Extreme Anxiety Research Articles

The impact of the COVID-19 pandemic and related measures on people with psychiatric disorders in a small town in Greece

IntroductionA pandemic can have significant effects on people’s emotional wellbeing. Infection control measures such as social distancing can lead people to feel isolated and to increased feelings of fear, anxiety, anger, and sadness. Recent research showed a worrying increase in depression and anxiety disorders, general distress, and sleep disorders. People who already suffer from a mental illness may be more vulnerable to stress caused by the pandemic and may experience a deterioration of already preexisting symptoms of anxiety and depression.ObjectivesThe purpose of the present study was to assess the pandemic’s psychological impact on people with preexisting mental illness, to investigate their COVID-19-related fear, anxiety, and depression in association with various variables and to explore their behavioral responses regarding the measures against the pandemic.MethodsA cross-sectional study was conducted from March to May 2022 in the outpatient mental health clinic of a provincial hospital in Greece. Participants were patients, who were not fully disorganized and have been diagnosed with a mental illness before the COVID-19 pandemic. Among the 50 adult patients, 11 lived in assisted living facilities. The study included sociodemographic questions, questions about fear of COVID-19, negative feelings, safety measures and behaviors, disease progression, and compliance with their therapists. DASS-21 scale was used to measure the 3 subscales of emotional states.ResultsSadness was reported as the most unpleasant emotion of the lockdown, following by hopelessness and denial. Several participants (36%) reported high levels of COVID-19-related fear, mainly patients living in the community and not in assisted facilities (40.1% vs 18.2%) and males compared to females (42.1% vs 32.3%). The majority (70%) declared high compliance with the therapy. A moderate to severe deterioration in disease progression during the pandemic was observed in 28%, mainly in females compared to males (38.7% vs 10.6%). Based on DASS-21 the mean scores ranged from moderate to severe symptoms in depression (16.2/42), anxiety (14.3/42), and stress (18.4/42) without a statistically significant correlation with age, gender, and living situation. However, 34%, 22% and 56% screened positive for severe and extreme severe depression, anxiety, and stress, respectively.ConclusionsThe study revealed a substantial proportion of patients with mental disorders to experience unpleasant emotions and increased levels of psychological distress and highlights the need for supportive mental health services to address the increased mental health symptoms in people with pre-existing mental illnesses during a pandemic.Disclosure of InterestNone Declared

A Comparative Study of Anxiety Levels in EFL Classrooms Before and After the Covid-19 Lockdown

The Covid-19 pandemic has drastically altered the way we live, threatening our lives and health, and also harming our economic, social, and educational systems. The purpose of this study was to assess anxiety levels in Saudi English as a Foreign Language students during the Covid-19 outbreak. The survey was conducted between March and June 2020. The Zung self-rating anxiety scale was used to assess the respondents' degree of anxiety. Of those surveyed, 35% noticed moderate to extreme anxiety levels. Age and education levels were all strongly associated with anxiety. It was discovered that the majority of respondents had moderate to extreme anxiety. This study provides important insight to government agencies and policy makers on the importance of acting quickly and effectively. Researchers should consider how to enhance students' resilience and adaptability in order to produce strategies to improve their resilience in future similar disasters.

Strengthening Academic Medicine's Response to Humanitarian Concerns.

Strengthening Academic Medicine's Response to Humanitarian Concerns.

Sensed Presence, Attenuated Psychosis, and Transliminality: At the Threshold of Consciousness

Introduction: The experience of “sensed presence” or “felt presence” in the absence of “other” has been described as a complex multimodal experience to which meaning is given. Sensed presence (SenP) is a transdiagnostic experience that exists along a continuum that can appear during isolation, spirit quests, exposure to extreme elements, bereavement, anxiety, and psychosis. Given the prevalence and vast heterogeneity of SenP, in addition to a surprising lack of targeted research into this phenomenon, this research examined the interrelationship of SenP, attenuated psychosis symptoms (APS), and transliminality. Transliminality is composed of absorption, fantasy proneness, paranormal belief, mystical experiences, increased creativity, and hyperaesthesia. Methods: A completely anonymous online survey of unusual experiences and mental health was distributed via social media (i.e., Twitter, Facebook, Reddit, and mass emailing lists) to recruit participants. Demographic data were analyzed using χ² tests and one-way ANOVAs. A two-step cluster analysis was conducted to identify distinct sub-categories of transliminality followed by ANOVAs with bootstrapping at 1,000 iterations to compare SenP, increased APS, and transliminality. Pearson’s bivariate correlations were conducted to determine the association between SenP, APS, and transliminality. Results: Together with descriptive findings, we show distinct characteristics between clusters. T1 cluster consisted of individuals with few SenP experiences, low APS, and low transliminality. T2 consisted of individuals with a moderate prevalence of SenP, low APS, moderate transliminality, and increased overall feeling of closeness to G-d. There was no significant difference in APS between T1 and T2 or in the level of distress associated with APS. T3 individuals showed a significantly higher prevalence of SenP in all domains (frequency, distress, vividness, and total score), higher APS, and higher transliminality, compared to T1 and T2. The T3 cluster met criteria for high risk to develop psychosis. Conclusion: Thus, our findings demonstrate a strong association and entanglement of these experiences which suggests that the interrelatedness of transliminality/absorption and APS may serve as a potentially provocative underlying structure in the phenomenology of SenP.

Barriers to nurses’ therapeutic communication practices in a district hospital in Ghana

BackgroundPatients accessing health care enter the hospital environment with extreme anxiety, fear and distress which impacts their interactions with nurses and other health care professionals who are expected to help allay these anxieties in order to enhance patients care satisfaction. However, evidence suggests that there is a lack of effective therapeutic nurse-patient interaction in hospitals and the clinical environment globally, especially in sub-Saharan Africa.MethodsA qualitative research approach with an exploratory design was used to purposively select 30 participants who were engaged in face-face interactions. A semi-structured interview guide was used to conduct five audio-recorded FGDs with the 30 participants (6 in each group—2 males and 4 females) after which the discussions were transcribed verbatim, and content analyzed.FindingsTwo (2) main themes and 10 sub-themes emerged from the analysis of the data. The two themes were: Therapeutic communication practices and Barriers to therapeutic communication. Some of the factors identified by patients to impede therapeutic nurse-patient interaction include family interference, negative attitude from patients, patient condition, a discriminatory attitude of nurses, increased workload, and stress.ConclusionCommunication practices identified in this study include nurses’ manner of communication, use of touch, positive reassurance, and nurses’ demeanor. Several obstacles affect communication practices, hence the need to implement measures to improve nurse-patient interaction.

Sustaining the Canadian Nursing Workforce: Targeted Evidence-Based Reactive Solutions in Response to the Ongoing Crisis.

Inadequate staffing, excessive workloads, endemic violence and unhealthy workplaces are some of the challenges facing Canadian nurses. Leaving these issues unaddressed has had pernicious impacts on the nursing workforce: thousands of nurses across Canada have been suffering from extreme stress, anxiety and burnout, leading many of them to leave their current jobs and, for some, the profession of nursing altogether. We conducted a comprehensive yet rapid review of evidence-based solutions from the peer-reviewed and policy literature, stakeholder dialogues and member surveys commissioned by the Canadian Federation of Nurses Unions that could be implemented and scaled across Canada. Our findings support coordinated series of collectively planned, carefully sequenced and evidence-based interventions to retain, return, integrate and recruit nurses targeted to support the nursing workforce from training to early-, mid- and late-career stages. The implementation of these reactive solution bundles will also enhance the quality of healthcare services and, more broadly, the healthcare system.

Depression, Anxiety, and Stress in Kazakhstani Women with Recurrent Pregnancy Loss: A Case-Control Study.

Background: Recurrent pregnancy loss (RPL) is associated with increased incidence and severity of depression, anxiety, and stress, and screening for these comorbidities following miscarriages is beneficial for women with RPL who are planning future pregnancies. This study aims to investigate depression, anxiety, and stress among Kazakhstani women with RPL. Methods: This was a case−control study involving 70 women with confirmed RPL and 78 ethnically matched control women. Depression, anxiety, and stress were evaluated using the Depression Anxiety Stress Scales (DASS)-21 instrument. Linear regression and correlation analysis were used in assessing the association of RPL with symptoms of depression, and/or anxiety, and/or stress, after adjusting for key covariates. Results: Women with RPL were found to have significantly higher mean scores for depression (p < 0.001), anxiety (p < 0.001), and stress (p < 0.001) symptoms. Mild−moderate stress and mild−moderate and severe−extreme depression and anxiety symptoms were more frequent in the RPL group than in the control group. Regression analysis demonstrated that RPL was the only significant variable associated with anxiety, depression, and stress symptoms. Conclusion: The results of this study suggest that women with RPL are more likely to experience heightened symptoms of depression, anxiety, and stress. Proper psychological counseling is recommended for women with RPL, as well as their spouses.

Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes

BackgroundSocial distancing may affect athletes’ training, causing negative effects on mental and physical health. ObjectiveThis study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic. MethodsThis was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies. ResultsA total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period. ConclusionThe quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.

Association of Depression, Anxiety, and Stress with Socio-demographic Characteristics among Preoperative Patients at Tertiary Care Hospitals in Karachi

Background: The preoperative period is known as one of the disturbing events. It habitually prompts cognitive, physiological, and emotional reactions. Depression, anxiety, and stress are considered emotional states usually found in preoperative surgical patients. Objective: To find out the frequency and association of depression, anxiety, and stress with socio-demographic variables among preoperative patients. Methods: This cross-sectional analytical study of 258 preoperative patients was conducted at Dow University Hospital and Dr. Ruth Pfau Civil Hospital, Karachi from August 01, 2019, to July 31, 2020. Ethical approval was obtained before conducting the study. Depression, Anxiety, and Stress Scale-42 tool was used for the data collection. The data was analyzed by using SPSS version 21. Mean and frequency analyses were performed for demographic characteristics. Moreover, a chi-square test was performed to check the association of socio-demographic characteristics of study participants with depression, anxiety, and stress. Results: The majority of the participants (72.5%) in this study were male and 59.7% were between the ages of 20-35 years. The finding of this study revealed that most of the patients had moderate depression (43.02%), extreme anxiety (54.26%), and moderate stress 57.13%. Significant associations were found for depression with gender and monthly income, with a p-value of 0.035 and 0.003 respectively. Gender (p=0.021) and level of education (p=0.013) were significantly associated with stress levels. Conclusion: This study concluded that patients before surgeries had different levels of depression, anxiety, and stress. Age is the only variable that showed a significant association with stress and depression. Furthermore, anxiety is the only domain that is not significantly associated with any demographic characteristics.

Depression, anxiety, and stress among 1st year medical undergraduates in a medical college in North Kerala – A cross-sectional study

Background: Prevalence of depression, anxiety, and stress is very high among medical undergraduates and there lacks a proper platform for students to express themselves and facilitators to assess them. Aims and Objectives: The objectives of this study were to assess the prevalence of depression, anxiety, and stress among 1st year medical undergraduates in a medical college in north Kerala. Materials and Methods: In this cross-sectional study, 210 1st year MBBS students participated in the study. They were interviewed, basic demographic data, and depression, anxiety, and stress scale 21 was administered. The data were analyzed with Microsoft Excel. Results: The prevalence of depression, anxiety, and stress was 12.9%, 43.5%, and 47.2%. Out of 210 students, 6% had mild depression, 5.7% had moderate depression, and 0.4% had severe depression. No one reported extreme depression. About 16.6% of total students had mild anxiety, 20.9% had moderate anxiety, 6.6% had severe anxiety, and 0.9% had extreme severe anxiety. Out of total students, 8.9% had mild stress, 5.71% had moderate stress, 26.6% had severe stress, and 6.6% had extreme severe stress. Conclusion: The prevalence of undetected anxiety and stress is high among 1st year MBBS students studying in this institution. This study highlights the relevance of systematic screening for psychological problems especially depression, anxiety, and stress among medical undergraduates in the years to come.

Effect of a monitored home-based exercise program combined with a behavior change intervention and a smartphone app on walking distances and quality of life in adults with peripheral arterial disease: the WalkingPad randomized clinical trial.

Investigate whether a Home-based Exercise Therapy (HBET) program for patients with Peripheral Arterial Disease (PAD) and Intermittent Claudication (IC) with a behavior change intervention, supported by a smartphone application, is effective in improving walking distances and performance, and quality of life (QoL) over 6 months. This was a single-center, prospective, two-arm, single-blinded randomized controlled trial including 73 patients with PAD and IC, and three assessment moments: baseline, 3, and 6 months. Participants were randomized to receive a walking exercise prescription, with the support (n = 38) or without the support (n = 35) of the WalkingPad app, between January 2021 and July 2022. Both groups received two face-to-face behavior change sessions and 12 structured and targeted reinforcement phone calls over 6 months. Primary outcomes were between-group differences in pain-free walking distance (PFWD), functional walking distance (FWD), maximal walking distance (MWD), and 6-min walk distance (6 MWD) at 3 and 6 months. Secondary outcomes were QoL and walking impairment. Seventy-three patients (mean age 64 ± 7.2 years, 88% men) participated in this study, 60 of whom completed the three assessment moments. The whole sample significantly improved all primary outcomes in the first 3 months; that is, the average PFWD (151.1 m), FWD (175.2 m), MWD (171.1 m), and 6 MWD (30.8 m) increased from T1 to T2. Only MWD exhibited a significant average increase (35.0 m). Secondary outcomes also increased from baseline to 3 and 6 months. There were no between-group differences, except for MWD, which showed a greater increase at 6 months in the group that used the app, excluding patients with weak walking ability and extreme anxiety symptoms at baseline. The intervention improved distances and walking skills as well as the physical, mental, and disease-related quality of life among adults with PAD and IC. The group that used the WalkingPad app improved their MWD in 6 months compared to the control group, except for patients with poor walking ability and extreme anxiety symptoms, which suggests the effectiveness of the WalkingPad app for patients with high walking ability and no severe anxiety symptoms. More research is needed to determine the durability of these findings and to explore what app functionality might promote the other outcomes. https://clinicaltrials.gov (NCT04749732).

COVID-19-related anxiety trajectories in children, young people and adults with rheumatic diseases.

Uncertainty regarding the risk of coronavirus disease 2019 (COVID-19), its complications and the safety of immunosuppressive therapies may drive anxiety among adults and parents of children and young people (CYP) with rheumatic diseases. This study explored trajectories of COVID-related anxiety in adults and parents of CYP with rheumatic diseases. Adults and parents of CYP participating in the international COVID-19 European Patient Registry were included in the current study if they had enrolled in the 4 weeks following 24 March 2020. COVID-related anxiety scores (0-10) were collected weekly for up to 28 weeks.Group-based trajectory models explored COVID-related anxiety clusters in adult and parent populations, with optimal models chosen based on model fit, parsimony and clinical plausibility. Demographic, clinical and COVID-19 mitigation behaviours were compared between identified clusters using univariable statistics. In 498 parents of CYP and 2640 adults, four common trajectory groups of COVID-related anxiety were identified in each cohort: persistent extreme anxiety (32% and 17%), persistent high anxiety (43% and 41%), improving high anxiety (25% and 32%) and improving moderate anxiety (11% and 10%), respectively. Few characteristics distinguished the clusters in the parent cohort. Higher and more persistent anxiety clusters in the adult cohort were associated with higher levels of respiratory comorbidities, use of immunosuppressive therapies, older age and greater self-isolation. COVID-19-related anxiety in the rheumatic disease community was high and persistent during the COVID-19 pandemic, with four common patterns identified. In the adult cohort, higher COVID-related anxiety was related to perceived risk factors for COVID-19 morbidity and mortality.

Functional Connectivity Between Basal Forebrain and Superficial Amygdala Negatively Correlates with Social Fearfulness

Social anxiety is characterized by an intense fear of evaluation from others and/or withdrawal from social situations. Extreme social anxiety can lead to social anxiety disorder. There remains an urgent need to investigate the neural substrates of subclinical social anxiety for early diagnosis and intervention to reduce the risk to develop social anxiety disorder. Twenty-nine young adults were recruited (10 males/19 females; mean age (SD) = 20.34 (2.29)). Trait-like social anxiety was assessed by Liebowitz Social Anxiety Scale. Functional magnetic resonance imaging was used with an emotional face-matching paradigm to probe brain activation in response to emotional stimuli including angry, fearful, and happy faces, with shape-matching as a control condition. Behavioral results showed positive correlations between Liebowitz Social Anxiety Scale scores and the reaction time in both angry and fearful conditions. The activation of superficial amygdala and the deactivation of basal forebrain in response to angry condition showed positive correlations with the level of social anxiety. In addition, the resting-state functional connectivity between these two regions was negatively correlated with the level of social anxiety. These results may help to understand the individual difference and corresponding neural underpinnings of social anxiety in the subclinical population, and might provide some insight to develop strategies for early diagnosis and interventions of social anxiety to reduce the risk of deterioration from subclinical to clinical level of social anxiety.

Comparison Of Handicap Inventory Tinnitus Scores Before and After Intra Tympanic Steroid Injection In Tinnitus Patients

Introduction. Tinnitus is a symptom in the form of a conscious perception of sound that is not produced by a sound source outside the body. Patients with tinnitus often have complaints of quality of life, with some situations of extreme anxiety, depression, and life changes. The Tinnitus Handicap Inventory (THI) is a valid questionnaire to be associated with patients associated with tinnitus. The Tinnitus Research Initiative (TRI), an international academic organization founded in 2006, recommends the use of THI for the evaluation of tinnitus defects and therapeutic effects. Therefore, a THI assessment is needed at RSUP Dr. Mohammad Hoesin Palembang as a result of therapy. Methods. This research using a design that aims to determine the comparison of THI scores before and after intratympanic injection of corticosteroids in 18 samples at RSUP Dr. Mohammad Hoesin Palembang. Results. The average age of the sample was 57 (23-66) years and the number of men and women were the same, namely 9 (50%) samples. Most of the samples had problems in unilateral ears by 14 (77,8%) samples. The average THI before intratympanic steroid injection was 37 (12-72) and after injection was 20 (4-80). Wilcoxon test results showed significant changes between before and after intratympanic steroid injection. Conclusion. There was a significant improvement in THI scores after intratympanic steroid injection.

Association of Eating Disorders in Prenatal and Perinatal Women and Its Complications in Their Offspring.

Numerous studies revealed that women in the first trimester of pregnancy (prenatal) and 6-12 months after delivery of a newborn (postnatal) suffer from eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. Pregnancy may increase or decrease the symptoms of eating disorders. It varies from person to person. The mother faces many complications during this period which may also affect the newborn child. Weight loss is an essential symptom of eating disorders, which may cause extreme anxiety and depression during and after pregnancy. Stress is another symptom that is associated with binge eating disorders. The main aim of this narrative review article is to critically analyze and discuss the association of prenatal and postnatal factors that lead to different eating disorders in the mother and child. A total of 38 published and standard articles were selected for this review. The studies under consideration showed numerous methodological shortcomings, necessitating additional investigation to explain these discrepancies. The evidence points to a connection between prenatal and perinatal variables, and the children of these women also developeating disorders. Earlier research focused on linking pregnancy and eating disorders, mainly emphasizing anorexia nervosa and bulimia nervosa. However, any significant correlation between binge eating disorder and pregnancy is yet to be found. In the first half of pregnancy, about 33%-35% of women who had binge eating disorder before becoming pregnant no longer met the diagnostic criteria, their illness improved, and they seemed to recover. These patients with eating disorders are more likely to have pregnancy-related complications and births. Therefore, creating a multidisciplinary screening strategy and guidelines for managing and supervising this particular patient population makes sense.

THE INFLUENCE OF COUNSELING AND STORYTELLING METHOD ON THE ANXIETY LEVELS OF PRIMARY SCHOOL CHILDREN TO RECEIVE COVID-19 VACCINE

Background: The World Health Organization, WHO explains that sadness and anxiety are the most common mental health problems. Anxiety for children occurs due to the COVID-19 vaccination program by the government may cause uncooperative attitudes. Thus, this situation may lower the children's effectiveness to join learning activities. This research analyzed the influence of counseling with the storytelling method on the anxiety of school learners to receive COVID-19 vaccination in Primary School 03 Bulungcangkring.Method: This research applied a quasi-experimental research design with a pre- and post-test control group approach. The sample consisted of 58 respondents taken with the proportionate stratified random sampling technique. Each group, the intervention, and control group, consisted of 29 respondents. The researchers analyzed the data with paired t-test.Results: The results showed that before the intervention group received the intervention, a percentage of 44.8% of learners were anxious. Then, a percentage of 55.2% of learners experienced extreme anxiety. In the control group side, a percentage of 65.5% of learners experienced moderate anxiety while a percentage of 35.5% of learners experienced extreme anxiety. After administering the counseling to manage the respondents’ anxiety levels, the respondents performed lower anxiety. Some respondents had mild, moderate, and extreme anxiety levels. In the intervention group, a percentage of 10.3% of learners experienced moderate anxiety, a percentage of 41.4% with moderate anxiety, and a percentage of 6.9% of respondents without anxiety level. On the other hand, in the control group, a percentage of 3.4% of respondents experienced mild anxiety, a percentage of 55.2% of respondents with moderate anxiety, and a percentage of 41.4% of respondents with extreme anxiety.Conclusion: The paired t-test results showed the influence of the respondents' anxiety levels in both groups after being treated by counseling with the storytelling method, a p-value of 0.001 &lt; 0.05.

정신건강 사회

This paper deals with how the major issues of public health in the United States played a multifaceted role in enacting the National Health Act of 1946, which was the first enactment of overarching mental health act at the federal level. At the beginning of WWII, the state of mental health system in American society was barely known. However, at the early stage of the war, their Selective Service System (SSS) with the psychiatric screening process based on the lessons of WWI and psychiatric knowledge during the time had failed to sort precisely out unfit soldiers. Luckily, most soldiers suffering from acute symptoms such as extreme anxiety, depression, regression, exhaustion, even numbness or deafness in a short period were able to return to their duty after a few-day convalescence. However, concerns about America’s public mental health problems skyrocketed during and right after the war. As a consequence, the consensus that needed a federal level measure inevitably established. By examining the text of the legislature and the hearings of the House of Representative and the Senate, this study looks into what were the focused problems and concerns in the process of enactment. Around the issue of a federal level of mental health policy, there had been overarching considerations of related fields, including academic, administrative, and even civilian. Looking into the details of each field’s consideration within the Congressional discussion, this paper aims at grasping how the concept of mental illness and disease changed and how the prominent actors of legislatures responded to the changing concept of mental illness. Through detailed examination of the related materials, this study presents the interconnection between the consequences of the great war and the will to maintain American society sane.

The Cult of Our Lady of Fátima—Modern Catholic Devotion in an Age of Nationalism, Colonialism, and Migration

In 1917, in the context of extreme anxiety of a rural Catholic population during a period of war, revolutionary upheaval, and anticlerical politics, the apparition of St Mary to three children near the Portuguese village of Fátima stirred up emotions that have created a cult that is still attracting hundreds of thousands of pilgrims each year and that has found followers all over the world. How did this happen? One has to look at the history of changing meanings related to the cult of Our Lady of Fátima, its integrative energy, and the global spread of the cult. The fact that, most recently, immigrants with Hindu and Muslim background are also among the pilgrims to Fátima speaks of the unpredictable cross-cultural and cross-religious possibilities of this cult, in which gender aspects of a female deity play an important role. This paper will analyze the various periods of the cult from its beginning in 1917 and the roles of secularism, the Salazar regime, Colonialism, the Cold War, and migration from and (later) to Portugal, in order to find insights into a fascinating global cult and how it has changed and adapted to a society that has developed a new attitude towards traditional Catholicism. While the history of the Cult of Fátima has been studied before, this article seeks to introduce a global and, at the same time, long-term historical perspective.

The association between depression and quality of life in the elderly

Abstract Background Depression is the most common cause of emotional disorder in older adults causing functional impairment and leading to lower quality of life (QOL). The aim of the study was to investigate the prevalence of depression, measure the perceived QOL and evaluate the impact of depression on life quality of older people in the community. Methods We conducted a cross-sectional study in older people, enrolled in open day care centers and other healthcare facilities. To all participants the Greek validated version of the Geriatric Depression Scale (GDS-15) was applied to screen for depressive symptoms and the EQ-5D-5L scale to estimate their self-reported health status. Results A total of 634 seniors participated in the study, 53% were females, mean age 78 years. 45.6% of the participants showed moderate to severe depression. Those who suffered from at least two chronic diseases (75.6%) were more likely to develop moderate or severe depressive symptoms compared to those with only one (19.3%) or none (2.2%) chronic disease. Increased risk of depression was observed in people with Parkinson’s disease (56.5%), mental illness (47.1%), respiratory disease (40%) and stroke (35.1%). Regarding the EQ-5D-5L scale, 72% reported slight to extreme anxiety or depression, 68.2% slight to extreme pain or discomfort, 59.8% slight to extreme problems in performing usual activities, 59.8% in mobility and 40.1% in self-care, respectively. Significant differences were found between people with or without depression. Specifically, participants who reported slight to severe problems in all five domains of the EQ-5D-5L, showed higher levels of depression in the GDS-15. Conclusions Our results revealed that elderly with depressive symptoms have a lower quality of life. Given the mutual relationship between chronic diseases, lower life quality and depression, assessment of depressive symptoms are needed in elderly population, mainly in people with multiple chronic diseases. Key messages • Depression can be a predictor of poorer quality of life in older population.

Long-Term Effects of COVID-19, and Its Impact on Business, Employees, and CO2 Emissions, a Study Using Arc-GIS Survey 123 and Arc-GIS Mapping

Further investigation is needed to study the impacts of the COVID-19 lockdown and subsequent lifestyle changes. The global pandemic caused a high degree of uncertainty, leading to extreme anxiety. These feelings were also compounded by the sudden changes in lifestyle at home, within families, work, studies, and recreation. With the end of the lockdown approaching in most regions of the world, many of these lifestyle changes, including work-from-home, might remain for a good percentage of the workforce. The primary objective of this research is to explore employees’ work-from-home model and its impact on commute time, job satisfaction, and carbon footprint. Quantitative variables include data from North America and Global country-specific carbon dioxide (CO2) emissions, and quantitative data, including employee satisfaction, commute time, miles traveled, and more, was collected using ArcGIS Survey123. This research focus on CO2 emissions data, comparing 2019 data (March to May) as a baseline to 2020, 2021, and 2022 (March to May) as the target year. The hypothesis is that the work-from-home order had a significant impact on short-term CO2 reductions and could have potential long-term impacts due to many corporations’ adoption of the “work-from-home” model. The data collected regarding CO2 were analyzed using ArcGIS Pro and Geostatistical Interpolation. This study also explored the potential impacts of this adoption on employee job satisfaction and CO2 emissions reductions based on surveyed employees. Another objective of this research is to look at the relationship between the COVID-19 lockdown with the work-from-home model and the reduction in air emissions, namely CO2.