Chronic Anxiety Research Articles

The chemotherapeutic bortezomib induces chronic pain and anxiety and depressive disorders in mice. Focus on the prokineticin system

The chemotherapeutic bortezomib induces chronic pain and anxiety and depressive disorders in mice. Focus on the prokineticin system

Socioeconomic disparities in the prevalence of comorbid chronic conditions among Canadian adults with cancer

Objective To evaluate the prevalence of comorbid chronic conditions among Canadian adults with cancer and the impact of socioeconomic background on the distribution of these conditions. Methods Canadian Community Health Survey (CCHS) 2017–2018 dataset was accessed and individuals with complete information about cancer history were reviewed. The prevalence of the following 10 chronic conditions was reviewed: asthma, chronic obstructive pulmonary disease, arthritis, hypertension, hypercholesterolemia/hyperlipidemia, heart disease, stroke, diabetes, mood disorder, and anxiety disorder. Stratification of the prevalence was done according to age, sex, and racial subgroups. Multivariable logistic regression analysis was done to evaluate the association between sociodemographic characteristics and having multiple comorbid conditions. Results A total of 104,362 participants were included in the current study (including 10,782 participants with a history of cancer; and 93,580 participants without a history of cancer). Among all age, sex, and race strata, participants with a history of cancer were more likely to have multiple chronic conditions (p < 0.05 for all comparisons). The most common three individual comorbid conditions among participants with cancer were arthritis (40.2%), hypertension (36.1%), and hypercholesterolemia (25.2%); while the most common cancer-comorbidity triad among participants with cancer was cancer/arthritis/hypertension (17.7%). In a multivariable logistic regression analysis among participants with cancer, the following sociodemographic factors were associated with having multiple comorbid conditions: older age (OR for age 80+ versus age 18–20 years: 8.32; 95% CI: 5.17–13.39), indigenous racial group (OR: 1.94; 95% CI: 1.43–2.63) and lower income (OR for income ≥80,000 Canadian dollars (CAD) versus income: ≤20,000 CAD: 0.29; 95% CI: 0.23–0.37). Conclusion History of cancer is associated with a higher probability of many comorbid conditions. This excess comorbidity burden seems to be unequally shouldered by individuals in the lower socioeconomic stratum as well as minority populations.

Decision Making Under Chronic Stress and Anxiety: State and Trait Anxiety Impact Contextual Updating but not Feedback Learning

Stress may alter executive functioning by causing structural and functional changes to the brain. Sub-optimal decisions made under high levels of stress and anxiety may act as a mediator for stress-related health effects. We examined the effect of three personality traits–chronic stress, state anxiety, and trait anxiety–on updating working memory and feedback learning across 330 participants, using electroencephalography (EEG). We hypothesized a decrease in P300 (updating working memory) and reward positivity (feedback learning) amplitudes with increasing chronic stress and anxiety scores. The three personality traits were not correlated with reward positivity amplitudes. Additionally, chronic stress had no effect on P300 amplitudes. However, state and trait anxiety were negatively correlated with P300 amplitudes. Anxiety appears to impact working memory processes, and this effect was amplified with decreasing anxiety score quantiles to reflect the tails of the distribution. Our results are evidence of the beginnings of a correlation between anxiety and the neural correlates of decision-making, offering insight into anxiety-related adverse health outcomes.

Perspectives of pediatric oncologists and palliative care physicians on the therapeutic use of cannabis in children with cancer.

BackgroundChildren with cancer are increasingly using cannabis therapeutically.AimThe purpose of this study was to determine the perspectives and practices of pediatric oncologists and palliative care physicians regarding the use of cannabis for medical purposes among children with cancer.MethodsA self‐administered, voluntary, cross‐sectional, deidentified online survey was sent to all pediatric oncologists and palliative care physicians in Canada between June and August 2020. Survey domains included education, knowledge, and concerns about cannabis, views on its effectiveness, and the importance of cannabis‐related research. Data were analyzed using descriptive statistics.ResultsIn total, 122/259 (47.1%) physicians completed the survey. Although 62.2% of the physicians completed some form of training about medical cannabis, nearly all (95.8%) desired to know more about the dosing, side effects, and safety of cannabis. Physicians identified a potential role of cannabis in the management of nausea and vomiting (85.7%), chronic pain (72.3%), cachexia/poor appetite (67.2%), and anxiety or depression (42.9%). Only four (0.3%) physicians recognized cannabis to be potentially useful as an anticancer agent. Nearly all physicians reported that cannabis‐related research for symptom relief is essential (91.5%) in pediatric oncology, whereas 51.7% expressed that future studies are necessary to determine the anticancer effects of cannabis.ConclusionsOur findings indicate that most pediatric oncologists and palliative care physicians recognize a potential role for cannabis in symptom control in children with cancer. Well‐conducted studies are required to create evidence for cannabis use and promote shared decision making with pediatric oncology patients and their caregivers.

Association between pain, anxiety, and alpha2 frontal activity in women with fibromyalgia

Fibromyalgia is a disorder of the central nervous system, with the presence of chronic generalized pain, fatigue, morning stiffness, anxiety and depression symptoms. Higher amplitudes of the frequency band alpha2 have been associated with higher relaxation in this population. In the present study, we analysed the association between pain, anxiety, and the spectral power of alpha2 frontal in women with fibromyalgia. Thirty-one women diagnosed with fibromyalgia, for at least three months, took part in the study. Results revealed a statistically significant positive relationship between pain and anxiety levels. However, we found no association between the spectral power of alpha2 in the frontal cortex and the measures between anxiety and pain in the patients. Present findings emphasize the importance of understanding the cortical activity and the central control mechanisms in fibromyalgia.

Kajian Pustaka: Potensi Hypnosis untuk Mengurangi Nyeri pada Pasien yang Mendapatkan Perawatan Gigi dan Mulut

The purpose of this literature review is to find out whether hypnosis can be used to reduce pain in patients receiving dental and oral care. Hypnosis has been used to treat acute and chronic pain, anxiety, and other positive benefits before, during and after surgery. However, in the field, the use of hypnosis is still little used and even many who doubt its effectiveness. We reviewed articles in English using keywords: hypnosis, pain, anesthesia, dental, procedure with a time span from 1846 to 2019, with 20 selected articles on google scholars, pubmed, science direct, and the national library portal of the republic of Indonesia (PNRI). , Mesmerism hypnosis and Ericsonian hypnosis have been used for anesthesia for a long time before chemical anesthesia was discovered, the use of chemical anesthesia makes hypnosis no longer used as the main anesthetic in surgery, but in certain cases such as patients with multiple chemical sensitivity or patients with contraindications for general anesthesia, hypnosis still used as the primary anesthetic in surgery, currently hypnosis is widely used in perioperative surgery. The use of hypnosis with chemical anesthetics can increase the benefits and there are no reported side effects. Conclusion: hypnosis can be used as primary anesthesia, especially in certain cases, it needs well-designed research such as randomized control trials on the use of hypnosis with chemical anesthetics, both perioperatively and intraoperatively to obtain clearer and consistent scientific information about hypnosis and chemical anesthetics.

S496 Examining the Impact of the COVID-19 Pandemic on the Prevalence of Rome IV Functional Gastrointestinal Disorders

Introduction: It is well established that SARS-CoV-2 is an enteropathic virus that can lead to diarrhea, nausea, and vomiting, among other GI symptoms. Given the direct impact of SARS-CoV-2 on GI function, combined with the potential of the pandemic to negatively impact the gut-brain axis for some individuals via chronic stress and anxiety, we hypothesized that the prevalence of functional GI disorders (FGIDs) may have increased over time. To test our hypothesis, we conducted a series of cross-sectional surveys using Rome IV questionnaires during the pandemic in nationally-representative samples of >100,000 Americans. Methods: We conducted the initial online survey from 5/3-6/24/2020 during the peak of the initial coronavirus 2019 (COVID-19) wave in the US and followed it with monthly surveys starting in 3/2021 (latter stages of the pandemic). For each survey, a representative adult sample based on US Census age, sex, and region data was recruited. The initial survey included Rome IV questionnaires for irritable bowel syndrome (IBS), chronic idiopathic constipation (CIC), and opioid-induced constipation (OIC) along with demographic and comorbidity questions. In addition, the monthly follow-up surveys also included Rome IV questionnaires for functional dyspepsia, bloating, diarrhea, and unspecific bowel disorder. Our primary outcome was the prevalence of FGIDs and we used logistic regression to adjust for confounding. Differences in prevalence between time periods were considered significant when the 95% confidence intervals (CI) did not overlap. Results: Overall, 103,850 individuals completed the surveys. The Table presents the prevalence of Rome IV FGIDs vs pre-COVID-19 benchmarks reported by Palsson et al. and Sperber et al. (both also used internet-based surveys) in 2015 and 2017, respectively. The prevalence of IBS increased over time; Palsson et al. found that 4.7% (95% CI, 3.8%-5.7%) had IBS in 2015 while we noted that 8.4% (95% CI, 7.5%-9.2%) had IBS in 5/2021. The prevalence of functional dyspepsia also increased, as Sperber et al. reported a rate of 10.1% (95% CI, 8.8%-11.4%) in 2017 vs our finding of 17.7% (95% CI, 16.7%-18.8%) in 5/2021. The prevalence of CIC, OIC, and functional bloating, diarrhea, and unspecified bowel disorder remained stable over time. Conclusion: We found that the prevalence of IBS and functional dyspepsia increased by 75% compared to pre-COVID-19 estimates. We will continue to track the prevalence of FGIDs monthly over the next year to evaluate whether these changes persist.Table 1.: Prevalence of Rome IV FGIDs; data are presented as % (95% CI).

One-day acceptance and commitment therapy (ACT) workshop improves anxiety but not vascular function or inflammation in adults with moderate to high anxiety levels in a randomized controlled trial

ObjectiveAcceptance and Commitment Therapy (ACT) is a behavioral intervention demonstrating sustained improvements in anxiety in individuals with chronic anxiety and psychological distress. Because anxiety disorders are associated with the development of cardiovascular disease (CVD), we hypothesized that a novel 1-day ACT workshop would both lower anxiety and improve vascular function in persons with moderate/high anxiety. MethodsIn a randomized controlled study, 72 adults (age 33.9 ± 8.6 (SD) years) with baseline moderate/high anxiety completed a one-day ACT intervention (n = 44, age 33.9 ± 8.7 years) or control (n = 28, age 37.1 ± 10.1 years). Pre-specified secondary outcomes were measured over 12 weeks: aortic stiffness (carotid-femoral pulse wave velocity [cfPWV]), forearm vascular endothelial function (post-ischemic peak forearm blood flow [FBF] via plethysmography), and brachial artery flow-mediated dilation (FMD). Carotid artery stiffness (β-stiffness index), and inflammatory markers (C-reactive protein and tumor necrosis factor-alpha) were also explored. ResultsAlthough the intervention had a significant and sustained effect on the primary outcome of anxiety as measured by the Beck Anxiety Inventory, the 1-day ACT workshop was not associated with improvement in vascular or inflammatory endpoints. The intervention was unexpectedly associated with increases in β-stiffness index that were also associated with changing trait anxiety. ConclusionAnxiety improvements did not translate into improvements in any of the vascular function outcomes. This may reflect a less-than-robust effect of the intervention on anxiety, failure in design to select those with vascular dysfunction, or not intervening on a relevant causal pathway. (Trial registration NCT02915874 at www.clinicaltrials.gov).

Association of sensory phenotype with quality of life, functionality, and emotional well-being in patients suffering from neuropathic pain.

Neuropathic pain highly affects quality of life, well-being, and function. It has recently been shown based on cluster analysis studies that most patients with neuropathic pain may be categorized into 1 of 3 sensory phenotypes: sensory loss, mechanical hyperalgesia, and thermal hyperalgesia. If these phenotypes reflect underlying pathophysiological mechanisms, they may be more relevant for patient management than underlying neurological diagnosis or pain intensity. The aim of this study was thus to examine the impact of these sensory phenotypes on mental health, functionality, and quality of life. Data of 433 patients from the IMI/EuroPain network database were analyzed, and results of HADS-D/A, Pain Catastrophizing Scale, Euro Quality of Life 5D/-VAS, Brief Pain Inventory, and Graded Chronic Pain Scale between the sensory phenotypes were compared using multiple regression analysis. There was no difference in chronic pain grade, pain intensity, depression, or anxiety scores between phenotypes. Pain interference (Brief Pain Inventory) was higher (P = 0.002); self-reported health state lower (Euro Quality of Life 5D VAS, P = 0.02); and problems regarding mobility (P = 0.008), usual activities (P = 0.004), and self-care (P = 0.039) more prominent (EQ5-D) in the sensory loss compared with the thermal hyperalgesia phenotype. Patients with sensory loss also showed higher pain catastrophizing scores (P = 0.006 and 0.022, respectively) compared with the 2 other groups. Sensory phenotype is associated with the impact of neuropathic pain conditions on well-being, daily functionality, and quality of life but is less associated with pain intensity. These results suggest that the somatosensory phenotype should be considered for personalized pain management.

Chronic Pain in Schoolchildren and its Association With Psychological Wellbeing Before and During the COVID-19 Pandemic

PurposeThe current longitudinal observational study aimed to explore how chronic pain among schoolchildren changed before and during the COVID-19 pandemic, and how changes in chronic pain were related to changes in psychological wellbeing and COVID-19-related experiences. MethodsData were collected from N = 777 German schoolchildren (aged 9–17 years) at two assessments before and one assessment during the COVID-19 pandemic lockdown. Participants self-reported chronic pain experience, anxiety, depression, and quality of life across all assessments; and COVID-19-related experiences at the last assessment. Trajectories of anxiety, depression, and quality of life as well as COVID-19-related experiences were analyzed separately for groups of stable chronic pain trajectories compared to chronic pain trajectories that changed during the pandemic. ResultsChronic pain prevalence was lowest at the assessment during the COVID-19 pandemic (22.8% vs. 29.2% and 29.9% before the pandemic). However, 4.6% experienced new chronic pain onset during the COVID-19 pandemic. This was preceded by heightened depression and anxiety, as well as lowered quality of life scores. These students were also more likely to describe time with their family during the COVID-19 pandemic as tense compared to students who did not develop chronic pain. During the COVID-19 pandemic boys were more likely to recover from ongoing chronic pain than girls. ConclusionsOverall, during the COVID-19 pandemic the prevalence of chronic pain decreased. However, stressful situations and pre-existing vulnerabilities in psychological wellbeing can facilitate the development of chronic pain during the pandemic.

Anxiolytic effect of GABAergic neurons in the anterior cingulate cortex in a rat model of chronic inflammatory pain

Chronic pain easily leads to concomitant mood disorders, and the excitability of anterior cingulate cortex (ACC) pyramidal neurons (PNs) is involved in chronic pain-related anxiety. However, the mechanism by which PNs regulate pain-related anxiety is still unknown. The GABAergic system plays an important role in modulating neuronal activity. In this paper, we aimed to study how the GABAergic system participates in regulating the excitability of ACC PNs, consequently affecting chronic inflammatory pain-related anxiety. A rat model of CFA-induced chronic inflammatory pain displayed anxiety-like behaviors, increased the excitability of ACC PNs, and reduced inhibitory presynaptic transmission; however, the number of GAD65/67 was not altered. Interestingly, intra-ACC injection of the GABAAR agonist muscimol relieved anxiety-like behaviors but had no effect on chronic inflammatory pain. Intra-ACC injection of the GABAAR antagonist picrotoxin induced anxiety-like behaviors but had no effect on pain in normal rats. Notably, chemogenetic activation of GABAergic neurons in the ACC alleviated chronic inflammatory pain and pain-induced anxiety-like behaviors, enhanced inhibitory presynaptic transmission, and reduced the excitability of ACC PNs. Chemogenetic inhibition of GABAergic neurons in the ACC led to pain-induced anxiety-like behaviors, reduced inhibitory presynaptic transmission, and enhanced the excitability of ACC PNs but had no effect on pain in normal rats. We demonstrate that the GABAergic system mediates a reduction in inhibitory presynaptic transmission in the ACC, which leads to enhanced excitability of pyramidal neurons in the ACC and is associated with chronic inflammatory pain-related anxiety.

ANXIETY AND DEPRESSION AFFECTING QUALITY OF LIFE DURING COVID-19 IN IT SECTOR WORKERS, DUE TO WORK FROM HOME

Background- Everyone has anxiety from time to time, but chronic anxiety can interfere with your quality of life. Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest.Major life events,such as bereavement or the loss of a job,can lead to depression. Aim &amp; Objectives:- The objective of this study was to demonstrate that anxiety and depression has a significant affect on QOL during covid-19 in IT sector workers due to work from home . Study Design-An survey design study was conducted. Methods-: Written consent from participants was taken.Qol was assessed by the Qol scale,Hamilton anxiety scale and patient health questionnaire (degree of depression severity).Statistical analysis was done . Result – There was mild correlation between the severity of anxiety and depression but also There was no correlation between QoL. Conclusion – It was seen that there was increase in Anxiety and Depression due to the external environmental factors but it didn't affect the Quality of life.

Role of Basolateral Amygdalar Somatostatin 2 Receptors in a Rat Model of Chronic Anxiety

Repeated exposure to stress has been implicated in inducing chronic anxiety states. Stress related increases in anxiety responses are likely mediated by activation of corticotropin-releasing factor receptors (CRFR) in the amygdala, particularly the basolateral amygdala (BLA). Within the BLA, acute injections of the CRFR agonist urocortin 1 (Ucn1) leads to acute anxiety, whereas repeated daily injections of subthreshold-doses of Ucn1 produces a long-lasting, persistent anxiety-like phenotype, a phenomenon referred to as Ucn1-priming. Relative gene expressions from the BLA of vehicle and Ucn1-primed rats were analyzed with quantitative RT-PCR using a predesigned panel of 82 neuroscience-related genes. Compared to vehicle-primed rats, only expression of the somatostatin receptor 2 gene (Sstr2) was significantly reduced in the BLA of Ucn1-primed rats. The contribution of Sstr2 on an anxiety phenotype was tested by injecting a Sstr2 antagonist into the BLA in un-primed rats. The Sstr2 antagonist increased anxiety-like behavior. Notably, pretreatment with Sstr2 agonist injected into the BLA blocked anxiety-inducing effects of acute Ucn1 BLA-injections and delayed anxiety expression during Ucn1-priming. However, concomitant Sstr2 agonist pretreatment during Ucn-1 priming did not prevent either the development of a chronic anxiety state or a reduction of BLA Sstr2 expression induced by priming. The data demonstrate that the persistent anxiety-like phenotype observed with Ucn1-priming in the BLA is associated with a selective reduction of Sstr2 gene expression. Although Sstr2 activation in the BLA blocks acute anxiogenic effects of stress and down-regulation of BLA Sstr2, it does not suppress the long-term consequences of prolonged exposure to stress-related challenges.

Alexithymia in ankylosing spondylitis.

Objectives This study aims to determine the effect of ankylosing spondylitis (AS) on alexithymia. Patients and methods In this study, a total of 55 AS patients (30 males, 25 females; mean age: 40±8 years; range, 21 to 57 years) who were under follow-up and 55 age- and sex-matched healthy volunteers (31 males, 24 females; mean age: 38.9±8.5 years; range, 21 to 53 years) were included between March 2016 and August 2016. Toronto Alexithymia Scale (TAS), and Beck Depression Inventory (BDI) were performed to assess both patient and control groups. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Ankylosing Spondylitis Quality of Life (ASQoL) were performed to assess AS patients. Results The mean diagnosis time in the patient group was 5.18±4.32 (range, 1 to 18) years. Compared to the control group, depression scores were higher in the patient group and the alexithymic characteristics were significantly higher in the patient group (p<0.05). There was a positive correlation between complaint duration and BASMI, BASFI, and ASQoL scores (p<0.01). In our study, alexithymia rate was significantly higher in women (p<0.05). Conclusion As in all inflammatory chronic diseases, depression and anxiety are commonly seen in AS patients. Alexithymia of these patients should be considered carefully.

In-Hospital Cardiac Arrest after Emotional Stress in a Patient Hospitalized with Gastrointestinal Symptoms and Chronic Anxiety Disorder

Background: We report an acute emotional stress–induced in-hospital cardiac arrest in a patient admitted with gastrointestinal symptoms after experiencing chronic anxiety disorder. Case Presentation: The patient was admitted to the Second Xiangya Hospital, Central South University, with gastrointestinal symptoms and chronic anxiety disorder, and experienced cardiac arrest during hospitalization after acute emotional stress. Malignant ventricular tachycardia and cardiogenic shock were evidenced in this patient after the acute emotional stress. Severe and extensive coronary spasm was confirmed by emergency coronary angiography, and coronary spasm was relieved by intracoronary injection of nitroglycerin. The patient recovered from myocardial infarction with nonobstructive coronary arteries. However, the patient developed acute kidney dysfunction and severe pulmonary infection and eventually died of respiratory circulatory failure on the ninth day after the successful rescue. Conclusions: Acute emotional stress on top of chronic anxiety disorder in patients hospitalized for noncardiovascular reasons might lead to the development of life-threatening cardiovascular diseases, including coronary artery spasm and myocardial infarction with nonobstructive coronary arteries. Psychological management is of importance to improve the outcome of these patients.

Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA).

IntroductionIncreasing multimorbidity is often associated with declining physical functioning, with some studies showing a disproportionate impact on functioning when mental health conditions are present. More research is needed because most multimorbidity studies exclude mental health conditions.ObjectivesThis study aims to improve our understanding of the association between functional limitation and multimorbidity, including a comparison of those with multimorbidity that includes versus excludes mental health conditions.MethodsThis is a population-based, cross-sectional analysis of data from The Canadian Longitudinal Study on Aging. Functional limitation was defined as the presence of any of 14 activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Multimorbidity, measured by the number of chronic conditions, included mood and anxiety disorders. Logistic regression explored the association between multimorbidity (with and without mental health conditions) and functional limitation. Factor analysis identified common condition clusters to help understand clinical complexity in those with mood/anxiety disorders and the potential influences on functional limitation.ResultsThere were 51,338 participants, with a similar proportion of men and women (49% versus 51%) and 42% age 65 years or older. Fifteen percent (15%) had no chronic conditions and 17% had 5+. Ten percent (10%) reported at least one ADL or IADL limitation. Odds ratios (ORs) for functional limitation increased with multimorbidity and were generally higher for those with versus without mental health conditions (e.g., ORs from 1 to 5+ chronic conditions increased 1.9 to 15.8 for those with mood/anxiety disorders versus 1.8 to 10.2 for those without). Factor analysis showed that mood/anxiety conditions clustered with somatic conditions (e.g., migraines, bowel/gastrointestinal disorders).ConclusionThis study found higher odds of functional limitation for those with multimorbidity that included versus excluded mental health conditions, at all levels of multimorbidity. It highlights the need for concurrent management of mental and physical comorbidities to prevent functional limitations and future decline. This approach is aligned with the NICE clinical assessment and management guidelines for people with multimorbidity.

Defining Primary Sclerosing Cholangitis: Results From an International Primary Sclerosing Cholangitis Study Group Consensus Process

Defining Primary Sclerosing Cholangitis: Results From an International Primary Sclerosing Cholangitis Study Group Consensus Process

Prevalence of and factors associated with COVID-19 diagnosis in symptomatic patients followed in general practices in Germany between March 2020 and March 2021

AimsThis study aimed to investigate the prevalence of and the factors associated with the diagnosis of coronavirus disease 2019 (COVID-19) in symptomatic patients followed in general practices in Germany between March 2020 and March 2021. MethodsSymptomatic patients tested for COVID-19 and followed in one of 962 general practices in Germany from March 2020 to March 2021 were included in this study. Covariates included sex, age, and comorbidities present in at least 3% of the population. The association between these factors and the diagnosis of COVID-19 was analyzed using an adjusted logistic regression model. ResultsA total of 301,290 patients tested for COVID-19 were included in this study (54.7% women; mean [SD] age 44.6 [18.5] years). The prevalence of COVID-19 was 13.8% in this sample. Male sex and older age were positively and significantly associated with COVID-19. In terms of comorbidities, the strongest positive associations with COVID-19 were observed for cardiac arrhythmias, depression, and obesity. There was also a negative relationship between the odds of being diagnosed with COVID-19 and several conditions such as chronic sinusitis, asthma, and anxiety disorders. ConclusionsApproximately 14% of symptomatic patients tested for COVID-19 were diagnosed with COVID-19 in German general practices from March 2020 to March 2021.

The Effects of Music Intervention on Pain and Anxiety in the Immediate Postoperative Period in Adults Undergoing Total Knee Arthroplasty and Total Hip Arthroplasty

<h3>Introduction</h3> This study evaluated the effect of music on acute and/or acute on chronic pain and anxiety during the immediate postoperative period. A standardized music intervention (Music Care) was used with patients who had undergone elective joint replacement. <h3>Identification of the problem</h3> The current opioid crisis has led us to examine adjunct therapies for pain control in postoperative care. One such therapy, music, has demonstrated value in the treatment of pain and anxiety in multiple clinical settings. Patients who receive fewer opioid analgesics postoperatively have shown fewer respiratory events and a decreased length of stay. <h3>EBP Question/Purpose</h3> PICO question. Databases utilized: Does the addition of music reduce postoperative pain, anxiety and analgesia during the initial recovery phase of orthopedic surgery patients? <h3>Methods/Evidence</h3> Study participants included patients of who underwent elective joint replacement in 2019 and early 2020. Historical data was gathered from the electronic health record (EHR) of patients January to April 2019 (n=50). From December 2019 to March 2020, the music intervention was initiated upon admission to the PACU (Phase 1 of recovery) and discontinued when patients entered Phase 2 of recovery (n=50) Perioperative data collected from EHR of all patients included: vital signs, Pasero Opioid Induced Sedation Scale (POSS), narcotics and benzodiazepines administered and pain ratings. Significance of the findings/Outcomes: There was a statistically significant decrease in the amount of Dilaudid administered in the study participants, with a p value of 0.03, as well as statistically significant decrease in heart rate (p value 0.006), respiratory rate (p value 0.05) and POSS (p value 0.05). <h3>Implications for perianesthesia nurses and future research</h3> These findings are important in supporting the use of adjunct therapies for pain control thus decreasing the use of narcotics and their untoward side effects and related sequelae. A lower POSS and decreased narcotic use may promote early mobility and discharge. Further research in the use of music throughout the entire operative experience, and beyond, may be of interest.

Associations of environment and lifestyle factors with suboptimal health status: a population-based cross-sectional study in urban China

IntroductionSuboptimal health status (SHS), an intermediate state between chronic disease and health, is characterized by chronic fatigue, non-specific pain, headaches, dizziness, anxiety, depression, and functional system disorders with a high prevalence worldwide. Although some lifestyle factors (e.g. smoking, alcohol consumption, physical exercise) and environmental factors (e.g. air quality, noise, living conditions) have already been studied, few studies can comprehensively illustrate the associations of lifestyle and environment factors with general, physical, mental, and social SHS.MethodsA cross-sectional study was conducted among 6750 urban residents aged 14 years or over in five random cities from September 2017 to September 2018 through face-to-face questionnaires. There were 5881 valid questionnaires with a response rate of 87%. A general linear model and structural equation model were developed to quantify the effects of lifestyle behaviors and environment factors on SHS.ResultsThe detection rates of general, physical, mental, and social SHS were 66.7, 67.0, 65.5, and 70.0%, respectively. Good lifestyle behaviors and favorable environment factors positively affected SHS (P < 0.001). Lifestyle behaviors had the largest effect on physical SHS (β = − 0.418), but the least on social SHS (β = − 0.274). Environment factors had the largest effect on mental SHS (β = 0.286), but the least on physical SHS (β = 0.225).ConclusionsLifestyle behaviors and environment factors were important influencing factors of SHS. Physical SHS was more associated with lifestyle. Lifestyle and environment were similarly associated with mental and social SHS.