High Prevalence Of Stress Research Articles

Psychological perturbs among undergraduate medical students of public and private sector universities in Pakistan

Background: Most stressing curricula in the world at present is medical science; excess stress among students lead to a decrease in their performance due to physical as well psychological decline. The study under consideration was done for determination of the psychological stress that is perceived by the undergraduate medical students, to identify the stressors causing stress, domains in which it is more prevalent in students of various medical disciplines in Pakistan. Materials and Methods: A comparative cross-sectional study using Medical Students Stressor Questionnaire was carried on a sample of 300 students of various medical disciplines of public and private universities chosen by convenience sampling. Results: Across the various disciplines of medical education, more stress was found in the DPT students and least in the AHS students. The results reported the prevalence of stress 28.5% in DPT students, 24.2% in MBBS students, 23.7% in DHND students, and 23.6% in AHS students. Among the sectors, more stress level was found in public sector university students (77.6%) than private sector students (22.4%). The stressors causing more stress among the undergraduate medical students were identified to be the group activity-related stressor and social activity- related stressor. Conclusion: The study showed that the high prevalence of stress was found to be in the DPT students followed by the MBBS, DHND, and AHS. Stress was more prevalent in public sector medical students as compared to the private sector.

Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study.

IntroductionA high prevalence of stress has been recorded among medical students worldwide. Additionally, high levels of personal distress may have a negative effect on the cognitive functioning and learning abilities of medical students.MethodsA cross-sectional study was conducted using medical students in the Al-Anbar governorate; data collection was carried out from February to March 2018. The assessment of stress levels among these students was administered using the Kessler10 Psychological Distress instrument (K10).Results231 students (77.5%) reported at least some degree of stress, ranging between severe (30.2%), moderate (25.5%) and mild (21.8%). The highest proportion of students with stress (11.5%) was reported by first-year students; this proportion largely fell within the moderate and severe categories. There was a significant statistical association between gender and stress level.ConclusionThere is a high level of stress among medical students in Falluja and Anbar Universities; this may require special programmes to identify any predisposing factors.

Improving Resiliency in Healthcare Employees.

The high prevalence of stress at the workplace has been well documented; however, few studies have investigated the efficacy of worksite resiliency programs. Therefore, the objec- tive of this project was to examine the impact of a worksite resilience training program on improving resiliency and health behaviors in healthcare employees. Between 2012 and 2016, 137 adult wellness center members of a healthcare institution participating in a single-arm cohort study of a 12-week resiliency training program were assessed at baseline, end of intervention, and at 3-month follow-up. Statistically significant (p ≤ .01) improvements were seen at the end of the intervention and extending to 3 months follow-up for resiliency, perceived stress, anxiety level, quality of life, and health behaviors. These results support the premise that worksite programs designed to improve resiliency in healthcare employees have efficacy in improving resiliency, quality of life and health behaviors. Given the importance of stress and burnout in healthcare employees, future randomized studies are warranted to determine more clearly the impacts of this type of resiliency intervention for improving the wellness of healthcare workers.

Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome.

Background:Stress is an invisible factor affecting modern day living and is strongly associated with many disease pathogenesis including polycystic ovarian syndrome (PCOS) in women. PCOS is the most frequent endocrinological disorder that affects women of reproductive age, leading to metabolic dysfunction and body composition alterations. Salivary amylase and cortisol are major stress mediators that have been implicated in PCOS. However, their role in altering body composition in PCOS is yet to be deciphered.Aim:The present study aimed at understanding the relation between stress-associated factors and alterations in body composition among PCOS patients.Design:This study enrolled a total of 100 patients (PCOS) and 60 age-matched controls. The female patients were of ages between 13 and 30 years.Materials and Methods:Standard assay kits were used to evaluate the α-amylase activity and cortisol level in saliva. The participants were chosen on the basis of the Rotterdam American Society for Reproductive Medicine/European Society of Human Reproduction criteria. Saliva was collected from each participant as per the protocol of Salimetrics, USA.Statistical Analysis:Statistical analysis was performed using SPSS version 20 for Windows. The quantitative variables are described as mean ± standard deviation. P < 0.05 was considered significant.Results:Increased salivary cortisol level and α-amylase activity were seen in the PCOS population as compared to age-matched controls suggesting patients a sustained stress scenario in their system. Moreover, overweight PCOS participants reflected higher amylase activity than the lean patients participants. Pulse rate, body mass index (BMI), visceral adiposity, and waist-hip ratio (WHR) was considerably higher in the PCOS patients participants compared to controls. A significant correlation could be drawn between the α-amylase activity and BMI or WHR, respectively, among PCOS patients. These observations indicate a strong link between the stress marker and alterations in the body composition parameters of PCOS patients participants.Conclusion:Higher prevalence of stress in PCOS patients participants has a critical role in their altered body composition.

Work-related stress assessment among a garment factory employees in Bangalore suburban locality

Background: India's Garment Industry has been rapidly growing in last few years. The Garment Industry is of major importance to the Indian economy as it contributes substantially to India's export earnings. Thus employees working in the above sociological context of working life are expected to be affected by the general acceleration of the pace of life, contributing to work intensification and constant time pressure. Managers play a key role in reducing the significant sources of stress and shaping the future of employees. Thus the above study was undertaken among managers and supervisory level staff. The objectives of the study were to estimate the magnitude and level of work-related stress and to find the association of socio-demographic factors with work-related stress in garment manufacturing factory. Methods: A cross-sectional study was undertaken for 4 months, from October 2015 to January 2016, in a selected garment factory, located in the periphery of Bangalore city. A total of 167 supervisors and 41 managers, were included in the study. Stress was assessed by using ‘Tool to assess and classify work stress and associated symptoms’, developed by Centre for public health, NIMHANS. Results: Prevalence of work-related stress was 26% (95% CI; 18.04-26.36). Managers had higher prevalence of stress (29.3%) when compared to supervisors (25.1%). Majority of managers were perceived to have moderate stress level (58.4%) when compared to supervisors (26.10%). Among all the socio-demographic factors; age, total monthly income, travel time and mode of transport were significantly associated with work-related stress (p&lt;0.05). Conclusions: Organization changes viz., effort-reward imbalances, needs to be corrected and appropriate transport facilities meeting the employee requirements have to be provided, to cope up stress associated with travelling.

Związki między stresem, zmęczeniem i zaburzeniami snu a zachowaniami dotyczącymi zdrowia jamy ustnej u studentów stomatologii – zmiany w ciągu roku akademickiego

Background. Stress, fatigue and sleep disturbances are common among university students and they have an impact on their personal health. The prevalence as well as the influence of these factors on oral health-related behaviors are likely to vary during the academic year.Objectives. The objective of this study was to evaluate the prevalence of symptoms related to stress, fatigue and sleep disturbances among dental students during the academic year and to investigate whether these symptoms are associated with oral health-related behaviors.Material and Methods. The prospective study surveyed dental students from Vilnius University, Institute of Odontology at the beginning of the academic year (September) and during the examination period (December). The questionnaire given was individually coded and consisted of Fatigue Assessment Scale, Karolinska Sleep Questionnaire, Reeder Stress Assessment Scale and questions assessing self-reported oral health-related behaviors. Out of 121 dental students, 92 students completed the questionnaire both times and were included in the study (dropout rate – 8.9%, response rate – 76%).Results. Correlations were found among disturbed sleep, insufficient amount of sleep, poor sleep quality and several oral health-related variables: tooth brushing frequency, flossing frequency, the use of a single-tuft toothbrush and a tongue cleaner (p < 0.05). Compared to the beginning of the academic year, a significant increase in the number of students suffering from difficulties waking up in the morning (from 52 (56.5%) to 63 (68.5%), p = 0.027), daytime sleepiness (from 19 (20.7%) to 34 (37%), p = 0.008), sleep quality disorders (from 9 (9.8%) to 25 (27.2%), p = 0.002) as well as perceiving fatigue (from 22 (23.9%) to 48 (52.2%), p < 0.001) and stress (from 31 (33.7%) to 54 (58.7%), p < 0.001) was observed during the examination period. Increased prevalence of these factors was related with insufficient oral health-related behavior.Conclusion. This study revealed that oral health-related behaviors worsen when there is a higher prevalence of stress, fatigue and sleep disturbances.

Prevalence, Sources and Severity of Stress among New Undergraduate Medical Entrants

Objectives: The past decade has seen a globally increasing trend in the prevalence of stress among medical students. The objectives of our study were to assess stress prevalence, sources of stress and their severity and to assess the determinants of stressed cases in new undergraduate medical entrants. Methods: Two hundred and fourteen students (M=130, F=84), who had just completed their first week in the institute, participated voluntarily in a cross-sectional, self-administered questionnaire based study. After collecting demographic data, the prevalence of stress was assessed using the 12 item General Health Questionnaire (GHQ-12) and sources of stress and their severity by the 40 item Medical Students Stressor Questionnaire (MSSQ). Results: Demographic characteristics of male and female participants were comparable. Prevalence of stress was 42.1% (M=27% F=17%) of which almost 8% had severe stress. The severity of academically related stressors was found to be the highest among medical students, with approximately one-third (34.1%) of the participants perceiving them to be causing high or severe stress. Self rated severity of all other stressor domains was either mild or moderate in more than 85% of the participants. There was a significant correlation of GHQ with total MSSQ scores (r=0.48, p Conclusion: Considerably high prevalence of stress was self-reported by new medical undergraduate entrants. Academic related factors were greater sources of stress when compared to non-academic factors in these participants.

Occupational Stress in Health Professionals of Combined Military Hospitals

Introduction: Stress is a term that is widely used in everyday life. Work-related stress is recognized globally as a major challenge to workers’ health and the health of an organization. Stress at work has become a serious problem affecting many people of different professions, life situation and age groups. The healthcare profession has been depicted as one of the most stressful occupations across the globe.&#x0D; Objective: To assess the extent of occupational stress among health professionals of Combined Military Hospitals and to explore its association with work-related factors and family-work interference.&#x0D; Materials and Methods: A total of 574 respondents were selected from five Combined Military Hospitals using simple random sampling considering doctors, nurses, paramedic medical assistants and technologists as the study population. Occupational stress was determined by Health Professions Stress Inventory (HPSI).&#x0D; Results: Stress of health professionals was reassessed through HPSI and 1.0%, 77.6%, 20.7% and 0.8% were found to be mild, moderate, very and extremely stressful respectively. About one fifth (21.4%) were found to be in high stress. High stress was more prevalent among Paramedic Medical Assistants (PMAs) (24.5%), Paramedic Medical Technologists (PMTs) (23.2%) and nurses (21.9%) on contrary to doctors (11.7%). Their mean stress scores were 55.70±13.75, 55.44±13.53, 56.18±10.55 and 50.92±10.93 respectively (p&lt;0.05) out of 124. Highest stress was in CMH Dhaka (56.50±14.27) followed by CMH, Rangpur (53.43±11.65) (p&lt;0.05). The mean work hour per week for doctors, nurses, PMAs and PMTs were 63.25(±18.95), 55.70(±9.72), 89.58 (±17.44) and 80.58 (±16.12) hours respectively (p&lt;0.05). Working for long/unsociable or unpredictable hours, financial and job insecurity were found to be related to the greater prevalence of high stress (p&lt;0.05). The parameters of pressures at work, job satisfaction and support from colleagues/superior were found to be associated with high stress (p&lt;0.05). Higher prevalence of family-work interference was found to be a predictor of high stress (p&lt;0.05).&#x0D; Conclusion: A large proportion health professional of Combined Military Hospitals were in high stress due to the prime stressors. Measures like workload-management, job-redesign, employee motivation and training should be taken to alleviate these stressors.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 37-41

High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment

Background/Aims: Subjective cognitive impairment (SCI) is a trigger for seeking health care in a possible preclinical phase of Alzheimer's disease (AD), although the characteristics of SCI need clarification. We investigated the prevalence of psychosocial stress, depressive symptoms and CSF AD biomarkers in SCI and MCI (mild cognitive impairment). Methods: Memory clinic patients (SCI: n = 90; age: 59.8 ± 7.6 years; MCI: n = 160; age: 63.7 ± 7.0 years) included in the Gothenburg MCI study were examined at baseline. Variables were analyzed using logistic regression with SCI as dependent variable. Results: Stress was more prevalent in SCI (51.1%) than MCI (23.1%); p < 0.0005. SCI patients had more previous depressive symptoms (p = 0.006), but showed no difference compared to MCI patients considering current depressive symptoms. A positive CSF AD profile was present in 14.4% of SCI patients and 35.0% of MCI patients (p = 0.001). Stress (p = 0.002), previous stress/depressive symptoms (p = 0.006) and a negative CSF AD profile (p = 0.036) predicted allocation to the SCI group. Conclusion: Psychosocial stress is more prevalent in SCI than previously acknowledged. The high prevalence and long-term occurrence of stress/depressive symptoms in SCI in combination with a low prevalence of altered CSF AD biomarkers strengthens the notion that AD is not the most likely etiology of SCI.

Identifying the Dominant Personality Profiles in Medical Students: Implications for Their Well-Being and Resilience.

PurposeThere is a high prevalence of stress, depression, and burn-out in medical students. Medical students differ widely in personality traits, self-perceptions, and values that may have an impact on their well-being. This study aimed to investigate variability in their personality profiles in relation to their potential for well-being and resilience.MethodParticipants were 808 medical students from The University of Queensland. An online questionnaire collected socio-demographics and the Temperament and Character Inventory to assess personality traits. Latent profile analyses identified students’ trait profiles.ResultsTwo distinct personality profiles were identified. Profile 1 (“Resilient”) characterized 60% of the sample and was distinguished by low Harm Avoidance combined with very high Persistence, Self-Directedness and Cooperativeness compared to Profile 2 ("Conscientious"). Both Profiles had average levels of Reward Dependence and Novelty Seeking and low levels of Self-Transcendence. Profiles did not differ by age, gender, or country of birth, but rural background students were more likely to have Profile 1. While both Profiles indicate mature and healthy personalities, the combination of traits in Profile 1 is more strongly indicative of well-being and resilience.ConclusionsFinding two distinct profiles of personality highlights the importance of considering combinations of traits and how they may interact with medical students’ potential for well-being. Although both profiles of students show healthy personalities, many may lack the resilience to maintain well-being over years of medical training. Programs that develop character and personality self-awareness would enhance their well-being and prepare them to promote the health of their patients.

The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study.

Studies have shown that psychosocial stressors are related to poor sleep. However, studies of African Americans, who may be more vulnerable to the impact of psychosocial stressors, are lacking. Using the Jackson Heart Study (JHS) baseline data, we examined associations of psychosocial stressors with sleep in 4,863 African Americans. We examined cross-sectional associations between psychosocial stressors and sleep duration and quality in a large population sample of African Americans. Three measures of psychosocial stress were investigated: the Global Perceived Stress Scale (GPSS); Major Life Events (MLE); and the Weekly Stress Inventory (WSI). Sleep was assessed using self-reported hours of sleep and sleep quality rating (1 = poor; 5 = excellent). Multinomial logistic and linear regression models were used to examine the association of each stress measure (in quartiles) with continuous and categorical sleep duration (< 5 ("very short"), 5-6 h ("short") and > 9 h ("long") versus 7 or 8 h ("normal"); and with sleep quality after adjustment for demographics and risk factors (body mass index, hypertension, diabetes, physical activity). Mean age of the sample was 54.6 years and 64% were female. Mean sleep duration was 6.4 + 1.5 hours, 54% had a short sleep duration, 5% had a long sleep duration, and 34% reported a "poor" or "fair" sleep quality. Persons in the highest GPSS quartile had higher odds of very short sleep (odds ratio: 2.87, 95% confidence interval [CI]: 2.02, 4.08), higher odds of short sleep (1.72, 95% CI: 1.40, 2.12), shorter average sleep duration (Δ = -33.6 min (95% CI: -41.8, -25.4), and reported poorer sleep quality (Δ = -0.73 (95% CI: -0.83, -0.63) compared to those in the lowest quartile of GPSS after adjustment for covariates. Similar patterns were observed for WSI and MLE. Psychosocial stressors were not associated with long sleep. For WSI, effects of stress on sleep duration were stronger for younger (< 60 y) and college-educated African-Americans. Psychosocial stressors are associated with higher odds of short sleep, lower average sleep duration, and lower sleep quality in African Americans. Psychosocial stressors may be a point of intervention among African Americans for the improvement of sleep and downstream health outcomes.

PERCEIVED STRESS AND ASSOCIATED FACTORS AMONG UNDERGRADUATE STUDENTS OF FACULTY OF PUBLIC HEALTH, HUE UNIVERSITY OF MEDICINE AND PHARMACY

Background: With the development of risk factors in modernizing the education system in Vietnam, stress among students is gradually increasing. Especially, among medical students there has been a high demonstration of stress. The main aim of this study was to identify associated factors of stress among first year undergraduate students of the Faculty of Public Health of Hue UMP. Methods: A cross-sectional survey was conducted with a total sample of 209 first year undergraduate students of the Faculty of Public Health, Hue UMP. Data collection was undertaken using self-admistrative structured-questionnaire, which included five main parts: demographic characteristics, personal relationships; factors related to hobbies and studies; factors related to the study environment; and stress situation of students. Stress situation was measured using the perceived stress scale (PSS-14 items). The cut off point of 30 and above was used to identify the situation of high stress among the students. Chi-square test with 95% CI and mutiple logistic regression were implemented to examine factors related to high stress situation. Results: The percentage of high stress among students was 24.9%. The proportion of high stress of female students was 2 times higher than male students (OR= 2.3; 95%CI: 1.10 – 4.83). Students who lived in other provinces had a 2.8 times higher prevalence of high stress compared to those from Thua Thien province (OR=2.83; 95%CI: 1.19 – 6.73). Related factors of high stress status included: (1) personal relationships (having close friends or not, difficulty in relationships with friends, difficulty in social activities) and (2) factors related to study environement (academic stress; aspiration of retaking the enrollment examination of entering university, difficulty in finding reference documents for study, difficulty of approaching new learning methods). Conclusion: High stress situation was common among first year undergraduate. Personal relationship and factors related to study environement were significantly associated with high stress situation among the students. Key words: Stress, Public Health, undergraduate first year student, Hue UMP

Factors influencing excessive daytime sleepiness in adolescents

ObjectiveSleep deprivation in adolescents has lately become a health issue that tends to increase with higher stress prevalence, extenuating routines, and new technological devices that impair adolescents’ bedtime. Therefore, this study aimed to assess the excessive sleepiness frequency and the factors that might be associated to it in this population. MethodsThe cross‐sectional study analyzed 531 adolescents aged 10–18 years old from two private schools and one public school. Five questionnaires were applied: the Cleveland Adolescent Sleepiness Questionnaire; the Sleep Disturbance Scale for Children; the Brazilian Economic Classification Criteria; the General Health and Sexual Maturation Questionnaire; and the Physical Activity Questionnaire. The statistical analyses were based on comparisons between schools and sleepiness and non‐sleepiness groups, using linear correlation and logistic regression. ResultsSleep deprivation was present in 39% of the adolescents; sleep deficit was higher in private school adolescents (p<0.001), and there was a positive correlation between age and sleep deficit (p<0.001; r=0.337). Logistic regression showed that older age (p=0.002; PR: 1.21 [CI: 1.07–1.36]) and higher score level for sleep hyperhidrosis in the sleep disturbance scale (p=0.02; PR: 1.16 [CI: 1.02–1.32]) were risk factors for worse degree of sleepiness. ConclusionsSleep deficit appears to be a reality among adolescents; the results suggest a higher prevalence in students from private schools. Sleep deprivation is associated with older age in adolescents and possible presence of sleep disorders, such as sleep hyperhidrosis.

Association of family stress with other psychosocial factors in female population 25–64 years in Russia: WHO program MONICA-psychosocial

AimTo explore association of family stress with other psychosocial factors in female population aged of 25–64 years in Russia.MethodsUnder the third screening of the WHO “MONICA-psychosocial” program random representative sample of women aged 25–64 years (n = 870) were surveyed in Novosibirsk. Questionnaire “Awareness and attitude towards the health” was used to estimate levels of family stress. Chi-square (χ2) was used for assessment of statistical significance.ResultsThe prevalence of high family stress level in women aged 25–64 years was 20.9%.High family stress was higher in age groups 25–34 years and 45–54 years: 27.6% and 30.5%, respectively. Among women with family stress, 58.7% had high level of trait's anxiety. Women with stress at family had high rate of major depression (11%). There were tendencies of higher prevalence of hostility and vital exhaustion in those with stress (41.1% and 27.4%, respectively). Among those in female population with stress at family, 60.6% had sleep disturbances. Social support like close contacts and social network tended to be lower in women with family stress: 59.1% and 80.3%, respectively. Rates of serious conflicts in family were more often in younger age groups and reached 48.6%. In women aged 25–34 years, 54.9% have no possibilities to have a rest at home after usual working day (P &lt; 0.001).ConclusionsThe prevalence of high stress in family in female population aged 25–64 years is more than 20% in Russia. High family stress closely associated with anxiety, major depression, high hostility and vital exhaustion, poor sleep and low social support.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Financial stress during medical residency training: an experience from Iran.

Dear editor We have read with great interest the article by Abdulghani et al,1 in which they well documented the high prevalence of stress among the Saudi Arabian medical residents and its effects on their working efficacy and general physical health during the residency training. This important issue similarly applies in Iran. Previous surveys performed on the Iranian resident trainees revealed the increased levels of psychological and emotional disorders such as depression, anxiety, and stress among them.2–4 There are several stressors such as difficult patients, job dissatisfaction, and large number of exams, which can have negative effects on the mental health status of medical residents during their training programs.5,6 However, among the Iranian medical residents, financial problem is other most important concern that has been less discussed by the policy makers. In Iran, unfortunately, the monthly income of residents of all medical specialties is very inadequate and this forces them to think about another work besides studying for subsistence,7 whereas educational policies, like most of the countries, interdict residents from working out of their learning environment and this take many occupational opportunities from them. On the other hand, the health care reform that has been recently implemented in Iran is associated with increased referring of the patients and working pressure of the residents, without increasing their income. This problem is more considerable for residents of more stressful specialties such as general surgery, neurosurgery, and orthopedics. Heavy workload and low income can provide serious stressful conditions for Iranian resident trainees and gradually this can be associated with burnout and dissatisfaction and have a serious negative effect on their professional functions. Therefore, it is necessary that Iranian authorities ordain the policies in order to improve the educational and financial status of residents during their residency programs, especially for more stressful specialties.

Mental health and future doctors: a cross-sectional study

Background: Stress may occur while pursuing a career in medical education, as it is a training that involves emotions. Medical professionals are found to experience stress, especially the medical students who are mostly occupied with a tight schedule. The stress experienced by the students leads to negative consequences on their academic performances and psychological well-being. Objective: To determine the level of stress and depression among the first-year medical students and to explore the sources of stress and depression. Materials and Methods: About 300 first-year MBBS students were selected for the study. The students were informed and explained about the nature of the study. General Health Questionnaire 12 and the Beck’s depression inventory were given to each participant to assess the stress and depression levels. Students were asked in detail about the academic and nonacademic problems. The responses were recorded. Data were analyzed using SPSS software. Result: Among the 300 medical students, 128 (42.33%) students revealed stress and 79 (26.33%) of them showed depression. The remaining 94 did not show stress/depression. The stress in female subjects was more (60.93%) when compared with male subjects (39.08%). The depression was also found to be more in female subjects (54.43%) when compared with male subjects (45.56%), but the results were not statistically significant. Conclusion: This study concluded that there is a high prevalence of stress and depression among medical students. Female subjects showed high prevalence then male subjects. Academic and nonacademic problems were contributing more to develop stress and depression.

Prevalence of perceived stress among clinical students of Bayero University Medical School

Background: The academic and psychological demands of undergraduate medical education may result in high-stress levels among students. High stress has been associated with poor academic performance, negative impact on physical and mental health. This study aims to determine the prevalence of stress among undergraduate clinical students of Bayero University Kano Medical School. Materials and Methods: This was a cross sectional study conducted among 224 clinical medical students from levels 400–600. The Cohen's Perceived stress scale (PSS-10) was used to assess the severity of among the students. The Chi-square test was used to determine associations and a significant association was considered at P Results: A prevalence of high stress of 59.8% was observed with a mean PSS score of 20.76 ± 5.58. The highest mean score of 22.29 ± 5.58 was observed among 400 level clinical students. There was no significant difference between both genders. A significantly higher proportion of students undergoing medicine, pathology, paediatrics and surgery postings were observed to be experiencing a higher level of perceived stress compared to those in Obstetrics and Gynaecology, ( χ 2 = 1617, df = 4, P χ 2 = 5.54, df = 1, P Conclusion: Further studies to determine the causes of stress need to be carried out. This will assist the students and teachers to appropriately manage stress.

Factors influencing excessive daytime sleepiness in adolescents

ObjectiveSleep deprivation in adolescents has lately become a health issue that tends to increase with higher stress prevalence, extenuating routines, and new technological devices that impair adolescents’ bedtime. Therefore, this study aimed to assess the excessive sleepiness frequency and the factors that might be associated to it in this population. MethodsThe cross-sectional study analyzed 531 adolescents aged 10–18 years old from two private schools and one public school. Five questionnaires were applied: the Cleveland Adolescent Sleepiness Questionnaire; the Sleep Disturbance Scale for Children; the Brazilian Economic Classification Criteria; the General Health and Sexual Maturation Questionnaire; and the Physical Activity Questionnaire. The statistical analyses were based on comparisons between schools and sleepiness and non-sleepiness groups, using linear correlation and logistic regression. ResultsSleep deprivation was present in 39% of the adolescents; sleep deficit was higher in private school adolescents (p<0.001), and there was a positive correlation between age and sleep deficit (p<0.001; r=0.337). Logistic regression showed that older age (p=0.002; PR: 1.21 [CI: 1.07–1.36]) and higher score level for sleep hyperhidrosis in the sleep disturbance scale (p=0.02; PR: 1.16 [CI: 1.02–1.32]) were risk factors for worse degree of sleepiness. ConclusionsSleep deficit appears to be a reality among adolescents; the results suggest a higher prevalence in students from private schools. Sleep deprivation is associated with older age in adolescents and possible presence of sleep disorders, such as sleep hyperhidrosis.

Stress, depression, quality of life and salivary cortisol levels in community health agents.

To determine the prevalence of and factors associated with depression and stress with perceived quality of life and the salivary cortisol levels in Community Health Agent (CHA). Materials and Methods Cross-sectional descriptive study of CHAs in Pelotas-RS, Brazil. Data collection, including sociodemographic information and factors related to work and health. Beck Depression Inventory (BDI) II was used to assess depressive symptoms, Inventory of Stress Symptoms Lipp (ISSL) was used for the analysis of stress and the WHOQOL-BREF was used to investigate quality of life. Salivary cortisol was quantified via ELISA test. The assessments showed that 71.0% are in a state of stress resistance, 30.5% were in the alert state of stress and 32.8% were in the stress state of exhaustion. Depressive episodes (BDI≥12) were observed in 28.2%. The environmental domain had the lowest score for quality of life. We observed significantly higher salivary cortisol levels in CHAs with less than 1 year of service and with the lowest quality of life scores in the environmental subsection. A high prevalence of stress and depression was observed in this sample of CHAs. In addition, the worst levels of quality of life were identified in the environmental subsection. Cortisol levels corroborate these findings regarding quality of life within the environmental domain and began working less than a year previously.

Overexpression of GRP78 confers protection against neurocognitive impairment in HIV-infected polydrug users

Aims: Due to the high prevalence of stress and neurocognitive impairment (NCI) in HIV infected and drug abuse patients worldwide, there is a need to study these disorders and their impact on the immune response. We hypothesize that HIV polydrug users (PDU) will have greater impact in stress and NCI leading to Endoplasmic Reticulum (ER) stress related T-lymphocyte protein and pro-inflammatory cytokine expression. To test this hypothesis, we will (1) identify stress levels and cytokine profiling in NCI in HIV+ and HIV−PDU, (2) detect biomarkers associated with NCI, stress and HIV polydrug use. Methods: The initial population analysis in this study was: 10 HIV+PDU+ and 10 HIV−PDU+. NCI and stress were respectively measured physiologically (homocysteine and cortisol levels) and psychologically (MOCA, IHDS andmodified PERI scale) in HIV+PDU. Immunoproteomics and flow cytometry were used to detect ER stress markers and cytokine profiling. Gene expression and western blots were used to validate the ER stress gene and protein expression. Results: HIV+PDU+ had elevated cortisol levels (1.25 g/dL) as compared to HIV−PDU+ (0.107 g/dL). Moreover, HIV+PDU+ with no NCI had an increase expression of proinflammatory cytokines. Immunoproteomics revealed the overexpression of ER stress marker GRP78 in HIV+PDU+NCI− participants. To compare significant differences between the HIV+PDU+NCI−/NCI+ groups, two-way ANOVA statistical analysis with 0.05 p value was used. Conclusions: Our findings showed that HIV infection in PDU contributes negatively in NCI, moreover, identification of GRP78 overexpression in HIV+PDUswith no NCI highlights its cytoprotective role and the identification of ER stress markers that may serve as candidates for early diagnostic of NCI HIV+, and polydrug use. Financial support:NIH andNIMHD (G12MD007583) (N Boukli) to the Universidad Central del Caribe) and K05DA015799 (J.C. Anthony, sponsor) to Michigan State University.