Exam-related Stress Research Articles

Prevalence of depressive symptoms among urban school adolescents in Vietnam: The role of youth, family, and school relationships

BackgroundAdolescents frequently encounter a spectrum of psychiatric conditions, predominantly depressive and anxiety disorders, along with various behavioral disturbances. ObjectiveThis investigation aims to delineate the prevalence of depressive disorders among adolescents in urban Vietnam and to elucidate the interrelationships between familial and school-related dynamics and adolescent depression. Materials and MethodsA cross-sectional survey was conducted in 2022, involving 507 students aged 15 to 17 from high schools in Hanoi, Vietnam. Reynolds Adolescent Depression Scale - Second Edition (RADS-2) was used to assess the presence of depressive symptoms. Social-demographic characteristics, adolescent-family and adolescent-school relationships, and academic environment characteristics of high school students were interviewed. Multivariate Tobit regression models were employed to discern contributory factors across four domains of RADS-2. ResultsAmong the 507 adolescents, the mean scores on the RADS scale were 15.1 ± 4.2 for the dysphoric mood domain, 16.4 ± 4.0 for the anhedonia-negative domain, 13.1 ± 4.4 for the negative self-evaluation domain, and 12.4 ± 3.7 for the somatic complaints domain. The analysis indicated that adolescents with suboptimal parental relationships, absence of confidants, frequent parental conflicts, exposure to parental arguments, substantial exam-related stress, or overwhelming academic demands were more likely to exhibit elevated depressive symptoms. Conversely, adolescents who were satisfied with their friendships at school and received care, support from teachers or friends, and involved in school's extracurricular activities lower exhibited levels of depression. ConclusionsFindings reveal the significant impact of family and peer relationships, as well as academic stress, on the development of depressive symptoms. These significant results inform the design and development of future interventions aimed at mitigating depression risks among high school students, emphasizing the crucial roles of both educational institutions and family dynamics.

Fostering a Peaceful Tomorrow - Investigating the Impact of Yoga on Exam Stress in Higher Secondary Level Students of Meerut District

This research endeavors to explore the impact of yoga on exam stress among higher secondary level students in Meerut District, with the overarching goal of contributing to a more peaceful tomorrow. The study holds significance in its dual focus: identifying various training schedules suitable for school students and evaluating stress levels experienced by secondary school students. The research design encompasses a total of 20 girls and 20 boys from higher secondary schools in Meerut District, establishing a controlled environment for in-depth analysis. Among these participants, 10 girls and 10 boys have been deliberately assigned to both control and experimental groups. The investigation aims to ascertain the efficacy of yoga interventions in mitigating exam-related stress, with potential implications for educational practices and policies. By assessing stress levels and introducing tailored yoga interventions, the study aspires to contribute valuable insights that can positively impact the mental well-being and academic performance of higher secondary-level students. This research serves as a stepping stone toward fostering a more serene educational environment, ultimately contributing to the cultivation of a peaceful tomorrow.

Medical Student Syndrome in Medical University students in Jordan: A Cross-sectional Study

BACKGROUND: The widely recognized phenomenon known as 'medical student syndrome' refers to the tendency of many medical students to develop fears and symptoms of illnesses they are studying. Extensive research has underscored the substantial psychological pressure that medical students endure due to factors like a demanding workload, exam-related stress, anxiety arising from new clinical experiences, and the competitive academic environment. Given its classification as a mental health issue, 'medical student syndrome' has been investigated in multiple countries. Consequently, our study aims to delve deeper into this phenomenon among medical students, considering various demographic factors. METHODS: A cross-sectional study was conducted. The survey includes sociodemographic questions and attitudes toward the syndrome, adapted from a Polish study. Data was using SPSS, with statistical tests conducted at a 95% confidence level. RESULTS: A total of 1,050 participants completed the questionnaire for this study, with 67.3% being females. The average age was 20.91 years, and the majority were unmarried (98.2%). Most participants reported a monthly income of less than 500 JDs, and only 16.2% identified as smokers. Clinical students accounted for 33.6% of the sample, while 11.2% indicated a history of mental illnesses. Additionally, 36.3% had taken previous courses related to mental illnesses, and 13.7% had sought psychiatric consultation. Furthermore, 15.6% had utilized psychiatric or psychotherapeutic counseling for other reasons, and 26.6% expressed a desire to visit a psychiatrist or psychologist due to their fear of falling ill. Mann–Whitney U and Kruskal–Wallis tests were conducted to explore potential differences in total scores based on demographic and mental background factors. Preclinical students had significantly higher mean scores compared to clinical students (41.68 vs. 39.35, p = 0.001). Respondents who had used psychiatric or psychotherapeutic counseling for reasons other than those inquired had significantly higher scores than those who did not (43.85 vs. 40.35, p < 0.001). Similarly, respondents planning to visit a psychiatrist/psychologist due to their fear of falling ill scored significantly higher than those who did not share this intention (43.85 vs. 39.96, p < 0.001). Multiple linear regression analysis revealed that the "year of study" variable was the only significant predictor of the total score, with a coefficient of -3.196, a t-statistic of -4.057, and a p-value < 0.001. This negative coefficient suggested that as the year of study increased, the total score tended to decrease significantly. However, the model had relatively weak explanatory power, with R² indicating that it explained only about 3.5% of the variance in the dependent variable, and R²adj accounting for approximately 2.7% after adjusting for model complexity. CONCLUSION: In summary, the study included a diverse group of participants with varying demographic and mental background factors. Preclinical students tended to have higher scores, and those with a history of seeking mental health services or expressing an intention to do so had higher scores. The year of study was a significant predictor of the total score, suggesting that as students progressed in their studies, their scores tended to decrease. However, the model's overall explanatory power was relatively limited.

Exams-related stress and the pattern of substance use and misuse among Palestinian medical and health sciences students

Substance use among school students is a public health concern. Exam-related anxiety is one of the main motives for drug use. This research aimed to determine the prevalence and characteristics of psychostimulant and antidepressants use and misuse among medical and health sciences students at two large representative medical schools in West Bank Palestine. The results of a cross-sectional study, that surveyed 984 Palestinian medical and health sciences students revealed how educational experiences and newfound independence affect substance use behaviors among Palestinian medical and health sciences students. In total, 7.7% of the students reported using illicit drugs. Hallucinogens were the most commonly used drugs (2.9%), followed by central nervous system (CNS) stimulants (2.4%) and CNS depressants (1.4%), while 4.4% were using nonprescribed antidepressants, with Fluoxetine being the most used. Most drug users (72.4%) started using before they enrolled in university, and 39.5% did not realize the potential harm of these drugs. Medical students tend to use these substances less frequently than their non-medical peers. The study indicated that exam-related stress was a crucial factor in the prevalence of drug use and misuse. Peer pressure, academic, psychological, and family pressures were other primary reasons behind drug use. The study’s results indicated that the misuse of antidepressant medications and other licit and illicit substances is highly prevalent among Palestinian medical and non-medical students. The results also underscore the importance of raising awareness about drug use and providing students with accurate information about the safe use of these substances.

The Impact of Exam Related Stress on Gastroesophageal Reflux Disease (GERD) Symptoms among High School Students in Bangkok

Gastroesophageal reflux disease (GERD) is a digestive condition where the stomach’s acidic contents consistently flow back up into the esophagus which serves as the conduit linking the throat to the stomach. In most cases, individuals with GERD experience symptoms such as heartburn and regurgitation due to the weakening or improper relaxation of the lower esophageal sphincter. Stress, on the other hand, is an instinctive response that stimulates individuals to address challenges in the environment through adaptations to cope with the situation. Correspondingly, it has been frequently observed that high-stress intensities can significantly affect our bodily functions which could potentially progress to more severe disorders. Thus, we conducted survey research on high school students in Bangkok using an online questionnaire to determine the impact of exam-related stress on an individual’s development of symptoms related to Gastroesophageal reflux disease (GERD). The survey conducted in this research has shown that stress and anxiety from exams are correlated with a person developing GERD symptoms. Albeit it can be concluded that stress from exam expectations influences GERD, further research is required to identify other causes relating to this outcome. Therefore, it is crucial that individuals efficiently manage their stress as it has the potential to prevent the onset of GERD symptoms. Thus, examining the impact of exam-related stress on the development of GERD symptoms among Bangkok high school students can promote awareness about effective stress management to attain healthy well-being.

Nourish: A pilot program to support self-Efficacy, learning, and wellness during USMLE step 1 preparation

ABSTRACT Purpose Medical trainees experience significant exam-related stress, such as preparing for the USA Licensing Medical Examination Step 1, which often negatively affects emotional health. Nourish, a novel Step 1 support program, was designed to foster improved self-efficacy and well-being during the process of studying for and taking the exam. Nourish was piloted at Oregon Health & Science University between December 2018 and February 2019. Methods Program elements were guided by Self-Efficacy Theory and included community building, wellness support, peer tutoring and social persuasion. Program evaluation included pre- and post-program surveys. Participation was optional and included 46 of 154 students (30%) with 40 of the 46 students (87%) completing pre and post evaluations. The pre-survey was given during the Nourish orientation in December prior to the Step 1 study period, and the post-survey was given in early February when most students had taken their exam but none had received their scores. Results While summary self-efficacy scores increased between baseline and post program (24.9 vs 27.7, p < 0.001), summary emotional health scores worsened (8.15 vs 8.75, p = 0.03). Summary scores for physical health also dropped but this difference was not statistically significant. Summary perceived stress scores increased from 15.5 at baseline to 23.7 post program (p < 0.001). All students who routinely participated in Nourish passed their USMLE Step 1 exam. One student who participated only in the orientation session did not pass. Conclusion Nourish appeared to improve self-efficacy, even though students reported being stressed with low emotional health. The program appeared to help students align task demands with their own personal resources and set reasonable expectations and strategies to pass the exam. Medical schools should consider similar peer- and faculty mentor-based wellness and tutoring programs to support medical students while they work to achieve academic success.

Altered stress responses in adults born by Caesarean section

Birth by Caesarean-section (C-section), which increases the risk for metabolic and immune disorders, disrupts the normal initial microbial colonisation of the gut, in addition to preventing early priming of the stress and immune-systems.. Animal studies have shown there are enduring psychological processes in C-section born mice. However, the long-term impact of microbiota-gut-brain axis disruptions due to birth by C-section on psychological processes in humans is unknown. Forty age matched healthy young male university students born vaginally and 36 C-section delivered male students were recruited. Participants underwent an acute stressor, the Trier social stress test (TSST), during a term-time study visit. A subset of participants also completed a study visit during the university exam period, representing a naturalistic stressor. Participants completed a battery of cognitive tests and self-report measures assessing mood, anxiety, and perceived stress. Saliva, blood, and stool samples were collected for analysis of cortisol, peripheral immune profile, and the gut microbiota. Young adults born by C-section exhibit increased psychological vulnerability to acute stress and a prolonged period of exam-related stress. They did not exhibit an altered salivary cortisol awakening response to the TSST, but their measures of positive affect were significantly lower than controls throughout the procedure. Both C-section and vaginally-delivered participants performed equally well on cognitive assessments. Most of the initial effects of delivery mode on the gut microbiome did not persist into adulthood as the gut microbiota profile showed modest changes in composition in adult vaginally-delivered and C-sectioned delivered subjects. From an immune perspective, concentrations of IL-1β and 1L-10 were higher in C-section participants. These data confirm that there is a potential enduring effect of delivery mode on the psychological responses to acute stress during early adulthood. The mental health implications of these observations require further study regarding policies on C-section use.

Behavioral Intervention in Children with Functional Abdominal Pain Disorders: A Promising Option.

The objectives of this study were to identify and classify patients with functional abdominal pain disorders (FAPD) into its various subtypes as per the Rome IV criteria and to evaluate the underlying psychological factors and the effect of behavioral intervention in children with FAPD. A validated Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) based on Rome IV criteria was used to identify and classify children presenting with abdominal pain. The children diagnosed as having FAPD were referred for psychological screening to evaluate for underlying psychosocial problems. The scales namely Pediatric Anxiety Rating Scale (PARS), Depression self-rating scale (DSRS), and Visual Analog Scale (VAS) were administered to children to assess the response of the child to behavioral therapy. Of 100 children, 32, 26, 22, and 20% of children belonged to the subtypes of functional abdominal pain-not otherwise specified, abdominal migraine, irritable bowel syndrome, and functional dyspepsia, respectively. The most common associated psychosocial factors were academic burden, poor financial condition, exam-related stress, and bullying at school. The influence of behavioral therapy was statistically significant (P < .05). The mean (±standard deviation) PARS and DSRS scores were significantly reduced at 3 months of follow-up. The most common subtypes reported were functional abdominal pain-not otherwise specified and abdominal migraine. Psychological factors such as academic burden, poor financial condition, exam-related stress, and bullying at school need to be ruled out in children with this condition. Non-pharmacological intervention such as behavioral therapy can confer a remarkable improvement in the symptoms of children with FAPD.

A Study to Evaluate the Effectiveness of Selected Coping Strategies on Exam Related Stress Among B. Sc Nursing Students in Mother Teresa College of Nursing, Pudukkottai

A quasi experimental study was conducted among B.sc nursing students of Mother Teresa College of nursing, Pudukkottai. It aims to assess the existing level of exam related stress and provided coping strategies on stress reduction technique and then evaluated the effectiveness of selected coping strategies. 40 samples were selected using purposive sampling technique. The data was collected using structured questionnaire scheduled. Data analysis and interpretation was done by using inferential statistics. The mean score of pretest level of stress is 55.85 and mean score of posttest level of stress is 36.45. The enhancement of knowledge in mean score and SD which the effectiveness of selected coping strategies. The analysis depicted that there is reduction in exam related stress level in B.Sc. Nursing students which indicate the effectiveness of selected coping strategies.

Learning to Learn with COVID-19: An Exploration into Sri Lankan Undergraduates’ Attitudes and Experiences vis-à-vis Emergency Remote Teaching

This article focuses on undergraduate students’ experiences and attitudes to Emergency Remote Teaching (ERT) during and after the first COVID-19 lockdown in Sri Lanka, which began in March 2020. The pandemic triggered a shift from traditional educational methods to online teaching and learning. For this transition to be successful, the opportunities and challenges of online learning during a pandemic should be studied. The article and its findings are based on a questionnaire and Focus Group Discussion (FGD) with eighteen undergraduates of a degree-awarding, non-state higher education institute (NSHEI). Overall, the majority of students displayed a favorable attitude to online education and a preference for blended learning in the future. Advantages were reduced travel time and cost, punctuality, the ability to attend lectures from comfortable surroundings, and the availability of recordings of the lecture. Disadvantages were inadequate internet facilities, devices, and training in the use of the internet and the Learning Management System (LMS). Disrupted concentration and motivation due to the absence of a good learning environment was also reported, as were the limitations of the mobile phone as the primary device for online learning, lack of face-to-face interaction and immediate feedback/ clarification, COVID fatigue, and exam related stress. Suggestions for overcoming these issues are provided at the end of the article.

Mindfulness Training: Success in Reducing First Year Health Professional Students’ Study and Exam Related Stress

PurposeStudents enrolling in high stakes, undergraduate entry, professional programs like medicine, dentistry and pharmacy may struggle to effectively achieve the transition from high school. This often results in high levels of mental distress. MethodThe College of Medicine and Dentistry at James Cook University have implemented a health professional self-care program (HPSC) with an aim of helping students recognize stressors and develop coping strategies. The HPSC program has been running for three years in the first year of each of the three courses. The HPSC program was delivered as a series of eight sessions focusing on evidenced based theory with some time for practicing coping strategies. Five-point Likert scale surveys were administered prior to commencing the program and after completion. ResultsAcross the College, students reported significantly improved abilities to reduce study and exam related stress and develop effective coping skills. These results were more pronounced in students that practiced techniques of mindfulness. DiscussionThe HPSC program changed student perceptions in being able to improve their own self-care and reduced study and exam related stress.

WITHDRAWN: Mindfulness Training: Success in reducing first year health professional students' study and exam related stress

The Publisher regrets that this article is an accidental duplication of an article that has been published in Volume 6, Issue 2, June 2020, Pages 162-169, https://doi.org/10.1016/j.hpe.2020.04.001 . The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

The effect of patient anxiety and depression on motion during myocardial perfusion SPECT imaging.

BackgroundPatient motion during myocardial perfusion SPECT imaging (MPI) may be triggered by a patient’s physical and/or psychological discomfort. The aim of this study was to investigate the impact of state anxiety (patient’s reaction to exam-related stress), trait anxiety (patient’s personality characteristic) and depression on patient motion during MPI.MethodsAll patients that underwent MPI in our department in a six-month period were prospectively enrolled. One hundred eighty-three patients (45 females; 138 males) filled in the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), along with a short questionnaire regarding their age, height and weight, level of education in years, occupation, and marital status. Cardiovascular and other co-morbidity factors were also evaluated. Through inspection of raw data on cinematic display, the presence or absence of patient motion was registered and classified into mild, moderate and severe, for both phases involved in image acquisition.ResultsThe correlation of patient motion in the stress and delay phases of MPI and each of the other variables was investigated and the corresponding Pearson’s coefficients of association were calculated. The anxiety-motion (r = 0.43, P < 0.0001) and depression-motion (r = 0.32, P < 0.0001) correlation results were moderately strong and statistically significant for the female but not the male patients. All the other variables did not demonstrate any association with motion in MPI, except a weak correlation between age and motion in females (r = 0.23, P < 0.001).ConclusionsThe relationship between anxiety-motion and depression-motion identified in female patients represents the first supporting evidence of psychological discomfort as predisposing factor for patient motion during MPI.

Evaluation of Cigarette Smoking Attitudes and Behaviors among Students of a State High School in İstanbul

Objective: We aimed to evaluate smoking habits of students, reasons of smoking and students’ level of knowledge on the adverse effects of smoking in a state high school in Istanbul. Methods: A 15-item questionnaire was administered to the students attending a state high school in Istanbul to evaluate their attitudes and behaviors towards cigarette smoking. The questionnaire was completed by each class of students at the same class period under the supervision of their teachers. Results: The questionnaire was completed by 415 students at the respective school. While 349 students (84%) never smoke, 66 (15.9%) students were either current smokers or quitters. Fifty five of the students (13.2%) were active smokers. When we looked at the reasons of smoking, they reported that 63.6% smoked cigarettes because their friends did; 47.2% smoked cigarettes due to exam-related stress; and 40% smoked cigarettes due to family problems. The rate of smoking friends in the smoker group was significantly higher than in the non-smoker group (p=0.0001). A logistic regression analysis showed that having smoking friends was associated with an 8-fold increase in the risk of smoking compared to having no smoking friends. Conclusion: The most common reasons of smoking at the school were friends who were smokers, exam-related stress and family problems. Having friends who smoke was associated with an 8-fold increase in the risk of smoking. We believe that counselling services’ close engagement with family problems of students and exam-related stress issues and helping them to cope with these problems may prevent their vulnerability to toxic substances.

‘Your whole life depends on it’: academic stress and high-stakes testing in Ireland

International research consistently shows that high-stakes exams are a significant source of stress and worry for students within secondary education. Existing research focuses on individual variation in exam-related stress levels among students with very little attention given to the influence of school context on student stress. Using data from the Irish Post-Primary Longitudinal Study, a mixed methods study of secondary students, this paper examines both individual and school level factors influencing the levels of stress among students preparing for the nationally standardised Leaving Certificate examination. The paper presents new findings which highlight the potential role of schools in ameliorating student stress. Findings show that student stress is not only influenced by individual-level factors but that certain aspects of the schooling process impact on stress levels. In particular, the quality of student–teacher interaction and peer relations within the school are found to have a significant impact on student stress levels. Students with more positive interactions with their teachers have lower stress levels with higher stress levels among those who have experienced bullying from peers. Stress is also influenced by programme choice at upper secondary level and the extent to which students are facilitated in their choice of subjects.

An investigation of adult attachment and coping with exam-related stress

ABSTRACT Students differ in how they cope with and manage stress associated with university life. This study investigates associations between adult attachment and coping strategies for exam-related stress. Fifty-seven students at a university in the north of England completed online questionnaires to assess attachment anxiety and avoidance, helpful and unhelpful coping strategies, and positive and negative affect. We found that students who were more avoidant in their attachment relationships were less likely to report using helpful problem-focused and emotion-focused strategies to cope with their exams. We also found that students who were more anxious in their attachment relationships reported using more dysfunctional coping strategies. We discuss the implications of the findings for university pastoral care and academic support systems.

Emotional intelligence, coping and exam-related stress in Canadian undergraduate students

The associations among emotional intelligence (EI), coping, personality and exam-related stress in a group of 475 Canadian undergraduate students were examined. Stress was measured at the start of the semester and again in the pre-exam period. Higher levels of stress were associated with lower scores on EI components, and higher scores on emotion-focused coping and neuroticism. A scale-level factor analysis of the EI and coping subscales produced three composite factors, which each had high loadings from at least one EI and one coping subscale. The associations of the Emotion Regulation factor (high loadings of several EI components and emotion-focused coping) and the Task Focus factor (high loadings of Adaptability EI and task-focused coping) with personality, stress and subjective wellbeing (SWB) were examined using structural equation modelling. The results showed that these factors mediated the effect of personality on stress and SWB.

Coping with examinations: Exploring relationships between students' coping strategies, implicit theories of ability, and perceived control

Relatively little is known about the contribution of students' beliefs regarding the nature of academic ability (i.e. their implicit theories) on strategies used to deal with examinations. This study applied Dweck's socio-cognitive model of achievement motivation to better understand how students cope with examinations. It was expected that students' implicit theories of academic ability would be related to their use of particular coping strategies to deal with exam-related stress. Additionally, it was predicted that perceived control over exams acts as a mediator between implicit theories of ability and coping. Four hundred and ten undergraduate students (263 males, 147 females), aged from 17 to 26 years old (M=19.73, SD=1.46) were volunteers for the present study. Students completed measures of coping, implicit theories of academic ability, and perception of control over academic examinations during regular classes in the first term of the university year. Multiple regression analyses revealed that incremental beliefs of ability significantly and positively predicted active coping, planning, venting of emotions, seeking social support for emotional and instrumental reasons, whereas entity beliefs positively predicted behavioural disengagement and negatively predicted active coping and acceptance. In addition, analyses revealed that entity beliefs of ability were related to coping strategies through students' perception of control over academic examinations. These results confirm that exam-related coping varies as a function of students' beliefs about the nature of academic ability and their perceptions of control when approaching examinations.

High rates of depressive symptoms among senior high school students preparing for national university entrance examination in Turkey

Tuncay Ergene, Ph.D., is supported by NIMH, ICORTHA Fogarty International Mental Health and Developmental Disabilities (MH/DD) Research Training Program (D43TW05807) at Children’s Hospital Boston; Principle Investigator (PI): Kerim M. Munir, MD, MPH, DSc. Introduction The purpose of the present study is to determine the prevalence of depressive symptoms among senior high school students preparing national university entrance examination (OSS) in Turkey. The survey was conducted in the second term of students’ senior year at high school, a time when they were exposed to a stressful standardized national examination. The aim of the study was to determine the prevalence of depressive symptoms and to identify a possible association of depressive symptoms with other student and socio-demographic characteristics. We used the Beck Depression Inventory (BDI), adapted for Turkey, to assess self-reported depressive symptoms among 984 students. Overall, 45.1% of the students reported depressive symptoms. The relationship between the presence of depressive symptoms and student gender, family size, living circumstances, academic grade, number of times national exams were taken, monthly family income, daily study time, number of friends of opposite sex and involvement in social activities were examined. Gender, academic succes and monthly family income had statistically significant differences on BDI scores. The high rate of self-reported depressive symptoms reflects heightened exam-related stress, social expectations, worries about future success linked to uncertainty about securing a university placement and personal, familial and demographic factors. The greater prevalence of depressive symptoms among females (49.5%) compared to males (40.6%) highlights higher degrees of stress or vulnerability among female adolescents facing similar circumstances to males in Turkey.

Can people remember how they coped? Factors associated with discordance between same-day and retrospective reports.

Using alternate forms derived from 6 scales from the Revised Ways of Coping Checklist (P. P. Vitaliano, 1993), the authors obtained daily coping scores from students as they prepared for a demanding test, then obtained a 7-day retrospective measure of their coping. On average, only 25% shared variance was found between the daily and retrospective accounts. A consistent pattern of retrospective overestimation of daily coping occurred, and large individual differences in degree of correspondence were observed. Among students who reported the highest level of exam-related stress, less than 10% of the retrospective coping score variance was predicted by the daily measures. The results indicate that retrospective coping reports cannot be considered equivalent to measures obtained in closer proximity to the event.