Mentally healthy living after pandemic social distancing: a study of older Canadians reveals helpful anxiety reduction strategies.

BACKGROUND: Throughout the COVID-19 pandemic, older Canadians were the most at risk of severe physical harm, including death, and their return to post-COVID life was expected to be especially anxiety-provoking. A study was conducted to obtain nationally representative evidence of older Canadians' self-perceived anxiety levels and their strategies to manage or mitigate it as public health restrictions were lifting. MATERIALS AND METHODS: This study had a cross-sectional descriptive design. An e-survey was used to collect data from 1327 Canadians aged 60+ stratified by age, sex, and education to resemble the larger general population. Participants completed the Geriatric Anxiety Scale (GAS-10) and indicated which of the 16 Centre for Addictions and Mental Health's (2022) Coping with Stress and Anxiety strategies they were using to manage or mitigate their anxiety when social distancing was lifting. Descriptive statistics, Pearson correlation, and multiple regression analysis were used to explore the data. RESULTS: While, on average, older Canadians were mildly anxious, nearly one-quarter of responders rated their anxiety as severe. Age, sex, perceived health, were statistically significant correlates of anxiety. Six coping strategies were associated with significantly lower anxiety scores. Moreover, accepting some fear and anxiety as normal, challenging worries and anxious thoughts, and practising relaxation/meditation appeared to increase anxiety. CONCLUSION: Older Canadians used multiple strategies to manage or mitigate their anxiety, and seemingly, with more successful than detrimental tries. Practitioners have much to learn and understand about older people's mental health promotion efforts after social distancing, now and for future pandemics.

The effectiveness of spiritual care training on medical students' self-reported competencies: A quasi-experimental study.

OBJECTIVES: To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies. METHODS: This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n = 64) who received spiritual care training and sixth-year students (n = 51) who did not receive this training - control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported. RESULTS: Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d = 0.99), "Improvement of care" (d = 0.69), "Counseling (d = 0.88)," "Referral" (d = 0.75), and "Total Spiritual Care" (d = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032. SIGNIFICANCE OF RESULTS: Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools.

Association between religiosity/spirituality and substance use among homeless individuals.

BACKGROUND: Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS: To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD: This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS: A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION: The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.

The influence of classical music on learning and memory in rats: a systematic review and meta-analysis.

During the learning process, music can activate important neural areas in the brain, promoting the retention of information and memory formation. However, studies testing music effects on memory had found different improvements, which could be due to the methodological differences across studies. Thus, the purpose of this article was to systematically review the literature and meta-analyze the effects of music on Rattus norvegicus' explicit memory (Maze tests) only in controlled investigations. The seven studies included led to a very homogeneous analysis (I2 = 0%), confirming the consistency of the significant standardized mean difference (SMD) between the memory of animals exposed and not exposed to music (SMD 0.60 (95% CI 0.38; 0.83, p < 0.001)). Exploratory analysis suggests music benefits on memory can be acquired when begun at any age, when tested with the three types of mazes evaluated, with exposure lasting from 8 to 83 days and when the age on test day was either under 30 days or over 30 days. To expand the actual understanding of music effects on memory, future studies should investigate different types of music and animal species, with different sex and health conditions, at different time points.

Prevalence of Polypharmacy of Older People in a Large Brazilian Urban Center and its Associated Factors.

BACKGROUND: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. OBJECTIVE: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. METHODS: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. RESULTS: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. CONCLUSION: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC.

The role of spirituality and religiosity on the suicidal ideation of medical students.

BACKGROUND: There is solid evidence that spirituality and religiousness may reduce the suicidal ideation of individuals. However, studies are scarce on medical students. AIMS: To investigate the relationship between spirituality, religiousness, and suicidal ideation among Brazilian medical students. METHODS: This is a cross-sectional study including Brazilian medical students. Sociodemographic and health variables, suicidal ideation (item 9 of the Beck Depression Inventory - BDI), spiritual and religious Coping (Brief SRC), religiousness (Duke Religion Index), spiritual well-being - Meaning, Peace and Faith (FACIT SP-12), and depressive (PHQ-9) and anxiety (GAD-7) symptoms were assessed. RESULTS: A total of 353 medical students were included, 62.0% presented significant depressive symptoms, 44.2% presented significant anxiety symptoms, and 14.2% presented suicidal ideation. In the adjusted Logistic Regression models, meaning (OR = 0.90, p = .035) and faith (OR = 0.91, p = .042) were associated with lower suicidal ideation, while negative spiritual and religious coping was associated with greater suicidal ideation (OR = 1.08; p = .006). CONCLUSION: There was a high prevalence of suicidal ideation among Brazilian medical students. Spirituality and religiousness were associated with suicidal ideation in two different directions. These findings could help educators and health professionals to understand suicidal ideation among medical students, helping in the development of preventive strategies to mitigate such problem.

The role of spirituality and religiosity on the cognitive decline of community-dwelling older adults: a 4-year longitudinal study.

OBJECTIVES: This study aims to assess whether having religious beliefs, attending religious services and using spiritual-religious coping (SRC) are longitudinally associated with cognitive decline in community-dwelling older adults. METHODS: A 4-year longitudinal study of 261 Brazilian older adults was conducted. Hierarchical adjusted linear regression models and logistic regression models were performed to evaluate the longitudinal effects of religious beliefs, church attendance and positive and negative SRC on cognitive decline. RESULTS: The findings revealed that spiritual and religious beliefs at baseline could affect cognitive function in two different ways. When older adults use religiosity and spirituality (RS) in a functional positive manner, it results in better cognitive outcomes and a slower rate of decline. However, when used in a negative manner, it results in worse cognitive outcomes. CONCLUSION: These results could help health care professionals address SRC among older adults, particularly those at a higher risk of cognitive decline. Considering that RS is very important for older adults, health care professionals should be aware of the beliefs of their patients and address RS in clinical practice.

Functional disability and associated factors in older adults seen at a primary health care unit / Incapacidade funcional e fatores associados em idosos atendidos na atenção primária

OBJECTIVES: To assess functional disability and associated factors in older patients cared for at a large Brazilian urban area. METHODS: This is a cross-sectional study performed at a primary health care unit in the city of São Paulo, Brazil. Participants were selected via probabilistic sampling of 400 older individuals. We used a sociodemographic and health questionnaire along with instruments for assessing fear of falling (FES-I), cognitive function (MMSE), and depression symptoms (GDS-15). For dependent variables, we used instruments for assessing basic activities (BADL; Katz) and instrumental activities of daily living (IADL; Lawton). Factors associated with functional disability were analyzed via logistic regression models. RESULTS: The mean age of participants was 75.23 (SD = 8.53); 63.20% were female, 27.00% were dependent in BADL and 39.25%, in IADL. Older individuals with better cognitive function and who had not been hospitalized in the previous year were less prone to functional disabilities. Factors such as older age, more depression symptoms, and greater fear of falling were more linked to disabilities in BADL. Factors such as older age, female sex, and greater fear of falling were more linked to disabilities in IADL. CONCLUSIONS: The prevalence of disability in BADL and IADL in the studied sample was high. Modifiable and non-modifiable factors were associated with functional disability. These results may help primary health care professionals understand the risk factors for functional disability in the older population

OBJETIVOS: Avaliar a incapacidade funcional e fatores associados em pacientes idosos atendidos em um grande centro urbano brasileiro. METODOLOGIA: Estudo transversal realizado em uma Unidade Básica de Saúde na cidade de São Paulo, Brasil. A seleção dos participantes foi por meio de amostragem probabilística de 400 indivíduos idosos. Foi utilizado um questionário sociodemográfico, de saúde e instrumentos para avaliar medo de queda (FES-I), status cognitivo (MEEM) e sintomas depressivos (GDS-15). Para as variáveis dependentes, utilizou-se os instrumentos para avaliar as atividades básicas (ABVD; Katz) e atividades instrumentais de vida diária (Lawton; AIVD). Os fatores associados à incapacidade funcional foram analisados por meio de modelos de regressão logística. RESULTADOS: A média de idade dos participantes foi de 75,23 (DP = 8,53), 63,20% eram do sexo feminino, 27,00% eram dependentes para ABVD e 39,25% para as AIVD. Indivíduos idosos com melhor status cognitivo e que não estiveram internados no último ano eram menos propensos às incapacidades funcionais. Fatores como ter mais idade, mais sintomas depressivos e mais medo de queda eram mais propensos às incapacidades das ABVD. Fatores como ter mais idade, ser do sexo feminino e mais medo de queda foram mais propensos às incapacidades das AIVD. CONCLUSÕES: A prevalência de incapacidade para ABVD e AIVD na amostra estudada foi alta. Fatores modificáveis e não modificáveis foram associados à incapacidade funcional. Esses resultados podem ajudar os profissionais da atenção primária à saúde a entenderem os fatores de risco de incapacidade funcional na população mais velha

Spirituality and religiosity are associated with physical and psychological status in patients with chronic obstructive pulmonary disease.

BACKGROUND: Management strategies that incorporate spirituality and religiosity (S/R) have been associated with better health status in clinical populations. However, few data are available for patients with chronic obstructive pulmonary disease (COPD) to improve the traditional disease-model treatment. AIMS: The objectives of this study were to evaluate the association between S/R and physical and psychological status in patients with stable COPD. DESIGN: This is a cross-sectional study. METHODS: Religiosity, spiritual well-being and S/R Coping were measured. Physical status was evaluated with the activity of daily living, dyspnoea and the impact of the disease. Psychological status was assessed with anxiety and depression symptoms and quality of life. Spearman correlation coefficients were calculated, multivariate linear regression was applied in the analyses. This study is reported following the STROBE recommendations. RESULTS: Seventy-two patients with stable COPD (male 58%, aged 68 ± 9 years, forced expiratory volume in 1s (FEV1 ) of 49.2 ± 19.6% predicted) were included. There was no association between S/R and activity of daily living. However, higher spiritual well-being and lower Negative S/R Coping was associated with reduced dyspnoea and burden of the disease. Increased S/R and lower Negative S/R Coping was also associated with less anxiety, depression and better quality of life. Multivariate linear regression showed that S/R variables explained the physical and psychological health status in people with stable COPD. CONCLUSIONS: Higher spirituality and less negative S/R Coping are associated with reduced dyspnoea, the burden of the disease, anxiety and depression symptoms, and better quality of life in patients with stable COPD. RELEVANCE TO CLINICAL PRACTICE: Understanding how religiosity and spirituality are associated with physical and psychological features in patients with COPD may contribute to the long-term management of this patient population.

Exploring Depressive Symptoms Among Healthcare Professionals and the General Population During the COVID-19 Pandemic in Brazil.

Our study aimed to examine the symptoms that might play a role in the co-occurrence of 9 DSM-5 symptom criteria of major depression among Brazil's adult population and healthcare professionals after three months of detecting the new coronavirus in Brazil. We estimated regularized Gaussian graphical models for both samples and compared the network structures. Depressed mood was the most central symptom in the general population network compared to the healthcare professional network. The findings revealed some individual symptoms showed a differential association between the general population and healthcare professionals. Those symptoms may be valuable targets for future research and treatment.

Mental health, quality of life and optimism during the covid-19 pandemic: a comparison between Brazil and Portugal.

PURPOSE: Although there have been numerous studies investigating the mental health of individuals during the pandemic, a comparison between countries is still scarce in the literature. To explore this gap, the present study aimed to compare the mental health (i.e., anxiety and depression), quality of life (QoL), and optimism/pessimism among individuals from Brazil and Portugal during the COVID-19 pandemic and the associated factors. METHOD: A cross-sectional population-based study was conducted during the COVID-19 pandemic in Brazil and Portugal. Data collection was carried out between May and June 2020, using an online form which was sent through social networks. A total of 2069 participants (1156 from Brazil and 913 from Portugal) were included. Depressive symptoms (PHQ-9), Anxiety (GAD-7), optimism/pessimism (Revised Life Orientation Test - LOT), QoL (WHOQOL-Bref), and sociodemographic, health, and social distancing variables were assessed. Data was analyzed using univariate and multivariate models. RESULTS: There were remarkable differences between Brazil and Portugal in all outcomes during the COVID-19 pandemic, including higher levels of depressive symptoms, anxiety, and optimism for the Brazilian individuals and higher levels of QoL and pessimism for the Portuguese individuals. The following factors were associated with the mental health and QoL in both Brazilian and Portuguese populations: gender, age, being a healthcare professional, and days in social distancing. CONCLUSION: Despite the fact that Brazilians were more optimistic during the COVID-19 pandemic, they had lower levels of mental health and QoL as compared to the Portuguese individuals.

Violência por parceiro intimo e resiliência em mulheres da Amazônia ocidental brasileira / Violencia del compañero íntimo y resiliencia en mujeres de la Amazonía occidental brasileña / Intimate partner violence and resilience in women from the western Brazilian Amazon

Resumo Objetivo Verificar a prevalência da violência contra a mulher perpetrada pelo parceiro íntimo, identificar o fator predominante da resiliência, verificar se a violência por parceiro íntimo influencia na resiliência. Métodos Pesquisa epidemiológica analítica transversal com 291 mulheres entre 18 e 59 anos, usuárias da Atenção Primária à Saúde, no período de abril a julho de 2018 em um município da Amazônia ocidental brasileira. Instrumentos: questionário socioeconômico; rastreador de violência validado por Schraiber e col.; escala de resiliência validada por Pesce e col. Resultados Prevalência de violência nos últimos 12 meses: 53,3%. A maior concentração de participantes foi no Fator I da resiliência com 55% das participantes. Existe relação estatisticamente significativa entre as variáveis da violência física e resiliência (p=0,023). Conclusão Mais da metade das participantes sofreu violência por parceiro íntimo, principalmente a violência psicológica, seguida da física e da sexual. Predominou nas participantes o Fator resiliente I de perseverança, disciplina, bom humor e empatia. A violência física influenciou negativamente no desenvolvimento da autoconfiança e capacidade de adaptação, tornando estas mulheres menos flexíveis às mudanças, mais dependentes e com menos autoconfiança.

Resumen Objetivo Verificar la prevalencia de violencia contra la mujer, perpetrada por el compañero íntimo, identificar el factor predominante de resiliencia, verificar si la violencia del compañero íntimo influencia en la resiliencia. Métodos Investigación epidemiológica analítica transversal con 291 mujeres entre 18 y 59 años, usuarias de la Atención Primaria de Salud, en el período de abril a julio de 2018 en un municipio de la Amazonía occidental brasileña. Instrumentos: encuesta socioeconómica; rastreador de violencia validado por Schraiber y col.; escala de resiliencia validada por Pesce y col. Resultados Prevalencia de violencia en los últimos 12 meses: 53,3 %. La mayor concentración de participantes se dio en el Factor I de resiliencia con 55 % de las participantes. Existe una relación estadísticamente significativa entre las variables de violencia física y la resiliencia (p=0,023). Conclusión Más de la mitad de las participantes padecieron violencia del compañero íntimo, principalmente la violencia psicológica, seguida por la física y la sexual. Entre las participantes predominó el Factor resiliente I de perseverancia, disciplina, buen humor y empatía. La violencia física influenció negativamente en el desarrollo de la autoconfianza y en la capacidad de adaptación, haciendo con que estas mujeres sean menos flexibles a los cambios, más dependientes y con menos autoconfianza.

Abstract Objective To verify the prevalence of violence against women perpetrated by the intimate partner, to identify the predominant factor of resilience, to verify whether intimate partner violence influences resilience. Methods Cross-sectional analytical epidemiological research with a total of 291 women between 18 and 59 years old, users of Primary Health Care, from April to July 2018 in a city in the western Brazilian Amazon. Instruments: socioeconomic questionnaire; violence tracker validated by Schraiber et al.; resilience scale validated by Pesce et al. Results Prevalence of violence in the last 12 months: 53.3%. The highest concentration of participants was in Factor I of resilience with 55% of participants. There is a statistically significant relationship between the variables of physical violence and resilience (p=0.023). Conclusion More than half of the participants suffered intimate partner violence, mainly psychological violence, followed by physical and sexual violence. The Resilient Factor of perseverance I, discipline, good humor and empathy predominated in the participants. Physical violence negatively influenced the development of self-confidence and adaptability, making these women less flexible to change, more dependent and with less self-confidence.

The Influence of Religiosity and Spirituality on the Happiness, Optimism, and Pessimism of Brazilian Medical Students.

BACKGROUND: Mental health problems are very common among medical students, becoming a concern for health care professionals and educators. Despite the fact that there is a growing body of literature supporting the role of religiosity and spirituality (RS) on mental health and on positive psychology outcomes, little evidence is available among medical students, a population subjected to important distress. AIMS: This study aimed to investigate the role of RS on the levels of optimism, pessimism, and happiness among Brazilian medical students. METHODS: This is a cross-sectional study including medical students from the first to the eighth semester of a private medical school. The instruments used were: TOT-R for optimism and pessimism, Lyubomirsk and Lepper subjective happiness scale, and sociodemographic profile. The independent variables were Brazilian Portuguese Duke University Religiosity Scale for religiosity, Brief Spiritual Religious Coping (SRC) for negative and positive SRC; and Facit-Sp for spiritual well-being. RESULTS: A total of 353 medical students were included (response rate 97.51%). Higher levels of intrinsic religiosity and peace were associated with greater happiness and optimism. However, negative SRC was associated with lower levels of happiness and optimism and higher levels of pessimism. CONCLUSION: Medical students tend to use their RS as a resource for dealing with the challenges of medical school, influencing their happiness and optimism. In this context, it seems that religiousness acts in two different ways, not only have positive but also negative outcomes among the participants.

The role of spirituality and religiosity on suicidal ideation of homeless people in a large Brazilian urban center.

BACKGROUND: Suicidal ideation is an important mental health issue among homeless people. Despite the fact that spirituality and religiousness (S/R) have been associated with lower levels of suicide behavior, there is little evidence on this relationship among homeless individuals. Thus, this study aims to investigate the association between S/R and suicidal ideation among homeless people living in a large Brazilian city. METHODS: This cross-sectional study included 456 homeless individuals living in Sao Paulo, Brazil. Logistic and linear regression models were used to determine the role of religious and spiritual beliefs (Duke Religion Index, FACIT SP-12 and Brief-RCOPE) on suicidal ideation, after adjustements. RESULTS: Most participants were male (75%) with a mean age of 44.53(SD 12.62) years. A total of 49.6% had significant depressive symptoms and the prevalence of suicidal ideation was 29.8%. In the adjusted logistic regression, higher levels of religiousness (organizational, nonorganizational and intrinsic), positive religious/spiritual coping, peace and meaning were associated with a lower suicidal ideation. The same results were found when using linear regression models. LIMITATIONS: Long questionnaires can be factors of inhibition and fatigue for the participants. Suicidal ideation was based on a single question. CONCLUSION: Our results revealed a high prevalence of suicidal ideation and depression in our sample. Religiousness and spirtuality were important factors in the life of homeless individuals, being negatively associated with suicidal ideation. These results could make healthcare professionals aware of the importance of addressing S/R issues in this vulnerable population.