association of ACE I/D polymorphism and hemodynamic response to exercise have been limited to primarily aerobic exercises. We hypothesized that D allele carriers would show greater hemodynamic response to resistance exercise, as has been observed with aerobic. This study aimed to investigate the association of ACE I/D polymorphism and hemodynamic (blood pressure (BP), heart rate (HR) and rate-pressure product (RPP)) response to resistance exercise in young healthy subjects. MATERIALS AND METHODS: ACE I/D polymorphisms were studied by PCR analysis from 75 healthy men. Subjects completed a resistance exercise session of three sets of 10 knee extension repetitions with loads of 50, 75 and 100% of 10RM and two-minute rest intervals. Hemodynamic measures were recorded before and immediately after each set. Analysis of variance was used to identify significant differences among ACE genotypes. RESULTS: ACE I/D polymorphism is associated with hemodynamic response to resistance exercise, as healthy subjects with ACE D allele were prone to higher responses. In addition, this phenotypic difference seems to be a load-dependent trend. CONCLUSION: ACE DD carriers exhibit greater heart work during resistance exercise. Future studies should focus on the influence of resistance training period with different workloads on the hemodynamic response in healthy individuals with different ACE genotypes.