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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic induced psychological distress, which is linked to emotional eating and symptoms of addiction to ultra-processed foods (UPFs). OBJECTIVE: This study aimed to investigate whether symptoms of addiction to UPFs mediate the relationship between psychological stress due to the COVID-19 pandemic and emotional eating behaviour. METHODS: A cross-sectional online study was conducted from May to November 2021 among 368 undergraduate Brazilian students. The participants answered demographic questions and completed validated scales, including the Coronavirus Stress Measure, Modified Yale Food Addiction Scale 2.0 and Emotional Eating Questionnaire. Mediation analysis was employed to examine the hypothesised relationships. RESULTS: The results revealed a significant indirect effect, indicating that symptoms of food addiction mediated the association between perceived stress during the COVID-19 pandemic and emotional eating behaviour. Specifically, 61% of the influence of perceived stress on emotional eating during the pandemic was explained by symptoms of UPF addiction. CONCLUSION: These findings suggest that addressing symptoms of UPF addiction could be pivotal in public health strategies aimed at promoting healthy eating habits among distressed undergraduate students in the post-COVID-19 era.

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BACKGROUND: Preterm birth and prolonged neonatal hospitalization are potential sources of stress for mothers of preterm and low birth weight infants. AIM: To evaluate maternal stress and its association with neurobehavioral indicators of preterm infants during hospitalization in the neonatal intensive care unit. METHODS: A cross-sectional study was conducted in a neonatal intensive care unit of a hospital in Goiânia, Brazil. The study included preterm and low birth weight infants of both genders and their mothers. The Parental Stressor Scale: Neonatal Intensive Care Unit and the Neurobehavioral Assessment of the Preterm Infant were respectively applied to mothers and infants in the neonatal intensive care unit. RESULTS: The study involved 165 premature infants and their mothers. The mean age of the mothers was 26.3 years and most had a high school education level (57.6%). Mothers perceived the experience of having an infant in the neonatal intensive care unit as moderately stressful (2.96 ± 0.81). The parental role alteration (4.11 ± 1.03) and sights and sounds (2.15 ± 0.90) subscales exhibited the highest and lowest stress levels, respectively. Significant correlations (rho < -0.3; p < 0.05) were found between maternal stress and neurobehavioral indicators of infants. In the multivariate analysis, low leg tone was a predictor of higher maternal stress. Low tone and limited arm movement were predictors of higher maternal stress in the maternal role item. CONCLUSIONS: The experience of having a preterm infant hospitalized was considered moderately stressful for mothers. Maternal stress levels were significantly correlated with low scores on neonatal neurobehavioral indicators.

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OBJECTIVE: The aim of the present study was to investigate whether oral problems, harmful oral habits, and sociodemographic factors are associated with the occurrence of stress in schoolchildren. MATERIALS AND METHODS: A case-control study nested within a cross-sectional study was conducted with a sample of 375 schoolchildren eight to ten years of age in the city of Diamantina, Brazil. The case group (with childhood stress) and control group (without childhood stress) were matched for age and sex at a 1:4 ratio (75 cases to 300 controls). Data collection involved the self-administration of a questionnaire by parents/caregivers addressing sociodemographic characteristics and the child's history of harmful oral habits. The children answered the Child Stress Scale (CSS) and underwent a clinical oral examination to determine the presence/absence of dental caries, malocclusion, and traumatic dental injuries. Data analysis involved the calculation of frequencies, the chi-square test, and conditional logistic regression (95% CI; p ≤ 0.05). RESULTS: The final adjusted conditional logistic regression model showed that dental caries (OR = 1.78, 95% CI: 1.01 - 3.14, p = 0.044) and biting objects (OR = 1.81, 95% CI: 1.02 - 3.22, p = 0.041) remained associated with stress in the schoolchildren analysed. CONCLUSION: The present results showed that children with dental caries and the habit of biting objects were more likely to have childhood stress. CLINICAL RELEVANCE: The study allows paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and serves as a guide for decision-making related to oral problems in schoolchildren.

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Introduction: Stress occurs more frequently in groups in which the degree of responsibility and decision-making power play notable roles in society, such as professors and health professionals. Objectives: To measure and understand the stress of professors in the undergraduate course of Medicine and Dentistry of a private educational institution in northeastern Brazil. Methods: Observational, descriptive and exploratory study with a quantitative approach was conducted between November 2018 and September 2019. A total of 184 professors participated in the study, answering the following instruments: demographic sociodata questionnaire, Stress Symptoms Inventory and the Preliminary Burnout Identification Questionnaire. The Post-Traumatic Stress Symptoms Scale was applied to the 60 professors with stress. The data obtained were submitted to data analysis through Pearson's chi-square test and logistic regression. Results: Stress was present in 40.3% of the professors, with a predominance of the resistance phase (85%) and signs indicative of burnout. There was a significant correlation between the presence of stress and the time of traumatic event either with the individual himself or with some relative and/or close friend. There was no correlation between the traumatic events and Post Traumatic Stress Disorder, although a significant correlation was observed between Post Traumatic Stress Disorder and burnout. Conclusions: The results point to the need to properly identify and manage stress so that the teaching experience is healthy and conducive to the teaching-learning process.

Introdução: O estresse ocorre de forma mais recorrente em grupos em que o grau de responsabilidade e poder de decisão perpetram notáveis papéis na sociedade, tais como docentes e profissionais de saúde. Objetivos: Mensurar e compreender o estresse docente dos cursos de graduação de Medicina e Odontologia de uma instituição de ensino privada do Nordeste do Brasil. Métodos: Tratou-se de um estudo observacional, descritivo, analítico e exploratório, com abordagem quantitativa no período de novembro de 2018 a setembro de 2019. Participaram do estudo 184 docentes, respondendo aos seguintes instrumentos: um questionário sociodemográfico, o Inventário de Sintomas de Estresse e o Questionário Preliminar de Identificação de Burnout. Já a Escala de Sintomas de Estresse Pós-Traumático foi aplicada nos 60 docentes com estresse. Foi realizada a análise de dados através do teste de qui-quadrado de Pearson e de regressão logística. Resultados: O estresse estava presente em 40,3% dos docentes, com predomínio da fase de resistência (85%) e sinais indicativos de burnout. Houve correlação significativa entre estresse e tempo de acontecimento traumático, seja com o próprio indivíduo ou com algum familiar e/ou amigo próximo. Não houve correlação entre o acontecimento traumático e o transtorno de estresse pós-traumático, embora tenha sido observada correlação significativa de transtorno de estresse pós-traumático e burnout. Conclusões: Os resultados apontam para a necessidade de identificar e manejar adequadamente o estresse para que a experiência docente seja salutar e propícia ao processo de ensino-aprendizagem.

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BACKGROUND: Diabetes mellitus is a chronic disease that can cause psychological stress. This study was conducted to perform the translation and cross-cultural adaptation of the QSD-R for diabetic patients into Portuguese (Brazil). METHODS: This study was a cross-cultural adaptation process carried out in a public university in São Paulo, Brazil, in three stages: translation and backtranslation by two native-speaking independent professionals, analysis by a committee of specialists, and a pre-test phase. RESULTS: The final version was created by seven experts after making semantic, idiomatic, and cultural changes to eighteen items. The results indicated a satisfactory content validation index (CVI ≥ 0.80). This version was applied to 30 patients. No item was excluded from the instrument. CONCLUSION: The translated version of the QSD-R was considered adequate and culturally adapted for use in Brazil to enable the psychometric validation of the instrument.

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PURPOSE: To evaluate the intraocular pressure (IOP) behavior after applying a standardized protocol to induce psychological stress in patients with primary open-angle glaucoma (POAG). DESIGN: Randomized controlled trial. PARTICIPANTS: A total of 39 patients with POAG were included: 18 in the stress group and 21 in the control group. METHODS: Patients were randomized to undergo the Trier Social Stress Test (TSST) or to be included in the control group. All participants were submitted to a modified diurnal tension curve (DTC) 1-4 weeks before randomization, with 3 IOP measurements performed between 8:00 am and 2:00 pm. We evaluated the response to the TSST by measuring the levels of salivary cortisol, salivary amylase, IOP, mean arterial pressure, and heart rate before, immediately after, and 40 minutes after the TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals. MAIN OUTCOME MEASURES: Changes in IOP (mmHg), salivary cortisol and amylase, heart rate, mean arterial pressure, and STAI scores. RESULTS: At baseline, there were no significant differences between the groups regarding age (P = 0.661), sex (P = 0.669), salivary cortisol (P = 0.104), and mean DTC IOP for the right (P = 0.439) and left (P = 0.576) eyes. We observed a significant mean IOP increase of 3.8 mmHg (right eye; P < 0.001) and 4.1 mmHg (left eye; P < 0.001) when we compared IOP measurements obtained during the DTC and immediately after TSST. Salivary cortisol (5.9 nmol/L; P = 0.004), salivary amylase (323 388 UL; P = 0.004), mean arterial pressure (10.1 mmHg; P < 0.001), and heart rate (12.9 bpm; P < 0.001) also increased significantly after the TSST. In addition, 61.1% (11 of 18) of the patients in the TSST group showed an IOP increase > 4 mmHg following the test. The STAI-state score significantly increased after the TSST compared to baseline (P < 0.001) and decreased from poststress to the recovery period (P < 0.001). CONCLUSIONS: Patients with POAG present significant elevations of IOP, salivary cortisol and amylase, mean arterial pressure, heart rate, and STAI scores after psychological stress induced by the TSST. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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As disfunções temporomandibulares são uma série de alterações que afetam os músculos mastigatórios, a articulação temporomandibular e as estruturas associadas. Sua etiologia é multifatorial e inclui fatores como hábitos parafuncionais desencadeados ou intensificados por condições psicológicas como o estresse emocional. Este artigo tem como objetivo investigar a frequência de sintomas de disfunções temporomandibulares e de hábitos parafuncionais e sua associação com estresse percebido em estudantes de uma universidade pública da cidade de Salvador. Os dados primários foram coletados por meio de um questionário sociodemográfico, do questionário anamnésico de Fonseca, da Lista de Verificação dos Comportamentos Orais e da Escala de estresse Percebido. Os dados foram analisados de forma descritiva e a análise estatística realizada por meio do teste qui-quadrado de Pearson e do teste exato de Fisher. Participaram do estudo 149 estudantes de Fisioterapia. A frequência de sintomas de disfunções temporomandibulares foi elevada (83,9%), como também uma maior prática de hábitos parafuncionais (55%). Observou-se associação positiva entre os hábitos parafuncionais e os sintomas temporomandibulares. Um alto nível de estresse foi encontrado em 92,8% dos estudantes com a presença de disfunção e em 71% dos alunos com maior prática de hábitos parafuncionais, sendo ambas as associações estatisticamente significativas. Assim, as frequências de sintomas de disfunções temporomandibulares e de hábitos parafuncionais foram elevadas e estão associadas ao estresse percebido em estudantes universitários. Sugere-se a realização de estudos com amostras mais robustas que busquem estabelecer relações de causalidade entre as variáveis estudadas.

Temporomandibular disorders constitute a series of changes that affect the masticatory muscles, the temporomandibular joint, and their associated structures. Its multifactorial etiology includes factors such as parafunctional habits triggered or intensified by psychological conditions such as emotional stress. The purpose is to investigate the frequency of symptoms of temporomandibular disorders and parafunctional habits and their association with perceived stress in students at a public university in the municipality of Salvador. Primary data collected by a sociodemographic questionnaire, the Fonseca anamnestic questionnaire, the Oral Behaviors Checklist, and the Perceived Stress Scale. Data were descriptively analyzed, and a statistical analysis was performed using the Pearson's chi-squared and Fisher's exact tests. Overall, 149 physical therapy students participated in this study. They showed a high frequency of temporomandibular disorder symptoms (83.9%) and more frequent parafunctional habits (55.0%). This study found a positive association between parafunctional habits and temporomandibular symptoms. It also observed a high level of stress in 92.8% of students with the dysfunction and in 71.0% of students with more common practice of parafunctional habits, statistically significant associations. This study found a high frequency of temporomandibular disorder and parafunctional habit symptoms, which are associated with perceived stress in college students. It is suggested to carry out studies with more robust samples that seek to establish causal relationships between the studied variables.

Los trastornos temporomandibulares son una serie de cambios que afectan a los músculos masticatorios, la articulación temporomandibular y estructuras asociadas. Su etiología es multifactorial e incluye factores como hábitos parafuncionales desencadenados o intensificados por condiciones psicológicas como el estrés emocional. el objetivo es determinar la frecuencia de los síntomas de trastornos temporomandibulares y de hábitos parafuncionales y su asociación con el estrés percibido en estudiantes de una universidad pública de la ciudad de Salvador (Brasil). Los datos primarios se recolectaron de un cuestionario sociodemográfico, del cuestionario anamnésico de Fonseca, de la Lista de Comportamientos Orales y de la Escala de Estrés Percibido. Los datos se analizaron de forma descriptiva, y el análisis estadístico se realizó mediante la prueba de chi-cuadrado de Pearson y la prueba exacta de Fisher. Participaron en el estudio 149 estudiantes de fisioterapia. La frecuencia de los síntomas de trastornos temporomandibulares fue alta (83,9%), así como una mayor práctica de hábitos parafuncionales (55,0%). Se observó una asociación positiva entre hábitos parafuncionales y síntomas temporomandibulares. Se encontró un alto nivel de estrés en el 92,8% de los estudiantes con presencia de disfunción y en el 71,0% de los estudiantes con mayor práctica de hábitos parafuncionales, y ambas asociaciones fueron estadísticamente significativas. La frecuencia de los síntomas de trastornos temporomandibulares y de los hábitos parafuncionales fue alta, y estuvo asociada con el estrés percibido en estudiantes universitarios. Se sugiere realizar estudios con muestras más robustas para establecer relaciones causales entre las variables estudiadas.

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BACKGROUND: Stress significantly affects both the physical and emotional health of individuals, particularly students in health-related fields. Medical students in Brazil face unique challenges due to the demanding nature of their studies, especially during assessment periods, which heighten academic pressure. These pressures often lead to poor coping strategies and mental health concerns. It is crucial to understand the complex dynamics of stress within medical education to develop strategies that improve student well-being and promote a healthier academic environment. This study aims to investigate the intricate relationship between assessment periods and stress levels among medical students. It seeks to understand how academic demands and sociodemographic factors contribute to stress dynamics during these periods. METHODS: An online observational, longitudinal, and prospective study was conducted from February to October 2022. Medical students were recruited through snowball sampling and participated in surveys administered via Google Forms at two timepoints: before (T1) and during (T2) assessment periods. The surveys collected sociodemographic data and stress symptoms using Lipp's Inventory of Stress Symptoms for Adults (LSSI). RESULTS: The transition from T1 to T2 was defined by a rise in the prevalence of stress from 59.6 to 84.2% (p = 0.001) and a decline in symptom-free students from 40.4 to 15.8% (p = 0.001). There was a significant increase in exhaustion, from 12.3 to 31.6% (p = 0.0001). Higher stress levels were notably more prevalent among younger students (≤ 24 years), females, those from wealthier families, students without scholarships, those without prior degrees, and those in the clinical phase of their studies. However, non significant correlations were found between these sociodemographic and academic factors and the increase in stress. CONCLUSION: The findings highlight significant concerns regarding the mental health of medical students during assessment periods, marked by increased stress and exhaustion levels. These results emphasize the need for proactive interventions to manage stress effectively in medical education, considering its profound impact on students' well-being.

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Resumen El proceso de enseñanza en medicina tiene desafíos que pueden inducir estrés académico y con ello afectaciones a la salud mental, por lo que es imprescindible el cuidado de la salud mental de los futuros médicos. Este estudio quiso identificar los factores asociados a la salud mental de estudiantes de medicina de una universidad privada en Colombia, ajustados por estrés académico. Mediante un diseño transversal, se reclutaron 443 estudiantes (68.4% mujeres, 31.6% hombres) quienes completaron un cuestionario con variables sociodemográficas, académicas, el Inventario Cognitivo Sistémico para el Estudio del Estrés Académico y el inventario Symptom Checklist-90-Revised. Los factores de riesgo se analizaron utilizando un Modelo Lineal Generalizado por la familia de Poisson y log link. El 38,3% de los estudiantes presentó un nivel de riesgo en salud mental. Los factores protectores incluyeron actividad física regular (RPa = 0.78) y actividades extracurriculares (RPa = 0.75), mientras que los factores de riesgo fueron uso de sustancias psicoactivas (RPa = 1.36), bebidas energéticas (RPa = 1.35) y tener una ocupación alternativa al estudio (RPa = 1.47). La salud mental de los estudiantes de medicina presenta riesgos más allá de la misma exigencia académica. Hay elementos del individuo y la institución formadora que pueden actuar como factores protectores, lo que se convierte en un insumo para la creación de programas de cuidado y mantenimiento de la salud mental.

Abstract The teaching process in medicine has challenges that can induce academic stress and thus affect mental health, so it is essential to take care of the mental health of future physicians. This study aimed to identify the factors associated with the mental health of medical students at a private university in Colombia, adjusted for academic stress. Using a cross-sectional design, 443 students were recruited (68.4% women, 31.6% men) who completed a questionnaire with sociodemographic and academic variables, the Systemic Cognitive Inventory for the Study of Academic Stress and the Symptom Checklist-90-Revised inventory. Risk factors were analyzed using a Generalized Linear Model by Poisson family and log link. Thirty-eight point three percent of the students presented a level of mental health risk. Protective factors included regular physical activity (RPa = 0.78) and extracurricular activities (RPa = 0.75), while risk factors were psychoactive substance use (RPa = 1.36), energy drinks (RPa = 1.35) and having an alternative occupation to studying (RPa = 1.47). The study provided information on the need for intervention in factors beyond academic stress, seeking to maintain the well-being of students and thus avoid academic dropout.

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Durante a pandemia de covid-19, os profissionais de saúde que atuaram na linha de frente viveram um cenário desafiador, com constante risco de infecção pelo SARS-CoV-2, uma demanda de trabalho aumentada e muitas incertezas. O objetivo deste estudo foi analisar as repercussões da covid-19 na saúde de fisioterapeutas baianos atuantes na linha de frente no ambiente hospitalar. Fisioterapeutas baianos participaram deste estudo, respondendo questões referentes aos seus dados sociodemográficos, à qualidade do sono e aos sintomas de ansiedade e depressão, através de um formulário eletrônico (Google Forms). Responderam ao formulário 38 fisioterapeutas residentes em Salvador (BA). A metade deles atua em Unidades de Terapia Intensiva (UTI) e, destes, 65% são trabalhadores do setor privado. Além disso, 68% foram infectados pelo SARS-CoV-2 uma ou mais vezes. O constante medo de infectar seus familiares foi declarado por 77,3% deles e, após o expediente, 36% dos profissionais apresentavam exaustão emocional; 34,2%, estresse psicológico; e 26%, cansaço físico. Os fisioterapeutas baianos relataram que durante a pandemia de covid-19 houve grandes desafios no local de trabalho, como o medo de adoecer e de transmitir a doença e, sobretudo, o medo da morte. O cansaço e o estresse psicológico foram constantes na prática profissional, mas, apesar disso, a maioria dos fisioterapeutas sentiu satisfação por ter atuado de forma tão indispensável em um momento delicado e único.

During COVID-19, health services and professionals who worked on the front line experienced a challenging scenario with a constant risk of infection by SARS-CoV-2, an increased demand for work, and many uncertainties. This study analyzed the repercussions of COVID-19 on the health of Bahian physical therapists working on the hospital front line. Bahian physical therapists participated in this study, answering questions related to their sociodemographic data, sleep quality, and symptoms of anxiety and depression by an electronic form (Google Forms). Overall, 38 physiotherapists living in Salvador (Bahia) answered this form. In total, 50% worked in Intensive Care Units (ICUs); 65%, in the private sector, and 68% suffered infection from SARS-CoV-2 one or more times. This study found that 77.3% of participants reported the constant fear of infecting their family members and 36% showed emotional exhaustion after working hours; 34.2%, psychological stress; and 26%, physical fatigue. Bahian physical therapists reported that COVID-19 brought major confrontations in the workplace, such as the fear of getting sick and transmitting the disease and, above all, death. Fatigue and psychological stress remained constant in the professional practice, but, despite this, most physical therapists felt satisfied for having acted in such an indispensable way in a delicate and unique moment.

Durante la pandemia de la COVID-19, los profesionales de la salud que trabajaban en primera línea vivieron un escenario desafiante, con un riesgo constante de infección por SARS-CoV-2, una mayor demanda de trabajo y muchas incertidumbres. El objetivo de este estudio fue analizar las repercusiones de la COVID-19 en la salud de los fisioterapeutas de Bahía, Brasil, que trabajan en primera línea en el ambiente hospitalario. En este estudio participaron 38 fisioterapeutas residentes en Salvador (Bahía, Brasil) que respondieron a un cuestionario electrónico (Google Forms) con preguntas relacionadas a sus datos sociodemográficos, calidad del sueño y síntomas de ansiedad y depresión. El 50% de ellos trabajan en Unidades de Cuidados Intensivos (UCI) y, de estos, el 65% pertenecen al sector privado. El 68% se ha infectado con el SARS-CoV-2 una o más veces. El miedo constante a contagiar a sus familiares fue declarado por el 77,3% de ellos, y después de la jornada laboral, el 36% de los profesionales presentaron agotamiento emocional; el 34,2%, estrés psicológico; y el 26%, fatiga física. Los fisioterapeutas de Bahía relataron que durante la pandemia de la COVID-19 hubo grandes retos en el lugar de trabajo, como el miedo a enfermarse y transmitir la enfermedad y, sobre todo, el miedo a la muerte. Aunque el cansancio y el estrés psicológico fueron constantes en la práctica profesional, la mayoría de los fisioterapeutas sintieron satisfacción por haber actuado de manera tan indispensable en un momento delicado y único.

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AIM: This study aimed to identify and map the production of knowledge on non-pharmacological strategies to reduce stress and anxiety in patients undergoing endovascular procedures. DESIGN: Scoping review. METHODS: The review was performed using the PRISMA-ScR guidelines. The searches were conducted in Scopus, PubMed, Web of Science, Wiley Online Library, BVS/BIREME, Lilacs, Gale Academic OneFile, SciELO, Cochrane Library, CAPES Catalog of Dissertations and Theses, Oswaldo Cruz Foundation Portal of Theses and Dissertations, and Theses and Dissertations from Latin America. RESULTS: Twenty-two articles were selected. The articles were published from 2001 to 2022, mostly in Iran, and there was a predominance of randomized clinical trials. The Spielberger State-Trait Anxiety Inventory was the most used instrument. The findings indicated that music therapy, educational guidelines or videos on the procedure, massage, psychological preparation and aromatherapy were the main non-pharmacological therapies used to reduce anxiety and stress in patients undergoing vascular procedures.

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BACKGROUND: Sleep alterations are common in college students, particularly during the COVID-19 pandemic. Sociodemographic factors may predict these alterations in this population. OBJECTIVE: To identify the sociodemographic factors and health characteristics associated with the number of hours of sleep of college students during the COVID-19 pandemic. METHODS: This was a cross-sectional study carried out with 244 university students from a multicampi public university in the State of Bahia, Northeast Brazil. Data collection was performed online and participants answered a specific questionnaire to assess sleep hours, sociodemographic and health variables. RESULTS: Significant associations were observed between hours of sleep and older students (odds ratio adjusted -ORaj: 3.75; 95% Confidence Interval -CI: 1.81-7.75; p < 0.01), attending the final semesters (ORaj: 1.85; 95% CI: 1.05-3.25; p < 0.03), and who reported having some disease (ORaj: 2.18; 95% CI: 1.05-4.50; p < 0.03) with greater chances of getting less sleep. However, those who used tobacco (ORaj: 0.08; 95% CI: 0.01-0.45; p < 0.001) were likely to have more hours of sleep per night. CONCLUSION: Sleep restriction was common among participating college students, which has likely intensified due to the COVID-19 pandemic and its restrictions. This encourages specific public health actions, contemplating the health and hours of sleep of this population.

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OBJECTIVES: To analyze the effects of Dignity Therapy (DT) on the physical, existential, and psychosocial symptoms of individuals with amyotrophic lateral sclerosis (ALS). METHODS: This is a mixed-methods case study research that used the concurrent triangulation strategy to analyze the effects of DT on 3 individuals with ALS. Data collection included 3 instances of administering validated scales to assess multiple physical symptoms, anxiety, depression, spiritual well-being, and the Patient Dignity Inventory (PDI), followed by the implementation of DT and a semi-structured interview. RESULTS: The scale results indicate that DT led to an improvement in the assessment of physical, social, emotional, spiritual, and existential symptoms according to the score results. It is worth noting that the patient with a recent diagnosis showed higher scores for anxiety and depression after DT. Regarding the PDI, the scores indicate improvements in the sense of dignity in all 3 cases, which aligns with the positive verbal reports after the implementation of DT. SIGNIFICANCE OF RESULTS: This study allowed us to analyze the effects of DT on the physical, existential, and psychosocial symptoms of individuals with ALS, suggesting the potential benefits of this approach for this group of patients. Participants reported positive effects regarding pain and fatigue, could reflect on their life trajectories, and regained their value and meaning.

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Endometriosis-related pain is supposedly mainly responsible for generating psychological stress and deteriorating the quality of life. However, the interaction between these factors has not been investigated, considering its multidimensional nature and through the path of effects of psychosocial approaches. The present study aims to investigate the effect of a brief mindfulness-based intervention (bMBI) on pain dimensions and its mediator role on psychological stress and QoL-Vitality improvement. A secondary analysis of a pilot randomized controlled trial using a series of parallel and serial mediators was carried out. The results showed that bMBI improves the sensory (B = -6.09 [-9.81, -2.52], ß = -0.42) and affective (B = -3.40 [-5.02, -1.80], ß = -0.47) pain. The bMBI effect on psychological stress reduction was mediated by these changes in sensory (B = -2.81 [-6.06, -0.41], ß = -0.21) and affective (B = -1.97 [-5.07, -0.17], ß = -0.15) pain. Serial sensory pain and psychological stress reduction (B = 2.27 [0.11, 5.81], ß = -0.09) mediated the bMBI effect on quality of life vitality. Meditation training promotes additional improvement in affective and sensory pain characteristics through which psychological stress is reduced. The sensory pain dimension must be positively impacted in combination with psychological stress for the bMBI improves women's vitality. Adding a psychosocial intervention like meditation training to the standard treatment plan may be required for some women to achieve the needed changes to restore well-being.

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A ansiedade e o estresse são condições naturais, pois fazem parte da resposta fisiológica a situações de ameaça e perigo. Porém, quando há uma resposta desproporcional, com prejuízos ao indivíduo, a ansiedade e o estresse são considerados patológicos, resultando em consequências diversas. É notória a necessidade de aprofundamento de estudos nessa área, com identificação precoce de quadros de ansiedade e estresse entre os graduandos em odontologia e fatores associados. A presente dissertação tem como objetivo geral avaliar a ansiedade e o estresse em estudantes do curso de graduação em odontologia, os fatores relacionados e as suas repercussões e está dividida em dois estudos. Estudo 1: Revisão sistemática da literatura. Busca realizada em dezembro de 2022, nas bases de dados PubMed, Web of Science, Biblioteca Virtual em Saúde, Cochrane, Embase e Scopus, considerando à seguinte pergunta: "A ansiedade e/ou o estresse impactam na qualidade de vida dos estudantes de Odontologia?". E Estudo 2: quantitativo, analítico e transversal, com objetivo de avaliar associações de ansiedade e estresse com fatores de necessidades humanas básicas (psicobiológicas, psicossociais e psicoespirituais) nos estudantes do curso de graduação em Odontologia da Universidade Federal de Minas Gerais (UFMG). Participaram 354 estudantes, do primeiro ao décimo período, correspondendo a 46,6% do total de matriculados em 2023. A respeito dos resultados do Estudo 1, cinco estudos foram incluídos na revisão, quatro estudos avaliaram ansiedade e um estudo avaliou estresse, sendo todos do tipo transversal. Embora não tenha estudos avaliando o impacto a longo prazo, foi identificada a associação entre ansiedade e qualidade de vida nos estudantes de graduação em Odontologia. Contudo, o mesmo não foi constatado para estresse. Enquanto no Estudo 2, variáveis associadas à ansiedade moderada/grave foram: relato de sentimento de abandonar o curso [3,55 (2,04-6,18); p<0,001]; autoavaliação do desempenho acadêmico como ruim/muito ruim/nem ruim nem bom [2,07 (1,18-3,64); p<0,011] e não fazer uso de práticas integrativas e complementares em saúde [0,56 (0,36-0,87); 0,011]; e associada aos escores de estresse acima da média entre estudantes da FAOUFMG foram as variáveis: sexo [3,37 (1,78-6,38); p<0,001]; relato de sentimento de abandonar o curso [2,46 (1,42-4,25); p<0,001]; autoavaliação do desempenho acadêmico como Ruim/Muito ruim/Nem ruim nem bom [2,34 (1,34-4,10); p<0,003].Conclui-se, com base nos estudos 1 e 2, que há associação entre ansiedade e qualidade de vida, comprovada por meio de estudos transversais da literatura científica, e que as variáveis relacionadas ao curso (sentimento de abandonar e autoavaliação de desempenho ruim) destacaram-se associadas ao estresse e a ansiedade entre os estudantes da FAOUFMG. Portanto, há necessidade de ações direcionadas à promoção de um ambiente acolhedor e atento às questões emocionais, psicológicas, sociais, pessoais e acadêmicas que afetam o estudante de Odontologia.

Anxiety and stress are natural conditions, as they are part of the physiological response to threatening and dangerous situations. However, when there is a disproportionate response, with harm to the individual, anxiety and stress are considered pathological, resulting in different consequences. There is a clear need for further studies in this area, with early identification of anxiety and stress among dentistry graduates and associated factors. The general objective of this dissertation is to evaluate anxiety and stress in undergraduate dentistry students, the related factors and their repercussions and is divided into two studies. Study 1: Systematic literature review. Search carried out in December 2022, in the databases PubMed, Web of Science, Virtual Health Library, Cochrane, Embase and Scopus, considering the following question: "Anxiety and/or stress impact the quality of life of Dentistry students?". And Study 2: quantitative, analytical and cross-sectional, with the objective of evaluating associations of anxiety and stress with factors of basic human needs (psychobiological, psychosocial and psychospiritual) in undergraduate Dentistry students at the Federal University of Minas Gerais (UFMG). 354 students participated, from the first to the tenth period, corresponding to 46.6% of the total enrolled in 2023. Regarding the results of Study 1, five studies were included in the review, four studies evaluated anxiety and one study evaluated stress, all of which transverse type. Although there are no studies evaluating the long-term impact, an association between anxiety and quality of life in undergraduate Dentistry students was identified. However, the same was not observed for stress. While in Study 2, variables associated with moderate/severe anxiety were: report of feeling like abandoning the course [3.55 (2.04-6.18); p<0.001]; self-rated academic performance as bad/very bad/neither bad nor good [2.07 (1.18-3.64); p<0.011] and not using integrative and complementary health practices [0.56 (0.36-0.87); 0.011]; and associated with above-average stress scores among FAOUFMG students were the following variables: gender [3.37 (1.78-6.38); p<0.001]; report of feeling like abandoning the course [2.46 (1.42-4.25); p<0.001]; self-assessment of academic performance as Poor/Very poor/Neither bad nor good [2.34 (1.34-4.10); p<0.003]. It is concluded, based on studies 1 and 2, that there is an association between anxiety and quality of life, proven through cross-sectional studies in the scientific literature, and that the variables related to the course (feeling of dropping out and self assessment of poor performance) highlighted associated with stress and anxiety among FAOUFMG students. Therefore, there is a need for actions aimed at promoting a welcoming environment that is attentive to the emotional, psychological, social, personal and academic issues that affect Dentistry students.

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Abstract Background Firefighters are regularly exposed to stress and have a high incidence of cardiovascular events. Investigating cardiovascular and autonomic reactivity to acute mental stress (AMS) and its association with adiposity may contribute to explaining the increased cardiovascular risk in these professionals. Objectives To evaluate cardiovascular and autonomic reactivity to AMS in firefighters while considering adiposity parameters. Methods This study recorded the blood pressure and heart rate (HR) of twenty-five firefighters (38±8 years) at rest, while performing the Stroop color-word test to induce AMS, and recovery. Cardiac autonomic modulation (HR variability), baroreflex sensitivity (BRS — sequential method), and adiposity (electrical bioimpedance) were assessed. One-way or two-way analysis of variance followed by Tukey's post hoc test and multiple linear regression were performed. The significance level was P<0.05. Results The AMS increased mean arterial pressure (MAP — Δ16±13 mmHg) and HR (Δ14±7 bpm) ( P <0.05). These responses were associated with parasympathetic modulation withdrawal (RMSSD: baseline: 29.8±18 vs. AMS: 21.5±14 ms; High-frequency: baseline: 5.2±1.4 vs. AMS: 4.5±1.3 Ln ms 2 ; P <0.05) and decreased in the Up gain of the baroreflex (baseline: 8.9±5.1 vs. AMS: 6.3±3.0 mmHg/ms; P <0.05). Groups divided by HR reactivity peak showed parasympathetic modulation withdrawal only in firefighters with lower adiposity (RMSSD: baseline: 27.8±17.6 vs. AMS: 14.4±9.2 ms; High-Frequency: baseline: 5.3±1.2 vs. AMS: 3.8±1.4 Ln ms 2 ; P <0.05). Fat percentage (β = -0.499), BRS (β = 0.486), and sympathetic/parasympathetic balance (β = -0.351) were predictors of HR reactivity ( P <0.05). Conclusion Our results demonstrated that HR reactivity to AMS modulated by cardiac vagal withdrawal seems to be influenced by body composition in this group of firefighters.

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Aim: Burnout syndrome describes the state of long-term physical, emotional and mental exhaustion related to work. This syndrome can cause health problems related to stress, insomnia, cardiovascular and musculoskeletal diseases, including an increase in alcohol consumption and drug use. It is important to recognize the presence of the initial signs of this syndrome, therefore this study aimed to determine the prevalence of the burnout syndrome in peruvian dental students. Methods: The study was observational, cross-sectional, and descriptive. It was carried out from September to November 2018, and it included a total of 154 dental students of four universities of La Libertad region, surveyed by census method. Three were private universities and one was public. Burnout was evaluated through the Maslach Burnout Student Survey Questionnaire (MBI-SS). The results were presented in absolute and percentage frequencies, as well as confidence intervals, using double-entry tables. Results: It was found that 24.68% of the students (24.71% in male students and 24.64% in female students) presented burnout syndrome. The public university of Trujillo presented the highest percentage of affected students (47.37%). A prevalence of 53,90% of emotional exhaustion was also found among the students under evaluation. Conclusions: Almost a quarter of the students surveyed presented burnout. It was also observed that the public University of Trujillo had a higher percentage of burnout than the three private ones. The percentage of prevalence of the burnout syndrome according to sex was similar. However according to dimensions, emotional exhaustion presented the highest percentage

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Abstract: Psychosocial evaluations are rarely conducted with community-dwelling individuals, especially those with higher risk of cardiovascular disease. This study aims to evaluate the perceptual stress and cardiovascular risk among women in a large cross-sectional study performed in Brazilian communities. Subjects aged over 18 years were included out of 500 public basic health units (BHU) in Brazil. All subjects were subjected to a clinical consultation and questionnaires application. Data were used to identify healthy lifestyle, smoking status, and self-perception of psychological stress. The National Health and Nutrition Examination Survey (NHANES) risk score (NRS) was used to estimate cardiovascular risk. Ethnicity information was self-reported, considering white versus non-white (black, brown, and mixed-race) women. A total of 93,605 patients were recruited from a primary care setting, of which 62,200 (66.4%) were women. Intense and severe auto-perception of stress was higher within non-white women at home (p < 0.001), at work (p = 0.008), socially (p < 0.001), and financially (p < 0.001) compared to white women. Therefore, the NRS indicates that non-white women had higher cardiovascular risk, lower physical activity, and lower daily vegetables/fruits consumption compared to white women (p < 0.001). Non-white women in Brazilian communities are susceptible to increased stress and cardiovascular disease risk, which adds up to disparities in access to the public health system.

Resumo: Avaliações psicossociais raramente são realizadas com indivíduos residentes na comunidade, especialmente aqueles com maior risco de doença cardiovascular. Este estudo tem como objetivo avaliar o estresse perceptivo e o risco cardiovascular entre mulheres em um grande estudo transversal realizado em comunidades brasileiras. Foram incluídas mulheres com idade superior a 18 anos de 500 unidades básicas de saúde (UBS) públicas do Brasil. Todas as participantes foram submetidas a consulta clínica e aplicação de questionários. Os dados foram utilizados para identificar estilo de vida saudável, tabagismo e autopercepção de estresse psicológico. O índice de risco (NRS) do National Health and Nutrition Examination Survey (NHANES) foi utilizado para estimar o risco cardiovascular. As informações de etnia foram autorreferidas, considerando mulheres brancas versus não brancas (negras, pardas e pardas). Um total de 93.605 pacientes foram recrutados em um ambiente de atenção primária, dos quais 62.200 (66,4%) eram mulheres. A autopercepção intensa e grave de estresse foi maior em mulheres não brancas em casa (p < 0,001), no trabalho (p = 0,008), socialmente (p < 0,001) e financeiramente (p < 0,001) em comparação com mulheres brancas. Portanto, a NRS indica que as mulheres não brancas apresentaram maior risco cardiovascular, menor atividade física e menor consumo diário de vegetais/frutas em comparação às mulheres brancas (p < 0,001). As mulheres não brancas nas comunidades brasileiras são suscetíveis ao aumento do estresse e do risco de doenças cardiovasculares, o que aumenta as disparidades no acesso ao sistema público de saúde.

Resumen: Raramente se realizan evaluaciones psicosociales con personas que viven en la comunidad, especialmente aquellas con mayor riesgo de enfermedad cardiovascular. Este estudio tiene como objetivo evaluar el estrés perceptivo y el riesgo cardiovascular entre las mujeres en un gran estudio transversal realizado en comunidades brasileñas. Se incluyeron mujeres mayores de 18 años de 500 unidades básicas de salud (UBS) públicas de Brasil. Todas las participantes fueron sometidas a una consulta clínica y aplicación de cuestionarios. Los datos se utilizaron para identificar el estilo de vida saludable, el tabaquismo y la autopercepción del estrés psicológico. Se utilizó la puntuación de riesgo (NRS) de la Encuesta Nacional de Examen de Salud y Nutrición (NHANES) para estimar el riesgo cardiovascular. La información étnica fue autoinformada, considerando mujeres blancas versus no blancas (negras, marrones y mestizas). Se reclutó a un total de 93.605 pacientes en un entorno de atención primaria, de los cuales 62.200 (66,4%) eran mujeres. La autopercepción intensa y severa del estrés fue mayor entre las mujeres no blancas en el hogar (p < 0,001), en el trabajo (p = 0,008), socialmente (p < 0,001) y financieramente (p < 0,001) en comparación con las mujeres blancas. Por lo tanto, el NRS indica que las mujeres no blancas tenían mayor riesgo cardiovascular, menor actividad física y menor consumo diario de verduras y frutas en comparación con las mujeres blancas (p < 0,001). Las mujeres no blancas en las comunidades brasileñas son susceptibles a un mayor estrés y riesgo de enfermedades cardiovasculares, lo que se suma a las disparidades en el acceso al sistema de salud pública.

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Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.

O estresse e a discriminação afetam negativamente a qualidade de vida, mas o apoio social pode amortecer seus efeitos. Os objetivos deste estudo são: (1) examinar as associações entre estresse psicológico, discriminação e qualidade de vida relacionada à saúde bucal (QVRSB); e (2) avaliar se apoio social, estresse e discriminação interagem para modificar suas associações com QVRSB. Os dados são de uma pesquisa transversal de base domiciliar de um estudo que incluiu 396 indivíduos com 14 anos ou mais de famílias registradas para benefícios federais em uma cidade no sul do Brasil. A QVRSB foi mensurada pelo Impactos Orais no Desempenho Diário (OIDP), enquanto o estresse psicológico foi avaliado pela Escala de Estresse Percebido (PSS). Além disso, o apoio social foi avaliado pelo número de parentes ou amigos próximos e a discriminação por meio da Escala de Discriminação Diária (EDS). As interações foram estimadas por meio do excesso relativo de risco devido à interação (RERI). Os efeitos ajustados foram calculados por meio de regressão logística. A prevalência de impactos bucais entre as pessoas com maior e menor escores de PSS foi de 81,6% e 65,5%, respectivamente (p < 0,01). O apoio social mostra interações inclusivas com níveis de estresse e discriminação. A associação entre discriminação social e QVRSB (escore OIDP > 0) foi OR = 2,03 (IC95%: 1,23; 3,34) dentre pessoas com baixo nível de estresse, mas foi de OR = 12,6 (IC95%: 1,31; 120,9) dentre aqueles com níveis mais altos (p = 0,09, para interação). Indivíduos que relataram níveis mais elevados de estresse psicológico e discriminação apresentaram pior QVRSB; o efeito sinérgico com o apoio social não foi evidente.

El estrés y la discriminación afectan negativamente a la calidad de vida, pero el apoyo social puede mitigar sus efectos. Los objetivos de este estudio son: (1) examinar las asociaciones entre el estrés psicológico, la discriminación y la calidad de vida relacionada con la salud bucal (CVRSB); y (2) evaluar si el apoyo social, el estrés y la discriminación interactúan para modificar sus asociaciones con la CVRSB. Los datos provienen de una encuesta transversal de hogares cuyo estudio incluyó a 396 individuos de 14 años o más de familias registradas en beneficios del gobierno en una ciudad del Sur de Brasil. La CVRSB se midió mediante el Impactos Orales en el Rendimiento Diario (OIDP), mientras que el estrés psicológico se evaluó mediante la Escala de Estrés Percibido (PSS). El apoyo social se basó en el número de familiares o amigos cercanos, y la discriminación en la Escala de Discriminación Cotidiana (EDS). Las interacciones se estimaron mediante el excesivo de riesgo relativo debido a la interacción (RERI). Los efectos ajustados se calcularon mediante regresión logística. La prevalencia de impactos orales entre las personas con puntajes de PSS más altas y más bajas fue del 81,6% y del 65,5%, respectivamente (p < 0,01). El apoyo social presenta interacciones inclusivas con niveles de estrés y discriminación. La asociación entre discriminación social y OHRQoL (puntuación OIDP > 0) fue OR = 2,03 (IC95%: 1,23; 3,34) entre personas con un nivel bajo de estrés, pero fue OR = 12,6 (IC95%: 1,31; 120,9) entre aquellos con niveles más altos (p = 0,09, para interacción). Las personas que informaron tener niveles más elevados de estrés psicológico y discriminación tuvieron una peor CVRSB; el efecto sinérgico con el apoyo social no estaba claro.

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Abstract Background The coronavirus disease 2019 (COVID-19) pandemic induced psychological distress, which is linked to emotional eating and symptoms of addiction to ultra-processed foods (UPFs). Objective This study aimed to investigate whether symptoms of addiction to UPFs mediate the relationship between psychological stress due to the COVID-19 pandemic and emotional eating behaviour. Methods A cross-sectional online study was conducted from May to November 2021 among 368 undergraduate Brazilian students. The participants answered demographic questions and completed validated scales, including the Coronavirus Stress Measure, Modified Yale Food Addiction Scale 2.0 and Emotional Eating Questionnaire. Mediation analysis was employed to examine the hypothesised relationships. Results The results revealed a significant indirect effect, indicating that symptoms of food addiction mediated the association between perceived stress during the COVID-19 pandemic and emotional eating behaviour. Specifically, 61% of the influence of perceived stress on emotional eating during the pandemic was explained by symptoms of UPF addiction. Conclusion These findings suggest that addressing symptoms of UPF addiction could be pivotal in public health strategies aimed at promoting healthy eating habits among distressed undergraduate students in the post-COVID-19 era.