Perceived stress experienced by undergraduate healthcare professional students throughout their degree

Rationale: Stress can be a part of third level education and experienced by undergraduate students across a range of degree courses. Stress can be positive in stimulating optimum performance. However, excessive stress leads to distress which is correlated with decreased health related quality of life (1). The aim of this research study is to investigate the causes of stress among undergraduate healthcare professional students in University College Cork (UCC) and to characterise the nature of the stress factors. Methods: All undergraduate students (excluding 1st year students) enrolled in degree courses in the College of Medicine and Health in UCC (Dentistry, Medicine, Nursing and Midwifery (NM), Occupational Therapy (OT), Pharmacy, Public Health Sciences, and Speech and Language Therapy (SLT)) were sent an email inviting them to participate in an anonymous online survey. The survey comprised two parts: (i) the Perceived Stress Scale (PSS) (2), which measures the perception of stress on a scale between 0 and 40, and (ii) a customised Academic Stress Factors survey, in which students gave a rating between 1 (little) and 5 (extreme) of how much stress each factor caused. Data were analysed using IBM SPSS Statistics for Windows, Version 26.0. (Armonk, NY: IBM Corporation). Findings: Of the 227 responses received (88.1% female); the majority were from NM students (46; 20.3%) while both OT and SLT had the fewest at 15 (6.6%) responses each. The mean PSS score for the total cohort was 21.3 with medical students reporting the highest mean score (24.5), signifying higher perceived stress and OT having the lowest mean score (19.0). The distribution of PSS scores did not vary significantly across degree courses, (F=1.555, p=0.162) gender, (t=-1.241, p=0.216) or year of study (F=0.210, p=0.811). ‘End of module examinations’, ‘overall academic workload’, and ‘oral presentations’ were the reasons associated with the highest average scores for causing stress. Conclusion: Stress affects students from all healthcare degree courses within the College of Medicines and Health. This study has identified the areas that seem to contribute most to the perceived stress experienced by students and therefore may signpost where UCC can act to support students

Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England : test negative case-control study

Objective To estimate the real world effectiveness of the Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S vaccines against confirmed covid-19 symptoms (including the UK variant of concern B.1.1.7), admissions to hospital, and deaths. Design Test negative case-control study. Setting Community testing for covid-19 in England. Participants 156 930 adults aged 70 years and older who reported symptoms of covid-19 between 8 December 2020 and 19 February 2021 and were successfully linked to vaccination data in the National Immunisation Management System. Interventions Vaccination with BNT162b2 or ChAdOx1-S. Main outcome measures Primary outcomes were polymerase chain reaction confirmed symptomatic SARS-CoV-2 infections, admissions to hospital for covid-19, and deaths with covid-19. Results Participants aged 80 years and older vaccinated with BNT162b2 before 4 January 2021 had a higher odds of testing positive for covid-19 in the first nine days after vaccination (odds ratio up to 1.48, 95% confidence interval 1.23 to 1.77), indicating that those initially targeted had a higher underlying risk of infection. Vaccine effectiveness was therefore compared with the baseline post-vaccination period. Vaccine effects were noted 10 to 13 days after vaccination, reaching a vaccine effectiveness of 70% (95% confidence interval 59% to 78%), then plateauing. From 14 days after the second dose a vaccination effectiveness of 89% (85% to 93%) was found compared with the increased baseline risk. Participants aged 70 years and older vaccinated from 4 January (when ChAdOx1-S delivery commenced) had a similar underlying risk of covid-19 to unvaccinated individuals. With BNT162b2, vaccine effectiveness reached 61% (51% to 69%) from 28 to 34 days after vaccination, then plateaued. With ChAdOx1-S, effects were seen from 14 to 20 days after vaccination, reaching an effectiveness of 60% (41% to 73%) from 28 to 34 days, increasing to 73% (27% to 90%) from day 35 onwards. On top of the protection against symptomatic disease, a further 43% (33% to 52%) reduced risk of emergency hospital admission and 51% (37% to 62%) reduced risk of death was observed in those who had received one dose of BNT162b2. Participants who had received one dose of ChAdOx1-S had a further 37% (3% to 59%) reduced risk of emergency hospital admission. Follow-up was insufficient to assess the effect of ChAdOx1-S on mortality. Combined with the effect against symptomatic disease, a single dose of either vaccine was about 80% effective at preventing admission to hospital with covid-19 and a single dose of BNT162b2 was 85% effective at preventing death with covid-19. Conclusion Vaccination with either one dose of BNT162b2 or ChAdOx1-S was associated with a significant reduction in symptomatic covid-19 in older adults, and with further protection against severe disease. Both vaccines showed similar effects. Protection was maintained for the duration of follow-up (>6 weeks). A second dose of BNT162b2 was associated with further protection against symptomatic disease. A clear effect of the vaccines against the B.1.1.7 variant was found

Age differences in gain- and loss-motivated attention

Adaptive gain theory (Aston-Jones & Cohen, 2005) suggests that the phasic release of norepinephrine (NE) to cortical areas reflects changes in the utility of ongoing tasks. In the context of aging, this theory raises interesting questions, given that the motivations of older adults differ from those of younger adults. According to socioemotional selectivity theory (Carstensen, Isaacowitz, & Charles, 1999), aging is associated with greater emphasis on emotion-regulation goals, leading older adults to prioritize positive over negative information. This suggests that the phasic release of NE in response to threatening stimuli may be diminished in older adults. In the present study, younger adults (aged 18–34 years) and older adults (60–82 years) completed the Attention Network Test (ANT), modified to include an incentive manipulation. A behavioral index of attentional alerting served as a marker of phasic arousal. For younger adults, this marker correlated with the effect of both gain and loss incentives on performance. For older adults, in contrast, the correlation between phasic arousal and incentive sensitivity held for gain incentives only. These findings suggest that the enlistment of phasic NE activity may be specific to approach-oriented motivation in older adults