Quality of life of college students: The effects of state anxiety and academic stress with self-control as a mediator

College education is expected to equip students with various types of knowledge. In reality, however, the learning process is not always easy. Problems can occur and affect students' quality of life. This study aims to examine the effect of state anxiety and academic stress on the quality of life through the mediation of student self-control. A quantitative method was used involving a sample of 400 students from 24 provinces in Indonesia. The measuring instruments employed were the World Health Organization Quality of Life (WHOQOL), The State Anxiety Scale, the Academic Stress Scale, and the Brief Self-Control Scale. Path analysis was conducted using R software. It was found that self-control partially mediates the effect of state anxiety on the quality of life. State anxiety has a direct effect, with a standardized coefficient of -.351 (p .01), and an indirect one, with a standardized coefficient of -.150 (p .01) on reducing the quality of life through the mediation of self-control. Academic stress has no indirect effect on the quality of life through the mediation of self-control with a standardized coefficient of -.000 (p = .990, p .05). However, it was found to play a direct role in reducing the quality of life, with a standardized coefficient of -.207 (p .01). The findings indicate the multi-dynamic impacts of state anxiety and academic stress toward the quality of life of students. Therefore, the development of anxiety and stress-management skills in students need to be addressed in the higher education management system in order to maintain the quality of life of students

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo