Aims: To explore the effectiveness of a new perioperative practice model on anxiety and health-related quality of life in patients undergoing total hip arthroplasty and total knee arthroplasty under spinal anaesthesia. Design: A randomized clinical trial. Methods: Control group participants (N = 222) received standard perioperative care, meaning they were cared for by various nurses during their perioperative process without postoperative visits. Intervention group participants (N = 231) were assigned one named anaesthesia nurse during their entire perioperative process who visited them postoperatively. Both groups responded to two self-reported questionnaires: the generic 15D health-related quality of life instrument and the State-Trait Anxiety Inventory (STAI) measuring anxiety two to three weeks pre-operatively and three months postoperatively. Results: There were no statistically significant differences between the groups at baseline or at follow-up in health-related quality of life or anxiety.

This review focuses on neurotrophic factors, especially CDNF, and Amyotropic lateral sclerosis (ALS). This review finds out which neurotrophic factors have been studied in clinical trials of ALS and what kind of results have been got. Neurotrophic factors are important for development and function of neurons because they prevent apoptosis of neurons. They also play role in differentiation, development and migration of neurons. It is also known that many of the neurotrophic factors have protective and restorative properties. ALS is a rare neurodegenerative disease which causes the destruction of motor neurons and leads to death in three years. The disease degenerate the upper and lower motor neurons. Symptoms are muscle weakness, muscle atrophy, cramps and problems with swallowing. At the moment there is no cure for ALS so it is important to study neurotrophic factors that could prevent the progression of the disease and perhaps to protect or repair destroyed motor neurons. This is why it is important to study potential of CDNF in ALS. The experimental part consists of three different parts. The purpose of the first part study was to determine the distribution of CDNF after intraventricular delivery at different time points. CDNF was labeled with 125I (125I-CDNF). The distribution was determined by gammacounter and autoradiography. To determine the stability of the injected 125-I CDNF we performed SDS-PAGE. The second part studied the diffusion volume of CDNF after intraventricular injection with seven wild type mice. After stereotaxic surgery CDNF-immunohistochemistry staining from coronal sections was done. The last experimental part studied the effect of single intracerebral injection of CDNF on motivation, locomotor activity, anxiety and depression with male and female mice. Light-dark box, open field, rotarod, forced swim test (FST), elevated plus maze and fear conditioning were carried out with male mice. After behavioural tests mice were sacrified for HPLC-analysis. Light-dark box and IntelliCage were carried out with female mice before c-fos staining. Gammacounter and autoradiography shows that 125I-CDNF distributes widely after intracerebroventricular injection. It spread throughout to the brain and also all the way to the spinal cord after one and three hours from injection. After 24 hours 125I-CDNF was cleared so the CDNF signal was very weak. SDS-PAGE showed the stability of radioactive CDNF. CDNF increased locomotor activity and decreased anxiety in male mice. But a statistically significant difference appeared in forced swim test and fear conditioning test. HPLC-analysis supported these results partly. CDNF also increased motivation of female mice in IntelliCage experiment. C-fos staining was observed in CDNF group and PBS group so quantitative analysis should be done from these sections so that reliable conclusions could be done. However, because CDNF distributed to spinal cord and it showed some effect on locomotor activity, motivation and depression it might be potential for ALS disease.

BACKGROUND: Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders METHODS: In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. RESULTS: Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. CONCLUSION: The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS.

Chronic stress has been linked to the pathogenesis of various disorders, such as generalized anxiety disorder, depression, and post-traumatic stress disorder (PTSD). Stress-induced hyperexcitability of the basolateral amygdala (BLA) has implications in anxiety-like behavior. Promising evidence points to the direction of GluK1 subunit containing kainate receptors (KARs) having a role in the modulation of GABAergic transmission in the lateral amygdala (LA). The aim of the present study was to investigate whether dysfunction of KARs contribute to stress-induced amygdala hyperexcitability and anxiogenesis in mice. Chronic restraint stress (CRS) is an animal model simulating chronic psychological stress. An in situ hybridization experiment was performed to investigate how CRS affects expression levels of GluK1 in the different neuronal populations in the LA. These data show that CRS leads to downregulation of GluK1 expression in the parvalbumin-positive (PV+) interneurons specifically. Patch clamp recordings of spontaneous inhibitory postsynaptic currents showed that CRS did not affect synaptic GABAergic transmission to the principal neurons in the LA. Lastly, conditional knock-out (cKO) mice that have the Grik1 gene knocked out selectively in the PV-expressing interneurons showed no change in anxiety-like behavior after CRS while their wild-type counterparts demonstrated an increase in anxiety-like behavior observable in the elevated plus maze test. Thus, ablation of GluK1 in PV+ interneurons affects the stress-induced anxiogenesis. Due to low number of animals, it cannot be confirmed yet whether the deletion leads to stress resilience or a phenotype where even regular handling is an aversive experience comparable to physical restraint. GluK1 KAR modulation of PV+ interneuron excitability and its susceptibility to stress-related alterations is only a recently discovered phenomenon, and even though this study provides some insight into the underlying mechanism, further research is needed. Systematic characterization of the mechanism could provide a novel tool for understanding and treating stress-related pathological anxiety, possibly helping patients suffering from anxiety disorders resistant to current treatments available.

Concern about global warming can lead to climate change anxiety, a form of anxiety characterized by excessive worry about the climate crisis and associated consequences on the natural world and human society. It has been suggested by previous research that humor can be used to manage feelings of anxiety. This study seeks to determine if this phenomenon can be applied specifically to climate change anxiety. The research combines a comprehensive literature review with an online survey that leveraged climate change themed internet memes as a proxy for humor to gather opinions about the intersections between these two topics. The survey data supplemented claims made by existing literature, indicating that climate change themed internet memes and humor in general can be useful coping mechanisms to mitigate feelings of climate anxiety. The survey was completed by 93 respondents; most of these participants were women, located in the US, and/or between the ages of 20 and 29. Results from the survey showed that people tend to feel best about their environmental anxiety when they are taking active steps to solve the problem. Conscious decisions such as reducing waste or participating in activist movements are easier to recognize and self-report than more passive coping skills. Reliance on humor was reported as a supplementary coping skill, but many respondents indicated that looking at humorous climate change themed memes did influence their feelings about climate change overall. The scope of this study was relatively small in scale, therefore the results presented in this thesis may not be indicative of broader social trends and likely require further research.

Sosiologist Aaron Antonovsky was among the first who was interested in factors that maintain and enhance health instead of risk factors for different diseases. He developed the sense of coherence (SOC) construct, which is the core concept of his salutogenic theory, to explain how some individuals stay healthy despite the numerous stressful situations they encounter during their life. Sense of coherence is a global orientation towards life that characterizes the extent to which an individual appraises his or her internal and external environments as comprehensible, manageable and meaningful. In previous studies, there has been a strong inverse association between the SOC scale and the measures of depressive symptoms and anxiety. This is in accordance with Antonovsky's theory but the size of the correlations raises the question whether the SOC scale measures similar construct to depression and anxiety measures. The aim of this thesis was to investigate what is the relationship of the SOC scale (short form) with the measures of depressive symptoms (Beck Depression Inventory) and anxiety (Spielberger's State Anxiety Scale), and if they are similarly related to health and health behaviours. The participants of the present study were 25 – 74 years old Finnish men (n=2351) and women (n=2291) from the national cardiovascular risk factor survey (FINRISK) conducted in 1997. The SOC scale had strong and inverse correlations with the measures of depression (r=-0.62 among men and women) and anxiety (r=-0.57 among men and r=-0.54 among women). In addition, sense of coherence was similarly associated with health and health behaviours as depressive symptoms (cognitive and affective) and anxiety. These results suggest that the SOC scale overlaps with depression and anxiety measures. Nevertheless, there were also small differences between these measures: education was related only to sense of coherence, and in factor analysis, items of the each scale defined their own factors. The SOC scale was more normally distributed than the measure of depressive symptoms as depression measure did not create variation among those respondents who did not have depressive symptoms. However, the low end of the SOC distribution was more important in the prediction of different health variables than the high end of the SOC distribution. This finding questions the status of sense of coherence (as measured by the SOC scale) as a protective factor for health that is qualitatively different from risk factors. It is concluded that the items of the 13-item SOC scale should be reconstructed to reflect better the SOC construct and be less confounded with negative emotional states. Most important references: Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass. Relevant articles from scientific peer reviewed journals.

Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein 'help-seeking' is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women's own perspectives. The aim of this study was to integrate and synthesize knowledge of women's experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.

Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. It is also associated with high mortality and poor prognosis due to advanced age of the patients and coexisting comorbidities. There is a dearth of data in the literature regarding depression and anxiety among those patients. The objective of this brief review is to discuss the intertwining relationship between depression and anxiety with bullous pemphigoid.

Anxiety and distress about the ecological crisis seems to be a rapidly growing phenomenon. This article analyzes the challenges and possibilities posed by such "eco-anxiety" for environmental education. Variations of eco-anxiety are analyzed, and it is argued that educators should be aware of the multiple forms that the phenomenon has. Eco-anxiety is found to be closely connected with many difficult emotions, such as grief, guilt, anger, and despair. However, anxiety also has an adaptive dimension, which can be called "practical anxiety". Anxiety is connected with expectation, motivation, and hopes. Previous research about eco-anxiety and ecological emotions in various disciplines is discussed, and related studies from various fields of education are brought together. Based on this extensive literature review, theoretical analyses are made, using a philosophical method. It is argued that environmental educators need organizational and peer support both in relation to their own difficult emotions and in order to develop emotional skills in their work. Educators should first practice self-reflection about eco-anxiety, after which they have many possibilities to help their audiences to develop emotional resilience. Potential practical activities related to eco-anxiety are discussed, drawing from various fields of education. These include validation of eco-anxiety and ecological emotions, providing safe spaces to discuss them, and, if possible, providing embodied and creative activities to more fully deliberate on them.

The aim of the study. Subjective time perception is prone to distortions, and one of the factors affecting it is a person's emotional state. Anticipation of unpleasant and threatening situations is of particular importance for coping. Previous research on the relationship between anticipation of unpleasant situations and perceived duration has shown conflicting results. Moreover, the experimental designs have been inadequate. The present study examines the effect of anticipating an unpleasant image and individual anxiety tendency on duration perception. The results are discussed in relation to the attentional gate model, which suggests that the influence of emotionality on perceived duration may be mediated through arousal or attentional allocation. Methods. Subjects (n=39) completed a temporal discrimination task in which the duration of a neutral visual cue stimulus was compared to previously learned short and long comparison durations. The colour of the stimulus indicated whether or not it was followed by an unpleasant image. The experiment consisted of three experimental conditions: (1) an unpleasant image was not anticipated nor presented, (2) an unpleasant image was anticipated but not presented, and (3) an unpleasant image was anticipated and presented. Psychometric functions were generated from the responses to obtain the points of subjective equality. The point refers to a duration that the person cannot distinguish as short or long. The effect of anticipating an unpleasant image and individual self-reported anxiety tendency on the points of subjective equality was analysed using multilevel linear modelling. Results. Anticipation of an unpleasant image led to longer perceived duration. Those reporting more anxiety perceived the duration of the cue stimulus to be longer than those reporting less anxiety. However, anxiety tendency did not moderate the effect of unpleasant image anticipation on perceived duration. Conclusions. Interpreted according to the attentional gate model, the perception of time passing slower is explained by arousal induced by the anticipation of an unpleasant situation, which speeds up the internal clock. In addition, anxious individuals are more aroused during anticipation, which is why they perceive time to pass more slowly than others. The role of attention in the relationship between anticipation of an unpleasant situation and duration perception seems to be more pronounced in situations where the threat is more biologically significant.