Initial Anxiety Research Articles

Osteopathic correction effect on anxiety and depression level according to HADS scale in children with various forms of epilepsy

Introduction.Epilepsy is a chronic brain disease, which treatment consists of relieving the seizures with the help of constant long-term use of anti-epileptic drugs. This, in turn, can cause various negative effects on the body. Epilepsy is not a single disease with various attacks, it is a whole spectrum associated with comorbid conditions, including anxiety and depression. Additional medication is suggested to correct this. Therefore, developing the effective drug-free methods with the help of osteopathic treatment to correct anxiety and depression in epilepsy complex therapy received priority.Goal of research— to study the osteopathic treatment potential to reduce anxiety and depression levels in children with various forms of epilepsy.Materials and methods.The study included 72 children with various forms of epilepsy, aged from 7 to 17 years, 35 girls, 37 boys. The selection criteria were as follows: at least 1 year of epilepsy course duration, no status or serial course of epileptic seizures, no motor and cognitive deteriorations, all children studied in public schools. All children received osteopathic treatment for 2 months, along with medical treatment. Before and after treatment, each patient′s anxiety and depression levels were assessed according to the Hospital Anxiety and Depression Scale (HADS), along with an osteopathic examination.Results.All children taken in the study revealed a range of somatic dysfunctions of craniosacral system, skull and reciprocal tension membranes, with biomechanical abnormality. By initial testing, anxiety and depression average values according to HADS scale were above normal in all children. After osteopathic treatment, a statistically signifi cant decrease in anxiety and depression levels was found.Conclusion. Osteopathic treatment is effi cient for epilepsy complex therapy in children. It helps to reduce drug load in correction of anxiety and depression that accompany the underlying disease.

Interaction Effect Of Dual N-Back Working Memory Training And Anxiety Levels On L2 Writing Performance

Burgeoning interest in the role of working memory (WM) in most cognitive endeavors has led to an increase in WM training programs. Within the field second language writing, however, WM improvement interventions are scarce, and even scarcer is research into how other variables interactwith WM in their effect on performance. Hence, this study examines how anxiety, often believed to be an impediment for both WM and writing, moderates the effect of WM training on writing. Learners’ (N=80) writing performance was assessed before and after Dual N-back training. Anxiety levels were examined for any interaction with the intervention. Results from ANCOVA, Pearson’s correlation, and Two-Way ANOVA have revealed that writing anxiety is significantly correlated with writing performance and that the treatment group outperformed the control group even after controlling for both initial performance and anxiety levels. The findings indicate that there is a significant anxiety-treatment interaction effect on writing performance

Results of a clinical study of a new anxiolytic, a blocker of central cholecystokinin receptors

To evaluate anxiolytic action of GB-115, a low-affinity blocker of central cholecystokinin receptors, used in tablets in a dose of 1 mg for the treatment of patients with anxiety disorders in order to determine effective dose, safety, tolerability and efficacy in clinical settings. The study included 31 patients (22 women, 9 men) diagnosed with generalized anxiety disorder (GAD, F41.1 according to ICD-10), aged from 22 to 53 years. The duration of treatment was 21 days. The Hamilton Anxiety Rating scale, Psychopathologic symptoms severity evaluation scale (PSSES), Spilberger State-Anxiety Inventory, Multidimensional Fatigue Inventory (MFI), Clinical Global Impression scale (CGI), computerized battery for evaluation of cognitive functions ('NS-Psychotest') were used. The effective dose of GB-115 was determined at 6 mg per day. Drug action is characterized by fast onset of anxiolytic effect with stimulating properties and beneficial effect on sleep disturbances and autonomic symptoms. GB-115 treatment was associated with favorable changes in attention parameters, reaction time and overall performance. In contrast to first-line drugs for GAD treatment (SSRIs and SNRIs), GB-115 does not induce initial overactivation, anxiety and sleep disturbances. GB-115 is safe and has a good tolerability.

Effects of live music therapy on heart rate variability and self-reported stress and anxiety among hospitalized pregnant women: A randomized controlled trial

ABSTRACTIntroduction: This study aims to evaluate the effects of live music therapy on heart rate variability (HRV) and self-reported stress and anxiety among hospitalized women with high-risk pregnancies. A total of 102 women at an antenatal ward due to pregnancy-related complications participated in a randomized controlled trial.Methods: The participants were randomly assigned to a music therapy group (N = 52) or control group (N = 50). The women in the music therapy group received live music therapy on three consecutive days, for half an hour at a time. The participants belonging to the control group were instructed to rest for equally long time periods. The physiologic stress of the participants was assessed using HRV measures. The participants also rated their perceived stress and anxiety. The physiologic stress of the participants was assessed using 12 HRV measures.Results: The SD2 measure of HRV increased significantly more in the music therapy group than in the control group during the therapy sessions. Moreover, the low frequency (LF) HRV measure decreased during the three-day therapy period. The self-reported stress was not significantly altered after the intervention. For women with high initial self-reported anxiety in both groups, their anxiety was significantly reduced during the three-day period.

Distress and Therapeutic Outcomes Among Transgender and Gender Nonconforming People of Color

Transgender and gender nonconforming (TGNC) People of Color experience stressors unique to both TGNC and racial and/or ethnic minority communities, resulting in disparities in mental health. Guided by minority stress and intersectionality theories, we examined initial anxiety and depression, as well as changes in symptoms, in 41,691 clients from the Center for Collegiate Mental Health 2012–2016 dataset. We sought to understand disparities that may exist in distress and therapeutic response between TGNC and cisgender clients. We also examined the intersection of gender and racial and/or ethnic identities to examine how these trends differ for TGNC People of Color. Results from hierarchical linear modeling indicated greater symptom severity, but a slower remission of symptoms of depression and anxiety, among TGNC clients. Interaction effects were nonsignificant; however, TGNC Clients of Color experienced more distress than either White TGNC clients or cisgender Clients of Color. On average, TGNC clients, compared to cisgender clients, utilized an additional 2.5 sessions of therapy.

Parent-Rated Severity of Illness and Anxiety among Caregivers of Children Born with a Disorder of Sex Development Including Ambiguous Genitalia

Background/Aims: Parents of children born with disorders of sex development (DSD) often experience anxiety, but risk factors, including parental perception of the severity of their child’s DSD, have not been examined. We hypothesized that severity of illness (SOI) ratings would relate to parental anxiety, and would be higher for parents of children with a potentially life-threatening DSD (e.g., 21-hydroxylase deficiency). Methods: Eighty-nine parents (M_age = 33.0, 56.2% mothers) of 51 children (M_{age in months} = 8.7) with a DSD including ambiguous genitalia were recruited from 12 specialized DSD clinics. Parents completed questionnaires prior to genitoplasty, 6 months post-genitoplasty, and 12 months post-genitoplasty (if completed). Data were analyzed with linear mixed modeling. Results: Parental anxiety decreased over time, χ²(1) = 10.14, p < 0.01. A positive relationship between SOI and anxiety was found, with SOI being a strong predictor of anxiety (b = 0.53, p < 0.01; χ²[1] = 5.33, p < 0.05). An SOI by time interaction indicated SOI had an increasing effect on anxiety over time, b = 0.06, p < 0.05; χ²(1) = 6.30, p < 0.05. There was no diagnosis by SOI interaction. Conclusion: Parental anxiety decreased over time, but those with higher SOI ratings reported greater initial anxiety followed by slower resolution over time. Underlying etiology of DSD had no effect on the relationship between SOI and anxiety.

Differences in Anxiety Levels of Various Murine Models in Relation to the Gut Microbiota Composition.

Psychobiotics are probiotic strains that confer mental health benefits to the host through the modulation of the gut microbial population. Mounting evidence shows that the gut microbiota play an important role in communication within the gut–brain axis. However, the relationship between the host genetics and the gut microbiota and their influence on anxiety are still not fully understood. Hence, in our research, we attempted to draw a connection between host genetics, microbiota composition, and anxiety by performing an elevated plus maze (EPM) test on four genetically different mice. Four different breeds of 5-week-old mice were used in this experiment: Balb/c, Orient C57BL/6N, Taconic C57BL/6N, and Taconic C57BL/6J. After 1 week of adaptation, their initial anxiety level was monitored using the EPM test via an EthoVision XT, a standardized software used for behavorial testing. Significant differences in the initial anxiety level and microbial composition were detected. Subsequently, the microbiota of each group was modulated by the administration of either a probiotic, fecal microbiota transplantation, or antibiotics. Changes were observed in host anxiety levels in correlation to the shift of the gut microbiota. Our results suggest that the microbiota, host genetics, and psychological symptoms are strongly related, yet the deeper mechanistic links need further exploration.

Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension.

Out-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement. To investigate patient experience of out-of-office BP monitoring, particularly home and practice waiting room BP measurement, before, during, and after diagnosis. A cross-sectional, qualitative study with patients from two UK GP surgeries participating in a feasibility study of waiting room BP measurement. Interviewees were identified from recent additions to the practice hypertension register. Interviews were recorded, transcribed, and coded thematically. Of 29 interviewees, 9 (31%) and 22 (76%) had used the waiting room monitor and/or monitored at home respectively. Out-of-office monitoring was used by patients as evidence of control or the lack of need for medication, with the printed results slips from the waiting room monitor perceived to improve 'trustworthiness'. The waiting room monitor enabled those experiencing uncertainty about their equipment or technique to double-check readings. Monitoring at home allowed a more intensive and/or flexible schedule to investigate BP fluctuations and the impact of medication and lifestyle changes. A minority used self-monitoring to inform drug holidays. Reduced intensity of monitoring was reported with both modalities following diagnosis as initial anxiety or patient and GP interest decreased. Home and practice waiting room measurements have overlapping but differing roles for patients. Waiting room BP monitors may be a useful out-of-office measurement modality for patients unwilling and/or unable to measure and record their BP at home.

A novel approach for effective integration of new faculty leadership.

PurposeWe report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department.MethodsAt University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward.ResultsApproximately half of the feedback described the “how” of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the “what”: comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process.ConclusionLeader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members’ thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader.

L'île au poisson venimeux by Barlen Pyamootoo

Reviewed by: L'île au poisson venimeux by Barlen Pyamootoo Jennifer L. Holm Pyamootoo, Barlen. L'île au poisson venimeux. L'Olivier, 2017. ISBN 978-2-87929-350-3. Pp. 176. Is it possible to disappear into thin air in the light of day on a small island? This is the question that Anil Ramloll's friends and family ask themselves after he goes missing one day after lunch, never returning to his shop, his wife Mirna or his children Ashok and Kamla. He disappears "comme par magie" (97), leaving no trace. Has he died in an accident, been kidnapped, or, as one friend suggests, been used in a ritual sacrifice on an island where,"beaucoup par ici, même parmi les notables, croient que ça existe encore, la sorcellerie" (44–45)? Search parties are organized, hypotheses generated, and a half-hearted police investigation initiated and closed, all with no results. Eventually, Mirna must let go of Anil to forge a new life for herself and her children. However, on such a small island how easy is it to start over? Throughout the novel, Pyamootoo shares his Mauritian home through an engrossing prose. He pulls the reader onto the island through meandering sentences that offer vivid descriptions and craft a deep sense of place and longing—two elements essential to the plot's development and unravelling. Mirna's initial anxiety at the thought her husband may be dead is palpable and as Anil's absence draws out, her desire to see him again ebbs and flows, evoking feelings of hope, fear, and anger. Following along the paths of those searching for Anil, the reader has the sense of walking through the dark streets in which the sounds of rats loudly echo. As the title forewarns, not all is beautiful in this supposed tropical paradise. The island's portrait here is one of mystery, suspicion, and evolution. Each character lives with a strange attachment to a murky past, subsisting on secrets and memories of what life used to be. Anil, his friends, and his extended family are deliberately ignorant of the future, trying only to simultaneously resist and keep up with the rapidly changing present. Modern phenomena such as AIDS, climate change, the influx of cheap consumer goods, and the dilution of traditional culture combine to create a sense of contemporary anxiety that underscores Anil's disappearance. His absence thus exemplifies the unanchored identity of all the characters that populate this novel and who, according to Anil's friend, are living as "étrangers dans un monde qui n'existe plus, mais avec lequel nous ne pouvons rompre" (45). The [End Page 218] denouement of Pyamootoo's haunting narrative at times leaves readers wondering if it is ever possible to separate oneself from one's past and forge a new life or if we are doomed to live under the sometimes-unbearable weight of our own memory. Jennifer L. Holm University of Virginia's College, Wise Copyright © 2018 American Association of Teachers of French

COMT genotype and non-recovery after a whiplash injury in a Northern European population

BackgroundThe COMT (Catechol-O-Methyl Transferase) gene may influence a person’s vulnerability to develop long-term pain and some COMT single nucleotide polymorphisms (SNPs) may associate with patterns of acute or chronic pain. Many patients with whiplash-associated disorders (WADs) suffer from long-term pain and other related symptoms, but it is less known if genetic factors play a role in the recovery process. The primary aim of this study was to evaluate whether self-reported non-recovery, including pain, was related to COMT genotype in patients with WAD. The secondary aim was to investigate whether or not background factors, including mental health, were related to genotype and non-recovery.MethodsA total of 133 patients with neck pain after a whiplash trauma were included. Background factors were collected and blood samples were taken during the acute phase after the accident. DNA was isolated from blood and used to genotype the SNPs rs6269, rs4633, rs4818 and rs4680 in the COMT gene; additionally haplotypes were estimated and haplogenotypes inferred. The patients were followed up after 12 months and asked to rate their recovery including pain, mental health and quality of life.ResultsThe overall reported non-recovery rate at 12 months was 44% with no significant differences in distribution of the COMT haplotypes. High levels of self-reported pain (OR 7.2) and anxiety (OR 4.4) after the accident were associated with non-recovery, but not related to the haplotypes. None of the other background factors were related to the haplotypes or non-recovery.ConclusionNo association between self-reported non-recovery or pain levels and COMT haplotypes in patients with acute whiplash injuries could be detected. Independent replications are necessary to discard the hypothesis that COMT haplotypes do not influence non-recovery or pain levels in patients with acute whiplash injuries. High levels of initial pain and anxiety were associated with non-recovery, thereby confirming previously published reports.

Assessment of anxiety in adolescents involved in a study abroad program: a prospective study.

Objective The aim of the study was to measure the effects on levels of anxiety in healthy teenagers caused by a temporary change of country and school during a study abroad program. Methods In a prospective study we gathered the data from six anxiety level related tests on high school participants in a study abroad program (age 15-17, n = 364, M 172, F 192). These volunteer participants were divided into two separate groups: with self-reported elevated levels of anxiety (n = 111; YES-group) and with self-reported normal levels of anxiety (n = 253; NO-group). Two control groups of schoolchildren drawn from two local schools were used for comparison (n = 100 each). Three tests were subjective, i.e. self-fill-out tests. The next three tests were objective psychological or neurophysiological tests designed to estimate reflex control, concentration and a feeling for the passage of time. Results The initial mean anxiety level score among the 364 participants was 41.5 ± 16.7 (min 16, max 80) on 5-110 scale. For the YES-group the score was 56.5 ± 15.9, and for the NO-group the score was 34.7 ± 17.4 (p = 0.05). The retesting after they had been in the same place for 7 weeks revealed that the mean anxiety level score of the participants decreased to 37.4 ± 16.9 (min 15, max 72). For the YES-group the score significantly decreased to 39.3 ± 15.5, and for the NO-group the score slightly elevated to 36.7 ± 16.4 producing similar results for both groups (p = 0.81). Conclusion A temporary change of country and school at first results in a rise in anxiety levels in about one third of participants. However, after an extended stay it falls to normal levels.

Body Image Dissatisfaction and Anxiety Trajectories During Adolescence

The primary goal of this study was to examine the associations between baseline body image dissatisfaction (BID) and subsequent anxiety trajectories in a diverse, community sample of adolescent girls and boys. Participants were 581 adolescents (baseline age: M = 16.1, SD = 0.7; 58% female; 65% non-Hispanic White) from U.S. public high schools. Self-report questionnaires were administered during school at 3 annual assessment waves. Latent growth curve modeling examined the association between baseline BID and growth factors of anxiety disorder symptom trajectories. Covariates included baseline gender, age, race/ethnicity, parental education attainment, body mass index standard scores, and depressive symptoms. Higher BID at baseline was significantly associated with higher initial symptoms of generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and significant school avoidance (SSA; ps = .001–.04) but was unrelated to initial separation anxiety disorder (SEP) symptoms (p = .27). Higher baseline BID also was associated with attenuated decreases in SAD symptoms across time (p = .001). Among adolescents with low baseline anxiety symptoms only, higher BID was associated with more attenuated decreases in SAD symptoms (p = .01) and greater increases in PD symptoms (p = .02). BID was unrelated to changes in GAD, SEP, and SSA symptoms (ps = .11–.94). Findings suggest that BID is associated with concurrent symptoms of multiple anxiety disorders and may have a prospective link to SAD and PD symptoms during adolescence. As such, assessing body image issues may be important to assess when identifying adolescents at risk for exacerbated SAD and PD symptoms.

Longitudinal associations between sleep and anxiety during pregnancy, and the moderating effect of resilience, using parallel process latent growth curve models

BackgroundFor many women, pregnancy-related sleep disturbances and pregnancy-related anxiety change as pregnancy progresses and both are associated with lower maternal quality of life and less favorable birth outcomes. Thus, the interplay between these two problems across pregnancy is of interest. In addition, psychological resilience may explain individual differences in this association, as it may promote coping with both sleep disturbances and anxiety, and thereby reduce their mutual effects. Therefore, the aim of the current study was to examine whether sleep quality and sleep duration, and changes in sleep are associated with the level of and changes in anxiety during pregnancy. Furthermore, the study tested the moderating effect of resilience on these associations. MethodsAt gestational weeks 14, 24, and 34, 532 pregnant women from the FinnBrain Birth Cohort Study in Finland filled out questionnaires on general sleep quality, sleep duration and pregnancy-related anxiety; resilience was assessed in week 14. ResultsParallel process latent growth curve models showed that shorter initial sleep duration predicted a higher initial level of anxiety, and a higher initial anxiety level predicted a faster shortening of sleep duration. Changes in sleep duration and changes in anxiety over the course of pregnancy were not related. The predicted moderating effect of resilience was not found. ConclusionsThe results suggested that pregnant women reporting anxiety problems should also be screened for sleeping problems, and vice versa, because women who experienced one of these pregnancy-related problems were also at risk of experiencing or developing the other problem.

Characteristics of the psycho-emotional-mnestic functions, vegetative changes and quality of life at the initial stages of discirculatory encephalopathy of the various genesis

The objective : to analyze the conditions of the autonomic nervous system, the function of attention and quality of life in middle aged people with the initial forms of CVP of different etiology. To conduct an analysis of the prevalence of anxiety depressive disorders, taking into account gender characteristics. Patients and methods . 217 persons aged from 40 to 59 years (mean age 51,4±5,9 years) were examined. According to the results of the complex examination, 140 people with an initial stage of DE were identified, which were divided into 3 groups depending on the etiologic factor of the development of the disease (arterial hypertension, atherosclerosis and their combination). All patients were assessed for mental performance and attention activity in the Munsterberg test. The state of the quality of life and the autonomic nervous system was assessed by the questionnaires of the Laboratory of Epidemiology and Prevention of Nervous System Diseases of the SCN of RAMS – «Quality of Life», «Syndrome of the vegetative dystonia». To identify anxiety depressive conditions, the Modified Hospital Anxiety and Depression Scale (MHADS) was used. Results . The analysis of the obtained data showed a high prevalence of anxiety depressive disorders in middle aged people. Subclinical and clinical manifestations were noted in 56,9%, with a predominance in women (p<0,05). Also, among women, there was a statistically significantly more frequent mild violation of attention, autonomic disorders (severe and moderate severity), and a slight decrease in the quality of life. Men were more likely to have slight attention disorders, as well as a lack of vegetative disorders and a good quality of life condition (p<0,05). Patients with different pathogenetic forms of the initial DE also have a high prevalence of anxiety and depressive symptoms – subclinical and clinical manifestations of which have been detected in more than 50%, with a certain predominance of anxiety in patients with initial ADE and anxiety depressive states in groups of patients with initial hypertensive and combined DE. Some intergroup differences in the function of attention and autonomic dysfunction were noted, but the difference in the indices did not reach the level of statistical significance. In this case, patients from the ADE group often, as compared to patients from the groups with HDE and CDE, determine their quality of life as good (p<0,05). Conclusion . The study showed a high prevalence of anxiety depressive disorders, among middle aged people. The revealed features of the state of attention function, autonomic nervous system and quality of life in groups of patients with initial forms of DE of different pathogenesis testify to the advisability of determining the degree of their changes for therapeutic correction in the general system of prevention and treatment of patients with initial forms of DE of different etiology.

Female subjects in Carmen Martín Gaite’s New York texts

ABSTRACTThis paper examines 3 of Carmen Martín Gaite’s texts that unfold in New York: her posthumously published collage notebook Visión de Nueva York (2005), the poem “Todo es un cuento roto en Nueva York” (1983) and the short novel Caperucita en Manhattan (1990). Through the critical lenses of Lefebvre, de Certeau, Baudrillard, Wilson and others, this paper explores how Martín Gaite depicts women’s spatial practice, as they make their way out of interior spaces to access urban space. By focusing on collages in Visión de Nueva York that contain windows or personal photographs, one can observe that, as time passes, the author’s assemblages communicate an increased sense of belonging after her initial anxiety about inhabiting a new city. Connections can be drawn among specific pages of Visión de Nueva York and the poem “Todo es un cuento roto en Nueva York”, where it is possible to see how the author develops ideas that she will later use in Caperucita en Manhattan. Scholars to date have paid little critical attention to Martín Gaite’s poetry, and this study attempts to fill in this gap by analyzing a poem that can be read as a precursor to her short novel.

Depression and Anxiety are Common in Acute HIV Infection and Associate with Plasma Immune Activation.

This observational study of 123 Thai participants sought to determine the rate and severity of affective symptoms during acute HIV infection (AHI) and possible associations to disease mechanisms. At diagnosis, just prior to starting combination antiretroviral therapy (cART), AHI participants completed assessments of depression and anxiety symptoms that were repeated at 4, 12, and 24weeks. Blood markers of HIV infection and immune activation were measured at study entry, with optional cerebrospinal fluid measures. A high frequency of participants reported symptoms that exceeded published thresholds supportive of depression (55.0%) and anxiety (65.8%) at diagnosis, with significant reductions after starting cART. Meeting a threshold for clinically relevant depressive symptoms at study entry was associated with higher baseline plasma HIV RNA (5.98 vs. 5.50, t=2.46, p=0.015), lower CD4 counts (328 vs. 436 cells/mm3, t=3.46, p=0.001), and higher plasma neopterin, a marker of macrophage activation (2694 vs. 1730pg/mL, Mann-Whitney U=152.5, p=0.011). Controlling for plasma HIV RNA and CD4 count, higher baseline plasma neopterin correlated with worse initial depression and anxiety scores. Depression and anxiety symptoms are frequent in acute HIV infection, associate with plasma immune activation, and can improve concurrent with cART.

Religious and Sexual Identities: An Intersectional, Longitudinal Examination of Change in Therapy

The current study employs an intersectional framework to understand how well counselors are meeting the needs of lesbian, gay, bisexual, queer, questioning (LGBQQ) and religious clients by examining clients’ initial anxiety and depression levels and changes in these symptoms through psychotherapy. Data from 12,825 participants from the Center for Collegiate Mental Health 2012–2014 data set were analyzed. Results from hierarchical linear modeling indicate lower baseline anxiety and depression among religious clients and faster rates of change of anxiety symptoms among nonreligious clients. LGBQQ clients presented with higher initial anxiety and depression, but there were no differences in rates of change of anxiety and depression between heterosexual and LGBQQ clients. Significant but minimal interaction effects between religious and sexual identities were found, indicating a need for further research. Counselors are encouraged to be mindful of these disparities in therapy.

Clinical Experiences of Nursing Students at a Selected Institute of Health Sciences in Botswana

Aim: The aim of the research was to explore the nursing students’ opinion and their experiences about their clinical learning. Objectives: • Explore how student nurses find their initial experiences in the clinical area. • Identify the contributory and hindering factors for effective learning in the clinical area. • Identify teaching strategies that will enhance learning in the clinical area. Background: Clinical learning is an important component of nursing education and takes place in a complex social contact of the clinical environment. Learning in a clinical setting creates challenges that are absent in a classroom. Design: Qualitative research design was used and data were collected from Level II and Level III nursing students. Convenience sampling technique was utilized to collect data from the participants. Two FGDs among level III and two among level II nursing students were conducted at the Institute of Health Sciences, Botswana. There were four focus groups discussions and each had eleven participants. Data analysis: The data were analysed by content analysis using a thematic framework approach. Results: Focus group discussions revealed that nursing students did experience initial clinical anxiety, stress, lack of teaching and guiding support, lack of organizational support and resources, inadequate clinical supervision, and role acceptance. Conclusion: The findings highlight the importance of clinical learning in the integration of nursing education and practice. Nurse educators and clinical nurses should strive to create a conducive environment, which maximises the nursing students’ clinical learning.

Oxytocin attenuates aversive response to nicotine and anxiety-like behavior in adolescent rats

Initial tobacco use is initiated with rewarding and aversive properties of nicotine and aversive response to nicotine plays a critical role in nicotine dependency. Decrease of nicotine aversion increases the nicotine use that causes behavioral and neuronal changes of animals. Oxytocin influences drug abuse and reciprocally affect vulnerability to drug use. To assess the effect of oxytocin on initial nicotine aversion and anxiety, we examined voluntary oral nicotine intake and anxiety-like behavior following oxytocin treatment in adolescent rats. Sprague-Dawley male rats (4 weeks old) were used. For oxytocin administration, rats were injected subcutaneously with saline or oxytocin (0.01, 0.1 and 1mg/kg) according to the assigned groups. Voluntary oral nicotine consumption test was performed by two bottle free-choice paradigm. To examine anxiety-like behavior in rats, we performed a light/dark box test. Oxytocin not only significantly increased the nicotine intake but also alleviated nicotine aversion after acclimation to nicotine solution in a concentration dependent manner. Meanwhile, oxytocin significantly reduced anxiety-like behavior. We suggest that oxytocin itself mitigates aversive response toward initial nicotine intake and anxiety-like behavior. These results widen the psychophysiological perspective on oxytocin for better understanding of nicotine addiction related behaviors influenced by diverse social factors.