The Association between Smartphone Addiction, Depression and Anxiety among Medical Students in Jordan

Introduction: Awareness of psychological disorders such as smartphone addiction, anxiety, and depression is a trending research area in the scientific community that has further escalated with the impact of COVID-19. In this regard, young adults and medical students are already considered to be under a high level of stress academically and culturally. This study aimed to investigate the relationship between depression, anxiety, and smartphone addiction among medical students in Jordan. Method(s): A cross-sectional study was conducted using an online structured questionnaire. The survey was completed by 164 male and female medical students stratified by years one to three in the basic medical sciences. The survey consisted of items from the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Smartphone Addiction Scale-Short Version (SAS-SV), in addition to two questions concerning the impact of the COVID-19 pandemic on smartphone addiction. Result(s): Among the students who participated, the mean age was 18.9, with almost half (47.2%) being first-year students. The results showed no significant difference in stress, anxiety or cell phone addiction based on gender or academic year. The logistic regression model was not statistically significant regarding the covariates, except for GAD, which had an OR=1.15 (CI: 1.06 -1.25). Furthermore, SAS-SV was positively correlated with GAD-7 and PHQ-9 scores (r=0.42, r=0.2, p< 0.000, p=0.029, respectively). Conclusion(s): The results of the study showed a statistically significant positive correlation between smartphone addiction, depression, and anxiety. These variables were not statistically different among medical students in terms of gender and academic year.Copyright © 2023 DSR Publishers / The University of Jordan. All Rights Reserved.

Factors associated with anxiety and depression in patients with erectile dysfunction: a cross-sectional study.

BACKGROUND: Few studies have investigated factors associated with anxiety and depression among patients with erectile dysfunction (ED). This study aimed to investigate associated factors and the prevalence of anxiety and depression in this special group in China. METHODS: Data from 511 patients with ED aged 18-60 years were collected between July 2021 and April 2022. The 5-item International Index of Erectile Function (IIEF-5) questionnaire, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate erectile function, anxiety and depression, respectively. Univariate analysis and multivariate linear regression analyses were used to explore the associated factors of depression and anxiety. RESULTS: The prevalence of anxiety and depression among ED patients was 38.16% and 64.97%, respectively. The mean anxiety index score was 47.37 ± 6.69 points, and the mean depression index was 54.72 ± 9.10 points. Multiple linear regression analysis showed that worse ED, low education level, and smoking were positively associated with increased risk of anxiety and depression. In addition, younger age, longer onset time, and irregular sleep were positively associated with high risk of anxiety, and irregular exercise was associated with severe depression. CONCLUSIONS: The prevalence of depression and anxiety in ED patients is high, and the severity of ED, age, education level, smoking, onset time, regular sleep, and exercise were associated with anxiety or depression. Reversible risk factors should be avoided and individualized psychological support services are necessary for ED patients.

Validity, reliability, and correlates of the Smartphone Addiction Scale-Short Version among Japanese adults.

BACKGROUND: The short version of the smartphone addiction scale (SAS-SV) is widely used to measure problematic smartphone use (PSU). This study examined the validity and reliability of the SAS-SV among Japanese adults, as well as cross-sectional and longitudinal associations with relevant mental health traits and problems. METHODS: Datasets from a larger project on smartphone use and mental health were used to conduct two studies. Participants were adults aged over 20 years who carried a smartphone. RESULTS: Study 1 (n = 99,156) showed the acceptable internal consistency and structural validity of the SAS-SV with a bifactor model with three factors. For the test-retest reliability of the SAS-SV, the intraclass correlation coefficient (ICC) was .70, 95% CI [.69, 70], when the SAS-SV was measured seven and twelve months apart (n = 20,389). Study 2 (n = 3419) revealed that when measured concurrently, the SAS-SV was strongly positively correlated with another measure of PSU and moderately correlated with smartphone use time, problematic internet use (PIU), depression, the attentional factor of impulsiveness, and symptoms related to attention-deficit hyperactivity disorder and obsessive-compulsive disorder. When measured 12 months apart, the SAS-SV was positively strongly associated with another measure of PSU and PIU and moderately associated with depression. DISCUSSION: The structural validity of the SAS-SV appeared acceptable among Japanese adults with the bifactor model. The reliability of the SAS-SV was demonstrated in the subsequent seven- and twelve-month associations. CONCLUSION: The cross-sectional and longitudinal associations of the SAS-SV provided further evidence regarding PSU characteristics.

Pregnant women: psychology, cognitive and behavioral responses, and solutions towards COVID-19.

COVID-19 (Corona Virus Disease 2019) has spread globally and is highly infectious, causing psychological disturbances such as anxiety, depression, or both. Pregnant women, as a vulnerable population, need further attention. This study aims to evaluate the psychological impact of pregnant women during COVID-19 to constitute base data for solution guidance. Using a self-designed questionnaire, self-rated anxiety scale (SAS), and self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women from February 20 to April 30, 2020. The prevalence of anxiety and depression during pregnancy was shown to be 12.93% and 31.21%, respectively. Besides, younger age, housewives, lower education level, and early pregnancy all contributed to psychological disturbance during the COVID-19 pandemic. The results revealed significant variations in cognitive and behavioral responses based on the levels of the COVID-19 pandemic concerns, perceptions of life impacts and family concerns, preparation of personal protection equipment and motherhood, and the need for psychological counseling (P < 0.05). Regarding their primary concerns, 73.2% of the participants worried about the health and safety of childbirth. And 90.6% of respondents anticipated scheduling prenatal appointments to avoid crowds. Pregnant women are susceptible to anxiety/depression during the COVID-19 outbreak, necessitating immediate psychological care and intervention.

Clinical safety and pharmacokinetic evaluation of aqueous extract of Cocculus hirsutus, an anti-viral phytopharmacetical drug as a potential for the treatment of dengue and COVID-19.

Background and aim: Dengue a worldwide concern for public health has no effective vaccine or drug available for its prevention or treatment. There are billions of people who are at risk of contracting the dengue virus (DENV) infections with only anti-mosquito strategies to combat this disease. Based on the reports, particularly in vitro studies and small animal studies showing anti-viral activity of aqueous extract of Cocculus hirsutus (AQCH), studies were conducted on AQCH tablets as a potential for the treatment of dengue and COVID-19 infections. The current study was part of the research on AQCH tablet formulation and was aimed to evaluate safety and pharmacokinetics in healthy human subjects. Materials and methods: Sixty healthy adult human subjects were divided into 5 groups (cohorts: I to V; n = 12 per cohort) and randomized in the ratio of 3:1 to receive active treatment or placebo in a blinded manner. Five doses 100 mg, 200 mg, 400 mg, 600 mg and 800 mg tablets were administered three times daily at an interval of 8 h for days 01-09 under fasting conditions and a single dose in morning on day 10. Safety assessment was based on monitoring the occurrence, pattern, intensity, and severity of adverse events during study period. Blood samples were collected for measurement of the bio-active marker Sinococuline concentrations by a validated LC-MS/MS method followed by pharmacokinetic evaluation. Results and conclusion: The test formulation was well tolerated in all cohorts. Sinococuline peak plasma concentration (Cmax) and total exposure of plasma concentration (AUC) demonstrated linearity up to 600 mg and saturation kinetics at 800 mg dose. There was no difference observed in elimination half-life for all the cohorts, suggesting absence of saturation in rate of elimination. Dose accumulation was observed and steady state was achieved within 3 days. The information on human pharmacokinetics of AQCH tablets would assist in further dose optimization with defined pharmacokinetic-pharmacodynamic relationship.

Asymptomatic or mildly symptomatic COVID-19 patients with craniomaxillofacial injuries have an increased risk of surgical site infection.

The aim of this paper was to evaluate the association between 'asymptomatic or mildly symptomatic' severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (AS/MS-COVID) and surgical site infection (SSI) after repair of craniomaxillofacial injury (CMFI). Using a case-control study design with a match ratio of 1:4, we enrolled a cohort of AS/MS-COVID cases with immediately treated CMFI during a one-year period. The main predictor variable was SARS-CoV-2 infection (yes/no), and the outcome of interest was SSI (yes/no). The other variables were demographic, clinical, and operative. Appropriate statistics were computed, and p<0.05 was considered statistically significant. The study group comprised 257 cases (28.8% female; 13.2% aged ≥ 60 years; 10.5% with fractures; 39.7% with involvement of nasal/oral/orbital tissue [viral reservoir organs, VROs]; 81.3% with blunt trauma; 19.1% developed an SSI [vs 6.8% in the control group]) with a mean (SD) age of 39.8 (16.6) years (range 19-87). There was a significant relation between SARS-CoV-2 infection and SSI events (p<0.0001; odds ratio 3.22; 95% confidence interval 2.17 to 4.78). On subgroup analysis, SSIs significantly increased with age ≥ 60 years, presence and treatment of fracture, contact with VROs, and prolonged antibiotic use (PAU). However, multivariate logistic regression analysis confirmed a positive effect only from old age, contact with VROs, and PAU (relative risk = 1.56, 2.52, and 2.03, respectively; r = 0.49; p = 0.0001). There was a significant 2.8-fold increase in SSIs among AS/MS-COVID cases, especially in those aged ≥ 60 years, or those with injuries to VROs, or both, who therefore required PAU.

La médecine d’urgence de la création aux perspectives

Résumé Pour comprendre la crise actuelle des urgences et les solutions que l’on peut y apporter, il est nécessaire de d’analyser les origines de la médecine urgence. Sa dimension pré hospitalière qui est parfois critiquée et décriée est directement issue de la réponse à des crises sanitaires majeures. Sa reconnaissance réglementaire a pris du temps et a fait l’objet de nombreuses discussions avant d’aboutir en 1986 à une loi. Le rapprochement de la composante pré hospitalière et hospitalière de la Médecine d’Urgence a permis la création d’une nouvelle spécialité médicale. Des événements récents, notamment la crise COVID, ont montré l’adaptabilité et l’évolutivité de ce système et sa pertinence. La crise actuelle des urgences fait partie d’un phénomène plus global qui touche tout l’hôpital. De nombreuses solutions existent optimiser aussi bien l’amont, l’aval et l’organisation du service d’accueil des urgences (SAU). Mais, au-delà de ces considérations c’est dans le cadre d’une refonte du système de soins qu’il faut définir un nouveau contrat rassemblant les professionnels et le public, autour de la demande et pas seulement l’offre existante de soins. C’est le meilleur garant d’une utilisation pertinente des ressources de médecine d’urgence aussi bien hospitalières que pré hospitalières. Summary To understand the current emergency care crisis and the solutions that can be brought to it, it is necessary to analyze the origins of emergency medicine. Its pre-hospital dimension, which is sometimes criticized and decried, comes directly from the response to major health crises. Its regulatory recognition took time and was the subject of many discussions before resulting in a law in 1986. Bringing together the pre-hospital and hospital components of Emergency Medicine has led to the creation of a new medical specialty. Recent events, including the COVID crisis, have shown the adaptability and scalability of this system and its relevance. The current emergency crisis is part of a larger phenomenon affecting the entire hospital. Many solutions exist to optimize both upstream, downstream patients flow and the organization of the Emergency Room (ER). But, beyond these considerations, it is within the framework of an overhaul of the healthcare system that a new contract must be defined bringing together professionals and the public, around the demand and not only the existing offer of healthcare. It is the best guarantee of the relevant use of emergency medicine resources, both hospital and pre-hospital.

Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic.

Background and objective: The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic. Methods: Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%. Results: There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome. Conclusion: The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.

Daily communication of corrected mortality estimates in Spain during the second wave of the COVID-19 pandemic

Introduction: MoMo monitors and communicates daily mortality in Spain, however, the delay in the notifi- cation of deaths biases downwards the estimates from MoMo. Objective: this study evaluates five methods that correct for the effect of notification delays on daily excess mortality estimates during the second wave of the COVID-19 pandemic. Methods: 1) estimates for the excess mortality in Spain were published daily and gathered within 01/09/2020-25/12/2020. 2) adjusted excess mortality estimates were computed by applying five different models that correct for the delay in the notification of deaths. 3) these corrections were evaluated using the mean absolute error (MAE) and the root mean square error (RMSE). Results: the delay in the notification implied that the cumulative excess mortality estimates from MoMo during the second wave were, on average, 87% of their definitive values. The quadratic and cubic regression models raised them to 98%, on average. Using quadratic regressions reduced the RMSE and the MAE of MoMo's estimates in 6 and 13%, respectively. Conclusion: to improve the daily estimates from MoMo for the cumulative excess of deaths, it is recommended to use quadratic regressions to correct the effect of the notification delay.

Vaccine dilemma for children at risk: Recently approved malaria vaccine versus ongoing COVID-19 vaccination campaign.

Recently, the World Health Organization (WHO) approved RTS, S/AS01 (RTS, S) as the world's first malaria vaccine for partial malaria protection in young children at risk. While this immunization drive begins during the unprecedented pandemic of the SARS-CoV-2 Virus, the WHO has also approved 7 Vaccines in 2021 for the vaccination of children at risk. This article explores the quandary that would occur to the officials in charge of carrying out large vaccination campaigns against these two deadly infectious illnesses in several regions including the continent of Africa. The article also outlines the priorities for resolving this dilemma, offers evidence-based solutions, and provides a summary of recent significant events and their consequences. While providing the latest data, a discussion on the causation of the dilemma with clear recommendations for possible solutions has been explored as well.

Using Neural Networks in Order to Analyze Telework Adaptability across the European Union Countries: A Case Study of the Most Relevant Scenarios to Occur in Romania.

Our study addresses the issue of telework adoption by countries in the European Union and draws up a few feasible scenarios aimed at improving telework's degree of adaptability in Romania. We employed the dataset from the 2020 Eurofound survey on Living, Working and COVID-19 (Round 2) in order to extract ten relevant determinants of teleworking on the basis of 24,123 valid answers provided by respondents aged 18 and over: the availability of work equipment; the degree of satisfaction with the experience of working from home; the risks related to potential contamination with SARS-CoV-2 virus; the employees' openness to adhering to working-from-home patterns; the possibility of maintaining work-life balance objectives while teleworking; the level of satisfaction on the amount and the quality of work submitted, etc. Our methodology entailed the employment of SAS Enterprise Guide software to perform a cluster analysis resulting in a preliminary classification of the EU countries with respect to the degree that they have been able to adapt to telework. Further on, in order to refine this taxonomy, a multilayer perceptron neural network with ten input variables in the initial layer, six neurons in the intermediate layer, and three neurons in the final layer was successfully trained. The results of our research demonstrate the existence of significant disparities in terms of telework adaptability, such as: low to moderate levels of adaptability (detected in countries such as Greece, Croatia, Portugal, Spain, Lithuania, Latvia, Poland, Italy); fair levels of adaptability (encountered in France, Slovakia, the Czech Republic, Hungary, Slovenia, or Romania); and high levels of adaptability (exhibited by intensely digitalized economies such Denmark, Sweden, Finland, Germany, Ireland, the Netherlands, Belgium, etc.).

Forecasting COVID-19 pandemic in Alberta, Canada using modified ARIMA models.

BACKGROUND AND OBJECTIVES: Auto regressive integrated moving average (ARIMA) model is a popular model to forecast future values of a time series using the past values of the same series. However, if the variance of the time series varies with time, the 95% confidence interval estimated by the ARIMA will not be accurate. This study proposes a method to revise the ARIMA model to suit time series with heteroscedasticity. METHODS: Multiple historical ARIMA models were constructed with publicly available COVID-19 data in Alberta, Canada. The time series between different time periods were applied for these models. The means and their 95% confidence intervals of the differences between the forecasted values and the corresponding actual values were computed. The forecasted values of the general ARIMA models were modified by adding these differences. RESULTS: The average incident cases forecasted with the proposed method are lower than those with a general ARIMA model during the forecasted period. The 95% confidence intervals of the forecasted incidence with the proposed method are narrower. During the forecasted period (13 weeks) the average incidence was predicted to increase first and then decrease exponentially. CONCLUSION: The proposed method can be used to automatically specify the best ARIMA model, to fit time series with heteroscedasticity and to forecast longer period of the trends in the future. In the next 13 weeks, the Covid-19 incidence may decrease but not eliminate. To stop the transmission of infections eventually, persistent effects complying with accurate forecasts are necessary.

Power and sample size calculation for the win odds test: application to an ordinal endpoint in COVID-19 trials.

The win odds is a distribution-free method of comparing locations of distributions of two independent random variables. Introduced as a method for analyzing hierarchical composite endpoints, it is well suited to be used in the analysis of ordinal scale endpoints in COVID-19 clinical trials. For a single outcome, we provide power and sample size calculation formulas for the win odds test. We also provide an implementation of the win odds analysis method for a single ordinal outcome in a commonly used statistical software to make the win odds analysis fully reproducible.

Time to get serious about distributed leadership: lessons to learn for promoting leadership development for non-consultant career grade doctors in the UK.

COVID-19 has exposed the National Health Service (NHS) to the greatest challenge in its existence, highlighting the need for nimble, reactive and inclusive leadership. It is set against a backdrop of a workforce recruitment and retention crisis predicted to worsen in coming years. There is a need to do things differently in healthcare, including better diversity and distribution of leadership. We make the case for senior non-consultant doctors, in the UK more usually referred to as specialty and associate specialist or locally employed doctors. These skilled, experienced medics have much to offer yet are frequently overlooked, with little guidance or support from central organisations and medical colleges or within NHS Trusts themselves. In this commentary, we suggest ways this workforce might be better tapped into, to the benefit of patients and healthcare systems, as well as the doctors themselves.

The physical and mental health of the medical staff in Wuhan Huoshenshan Hospital during COVID-19 epidemic: A Structural Equation Modeling approach.

INTRODUCTION: Early in the epidemic of coronavirus disease 2019, the Chinese government recruited a proportion of healthcare workers to support the designated hospital (Huoshenshan Hospital) in Wuhan, China. The majority of front-line medical staff suffered from adverse effects, but their real health status during COVID-19 epidemic was still unknown. The aim of the study was to explore the latent relationship of the physical and mental health of front-line medical staff during this special period. METHODS: A total of 115 military medical staff were recruited between February 17th and February 29th, 2020 and asked to complete questionnaires assessing socio-demographic and clinical characteristics, self-reported sleep status, fatigue, resilience and anxiety. RESULTS: 55 medical staff worked within Intensive Care and 60 worked in Non-intensive Care, the two groups were significantly different in reported general fatigue, physical fatigue and tenacity (P<0.05). Gender, duration working in Wuhan, current perceived stress level and health status were associated with significant differences in fatigue scores (P<0.05), the current perceived health status (P<0.05) and impacted on the resilience and anxiety of participants. The structural equation modeling analysis revealed resilience was negatively associated with fatigue (ß=-0.52, P<0.01) and anxiety (ß=-0.24, P<0.01), and fatigue had a direct association with the physical burden (ß=0.65, P<0.01); Fatigue mediated the relationship between resilience and anxiety (ß=-0.305, P=0.039) as well as resilience and physical burden (ß=-0.276, P=0.02). CONCLUSION: During an explosive pandemic situation, motivating the effect of protective resilience and taking tailored interventions against fatigue are promising ways to protect the physical and mental health of the front-line medical staff.

Psychological Impact of COVID-19 and Lockdown among University Students in Malaysia: Implications and Policy Recommendations.

The COVID-19 pandemic and the lockdown has taken the world by storm. This study examines its impact on the anxiety level of university students in Malaysia during the peak of the crisis and the pertinent characteristics affecting their anxiety. A cross-sectional online survey, using Zung's self-rating anxiety questionnaire was conducted during the COVID-19 pandemic and lockdown. Out of the 983 respondents, 20.4%, 6.6%, and 2.8% experienced minimal to moderate, marked to severe, and most extreme levels of anxiety. Female gender (OR = 21.456, 95% CI = 1.061, 1.998, p = 0.020), age below 18 years (OR = 4.147, 95% CI = 1.331, 12.918, p = 0.014), age 19 to 25 (OR = 3.398, 95% CI = 1.431, 8.066, p = 0.006), pre-university level of education (OR = 2.882, 95% CI = 1.212, 6.854, p = 0.017), management studies (OR = 2.278, 95% CI = 1.526, 3.399, p < 0.001), and staying alone (OR = 2.208, 95% CI = 1.127, 4.325, p = 0.021) were significantly associated with higher levels of anxiety. The main stressors include financial constraints, remote online teaching and uncertainty about the future with regard to academics and career. Stressors are predominantly financial constraints, remote online learning, and uncertainty related to their academic performance, and future career prospects.

The Impact of COVID-19 on Anxiety in Chinese University Students.

COVID-19 had become a pandemic raising concerns of widespread panic and increasing anxiety and stress in individuals all over the world (World Health Organization, 2020a). Lots of countries had closed their schools. As the first country to do so, Chinese colleges and universities were making use of different modes of learning, including online-learning based on different platforms to achieve the goal suggested by Ministry of Education in China, "suspending classes without suspending learning," since middle February. This paper is the first one which aims to investigate the anxiety of Chinese university students after the outbreak of COVID-19 right before the start of new spring term. 3611 university students (female: male = 1.48:1) aged between 18 to 24 from all over China were enrolled to this study from a top university in China. The Self-Rating Anxiety Scale - SAS (Zung, 1971) was used to assess anxiety 2 days before the start of new spring term in middle February. All four-year undergraduate students were included in the study. The mean SAS score was 40.53 (SD = 10.15), significantly higher than the national norm (Mean = 29.78, SD = 10.07, and p ≤ .001), and there were still 557 (15.43%, Mean = 58.75, and SD = 8.9) students met the cutoff of 50 and were screened positive. Comparisons among sexes, grades and majors were also conducted. Significant differences were found between all males and all female (p ≤ .001), and between all students majoring arts and sciences in the anxiety sample (n = 557, p = 0.05). The results also showed that the mean SAS scores were not correlated with the regions they came from/lived in. This study concluded that the Chinese university students showed higher anxiety for COVID-19.