International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% (n = 363). While the majority of the students (74.7%; n = 271) said that they had used substances to improve cognitive functions, only 2 students (0.6%) reported the use of prescription-only medications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students (n = 295). A positive attitude toward use was held by 60.3% (n = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the following variables were related to the propensity to use substances as CE: male gender, self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days.

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Background: Evidence suggests increased anxious-depressive symptoms in the general population during the COVID-19 pandemic, also in its second wave. High symptom variability across individuals suggests that risk and protective factors, including coping strategies, can play a mediating role. Methods: General Anxiety Disorder-7, Patient Health Questionnaire-9, and Brief-COPE questionnaires were administered to people attending a COVID-19 point-of-care. Univariate and multivariate methods were used to test the association of symptoms with risk and protective factors. Results: A total of 3509 participants (27.5% with moderate-severe anxiety; 12% with depressive symptoms) were recruited. Sociodemographic and lifestyle factors, including age, sex, sleep, physical activity, psychiatric treatments, parenthood, employment, and religiosity were associated with affective symptoms. Avoidant (self-distraction, venting, behavioral disengagement) and approach (emotional support, self-blame but not positive reframing and acceptance) coping strategies predicted greater anxiety. Avoidant strategies, including venting, denial, behavioral disengagement, substance use, and self-blame, and the humor strategy were associated with more severe depressive symptoms, while the planning predicted the opposite. Conclusions: Coping strategies, in addition to socio-demographic and life-habit factors, could have contributed to modulating anxious and depressive symptoms during the second-wave of the COVID-19 pandemic, thus advocating for interventions aimed at promoting positive coping strategies to reduce the psychosocial toll of the pandemic.

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IntroductionCardiac surgery is being performed more frequently in octogenarians with huge pressure on health care resources. Quality of Life (QoL) improvement should be the primary goal in this high-risk patients.Aims/objectivesThis study evaluates the feasibility of QoL assessment in octogenarians after cardiac surgery.MethodsQoL was assessed by three self-administered psychometric tests: modified Seattle Angina Questionnaire, SF-36, and Hospital Anxiety and Depression Scale. QoL was evaluated after a mean time of 5.5 years after operation in 86 patients, and before and 6 months after surgery in 21 patients.ResultsRetrospective evaluation of QoL showed absence of physical limitation in 50% of patients, treatment satisfaction in 80%, symptoms-free conditions in 62%, poor or absent disease perception in 94%, satisfactory wellbeing and enjoyment of life in 78%. QoL six-month variance analysis showed significant improvement in 4 of 5 modified SAQ domains (except of Treatment Satisfaction), 6 of 8 SF-36 domains (except of Emotional Role Limitation and Vitality), and in both depression and anxiety HADS subscales. However, test's self-administration failed, always necessitating physician and relatives’ help. Moreover, several questions showed to be unfit for this subset of patients.ConclusionsDespite the emerged limitations using these tests, cardiac surgery seems to improve QoL in octogenarians with cardiac disease. After 5 years the prevalence of physical disability, cardiac symptoms and functional limitation due to cardiac symptoms, are comparable to the overall octogenarian population. QoL improvement appears more evident 6 months after the operation. New suitable tests are required for old patients.