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Anxiety is a common issue among university students, many of them experience anxiety, depression, and stress during their school life. This study aimed to compare the acute physiological stress responses of students divided into two groups according to their perceived anxiety levels (positive test anxiety, PTA+, and negative test anxiety, PTA-). Heart rate variability (HRV) and electrodermal activity (EDA) were used to assess stress.Thirty-one healthy volunteers participated in the study. Participants completed anxiety assessments, including the Westside Test Anxiety Scale (WTAS), the State-Trait Anxiety Inventory (STAI), and the Test State Anxiety Inventory (TSAI). Based on their scores, participants were categorized into PTA+ and PTA- groups. All participants underwent 24-h continuous recordings of pulse and electrodermal activity (EDA) on two separate occasions: one day prior to a written exam and during a designated exam-free day serving as a baseline control.We compared the HRV and EDA data obtained on a regular day and on an exam day between the two groups. Results showed that the PTA+ group had significantly higher heart rate, stress index, low frequency, and short-term detrended fluctuation analysis (DFAα1) on the exam day. The tonic EDA component was also higher in the PTA+ group. Stress-related HRV and EDA parameters were negatively correlated with exam scores.In conclusion, the study found that physiological stress indicators obtained from HRV and EDA are associated with perceived exam anxiety in students.

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BACKGROUND: Food insecurity is a significant health issue among older adults and contributes to poorer quality of life and mental health. However, limited evidence is available among older adults. Thus, the study evaluated the associations between food security and multiple outcomes related to health-related quality of life. We examined whether participants' sex and participation in the federal Supplemental Nutrition Assistance Program (SNAP)/or receiving the Food Stamp program might modify these associations. METHODS: Cross-sectional analysis of the 2007-2012 National Health and Nutrition Examination Surveys (NHANES). A sample of 3,375 adults aged ≥ 60 years with household incomes ≤ 300% of the federal poverty level (FPBL). Food security was assessed using the 18-item US Household Food Security Survey Module and categorized as food security, marginal food security, and food insecurity. Outcomes were the CDC Health-Related Quality of Life measures (HRQOL-4). RESULTS: Approximately 8% experienced marginal food security and 12% experienced food insecurity. Over the past month, food insecurity was significantly associated with ≥ 16 days of poor physical health (OR 1.88, 95% CI 1.23, 2.85, P-trend = 0.005), ≥ 16 days of poor mental health (OR 2.22, 95% CI 1.50, 3.28, P-trend < 0.0001), and ≥ 16 days of feeling anxious (OR 3.33, 95% CI 2.30, 4.81, P-trend < 0.0001) after multivariate adjustment. The association between food insecurity and poor physical health was stronger in females (P-interaction = 0.02). There was no evidence for effect modification in any of these associations among those receiving benefits from the federal SNAP/Food Stamp program. CONCLUSIONS: Food insecurity was positively associated with multiple adverse health outcomes. Public health programs and policies targeted for older adults are needed to mitigate the extent of food insecurity to promote overall health and well-being.

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BACKGROUND: Magnetic resonance imaging (MRI) generates patient anxiety (PA) and, therefore, it is important to understand individual and contextual variables that may cause it. In study one, we explored those anxiety predictors. In study two, we examined the effect of the experience of MRI on PA comparing anxiety pre- to post-MRI. METHODS: PA was measured with an anxiety and stress scale in an interview format. Data collection occurred at a public hospital with MRI outpatients aged 18 or older. In study one (n = 204), participants answered the questionnaire immediately after experiencing the MRI and the data were analyzed through structural equation modeling. In study two (n = 242), participants answered the questionnaire before and after the examination and the data were analyzed through Bayesian statistics. RESULTS: Being female, having a higher education level (EL), and not receiving information about the examination predicts higher PA after MRI. Patients with prior information have a decrease in PA from pre- to post-MRI. Those who do not have no change in PA. In low-educated patients, PA also decreases and no changes occur in highly educated patients. CONCLUSION: This study provides health professionals with valuable indicators about patients who are more likely to perceive and express anxiety during MRI.

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Introduction: Postural threat elicits modifications to standing balance. However, the underlying neural mechanism(s) responsible remain unclear. Shifts in attention focus including directing more attention to balance when threatened may contribute to the balance changes. Sample entropy, a measure of postural sway regularity with lower values reflecting less automatic and more conscious control of balance, may support attention to balance as a mechanism to explain threat-induced balance changes. The main objectives were to investigate the effects of postural threat on sample entropy, and the relationships between threat-induced changes in physiological arousal, perceived anxiety, attention focus, sample entropy, and traditional balance measures. A secondary objective was to explore if biological sex influenced these relationships. Methods: Healthy young adults (63 females, 42 males) stood quietly on a force plate without (No Threat) and with (Threat) the expectation of receiving a postural perturbation (i.e., forward/backward support surface translation). Mean electrodermal activity and anterior-posterior centre of pressure (COP) sample entropy, mean position, root mean square, mean power frequency, and power within low (0-0.05 Hz), medium (0.5-1.8 Hz), and high-frequency (1.8-5 Hz) components were calculated for each trial. Perceived anxiety and attention focus to balance, task objectives, threat-related stimuli, self-regulatory strategies, and task-irrelevant information were rated after each trial. Results and Discussion: Significant threat effects were observed for all measures, except low-frequency sway. Participants were more physiologically aroused, more anxious, and directed more attention to balance, task objectives, threat-related stimuli, and self-regulatory strategies, and less to task-irrelevant information in the Threat compared to No Threat condition. Participants also increased sample entropy, leaned further forward, and increased the amplitude and frequency of COP displacements, including medium and high-frequency sway, when threatened. Males and females responded in the same way when threatened, except males had significantly larger threat-induced increases in attention to balance and high-frequency sway. A combination of sex and threat-induced changes in physiological arousal, perceived anxiety, and attention focus accounted for threat-induced changes in specific traditional balance measures, but not sample entropy. Increased sample entropy when threatened may reflect a shift to more automatic control. Directing more conscious control to balance when threatened may act to constrain these threat-induced automatic changes to balance.

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Objective: Although parental threatening behaviors are associated with poor mental health outcomes among college students, the underlying mechanisms of this relationship are understudied. This investigation examined the underlying role of perceived anxiety control in the association between childhood exposure to maternal threatening behaviors and depression, worry, and attention/deficit hyperactivity disorder (attention-deficit/hyperactivity disorder) symptoms. Participants: Participants (N = 862; Mage = 18.75 years, SD = 1.04, age range = 18-24) were recruited from a large state university in the northeast. Methods: Participants completed a battery of self-report questionnaires. Results: Tests of indirect effects indicated that greater childhood exposure to maternal threats was associated with lower perceived anxiety control, which in turn was associated with more severe depression, worry, and ADHD symptoms, respectively. Conclusions: Childhood exposure to maternal threatening behaviors may contribute to college students' low perceived anxiety control, which in turn increases the risk for these symptom clusters.

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Taking into account the literature on technology acceptance and adoption, this study aimed to investigate the mediating role of adoption readiness, which was built on the Unified Theory of Acceptance and Use of Technology (UTAUT), on the relationship between perceived anxiety and attitude toward using the system. This research also evaluated demographic variations and gender roles that could be considered when developing technology-use strategies. In a nutshell, this research looked into the negative and positive effects of technology integration through UTAUT's Correctional Database System (CDS). A survey was used to gather information from 230 middle managers whose responsibility is to manage information system database in correctional institutions. The data were then analyzed with SmartPLS 3 Software. The findings revealed that perceived anxiety has a significant effect on attitude toward using database management system and adoption readiness. Whereas adoption readiness could mediate perceived anxiety and attitude toward using database management system. However, gender was not proven to moderate the effect of adoption readiness on attitude toward using a database management system. This study provided a thorough grasp of both the supports that can help individuals develop positive attitudes toward an application system and the challenges that can obstruct the process. This study also gave an understanding that correctional institutions need to ascertain the middle managers that database management systems can be used easily and can overcome errors caused by human error.

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Context: The association between noise sensitivity and misophonia has not been explored in any population, according to the available literature. Aims: To assess the proportion of misophonia symptoms among young healthy adults, to propose the criteria for high perceived misophonia, and to explore the association between misophonia with noise sensitivity with adjustment for sex, age, perceived anxiety, and depression. Settings and Design: A cross-sectional study on 1132 medical students, aged 21.4 ± 2.1 years. Methods and Material: Misophonia symptoms were self-reported using the Amsterdam Misophonia Scale. Nine criteria for high perceived misophonia are proposed. Noise sensitivity was measured with Weinstein scale. Perceived anxiety and depression were measured using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, respectively. Statistical Analysis Used: Multiple logistic regression. Results: Almost half of the students reported the feeling of irritation against people making provoking sounds. Only one in 10 claimed the feeling of loss of self-control when exposed to provoking sounds. High noise sensitivity and high depression were associated with higher odds of meeting the criteria for high perceived misophonia. Conclusion: Noise-sensitive students are at higher risk of reporting misophonia symptoms and of being classified with high perceived misophonia. The combination of at least four or more symptoms, which classifies every 10th student with high perceived misophonia, is proposed as a self-assessment tool for epidemiological studies among young healthy adults.

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The ultra-Orthodox population in Israel was heavily impacted by COVID-19; it is important to understand the factors that contributed to this. There may be a friction between religious versus governmental guidelines that may reduce adherence to COVID mitigation guidelines, such as social distancing and masking. The purpose of this study is to explore this tension and the extent to which it existed in the surveyed sample. The study identified attitudes of ultra-Orthodox individuals concerning religious and public health measures to mitigate COVID-19 infection. A closed-ended questionnaire was completed by 405 ultra-Orthodox Jews. Most respondents believe that religious learning protects from harm (91%); 74% believe that periodically there are inconsistencies between religious guidelines and medical guidelines; 59% believe that preventive medicine may clash with "Divine protection". Some public health measures applied to contain the pandemic threaten religious lifestyle; this is a source of dissonance among ultra-religious populations, which may substantially decrease willingness to comply with public health measures.

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Higher education has given the flipped classroom a lot of attention as a result of its pedagogical success. As a result of the adoption of social media, smartphones, and computers in the classroom, new strategies for providing online courses, such as flipped classrooms, have evolved. To further understand the effects of such technology integration in teaching, the study looked at the responses of 213 undergraduate students at King Faisal University. For a semester, participants took their regular classes in a flipped classroom. The participants answered a survey made expressly for this study to find out if they would still be willing to use flipped classes following this experience. A structural equation modeling approach was used to analyze the research paradigm, which is based on the technological adoption model. The findings demonstrated that each variable category had a favorable influence on perceived usefulness and perceived ease of use. Perceived utility and ease of use serve as mediating elements in the relationship between independent variables and attitudes toward adopting flipped classrooms. Additionally, the findings indicated that ATFC and BIFC have a positive influence on the acceptance of flipped classrooms. In terms of education and learning, the utilization of classroom instruction is positively impacted by both ATFC and BIFC. These findings show that attitudes toward blended learning and intentions to use flipped classrooms have the biggest impacts on the adoption of the concept in Saudi Arabia higher education.

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OBJECTIVE: We examined how a patient-centered communication training program for magnetic resonance imaging (MRI) affected health professional (HP) practice and patients' perceived anxiety (PA). METHODS: We implemented an intervention program. Six of the 17 eligible HPs completed the study. The proportion of observed desired behaviors (PODBs), including MRI procedure explanation (MRI-PE), communication, and MRI checking procedures was measured using an observation grid. We tested 182 patients (85 pre-, 58 post-, and 39 at follow-up) for PA pre- and post-MRI. RESULTS: The Bayesian ANOVA effect size suggested moderate evidence of improvement in HP PODBs, pre- to post-intervention. Use of MRI-PE declined between post-intervention and follow-up (6 months later). Observed changes in PA, pre- to post-MRI, could be related to time constraints and perceived pressure to explain the exam in detail once institutional routines are reestablished. CONCLUSION: In MRI units, time constraints condition the performance of HPs who address patients' PA. PRACTICE IMPLICATIONS: "Real workplace" interventions that promote better patient-centered communication and provide each patient with a comprehensive explanation of MRI procedures also appear to improve HP PODBs.

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OBJECTIVE: Clinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors. DESIGN: Population-based cross-sectional study conducted from January to September 2017. SETTING: Northern Japan, including eight prefectures. PARTICIPANTS: Emergency life-saving technicians (ELSTs) authorised to perform ETI. OUTCOME MEASURES: Annual ETI exposure and confidence in performing ETI, according to a five-point Likert scale. To determine factors associated with ETI confidence, differences between confident ELSTs (those scoring 4 or 5 on the Likert scale) and non-confident ELSTs were evaluated. RESULTS: Questionnaires were sent to 149 fire departments (FDs); 140 agreed to participate. Among the 2821 ELSTs working at responding FDs, 2620 returned the questionnaire (response rate, 92.9%); complete data sets were available for 2567 ELSTs (complete response rate, 91.0%). Of those 2567 respondents, 95.7% performed two or fewer ETI annually; 46.6% reported lack of confidence in performing ETI. Multivariable logistic regression analysis showed that years of clinical experience (adjusted OR (AOR) 1.09; 95% CI 1.05 to 1.13), annual ETI exposure (AOR 1.79; 95% CI 1.59 to 2.03) and the availability of ETI skill retention programmes including regular simulation training (AOR 1.31; 95% CI 1.02 to 1.68) and operating room training (AOR 1.44; 95% CI 1.14 to 1.83) were independently associated with confidence in performing ETI. CONCLUSIONS: ETI is an uncommon event for most ELSTs, and nearly half of respondents did not have confidence in performing this procedure. Since confidence in ETI was independently associated with availability of regular simulation and operating room training, standardisation of ETI re-education that incorporates such methods may be useful for prehospital rescuers.

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Stuttering is a neurodevelopmental disorder characterized by frequent and involuntary disruptions during speech production. Adults who stutter are often subject to negative perceptions. The present study examined whether negative social and cognitive impressions are formed when listening to speech, even without any knowledge about the speaker. Two experiments were conducted in which naïve participants were asked to listen to and provide ratings on samples of read speech produced by adults who stutter and typically-speaking adults without knowledge about the individuals who produced the speech. In both experiments, listeners rated speaker cognitive ability, likeability, anxiety, as well as a number of speech characteristics that included fluency, naturalness, intelligibility, the likelihood the speaker had a speech-and-language disorder (Experiment 1 only), rate and volume (both Experiments 1 and 2). The speech of adults who stutter was perceived to be less fluent, natural, intelligible, and to be slower and louder than the speech of typical adults. Adults who stutter were also perceived to have lower cognitive ability, to be less likeable and to be more anxious than the typical adult speakers. Relations between speech characteristics and social and cognitive impressions were found, independent of whether or not the speaker stuttered (i.e., they were found for both adults who stutter and typically-speaking adults) and did not depend on being cued that some of the speakers may have had a speech-language impairment.