Mean Anxiety Scores Research Articles

The Relationship Between Dietary Intake and Anthropometric Indices Between Dietary Intake and Anthropometric Indices with Anxiety in Female Medical Students

Background: Vitamins play an important role in improving mental health. Healthy diets can significantly influence the development, progression, and treatment of mental health disorders. Objectives: This study aimed to investigate the correlation between dietary intake and anthropometric profiles with anxiety in female students of Zahedan University of Medical Sciences. Methods: This cross-sectional study evaluated 200 female medical students for daily intake of B vitamins, omega-3, anthropometric indices, and their correlation with anxiety. The Food Frequency Questionnaire and Bronze Anxiety Questionnaire were used to examine the relationship between dietary intake and anxiety. The associations between parameters were analyzed using Pearson’s correlation. Results: The findings revealed that the mean age of the female medical students was 22.60 ± 2.10 years, with a Body Mass Index (BMI) of 23.37 ± 4.01, a waist-to-hip ratio (WHpR) of 0.81 ± 0.11, a waist-to-height ratio (WHtR) of 10.55 ± 0.10, and an anxiety score of 44.83 ± 17.71. Positive correlations were observed between BMI (r = 0.89, P = 0.0001), WHpR (r = 0.86, P = 0.0001), and WHtR (r = 0.898, P = 0.0001) with anxiety. The mean anxiety scores were 23.84 ± 4.36, 38.59 ± 4.62, 61.44 ± 13.63, and 74.44 ± 5.96 in underweight, normal, overweight, and obese participants, respectively. A negative correlation was identified between the consumption of vitamins and omega-3 and anxiety scores (r = -0.63, P < 0.001). Conclusions: This study suggests that a higher intake of dietary B vitamins and omega-3 is associated with lower anxiety scores in Zahedan medical students.

A prospective study of antenatal anxiety and depression in pregnant women with polycystic ovary syndrome.

Women with polycystic ovary syndrome (PCOS) experience higher rates of depression and anxiety. There is limited research relating to perinatal mental health in women with PCOS. Studies suggest PCOS is associated with a higher prevalence of perinatal mental health disorders. Perinatal guidelines currently do not recognise PCOS as a risk factor for perinatal mental health disorders. We aimed to prospectively assess the prevalence of mental health disorders in pregnant women with PCOS. Consenting pregnant women, with and without PCOS, were invited to participate. Standardised validated questionnaires were carried out including Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS). Fifty-one with PCOS and 49 without PCOS responded. Pregnant women with PCOS had a higher mean (SD) anxiety score (GAD-7) than those without PCOS (8.2 [6.7] vs. 5.89 [4.7], p = 0.04). Pregnant women with PCOS had higher mean (SD) depression scores than those without PCOS on EPDS (9.1 [6.4] vs. 6.4 [4.5], p = 0.02) but not PHQ-9 score (median (IQR) 4 (3-9) vs. 4 (2-7.5), p = 0.25). Women with PCOS were more likely to experience moderate/severe anxiety (PCOS 34%, control 20%) and moderate/severe depression (PCOS 34%, control 20%) symptoms than women without PCOS. Twenty-nine percent of pregnant women with PCOS had an EPDS score >13 showing significantly higher rates of severe depression (PCOS 29%, control 12%, p = 0.03). Our findings suggest a higher prevalence of perinatal depression and anxiety in women with PCOS. Our findings may suggest increased need for screening for mental health disorders in women with PCOS.

Exploring and comparing the relationship between maternal anxiety and children’s anxiety during admission, hospitalization, and discharge in pediatric wards of Iranian hospitals

BackgroundParental anxiety levels increase during their child’s hospitalization. Consequently, anxiety can disrupt parental functioning as a caregiver and potentially transfer distress to the child. This study seeks to explore how maternal anxiety affects the anxiety levels of hospitalized children across three key stages: admission, in-hospital stay, and discharge.MethodsA cross-sectional study was conducted with hospitalized children aged 8 to 15 years their mothers. The sample size was determined based on the formula. Data were collected using demographic questionnaires and validated tools, including the State-Trait Anxiety Inventory (STAI) and the Spence Children’s Anxiety Scale (SCAS). The STAI measures state and trait anxiety, while the SCAS assesses various domains of child anxiety. Data analysis involved descriptive statistics, Pearson correlation coefficients, and fractional polynomial modeling to assess anxiety trends.ResultsThe study involved 179 participants, with mothers averaging 36.95 years old. Most participants were homemakers (82.7%) and had less than a high school education (62.6%). The average number of children per mother was 2.02, and only 2.8% utilized assisted reproductive technologies. Maternal anxiety levels were notably high, with mean state anxiety scores decreasing slightly from 45.74 at admission to 44.53 at discharge. Trait anxiety scores followed a similar trend, averaging 42.79 at admission and dropping to 41.60 at discharge. The Spence Children’s Anxiety Scale scores were relatively stable, starting at 50.93 at admission and ending at 50.89 at discharge. Severe state anxiety affected 25.7% of participants, while 11.2% experienced severe trait anxiety. Importantly, significant positive correlations were identified between maternal anxiety and children’s anxiety throughout the hospitalization period.ConclusionThis study reveals high levels of both maternal and pediatric anxiety throughout hospitalization. Mean scores for state and trait anxiety remained elevated at all stages, with significant correlations between maternal and child anxiety. These results highlight the need for targeted interventions to address and manage anxiety in both mothers and children during hospital stays. Future research should focus on strategies to mitigate these anxieties and improve support for families.

The effectiveness of multimedia mental health self-care program based on cyber space on the mental health of infertile women: a randomized controlled trial

BackgroundSo far, some training interventions have been carried out to improve the mental health in women with infertility, but designing the need and evidence-based, as well as multimedia mental health self-care interventions based on cyber space has received less attention. Due to the spread of the internet and the role of self-care in improving mental disorders, this study was conducted to evaluate the effectiveness of the multimedia mental health self-care program on mental health and to assess the users' satisfaction.MethodsThis study is a randomized controlled trial with pretest–posttest follow-up design. The sample was selected using a convenience sampling method (n = 90). The random number function was used to assign random numbers. The research instruments include a demographic, psychological Well-being, depression, anxiety, perceived stress, fertility problems and satisfaction with training questionnaire. Six weeks of intervention was conducted following the pre-test and the link of each session's content was sent to the participants, based on the training schedule, through Eitaa Messenger. The post-test and follow-up were conducted 1 week and 1 month post intervention. The data were analyzed using independent t-test and repeated measures ANOVA.ResultsA statistically significant difference was observed between the intervention and control group in the mean score of psychological well-being, perceived stress and infertility stress 1 week and 1 month post intervention and in the mean score of depression and anxiety 1 month post intervention. The intervention group scored higher than the control in psychological well-being but lower in perceived stress, depression, anxiety and infertility stress. The intervention had a positive effect and reduced the score of perceived stress, depression, anxiety and infertility in the intervention group over time. The score reduction continued until the follow-up stage. No significant time-interaction effect was observed on psychological well-being and on the control group. Satisfaction with the program and subscales was desirable.ConclusionThis program could significantly reduce the depression, anxiety, perceived stress and infertility stress and desirable satisfaction with the program was observed among users. This program can be used in designing the experimental and therapeutic interventions to improve mental-health self-care behaviors.Trial registrationRCT Registry: Iranian Registry of Clinical Trials; RCT registration number: IRCT20210526051410N1; Registration date: 2022–11-06. Last update: 2023–01-28 https://irct.behdasht.gov.ir/trial/57874

Abstract 4138578: NICE-Support program effectively improves symptom and psychological distress in patients with heart failure

Background: Patients with heart failure may suffer from symptom distress, affecting their overall quality of life and psychological well-being including depression. Limited researches focused on the effects of intervention on symptoms and psychological distress for patients with heart failure. Research Hypothesis: Nutritional education and exercise intervention can significantly improve symptoms and psychological distress in patients with heart failure. Aims: To investigate the effectiveness of the Nutrition Instruction Combined Exercise and Support program (NICE-Support) on symptom and psychological distress in patients with heart failure. Methods: This randomized controlled trial recruited 240 patients with heart failure from two medical centers in Taiwan by convenience sampling. Participants were divided into two subgroups based on participation in the "Post-Acute Care Integration Program (PAC)." Each group was randomly assigned to the experimental group and control group, including PAC, PAC+NICE, N-PAC, and N-PAC+NICE groups. The experimental group received a 12-week NICE-Support intervention, encompassing nursing instruction, nutritional counseling, exercise, and support. The control group followed routine hospital care. Data were collected through a structured questionnaire, including basic information, the Heart Failure Symptom Distress Scale, Hospital Anxiety and Depression Scale at baseline, 4, 12, and 24 weeks after enrollment. Data were analyzed using SPSS 24, including descriptive, t-tests, one-way ANOVA, Pearson correlation coefficients, chi-square tests, and generalized estimating equations. Results: The overall symptom distress score was 45.02 (SD = 13.50). Anxiety and depression were reported in 23.8% and 30.9% patients, with the mean anxiety and depression score of 5.01 (SD = 4.50) and 5.98 (SD = 4.16), respectively. Compared with the N-PAC control group, the PAC+NICE group and N-PAC+NICE group exhibited significant greater improvements in symptom distress at 4, 12, and 24 weeks post-intervention, while the N-PAC+NICE group showed statistically significant greater improvement in anxiety at 12 and 24 weeks. Conclusion: The NICE-Support program effectively improves symptom and psychological distress in patients with heart failure and could implement in patients with heart failure.

TEC-ADHERE: Real-World Persistence and Adherence on Dimethyl Fumarate in Patients with Relapsing-Remitting Multiple Sclerosis in the French OroSEP Patient-Support Program.

Treatment persistence and adherence are essential for achieving therapeutic goals in patients with multiple sclerosis (MS). OroSEP is an independent patient-support program (PSP) in France for patients with relapsing-remitting MS (RRMS) receiving oral disease-modifying therapies. TEC-ADHERE (NCT04221191; 08/19/2019-09/15/2022) was a prospective, non-interventional, phase4 study to assess the effect of OroSEP on persistence and adherence to dimethyl fumarate (DMF; Tecfidera™) in patients with RRMS. Outcomes were compared for patients in OroSEP versus non-OroSEP patients who received their neurologists' standard of care (SoC). Patients initiated DMF at month0 (M0); follow-up visits occurred at M3 and M6. Primary outcome was persistence at M6. Secondary outcomes included persistence at M1 and M3, adherence at M6 (Girerd questionnaire), anxiety (Generalized Anxiety Disorder Assessment), patient satisfaction at M6 (Treatment Satisfaction Questionnaire for Medication), patient and neurologist satisfaction with OroSEP participation, and adverse events (AEs). Per-protocol population included 341 patients (OroSEP, n = 135; SoC, n = 206). Persistence was similar for OroSEP vs SoC (M6, 75.9% vs 76.6%; M1, 96.0% vs 92.4%; M3, 85.5% vs 89.0%). At M6, mean adherence was higher for OroSEP (5.4) vs SoC (4.7; p < 0.0001), and good adherence (Girerd score = 6) was achieved by more OroSEP patients (55.7%) than SoC patients (29.6%; p < 0.01). Mean anxiety scores were lower in the OroSEP group than in the SoC group at baseline (7.1 vs 8.8; p = 0.02) and M6 (3.4 vs 6.1; p < 0.001). Mean satisfaction scores at M6 were higher for OroSEP (77.4) vs SoC (64.2; p < 0.01). Most neurologists (n = 11/14) agreed that OroSEP helped improve adherence. Treatment-related AEs occurred in 62 (36.3%) OroSEP patients and 76 (42.9%) SoC patients; most common were flushing, diarrhea, hot flush, and abdominal pain. These outcomes support the value of PSPs in encouraging adherence, alleviating anxiety, improving patient satisfaction, and supporting patients to be more independent in managing MS. ClinicalTrials.gov identifier, NCT04221191.

The effects of virtual reality on pain, anxiety, and comfort during the chest tube removal procedure: A randomized clinical trial

PurposeThe purpose of the current study is to determine the effects of virtual reality on pain, anxiety, and comfort during chest tube removal. Materials and methodsThe research was conducted in the Cardiovascular Surgery Department of Atatürk University Health Practice and Research Hospital between January 2023 and April 2024. The study was performed as a randomized controlled experimental trial with a pretest-posttest control group. Eighty-two patients (41 in the intervention group and 41 in the control group) were included in the research. Patients in the intervention group watched a video with virtual reality glasses during chest tube removal. The “Descriptive Information Form,” “Visual Analog Scale,” “Verbal Pain Scale,” “State Anxiety Inventory,” and “Comfort Scale” were used to collect data. Number, percentage, mean, standard deviation, chi-square, paired sample t-test, independent sample t-test, Mann-Whitney U test, Wilcoxon test, and linear regression analysis were used in data evaluation. Our study was recorded in the Clinical Trials database with protocol number “NCT06550323.” ResultsThe groups had similar descriptive characteristics (p > 0.05). The pre-procedural mean pain, anxiety, and comfort scores were similar in the two groups (p > 0.05). The post-procedural mean VAS and verbal pain scores, mean anxiety, and comfort scores of the intervention group were lower in comparison with the control group (p < 0.05). ConclusionThe research findings showed that virtual reality significantly reduced pain and anxiety while increasing comfort levels during chest tube removal. Therefore, it is recommended that virtual reality be used during chest tube removal.

The effect of educational- supportive program on the anxiety of mothers of infants admitted to the neonatal intensive care unit (NICU)

IntroductionThe admission of preterm infants to the neonatal intensive care unit (NICU) often causes stress and anxiety in their mothers. Nurses must implement nursing interventions for mothers as the most important caregivers of infants. Accordingly, the present study aimed to explore the effect of Educational- Supportive Program (multi-sensory stimulation) on the anxiety of mothers of preterm infants admitted to neonatal intensive care units. MethodsThe present study used a quasi-experimental design with two groups and pretest and posttest and was conducted on 100 mothers of preterm infants admitted to the neonatal intensive care unit. The mothers who met the inclusion criteria were selected as the participants using convenience sampling and were randomly placed into intervention and control groups (50 persons in each group) by drawing lots. The participants in the intervention group performed multi-sensory interventions for the infant for 12 min at a time, once a day for 5 days a week according to the instructions provided by the researcher. The mothers in the control group did not perform any intervention for their infants. The participants in both groups completed the Spielberger State-Trait Anxiety Inventory (STAI) on the first day and one week after admission. ResultsThe results showed that the mean scores of maternal anxiety for the participants in the intervention and control groups before the intervention were 38.98 ± 3.44 and 35.86 ± 7.16, respectively, showing a statistically significant difference (P = 0.007). Besides, the mean scores of maternal anxiety for the participants in the intervention and control groups one week after the intervention were 33.36 ± 3.46 and 36.22 ± 7.46, respectively, showing a statistically significant difference (P < 0.001). ConclusionThe present study showed that the multisensory stimulation intervention had a positive and significant effect on the anxiety of mothers of preterm infants and reduced it. Therefore, this simple and practical relaxing measure can be used by nurses in clinical settings to reduce maternal anxiety.

Effect of Preoperative Oral Cannabidiol-Rich Cannabis Extract on Anxiety and Postoperative Pain after Endodontic Treatment: A Double-Blind Randomized Clinical Trial

IntroductionThe aim of the present study was to evaluate the effectiveness of cannabidiol (CBD)-rich Cannabis extract in reducing anxiety and postoperative pain in patients submitted to endodontic treatment. MethodsThe study was carried out after approval by the Research Ethics Committee (Registration No. 5.075.961). The following groups were tested: CBD and placebo. Pain was measured using a visual analog scale before the start of treatment and 24, 48, and 72 hours and 7 days after the session. Anxiety was assessed using the Modified Dental Anxiety Scale and a visual analog scale, before and immediately after treatment. In addition, salivary cortisol was measured before drug administration and after anesthesia. Data were analyzed descriptively using absolute frequencies and percentages, with a 5% margin of error. ResultsThe mean anxiety scores were higher in the CBD group than in the placebo group in each assessment (pre: 5.06 vs 3.07, respectively; post: 4.61 vs 2.60). However, there was no significant difference in the reduction of dental anxiety at the beginning of the consultation and throughout the procedure. We did not find statistically significant differences in postoperative pain between the CBD and placebo groups at any of the time points. ConclusionsThere was no evidence of an exposure-response relationship between the intervention and control groups. However, more studies are needed to determine clinical outcomes.

Anxiety and Depression among patients with chronic pain

Background: Chronic pain is a pervasive and debilitating state experienced by many individuals across the globe. It produces a wide range of physiological impact which are well documented in literature but the psychological impact which is also equally profound has not received much attention. This study aims to investigate severity of anxiety and depression in patients with chronic pain that contributes to the development of holistic and effective treatment approaches. Materials and Methods: A non-experimental descriptive cross-sectional design was adopted. Non probability purposive sampling was used to recruit a sample of 50 patients with chronic pain attending OPD services in a secondary hospital, Chittoor, Andhra Pradesh. Patients who aged between 20 and 70 years with a chronic pain for at least 3 months were included. Patients with malignant pain were excluded. Hospital Anxiety and Depression Scale (HADS) was used to capture data on anxiety and depression. Results: The mean anxiety score on HADS was 9.2 (SD-3.72) and depression score was 8.48 (SD-3.23). Nearly one third of participants (32%) reported abnormal level of anxiety and 26% had reported abnormal depression. There is no significant association found between level of anxiety and Sociodemographic variables such as age, gender, marital status, type of family, education and occupation. Level of depression showed a significant association with age (p=0.042). Conclusion: Patients with chronic pain experience varying degrees of anxiety and depression. Routine assessment of these attributes would help the healthcare team to plan patient-tailored interventions to manage pain and to prevent anxiety and depression.

Investigating the Impact of Test Anxiety and Self-Regulation on Foreign Language Learning: A Quantitative Correlational Approach

The present study investigated the self-regulated learning strategies adopted by EFL learners, their levels of cognitive test anxiety, and the potential correlations between self-regulated learning and cognitive test anxiety. The study also examined whether gender and level of language proficiency had a significant effect on self-regulated learning and cognitive test anxiety. A correlational survey design was employed to investigate EFL learners and cross-sectional data were collected through an online questionnaire. Data analysis of 269 undergraduate students revealed that gender consistently emerged as a significant variable. Notably, female students exhibited higher mean scores in both self-regulated learning and cognitive test anxiety. Furthermore, the results consistently found a correlation between self-regulated learning and cognitive test anxiety, with self-regulated learning effectively predicting cognitive test anxiety. Specifically, the predictive power of self-regulated learning for cognitive test anxiety was found to be statistically significant only within the group of students at A2 language level.

Epidemiological profile of patients consulting for smoking cessation in Tunisia from 2020 to 2023

Abstract Background Tobacco addiction poses a significant global health challenge, contributing to various diseases and premature mortality. The main objective of our work was to describe the epidemiological profile of smokers seeking assistance at the smoking cessation departement of the ‘Abderrahmane Mami’ hospital. Methods We conducted a retrospective study involving smokers who attended the smoking cessation department between January 2020 and December 2023. Data were collected from the consultants’ records. The descriptive study was conducted using IBM SPSS 25 software. Results The number of consultants was 440 during the years of the study. The study population was predominantly male (75.2%). The average age of the consultants was 45.41 ± 13.9 years [14-89 years]. The education level of the patients was predominantly university-level (42.4%), followed by secondary education (33.6%). Cardiovascular history was the most common (22.42%). More than half of the consultants (n = 279; 63.4%) had tried to quit smoking at least once. More than half of the smokers followed (57.9%) were highly dependent on nicotine (Fagestrom score ≥ 7). The mean score of the hospital anxiety and depression scale was 8.03 ± 5.398 for anxiety and 5.44 ± 5.185 for depression. Conclusions Our study provides informations about the epidemiological profile of individuals seeking tobacco cessation support during the study period. The findings underscore the diverse demographic and clinical characteristics of this population. Understanding these profiles can provide information for the development of effective anti-tobacco programs. Key messages • Tailored interventions are essential to meet the diverse needs of people seeking smoking cessation, optimizing the impact on public health. • Understanding cessation seeker profiles crucial for effective strategies.

Relationship of Resilience With Depression, Anxiety, and Stress Among Nursing and Midwifery Students in Qom, Iran, During the COVID-19 Pandemic

Background and Objectives: The COVID-19 pandemic affected physical and mental health of people, including college students. Several studies in Iran have reported high symptoms of depression, anxiety, and stress in college students during the pandemic; however, few studies have investigated their resilience during the pandemic. This study aims to determine the relationship of resilience with anxiety, depression, and stress of nursing and midwifery students in Qom, Iran during the COVID-19 pandemic. Methods: This is a descriptive-correlational study. Participants were 192 nursing and midwifery students of Qom University of Medical Sciences in 2021, who were selected using a simple random sampling method. The instruments included the Corona Disease Anxiety Scale, the Connor-Davidson resilience scale, and the 21-item depression, anxiety, stress scale (DASS-21). The data was analyzed using descriptive statistics and analytical tests of Pearson’s correlation test and regression analysis in SPSS software, version 22. Results: The mean score of anxiety, depression, stress, and total DASS-21 score was 14.6±4.4, 14.48±4.29, 15±4.32, and 32.46±9.88, respectively. The mean total resilience score was 53.5±16.5. There was a significant negative correlation between depression, anxiety, stress, and total DASS-21 score with resilience in students during the pandemic (P&lt;0.001). Conclusion: During the COVID-19 pandemic, nursing and midwifery students’ resilience had a significant relationship with their depression, anxiety, and stress. The lower resilience can increase the stress, depression, and anxiety of nursing and midwifery students.

The Relationship of Cyber Bullying and Victimization with Anxiety and Depression Risk in High School Students

In this research, it was intended to find out the frequency of cyber bullying and cyber victimization experienced by students who are attending different schools in a city center and to investigate the relationship between these situations and anxiety and risk of depression. The research population consisted of 460 students studying at Anatolian High School, Private High School, and Imam Hatip High School. This cross-sectional, analytical study included 9th, 10th, 11th and 12th grade voluntary students. Data collected via questionnaire consisted of three parts: socio-demographic information form, the cyber bullying scale (CBS) and the hospital anxiety and depression scale (HADS). The daily internet usage time of the participants were found to be 4.07±3.77 hours. Fifty-eight point seven percent (n=270) of the students were victims while 24.5% (n=112) of them were both bully and victims. The cyber victimization score of male students was found to be 24.1±9.6. The mean anxiety and depression scores of the students were 9.6 ± 4.3 and 7.2 ±3.9 respectively, and difference was significant between cyber victims and those who are neither bully nor victims (p&amp;lt;0.001). Anxiety and depression risk were positively correlated to cyber victimization score. The results of this study reveal that cyber bullying and victimization in young people are quite high. The relationship between cyber bullying, cyber victimization and anxiety and depression poses a significant threat for adolescents.

Measures of Well-Being in U.S. Animal Shelter Staff During 2023

Introduction: The demands of animal shelter work can take a toll on staff well-being. The years following the coronavirus pandemic have been especially demanding as shelters struggle to navigate a series of unprecedented challenges, including pandemic-related restrictions, the shortage of veterinary professionals, adoptions not keeping pace with increasing animal admissions (especially of dogs), the expiration of eviction moratoriums, and rising inflation. These factors create a context that is potentially deleterious to the well-being of shelter staff. Methods: We used an online survey to collect information from U.S. shelter staff (N = 243). Specifically, we used the Patient-Reported Outcomes Measurement Information System (PROMIS) and Professional Quality of Life (ProQOL) instruments to quantify various aspects of staff well-being. We also collected basic demographic information and details about participants’ experience in the animal welfare field. Results: PROMIS results reveal mean anger, anxiety, depression, and fatigue scores in the mild/moderate range, significantly higher than those of the general U.S. population. ProQOL results show that nearly half of shelter staff respondents (49.4%) recorded compassion satisfaction scores in the high range, with the remainder falling into the moderate (39.1%) or low (11.5%) range; 53.5% recorded burnout scores in the high range, with the remainder falling into the moderate (32.1%) or low (14.4%) range; and 90.9% recorded secondary traumatic stress scores in the high range, with the remainder falling into the moderate (8.2%) or low (0.8%) range. Conclusion: Although the shelter staff surveyed reported high levels of job satisfaction, their high burnout and secondary traumatic stress scores, and lower mental and physical health scores raise serious concerns about employee well-being and potential turnover following the coronavirus pandemic. If much of the trauma that comes with animal sheltering work cannot be avoided, policymakers should consider providing shelter staff with the resources necessary to mitigate its impact.

Assessing Anxiety and Satisfaction Levels among Dental Students during Online Learning amid the COVID-19 Pandemic: A Cross-Sectional Study

Introduction: The COVID-19 pandemic led to widespread adoption of online learning. In April 2020, the Higher Education Commission (HEC) of Pakistan released policy guidance on online readiness with three levels: basic, effective, and exemplary. However, concerns about the quality and readiness for online curriculum delivery in Pakistan persisted. This study assesses the anxiety and satisfaction levels of undergraduate dental students with online classes during the pandemic. Methods: An analytical cross-sectional study was conducted between June and July 2020. Data were collected via email from undergraduate dental students of a private dental college using convenience sampling, after three months of online teaching. Two tools were used: a student satisfaction questionnaire adapted from Bolliger and Halupa’s study, and a student anxiety questionnaire. Frequencies, percentages, means, and standard deviations were calculated for satisfaction and anxiety scores. Univariate and multiple linear regression analyses were performed to assess factors associated with student satisfaction. Results: Out of 300 eligible participants, 237 responded (79% response rate). Most participants (53.16% female, 59.07% hostellers) had no prior experience with online learning (85.65%). The mean anxiety score was 54.87 (SD=9.6), and the mean satisfaction score was 58.63 (SD=16.66). Male students showed less satisfaction than females, though not statistically significant. Second-year students had significantly higher satisfaction scores than third- and fourth-year students. Conclusion: Most students had no prior experience with online learning, resulting in increased anxiety and poor satisfaction with the modality during the COVID-19 pandemic.

Association between pre-procedural anxiety and vomiting in children who undergo procedural sedation and analgesia in the emergency department

IntroductionChildren presenting to the emergency department (ED) often require procedural sedation and analgesia (PSA) prior to procedures. Although ketamine is used widely for PSA safely, there is a risk of adverse effects. Among them, vomiting is significant as it occurs in about 10% of patients and can potentially endanger the airway. Because there is evidence that post-operative complications might be due to anxiety prior to the operation, this study aims to investigate the association between pre-procedural anxiety and vomiting in the ED.MethodsIn this cohort study, a convenient sample of children aged 2 to 14 years who were a candidate for PSA with ketamine in the ED were enrolled. Anxiety was evaluated using the short version of the modified Yale preoperative anxiety scale (mYAS). Vomiting was recorded during the period of hospitalization in the ED and 24 h after discharge by a phone call. Association between anxiety level and vomiting was analyzed using the independent samples t-test and multivariable logistic regression was used to control for covariates.Results102 children were enrolled and 93 were included in final analysis. The mean age of participants was 3.95 ± 1.79 years and 55.9% were male. According to the mYAS, the mean score of anxiety was 48.67 ± 21.78 in the waiting room and 59.10 ± 23.86 in the operating room. The mean score of anxiety was 58.3±25.3 and 51.0±20.7 in the vomiting and non-vomiting groups, respectively. At least one episode of vomiting was reported in 23 children of which, 19 took place in the hospital and 4 after discharge. No significant association was observed between pre-procedural anxiety and the occurrence of vomiting. On univariate regression model, the odds ratio of the association between mean anxiety and vomiting was 1.02 (CI 95%: 0.99–1.04) (P-value: 0.16). On the multivariable logistic regression model, after adjusting for all the covariates, the odds ratio was 1.03 (CI 95%: 1.0–1.05) (P-value: 0.05).ConclusionThe present study showed that anxiety before procedural sedation and analgesia with ketamine in children was not associated with the incidence of vomiting.

Demographics, Clinical Characteristics, and Well-Being of Veterans with TBI and Dementia and Their Caregivers.

This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans' demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers' demographic, clinical, and care-related characteristics and well-being. Veterans' caregivers (N = 110) completed a telephone-based survey. Veterans averaged eight comorbid health conditions, with over 60% having chronic pain, hypertension, post-traumatic stress disorder, or depression. Caregivers reported helping with an average of three activities of daily living, with the highest percentages of Veterans needing assistance with grooming, dressing, and bathing. Almost all Veterans needed assistance with shopping, cooking, medication management, housework, laundry, driving, and finances. Veterans averaged two safety risks, the most common being access to dangerous objects, access to a gun, and not being able to respond to emergency situations. Although Veterans averaged 14 behavioral concerns, caregivers reported that their family needs relating to TBI were generally met or partly met, and they voiced confidence in their ability to respond to behaviors and control their upsetting thoughts. Caregivers' mean burden score was severe, while mean depression and anxiety scores were mild. Caregivers reported an average of 10.5 h per day providing care and 20.1 h per day on duty. The findings demonstrate the increased presence of impairments, safety risks, and behavioral issues in Veterans with comorbid TBI and dementia, as well as increased impacts on families' burdens and care provision requirements. Clinicians should be alert for and educate TBI patients and caregivers on the warning signs of post-TBI dementia and its associated functional, behavioral, and safety risk profile, as well as challenges related to caregiver well-being. Healthcare policymakers must consider the increased caregiver demands associated with comorbid TBI and dementia, as well as the need for expanded long-term support and services.

The Effect of Quantum Learning Model on Attitude, Anxiety, and Achievement of Middle School Students Towards Mathematics

We conducted this research to investigate the impact of the Quantum Learning Model (QLM) on the academic achievement, attitudes toward mathematics, and anxiety levels of seventh-grade middle school students. A total of fifty-six 7th-grade students participated in the research. The research used a quasi-experimental model with a pretest-posttest control group. The experimental group used QLM during the research process, while the control group used the current learning approach. We conducted the research for 28 lesson hours. We collected data using attitude, anxiety scale, and academic achievement tests. We applied tests to both groups before and after the experimental procedure. We used independent-samples-T-tests and paired-samples-T tests in the analyses. We also evaluated the journals of students and the researcher. Accordingly, QLM had a positive effect on middle school students' academic achievement in mathematics. The posttest mean scores of attitudes decreased significantly in the control group. The experimental group experienced a decrease in post-test mean scores of anxiety, which was not statistically significant, whereas the control group experienced a statistically significant increase in post-test scores. Students and teachers have expressed positive opinions about the use of note-taking and mind maps, which enhance the durability of learning, the establishment of a classroom environment and atmosphere conducive to QLM, and the implementation of celebration activities.

Relationship between sleep quality during pregnancy and postpartum anxiety: a prospective birth cohort study

The present study aimed to determine the relationship between sleep quality during pregnancy and postpartum anxiety.A total of 237 pregnant women participated in this birth cohort study, using the sequential sampling method. The data collection tools included a demographic information form, Pittsburgh Sleep Quality Inventory, and Spielberger State-Trait Anxiety Inventory. The PSQI was completed by the participants at 28 and 40 weeks of gestation, and the STAI was completed in two stages, that is, once in the third trimester and once at eight weeks postpartum.The mean global PSQI score of the participants was 8.11 (SD=5.41) in this study. Overall, 138 (58.2%) women had poor sleep quality. The mean score for overt anxiety was 36.58 (SD=9.37), and the mean score for latent anxiety was 37.56 (SD=9.44). There was a significant positive correlation between the total score of sleep quality during pregnancy and the scores of overt anxieties (r=0.314, P&lt;0.001) and latent anxiety (r=0.344, P&lt;0.001) after delivery.The results of the present study indicated a significant relationship between sleep quality during pregnancy and postpartum anxiety. Therefore, it is recommended to evaluate the quality of sleep of pregnant women and design appropriate interventions during pregnancy to reduce postpartum anxiety. Keywords: Sleep; pregnant woman; postpartum period.