Severe Stress Levels Research Articles

RELATIONSHIP BETWEEN STRESS LEVEL AND EMOTIONAL EATING WITH NUTRITIONAL STATUS IN HEALTH FACULTY STUDENTS AT MUHAMMADIYAH GRESIK UNIVERSITY

This study found that when a person experiences stress, it will cause a response in the form of emotional eating. Emotional eating is an eating urge that arises in response to negative emotions. This study aims to determine the relationship between stress levels, emotional eating and nutritional status in students of Universitas Muhammadiyah Gresik Faculty of Health. This research was conducted on 81 students of level I, II and III. The measuring instruments used in this study used the Perceived Sources Academy of Stress, the Dutch Eating Behavior Questionnaire (DEBQ) scale, anthropometric data and 2x24 hour Recall. Bivariate analysis was performed using the Spearman Rank test and multivariate analysis using multiple linear regression. Results: 93.8% of respondents experienced severe stress levels, 45.7% of respondents experienced moderate emotional eating and 61.7% of respondents had normal nutritional status. There is a significant relationship between stress levels and emotional eating (Sig. of 0.001 (0.001 <0.05) and there is no significant relationship between stress levels, emotional eating and nutritional status (p = 0.700; p = 0.876). So, it can be concluded that respondents should be able to manage stress well and maintain the intake of food to be consumed.

Quality of sleep after COVID-19 infection: a cross-sectional study in the Southern Italy.

This study investigated the quality of sleep in a sample of individuals from Southern Italy after the major waves of the COVID-19 pandemic, with the aim of evaluating how sleep patterns changed. A cross-sectional study was conducted between March 2022 and January 2023 and involved adults who had a COVID-19 infection, who were invited to complete a self-administered online questionnaire. A total of 408 individuals participated in the survey. Overall, 66.4% had a reduction in social relations; 72.1% had an increase in the use of social media; and 86%, 77.2%, and 71.1% reported an extremely severe level of anxiety, stress, and depression, respectively. Almost all of the respondents had a Pittsburgh Sleep Quality Index score (PSQI) ≥5, indicating poor sleep quality. Subjects with a severe or extremely severe depression score, a severe or extremely severe stress score, who had a job, and who had someone close who died because of a COVID-19 infection were more likely to have a high PSQI global score. The use of sleep medication in the past months was significantly higher in those who were older, who had a job, who had a COVID-19 infection in the first and second waves, who had someone close who died from COVID-19, and who did not have changes in social relationships during the pandemic. Moreover, participants with severe or extremely severe depression scores, with severe or extremely severe stress scores, who were women, and who were older had troubles staying awake while engaging in social activities during the past month. The results bring to light the high prevalence of poor sleep quality among individuals who were infected with SARS-CoV-2. Future research is needed to understand whether these disturbances are still present in the endemic period and whether it is necessary to investigate further determinants that have affected and/or are affecting sleep quality.

Neurosciences and Emotional States of Latin American University Professors in the Post-Covid-19 Pandemic Stage

The article aimed to determine the relationship between neuroscience and emotional states in university faculty members from Latin America during the post-pandemic stage of COVID-19. It highlights the importance of understanding emotions from a neuroscientific perspective to develop strategies that enhance emotional management and resilience in the educational context. The descriptive-correlational research included a sample of 318 faculty members from various Latin American countries. The results revealed severe levels of stress (88.4%) and anxiety (92.1%), as well as inadequate (40.9%) or moderate (46.9%) levels of resilience among the faculty members. A strong positive correlation was found between neuroscience and emotional states (rho=0.860), as well as a good positive correlation between neuroscience and resilience (rho=0.739). The study concludes that the knowledge and application of neuroscience principles could contribute to lower levels of stress and anxiety and increase resilience in university faculty members, emphasizing the importance of integrating these disciplines into the understanding and management of emotions in the educational field.

Depression, Anxiety and Stress with Problematic Internet use Among Youth Attending; A Tertiary Care Hospital in Bangladesh

Background: Excessive and uncontrolled internet use can significantly impair daily functioning in various life domains. Despite the numerous benefits of the internet, its addictive use is a growing concern, particularly among youth, who are prone to anxiety, depression, and stress-related disorders. Understanding the current scenario is essential for devising effective interventions, yet no scientific data is available in Bangladesh. Objective: To assess between depression, anxiety, and stress among youth with problematic internet use (PIU) attending a tertiary care hospital. Methods: This cross-sectional and descriptive study was conducted at the Department of Psychiatry, Department of Bangabandhu Sheikh Mujib Medical University, from October 2020 to September 2022. Participants were interviewed using a structured socio-demographic questionnaire, the Bangla versions of the Internet Addiction Test (IAT), and the Depression Anxiety and Stress Scale-21 (DASS-21-BV). Data were analyzed using SPSS 26.0, with significance set at p<0.05. Results: Among the 90 participants (mean age: 21.33 years; 68% male, 32% female), 95% were students, and 87% were from nuclear families. Internet use exceeded one year for 83% of participants. PIU levels were minimal in 15%, moderate in 62%, and excessive in 22%. Severe depression was observed in 15% of participants, severe anxiety in 25%, and severe stress in 25%. Extremely severe levels of depression, anxiety, and stress were found in 14%, 5%, and 14% of participants, respectively. Significant risk factors for PIU included male gender (χ²=8.217; p=0.02) and over three hours of daily internet use (χ²=35.289; p=0.001). PIU was significantly associated with depression (χ²=20.380; p=0.001), anxiety (χ²=16.159; p=0.019), and stress (χ²=14.734; p=0.019). Conclusion: Depression, anxiety, and stress are significantly associated with PIU. Early risk assessment, proper internet use, and initial screening are essential for managing potential mental disorders linked to PIU.

Gambaran Stres pada Adult-Child Caregiver dalam Merawat Orang Tua dengan Penyakit Pikun

There are currently more than 55 million people suffering from senile worldwide, more than 60% of whom are dominated by middle and low income countries. Every year, 10 million cases of senile occur. Senile is caused by various diseases that attack the brain. Alzheimer's disease is one of the most common forms of this disease and can cause 60-70% of cases in elderly people with senile. Caring for a parent with senile has the potential to be very stressful. The aim of this research is to determine the description (aspects, levels, & influencing factors) of stress in adult-child caregivers in caring for parents with senile. The method used in this research is qualitative with a phenomenological type. The subjects in this study were 3 people who played the role of Adult-Child Caregiver for a period of 4 years or more. The data collection technique uses the interview method. The data analysis technique uses the Miles and Hubberman model. The data credibility techniques used are source triangulation and member checking. The results of this research show that there is a description of the stress experienced by the subject with both biological and psychological aspects. 2 of the 3 subjects studied had Very Severe Stress levels with the influence of economic, family and environmental factors. 1 in 3 subjects have symptoms of excessive stress and have experienced it for a very long time. The results of this research can be a suggestion for other adult-child caregivers to receive training to increase their skills in caring for elderly parents.

Poor sleep quality and associated factors among undergraduate students: a single-university cross-sectional study

Poor sleep quality is a global health concern. It leads to reduced cognitive abilities and delayed reactions, which negatively affect students’ ability to study and contribute to health-related issues such as depression, obesity, cardiovascular disease, and accidents. This study aims to estimate the rate of poor sleep quality among Thai undergraduate students and identify the factors associated with poor sleep quality. A cross-sectional study was conducted using self-administered questionnaires that included questions on demographic data, caffeine consumption, stress levels, health status, sleep behavior, and sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). The participants comprised 609 students from different faculties who were enrolled at the university. The factors related to poor sleep quality were analyzed using a multiple logistic regression model. The overall rate of poor sleep quality was 66.3% (95% CI [62.4, 70.1]). Multivariate analysis showed that poor sleep quality was significantly associated with high and severe stress levels (AOR = 4.51; 95% CI [2.53, 8.03]), weak and very weak overall physical health in the previous month (AOR = 1.87; 95% CI [1.03, 3.38]), and physical illnesses in the previous month (AOR = 1.64; 95% CI [1.04, 2.57]). The present study found that being stressed was associated with poor sleep quality. Stress management and lifestyle modifications are highly recommended for undergraduate students to enhance their sleep quality.

Depression, anxiety, stress, and current e-cigarette use: Results from the Truth Longitudinal Cohort of youth and young adults (2022−2023)

ObjectiveTo examine associations between depression, anxiety, and stress, as measured by the Depression, Anxiety and Stress Scale (DASS-21) scale, with current e-cigarette use. MethodsData from the Truth Longitudinal Cohort – a nationally representative sample of youth and young adults – was collected between October 2022 to February 2023. The analytic sample was comprised of participants who provided information on e-cigarette use and the DASS-21 scale (N = 4198). Chi-square statistics were used to determine differences by current e-cigarette use across covariates and DASS-21 items. Logistic regression analyses were applied to the cross-sectional data to determine which scales predicted current e-cigarette use, adjusted for the effects of age, gender identity, race and ethnicity, parental educational attainment, perceived financial situation, and current use of alcohol, marijuana, and other tobacco use. ResultsThose who had severe/extremely severe levels of depression, anxiety, and stress had greater odds of current e-cigarette use, relative to those who had normal levels of depression, anxiety, and stress, even after adjusting for covariates. Results also demonstrated associations between age, race/ethnicity, parental education, and current use of alcohol, marijuana, and other tobacco products with current e-cigarette use. LimitationsCross-sectional analyses of self-reported data limit the ability to determine directionality of effects between depression, anxiety, stress, and current e-cigarette use. DiscussionMore severe levels of depression, anxiety, and stress were associated with a greater likelihood of current e-cigarette use. Future research is needed to evaluate changes in e-cigarette use, in response to depression, anxiety, and stress symptomatology.

Feasibility characteristics of wrist-worn fitness trackers in health status monitoring for post-COVID patients in remote and rural areas.

Common, consumer-grade biosensors mounted on fitness trackers and smartwatches can measure an array of biometrics that have potential utility in post-discharge medical monitoring, especially in remote/rural communities. The feasibility characteristics for wrist-worn biosensors are poorly described for post-COVID conditions and rural populations. We prospectively recruited patients in rural communities who were enrolled in an at-home rehabilitation program for post-COVID conditions. They were asked to wear a FitBit Charge 2 device and biosensor parameters were analyzed [e.g. heart rate, sleep, and activity]. Electronic patient reported outcome measures [E-PROMS] for mental [bi-weekly] and physical [daily] symptoms were collected using SMS text or email [per patient preference]. Exit surveys and interviews evaluated the patient experience. Ten patients were observed for an average of 58 days and half [N = 5] were monitored for 8 weeks or more. Five patients [50%] had been hospitalized with COVID [mean stay = 41 days] and 4 [36%] had required mechanical ventilation. As baseline, patients had moderate to severe levels of anxiety, depression, and stress; fatigue and shortness of breath were the most prevalent physical symptoms. Four patients [40%] already owned a smartwatch. In total, 575 patient days of patient monitoring occurred across 10 patients. Biosensor data was usable for 91.3% of study hours and surveys were completed 82.1% and 78.7% of the time for physical and mental symptoms, respectively. Positive correlations were observed between stress and resting heart rate [r = 0.360, p<0.01], stress and daily steps [r = 0.335, p<0.01], and anxiety and daily steps [r = 0.289, p<0.01]. There was a trend toward negative correlation between sleep time and physical symptom burden [r = -0.211, p = 0.05]. Patients reported an overall positive experience and identified the potential for wearable devices to improve medical safety and access to care. Concerns around data privacy/security were infrequent. We report excellent feasibility characteristics for wrist-worn biosensors and e-PROMS as a possible substrate for multi-modal disease tracking in post-COVID conditions. Adapting consumer-grade wearables for medical use and scalable remote patient monitoring holds great potential.

Support Group dalam Menurunkan Tingkat Stres pada Caregiver Skizofrenia

One of the cases experienced by schizophrenia caregivers is stress. One intervention to reduce stress levels in schizophrenia caregivers is a support group. Support groups are carried out with peer groups who have relatively similar problems by sharing information about the problems experienced by schizophrenia caregivers. This research aims to reduce the level of stress felt by caregivers of schizophrenia, using a quasi-experiment and using 6 research subjects consisting of 5 female subjects and 1 male subject who have moderate to severe stress level scores. The data collection method was carried out using the Kingston Caregiver Stress Scale (KCSS) and analysis used the Repeated Measured Anova Test. The results of the support group intervention showed that caregivers experienced significant changes (p&lt;0.05) in terms of reducing stress levels before and after providing support group therapy. This study has important implications for the implementation of support groups in reducing stress levels among caregivers of individuals with schizophrenia. It can be concluded that support groups are effective in lowering stress levels in schizophrenia caregivers.

Psychological Distress and the Needs of Family Members of Critically Ill Patients in Emergency Departments During the COVID-19 Pandemic: A Cross-Sectional Study

IntroductionThe literature highlights the importance of the needs of family members of critical patients in emergency departments. Understanding these needs helps to alleviate psychological distress and contribute to the patients’ recoveries. This study aimed to examine the psychological distress and needs of family members of critical patients in emergency departments. MethodsA cross-sectional design was used to collect data using the Depression, Anxiety, and Stress Scale-21, the Critical Care Family Needs Inventory for the Emergency Department, and the Needs Met Inventory questionnaire from a convenience sample of 170 family members of critical patients. Descriptive analysis and importance-performance analysis were applied to analyze the data. ResultsThe results showed that 52.4% of family members reported mild to extremely severe levels of depression, 60% reported mild to extremely severe levels of anxiety, and 53.5% had mild to extremely severe levels of stress. Anxiety showed a significant negative correlation with comfort needs (r = −0.17) and support needs being met (r = −0.16). The importance-performance analysis showed that the coordinates for support needs were in quadrant IV, signifying a higher level of importance perceived by family members but a lower level of the needs being met. ConclusionProviding the assessment and necessary support to alleviate psychological distress will help enhance the ability of the emergency department to meet families’ needs.

Maternal Malnutrition and Elevated Disease Risk in Offspring.

US populations have seen dramatic increases in the prevalence of chronic disease over the past three generations. Rapid increases in type 2 diabetes and obesity have occurred in all the states but have been particularly striking in the Deep South. These increases have contributed to decreases in life expectancy and to painful elevations in health care costs. The causes of worsening population health are complex and incompletely understood. However, there is strong evidence that vulnerability to chronic conditions is determined in early life. Most chronic diseases are developmentally driven. There are specific stressors experienced in early life that influence epigenetic and structural changes during development. These include malnutrition, severe levels of social stress, toxic chemicals, and low oxygen levels. Most US populations have experienced a decrease in the quality of the food they consume as industrial foods have replaced garden-grown foods. Thus, the consumption of too few nutrients before and during pregnancy and during lactation influences the growth of the placenta and fetal organs and their level of resilience when faced with stresses in postnatal life and particularly as adults. Animal studies have shown that the effects of poor nutrition can be passed on to future generations. The most powerful way that the current epidemics of obesity and insulin resistance can be reversed is by providing key nutrients to prospective mothers and those already pregnant.

Supporting Mental Health Well-Being in the Most Vulnerable Future Nurses.

The aim of the study was to explore relationships between perceived faculty support and prevalence of severe/extremely severe depression, anxiety, and stress levels among undergraduate baccalaureate nursing students. Emerging research supports nursing students suffering from extreme psychological distress. Educational success and mental health wellness are influenced by external support. A mixed-methods design was used for this descriptive, cross-sectional study. A national convenience sample of 1,163 undergraduate baccalaureate nursing students completed the Depression, Anxiety and Stress Scale-21, Perceived Faculty Support Scale, and a demographic questionnaire. Emerging themes in the qualitative data were identified. Nearly 54 percent of nursing students suffered from severe/extremely severe depression, anxiety, or stress. Faculty support was critical to nursing student mental health well-being. This multisite study provides a better understanding of the enormity of psychological distress among undergraduate baccalaureate nursing students and emphasizes the immediate need for faculty to provide necessary support to this vulnerable student population.

Evaluating phytoremediation potential and nutrients status of Bassia indica (Wight) A. J. Scott (Indian Bassia) in a cadmium-contaminated saline soil.

Bassia indica (Wight) A. J. Scott is a fast-growing halophyte suitable for the remediation of saline lands on a large scale. However, no information is available regarding its phytoremediation potential for cadmium (Cd) alone or in combination with salinity. Besides evaluating phytoremediation, assessing micronutrient hemostasis as a crucial physiological insight into the mechanism involved in the tolerance of B. indica under saline soil contaminated with Cd was subjected. Under salinity stress, a considerable amount of sodium accumulates in the plant. Moreover, the accumulation of sodium increased by Cd stress levels. The increase in the exchangeable form of Cd in the rhizosphere in the presence of NaCl ions further elevated the Cd content in the plant tissues. For instance, compared to non-saline conditions, applying 2.5 and 5 g NaCl kg-1 to soil treated with 60 mg Cd kg-1 increased exchangeable Cd by 28.4 and 49.5% in rhizosphere soil, which led to increased cadmium content by 16.1 and 29.6% in the root (as amainpart of Cd accumulation), respectively. Under most stress conditions, potassium homeostasis in the shoot remained undisturbed. It was observed that this plant could transfer an optimal level of potassium from the roots to the shoots at a moderate salinity level. Changes and the distribution of Cu and Zn levels followed a similar pattern in the plant, indicating a common regulation mechanism for these nutrients. Generally, the plant could maintain an appropriate level of Fe, Zn, and Cu ions under most stressed conditions. However, the level of Mn decreased significantly under severe stress levels. Growth parameters, tolerance index, and the values of translocation factor < 1 and shoot bioconcentration factor > 1 under 5 mg Cd kg-1 soil treatment at different salinity levels indicated that B. indica could mitigate the detrimental effect of Cd toxicity and tolerate the NaCl stress via a phytostabilizer mechanism. However, the shoot bioconcentration factor values were very close to one at other Cd levels. Therefore, considering the obtained evidence and the innate ability of B. indica to remediation salinity, this plant is still recommended, even for higher Cd levels (even until 30 mg kg-1), in the presence of salinity.

Mental Health Challenges in Architecture and Landscape Architecture Students

Background: College students are experiencing increasing levels of stress, anxiety, and depression, but little research exists on factors weakening the mental health of design students.Aim: This study investigates the prevalence and precursors of mental health challenges among architecture and landscape architecture students.Methods: This study used a convergent mixed-methods research design with three data collection methods: The Depression and Anxiety Stress Scale (DASS-21; n = 399 students), an online wellness survey (n = 269), and semi-structured interviews (n = 37).Results: Findings reveal that 33%, 46%, and 33% of students screened positive for moderate to extremely severe levels of depression, anxiety, and stress, respectively. The leading factors elevating stress included school deadlines and schedule, workload demands or amount of work outside of class, inadequate sleep, and time spent at work. Negative behaviors due to stress were discussed, including neglect of self-care (e.g., poor sleep patterns, eating habits, and physical inactivity), inability to focus, emotional instability, and social withdrawal.Conclusions: This study underscores mental health concerns among design students and identifies potential factors that contribute to unhealthy habits and compromise academic performance, including pedagogical approaches, learning and teaching culture, studio environment, and lifestyle choices.

Consequences of the COVID-19 pandemic on the mental health of nurses in the Spanish out-of-hospital Emergency Service

ObjectiveTo analyse the impact of the COVID-19 pandemic on the mental health of nurses in Spanish out-of-hospital Emergency Services, identifying predictor factors of greater severity. MethodA multicentre cross-sectional descriptive study was designed, including all nurses working in any Spanish out-of-hospital Emergency Services between 01/02/2021 and 30/04/2021. The main outcomes were the level of depression, anxiety and stress assessed through the DASS-21 scale. Sociodemographic, clinical, and occupational information was also collected. Univariate and multivariate analyses were conducted to determine possible associations between variables. ResultsThe sample included 474 nurses. 32.91%, 32.70% and 26.33% of the participants had severe or extremely severe levels of depression, anxiety and stress, respectively. Professionals with fewer competencies to handle stressful situations, those who had used psychotropic drugs and/or psychotherapy on some occasion before the pandemic onset, or those who had changed their working conditions presented more likelihood of developing more severe levels of depression, anxiety and/or stress. ConclusionNurses in Spanish out-of-hospital Emergency Services have presented medium levels of depression, anxiety and stress during the pandemic. Clinical and occupational factors have been associated with a higher degree of psychological distress. It is necessary to adopt strategies that promote professionals’ self-efficacy and mitigate the triggers of negative emotional states.

EVALUATION OF MENTAL DISORDERS AMONG DAY SCHOLARS AND HOSTEL MEDICAL STUDENTS - PLACE OF RESIDENCE MATTERS

ABSTRACT OBJECTIVE: To assess stress, anxiety, and depression among medical students and compare the mental health status of medical students living at home and in hostels. STUDY DESIGN: Cross-sectional study PLACE AND DURATION OF STUDY: The study was conducted at a private Medical University from 10th July to October 2019 in Karachi. SUBJECTS AND METHODS: Data was collected through convenient sampling technique from 300 undergraduate medical, of which, 284 participants completed the questionnaire. After taking informed consent data was collected. The data collection tools used was Perceived Stress Scale-10 for stress and Agha Khan University Anxiety Depression Scale for anxiety and depression. All the data were analyzed on SPSS version 26. RESULTS: Results showed the mean age of the students was 21.3± 1.9 years. A moderate to severe level of stress was found in 221 (77.8%) medical students while a majority (69 %) of the students screened positive for anxiety and depression. Moderate to severe stress was found in 162 (77.9%) of the hostel students, while anxiety and depression was also higher among hostel students (73.6%). According to PSS-10 scale, moderate to high levels of stress was found to be statistically significant in younger students as compared to older students (P-value 0.03). CONCLUSION: Most medical students had psychological issues especially higher in those living away from home. Early detection of stress, anxiety and depression and its counseling are a golden rule for curbing and preventing psychological issues in medical students.

Work-related stressors and psychological distress predict career change ideation among Lithuanian healthcare workers.

The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents. The study included 1618 responders who completed an online survey in December 2021 - January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale - 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student's t test, and binary logistic regression evaluated career change predictors. Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels. Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287-99.

Exploring the prevalence of depression, anxiety, and stress among university students in Bangladesh and their determinants

BackgroundDepression, anxiety and stress among university students present a growing global challenge. This study aims to explore the prevalence of depression, anxiety, and stress and identifying their associated factors among university students in Bangladesh. MethodsWe analyzed data of 738 university students collected through a cross-sectional survey. Outcome variables considered were depression, anxiety, and stress levels. Explanatory variables considered were several socio-demographic characteristics. Multinomial logistic regression analysis was employed to explore the association of the outcome variables with explanatory variables. ResultsWe found a notable prevalence of moderate to severe levels of depression, anxiety, and stress among university students in Bangladesh, ranging from 25 % to 71 %. Among students from extended families, there was a 32 % lower likelihood of experiencing moderate depression (relative risk ratio [RRR], 0.68; 95 % confidence interval [CI], 0.47–0.97) and a 35 % lower likelihood of experiencing stress (RRR, 0.65; 95 % CI, 0.44–0.97) compared to their counterparts without depression and stress. Furthermore, students enrolled in the business faculty reported a significantly higher likelihood of stress, with a 2.28 times greater odds (95 % CI, 1.32–3.93) compared to students in the Science and Engineering faculty. ConclusionThis study underscores the pressing necessity for tailored interventions to address the elevated prevalence of depression, anxiety, and stress among university students in Bangladesh. The findings accentuate the importance of recognizing diverse risk factors and implementing mental health support programs.

Deletion of Nrf2 induced severe oxidative stress and apoptosis in mice model of diabetic bladder dysfunction

The nuclear factor erythroid 2-related factor 2 (Nrf2) pathway has been confirmed as a therapeutic target for type 2 diabetes mellitus (T2DM), however few studies revealed its effect in diabetic bladder dysfunction (DBD). Herein, we reported a Nrf2 deletion diabetic mouse model induced by 8-week high-fat diet feeding combined with streptozocin (STZ) injection in Nrf2 knockout mice. Besides, wild-type mice (WT) were used as control group, wild-type mice with high-fat diet feeding and STZ injection as diabetic group (WT-T2DM), and Nrf2 knockout mice as Nrf2 deletion group (KO). The pathophysiological indexes and bladder morphology showed typical pathological features of diabetic bladder dysfunction in Nrf2 knockout diabetic mouse mice (KO-T2DM). ELISA results showed that advanced glycation end products (AGEs), ROS and malondialdehyde (MDA) levels in bladder was were up-regulated in both WT-T2DM and KO-T2DM group, while superoxide dismutase (SOD) and glutathione (GSH) levels decreased in these two groups. Compared with WT-T2DM group, western blot analysis of the bladder showed down-regulated expression of NQO1 and HO-1 in KO-T2DM group. However, apoptosis, marked by Caspase3 and bax/bcl-2 ratio, was increased in KO-T2DM group. Neurotrophic factor (NGF) was significantly decreased in DBD model, and even much lower in KO-T2DM group. Collectively, our findings demonstrated that deletion of Nrf2 lead to severe oxidative stress, apoptosis, and lower level of neurotrophic factor, and provided the first set of experimental evidence, in a mouse model, to support Nrf2 as a promising target for DBD.

STRESSORS AND COPING MEASURES AMONG UNDERGRADUATE NURSING STUDENTS IN WESTERN NIGERIA

Nursing students are frequently exposed to various stressors throughout their training; the resultant stress affects their personal, professional, and academic achievements and well-being directly or indirectly. This study aimed to identify the causes/sources of stress, the levels of stress, coping measures, and possible suggestions for reducing stress and its effects among nursing students. A descriptive cross-sectional design was used to assess stress and coping variables among undergraduate nursing students at a federal university in Western Nigeria. This study recruited 151 full-time undergraduate nursing students in their first to fifth study years using a simple random sampling technique. Data were collected using the Perceived Stress Scale (PSS) and self-structured questions. The results were summarized using descriptive statistics of frequency, percentages, and mean ± SD. Academic, personal, financial, and relationship-related stressors were found to be the most common sources of stress. Most of nursing students experienced either low (47.7%) or severe (44.3%) stress levels and coped with it through positive thinking, optimism, sleep, and relaxation. Respondents suggested that more emphasis be placed on health promotion programs, reducing the number of exams in a week, and teaching students how to develop their social, coping, and time management skills.