Fourteen-item perceived stress scale assessment using item response theory among pregnant women

The current study aimed to assess the psychometric properties of the Spanish language version of the 14-item Perceived Stress Scale (PSS-S) in a population of pregnant women who speak Spanish in Peru using item response theory (IRT). Our study consisted of 5,435 pregnant women who participated in the Pregnancy Outcomes Maternal and Infant Study (PrOMIS) cohort in Peru. Exploratory and confirmatory factor analyses were conducted to determine dimensionality of the scale in this population, and item response theory was conducted to determine the applicability of the PSS. The PSS consisted of a 2-factor questionnaire measuring perceived stress and coping capacity accounting for 77% of variability. The IRT analysis showed differences in item difficulty and discrimination. Item difficulty represents the level of the latent construct where 50% of respondents endorse a particular response, and item discrimination determines the rate of change of the probability of endorsing an item for differing ability levels. For the first factor, perceived stress, item 12 was the least difficult and item 2 was the most difficult. For the second factor, coping capacity, item 9 was the least difficult and item 6 was the most difficult. The Spanish version of the 14-item PSS can be a useful assessment tool for perceived stress, but more IRT should be done to delve further into the psychometric properties of the questionnaire to inform clinicians and policy makers more appropriately.

Changes of college students' psychological stress during the COVID-19 pandemic in China: A two-wave repeated survey

COVID-19 has posed unprecedented challenges to the mental health of college students worldwide. We examined the trends in students' stress levels during and after China's first wave of COVID-19 outbreaks by analyzing their demographics, behavior, mental health status, career confidence, and Chinese Perceived Stress Scale (CPSS) scores. Our findings indicate an increase in students' stress levels since the COVID-19 onset, with more students experiencing higher stress levels after the first outbreak than during it (OR = 2.03, 95% CI 1.79, 2.30). Several factors were identified as being associated with higher CPSS scores, including higher class levels, residence in rural or town areas, low family income, and lack of familiarity with COVID-19, among others. Our study highlighted the urgency of developing and implementing effective strategies to cope with students' stress during and after a global pandemic.

Effect of onion (Allium cepa L.) peel extract on natural killer cell and cytokines in a randomized, double-blind, placebo-controlled trial

BACKGROUND/OBJECTIVES

Onion, particularly onion peel, is a quercetin-rich food with, anti-inflammatory and immunomodulatory effects. However, the effect of onion peel extract (OPE) in humans is unclear. Thus, the present study aimed to investigate whether OPE improves natural killer (NK) cell activity and cytokine concentration in a randomized double-blind placebo-controlled trial.

SUBJECTS/METHODS

Eighty participants aged 19-64 yrs old with a white blood cell count of 4,000-10,000 cells/µL, symptoms of upper respiratory infection at least once within the previous 12 mon, and perceived stress scale (PSS) over 14 were included. Participants were randomly assigned to take either 1,000 mg/day OPE or a placebo for 8 weeks.

RESULTS

Compliance were 87.4 ± 8.6% and 86.9 ± 79.0% in OPE and placebo groups. Compared to the placebo, OPE supplementation improved "Hoarseness" (P = 0.038) of the Wisconsin Upper Respiratory Symptom Survey (WURSS)-21 symptom, and stress scores (P = 0.001; 0.021) of PSS. Supplementation of OPE had no significant effect on NK cell activity and concentrations of cytokines such as interleukin (IL)-2, IL-6, IL-12, IL-1β, interferon-γ, and tumor necrosis factor-α. At baseline, the WURSS-21 symptom and PSS score (P = 0.024; 0.026) were higher in the OPE group than the placebo group. Among participants with higher than median WURSS-21 symptom score, OPE supplementation increased NK cell activity (P = 0.038). Supplementation of OPE had no significant effects on safety measurements and adverse events.

CONCLUSIONS

The present study suggested that OPE supplementation improves NK cell activity in participants with moderate upper respiratory symptoms without any significant adverse effects.

Trial Registration

ClinicalTrials.gov Identifier: NCT05666752.

Evaluation of the psychometric properties of the Italian version of the 10-item perceived stress scale in a sample of teachers

Background

The 10-item Perceived Stress Scale is a widely used questionnaire for measuring perceived stress.

Aim

This study aimed to assess the psychometric properties of the Italian version of the 10-item Perceived Stress Scale in a sample of Italian teachers during the COVID-19 pandemic.

Methods

A cross-sectional study was performed. A sample of 1,179 teachers of pre-primary, primary, and secondary schools anonymously completed an online questionnaire. A Confirmatory Factor Analysis was performed to compare the fit of a two-factor model against a one-factor solution of the scale. Multigroup CFA was run to test the measurement invariance of the two-factor PSS-10 solution across gender. The internal reliability of the scale was evaluated using Cronbach's alpha and McDonald' omega coefficients. Convergent validity with measures of subjective well-being and self-reported health was evaluated.

Results

The results of the Confirmatory Factor Analysis showed that the two-factor structure of the 10-items Perceived Stress Scale provided a better fit to the data and supported the adequacy of the Italian version of the scale. The two-factor model showed measurement invariance across female and male groups, as result of the multigroup CFA. The scale proved to have good internal reliability. Correlation analyses with measures of the Positive Affect and Negative Affect Schedule and self-reported health supported convergent validity.

Conclusion

These results suggest that the Italian version of the 10-item Perceived Stress Scale has good psychometric properties and can be considered a valid and reliable instrument to assess perceived stress.

The Impact of Music on Stress Reduction and Academic Performance of Dental Students

Background Dental education, one of the most demanding healthcare fields, is linked to higher physical and mental illnesses in students. Stress, which arises when demands surpass an individual's ability to adapt, can lead to disruptions in cognition, mood, and behavior. Due to the intense academic pressure, dental students are susceptible to stress and other mental issues. Music therapy, an ancient practice, is now popular for stress reduction. However, its effect on academic performance is debated. Objectives This study aimed to evaluate the impact of music on stress levels and academic performance of dental students. Methods The study included third-year dental students from the College of Dentistry, Komar University of Science and Technology, Sulaymaniyah, Iraq. The demographic data were collected using a self-administered questionnaire. Results The study found that music intervention reduced the perceived stress levels of dental students in the intervention group compared to the baseline but did not reach a significant level. The final stress levels were positively correlated with baseline stress levels but did not correlate with other parameters. No association between sociodemographic variables and the Perceived Stress Scale was found. The study also found no significant positive or negative effect of music on academic performance. Conclusion The study suggests that music may positively impact stress reduction for dental students during their academic years in dental school. It highlighted the significance of stress-reduction programs in the academic curriculum in lowering dentistry students' stress and, as a result, potentially improving their learning abilities.

Linking the Perceived Stress Scale to the PROMIS Psychological Stress Experiences-Pediatric in adolescents

The Perceived Stress Scale (PSS) and PROMIS Psychological Stress Experiences-Pediatric (PPSE) are two self-report instruments that have been used with adolescents to measure subjective feelings of stress. Stress is a critical construct to evaluate, as chronic stress can result in negative long-term consequences for an individual's physical and mental health. While the PSS is more commonly used in research and clinical practice, use of the PPSE is becoming more widespread. This increased usage necessitates a way to compare the measures, for example, when changing which instrument is used in practice or when combining data from the two measures in pooled analysis. After assessing linking assumptions, we used equipercentile linking to score-link the two measures on the raw score and T-score metrics for both longer forms (10 PSS items; 8 PPSE items) and shorter forms (4 PSS or PPSE items), yielding crosswalk tables (Open Science Framework: https://osf.io/9pzyk/) to convert scores on each measure to the metric of the other. Raw scores between measures (.670 ≤ r ≤ .794) were not sufficiently correlated for score linking. Therefore, linked scores were treated as predictions, rather than counterfactual values on the alternative measure. Further, confirmatory factor analyses revealed that this low correlation was primarily due to the low reliability and multidimensionality of the PSS, and the derived linking functions were found to have minimal bias. Recommendations for the use of these conversion tables by researchers and practitioners are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recurrent Oral Ulcers and Its Association With Stress Among Dental Students in the Northeast Indian Population: A Cross-Sectional Questionnaire-Based Survey

Aim The term "aphthous" is derived from the Greek word "aphtha," which means ulceration. The cause of aphthous ulcers is multifactorial, but emotional stress is one of the most important risk factors for its occurrence in young individuals. The aim of this study was to evaluate the association of recurrent oral ulcers (ROUs) with stress among dental students in the Northeast Indian Population. Materials and methods A total of 1,134 students were recruited for the study. Two sets of questionnaires were designed. The first set consisted of 11 questions related to demographic data and information about recurrent oral ulcers. The second set of questionnaire had 14 questions related to stress symptoms. Google Forms (Google, Inc., Mountain View, CA, USA) was used for recording the responses of the study participants. Questionnaires were sent to the participants through e-mail, and responses were recorded. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 21 (IBM SPSS Statistics, Armonk, NY, USA) and Microsoft Office Excel (Microsoft Corp., Redmond, WA, USA). The chi-square test was used to compare categorical variables. Results Among the 1,134 participants, 32.7% (371 students) reported a previous history of recurrent oral ulcers. Out of 371 participants who had given a history of oral ulcers, only 27.2% exhibited direct stress to ulcer association. On further assessment using the Perceived Stress Scale (PSS), it was found that a far greater percentage of students (i.e., more than 27.2%) were under some form of stress or the other. Conclusions The results of this study will help improve the quality of life among the study population, either by tackling their stress levels or by identifying adequate interventions.

Resilient Coping is More Important Than Previous Virtual Learning Experience: Predicting Pharmacy Student Stress During the COVID-19 Pandemic

Purpose

The COVID-19 pandemic precipitated a swift transition to online learning in medical and health sciences. This study investigated the associations of previous experience with online learning, current confidence with online learning, and resilient coping skills with perceived stress reported by pharmacy students during the emergency transition to online learning.

Methods

Undergraduate pharmacy students (N=113, response rate = 41%) completed an online, self-report, cross-sectional survey during April-June 2020. Measures included Likert items measuring prior experience and current comfort levels with online learning, the Brief Resilient Coping Scale (BRCS), and the Perceived Stress Scale 10-Item Version (PSS-10). Experience, comfort with online learning, reported scores, and internal consistency for the BRCS and PSS-10 were summarized. A linear regression model examined the associations of prior experience with online education, gender, and resilient coping with perceived stress.

Results

Of the 113 respondents (78% female, mean age 22.3 years), > 50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3, respectively, and both scales demonstrated good internal consistency (α > 0.80). BRCS score was the single predictor of the PSS-10 score (r² = 0.18, p < 0.001). Female gender was not a significant predictor (p = 0.11). A multiple regression model explained moderate variation in perceived stress (adjusted R² = 0.19).

Conclusion

PSS-10 and BRCS scores indicated moderate levels of stress and coping skills among students during online teaching. Most students had some prior exposure to online learning, coursework, and examinations. Higher resiliency scores, but not prior online learning experience, predicted lower perceived stress.

COVID-19 Caregiving Strategies, Quality of Life, and Stress Among Faith Community Nurses and Faith Leaders in Appalachia

ABSTRACT

Faith community nurses (FCNs), pastors, and priests faced many challenges from the COVID-19 pandemic, serving as frontline sources of support for congregants. The aim of this study was to identify the most common care strategies used during the COVID-19 pandemic and examine professional quality of life, perceived stress, and associated factors in faith leaders and FCNs in rural Appalachia. Using a cross-sectional, descriptive survey design, high compassion satisfaction was reported along with compassion fatigue as caregiving moved to virtual platforms, suggesting the need for greater support.

Anxiety and Stress During the COVID-19 Lockdown Among the General Population in Perambalur: A Cross-Sectional Study

Background The coronavirus disease 2019 (COVID-19) pandemic and lockdown had a significant impact on mental health during the last two years. However, the majority of studies do not concentrate on the risk and protective factors that influence the relationship between COVID-19 and subjective well-being. Therefore, the present study aims to identify such stressful experiences and the influence of COVID-19 and various stressors. Methodology We have conducted this community-based, cross-sectional, analytical study in the Perambalur district of Tamil Nadu for four months. After obtaining approval from the Institutional Ethics Committee, we gathered data for the study. Two field practice areas were involved in data collection. A convenient sampling procedure was used to select 291 households for the study. The lead investigator interviewed one individual from each household, preferably the head of the family. A semi-structured questionnaire was used to collect the pertinent information. The Coronavirus Anxiety Scale (CAS), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder (GAD) scale were used to assess anxiety and stress. All collected data were entered into Microsoft Excel (Microsoft Corporation, Redmond, WA), and SPSS software version 21 (IBM Corp., Armonk, NY) was used to analyze the results. Results Among the participants, 34% had a history of COVID-19 infection, and 58.4% of the families had at least one chronic comorbidity among the family members. The CAS score was significantly associated with the residence (p = 0.049), marital status (p = 0.001), and previous history of COVID-19 (p = 0.016) of the study participants. The study found that gender was the only factor associated with both the PSS score (p = 0.022) and the GAD scale score (p = 0.010) of the study participants. Conclusions Even though doctors can treat many mental health illnesses for a comparatively minimal cost, there is still a wide disparity between those who require care and those who have access to it. Governmental programs and regulations that conduct routine surveys to identify anxiety and stress can lead to successful preventative strategies.

Premenstrual Syndrome and Its Association with Perceived Stress: The Experience of Medical Students in Jordan

Objective

To assess the prevalence of premenstrual and menstrual symptoms and to investigate premenstrual severity’s association with perceived stress of premenstrual syndrome among medical students.

Methods

This is a cross-sectional study. Data were collected between March and April 2021, a self-administered online questionnaire (Supplementary Material) was distributed to a sample of female medical students in Jordan (n=594).

Results

The mean age was 21.6 ±2.2 years, and the mean body mass index (BMI) was 22.8 ±4.1 kg/m2. Most students were in their 5th and 6th university year, where 75.4% reported having dysmenorrhea, 45.8% used pharmacological agents for pain relief, while 54.2% used non-pharmacological means, and 58.1% occasionally skipped lectures. Most participants reported a constellation of physical and psychological symptoms. The mean for the premenstrual severity scale score was 29.3, and the mean for the perceived stress scale scores was 21.6. There was a statistically significant correlation between the premenstrual severity scale score and the perceived stress scale, between the premenstrual severity scale and absenteeism, between premenstrual severity scale and year of study, and between dysmenorrhea and the perceived stress scale, but not between the severity of symptoms and method of pain relief.

Conclusion

Premenstrual and menstrual symptoms have a negative impact on students that affects their academic participation. More support should be given from universities to address the menstruation-related struggles of female students.

Associations of perceived stress and salivary cortisol with the snack and fast-food dietary pattern in women shift workers

This study aimed to investigate the association of perceived stress and salivary cortisol levels with the snack and fast-food dietary pattern in a sample of women shift workers. We conducted a cross-sectional study of 539 women aged 18-53 years working in the production line of a poultry processing plant. Stress was assessed with the 10-item Perceived Stress Scale (PSS-10) and by salivary cortisol levels (immediately after waking and upon returning home from work). Dietary patterns were identified by principal component analysis. We used linear and Poisson regression models to assess multivariable-adjusted associations of perceived stress and salivary cortisol levels with the snack and fast-food dietary pattern. After adjustments, women with higher PSS-10 scores had a 28% higher probability (95% confidence interval, 1.04-1.56) of consuming snacks/fast food. Mean (SD) waking cortisol levels were inversely associated with quartiles of the dietary pattern: Q1, 6.63 (0.43) nmol/L; Q2, 6.00 (0.38) nmol/L; Q3, 5.62 (0.40) nmol/L; and Q4, 5.29 (0.35) nmol/L (p = 0.019). Perceived stress was not associated with salivary cortisol levels. The work shift was not associated with perceived stress or cortisol levels. This study demonstrated an association of psychological and physiological measures of stress with a dietary pattern characterized by high intakes of hyper-palatable, energy-dense, ready-to-eat foods among women shift workers.

Impact of Stress on Menstrual Cyclicity During the Covid-19 Pandemic: A Survey Study

Background: The Covid-19 pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the Covid-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the Covid-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.

Prevalence of stress, stressors, and coping strategies among medical undergraduate students in a medical college of Mumbai

BACKGROUND

Stress is a subjective experience which creates an obstacle in a person's path of achieving his or her goals. It creates negative outcomes among the population. Medical curriculum is very vast and stressful. As doctors are the very important part of society, medical students must be allowed to learn their trade in a stress-free environment. The present study aimed to assess the perceived stress, various sources of stress among medical undergraduate students, and the coping strategies adopted.

MATERIALS AND METHODS

This was a cross-sectional study conducted among medical under-graduate students studying at a tertiary care hospital situated in Mumbai city of Maharashtra between January and June 2018. Using purposive sampling technique, a total of 450 medical students from 1^st year to final year were invited to participate in the study. A self-administered questionnaire consisting of sociodemographic details and perceived stress scale questions was used. Logistic regression analysis was carried out to assess the determinants of stress. Odds ratio, 95% confidence interval was calculated. P < 0.05 was considered statistically significant.

RESULTS

The overall response rate was 79.11%, with 356 out of 450 students returning the questionnaire. Among 356 participants, 324 participants (91%) were suffering from high levels of stress. Factors such as curriculum vastness, frequency of examination, competition with peer, performance in examinations, worry about future, loneliness, relation with opposite sex, and quality of food played a major role in creating additional stress.

CONCLUSIONS

The perceived stress was higher among female medical students. Academic factors are greater perceived cause of stress in medical students in this study. A substantial proportion of medical undergraduate students were found to be stressed which necessitates appropriate and timely interventions. Reframing the academic curriculum along with examination and evaluation patterns, incorporating extracurricular activities, and establishment of counselling cells in the institution is the need of the hour.

A patient-focused survey to assess the effects of the COVID-19 pandemic and social guidelines on people with muscular dystrophy

Introduction/Aims

In this study, we examined the social and health impacts of the coronavirus disease 2019 (COVID‐19) pandemic and social guidelines on people with muscular dystrophies.

Methods

A prospective de‐identified electronic survey was distributed to adults with self‐reported facioscapulohumeral muscular dystrophy (FSHD), myotonic dystrophy (DM), and limb‐girdle muscular dystrophy (LGMD) enrolled in national registries or with patient advocacy groups.

The COVID‐19 Impact Survey was developed by muscular dystrophy experts in association with patient collaborators and advocacy groups. The Perceived Stress Scale was used to measure perceived stress.

Results

Respondents (n = 774: 56% FSHD; 35% DM, and 9% LGMD) were mostly women and middle‐aged (range 19–87 y). Rates of COVID‐19 infections were low (<1%), compliance with local social distancing guidelines and policies high (98%). Major challenges reported during the pandemic included: obtaining treatment (40%), managing stress (37%), social distancing (36%), and obtaining essentials (34%). The majority reported a slight worsening in their disease state. Respondents reported moderate stress levels (stress score = 15.4; range = 0–35), with higher stress levels reported by women and those under age 30 y. Three‐quarters of participants who participated in telemedicine visits were satisfied with the encounters; however, most reported a preference for in‐person visits.

Discussion

People with muscular dystrophy reported moderate stress and challenges during the COVID‐19 pandemic. Interventions such as exercise and stress‐coping strategies, including strategies specific to women or individuals <30 y, may be important. Further investigation is needed into the role of telemedicine in the care of individuals with muscular dystrophy.

Perceived Stress Predicts Subsequent Self-Reported Problems With Vision and Hearing: Longitudinal Findings From the German Ageing Survey

Although stress is a risk factor for various diseases in later life, its role for sensory abilities in the second half of life has rarely been empirically addressed. We examined if perceived stress at baseline predicts self-reported difficulties with vision and hearing 3 years later. We also explored whether chronological age is a moderator of associations between stress and sensory difficulties. Our sample was derived from the German Ageing Survey and consisted of n = 5,085 individuals aged 40-95 years (M = 64.01 years, SD = 10.84 years). Controlling for baseline self-reported sensory functioning, socio-demographic indicators, self-rated health and chronic diseases, greater perceived stress at baseline predicted greater self-reported difficulties with vision and hearing 3 years later. The effect of stress did not vary by age. Our findings suggest that, from middle adulthood to advanced old age, stress is a risk factor for increases in self-perceived problems with vision and hearing.

Major dietary patterns and metabolic syndrome associated with severity of coronary artery disease: A structural equation modeling

BACKGROUND

The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known.

AIM

This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM).

METHODS

In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35-65 years, who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested by using a semi-quantitative food frequency questionnaire, international physical activity questionnaire, perceived stress scale, lipid profile, fasting blood glucose, and anthropometric and blood pressure measurements. Statistical analysis was performed using SPSS and AMOS version 24.

RESULTS

Two dietary patterns (DPs) were identified by principal components analysis and labeled as "unhealthy DP" and "healthy DP". The results of SEM analysis showed that the unhealthy DP has a significant positive direct association with the severity of CAD (β=0.304, p<0.001), which is indirectly mediated by the presence of metabolic syndrome (β=0.021, p=0.021), adjusted for age and perceived stress scale. However, healthy DP has a significant negative direct association with the Gensini score (β=-0.213, p<0.001), and an indirect association through negative metabolic syndrome (β=-0.019, p=0.022), controlled for gender, physical activity, and perceived stress scale.

CONCLUSIONS

The severity of CAD was directly associated with the unhealthy DP and indirectly mediated by the presence of the metabolic syndrome, while a healthy DP had a direct inverse association with CAD severity and indirectly mediated by the absence of metabolic syndrome.

Perceived Stress and Perceived Lack of Control of Spanish Education-Degree University Students: Differences Dependent on Degree Year, Basis for Admission and Gender

Stress in higher education students is an issue of growing concern, as stress impacts quality of life and has been linked to drop-out from higher education. The aim was to investigate how stress was related to how far along students were in their degree program, using the Spanish Perceived Stress Scale (PSS10). We expected 1) first-year education students to experience more perceived lack of control than second-year students, 2) second-year students to experience more perceived stress than first-year students. Participants were students in three university education-degree programs (N = 399). The psychometric properties of the Perceived Stress (PS) and Perceived Lack of Control (PLC) subscales were investigated using Rasch models. One item was eliminated from each subscale. The estimated interval-level Rasch scores were utilized for testing hypotheses with general linear models. Results showed a somewhat more complex pattern than predicted as interaction effects between degree year and gender and between degree year and basis for admission were found.

Nursing students' views on the COVID-19 pandemic and their percieved stress levels

PURPOSE

This study was conducted to evaluate nursing students' views on the COVİD-19 pandemic and their perceived stress levels.

DESIGN AND METHODS

A cross-sectional design was used to carry out this study. The research was conducted between April and May 2020 with 662 nursing students. Data were collected by an information form developed for the study and the Perceived Stress Scale (PSS).

FINDINGS

The average score on the PSS was 31.69 ± 6.91, indicating that the students had a moderate level of stress. Significant differences in PSS score were found in terms of age and sex (P < .001 and P < .001, respectively).

PRACTICE IMPLICATIONS

Results of this study indicated that age, sex, and some variables related to the pandemic process affect perceived stress levels of nursing students.

Perception of Tinnitus Handicap And Stress Across Age Groups in Normal Hearing

INTRODUCTION

This research was conducted to investigate the severity of tinnitus, its impact on subject's daily, personal and emotional life, which varies widely across the age groups.

METHODOLOGY

Sample population of 60 unilateral tinnitus subjects with normal hearing between the age ranges of 15-55years were divided into four age groups. Tinnitus severity was measured using tinnitus severity index, impact of tinnitus on daily life was documented through tinnitus handicap inventory and the stress levels through perceived stress scale.

RESULTS

A high frequency tinnitus was observed in age group of 56-65years, in contrast to noise like tinnitus in subjects aged 15-25years. The tinnitus was found to be most handicapping (38-56; moderate handicap) in Group 4(56-65years), the perceived stress levels were also falling in very high range (21 and over). Tinnitus severity index did not show any significant difference between the Group 1:15-25yrs, Group 2: 26-40yrs, Group 3:41-55yrs, and however group 4(56-65 yrs) did report with mild severity. The outcomes of present study demonstrated that elderly subjects certainly require modifications in the test protocols and referrals to address to their significant responses to tinnitus.

Emotional intelligence and perceived stress among undergraduate students of arts and science colleges in Puducherry, India: A cross-sectional study

Background

The concept of emotional intelligence has gained great popularity in the last few decades. With significant rise in stress and other emotional disturbances among students, it becomes necessary to determine whether high emotional intelligence could help manage perceived stress better. This study aims to assess emotional intelligence and perceived stress among undergraduate students of Arts and Science colleges, to determine the association of emotional intelligence with perceived stress, academic performance, and selected socio-demographic factors.

Methods and Material

Using multistage sampling, 720 students aged 18 years and above were selected from four colleges in Puducherry. Emotional intelligence and perceived stress were assessed using standard self-administered questionnaires "The Schutte Self-Report Emotional Intelligence Test (SEIT)" and "Perceived Stress Scale (PSS-14)," respectively.

Results

The median (IQR) Emotional Intelligence score and Perceived Stress score were 127 (114-137) and 43 (39-47), respectively. The study was not able to establish a significant association between emotional intelligence and perceived stress. A weak significant correlation existed between emotional intelligence and academic performance. Multiple variable analysis revealed gender, year of study, volunteering with youth organizations, and mother's occupation to be significantly associated with emotional intelligence (p < 0.05).

Conclusions

Women, final year students and those who volunteered with youth organizations had higher emotional intelligence. Children of mothers who were employed in knowledge-intensive occupations were more emotionally intelligent. Academic performance had a weak positive significant correlation with emotional intelligence.

Epidemiological and biochemical factors (serum ferritin and vitamin D) associated with premature hair graying in Egyptian population

BACKGROUND

The etiology of premature hair graying (PHG) remains incompletely understood with limited treatment options, although has profound impacts on patient's quality of life.

AIMS

To assess demographic and clinical profiles of Egyptian PHG patients and explore association of various epidemiological risk factors and serum vitamin D and ferritin levels with PHG.

PATIENTS AND METHODS

Three hundred PHG patients and equal number of controls, aged <30 years, were included. Assessment of epidemiological and clinical characteristics, biometric data and stress perception using perceived stress scale (PSS-10) was done, with measurement of serum vitamin D and ferritin levels for all subjects. PHG was graded into mild, moderate, and severe if <10, 10-100, and >100 gray hairs, respectively. Statistical significance for various compared parameters was done employing suitable tests, with P-value ≤ .05 considered significant.

RESULTS

Results reported significant positive relation of PHG with family history, sedentary life style, and stress (P = .001, .029, and .001, respectively), while no significant relation with smoking, body mass index, or frequent hair dyes use (>3 per year) (P = .425, .5, and .65, respectively). No significant difference was found in mean vitamin D between patients and controls (23.79 ± 13.01 ng/mL vs 24.85 ± 13.19 ng/mL, P = .701), while low serum ferritin (<20 ng/mL) was significantly associated with PHG (14.7 % patients vs 2.7% controls, P = .017).

CONCLUSION

PHG in Egyptian population is significantly associated with positive family history, stress, sedentary life style, and low serum ferritin level, while role of vitamin D deficiency should be further evaluated.

Perceived Stress and Associated Factors in Russian Medical and Dental Students: A Cross-Sectional Study in North-West Russia

The aim was to assess perceived stress (PS) and factors associated with PS in Russian medical and dental students. A total of 406 medical and 283 dental students aged 18–25 years that attended the Northern State Medical University in Arkhangelsk, North-West Russia participated in this cross-sectional study. A structured, self-administered questionnaire was used to collect information on socio-demographic and socioeconomic factors, oral health (OH) behavior, and self-reported OH. All students were clinically examined to assess dental caries, oral hygiene, and gingiva. PS was measured by the Perceived Stress Scale 10 (PSS-10). Of the students, 26.0%, 69.1%, and 4.9% reported low, moderate, and high PS, respectively. Female sex (b = 2.28, 95% confidence interval (CI): 1.38–3.18), dental faculty (b = 1.74, 95% CI: 0.94–2.54), low subjective socioeconomic status (SES) (b = 1.71, 95% CI: 0.91–2.51), and irregular dental visits (b = 1.65, 95% CI: 0.72–2.58) were associated with higher PSS-10 score. These factors were assumed to be clinical meaningful, given that minimal clinically important difference of PSS-10 fell between 2.19 and 2.66 points. The majority of the medical and dental students reported moderate PS. Based on statistical significance and clinical meaningfulness, socio-demographic factors (sex, faculty), subjective SES, and OH behavior (regularity of dental visits) were associated with PS.

Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

BACKGROUND

A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients' self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome.

AIMS

The aim of this study was to describe stress before and after the onset of Takotsubo syndrome.

METHODS

Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up.

RESULTS

Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful.

CONCLUSION

Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.

A Pilot Study Evaluating the Prevalence of Cervical Spine Dysfunction Among Students of Dentistry at the Medical University

Introduction: Cervical pain affects most people at some stage, especially middle-aged. It is one of the symptoms of cervical spine dysfunction. The prevalence of neck pain varies and depends on the population studied.

Aim: The aim of the study was to assess the prevalence of cervical spine dysfunction among dentistry students from a medical university.

Materials and Methods: The study was conducted on a group of 112 randomly chosen, generally healthy students (73 women and 39 men) of the faculty of medicine, division of dentistry at a medical university, aged 20–32, average 22.88 ± 2.7. The survey was based on a questionnaire about possible symptoms and disorders of the cervical spine in the 6 preceeding months. A bodychart was used to visualize ailments in relation to the scheme of human body, and a Graded Chronic Pain Scale was applied to assess levels of pain. Additionally, the Perceived Stress Scale and Neck Disability Index were evaluated.

Results: With respect to the questionnaire about possible symptoms of cervical spine disorders in the 6 preceeding months, 22.32% of students declared headaches 2–3 times a week, and 45.53% 2–3 times a month. 42.85% of the participants reported difficulties with concentration, 56.25% showed attention issues, and 25% had problems with memory. Moreover, 9.82% of the subjects suffered from depression, and 27.67% declared mood disorders. The bodychart revealed the occurrence of pain within the cervical spine in 47.32% of the respondents. 31.25% of students declared discomfort in the suboccipital area. In 57.14% of people, low intensity of chronic pain without functional disorders was noted. A moderate level of stress was reported in 58.03% of students. Mild cervical spine disorders were found in 53.57% of cases.

Conclusion: The relatively high prevalence of symptoms of the cervical spine dysfunction, chronic pain, stress, and neck disability among young people may indicate that numerous spinal disorders identified in dentists result not only from their profession, in which spine is significantly overloaded, but also individual predispositions including biopsychosocial profile and the changing lifestyle habits of young people.

EEG based Classification of Long-term Stress Using Psychological Labeling

Stress research is a rapidly emerging area in the field of electroencephalography (EEG) signal processing. The use of EEG as an objective measure for cost effective and personalized stress management becomes important in situations like the nonavailability of mental health facilities. In this study, long-term stress was classified with machine learning algorithms using resting state EEG signal recordings. The labeling for the stress and control groups was performed using two currently accepted clinical practices: (i) the perceived stress scale score and (ii) expert evaluation. The frequency domain features were extracted from five-channel EEG recordings in addition to the frontal and temporal alpha and beta asymmetries. The alpha asymmetry was computed from four channels and used as a feature. Feature selection was also performed to identify statistically significant features for both stress and control groups (via t-test). We found that support vector machine was best suited to classify long-term human stress when used with alpha asymmetry as a feature. It was observed that the expert evaluation-based labeling method had improved the classification accuracy by up to 85.20%. Based on these results, it is concluded that alpha asymmetry may be used as a potential bio-marker for stress classification, when labels are assigned using expert evaluation.

Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study

Background

Stress, anxiety and impeded sleep are a frequent feature of life in modern societies. Across socio-economic strata, stress, anxiety and ineffective sleep detract from healthful living and serve as precursors of various ailments. The use of herbs to offset these antecedents and outcomes has greatly increased in recent years. Ashwagandha, an adaptogenic Ayurvedic herb, has been often used to combat and reduce stress and thereby enhance general wellbeing. While there have been other studies documenting the use of Ashwagandha for stress resistance, this is the first study to use a high-concentration root extract while also varying the dosage substantially. Therefore, this is the first study to offer insight into dose-response of a high concentration root extract.

Material and methods

In this eight-week, prospective, randomized, double-blind, placebo-controlled study, the stress-relieving effect of Ashwagandha root extract was investigated in stressed healthy adults. Sixty male and female participants with a baseline perceived stress scale (PSS) score >20 were randomized to receive capsules of Ashwagandha extract 125 mg, Ashwagandha extract 300 mg or identical placebo twice daily for eight weeks in a 1:1:1 ratio. Stress was assessed using PSS at baseline, four weeks and eight weeks. Anxiety was assessed using the Hamilton-Anxiety (HAM-A) scale and serum cortisol was measured at baseline and at eight weeks. Sleep quality was assessed using a seven-point sleep scale. A repeat measures ANOVA (general linear model) was used for assessment of treatment effect at different time periods. Post-hoc Dunnett’s test was used for comparison of two treatments with placebo.

Results

Two participants (one each in 250 mg/day Ashwagandha and placebo) were lost to follow-up and 58 participants completed the study. A significant reduction in PSS scores was observed with Ashwagandha 250 mg/day (P < 0.05) and 600 mg/day (P < 0.001). Serum cortisol levels reduced with both Ashwagandha 250 mg/day (P < 0.05) and Ashwagandha 600 mg/day (P < 0.0001). Compared to the placebo group participants, the participants receiving Ashwagandha had significant improvement in sleep quality.

Conclusion

Ashwagandha root aqueous extract was beneficial in reducing stress and anxiety.

Psychophysiological Patterns Related to Success in a Special Operation Selection Course

Actual theaters of operations require fast actions from special operations units with a high level of readiness and survival. Mission accomplishment depends on their psychological and physiological performance. The aim of the present study was to analyze: (1) the physical parameters related with success in a special operation selection course; and (2) the modifications of the psychological profile of recruits before and after a special operation selection course. Fifty-five male soldiers of the Spanish Army (25.1 ± 5.0 years, 1.8 ± 0.1 cm, 76.8 ± 7.9 kg, 24.4 ± 2.5 kg/m²) undertaking a 10-week special operation selection course performed a battery of physiological and psychological tests. Results showed how successful soldiers presented higher leg strength, anaerobic running performance, and cardiovascular response than non-successful soldiers. The psychological values of life engagement test, acceptance and action questionnaire, coping flexibility scale, and perceived stress scale did not present significant differences after the selection course. We can conclude that success in a special operation selection course was related to higher anaerobic and cardiovascular fitness. This special operation selection course did not modify the psychological profile of successful soldiers.

Stressors and Coping Strategies during Clinical Practice among Diploma Nursing Students

Introduction

Consistent with the significant of the stress issue in education, this study aimed to survey type of stressors and identifies the coping strategies used by diploma nursing students during clinical practices.

Methods

A descriptive cross-sectional study was carried out at the Kubang Kerian Nursing College, Kelantan which involved 346 respondents using simple random sampling method. The inclusion criteria were year one, two and three of nursing students who have clinical posting and voluntarily joining the study. Perceived Stress Scale (PSS) and Brief COPE inventory were utilised in the data collection. Higher mean score indicates higher degree of stress.

Results

Clinical assignments and workload were the main stressor (mean = 3.19, SD = 1.09). Religion approach was the most coping strategy applied (mean = 3.30, SD = 0.71). Pearson’s correlation coefficient test found that six domains of stressors during clinical practices (taking care of patients; clinical educators/instructors and ward staff; clinical assignments and workload; peers and nursing students from other college; lack of professional knowledge and skills and clinical environment) were statistically significant correlation with coping strategies, where P-value < 0.05.

Conclusion

Clinical assignment was the main stressor among nursing students; therefore, successful activities should be promoted to help them in managing clinical assignment and enhancing knowledge in religion.

Postpartum blood pressure patterns in severe preeclampsia and normotensive pregnant women following abdominal deliveries: a cohort study

Objective: To determine blood pressure (BP) patterns in the immediate postpartum period in preeclampsia with severe features (sPE) and normotensive pregnant women who had cesarean deliveries (CD).Study design: The BP levels of two groups comprising 50 sPE and 90 normotensive pregnant women who had CD were measured before delivery and on days 0-3 postpartum at four time points (05:00, 08:00, 14:00, and 22:00). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PIGF) were measured in the maternal serum ≤48 h before delivery.Results: Antihypertensive therapy was administered to 98, 96, 82, 78, and 56% of sPE antepartum and on postpartum days 0-3, respectively. De novo postpartum hypertension (BP ≥ 140/90 mmHg) occurred in 24.4% (22/90) of the normotensive group but only one required antihypertensive therapy. The occurrence of de novo postpartum hypertension was associated with maternal weight before delivery ≥ 84.5 kg (relative risks (RR) 2.6, CI 95% 1.2-5.8, p = .017), and body mass index before delivery ≥ 33.3 kg/m² (RR 2.9, CI 95% 1.3-6.4, p = .008). In sPE, the BP decreased between predelivery period and postpartum day 0. From days 1 to 3 postpartum, there was a continuous increase in the daily mean BPs in both groups, with average daily increments (systolic/diastolic) being 5.6/4.6 mmHg and 0.6/1.3 mmHg in the sPE and normotensive women, respectively. Patient's group and time had a significant effect on BP, p < .001. Overall, daily mean BPs were higher in the sPE than the normotensive group (p < .001). Perceived stress (p = .022), low birth weight (p = .002), 5 min Apgar score ≤ 6 (p < .001) were significantly higher in the sPE group. sFlt-1/PIGF ratio was high in the hypertensive groups: sPE versus normotensive group, p < .001; de novo postpartum hypertension versus normotensives group that remained normotensive, p = .102.Conclusion: Postpartum BP and antihypertensive requirements are important considerations in managing sPE and normotensive pregnancies. sPE is associated with increased maternal stress and poor perinatal outcomes.

Association of Fatigue and Stress With Gray Matter Volume

Stress is associated with a greater risk for various health problems including reduced gray matter volume (GMV) and density in a number of brain regions. Previous studies show that neuroimaging could be a means to objectively evaluate stress. However, to date, no definite neuroimaging-derived measures are available to detect stress. In this research we used the gray-matter brain healthcare quotient (GM-BHQ), an MRI-based quotient for monitoring brain health based on GMV, as an objective scale to measure the association of stress with the whole brain. We recruited 63 healthy adults to acquire structural T1-weighted images and stress levels evaluated using three representative stress scales: the Profile of Mood States (POMS), Perceived Stress Scale (PSS) and Chalder Fatigue Scale (CFS). We found that the GM-BHQ was sensitive to fatigue and the interaction between fatigue and stress.

Effects of maternity yoga on the autonomic nervous system during pregnancy

AIM

To elucidate the changes in the daily variation seen in the autonomic nervous system during pregnancy brought about by maternity yoga and to evaluate how maternal yoga affects stress and sleep.

METHODS

A prospective, longitudinal study was conducted between January 2013 and December 2014. Pregnant women who were attending maternity yoga classes at Palmore Hospital between 20 and 23 weeks' gestation were enrolled as the yoga group, and a matched control group was also enrolled. Study participants completed questionnaires, including a perceived stress scale and sleep logs, during their second and third trimesters. Heart rate variability and salivary α-amylase levels were evaluated as stress indices at 20-23 weeks' gestation, 28-31 weeks' gestation and 36-40 weeks' gestation.

RESULTS

A total of 38 women were in the yoga group, with 53 in the control group. At 28-31 weeks' gestation, heart rate variability during night and late-night periods was significantly higher in the yoga group than in the control group. At 36-40 weeks' gestation, variability between the morning, afternoon and late night was significantly higher in the yoga group. Salivary α-amylase levels decreased significantly immediately after practicing yoga during all evaluation periods in the yoga group. Night-time sleep duration was significantly longer in the yoga group.

CONCLUSION

Our results suggest that practicing yoga activates the parasympathetic nervous system during the third trimester of pregnancy, consolidating sleep during the night and decreasing α-amylase levels, which indicates reduced stress.

A Self-Reported Association between Temporomandibular Joint Disorders, Headaches, and Stress

AIMS AND OBJECTIVES

Temporomandibular joint disorder (TMD) is an umbrella term for a number of conditions in the area of the joint, temple, and masticatory system. Many of those with TMD also suffer from headaches and anxiety. The aims and objectives of this study were to determine if there exists an association between the Diagnostic Criteria of TMD (DC/TMD) symptom questionnaire and report of headaches as well as stress.

MATERIALS AND METHODS

A cross-sectional study was implemented via the use of the DC/TMD symptom questionnaire and the perceived stress scale (PSS). This was distributed conveniently among dental students in a multi-dental school setting in Riyadh, Saudi Arabia, and was completed by 152 dental students. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05.

RESULTS

Those who ticked yes for pain on the TMD pain screener for pain with chewing hard or tough food, pain on mouth opening and lateral excursion, and pain with jaw habits as parafunction were at an odds risk from twice to thrice as likely to experience headaches. Similarly, those with poor coping skills on the PSS were more likely to have headaches (P = 0.002). Likewise, positive answers on the screener and symptom questionnaire were relevant with higher stress scores on the PSS.

CONCLUSION

This study clarifies and reiterates the intertwined power of both stress and headaches; the former being a role player in TMD progression and the latter its product. TMD is unfortunately on the rise; it should not be brushed off as a nuisance. A multidisciplinary approach in diagnosis and treatment of both TMD and headaches by a team of orofacial pain specialist, neurologist, psychiatrist and/or psychologist, and physical therapists to untangle the deceiving presentation of both conditions would not only provide a more favorable prognosis but also improve cost and time expenditures.

The Relationship of 5-Aminolevulinic Acid on Mood and Coping Ability in Prediabetic Middle Aged and Older Adults

In 2010, approximately 79 million Americans had prediabetes and about 50 percent of those individuals were 65 years and older. The most effective diabetes prevention method in prediabetic adults is lifestyle modification. However, despite the benefits of lifestyle change, diabetes prevalence continues to increase. Maintaining a regular exercise routine and a healthy eating plan may be difficult because of the negative emotional barriers (i.e., stress, mood) that a prediabetic individual faces. This is particularly evident in older individuals when you combine that with decreases in mobility and geriatric syndromes. A potential treatment for these emotional barriers is a natural supplement called 5-aminolevulinic acid (5-ALA). In the current study, the group included 154 participants, both men and women, ranging between the ages of 41 to 71 years old. The study design was a double-blind, randomized parallel-group study. The Psychosocial Depressive Symptoms Questionnaire (PDS) and the Perceived Stress Scale (PSS) were used to examine the effect of two doses of 5-ALA (15 mg and 50 mg) on various components of mood (i.e., hopefulness, loneliness, and motivation) and coping ability. Using SAS software, an ordered logistic regression model was used to analyze the association between the dose groups (control, 15 mg, and 50 mg) and the responses to the two questionnaires, the PDS and PSS, used in this study. An integrative literature review, using the PubMed database, searched for studies on the relationship between 5-ALA administration and mood and coping ability. Our literature review resulted in zero published articles. Next, we found that the intake of 5-ALA was significantly associated with improved coping ability (p = 0.004) and improved self-perception of effort spent (p = 0.002). Finally, we found a significant dose-dependent relationship for the association of 5-ALA intake on measures of effort (p = 0.003), loneliness (p = 0.006), and coping ability (p = 0.003). The 50 mg dose was more effective than the 15 mg dose in improving these measures. In conclusion, after 12 weeks of taking 5-ALA, we found significant improvements in self-perception of effort spent, loneliness, and coping ability in prediabetic middle age and older adults. Improved mood and coping ability may allow prediabetic individuals to overcome the emotional obstacles preventing them from maintaining a healthy lifestyle and ultimately, help them to avoid the development of diabetes.

Association of Epidemiological and Biochemical Factors with Premature Graying of Hair: A Case-Control Study

Background:

Premature hair graying (PHG) is often a matter of great concern for patients as it is viewed as a sign of increasing age, debility, decreasing vigor, and may lead to low self-esteem and psychological morbidity. Its etiopathogenesis is not completely understood but genetic, and various acquired factors have been implicated. The present study was undertaken to evaluate various epidemiological and biochemical variables associated with PHG.

Materials and Methods:

A cross-sectional case–control study was conducted at a tertiary care hospital in North India for 1 year which comprised 120 patients and equal number of controls. Various epidemiological variables were recorded and compared to controls. Serum ferritin, serum calcium, serum Vitamin D, serum Vitamin B12, lipid profile, thyroid profile, and fasting blood sugar were measured and compared among cases and controls.

Results:

Significantly higher proportion of cases had atopic diathesis, sedentary lifestyle, family history, history of smoking, and higher perceived stress values as compared to controls. Hair oiling seemed to protect against premature graying. Significantly, lower levels of serum calcium, ferritin, Vitamin B12, high-density lipoprotein-cholesterol, and high low-density lipoprotein-cholesterol were observed among cases.

Conclusion:

In the light of the present study, further studies with larger sample size are required to establish the definite etiological significance of these variables and formulate various preventive and therapeutic targets to prevent and treat PHG.

Study of stress-induced temporomandibular disorders among dental students: An institutional study

Aim and Objectives:

The aim and objectives of this study are to investigate the various types of stress-inducing factors, most prevalent etiological factor and to determine the correlation between stress and temporomandibular disorders (TMDs) in Dental students in Modinagar, Ghaziabad, Uttar Pradesh.

Materials and Methods:

A sample of 450 students were selected for the study divided into two groups of undergraduate (UG) and postgraduate (PG) students further subdivided into UG (1^st, 2^nd, 3^rd, and 4^th, interns) and PG (1^st, 2^nd, 3^rd year). Study includes clinical evaluation of temporomandibular joint (TMJ) system (TMJ sounds, muscles of mastications, mouth opening, and range of mandibular motion) and questionnaire which covers demographic data (i.e., age, sex, and academic year), TMD symptoms and TMD signs along with standardized scales related to stress dental environmental stress scale and perceived stress scale (PSS).

Results:

Most of the students included into study are mostly of 21–25 years of age (64.3%), males (52.7%), females 47.3% with more number of UGs (91.4%) predominantly 1^st year students (23.9%). Headache was found to be the most prevalent TMD symptom (26.2%) followed by clicking (24.9%), pain on clicking (5.5%), jaw lock (3.4), and difficulty in mouth opening (0.9%). Clicking was found to be the most prevalent TMD sign (24.9%) among dental students followed by deviation (16.3%), muscle tenderness (14.3%), and TMJ pain (5.7%). The most prevalent TMD was disc displacement 22.6% followed by myofascial pain dysfunction syndrome (MPDS) with disc displacement (13.5%) and MPDS (3.8%). TMD was higher in UG females students of 21–-25 years of age group, dental environment stress scale score and PSS score shows statistically significant results.

Conclusion:

Stress is a significant etiologic factor involved in initiation and maintenance of TMDs in Dental students.

Do levels of perceived stress increase with increasing age after age 65? A population-based study

BACKGROUND

psychological and health-related stressors often occur in advanced ages, but little is known about perceived stress in adults aged 65 and over. This study aimed to test the hypothesis that levels of perceived stress increase with increasing age and to detect factors that may account for the association.

METHODS

a dementia-free cohort of 1,656 adults aged 66-97 years living at home or in institutions, participating in the Swedish National Aging and Care study, Kungsholmen (SNAC-K) was assessed for levels of perceived stress using the 10-item perceived stress scale (PSS).

RESULTS

prevalence of high stress according to the top tertile of the population (PSS score 20+) was 7.8% in adults aged 81+ years, 7.5% in adults aged 72-78 and 6.2% in adults aged 66 years (P = 0.020). More women than men reported high stress, 8.3 versus 5.4% (P = 0.001). Levels of stress increased with increasing age (P = 0.001) in the linear regression model. This association remained after adjustment for demographic and psychosocial factors, but no longer was present after adjusting for health-related factors.

CONCLUSION

health-related stress is highly prevalent in older adults and seems to play an important role in the association between levels of perceived stress and age in older adults.

Aphthous ulcers, salivary peroxidase and stress: Are they related?

Background:

In today's high strung lifestyle, stress plays a major role on our health. Studies using ultraweak chemiluminescence have been able to demonstrate this effect, of psychological stress on the immune system, using saliva as a psychological stress marker. The impact of psychosocial factors on the oral mucosal lesions of individuals found that stress can contribute to weakened immunity and increased susceptibility to infection.

Aim:

To study the role of salivary peroxidase (SPOx) in psychologically stressed individuals with and without the presence of aphthous ulcer.

Materials and Methods:

The study involved evaluating subjects for stress, using Perceived Stress Scale. Depending on the stress scores and the presence or absence of oral aphthae, they were assigned into 3 groups of 30 each. After a thorough oral examination, individual samples of saliva was collected and subjected to microprotein estimation using a biochemical analyzer.

Statistical Analysis Used:

Analysis of variance (ANOVA) and Student's t-test.

Results:

Decreased levels of peroxidase were found in individuals’ with aphthous ulcers, while the same was increased when no lesions were found and also on a lower stress scale.

Conclusions:

Our study analysis does show a variation in enzyme levels between the different groups highlighting the influence of stress on the peroxidase levels, which in turn when imbalanced, results in tissue damage, leading to aphthous formation.

New, normative, English-sample data for the Short Form Perceived Stress Scale (PSS-4)

This article provides population norms for the Short Form Perceived Stress Scale (PSS-4) and investigates the relationship between PSS-4 scores and sociodemographic variables. The PSS-4 was administered to an English sample (n = 1568) and was found to have acceptable psychometric properties. Sociodemographic variables explained 19.5% of variance in PSS-4 scores, and mean PSS-4 scores were significantly different from the mean scores reported in Cohen and Williamson's original study. Greater levels of perceived health status, greater levels of social support, being male and being older were predictive of lower PSS-4 scores. Norm values for interpreting PSS-4 scores are presented.

Validation of the postnatal perceived stress inventory in a French speaking population of primiparous women

OBJECTIVE

To develop a Postnatal Perceived Stress Inventory (PNPSI) and assess its psychometric properties.

DESIGN

Cross-sectional quantitative study.

SETTING

One nurse-managed labor and delivery unit in a university hospital in a major metropolitan area.

PARTICIPANTS

One hundred seventy-nine (179) primiparous French speaking women who gave birth at term.

METHODS

The PNPSI was validated at 6 weeks postpartum. Its predictive validity for depression and anxiety was assessed at the same time.

RESULTS

The exploratory analysis revealed a 19-item structure divided into six factors. This inventory has good internal consistency (Cronbach's alpha = .815). The predictive validity shows that the PNPSI significantly predicts depression and anxiety at 6 weeks postpartum, and that certain factors are particularly prominent.

CONCLUSION

The PNPSI's psychometric properties make it a useful tool for future research to evaluate interventions for perceived stress during the postnatal period. Its predictive power for depression indicates that it is also a promising tool for clinical settings.

Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students

Context:

Perceived stress is higher for students in various healthcare courses. Previous studies have shown that pranayama practice is beneficial for combating stress and improve cardiovascular functions but both fast and slow pranayama practice produce different physiological responses.

Aim:

Present study was conducted to compare the effects of commonly practiced slow and fast pranayama on perceived stress and cardiovascular functions in young health-care students.

Materials and Methods:

Present study was carried out in Departments of Physiology and Advanced Centre for Yoga Therapy Education and Research, JIPMER, Pondicherry. Ninety subjects (age 18-25 years) were randomized to fast pranayama (Group 1), slow pranayama (Group 2) and control group (Group 3). Group 1 subjects practiced Kapalabhati, Bhastrika and Kukkuriya Pranayama while Group 2 subjects practiced Nadishodhana, Savitri and Pranav Paranayama. Supervised pranayama training was given for 30 min, 3 times a week for the duration of 12 weeks to Groups 1 and 2 subjects by certified yoga trainer. Following parameters were recorded at the baseline and after 12 weeks of training; perceived stress scale (PSS), heart rate (HR), respiratory rate, systolic blood pressure and diastolic blood pressure (DBP), mean arterial pressure (MAP), rate pressure product (RPP), and double product (Do P).

Results:

There was a significant decrease in PSS scores in both Group 1 and Group 2 subjects but percentage decrease was comparable in these groups. Significant decrease in HR, DBP, RPP, and Do P was seen in only Group 2 subjects.

Conclusion:

This study demonstrates that both types of pranayama practice are beneficial in reducing PSS in the healthy subjects but beneficial effect on cardiovascular parameters occurred only after practicing slow pranayama.