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Haeny AM, Schick MR, McKenley C, Chowdhary A, Bellamy CD, O'Malley SS, Sinha R. Evidence that personalized racial stress procedures elicit a stress response and increases alcohol craving among Black adults with alcohol use disorder: A laboratory pilot study. Drug Alcohol Depend 2024; 260:111312. [PMID: 38749311 DOI: 10.1016/j.drugalcdep.2024.111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The objective of this study was to pilot test newly developed personalized imagery procedures to investigate the impact of racial stress on alcohol craving and emotional and physiological response in Black adults with alcohol use disorder (AUD). METHODS Twenty Black adults (45% women, meanage=37.05, SDage=13.19) with AUD participated in two sessions. In the first, participants described a stressful personal event involving their race and a neutral relaxing situation and these descriptions were used to develop scripts for the subsequent laboratory exposure session. The second session was an experimental provocation session in which participants reported on alcohol craving and emotional response before and after imagined exposure to stress and neutral conditions using personalized racial stress and neutral/relaxing scripts. Conditions were randomized and counterbalanced across subjects, and heart rate and blood pressure were assessed before and after each image. RESULTS Alcohol craving and negative emotions significantly increased, and positive emotions decreased following the racial stress script relative to the neutral/relaxing script. We found no differences in physiological response. Exploratory analyses found that increase in alcohol craving was correlated with racial identity exploration but not racial identity commitment, men reported greater reductions in anger than women in the neutral condition only, and income was correlated with fear in the racial stress condition only. CONCLUSIONS This study provides evidence that personalized racial stress procedures elicit a stress response and increases alcohol craving and emotional response but not physiological response among Black adults with AUD. These findings warrant replication in a larger study.
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Affiliation(s)
- Angela M Haeny
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Racial Equity and Addiction Lab at Yale, New Haven, CT 06519, USA.
| | - Melissa R Schick
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Racial Equity and Addiction Lab at Yale, New Haven, CT 06519, USA
| | - Claudia McKenley
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Racial Equity and Addiction Lab at Yale, New Haven, CT 06519, USA
| | - Aishwarya Chowdhary
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Racial Equity and Addiction Lab at Yale, New Haven, CT 06519, USA; Yale Stress Center, New Haven, CT 06511, USA
| | - Chyrell D Bellamy
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA
| | | | - Rajita Sinha
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, USA; Yale Stress Center, New Haven, CT 06511, USA
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Walther LM, Auer A, Sauter C, Wirtz PH. Stress in the collective: Psychophysiological reactivity to an orchestra concert as a collective naturalistic, real-life stressor of psychosocial nature. Psychoneuroendocrinology 2024; 167:107109. [PMID: 38943721 DOI: 10.1016/j.psyneuen.2024.107109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND & OBJECTIVES The investigation of collective stress experiences, including collective stressors and the psychophysiological reactivity of a collective to these stressors, has been widely neglected so far. Here, we examined public non-professional orchestra concerts as collective naturalistic, real-life stressors of psychosocial nature and the resulting psychophysiological reactivity in a collective of non-professional orchestra musicians. METHODS The members of two non-professional music orchestras (N = 54) were accompanied during a public concert (stress condition) and a rehearsal (control condition). We repeatedly assessed heart rate, salivary cortisol, and excitement levels before, during, and after the concert/rehearsal in addition to the anticipatory cognitive stress appraisal. RESULTS We observed greater physiological reactivity to the concert compared to the rehearsal (p's ≤.017), with higher increases in heart rate levels in anticipation of and in reaction to the concert and in cortisol levels in reaction to the concert compared to the rehearsal. Moreover, orchestra members reported greater psychological reactivity to the concert than to the rehearsal (p's ≤.024) in terms of higher cognitive stress appraisal in anticipation and increased excitement levels before and during the concert compared to the rehearsal. DISCUSSION Our findings indicate that orchestra concerts by non-professional musicians constitute collective naturalistic, real-life stressors of psychosocial nature, resulting in significant psychophysiological stress responses with reactivity kinetics differing between the sympathetic-adrenal-medullary axis, the hypothalamic-pituitary-adrenal axis, and the psychological response. Potential implications and modulating factors need to be elucidated in future studies.
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Affiliation(s)
- Lisa-Marie Walther
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany; Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
| | - Alisa Auer
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany; Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
| | - Christine Sauter
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Petra H Wirtz
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany; Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany.
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Peng Y, Wei X, Wu F, Fan M, Wang K, Zhou J. Electroacupuncture for slow flow/no-reflow phenomenon in patients with acute myocardial infarction undergoing percutaneous coronary intervention: protocol for a pilot randomized controlled trial. Front Cardiovasc Med 2024; 11:1401269. [PMID: 38957330 PMCID: PMC11218819 DOI: 10.3389/fcvm.2024.1401269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024] Open
Abstract
Background Slow flow/no-reflow (SF-NR) during percutaneous coronary intervention (PCI) is associated with poor prognosis of patients with acute myocardial infarction (AMI). Currently, effective treatment is not available for SF-NR. Electroacupuncture (EA) has shown significant efficacy as an adjuvant therapy for many cardiovascular diseases by improving microcirculation and reducing ischemia-reperfusion injury. However, its effects on SF-NR in the AMI patients during PCI are not clear. This pilot trial aims to determine the efficacy of intraoperative EA in alleviating SF-NR in AMI patients undergoing PCI. Methods This prospective, single-center, randomized controlled, pilot trial will recruit 60 AMI patients scheduled for PCI at the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, China. The patients will be randomized in a 1:1 ratio into the EA or the control groups. Patients in the control group will undergo standard PCI. Patients in the EA group will undergo intraoperative electroacupuncture while undergoing standard PCI. Incidence of SF-NR is the primary outcome for this study. This study will also assess secondary outcomes including cardiac biomarkers, inflammatory biomarkers, pain and anxiety scores, electrocardiography parameters, traditional Chinese medicine (TCM) symptom score, and major adverse cardiovascular and cerebrovascular events (MACCE). All the included patients will undergo laboratory tests including routine blood tests, levels of electrolytes, as well as liver and renal function tests. Patients will be followed up for 1 month after the procedure. Discussion This pilot trial will provide evidence for the potential benefits of intraoperative EA in improving microvascular perfusion and preventing or alleviating SF-NR during PCI in patients with AMI. If proven effective, intraoperative EA will provide a new and effective strategy against SF-NR and provide evidence for subsequent multicenter trials. Clinical Trial Registration ClinicalTrials.gov, identifier (ChiCTR2300072265). Registered on 8 June 2023.
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Affiliation(s)
- Yanbin Peng
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuqiang Wei
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Feng Wu
- Department of Cardiovascular Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fan
- Department of Cardiovascular Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ke Wang
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia Zhou
- Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Milot E, Rehel S, Langeard A, Bigot L, Pasquier F, Matveeff L, Gauthier A, Bessot N, Quarck G. Effectiveness of multi-modal home-based videoconference interventions on sleep in older adults: study protocol for a randomized controlled trial. Front Public Health 2024; 12:1326412. [PMID: 38686035 PMCID: PMC11057197 DOI: 10.3389/fpubh.2024.1326412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.
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Affiliation(s)
- Emma Milot
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Stéphane Rehel
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Antoine Langeard
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | | | - Florane Pasquier
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Laura Matveeff
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Antoine Gauthier
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Nicolas Bessot
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Gaëlle Quarck
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
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Hertz-Palmor N, Yosef Y, Hallel H, Bernat I, Lazarov A. Exploring the 'mood congruency' hypothesis of attention allocation - An eye-tracking study. J Affect Disord 2024; 347:619-629. [PMID: 38070744 DOI: 10.1016/j.jad.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/07/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The 'mood-congruency' hypothesis of attention allocation postulates that individuals' current emotional states affect their attention allocation, such that mood-congruent stimuli take precedence over non-congruent ones. This hypothesis has been further suggested as an underlying mechanism of biased attention allocation in depression. METHODS The present research explored the mood-congruency hypothesis using a novel video-based mood elicitation procedure (MEP) and an established eye-tracking attention allocation assessment task, elaborating prior research in the field. Specifically, in Study 1 (n = 91), a video-based MEP was developed and rigorously validated. In study 2 (n = 60), participants' attention allocation to sad and happy face stimuli, each presented separately alongside neutral faces, was assessed before and after the video-based MEP, with happiness induced in one group (n = 30) while inducing sadness in the other (n = 30). RESULTS In Study 1, the MEP yielded the intended modification of participants' current mood states (eliciting either sadness or happiness). Study 2 showed that while the MEP modified mood in the intended direction in both groups, replicating the results of Study 1, corresponding changes in attention allocation did not ensue in either group. A Bayesian analysis of pre-to-post mood elicitation changes in attention allocation supported this null finding. Moreover, results revealed an attention bias to happy faces across both groups and assessment points, suggestive of a trait-like positive bias in attention allocation among non-selected participants. CONCLUSION Current results provide no evidence supporting the mood-congruency hypothesis, which suggests that (biased) attention allocation may be better conceptualized as a depressive trait, rather than a mood-congruent state.
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Affiliation(s)
- Nimrod Hertz-Palmor
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel; Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Yam Yosef
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Hadar Hallel
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Inbar Bernat
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel.
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Lawal O, Regelous P, Omiyi D. Supporting claustrophobic patients during magnetic resonance imaging examination- the radiographer perspective. Radiography (Lond) 2024; 30:80-86. [PMID: 37871369 DOI: 10.1016/j.radi.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Some patients cannot complete their magnetic resonance imaging (MRI) examinations because of claustrophobia. Evidence showed that supportive instruction is an effective intervention used to assist claustrophobic patients in MRI. However, the effectiveness of this intervention depends on the experience and education level of the MRI radiographer. This study aimed to understand the views of MRI radiographers on supporting claustrophobic patients and develop a guide to improve the effectiveness of the intervention. METHODS A qualitative descriptive approach utilising focus group discussion was considered suitable. A purposive sampling method was used to enrol eligible participants into the study. The study was advertised in print newspapers and on social media platforms. There were seven MRI radiographers in the focus group discussion. The conversation was recorded and transcribed for analysis, with content analysis employed to group the data into relevant codes and categories. RESULTS The radiographer's understanding of claustrophobia and knowledge of the interventions used to support claustrophobic patients were the key elements that influenced claustrophobic patients' experience in MRI. However, there were some factors inhibiting the radiographer's ability to support these patients. These factors include insufficient appointment slots, availability of supportive tools and support with developing communication skills. CONCLUSION Communication and identifying anxiety signs are essential for MRI radiographers to address patient anxiety during examinations. This might increase the MRI examination completion rate and give the patient a positive experience in the department. IMPLICATIONS FOR PRACTICE MRI radiographers can better understand how to support claustrophobic patients. Also, the guide developed from the data could help improve consistency in the use of supportive instruction in clinical practice.
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Affiliation(s)
- O Lawal
- Department of Allied Health Professions, Midwifery and Social Work, School of Health and Social Work, University of Hertfordshire, UK.
| | - P Regelous
- Department of Allied Health Professions, Midwifery and Social Work, School of Health and Social Work, University of Hertfordshire, UK
| | - D Omiyi
- School of Allied Health Professions & Midwifery, Faculty of Health Studies, University of Bradford, England
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Jaquez SD, Haller CN, England ME, Bruinsma RL, Arbet G, Croce EA, Ruth J, Levy ML, Diaz LZ. Virtual reality and noise canceling headphone distraction during pediatric dermatologic procedures. Pediatr Dermatol 2023; 40:1161-1163. [PMID: 37816939 PMCID: PMC11016310 DOI: 10.1111/pde.15401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 07/03/2023] [Indexed: 10/12/2023]
Abstract
Pain and anxiety related to medical procedures have long been recognized as a significant healthcare concern. If a patient's procedural pain and anxiety are not addressed, long-term physical and psychological sequelae including increased perceived pain, anxiety, disruptive behavior, trauma reactions, or refusal of future procedures can occur. The objective of our study was to assess the utility of a virtual reality (VR) headset or noise-canceling headphones (HP) compared to treatment as usual (TAU) in reducing pain and anxiety during pediatric dermatology procedures. Results indicated a significant difference between pre- versus post-procedure anxiety in the VR and HP groups but not the TAU group suggesting non-pharmacologic technology-based interventions such as VR and headphones may reduce patients' anxiety during pediatric dermatology procedures.
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Affiliation(s)
- Sasha D. Jaquez
- Dell Children’s Medical Center, Austin, Texas, USA
- Department of Psychiatry & Behavioral Sciences, Dell Medical School, Austin, Texas, USA
- Department of Pediatrics, Dell Medical School, Austin, Texas, USA
| | - Courtney N. Haller
- Department of Medicine, Division of Dermatology, Dell Medical School, Austin, Texas, USA
| | - Maryann E. England
- Long School of Medicine, The University of Texas Health Science Center in San Antonio, San Antonio, Texas, USA
| | - Raquel L. Bruinsma
- Department of Medicine, Division of Dermatology, Dell Medical School, Austin, Texas, USA
| | - Gregory Arbet
- Department of Education, The University of Texas, Austin, Texas, USA
| | - Emily A. Croce
- Dell Children’s Medical Center, Austin, Texas, USA
- Department of Population Health, Dell Medical School, Austin, Texas, USA
| | - Jennifer Ruth
- Dell Children’s Medical Center, Austin, Texas, USA
- Department of Medicine, Division of Dermatology, Dell Medical School, Austin, Texas, USA
- Department of Pediatrics, Division of Pediatric Dermatology, Dell Medical School, Austin, Texas, USA
| | - Moise L. Levy
- Dell Children’s Medical Center, Austin, Texas, USA
- Department of Medicine, Division of Dermatology, Dell Medical School, Austin, Texas, USA
- Department of Pediatrics, Division of Pediatric Dermatology, Dell Medical School, Austin, Texas, USA
| | - Lucia Z. Diaz
- Dell Children’s Medical Center, Austin, Texas, USA
- Department of Medicine, Division of Dermatology, Dell Medical School, Austin, Texas, USA
- Department of Pediatrics, Division of Pediatric Dermatology, Dell Medical School, Austin, Texas, USA
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Scott SE, Bruj G, Beheshti S, Evans R, Awojobi O. Talking about cancer: Patient responses to raising awareness of oral cancer in primary dental care. Community Dent Oral Epidemiol 2023; 51:887-895. [PMID: 35964230 PMCID: PMC10946823 DOI: 10.1111/cdoe.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Dentists and other members of the dental team could raise awareness by talking about oral cancer during routine dental check-ups. A communication guide has been developed to facilitate this. However, it has been suggested that discussions about oral cancer may raise patients' anxiety and this has been documented by dentists as a barrier to having these conversations. The current research aimed to investigate implementation of the communication guide and its impact on the dental patient. METHODS A consecutive-case sample of adult dental patients attending primary dental care for a routine NHS check-up at one dental practice were invited to take part in the study via letter prior to their appointment. Consultations of participating patients (n = 77) were audio-recorded. Before and after their appointment, patients were asked to rate their current anxiety via the six-item version of Spielberger's State-Trait Anxiety Inventory. Audio recordings of each consultation were reviewed by two raters to determine the extent to which the dentist covered the topics recommended in the communication guide. RESULTS The dentist informed all patients that they were being checked for oral cancer, spoke about signs and symptoms, and discussed risk factors. However, they rarely recommended where help should be sought or addressed barriers to seeking help. Discussions took an average of 95 s. The extent to which oral cancer was discussed did not correlate with patients' post-appointment anxiety. Patients made positive or neutral responses to the discussions. The few questions that were asked were easily addressed. CONCLUSIONS As findings are based on one dentist working at one practice, generalization of these results should be cautious. The study indicated that using an evidence-based guide to talk about oral cancer did not appear to raise patients' anxiety in this practice population. This could help to increase awareness of oral cancer in the endeavour to facilitate early cancer diagnosis.
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Affiliation(s)
- Suzanne E. Scott
- Wolfson Institute of Population HealthQueen Mary University of LondonLondonUK
- Faculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonLondonUK
| | | | | | - Ruth Evans
- Faculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonLondonUK
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Pua YH, Tan BY, Low J, Woon EL, Yeo SJ, Clark RA, Bettger JP, Pereira MJ, Tan CY, Thumboo J. Discordance Between Self-Reported and Performance-Based Physical Function in Patients Who Have Knee Osteoarthritis: Associations With Pain Intensity and Negative Affect. J Arthroplasty 2023; 38:1705-1713.e1. [PMID: 36940758 DOI: 10.1016/j.arth.2023.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Although self-reported measures of physical disability are strong indication criterion for total knee arthroplasty (TKA) in painful knee osteoarthritis (OA), some patients may report greater-than-observed disability. Contributing factors to this discordance are relatively unexplored. We aimed to examine whether pain and negative affect, including anxiety and depression, were associated with the discordance of self-reported measures with performance-based measures (PPM) of physical function. METHODS We used cross-sectional data (n = 212) from two randomized rehabilitation trials in knee OA. All patients were assessed for knee pain intensity and symptoms of anxiety and depression. Self-reported function was assessed by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical-function subscale. Objective performance-based measures (PPMs) of physical function were assessed by timed gait and stair tests. Continuous discordance scores were quantified by the difference in percentiles between WOMAC and PPMs (WOMAC-PPM), where a positive discordance, WOMAC-PPM >0, implied greater perceived than observed disability. RESULTS Around 1 in 4 patients had >20 percentile units in WOMAC-PPM discordance. In Bayesian regression analyses, knee pain intensity had >99% posterior probability of positive associations with WOMAC-PPM discordance. Among patients awaiting TKA, anxiety intensity had approximately 99% probability of positive associations with discordance, and these associations had >65% probability of exceeding 10 percentile units. In contrast, depression had low (79% to 88%) probability of any association with discordance. CONCLUSION In patients who have knee OA, a sizable proportion reported substantially greater physical disability than actually observed. Pain and anxiety intensity, but not depression, were meaningful predictors of this discordance. If validated, our findings may help in refining patient selection criteria for TKA.
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Affiliation(s)
- Yong-Hao Pua
- Department of Physiotherapy, Singapore General Hospital, Singapore; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore
| | - Bryan Yijia Tan
- Department of Orthopaedic Surgery, Woodlands Health Campus, National Healthcare Group, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Juanita Low
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - Ee-Lin Woon
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - Seng-Jin Yeo
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| | - Ross A Clark
- Research Health Institute, University of the Sunshine Coast, Australia
| | - Janet P Bettger
- Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Michelle J Pereira
- Health Services and Outcome Research, National Healthcare Group, Singapore
| | - Chun-Yue Tan
- Department of Orthopaedic Surgery, Woodlands Health Campus, National Healthcare Group, Singapore
| | - Julian Thumboo
- Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Health Services Research & Evaluation, Singhealth Office of Regional Health, Singapore
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Kakar E, Ottens T, Stads S, Wesselius S, Gommers DAMPJ, Jeekel J, van der Jagt M. Effect of a music intervention on anxiety in adult critically ill patients: a multicenter randomized clinical trial. J Intensive Care 2023; 11:36. [PMID: 37592358 PMCID: PMC10433648 DOI: 10.1186/s40560-023-00684-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Previous studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce. Therefore, we studied the effect of music intervention on anxiety in ICU patients. METHODS A multicenter randomized clinical trial was conducted between August 2020 and December 2021 in ICU's at an academic medical centre and two regional hospitals. Adult critically ill patients were eligible when hemodynamically stable and able to communicate (Richmond agitation-sedation scale (RASS) of at least - 2). Patients in the intervention arm were offered music twice daily during three days for at least 30 min per session. Patients in the control group received standard care. The primary outcome was anxiety level assessed with the visual analogue scale for anxiety [VAS-A; range 0-10] twice daily (morning and evening). Secondary outcomes included; 6-item state-trait anxiety inventory (STAI-6), sleep quality, delirium, heart rate, mean arterial pressure, pain, RASS, medication, ICU length of stay, patients' memory and experience of ICU stay. RESULTS 94 patients were included in the primary analysis. Music did not significantly reduce anxiety (VAS-A in the intervention group; 2.5 (IQR 1.0-4.5), 1.8 (0.0-3.6), and 2.5 (0.0-3.6) on day 1, 2, and 3 vs. 3.0 (0.6-4.0), 1.5 (0.0-4.0), and 2.0 (0.0-4.0) in the control group; p > 0.92). Overall median daily VAS-A scores ranged from 1.5 to 3.0. Fewer patients required opioids (21 vs. 29, p = 0.03) and sleep quality was lower in the music group on study day one [5.0 (4.0-6.0) vs. 4.5 (3.0-5.0), p = 0.03]. Other outcomes were similar between groups. CONCLUSIONS Anxiety levels in this ICU population were low, and music during 3 days did not decrease anxiety. This study indicates that efficacy of music is context and intervention-dependent, given previous evidence showing decreased anxiety. Trial registration Netherlands Trial Register: NL8595, Registered, 1 April 2020. CLINICALTRIALS gov ID: NCT04796389, Registered retrospectively, 12 March 2021.
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Affiliation(s)
- Ellaha Kakar
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands.
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Thomas Ottens
- Department of Intensive Care, Haga Teaching Hospital, The Hague, The Netherlands
| | - Susanne Stads
- Department of Intensive Care, Ikazia Hospital, Rotterdam, The Netherlands
| | - Sanne Wesselius
- Department of Intensive Care, Haga Teaching Hospital, The Hague, The Netherlands
| | - Diederik A M P J Gommers
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands
| | - Johannes Jeekel
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mathieu van der Jagt
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands
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11
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Stangl FJ, Riedl R, Kiemeswenger R, Montag C. Negative psychological and physiological effects of social networking site use: The example of Facebook. Front Psychol 2023; 14:1141663. [PMID: 37599719 PMCID: PMC10435997 DOI: 10.3389/fpsyg.2023.1141663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/03/2023] [Indexed: 08/22/2023] Open
Abstract
Social networking sites (SNS), with Facebook as a prominent example, have become an integral part of our daily lives and more than four billion people worldwide use SNS. However, the (over-)use of SNS also poses both psychological and physiological risks. In the present article, we review the scientific literature on the risk of Facebook (over-)use. Addressing this topic is critical because evidence indicates the development of problematic Facebook use ("Facebook addiction") due to excessive and uncontrolled use behavior with various psychological and physiological effects. We conducted a review to examine the scope, range, and nature of prior empirical research on the negative psychological and physiological effects of Facebook use. Our literature search process revealed a total of 232 papers showing that Facebook use is associated with eight major psychological effects (perceived anxiety, perceived depression, perceived loneliness, perceived eating disorders, perceived self-esteem, perceived life satisfaction, perceived insomnia, and perceived stress) and three physiological effects (physiological stress, human brain alteration, and affective experience state). The review also describes how Facebook use is associated with these effects and provides additional details on the reviewed literature, including research design, sample, age, and measures. Please note that the term "Facebook use" represents an umbrella term in the present work, and in the respective sections it will be made clear what kind of Facebook use is associated with a myriad of investigated psychological variables. Overall, findings indicate that certain kinds of Facebook use may come along with significant risks, both psychologically and physiologically. Based on our review, we also identify potential avenues for future research.
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Affiliation(s)
- Fabian J. Stangl
- Digital Business Institute, School of Business and Management, University of Applied Sciences Upper Austria, Steyr, Austria
| | - René Riedl
- Digital Business Institute, School of Business and Management, University of Applied Sciences Upper Austria, Steyr, Austria
- Institute of Business Informatics – Information Engineering, Johannes Kepler University Linz, Linz, Austria
| | - Roman Kiemeswenger
- Institute of Business Informatics – Information Engineering, Johannes Kepler University Linz, Linz, Austria
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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12
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Dupuy M, Dutheil F, Alvarez A, Godet T, Adeyemi OJ, Clinchamps M, Schmidt J, Lambert C, Bouillon-Minois JB. Influence of COVID-19 on Stress at Work During the First Wave of the Pandemic Among Emergency Health Care Workers. Disaster Med Public Health Prep 2023; 17:e455. [PMID: 37533367 DOI: 10.1017/dmp.2023.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVES For more than 2 years, coronavirus disease (COVID-19) has forced worldwide health care systems to adapt their daily practice. These adaptations add to the already stressful demands of providing timely medical care in an overcrowded health care system. Specifically, the COVID-19 pandemic added stress to an already overwhelmed emergency and critical care health care workers (HCWs) on the front lines during the first wave of the pandemic.This study assessed comparative subjective and objective stress among frontline HCWs using a visual analog scale and biometric data, specifically heart rate variability (HRV). METHODS This is a prospective, observational study using surveys and heart rate monitoring among HCWs who work in 3 frontline health care units (emergency department, mobile intensive care unit, and intensive care unit) in the University Hospital of Clermont-Ferrand, France. Two sessions were performed: 1 during the first wave of the pandemic (April 10 to May 10, 2020) and 1 after the first wave of the pandemic (June 10 to July 15, 2020).The primary outcome is the difference in stress levels between the 2 time points. Secondary objectives were the impact of overcrowding, sociodemographics, and other variables on stress levels. We also assessed the correlation between subjective and objective stress levels. RESULTS Among 199 HCWs, 98 participated in biometric monitoring, 84 had biometric and survey data, and 12 with only biometric data. Subjective stress was higher during the second time point compared to the first (4.39 ± 2.11 vs 3.16 ± 2.34, P = 0.23). There were higher objective stress levels with a decrease in HRV between the first and the second time points. Furthermore, we found higher patient volumes as a source of stress during the second time point. We did not find any significant correlation between subjective and objective stress levels. CONCLUSION HCWs had higher stress levels between the 2 waves of the pandemic. Overcrowding in the emergency department is associated with higher stress levels. We did not find any correlation between subjective and objective stress among intensive care and emergency HCWs during the first wave of the pandemic.
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Affiliation(s)
- Marie Dupuy
- Université Clermont Auvergne, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Clermont-Ferrand, France
| | - Al'ai Alvarez
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Thomas Godet
- CHU Clermont-Ferrand, Department of Anesthesiology and Critical Care, Reproduction and Developmental Diseases (R2D2) Unit, EA 7281, Clermont-Ferrand, France
| | - Oluwaseun John Adeyemi
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York University Langone Health, New York, NY, USA
| | - Maëlys Clinchamps
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
| | - Jeannot Schmidt
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
| | - Céline Lambert
- CHU Clermont-Ferrand, DRCI, Biostatistics unit, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency Medicine, Clermont-Ferrand, France
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Nightingale BA, Cassin SE. Self-Compassion May Have Benefits for Body Image among Women with a Higher Body Mass Index and Internalized Weight Bias. Healthcare (Basel) 2023; 11:healthcare11070970. [PMID: 37046897 PMCID: PMC10094015 DOI: 10.3390/healthcare11070970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
Negative attitudes towards one’s own body are common among women and are linked to adverse consequences including negative affect, low self-esteem, and eating pathology. Self-compassion has been found effective in improving body image; however, few published studies have examined self-compassion in populations with higher BMIs despite the positive correlation between weight and body dissatisfaction. The current study examined the efficacy of a self-compassion letter-writing exercise versus two active control groups in response to a negative body image induction. The sample of college-aged females (M age = 20.91 years; SD = 5.47) was split between higher and lower BMI to determine whether self-compassion affects body image, affect, and self-esteem differently across weight groups. Weight bias internalization (WBI: i.e., internalization of society’s negative stigma against those with higher BMIs) was examined as a moderator of this relationship in the higher BMI group. Results suggest that letter writing improved body image regardless of condition (p < 0.001). The self-compassion exercise promoted more adaptive body image (p = 0.007) and self-compassion (p = 0.013) than one control condition for those with high WBI. Results suggest that self-compassion can be helpful in ameliorating negative body image for females of all sizes, and that levels of WBI may alter the effect of body image interventions.
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14
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Girondini M, Stefanova M, Pillan M, Gallace A. The Effect of Previous Exposure on Virtual Reality Induced Public Speaking Anxiety: A Physiological and Behavioral Study. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:127-133. [PMID: 36809117 DOI: 10.1089/cyber.2022.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Public speaking anxiety (PSA) is defined as a strong distress when performing a speech in front of an audience, causing impairment in terms of work possibilities and social relationships. Audience behavior and feedback received during a speech are a crucial variable to induce PSA, affecting performance and perception. In this study, two different virtual reality public speaking scenarios were developed to investigate the impact of positive (more assertive) versus negative (more hostile) audience behavior regarding perceived anxiety and physiological arousal during performance. Moreover, the presence of any carry-over effect based on first experiences (positive vs. negative) was investigated by using a within-between design. Both explicit (questionnaires) and implicit physiological measures (heart rate [HR]) were used to assess participants' experience. The results confirmed the influence of audience behavior on perceived anxiety. As expected, negative audience elicited greater anxiety and lower experience pleasantness. More interesting, the first experience influenced the perceived anxiety and arousal during performance, suggesting some sort of priming effect due to the valence of previous experience. In particular, starting with an encouraging feedback scenario did not increase the perceived anxiety and HR in front of a subsequent annoying audience. This modulation did not appear in the group who started with the annoying audience, which clearly reported higher HR and anxiety during the annoying exposure compared with the encouraging audience. These results are discussed considering previous evidence on the effect of feedback on performance. In addition, physiological results are interpreted considering the role of somatic marker theory in human performance.
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Affiliation(s)
- Matteo Girondini
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milano, Italy.,Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Milena Stefanova
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milano, Italy
| | | | - Alberto Gallace
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milano, Italy.,Department of Psychology, University of Milano-Bicocca, Milano, Italy
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15
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García Pagès E, Arza A, Lazaro J, Puig C, Castro T, Ottaviano M, Arredondo MT, Bernal ML, López-Antón R, Cámara CDL, Gil E, Laguna P, Bailón R, Aguiló J, Garzón-Rey JM. Psychosomatic response to acute emotional stress in healthy students. Front Physiol 2023; 13:960118. [PMID: 36699693 PMCID: PMC9870289 DOI: 10.3389/fphys.2022.960118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/29/2022] [Indexed: 01/11/2023] Open
Abstract
The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.
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Affiliation(s)
- Esther García Pagès
- Universitat Autònoma de Barcelona, UAB, Barcelona, Spain,*Correspondence: Esther García Pagès,
| | - Adriana Arza
- École Polytechnique Fédérale de Lausanne, EPFL, Lausanne, Switzerland
| | | | - Carlos Puig
- Universitat Autònoma de Barcelona, UAB, Barcelona, Spain
| | - Thais Castro
- Universitat Autònoma de Barcelona, UAB, Barcelona, Spain,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
| | - Manuel Ottaviano
- Life Supporting Technologies, Universidad Politécnica de Madrid, UPM, Madrid, Spain
| | | | | | | | | | - Eduardo Gil
- Universidad de Zaragoza, UZ, Zaragoza, Spain
| | - Pablo Laguna
- Universidad de Zaragoza, UZ, Zaragoza, Spain,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
| | - Raquel Bailón
- Universidad de Zaragoza, UZ, Zaragoza, Spain,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
| | - Jordi Aguiló
- Universidad de Zaragoza, UZ, Zaragoza, Spain,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
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Li Y, Tian Y, Fan F, Chen J, Fu F, Zhu R, Wei D, Tang S, Zhou H, Wang D, Zhang X. Prevalence, demographics, and clinical correlates of antisocial personality disorder in Chinese methamphetamine patients. Am J Addict 2023; 32:47-53. [PMID: 36403120 DOI: 10.1111/ajad.13361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Antisocial personality disorder (ASPD) is very common among methamphetamine (MA) patients, but very few studies have been conducted in China. This study aimed to investigate the prevalence and clinical correlates of ASPD among Chinese MA patients. METHODS We recruited 627 MA patients and collected demographic and MA use data through one-on-one semi-structured interviews. ASPD was measured by the Mini International Neuropsychiatric Interview (M.I.N.I.). The Desires for Drug Questionnaire (DDQ) and visual analog scale (VAS) were used to assess drug cravings. RESULTS The prevalence rate of ASPD among MA patients was 27.59% (173/627). Patients with ASPD had greater age at the first onset, duration of MA use, length of abstinence, VAS, DDQ desire and intention, negative reinforcement, and total DDQ scores than patients without ASPD. Stepwise binary logistic regression analysis revealed that age, age at the first onset, length of abstinence, and DDQ-negative reinforcement were independently associated with ASPD in MA patients. DISCUSSION AND CONCLUSIONS Our findings suggest that the prevalence of ASPD is high among Chinese MA patients. Furthermore, some demographic and clinical variables are associated with ASPD in MA patients. SCIENTIFIC SIGNIFICANCE We focused our study on the clinical profile of ASPD and the reasons for its high prevalence in Chinese methamphetamine patients. We identified several demographic and clinical variables as correlates of the occurrence of ASPD in methamphetamine patients, which provides evidence for ASPD comorbidity in methamphetamine patients.
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Affiliation(s)
- Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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17
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Suh J, Na S, Jung S, Kim KH, Choo S, Choi J, Kim J. Family caregivers' responses to a visitation restriction policy at a Korean surgical intensive care unit before and during the coronavirus disease 2019 pandemic. Heart Lung 2023; 57:59-64. [PMID: 36058109 PMCID: PMC9399133 DOI: 10.1016/j.hrtlng.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since the COVID-19 pandemic, restricting family visits in the ICU has increased concerns regarding negative psychosocial consequences to patients and families. OBJECTIVES To compare the quality of life, depressive symptoms, and emotions in family caregivers of ICU patients before and during the COVID-19 pandemic, and to explore families' perceptions and suggestions for the visitation. METHODS A cross-sectional descriptive survey was conducted in 99 family caregivers of adult surgical ICU patients from an urban academic medical center in South Korea (February to July 2021). The WHO's Quality of Life-BREF, Center for Epidemiologic Studies Depression, and Visual Analogue Scale were used to assess quality of life, depressive symptoms, and emotions, respectively. The Family Perception Checklist was used to assess families' perceptions and suggestions about the visitation restriction. Results were compared with the data from our previous survey (n = 187) in 2017. RESULTS Family caregivers were mostly women (n = 59), adult children (n = 43) or spouse (n = 38) of patients with mean age of 47.34 years. Family caregivers surveyed during the pandemic reported worsening sadness (54.66 ± 28.93, 45.58 ± 29.44, P = 0.005) and anxiety (53.86 ± 30.07, 43.22 ± 29.02, P = 0.001) than those who were surveyed in. While majority of families were satisfied with the visitation restrictions (86.9%), only 50.5% were satisfied with the amount of information provided on the patient's condition. CONCLUSIONS Visitation restriction is necessary during the COVID-19 pandemic despite sadness and anxiety reported in caregivers. Hence, alternative visitation strategies are needed to mitigate psychological distress and provide sufficient information to ICU family caregivers.
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Affiliation(s)
- Jiwoo Suh
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungwon Na
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seungho Jung
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwan Hyung Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungji Choo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - JiYeon Choi
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
| | - Jeongmin Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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18
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Jabr L, Altuhafy M, Barmak AB, Rossouw PE, Michelogiannakis D. Comparative assessment of chewing sugar-free gum and conventional analgesic drugs in alleviating self-reported pain associated with fixed orthodontic appliances: A systematic review and meta-analysis. J Orthod 2022; 50:215-228. [PMID: 36550619 DOI: 10.1177/14653125221144059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the effect of chewing sugar-free gum towards alleviating self-reported orthodontic treatment (OT) pain compared with conventional analgesic drugs (CADs). SEARCH SOURCES An unrestricted search of indexed databases and manual searching was performed up to September 2021. DATA SELECTION Randomised controlled trials (RCTs) comparing the impact of chewing gum and CADs on relieving self-reported orthodontic pain were included. DATA EXTRACTION Data screening, extraction and risk of bias (RoB) assessment were performed by two authors. Meta-analyses were performed using a random-effects model. The quality of available evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS Nine RCTs were included. Eight RCTs used the Visual Analogue Scale for self-reported pain assessment, while one RCT used the Numeric Rating Scale. Five RCTs had a high RoB and four RCTs had a moderate RoB. Power analysis for sample size estimation was performed in six RCTs. Separate meta-analyses were performed by pooling quantitative data from five RCTs that compared self-reported orthodontic pain between chewing gum and ibuprofen groups for the following timepoints: baseline; immediately; 2 hours; 6 hours; bedtime; 24 hours; 2 days; 3 days; 5 days; and 7 days after the placement of orthodontic appliances. None of the timepoints individually indicated a difference in self-reported pain scores between chewing sugar-free gum and ibuprofen groups. The overall level of evidence was very low. CONCLUSION Chewing sugar-free gum is a potentially useful alternative to CADs towards pain alleviation during fixed OT.
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Affiliation(s)
- Luay Jabr
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Maryam Altuhafy
- Department of Orofacial Pain and Temporomandibular Joint Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Abdul Basir Barmak
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Paul Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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The Use of Therapeutic Inhaled Essential Oils (TIEO) as a Holistic Approach to Decrease Preoperative Anxiety in ERAS Gynecological Surgery. J Perianesth Nurs 2022; 37:787-794. [PMID: 35637078 DOI: 10.1016/j.jopan.2022.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/12/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Preoperative anxiety is a negative symptom frequently experienced by surgical patients. This evidence-based-practice (EBP) project evaluated the effectiveness of therapeutic inhaled essential oils (TIEO) on anxiety levels during the preoperative phase of surgery in enhanced recovery after surgery (ERAS) gynecological patients ages 18 to 65 years old. METHODS A prospective, preposttest, quasiexperimental design was used to evaluate preoperative anxiety scores. Patients (N = 53) scheduled for gynecological surgeries were enrolled at a level II trauma center. Upon arrival to the preoperative area on the day of surgery, patients were asked to score their anxiety level using the Visual Analog Scale for Anxiety (VAS-A). Patients were provided the TIEO intervention during their preoperative phase of surgery ranging from 15 to 60 minutes. Patients were encouraged to take mindful deep breaths and inhale the essential oil vapor. Before being transported into the operating room, patients were asked to re-evaluate their anxiety level using the VAS-A. RESULTS A matched paired t-test revealed the post-VAS-A measurements were significantly lower (n = 52, M = 31.37, SD = 24.334) than the pre-VAS-A measurements (n = 52, M = 53.50, SD = 26.863), t51 = 8.756, P = .000). On average, postanxiety scores were 22.135 mm lower than pre-anxiety scores (95% CI [17.060, 27.209]). CONCLUSIONS The use of TIEO demonstrated a statistically significant decrease in preoperative anxiety scores within the ERAS gynecological population. TIEO can be used as an adjunct intervention to manage preoperative anxiety. TIEO can be successfully administered in the preoperative area. Decreasing anxiety in the preoperative period may lead to many perioperative benefits such as improving surgical outcomes, patient satisfaction, and quality of care.
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Winkler CD, Koval P, Phillips LJ, Felmingham KL. Does prediction error during exposure relate to clinical outcomes in cognitive behavior therapy for social anxiety disorder? A study protocol. Front Psychiatry 2022; 13:1000686. [PMID: 37082515 PMCID: PMC10111196 DOI: 10.3389/fpsyt.2022.1000686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
Facing your fears, or exposure therapy, is an effective psychological intervention for anxiety disorders that is often thought to work through fear extinction learning. Fear extinction learning is a type of associative learning where fear reduces through repeated encounters with a feared situation or stimulus in the absence of aversive outcomes. Laboratory research suggests fear extinction learning is driven by threat prediction errors, defined as when fearful predictions do not eventuate. Threat prediction error and its relationship to exposure therapy outcomes haven't been studied enough in actual therapy settings. It remains unclear whether prediction error and extinction learning are central mechanisms of exposure therapy. We are conducting a longitudinal and observational study of how threat prediction error during exposure in social anxiety disorder (SAD) treatment relates to session-by-session symptom change and treatment outcome in addition to exposure surprise and learning outcome. We aim to recruit 65 adults with a primary diagnosis of SAD through an outpatient psychology clinic. Participants will receive 12 sessions of individual manualized cognitive behavioral therapy (CBT), adapted from an efficacious group protocol, that includes graded exposure. Exposure processes, including self-report measures of anxiety, threat prediction, threat outcomes, surprise, and learning outcome, will be measured with smartphone-based event-contingent ecological momentary assessments (EMAs) of all behavioral experiments completed during treatment. Clinical outcomes include self-reported social anxiety symptoms and social threat appraisals, at each session, post and 3-months after treatment. Prediction error will be operationalized as the mismatch between the threat prediction and threat outcome. The joint effect of threat prediction and threat outcome on session-by-session symptom change, treatment outcome, exposure surprise, and learning outcome will be explored using multilevel modeling. The present study will help determine whether threat prediction error during exposures in SAD treatment is related to theoretically implied clinical outcomes. This would contribute to the larger research aim of clarifying exposure therapy mechanisms.
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Affiliation(s)
- Christopher D. Winkler
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
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21
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Napierala H, Kopka M, Altendorf MB, Bolanaki M, Schmidt K, Piper SK, Heintze C, Möckel M, Balzer F, Slagman A, Schmieding ML. Examining the impact of a symptom assessment application on patient-physician interaction among self-referred walk-in patients in the emergency department (AKUSYM): study protocol for a multi-center, randomized controlled, parallel-group superiority trial. Trials 2022; 23:791. [PMID: 36127742 PMCID: PMC9490986 DOI: 10.1186/s13063-022-06688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Due to the increasing use of online health information, symptom checkers have been developed to provide an individualized assessment of health complaints and provide potential diagnoses and an urgency estimation. It is assumed that they support patient empowerment and have a positive impact on patient-physician interaction and satisfaction with care. Particularly in the emergency department (ED), symptom checkers could be integrated to bridge waiting times in the ED, and patients as well as physicians could take advantage of potential positive effects. Our study therefore aims to assess the impact of symptom assessment application (SAA) usage compared to no SAA usage on the patient-physician interaction in self-referred walk-in patients in the ED population. Methods In this multi-center, 1:1 randomized, controlled, parallel-group superiority trial, 440 self-referred adult walk-in patients with a non-urgent triage category will be recruited in three EDs in Berlin. Eligible participants in the intervention group will use a SAA directly after initial triage. The control group receives standard care without using a SAA. The primary endpoint is patients’ satisfaction with the patient-physician interaction assessed by the Patient Satisfaction Questionnaire. Discussion The results of this trial could influence the implementation of SAA into acute care to improve the satisfaction with the patient-physician interaction. Trial registration German Clinical Trials Registry DRKS00028598. Registered on 25.03.2022
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Affiliation(s)
- Hendrik Napierala
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of General Practice and Family Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Marvin Kopka
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, 10117, Berlin, Germany.,Cognitive Psychology and Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany
| | - Maria B Altendorf
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Emergency and Acute Medicine and Health Services Research in Emergency Medicine (CVK, CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Myrto Bolanaki
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Emergency and Acute Medicine and Health Services Research in Emergency Medicine (CVK, CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Konrad Schmidt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of General Practice and Family Medicine, Charitéplatz 1, 10117, Berlin, Germany.,Jena University Hospital, Institute of General Practice and Family Medicine, Bachstr. 18, 07743, Jena, Germany
| | - Sophie K Piper
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, 10117, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christoph Heintze
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of General Practice and Family Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Martin Möckel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Emergency and Acute Medicine and Health Services Research in Emergency Medicine (CVK, CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Felix Balzer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, 10117, Berlin, Germany
| | - Anna Slagman
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Emergency and Acute Medicine and Health Services Research in Emergency Medicine (CVK, CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Malte L Schmieding
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, 10117, Berlin, Germany. .,docport Services GmbH, Tußmannstr. 75, 40477, Düsseldorf, Germany.
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22
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Segal A, Pine DS, Bar-Haim Y. Personalized attention control therapy for PTSD: effectiveness and moderators of outcome in a randomized controlled trial. Psychol Med 2022; 52:2365-2375. [PMID: 33231534 DOI: 10.1017/s0033291720004304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous randomized controlled trials (RCTs) suggest that attention control therapy (ACT), targeting aberrant fluctuations of attention toward and away from threats in patients with PTSD, may be effective in reducing symptoms. The current RCT examined whether the use of personalized-trauma stimuli enhances ACT efficacy in patients with PTSD. Additional moderators of treatment outcome were tested on an exploratory basis. METHODS Sixty patients with PTSD were randomly assigned to either personalized ACT, non-personalized ACT, or a control condition. Changes in symptoms were examined across pre-treatment, post-treatment, and a 3-month follow-up. Attentional interference was examined pre- and post-treatment. Baseline clinical and cognitive indices as well as the time elapsed since the trauma were tested as potential moderators of treatment outcome. RESULTS A significant reduction in clinical symptoms was noted for all three conditions with no between-group differences. Attention bias variability decreased following ACT treatment. Personalized ACT was more effective relative to the control condition when less time had elapsed since the trauma. Baseline clinical and cognitive indices did not moderate treatment outcome. CONCLUSIONS In this RCT of patients with PTSD, ACT was no more effective in reducing PTSD symptoms than a control condition. The data also suggest a potential benefit of personalized ACT for patients who experienced their trauma more recently.
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Affiliation(s)
- Adva Segal
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, Intramural Research Program, National Institutes of Mental Health, Bethesda, Maryland, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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23
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Michelsen C, Kjellgren A. The Effectiveness of Web-Based Psychotherapy to Treat and Prevent Burnout: Controlled Trial. JMIR Form Res 2022; 6:e39129. [PMID: 35802001 PMCID: PMC9412737 DOI: 10.2196/39129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Burnout is a hidden productivity killer in organizations. Finding a solution to efficiently measure and proactively prevent or rehabilitate employees with burnout is a challenge. To meet this unabated demand, companies and caregivers can focus on proactive measures to prevent “Burnout as an Occupational Phenomenon.” Objective We aimed to address effectiveness, reliability, and validity of the empowerment for participation (EFP) batch of assessments to measure burnout risk in relation to the efficacy of web-based interventions using cognitive behavioral therapy (CBT) and floating to improve mental health and well-being. We introduced three risk assessments: risk for burnout, risk of anxiety, and risk for depression. Methods We used an interventional, empirical, and parallel design using raw EFP psychometric data to measure the effectiveness of web-based therapy to reduce the risk of burnout between a control group and web-based therapy group. A total of 50 participants were selected. The rehabilitation and control groups consisted of 25 normally distributed employees each. The rehabilitation group received therapy, whereas the control group had not yet received any form of therapy. IBM SPSS was used to analyze the data collected, and a repeated measures ANOVA, an analysis of covariance, a discriminant analysis, and a construct validity analysis were used to test for reliability and validity. The group was selected from a list of employees within the My-E-Health ecosystem who showed a moderate or high risk for burnout. All assessments and mixed-method CBT were web-based, and floating was conducted at designated locations. The complete EFP assessment was integrated into a digital ecosystem designed for this purpose and therapy, offering a secure and encrypted ecosystem. Results There was a statistically significant difference between pre- and postassessment scores for burnout. The reliability of the burnout measure was good (Cronbach α=.858; mean 1.826, SD 3.008; Cohen d=0.607; P<.001) with a high validity of 0.9420. A paired samples 2-tailed test showed a good t score of 4.292 and P<.001, with a good effect size, Cohen d=0.607. Web-based therapy reduced the risk for burnout in participants compared with the control group. Tests of between-subject effects show F=16.964, a significant difference between the control group and the web-based therapy group: P<.001, with movement between the group variables of 0.261 or 26.1% for the dependent variable. Conclusions This study suggests good reliability and validity of using web-based interventional mixed methods CBT to reduce the risk of burnout. The EFP batch of web-based assessments could reliably identify morbidity risk levels and successfully measure clinical interventions and rehabilitation with consistently reliable results to serve as both a diagnostic and therapeutic tool worthy of major research in the future. Trial Registration ClinicalTrials.gov NCT05343208; https://clinicaltrials.gov/ct2/show/NCT05343208
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24
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Thompson M, Carlson D, Crawford W, Kacmar KM, Weaver S. You Make Me Sick: Abuse at Work and Healthcare Utilization. HUMAN PERFORMANCE 2022. [DOI: 10.1080/08959285.2022.2104846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Chen YYK, Soens MA, Kovacheva VP. Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption. J Anesth 2022; 36:532-553. [PMID: 35779126 DOI: 10.1007/s00540-022-03081-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
Preoperative anxiety has an incidence of 11-80% in patients undergoing surgical or interventional procedures. Understanding the role of preoperative anxiety on intraoperative anesthetic requirements and postoperative analgesic consumption would allow personalized anesthesia care. Over- or under-anesthetizing patients can lead to complications such as postoperative cognitive dysfunction in elderly patients, or procedural discomfort, respectively. Our scoping review focuses on the current evidence regarding the association between preoperative anxiety and intraoperative anesthetic and/or postoperative analgesic consumption in patients undergoing elective surgical or interventional procedures. Based on 44 studies that met the inclusion criteria, we found that preoperative anxiety has a significant positive correlation effect on intraoperative propofol and postoperative opioid consumption. The analysis of the literature is limited by the heterogeneity of preoperative anxiety tools used, study designs, data analyses, and outcomes. The use of shorter, validated preoperative anxiety assessment tools may help optimize the intraoperative anesthetic and postoperative analgesic regimen. Further research to determine the most feasible and clinically relevant preoperative anxiety tool and subsequent implementation has the potential to optimize perioperative care and improve patient outcomes.
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Affiliation(s)
- Yun-Yun K Chen
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Mieke A Soens
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Vesela P Kovacheva
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America.
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26
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Seon Q, Mady N, Yang M, Karia M, Lashley M, Sescu C, Lalonde M, Puskas S, Outerbridge J, Parent-Racine E, Pagiatakis C, Gomez-Cardona L, Yiang D, Bouchard S, Linnaranta O. A Virtual Reality-Assisted Cognitive Behavioral Therapy (VR-CBT) for and with Inuit in Quebec - a protocol for a proof-of-concept randomized controlled trial (Preprint). JMIR Res Protoc 2022; 12:e40236. [DOI: 10.2196/40236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/19/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
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27
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Diagnostic Concordance between the Visual Analogue Anxiety Scale (VAS-A) and the State-Trait Anxiety Inventory (STAI) in Nursing Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127053. [PMID: 35742303 PMCID: PMC9222809 DOI: 10.3390/ijerph19127053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 01/27/2023]
Abstract
Anxiety is one of the most common problems among nursing students. The State-Trait Anxiety Inventory (STAI) is used to detect anxiety in this population; however, its length hinders speedy detection. For this reason, a faster and more efficient instrument is needed for early detection. This study aimed to determine the relationship between the anxiety measurement scales State-Trait Anxiety Inventory (STAI) and the Visual Analogue Scale for Anxiety (VAS-A) by establishing a discrimination threshold through the contrast of true positive rates (VPR) and false positive rates (FPR). To this end, a cross-sectional quantitative observational and analytical study was carried out on 185 fourth-year nursing students. The data collected were anxiety (STAI and VAS-A) and socio-demographic variables during the COVID-19 pandemic. The results showed a correlation between the two scales (VAS-A and STAI). The VAS-A is a useful instrument for assessing students in a crisis that could potentially generate anxiety. The study established a reasonably safe error probability range (>5%), allowing the VAS-A scale to be used as a rapid diagnostic or pre-diagnostic tool, depending on the scores. The study shows that speedy detection of anxiety using the VAS-A and an in-depth approach with the STAI by teaching staff in crises is possible.
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28
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Massad R, Hertz-Palmor N, Schneier FR, Lazarov A. Development and initial validation of the Visual Social Anxiety Scale (VSAS): Could a picture be worth a thousand words? J Anxiety Disord 2022; 89:102589. [PMID: 35689849 DOI: 10.1016/j.janxdis.2022.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/13/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022]
Abstract
Accurate assessment is crucial for determining appropriate therapeutic interventions for social anxiety and conducting sound clinical research. While self-report measures of social anxiety are widely used in both research and clinical settings, they have several drawbacks inherent to their textual nature. Here, we describe the development and initial validation of the Visual Social Anxiety Scale (VSAS), a novel picture-based self-report measure of social anxiety, based on the well-established widely-used Liebowitz Social Anxiety Scale (LSAS). Specifically, the 24 items of the LSAS were used as the basis for social situations to be included in the VSAS. First, pictures to serve as VSAS items were selected using a rigorous two-phase process (four pilot studies; n = 225). Next, reliability (internal consistency, test-retest) and validity (convergent, discriminant) were explored with new participants (n = 304) who completed the VSAS and a battery of additional self-report questionnaires, delivered in a random order. The VSAS was completed again a month later (n = 260/304). The VSAS showed high internal consistency and test-retest reliability, and good convergent and discriminant validities. VSAS correlations with convergent measures were significantly greater than its correlations with discriminant measures. Thus, the VSAS shows initial promise as a novel picture-based self-report measure of social anxiety.
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Affiliation(s)
- Raz Massad
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | | | - Franklin R Schneier
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, NY, USA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel.
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29
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Gomutbutra P, Srikamjak T, Sapinun L, Kunaphanh S, Yingchankul N, Apaijai N, Shinlapawittayatorn K, Phuackchantuck R, Chattipakorn N, Chattipakorn S. Effect of intensive weekend mindfulness-based intervention on BDNF, mitochondria function, and anxiety. A randomized, crossover clinical trial. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 11:100137. [PMID: 35757176 PMCID: PMC9216335 DOI: 10.1016/j.cpnec.2022.100137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background The previous metanalysis found that Mind-body intervention (MBI) improves neuropsychologic well-being and may increase brain-derived growth factor (BDNF). BDNF is a neurotrophic factor related to neuroplasticity. Objective To evaluate the effect of the short intensive MBI compared to control-relaxation on Site on BDNF and examine if this change is related to mitochondria function or stress-related neurohormonal activity. Methods Randomized, controlled, two-period cross-over trial conducted in a medical center in Thailand. Healthy-meditation naive Nurse and Occupational Therapy Students, 23 assigned randomly to MBI, and 24 relaxations at the site for 8 h during the weekend. The wash-out period was three months between the two periods. All volunteers took the blood test for BDNF, mitochondrial oxidative phosphorylation (OXPHOS), Cortisol, and Heart rate variability (HRV) measurement before and Visual Analogue Scale for Anxiety (VAS-A), forward and backward digit span after each period. Results A total of 40 participants finished the trials. The cross over trial analysis showed a significant treatment effect between MBI and Relaxation on-site for the mean VAS-A as 9.89 (95% CI 4.81 to 19.47; P = 0.001), serum BDNF as 1.24 (95% CI 0.16 to 2.32; P = 0.04), and OXPHOS complex-1 was decreased 0.41 (95% CI 0.03–0.29 p = 0.03). There were no significant differences for digit span, cortisol, and HRV. Conclusion In healthy meditation naïve females, even a short period of MBI may increase serum BDNF and reduce anxiety more than relaxation on-site. The more reduction of OXPHOS complex-1 in the mindfulness group suggests oxidative stress may be a more sensitive indicator than stress-related neurohormonal activity. The effects of a short, intensive mindfulness session are scarce. Brain-derived growth factor (BDNF) is impacted by mindfulness-based intervention. The results indicate that mindfulness practice increased BDNF. This can be applied to the promotion of women's health.
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30
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Lim K, Jung S, Kim H. Integrative review of non-pharmacological intervention and multidimensional evaluation for intraoperative anxiety under spinal anaesthesia. J Clin Nurs 2022; 32:2114-2127. [PMID: 35352416 DOI: 10.1111/jocn.16309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/22/2021] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients under spinal anaesthesia experience high levels of anxiety during surgery. Clinical nurses tried to manage patient's anxiety under spinal anaesthesia using non-pharmacological interventions for its benefit. Thus, it is required to identify comprehensive evidences of various non-pharmacological interventions and of how to measure anxiety under spinal anaesthesia. AIMS This study aims to review current research on the non-pharmacological interventions to relieve intraoperative anxiety under spinal anaesthesia and to identify subjective and objective measures of intraoperative anxiety under spinal anaesthesia. METHODS Wittemore and Knafl's integrative review methodology was used. Researchers conducted five scientific rigor steps; problem identification, searching literature, evaluation of literature, analysis of literature and presentation of results. The PRISMA checklist was used. To evaluate the level of evidence, critical appraisal tools of Joanna Briggs Institute were used. RESULTS Eleven studies were included in this integrative review. Delivering music is the most frequently used as non-pharmacological intervention by researchers. They tried to manage intraoperative anxiety under spinal anaesthesia with using diverse genre and application of music. In addition, dry cupping method, progressive muscle relaxation (PMR) exercise and virtual reality (VR) goggles were used in included studies. Researchers measured intraoperative anxiety under spinal anaesthesia with objective or subjective way. The State-Trait Anxiety Inventory and visual analogue scale were used as subjective method to approach intraoperative anxiety. In contrary, researchers tried to obtain objective evidence of intraoperative anxiety with vital signs, cortisol, blood glucose, alpha-amylase and adrenocorticotropic hormone. CONCLUSION Various types of non-pharmacological interventions are effective to manage patient's intraoperative anxiety under spinal anaesthesia. It is recommended to measure intraoperative anxiety under spinal anaesthesia with using both objective and subjective methods. RELEVANCE TO CLINICAL PRACTICE Clinical nurses can use non-pharmacological interventions to manage intraoperative anxiety under spinal anaesthesia by comprehensive monitoring with diverse measures.
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Affiliation(s)
- Kyuhee Lim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Sooah Jung
- Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Heejung Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Brain Korea 21 FOUR Project, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Seoul, Republic of Korea.,Yonsei Evidence Based Nursing Centre of Korea: a JBI Affiliated Group, Yonsei University, Seoul, Republic of Korea
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31
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Dutheil F, Vilmant A, Boudet G, Mermillod M, Lesage FX, Jalenques I, Valet G, Schmidt J, Bouillon-Minois JB, Pereira B. Assessment of sick building syndrome using visual analog scales. INDOOR AIR 2022; 32:e13024. [PMID: 35347792 DOI: 10.1111/ina.13024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/06/2022] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Despite there is no recommendations for assessing symptoms of sick building syndrome, the use of visual analog scales (VAS) seems attractive and appropriate. We aimed to demonstrate the benefits of using VAS for evaluating subjective symptoms of sick building syndrome. METHOD We compared an exposed group to a control group with a one-year follow-up. To assess chronology of symptoms, employees were asked to complete four VAS at different times: after vacations (time 1), beginning of the week-beginning of the day (time 2), beginning of the week-end of the day (time 3), and end of the week-end of the day (time 4). Measurements were repeated before and after ventilation work for the exposed group and at the same time in the control group without intervention. Confounding factors were assessed. RESULTS We included 36 employees (21 in the exposed group and 15 in the control group). Both groups were comparable. Prior to ventilation work, the exposed group had more subjective symptoms than the control group with a chronology of symptoms. After ventilation work, symptoms did not differ between groups, and most symptoms decreased within the exposed group. PRACTICAL IMPLICATION The use of VAS provided reliable data for assessing sick building syndrome and showed a dose-response relationship between occupational exposure and symptoms.
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Affiliation(s)
- Frédéric Dutheil
- LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Preventive Medicine, WittyFit, Université Clermont Auvergne, CNRS, Clermont-Ferrand, France
| | - Audrey Vilmant
- Association Interentreprises en Santé au Travail La Prévention Active, RIOM, France
| | - Gil Boudet
- LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Preventive Medicine, Université Clermont Auvergne, CNRS, Clermont-Ferrand, France
| | - Martial Mermillod
- LPNC, Univ. Grenoble Alpes, CNRS, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - François-Xavier Lesage
- Laboratory Epsylon EA 4556, Dynamic of Human Abilities & Health Behaviors, CHU Montpellier, Occupational Medicine, University of Montpellier, Montpellier, France
| | - Isabelle Jalenques
- CHU Clermont-Ferrand, Addictology, Université Clermont Auvergne, NPsy-Sydo, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Guillaume Valet
- LaPSCo, Physiological and Psychosocial Stress, Université Clermont Auvergne, CNRS, , Clermont-Ferrand, France
| | - Jeannot Schmidt
- LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency, Université Clermont Auvergne, CNRS, Clermont-Ferrand, France
| | - Jean-Baptiste Bouillon-Minois
- LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Emergency, Université Clermont Auvergne, CNRS, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, Clinical Research and Innovation Direction, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Castle M, O Hagan R, Anderberg E, Wangman A, Harrington H, Dhakal L. About face: regional allied health professional early adaptation during the COVID-19 pandemic. Aust J Prim Health 2022; 28:110-116. [PMID: 35164898 DOI: 10.1071/py21150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022]
Abstract
The coronavirus pandemic has led to significant change in allied health practice in Australia. Measures to slow virus spread have included replacing face-to-face services with telehealth services, and hands-on practice with socially distanced intervention. In the present mixed-methods, cross-sectional study, 51 allied health professionals across two public health services in regional Victoria, Australia, completed an online questionnaire with open and closed questions. The aim was to explore their experience in adapting to directed practice change during the first wave of the pandemic. The clinicians reported low levels of clinical satisfaction due to a perceived reduction in service quality and accessibility. Directed use of telehealth significantly contributed to dissatisfaction, with challenges including infrastructure, clinician and patient digital literacy and platform suitability for some patient groups and interventions. In contrast, peer support, timely and accurate communication, decision transparency, recognition and strong leadership from management supported adaptation, as did individuals' flexibility and learning. Our findings highlight the leadership qualities and support strategies conducive to workplace adaptation during a crisis period. They also support calls for further resource development to support skill translation for telehealth platform use and initiatives to increase digital literacy and infrastructure availability in regional Australia.
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Affiliation(s)
- Meredith Castle
- Northeast Health, Subacute Services, Green Street, Wangaratta, Vic. 3677, Australia; and Corresponding author
| | - Rowan O Hagan
- Northeast Health, Education and Research Unit, Green Street, Wangaratta, Vic. 3677, Australia
| | - Erin Anderberg
- Gateway Health, Rural Health Team, 45-47 MacKay Street, Wangaratta, Vic. 3677, Australia
| | - Amanda Wangman
- Northeast Health, Subacute Services, Green Street, Wangaratta, Vic. 3677, Australia
| | - Helen Harrington
- Northeast Health, Subacute Services, Green Street, Wangaratta, Vic. 3677, Australia
| | - Lakshmi Dhakal
- Northeast Health, Subacute Services, Green Street, Wangaratta, Vic. 3677, Australia
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Intraoral Scanners in Orthodontics: A Critical Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031407. [PMID: 35162430 PMCID: PMC8834929 DOI: 10.3390/ijerph19031407] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
Background: The use of digital technology has exponentially increased over recent years. Intraoral scanners, especially, have gained traction within orthodontics. The objective of the present review is to investigate the available evidence to create an up-to-date presentation of various clinical aspects of intraoral scanners in orthodontics. Methods: Search without restrictions in seven databases (Pubmed, CENTRAL, Cochrane Reviews, Scopus, Web of Science, Clinical Trials, Proquest) since inception, and hand searching until October 2020, were conducted. Results: The majority of studies were either cross-over or parallel group studies. The accuracy and reproducibility of intraoral scanners, in comparison to conventional methods, were investigated in several studies, with controversial results. The duration of the procedure did not report any clear outcome in favor of any method. Patients seem to prefer intraoral scanning, even though numerous studies point out the importance of operators’ experience and skills. Conclusions: Despite the innovations that intraoral scanners have brought in orthodontic clinical practice, there are still some challenges and limitations in their use. The majority of existing limitations may be overcome with experience and good clinical skills. More high-quality studies need to be conducted so that clinicians can have a clear image of this new technology.
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COVID-19 epidemic-induced changes in mood and anxiety mediate the relationship between resilience and symptoms of depression and generalized anxiety in sexual assault survivors. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 6:100252. [PMID: 35036985 PMCID: PMC8743166 DOI: 10.1016/j.jadr.2021.100252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 01/02/2023] Open
Abstract
Background Sexual assault survivors are a vulnerable sub-population that might be severely affected by the COVID-19 pandemic, yet received little research attention during this global crisis. Higher levels of resilience are generally associated with lower symptoms of depression and anxiety and are thus considered as promoting adjustment to stress. Here, we tested the associations between resilience, depression, and anxiety symptoms among sexual assault survivors during the COVID-19 epidemic. Pandemic-induced changes in mood and anxiety were also examined as potential mediators of the relations between resilience and clinical symptoms of depression and anxiety. Methods At the pandemic onset, 83 sexual assault survivors (66 females, average age=37.68±10.90 years) undergoing treatment at a specialized psychiatric outpatient clinic completed a survey aimed at identifying patients in distress during the lockdown. The survey included a battery of questionnaires assessing resilience, pandemic-induced changes in mood and anxiety, and clinical symptoms of depression and generalized anxiety. Results Resilience scores were significantly negatively correlated with both depression and generalized anxiety symptoms. Furthermore, pandemic-induced changes in mood and anxiety significantly mediated these effects. Limitations Due to the cross-sectional study design, a temporal relationship between pandemic induced changes (mood and anxiety) and clinical symptoms (depression and generalized anxiety) could not be determined. Conclusions Our findings highlight the need to develop interventions for reducing situational changes in mood and anxiety during periods of acute stress, while increasing resilience factors, in order to decrease the burden of stress on sexual assault survivors’ mental health during the pandemic and beyond.
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Campos MD, Williams RC, Joshi V, Hall E, Reid R, Rosenthal RJ, Fong TW. Dropout or Early Treatment Response Among Gamblers with Depressive Symptoms. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00586-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Panchal N, Kharod U, Varma J, Sutaria K. Effect of pre-operative communication using anaesthesia information sheet on pre-operative anxiety of patients undergoing elective surgery—A randomised controlled study. Indian J Anaesth 2022; 66:559-572. [PMID: 36274808 PMCID: PMC9580597 DOI: 10.4103/ija.ija_32_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/04/2022] Open
Abstract
Background and Aims: Methods: Results: Conclusion:
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Jovanovic K, Kalezic N, Sipetic Grujicic S, Zivaljevic V, Jovanovic M, Savic M, Bukumiric Z, Dragas M, Sladojevic M, Trailovic R, Koncar I, Davidovic L. Translation and validation of the Amsterdam preoperative anxiety and information scale (APAIS) in Serbia. Brain Behav 2022; 12:e2462. [PMID: 34908243 PMCID: PMC8785621 DOI: 10.1002/brb3.2462] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/22/2021] [Accepted: 11/14/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Preoperative anxiety is common and might affect surgical treatment outcomes. The aim was to translate and validate the Serbian version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). METHODS Following translation and initial evaluation, the Serbian version (S-APAIS) was administered to 385 patients. Internal consistency, construct validity, prognostic criteria validity, and concurrent validity between S-APAIS and Visual Analogue Scale for Anxiety (VAS-A) were evaluated. RESULTS Factor analysis revealed two factors: APAIS-anesthesia (items 1, 2, 3) and APAIS-procedure (items 4, 5, 6). The whole scale, APAIS-anesthesia, and APAIS-procedure subscales showed an adequate level of internal consistency (Cronbach's αs: 0.787, 0.806, and 0.805, respectively). High concurrent validity was observed between APAIS-anesthesia and VAS-A (ρ = 0.628, p < .001). A moderate correlation was found between APAIS-procedure and VAS-A scale (ρ = 0.537, p < .001). At the cut-off point of 9, the area under the curve (AUC) of APAIS-anesthesia was 0.815 (95% CI: 0.77-0.85, p < .001). For the APAIS-procedure, AUC was 0.772 (95% CI: 0.73-0.81, p < .001) at the cut-off point of 8. CONCLUSION The structure of S-APAIS substantially differs from the original and allows separate measurement of anesthesia- and procedure-related anxieties. S-APAIS is a comprehensive, valid, and reliable instrument for the measurement of preoperative anxiety.
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Affiliation(s)
- Ksenija Jovanovic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | - Nevena Kalezic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | | | - Vladan Zivaljevic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Center for Endocrine SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milan Jovanovic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Center for Endocrine SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milica Savic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Zoran Bukumiric
- Institute of Medical Statistics and InformaticsFaculty of Medicine, University of BelgradeBelgradeSerbia
| | - Marko Dragas
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milos Sladojevic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Ranko Trailovic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | - Igor Koncar
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Lazar Davidovic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
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Johnson AJ, Laffitte Nodarse C, Peraza JA, Valdes-Hernandez PA, Montesino-Goicolea S, Huo Z, Fillingim RB, Cruz-Almeida Y. Psychological profiles in adults with knee OA-related pain: a replication study. Ther Adv Musculoskelet Dis 2021; 13:1759720X211059614. [PMID: 34900003 PMCID: PMC8664321 DOI: 10.1177/1759720x211059614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/26/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Psychological factors have been associated with knee osteoarthritis pain severity and treatment outcomes, yet their combined contribution to phenotypic heterogeneity is poorly understood. In particular, empirically derived psychological profiles must be replicated before they can be targeted or considered for treatment studies. The objectives of this study were to (1) confirm previously identified psychological profiles using unsupervised clustering methods in persons with knee osteoarthritis pain, (2) determine the replicability of profiles using supervised machine learning in a different sample, and (3) examine associations with clinical pain, brain structure, and experimental pain. Methods Participants included two cohorts of individuals with knee osteoarthritis pain recruited as part of the multisite UPLOAD1 (n = 270, mean age = 56.8 ± 7.6, male = 37%) and UPLOAD2 (n = 164, mean age = 57.73 ± 7.8, male = 36%) studies. Similar psychological constructs (e.g. optimism, coping, somatization, affect, depression, and anxiety), sociodemographic and clinical characteristics, and somatosensory function were assessed across samples. UPLOAD2 participants also completed brain magnetic resonance imaging. Unsupervised hierarchical clustering analysis was first conducted in UPLOAD1 data to derive clusters, followed by supervised linear discriminative analysis to predict group membership in UPLOAD2 data. Associations among cluster membership and clinical variables were assessed, controlling for age, sex, education, ethnicity/race, study site, and number of pain sites. Results Four distinct profiles emerged in UPLOAD1 and were replicated in UPLOAD2. Identified psychological profiles were associated with psychological variables (ps < 0.001), and clinical outcomes (ps = 0.001-0.03), indicating good internal and external validation of the cluster solution. Significant associations between psychological profiles and somatosensory function and brain structure were also found. Conclusions This study highlights the importance of considering the biopsychosocial model in knee osteoarthritis pain assessment and treatment.
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Affiliation(s)
- Alisa J Johnson
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | | | - Julio A Peraza
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | | | | | - Zhiguang Huo
- Department of Biostatistics, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, PO Box 103628, 1329 SW 16th Street, Ste 5180, Gainesville, FL 32610, USA
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Froreich FV, Vartanian LR, Grisham JR, Pinkus RT. The psychological effects of blind and open weighing in women with a high drive for thinness: A mixed method inquiry. Body Image 2021; 39:232-236. [PMID: 34628232 DOI: 10.1016/j.bodyim.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022]
Abstract
Regular weighing is a routine component of public health interventions but concerns have been raised about possible negative psychological consequences. Blind weighing is an alternative form of weighing that is commonly used in clinical contexts, and that is thought to decrease weighing anxiety and engagement with disordered eating behaviours. In this study, normal weight female participants who indicated a high drive for thinness (N = 53) were randomly assigned to receive bi-weekly open or blind weighing for three weeks. Participants who were open weighed felt increasingly anxious over time, whereas participants who were blind weighed felt less anxious. Both groups experienced increased weight preoccupation and disordered eating behaviours on weighing days compared to non-weighing days. Analyses of participants' qualitative responses further indicated that open weighed participants experienced increased urges to engage in weight-controlling behaviours throughout the experiment whereas blind weighed participants reported reduced concern with weight. Findings suggest that blind weighing may be a safer approach to weight monitoring, even though weighing in both forms can have a (transient) negative effect. Future research should evaluate whether the current findings are generalisable for other subgroups of the population.
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Affiliation(s)
- Franzisca V Froreich
- UNSW Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales 2052, Australia.
| | - Lenny R Vartanian
- UNSW Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales 2052, Australia
| | - Jessica R Grisham
- UNSW Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales 2052, Australia
| | - Rebecca T Pinkus
- The University of Sydney, Faculty of Science, School of Psychology, Australia
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Kim J, Kim H, Kim DH, Lee SK, Roh JY, Kim CH, Chang JG, Roh D. Effects of cranial electrotherapy stimulation with novel in-ear electrodes on anxiety and resting-state brain activity: A randomized double-blind placebo-controlled trial. J Affect Disord 2021; 295:856-864. [PMID: 34706456 DOI: 10.1016/j.jad.2021.08.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cranial Electrotherapy Stimulation (CES) is a promising non-invasive brain stimulation technique with the potential to alleviate anxiety. We examined the effectiveness of home-based CES with novel, headphone-like, in-ear electrodes on anxiety-related symptoms and resting-state brain activity. METHODS This study spanned 3-weeks, with randomized, double blind, and active-controlled design. Nonclinical volunteers experiencing daily anxiety were randomly assigned to either the active or the sham groups. CES provides an alternating current (10 Hz frequency, 500 μA intensity), connected to smartphone recording treatment logs. Participants treated themselves with 20 trials of CES at home. We evaluated the effectiveness using State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Wisconsin Card Sort Test (WCST), and resting-state electroencephalography (EEG). RESULTS The active group showed a significant improvement in state-anxiety compared to sham, while there was a statistical trend in the WCST-Category Completed (p = .061) and no change in depression. In EEG analysis, the active group showed significantly increased relative power for theta in the left frontal region compared with the sham, and this significantly correlated with the changes in state-anxiety. The active group exhibited significantly increased high-beta source activity in cuneus and middle occipital gyrus after intervention compared with the baseline. LIMITATIONS This study had a relatively short treatment period and small sample size. CONCLUSIONS Our findings provide the first electrophysiological evidence for CES for novel in-ear electrodes to improve anxiety. The modulatory effects of CES on resting-state oscillations of EEG imply that CES could beneficially affect functional brain activity.
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Affiliation(s)
- Jiheon Kim
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hansol Kim
- Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Do-Hoon Kim
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jung Yun Roh
- Fine art department, University of Reading, Reading, UK
| | - Chan-Hyung Kim
- Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jhin Goo Chang
- Department of Psychiatry, Myongi Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Daeyoung Roh
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; Mind-Neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea.
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Nijland JWHM, Veling W, Lestestuiver BP, Van Driel CMG. Virtual Reality Relaxation for Reducing Perceived Stress of Intensive Care Nurses During the COVID-19 Pandemic. Front Psychol 2021; 12:706527. [PMID: 34659021 PMCID: PMC8511693 DOI: 10.3389/fpsyg.2021.706527] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/31/2021] [Indexed: 12/30/2022] Open
Abstract
During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N=66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p<0.005). Mean score on the perceived stress scale-10 was 11.4 (SD=6.50), mean score on the Connor-Davidson Resilience Scale-10 was 29.0 (SD=5.51). Sixty-two percentage of the ICU nurses thought VRelax was helpful to reduce stress. Main barrier for use was a high workload. It is feasible for nurses to use VRelax in an ICU context. VRelax is an effective intervention to reduce immediate perceived stress and is of added value in stressful situations as during the COVID-19 pandemic, inducing a positive affective state and lowering perceived stress.
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Affiliation(s)
- J W H Mathijs Nijland
- Department of Psychiatry, University Medical Centre Groningen, Groningen, Netherlands
| | - Wim Veling
- Department of Psychiatry, University Medical Centre Groningen, Groningen, Netherlands.,VRelax B.V., Groningen, Netherlands
| | - Bart P Lestestuiver
- Department of Psychiatry, University Medical Centre Groningen, Groningen, Netherlands
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Søberg S, Löfgren J, Philipsen FE, Jensen M, Hansen AE, Ahrens E, Nystrup KB, Nielsen RD, Sølling C, Wedell-Neergaard AS, Berntsen M, Loft A, Kjær A, Gerhart-Hines Z, Johannesen HH, Pedersen BK, Karstoft K, Scheele C. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men. CELL REPORTS MEDICINE 2021; 2:100408. [PMID: 34755128 PMCID: PMC8561167 DOI: 10.1016/j.xcrm.2021.100408] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 07/13/2021] [Accepted: 09/17/2021] [Indexed: 12/18/2022]
Abstract
The Scandinavian winter-swimming culture combines brief dips in cold water with hot sauna sessions, with conceivable effects on body temperature. We study thermogenic brown adipose tissue (BAT) in experienced winter-swimming men performing this activity 2–3 times per week. Our data suggest a lower thermal comfort state in the winter swimmers compared with controls, with a lower core temperature and absence of BAT activity. In response to cold, we observe greater increases in cold-induced thermogenesis and supraclavicular skin temperature in the winter swimmers, whereas BAT glucose uptake and muscle activity increase similarly to those of the controls. All subjects demonstrate nocturnal reduction in supraclavicular skin temperature, whereas a distinct peak occurs at 4:30–5:30 a.m. in the winter swimmers. Our data leverage understanding of BAT in adult human thermoregulation, suggest both heat and cold acclimation in winter swimmers, and propose winter swimming as a potential strategy for increasing energy expenditure. Winter swimmers have a lower core temperature at a thermal comfort state than controls Winter swimmers had no BAT glucose uptake at a thermal comfort state Winter swimmers have higher cold-induced thermogenesis than control subjects Human supraclavicular skin temperature varies with a diurnal rhythm
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Affiliation(s)
- Susanna Søberg
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Johan Löfgren
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Frederik E Philipsen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Michal Jensen
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Adam E Hansen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Esben Ahrens
- Department of Neurophysiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Kristin B Nystrup
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Rune D Nielsen
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Christine Sølling
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Anne-Sophie Wedell-Neergaard
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Marianne Berntsen
- Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen 2100, Denmark
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Zachary Gerhart-Hines
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Helle H Johannesen
- Department of Clinical Physiology, Nuclear Medicine & PET, and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen 2100, Denmark
| | - Bente K Pedersen
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark
| | - Kristian Karstoft
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen 2400, Denmark
| | - Camilla Scheele
- The Center of Inflammation and Metabolism and the Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
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Kakar E, Van Mol M, Jeekel J, Gommers D, van der Jagt M. Study protocol for a multicentre randomised controlled trial studying the effect of a music intervention on anxiety in adult critically ill patients (The RELACS trial). BMJ Open 2021; 11:e051473. [PMID: 34642197 PMCID: PMC8513337 DOI: 10.1136/bmjopen-2021-051473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Anxiety is common in critically ill patients and has likely become more prevalent in the recent decade due to the imperative of the recent Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients (PADIS) to use low levels of sedation and strive for wakefulness. However, management of anxiety has not been included in the PADIS guidelines, and there is lack of evidence to treat it in spite of its growing importance. Administration of sedative and analgesic medication is often chosen to reduce anxiety, especially when associated with agitation. Sedatives are associated with prolonged mechanical ventilation, delirium and muscle wasting and are therefore preferably minimised. Previous studies have suggested positive effects of music interventions on anxiety in the critically ill. Therefore, we aim to study the effect of music intervention on anxiety in adult critically ill patients. METHODS AND DESIGN A multicentre randomised controlled trial was designed to study the effect of a music intervention on the level of anxiety experienced by adult patients admitted to the intensive care unit (ICU). One hundred and four patients will be included in three centres in the Netherlands. Patient recruitment started on 24-08-2020 and is ongoing in three hospitals. The primary outcome is self-reported anxiety measured on the visual analogue scale. Secondary outcomes include anxiety measured using the six-item State-Trait Anxiety Inventory, sleep quality, agitation and sedation level, medication requirement, pain, delirium, complications, time spend on mechanical ventilation, physical parameters and ICU memory and experience. ETHICS AND DISSEMINATION The Medical Ethics Review Board of Erasmus MC University Medical Centre Rotterdam, The Netherlands, has approved this protocol. The study is being conducted in accordance with the Declaration of Helsinki. Results of this trial will be published in peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBER NCT04796389.
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Affiliation(s)
- Ellaha Kakar
- General surgery, Erasmus MC, Rotterdam, South-Holland, The Netherlands
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Margo Van Mol
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | | | - Diederik Gommers
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Mathieu van der Jagt
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
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Heyming TW, Fortier MA, Martin SR, Lara B, Bacon K, Kain ZN. Predictors for COVID-19-related new-onset maladaptive behaviours in children presenting to a paediatric emergency department. J Paediatr Child Health 2021; 57:1634-1639. [PMID: 34042245 PMCID: PMC8242733 DOI: 10.1111/jpc.15579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/08/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE The goal of the present study was to determine the incidence of new onset maladaptive behaviours in paediatric emergency department (PED) patients during the COVID-19 pandemic and to examine whether child and parent anxiety and parental health status were predictors for the new-onset of maladaptive behaviours. METHODS Participants included child-parent dyads seen in a PED following the state's issuance of mandatory stay-at-home orders on 19 March 2020. A total of 351 children age 0-25 years and 335 parents enrolled in the study. Parents provided baseline demographic data and completed standardised surveys that assessed aspects of parental and child anxiety and parental health, as well as child new-onset maladaptive behaviours. Children ≥8 years of age completed surveys that assessed child anxiety. FINDINGS Parents reported the new onset of maladaptive behaviours in children during the pandemic with frequencies up to 43%. Bivariate analysis identified predictors such as child anxiety (t(96) = -2.04, P = 0.044) as well as parental variables such as state anxiety (t(190) = -4.91, P < 0.001) and parental sensitivity to anxiety (t(243) = -3.19, P = 0.002). A logistic regression model identified parent mental health and COVID-19 anxiety as predictors of new onset maladaptive behaviours in children (X2 (6) = 42.514, P < 0.001). Specifically, every unit change in parental anxiety of COVID-19 was associated with a unit increase in maladaptive behaviours in children. CONCLUSIONS We identified distinct parent and child-related factors that predicted new onset child maladaptive behaviours during the COVID-19 pandemic. The identification of such predictors may help clinicians to prevent maladaptive responses to the pandemic quarantine.
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Affiliation(s)
- Theodore W Heyming
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Department of Emergency MedicineUniversity of CaliforniaIrvineCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA
| | - Michelle A Fortier
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Sue & Bill Gross School of NursingUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
| | - Sarah R Martin
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
| | - Bryan Lara
- Children's Hospital of Orange CountyOrangeCaliforniaUSA
| | - Kellie Bacon
- Children's Hospital of Orange CountyOrangeCaliforniaUSA
| | - Zeev N Kain
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
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Kappen P, Jeekel J, Dirven CMF, Klimek M, Kushner SA, Osse RJ, Coesmans M, Poley MJ, Vincent AJPE. Music to prevent deliriUm during neuroSurgerY (MUSYC) Clinical trial: a study protocol for a randomised controlled trial. BMJ Open 2021; 11:e048270. [PMID: 34598983 PMCID: PMC8488750 DOI: 10.1136/bmjopen-2020-048270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Delirium is a neurocognitive disorder characterised by an acute and temporary decline of mental status affecting attention, awareness, cognition, language and visuospatial ability. The underlying pathophysiology is driven by neuroinflammation and cellular oxidative stress.Delirium is a serious complication following neurosurgical procedures with a reported incidence varying between 4% and 44% and has been associated with increased length of hospital stay, increased amount of reoperations, increased costs and mortality.Perioperative music has been reported to reduce preoperative anxiety, postoperative pain and opioid usage, and attenuates stress response caused by surgery. We hypothesize that this beneficial effect of music on a combination of delirium eliciting factors might reduce delirium incidence following neurosurgery and subsequently improve clinical outcomes. METHODS This protocol concerns a single-centred prospective randomised controlled trial with 6 months follow-up. All adult patients undergoing a craniotomy at the Erasmus Medical Center in Rotterdam are eligible. The music group will receive recorded music through an overear headphone before, during and after surgery until postoperative day 3. Patients can choose from music playlists, offered based on music importance questionnaires administered at baseline. The control group will receive standard of clinical careDelirium is assessed by the Delirium Observation Scale and confirmed by a delirium-expert psychiatrist according to the DSM-5 criteria. Risk factors correlated with the onset of delirium, such as cognitive function at baseline, preoperative anxiety, perioperative medication use, depth of anaesthesia and postoperative pain, and delirium-related health outcomes such as length of stay, daily function, quality of life (ie, EQ-5D, EORTC questionnaires), costs and cost-effectiveness are collected. ETHICS AND DISSEMINATION This study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Center Rotterdam, The Netherlands, approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBERS NL8503 and NCT04649450.
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Affiliation(s)
- Pablo Kappen
- Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johannes Jeekel
- Neuroscience, Erasmus MC, Rotterdam, The Netherlands
- Surgery, Erasmus MC, Rotterdam, The Netherlands
| | | | - M Klimek
- Anesthesiology, Erasmus MC, Rotterdam, The Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert-Jan Osse
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Michiel Coesmans
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marten J Poley
- Pediatric Surgery, Erasmus MC Sophia, Rotterdam, The Netherlands
- Medical Technology Assessment (iMTA), Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
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Baumgartner JN, Quintana D, Leija L, Schuster NM, Bruno KA, Castellanos JP, Case LK. Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2021; 23:156-174. [PMID: 34425251 DOI: 10.1016/j.jpain.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
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Affiliation(s)
- Jennifer N Baumgartner
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Desiree Quintana
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Linda Leija
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Nathaniel M Schuster
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Kelly A Bruno
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Joel P Castellanos
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Laura K Case
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California.
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Brosh K, Roditi E, Wasser LM, Aryan A, Hanhart J, Potter MJ. Effect of Music Selection on Anxiety Level during Intravitreal Injections for Individuals of Varying Cultures. Ophthalmic Epidemiol 2021; 29:582-587. [PMID: 34293998 DOI: 10.1080/09286586.2021.1955390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To investigate music selection as a treatment for anxiety during Intravitreal injections (IVI) for individuals of varying cultures.Methods: 106 individuals were enrolled in this randomized controlled study. Individuals were randomized into one to three categories: (1) a control group in which the IVI procedure was performed without music (n = 35), (2) an experimental group in which the music was selected by the physician (n = 36), (3) an experimental group in which the music was selected by the patient (n = 35). After the procedure, all patients responded to a questionnaire regarding their level of experienced anxiety, pain and discomfort (grade 0-10). The primary outcome was anxiety level during the procedure.Results: The experimental group in which patients selected music had higher number of patients with low anxiety score compared to the other groups (anxiety score <4 in 19,18 and 27 patients, respectively, p = .04). Interestingly, patients who answered the questionnaire in Arabic were less likely to desire music on subsequent injections compared to Hebrew and English speakers (52% Vs 78% Vs 100%, p = .02). Music was deemed by both experimental groups as an effective method to induce relaxation (average score of 6.6 and 7.2 in group 2 and 3, respectively). Preference for music on subsequent injections was increased in both experimental groups compared to the control group (P < .01). Patients in the third group preferred music selection on future injections more than the other groups (P < .01).Conclusion: Music selection may be an effective way to reduce anxiety levels during IVI. Preference for music during future injections is higher in patients who were exposed to music during IVI and may be influenced by culture.
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Affiliation(s)
- Koby Brosh
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Eduardo Roditi
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Lauren M Wasser
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Ahmad Aryan
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Joel Hanhart
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Michael J Potter
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
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Trait and state math EAP (emotion, appraisals and performance) profiles of Dutch teenagers. LEARNING AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.lindif.2021.102029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Aguiló Mir S, García Pagès E, López Barbeito B, Ribeiro TC, Garzón-Rey JM, Aguiló Llobet J. Design and validation of an electrophysiological based tool to assess chronic stress. Case study: burnout syndrome in caregivers. Stress 2021; 24:384-393. [PMID: 32865469 DOI: 10.1080/10253890.2020.1807512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Caregiver burnout syndrome is an increasingly seen condition, although the subjective nature of self-administered psychometric tests and the lack of a consensual diagnostic tool might hinder a proper diagnosis. The availability of objective psychosomatic measures of stress might facilitate the early diagnosis and clinical management of these patients. For this reason, the aim of this work was to develop a quantitative tool to evaluate the stress level of caregivers in a noninvasive and repeatable manner. An observational, controlled, matched study was designed including a group of 38 principal caregivers of chronic patients and a control group of 38 non-caregivers. Psychometric, biochemical, and electrophysiological data were analyzed along with sociodemographic data. A quantitative chronic stress reference scale (CSRs) was constructed based on the weighted contribution of several psychometric and biochemical variables and afterwards, a predictive psychosomatic model (ESBSm) correlated with CSRs was elaborated from extracted variables of several electrophysiological signals monitored for 10 min. The resulting CSR scale shows a high power to discriminate caregivers from the control group while the ESBSm shows a 79% correlation with the CSR scale validated through a 5-fold process. Therefore, the results demonstrate that the ESBS model is an objective and validated tool to diagnose the degree of stress linked to burnout in caregivers of chronic patients from a 10-min session of noninvasive monitoring with a reliability equivalent to the questionnaires currently used to quantify stress in caregivers.
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Affiliation(s)
- Sira Aguiló Mir
- Emergency Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Esther García Pagès
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Thais Castro Ribeiro
- Microelectronics and Electronic Systems Department, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Jorge M Garzón-Rey
- Aragon Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
| | - Jordi Aguiló Llobet
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona, Bellaterra, Spain
- Microelectronics and Electronic Systems Department, Autonomous University of Barcelona (UAB), Barcelona, Spain
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Koehler T. Lavender Aromatherapy as a Nurse-Driven Intervention for Preoperative Anxiety. Nurs Womens Health 2021; 25:286-295. [PMID: 34153228 DOI: 10.1016/j.nwh.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/29/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore potential clinical applications, based on evidence and a nurse-driven test of change, of using lavender aromatherapy for preoperative anxiety as an intervention complementary to standard preoperative care. DESIGN A pre- versus postaromatherapy comparison using a visual analog scale (VAS). SETTING The preoperative department at a level 2 trauma hospital with 544 beds. PARTICIPANTS Forty-four surgical patients, including 29 female participants and 15 male participants. INTERVENTION/MEASUREMENTS Participants reported their anxiety on a VAS before receiving a lavender aromatherapy inhaler. Anxiety scores were measured again after receiving the lavender aromatherapy and shortly before participants left the preoperative area for surgery. A pre-post comparison of the two VAS anxiety measurements before and after receiving the lavender aromatherapy was completed, analyzed, and is discussed. RESULTS Mean anxiety scores were calculated for the pre- and postaromatherapy groups. Forty-eight percent of female participants (n = 29) reported a decrease in their anxiety after receiving preoperative lavender aromatherapy. Female participants reported higher preoperative anxiety scores and a larger decrease in their mean anxiety scores after receiving lavender aromatherapy when compared to male participants. CONCLUSION The use of a nurse-driven complementary intervention in the preoperative area was associated with a decrease in mean anxiety scores among female patients about to undergo elective surgery. However, cause and effect cannot be determined because of a lack of a control group and randomization. Opportunities exist with support from seasoned staff for nurses to incorporate safe, evidence-based complementary interventions into the current standard of care for preoperative anxiety.
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