The Associations between Mental Well-Being and Adherence to Physical Activity Guidelines in Patients with Cardiovascular Disease: Results from the Scottish Health Survey

Associations of mental well-being with higher education-related stress and orientation of the academic goals among nursing students: A cross-sectional study

To investigate the association between the mental health of nursing students, the stress of higher education, and academic goal orientation. At a medical college, 1170 nursing students volunteered for this cross-sectional survey. The Warwick-Edinburgh Well-being Scale, the Higher Education Stress Scale, and the Academic Goal Orientation Questionnaire were utilised to collect data. Descriptive statistics, ANOVA, and Pearson correlation analysis were all performed to evaluate the data. The significance level for all statistical tests was p < 0.05. A total of 1126 valid samples, with a 96.23% effective recovery rate. The Higher Education Stress Scale score for nursing students was (38.31 ± 8.29), the Academic Goal Orientation Questionnaire result was (49.32 ± 9.62), and the Mental Health Scale value was (31.24 ± 14.00). Overall, there was a strong relationship between the stress associated with higher education, academic goal orientation, and the mental health of nursing students. Therefore, in future interventions, the Chinese government and its relevant educational authorities can enhance nursing students' ability to reasonably regulate stress related to higher education and set clear academic goals by adjusting the strategies for regulating nursing students' academic stress and increasing the number of academic goal-oriented courses to improve their mental health.

Prevalence, demographic, socio-economic, and lifestyle factors associated with cigarette, e-cigarette, and dual use: evidence from the 2017-2021 Scottish Health Survey

Understanding the correlation between demographic, socio-economic, and lifestyle factors with e-cigarette use, cigarette smoking, and dual use is essential for targeted public health interventions. This study examines the prevalence of these behaviors in Scotland and identifies the associated factors. We conducted a repeated cross-sectional analysis of the Scottish Health Survey data from 2017 to 2021, leveraging data from 12,644 participants aged 16 and older: 2271 cigarette smokers, 687 e-cigarette users, 428 dual users, and 9258 never users. Weighted prevalences were calculated by age group, sex, and survey year, followed by weighted multinomial logistic regression to explore associated factors. The overall prevalences were 72.0% (95% CI 70.9-73.1) for never users, 18.9% (95% CI 17.9-19.9) for cigarette smokers, 5.5% (95% CI 5.0-6.1) for e-cigarette users, and 3.6% (95% CI 3.2-4.0) for dual users. From 2017 to 2021, cigarette smoking declined from 21.7% (95% CI 19.6-23.9) to 13.1% (95% CI 11.5-15.0), e-cigarette use from 6.5% (95% CI 5.4-7.8) to 4.8% (95% CI 3.6-6.4), and dual use from 3.7% (95% CI 2.9-4.6) to 2.7% (95% CI 1.9-3.7). Age was a critical factor, with the 25-34 age group more likely to use e-cigarettes (p = 0.007) and the 35-44 age group more likely to engage in dual use (p = 0.006) compared to the 16-24 age group. Males had higher odds of e-cigarette use than females (p = 0.031). White individuals had higher odds of using e-cigarettes (p = 0.023) and being dual users (p = 0.017) compared to non-whites. Previously married individuals had higher odds of dual use than singles (p = 0.031). Larger household sizes were linked to reduced odds of all three behaviors (p = 0.001). Rural residents were less likely to use e-cigarettes compared to urban residents (p = 0.025). Higher education correlated with lower odds of all three behaviors (p = 0.001). Manual occupation increased the likelihood of dual use (p = 0.042). Lower income and higher deprivation significantly increased the odds of all three behaviors (p < 0.001). Excessive alcohol consumption was associated with increased odds of the three behaviors (p < 0.001). Poor sleep quality correlated with increased odds of dual use (p = 0.002) and cigarette smoking (p < 0.001). Adherence to physical activity guidelines was associated with reduced odds of all three behaviors (cigarette smoking p < 0.001, e-cigarette use p = 0.031, dual use p = 0.016). In conclusion, this study showed a decline in the prevalence of cigarette smoking, e-cigarette use, and dual usage from 2017 to 2021 in Scotland. Significant associations with demographic, socio-economic, and lifestyle factors highlight the need for targeted public health interventions.

Effect of acute exercise intensity on cognitive inhibition and well-being: Role of lactate and BDNF polymorphism in the dose-response relationship

Introduction

There is evidence in the literature that acute exercise can modify cognitive function after the effort. However, there is still some controversy concerning the most effective exercise modality to improve cognitive function in acute interventions. Regarding these different exercise modalities, the dose-response relationship between exercise intensity and cognitive response is one of the most challenging questions in exercise and cognition research.

Methods

In this study, we tested the impact of moderate-intensity (MICT), high-intensity (HIIT) exercise sessions, or control situation (CTRL) on cognitive inhibition (measured with the Stroop Test). Thirty-six young college students participated in this study, where a within-subject repeated measure design was used.

Results

ANOVA 2×3 demonstrated that HIIT improved the acute cognitive response to a higher degree when compared to MICT or CTRL (p < 0.05). The cognitive improvements correlated with lactate release, providing a plausible molecular explanation for the cognitive enhancement (r < -0.2 and p < 0.05 for all the Stroop conditions). Moreover, a positive trend in wellbeing was observed after both exercise protocols (HIIT and MICT) but not in the CTRL situation. Genetic BDNF single nucleotide polymorphism did not influence any interactions (p < 0.05).

Discussion

In this sense, our results suggest that exercise intensity could be a key factor in improved cognitive function following exercise in young college students, with no additional impact of BDNF polymorphism. Moreover, our results also provide evidence that exercise could be a useful tool in improving psychological wellbeing.

Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN)

BACKGROUND

Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control.

METHODS

Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg.

RESULTS

Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control.

CONCLUSION

NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.

Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study

BACKGROUND

Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions.

METHODS

The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved.

RESULTS

The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance.

CONCLUSION

The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model.

Sleep Duration, Sleep Quality and Physical Activity, but Not Sedentary Behaviour, Are Associated with Positive Mental Health in a Multi-Ethnic Asian Population: A Cross-Sectional Evaluation

BACKGROUND

We assessed the associations of sleep, physical activity and sedentary behaviour with positive mental health (PMH) in the multi-ethnic population of Singapore.

METHODS

The Singapore Health 2 study is a nationally representative cross-sectional survey among residents aged 18-79 years. A PMH instrument was administered to 1925 participants to obtain total PMH and six sub-component scores. Self-rated sleep duration, sleep quality, sedentary behaviour and physical activity were assessed. Multivariable linear regression analyses were conducted.

RESULTS

The mean age of the participants was 40.1 (SD 14.3) years. Sleep duration (≥8 h/night: β = 0.17,95% CI: 0.02-0.32; 7-< 8 h/night: β = 0.17,95% CI: 0.03-0.30 versus <6 h/night, p = 0.002), sleep quality (very good: β = 0.45,95% CI: 0.29-0.60; fairly good: β = 0.20,95% CI: 0.06-0.33 versus very/fairly bad; ptrend < 0.001) and physical activity (high: β = 0.19,95% CI: 0.05-0.32; moderate: β = 0.15, 95% CI: 0.03-0.27 versus low; ptrend < 0.001) were directly associated with total PMH. Sedentary behaviour was not significantly associated with PMH. Sleep duration, sleep quality and physical activity were directly associated with the PMH sub-components 'emotional support' and 'personal growth and autonomy'.

CONCLUSIONS

Duration and quality of sleep and physical activity were directly associated with PMH in an urban Asian population. These findings support incorporating sleep and physical activity interventions to improve population mental health.

Physical Activity Promotes Health and Reduces Cardiovascular Mortality in Depressed Populations: A Literature Overview

Major depression is associated with premature mortality, largely explained by heightened cardiovascular burden. This narrative review summarizes secondary literature (i.e., reviews and meta-analyses) on this topic, considering physical exercise as a potential tool to counteract this alarming phenomenon. Compared to healthy controls, individuals with depression consistently present heightened cardiovascular risk, including "classical" risk factors and dysregulation of pertinent homeostatic systems (immune system, hypothalamic-pituitary-adrenal axis and autonomic nervous system). Ultimately, both genetic background and behavioral abnormalities contribute to explain the link between depression and cardiovascular mortality. Physical inactivity is particularly common in depressed populations and may represent an elective therapeutic target to address premature mortality. Exercise-based interventions, in fact, have proven effective reducing cardiovascular risk and mortality through different mechanisms, although evidence still needs to be replicated in depressed populations. Notably, exercise also directly improves depressive symptoms. Despite its potential, however, exercise remains under-prescribed to depressed individuals. Public health may be the ideal setting to develop and disseminate initiatives that promote the prescription and delivery of exercise-based interventions, with a particular focus on their cost-effectiveness.