BACKGROUND: Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA's have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally. METHODS: Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity. RESULTS: On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism. CONCLUSIONS: Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40557-017-0172-1) contains supplementary material, which is available to authorized users.
Absenteeism ; Anxiety ; Depression ; Developed Countries ; Developing Countries ; Efficiency ; Internship and Residency ; Job Satisfaction ; Linear Models ; Obesity ; Occupational Health* ; Pain Management ; Presenteeism ; Risk Assessment ; Risk Factors ; Work Performance*

BACKGROUND: Benzodiazepines have been used preoperatively as part of an anesthesia regimen to attenuate the anxiety of patients. In this study, we aimed to examine the effect of oral triazolam, a short-acting benzodiazepine, on anxiety, sedation, and amnesia. METHODS: Ninety patients, aged 20–55 years, were randomly assigned to receive no premedication, or to receive triazolam 0.25 mg or 0.375 mg 1 h before anesthesia. Anxiety score, sedation score, blood pressure, heart rate and psychomotor performance were measured on the evening before surgery and on the day of surgery. Additional tests of psychomotor performance were performed in the postanesthesia care unit and on the next day of surgery. The occurrence of amnesia, bispectral index (BIS), recovery profiles and patient satisfaction with overall anesthesia care were also evaluated. RESULTS: Changes in the anxiety and sedation scores on the day of surgery were not significantly different among groups, whereas the increases in systolic blood pressure and heart rate were significantly less in both triazolam groups. The triazolam groups both showed a higher incidence of high satisfaction scores (≥ 2). The two triazolam groups also showed similar outcomes, except for a dose-dependent increase in the number of patients with amnesia and BIS values < 90. Delayed recovery from general anesthesia and psychomotor impairment were not observed in the triazolam groups. CONCLUSIONS: Triazolam 0.25 mg or 0.375 mg reduced the hemodynamic changes associated with anxiety, produced potent amnesia, and improved patient satisfaction. We suggest that triazolam can be used effectively as anesthetic premedication in adults.
Adult ; Amnesia* ; Anesthesia ; Anesthesia, General* ; Anxiety* ; Benzodiazepines ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Patient Satisfaction ; Premedication* ; Psychomotor Disorders ; Psychomotor Performance ; Triazolam*

OBJECTIVES: The purpose of this study was to evaluate anti-depressive effects of exercise on child and adolescent and its association with brain derived neurotrophic factor (BDNF). METHODS: Twenty nine middle school boys (age 13.3±0.7) were divided into two groups, 15 boys for control group and 14 in the experimental group. The control group participated in a regular exercise program, 3 times a week for 15 weeks. During the same period, the experimental group participated in an aerobic exercise program specifically designed to enhance anti-depressive effect of exercise. Serum BDNF level and its performance of each group on the Beck Depression Index (BDI), Children's Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders (SCARED), Aggression Questionnaire (AK-Q), and Stroop task were compared before and after the exercise program. RESULTS: Scores of BDI, CDI, SCARED, and AK-Q were significantly lower in both groups after the exercise programs compared to those before the programs. The Stroop task performances were significantly improved after the programs. However, there were no significant differences between two exercise programs, except SCARED separation anxiety, AK-Q physical, and verbal aggression scores. Also, no association was found between serum BDNF level and anti-depressive effects of exercise. CONCLUSION: Our preliminary results suggest a possible effect of exercise on depression, anxiety, aggression, and cognition of child and adolescents.
Adolescent* ; Aggression ; Anxiety ; Anxiety, Separation ; Brain-Derived Neurotrophic Factor* ; Child ; Cognition ; Depression ; Exercise ; Humans ; Task Performance and Analysis

Etifoxine (etafenoxine, Stresam(R)) is a non-benzodiazepine anxiolytic with an anticonvulsant effect. It was developed in the 1960s for anxiety disorders and is currently being studied for its ability to promote peripheral nerve healing and to treat chemotherapy-induced pain. In addition to being mediated by GABA(A)alpha2 receptors like benzodiazepines, etifoxine appears to produce anxiolytic effects directly by binding to beta2 or beta3 subunits of the GABA(A) receptor complex. It also modulates GABA(A) receptors indirectly via stimulation of neurosteroid production after etifoxine binds to the 18 kDa translocator protein (TSPO) of the outer mitochondrial membrane in the central and peripheral nervous systems, previously known as the peripheral benzodiazepine receptor (PBR). Therefore, the effects of etifoxine are not completely reversed by the benzodiazepine antagonist flumazenil. Etifoxine is used for various emotional and bodily reactions followed by anxiety. It is contraindicated in situations such as shock, severely impaired liver or kidney function, and severe respiratory failure. The average dosage is 150 mg per day for no more than 12 weeks. The most common adverse effect is drowsiness at the initial stage. It does not usually cause any withdrawal syndromes. In conclusion, etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. It potentiates GABA(A) receptor-function by a direct allosteric effect and by an indirect mechanism involving the activation of TSPO. It seems promising that non-benzodiazepine anxiolytics including etifoxine will replenish shortcomings of benzodiazepines and selective serotonin reuptake inhibitors according to animated studies related to TSPO.
Amnesia, Anterograde ; Anti-Anxiety Agents ; Anticonvulsants ; Anxiety Disorders ; Anxiety* ; Benzodiazepines ; Flumazenil ; Humans ; Kidney ; Liver ; Mitochondrial Membranes ; Nerve Regeneration ; Neuralgia ; Neurotransmitter Agents ; Peripheral Nerves ; Peripheral Nervous System ; Psychomotor Performance ; Receptors, GABA-A ; Respiratory Insufficiency ; Serotonin Uptake Inhibitors ; Shock ; Sleep Stages

BACKGROUND: Triazolam has similar pharmacological properties as other benzodiazepines and is generally used as a sedative to treat insomnia. Alprazolam represents a possible alternative to midazolam for the premedication of surgical patients. The purpose of this study was to evaluate the anxiolytic, sedative, and amnestic properties of triazolam and alprazolam as pre-anesthetic medications. METHODS: Sixty adult patients were randomly allocated to receive oral triazolam 0.25 mg or alprazolam 0.5 mg one hour prior to surgery. A structured assessment interview was performed in the operating room (OR), the recovery room, and the ward. The levels of anxiety and sedation were assessed on a 7-point scale (0 = relaxation to 6 = very severe anxiety) and a 5-point scale (0 = alert to 4 = lack of responsiveness), respectively. The psychomotor performance was estimated using a digit symbol substitution test. As a memory test, we asked the patients the day after the surgery if they remembered being moved from the ward to the OR, and what object we had shown them in the OR. RESULTS: There were no significant differences between the groups with respect to anxiety and sedation. The postoperative interviews showed that 22.2% of the triazolam-treated patients experienced a loss of memory in the OR, against a 0% memory loss in the alprazolam-treated patients. In comparison with alprazolam 0.5 mg, triazolam 0.25 mg produced a higher incidence of amnesia without causing respiratory depression. CONCLUSIONS: Oral triazolam 0.25 mg can be an effective preanesthetic medication for psychomotor performance.
Adult ; Alprazolam* ; Amnesia ; Anesthesia, General* ; Anxiety ; Benzodiazepines ; Humans ; Incidence ; Memory ; Memory Disorders ; Midazolam ; Operating Rooms ; Preanesthetic Medication ; Premedication* ; Psychomotor Performance ; Recovery Room ; Relaxation ; Respiratory Insufficiency ; Sleep Initiation and Maintenance Disorders ; Triazolam*

INTRODUCTION: Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Sleep deprivation can have significant effects on athletic performance. However, there are few published data related to the amount of sleep obtained by elite athletes. We investigated sleep patterns of Korean women golfers using sleep-related questionnaires. METHODS: For this study, 98 Korean university women golfers and 46 age- and sex-matched controls were recruited. All subjects were asked to complete the self-administered sleep questionnaire consisting of questions about habitual sleep patterns (sleep onset time, sleep latency, awakening time in the morning, day time napping time), exercise habits, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Pittsburgh Sleep Quality Index (PSQI), validation of the Perceived Stress Scale (PSS), and Beck Anxiety Inventory (BAI). RESULTS: The sleep onset time was significantly earlier (pm 23 : 05 +/- 00 : 52 and 00 : 14 +/- 00 : 51 ; t = 5.287, p < 0.001), the waking time was later (am 07 : 21 +/- 01 : 09 and 6 : 35 +/- 00 : 32; t = -2.715, p = 0.008), the weekday total sleep time was greater (417.77 +/- 78.18 minute and 351.52 +/- 77.83 minute ; t = 4.406, p = 0.001), and the daytime nap time was greater (77.73 +/- 41.28 minute and 20.22 +/- 33.03 minute ; t = 7.623, p < 0.001) in the golf athletes compared to the controls. The PSQI scores were significantly lower, but estimated sleep latency and ESS, ISS, PSS, and BAI scores were not different among the two groups. CONCLUSION: This study suggests that Korean university women golfers have good sleep patterns resulting in no difference in sleep-related stress compared to age- and sex-matched control students.
Anxiety ; Athletes ; Athletic Performance ; Female ; Golf ; Humans ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

Currently, phosphodiesterase type 5 (PDE5) inhibitors are the initial treatment option for erectile dysfunction. The reported efficacy of PDE5 inhibitors is about 70%, although it is significantly lower in difficult-to-treat subpopulations. Treatment failures might be due to the severity of the underlying pathophysiology, improper use of medication, unrealistic patient expectations, difficult relationship dynamics, severe performance anxiety, and other psychological problems. Physicians must address these issues to identify true treatment failures attributable to the drugs. This article discusses factors that might affect the response to PDE5 inhibitors and develops a strategy to maximize the overall efficacy of PDE5 inhibitors in initial non-responders to PDE5 inhibitors.
Carbolines ; Erectile Dysfunction ; Humans ; Imidazoles ; Male ; Performance Anxiety ; Phosphodiesterase 5 Inhibitors ; Piperazines ; Purines ; Sulfones ; Treatment Failure ; Triazines ; Sildenafil Citrate ; Tadalafil ; Vardenafil Dihydrochloride

PURPOSE: Psychiatric problem such as depression and anxiety is prevalent and is associated with morbidity and mortality in hemodialysis patients. But it is difficult to assess and is undertreated. The aim of this study is investigating the prevalence and the risk factors for depression and anxiety among patients receiving maintenance hemodialysis. METHODS: We used the Hospital Anxiety and Depression scale (HADS. Korean version) as a screening test for 104 hemodialysis patients in a single center. Univariate analysis and mutltivariable logistic regression analysis were used to evaluate the association between the psychiatric problem (depression and anxiety) and other patients' factors (social economic factors and medical conditions). RESULTS: The mean age was 58.2+/-12.1 years and the causes of ESRD were diabetes mellitus (50%), hypertension (27.9%), chronic glomerulonephritis (8.7%), and other or unknown causes (14%). The prevalence of depression was 58.7%, and univariate analysis revealed that comorbidity index, Karnofsky index, serum creatinine, and age were statistically significantly correlated with depression. But Multivariable logistic regression analysis demonstrated that only Karnofsky index was independently associated with depression [odds ratio (OR)=5.834, p=0.007]. The prevalence of anxiety was 27.9% and only karnofsky index was significantly correlated with anxiety on both univariate and multivariable logistic regression analysis. CONCLUSION: Depression and anxiety were prevalent in hemodialysis patients. Poor performance status was highly associated with depression and anxiety.
Anxiety ; Comorbidity ; Creatinine ; Depression ; Diabetes Mellitus ; Glomerulonephritis ; Humans ; Hypertension ; Karnofsky Performance Status ; Kidney Failure, Chronic ; Logistic Models ; Mass Screening ; Prevalence ; Renal Dialysis ; Risk Factors

OBJECTIVES: In addition to the main symptoms of posttraumatic stress disorder (PTSD), which include reexperience, avoidance and hyperarousal, many patients complain of cognitive deficits and especially in attention and memory. This study was conducted to evaluate the cognitive deficits of survivors of a tragic shooting incident at a frontline guard post. All of the survivors experienced the same accident, and they were homogeneous in terms of age and education level, which are closely associated with cognitive performance. METHODS: We recruited 12 survivors who suffered from PTSD following the same traumatic incident and we also recruited 12 normal volunteers, and we assessed their neurocognitive functions with using a vigilance test, a continuous attention test, a reaction unit test and the Corsi block tapping test in the computerized Vienna Test System, as well as an auditory verbal learning test and complex figure test in the Rey-Kim Memory Test. Standardized clinical scales, including the Clinician-Administered PTSD Scale, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the State-Trait Anxiety Scale I and II, were used to assess the involved mental areas and the severity of the PTSD symptoms. RESULTS: The patient group showed significant impairments in continuous attention, and the visual and auditory information processing time on the Vienna test when compared to the control group. The patient group also showed significant impairments in the verbal memory, visual memory and visuospatial function on the Rey-Kim Memory Test. CONCLUSION: In this study, the author reports on the cognitive impairments in patients with PTSD as measured by computerized neurocognitive tests and memory tests. Future studies are needed to determine the changes in cognitive functioning that are related to symptom improvement, as well as the influence of the therapeutic effects on the cognitive improvement.
Anxiety ; Automatic Data Processing ; Cognition ; Depression ; Humans ; Memory ; Neuropsychological Tests ; Psychomotor Performance ; Stress Disorders, Post-Traumatic ; Survivors ; Verbal Learning ; Weights and Measures

Objectives : Depression is a common psychiatric disorder in cancer patients. The Brief Edinburgh Depression Scale(BEDS), which is an abbreviated version of the Edinburgh Depression Scale, may serve as a useful tool in screening for the depression in patients with the medical illnesses. This report investigated the reliability and validity of the Korean Version of the BEDS(K-BEDS) for the depression in cancer patients. METHODS : One-hundred cancer patients were enrolled in this study. All subjects completed the K-BEDS, the Hospital Anxiety Depression Scale(HADS), and the Karnofsky Performance Status Scale(KPSS). Reliability, validity and Receiver Operating Characteristic(ROC) curve analysis measures were assessed. RESULTS : The K-BEDS showed good internal consistency(Cronbach alpha=0.77) and test-retest reliability(0.94, p<0.001). All item-total correlations were above 0.3. Also, it revealed moderate correlation with the depression subscale of the HADS(r=0.617), but no correlation with the KPSS. Exploratory factor analysis produced only one factor, accounting for 47.1% of the total variance. The most valid cutoff value to screen for depression was a total score of 5 on the K-BEDS, which showed sensitivity of 62.5% and specificity of 86.4% with a positive predictive value of 4.60 and a negative predictive value of 0.43. CONCLUSION : The present findings suggested that the K-BEDS would have good psychometric properties to screen for the depression in cancer patients.
Accounting ; Anxiety ; Depression ; Humans ; Karnofsky Performance Status ; Mass Screening ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity