The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation

The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We e...

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Autores:
Ramírez-Adrados, Ana
Martínez-Pascual, Beatriz
González-de-Ramos, Cristina
Fernández Martínez, Silvia
Fernández-Elías, Valentín Emilio
Clemente-Suárez, Vicente Javier
Tipo de recurso:
Article of journal
Fecha de publicación:
2021
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/8288
Acceso en línea:
https://hdl.handle.net/11323/8288
https://doi.org/10.3390/ijerph18084035
https://repositorio.cuc.edu.co/
Palabra clave:
Autonomic modulation
Multiculturalism
Heart rate variability
Stress
University
Physiotherapy academic achievement
Rights
openAccess
License
CC0 1.0 Universal
id RCUC2_df6e803c63ece5079f92d4f1b95ca14d
oai_identifier_str oai:repositorio.cuc.edu.co:11323/8288
network_acronym_str RCUC2
network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.spa.fl_str_mv The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
title The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
spellingShingle The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
Autonomic modulation
Multiculturalism
Heart rate variability
Stress
University
Physiotherapy academic achievement
title_short The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
title_full The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
title_fullStr The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
title_full_unstemmed The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
title_sort The impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertation
dc.creator.fl_str_mv Ramírez-Adrados, Ana
Martínez-Pascual, Beatriz
González-de-Ramos, Cristina
Fernández Martínez, Silvia
Fernández-Elías, Valentín Emilio
Clemente-Suárez, Vicente Javier
dc.contributor.author.spa.fl_str_mv Ramírez-Adrados, Ana
Martínez-Pascual, Beatriz
González-de-Ramos, Cristina
Fernández Martínez, Silvia
Fernández-Elías, Valentín Emilio
Clemente-Suárez, Vicente Javier
dc.subject.spa.fl_str_mv Autonomic modulation
Multiculturalism
Heart rate variability
Stress
University
Physiotherapy academic achievement
topic Autonomic modulation
Multiculturalism
Heart rate variability
Stress
University
Physiotherapy academic achievement
description The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-05-27T18:27:25Z
dc.date.available.none.fl_str_mv 2021-05-27T18:27:25Z
dc.date.issued.none.fl_str_mv 2021-04-12
dc.type.spa.fl_str_mv Artículo de revista
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.content.spa.fl_str_mv Text
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/article
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dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
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dc.identifier.issn.spa.fl_str_mv 1660-4601
1661-7827
dc.identifier.uri.spa.fl_str_mv https://hdl.handle.net/11323/8288
dc.identifier.doi.spa.fl_str_mv https://doi.org/10.3390/ijerph18084035
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC - Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
identifier_str_mv 1660-4601
1661-7827
Corporación Universidad de la Costa
REDICUC - Repositorio CUC
url https://hdl.handle.net/11323/8288
https://doi.org/10.3390/ijerph18084035
https://repositorio.cuc.edu.co/
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.references.spa.fl_str_mv 1. Wächter, B. The Bologna Process: Developments and Prospects. Eur. J. Educ. 2004, 39, 265–273. [CrossRef]
2. Powell, J.J.W.; Finger, C. The Bologna Process’s Model of Mobility in Europe: The relationship of its spatial and social dimensions. Eur. Educ. Res. J. 2013, 12, 270–285. [CrossRef]
3. Todd, M.; Bannister, P.; Clegg, S. Independent inquiry and the undergraduate dissertation: Perceptions and experiences of final-year social science students. Assess. Eval. High. Educ. 2004, 29, 335–355. [CrossRef]
4. Webster, F.; Pepper, D.; Jenkins, A. Assessing the undergraduate dissertation. Assess. Eval. High. Educ. 2000, 25, 71–80. [CrossRef]
5. Bellido, A.; Ruisoto, P.; Beltran-Velasco, A.; Clemente-Suárez, V.J. State of the Art on the Use of Portable Digital Devices to Assess Stress in Humans. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]
6. Clemente-Suárez, V.J.; Arroyo-Toledo, J.J. Use of Biotechnology Devices to Analyse Fatigue Process in Swimming Training. J. Med. Syst. 2017, 41, 513–516. [CrossRef] [PubMed]
7. Fuentes, J.P.; Villafaina, S.; Collado-Mateo, D.; de la Vega, R.; Gusi, N.; Clemente-Suárez, V.J. Use of Biotechnological Devices in the Quantification of Psychophysiological Workload of Professional Chess Players. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]
8. Beltrán-Velasco, A.I.; Ruisoto-Palomera, P.; Bellido-Esteban, A.; García-Mateos, M.; Clemente-Suárez, V.J. Analysis of Psychophysiological Stress Response in Higher Education Students Undergoing Clinical Practice Evaluation. J. Med. Syst. 2019, 43. [CrossRef]
9. Sánchez-Conde, P.; Beltrán-Velasco, A.I.; Clemente-Suárez, V.J. Influence of psychological profile in autonomic response of nursing students in their first hospital clinical stays. Physiol. Behav. 2019, 207, 99–103. [CrossRef]
10. Clemente-Suárez, V.J.; Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P. Autonomic Adaption to Clinical Simulation in Psychology Students: Teaching Applications. Appl. Psychophysiol. Biofeedback 2018, 43, 239–245. [CrossRef]
11. Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P.; Clemente-Suárez, V.J. Use of Portable Digital Devices to Analyze Autonomic Stress Response in Psychology Objective Structured Clinical Examination. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]
12. Beltrán-Velasco, A.I.; Mendoza-Castejón, D.; Fuentes-García, J.P.; Clemente-Suárez, V.J. Behavioural, psychological, and physiological stress markers and academic performance in immigrant and non-immigrant preschool and school students. Physiol. Behav. 2020. [CrossRef]
13. Delgado-Moreno, R.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Combat Stress Decreases Memory of Warfighters in Action. J. Med. Syst. 2017, 41. [CrossRef] [PubMed]
14. Delgado-Moreno, R.; Robles-Pérez, J.J.; Aznar-Laín, S.; Clemente-Suárez, V.J. Effect of Experience and Psychophysiological Modification by Combat Stress in Soldier’s Memory. J. Med. Syst. 2019, 43, 1–8. [CrossRef] [PubMed]
15. Kane, M.J.; Engle, R.W. The role of prefrontal cortex in working-memory capacity, executive attention, and general T. Wynn, F. Cool. J. Hum. Evol. 2002, 46, 341–365.
16. Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P.; Mendoza, K.H.; Clemente-Suárez, V.J. The Effect of Cultural Differences in Psychophysiological Stress Response in High Education Context: A Pilot Study. Appl. Psychophysiol. Biofeedback 2019. [CrossRef] [PubMed]
17. Hoffman-Goetz, L.; Pedersen, B.K. Exercise and the immune system: A model of the stress response? Immunol. Today 1994, 15, 382–387. [CrossRef]
18. Kitraki, E.; Soulis, G.; Gerozissis, K. Impaired neuroendocrine response to stress following a short-term fat-enriched diet. Neuroendocrinology 2004, 79, 338–345. [CrossRef] [PubMed]
19. Redondo Flórez, L.; Tornero-Aguilera, J.F.; Clemente-Suárez, V.J. Could academic experience modulate psychophysiological stress response of biomedical sciences students in laboratory? Physiol. Behav. 2020. [CrossRef]
20. Mendoza-Castejon, D.; Fraile-García, J.; Diaz-Manzano, M.; Fuentes-Garcia, J.P.; Clemente-Suárez, V.J. Differences in the autonomic nervous system stress status of urban and rural school teachers. Physiol. Behav. 2020. [CrossRef] [PubMed]
21. Mendoza-castejón, D.; Clemente-suárez, V.J. Psychophysiological stress markers and behavioural differences between rural and city primary school students. Int. J. Environ. Res. Public Health 2020, 17, 3157. [CrossRef]
22. Mendoza-Castejón, D.; Clemente-Suárez, V.J. Autonomic profile, physical activity, body mass index and academic performance of school students. Sustainability 2020, 12, 6718. [CrossRef]
23. Beltrán-Velasco, A.I.; Sánchez-Conde, P.; Ramos-Campo, D.J.; Clemente-Suárez, V.J. Monitorization of Autonomic Stress Response of Nurse Students in Hospital Clinical Simulation. BioMed Res. Int. 2021, 2021. [CrossRef] [PubMed]
24. Clemente-Suarez, V.J.; Herrera-Mendoza, K.; Montañez-Romero, M.; Navarro, M.C.; Crespo-Ribera, W.; Vargas, C.; Arroyo-Alvis, K.; Morales, M.; Fábregas, L.; Cadena-Díaz, I.; et al. Respuesta Autonómica de estrés en estudiantes de Doctorado. Cult. Educ. Soc. 2020, 12, 9–18. [CrossRef]
25. Redondo-Flórez, L.; Fernández-Lucas, J.; Clemente-Suárez, V.J. Cultural differences in stress-related psychological, nutrition, physical activity and oral health factors of professors. Nutrients 2020, 12, 3644. [CrossRef] [PubMed]
26. Zivojinovic, J.I. Gender differences in academic stress and burnout among medical students in final years of education. Psychiatr. Danub. 2018, 24, 175–181.
27. Wang, H.F.; Yeh, M.C. Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam. J. Nurs. Res. 2005, 13, 106–116. [CrossRef]
28. Clemente-Suárez, V.J.; Fernandes, R.J.; Arroyo-Toledo, J.J.; Figueiredo, P.; González-Ravé, J.M.; Vilas-Boas, J.P. Autonomic adaptation after traditional and reverse swimming training periodizations. Acta Physiol. Hung. 2015, 102, 105–113. [CrossRef] [PubMed]
29. Clemente-Suárez, V.J.; Diaz-Manzano, M. Evaluation of Central Fatigue by the Critical Flicker Fusion Threshold in Cyclists. J. Med. Syst. 2019, 43. [CrossRef]
30. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 2019, 208. [CrossRef]
31. Clemente-Suárez, V.J. The Application of Cortical Arousal Assessment to Control Neuromuscular Fatigue During Strength Training. J. Mot. Behav. 2017. [CrossRef]
32. Belinchón-deMiguel, P.; Tornero-Aguilera, J.F.; Dalamitros, A.A.; Nikolaidis, P.T.; Rosemann, T.; Knechtle, B.; Clemente-Suárez, V.J. Multidisciplinary Analysis of Differences Between Finisher and Non-finisher Ultra-Endurance Mountain Athletes. Front. Physiol. 2019, 10, 1507. [CrossRef] [PubMed]
33. Uusitalo, A.L.T.; Uusitalo, A.J.; Rusko, H.K. Exhaustive endurance training for 6-9 weeks did not induce changes in intrinsic heart rate and cardiac autonomic modulation in female athletes. Int. J. Sports Med. 1998. [CrossRef] [PubMed]
34. Diaz-Manzano, M.; Fuentes, J.P.; Fernandez-Lucas, J.; Aznar-Lain, S.; Clemente-Suárez, V.J. Higher use of techniques studied and performance in melee combat produce a higher psychophysiological stress response. Stress Health 2018, 34, 622–628. [CrossRef] [PubMed]
35. Ramírez-Adrados, A.; Fernández-Martínez, S.; Martínez-Pascual, B.; Gonzalez-de-Ramos, C.; Fernández-Elías, V.E.; ClementeSuárez, V.J. Psychophysiological stress response of physiotherapy last year students in his final degree dissertation. Physiol. Behav. 2020, 222, 112928. [CrossRef]
36. Clemente-Suárez, V.J.; Robles-Pérez, J.J. Psycho-physiological response of soldiers in urban combat. Anal. Psicol. 2013, 29, 598–603. [CrossRef]
37. Clemente-Suárez, V.J. Multidisciplinary intervention in the treatment of mixed anxiety and depression disorder. Physiol. Behav. 2020. [CrossRef]
38. Clemente-Suárez, V.J.; Robles-Pérez, J.J.; Fernández-Lucas, J. Psycho-physiological response in an automatic parachute jump. J. Sports Sci. 2017, 35, 1872–1878. [CrossRef] [PubMed]
39. Belinchon-deMiguel, P.; Clemente-Suárez, V.J. Psychophysiological, Body Composition, Biomechanical and Autonomic Modulation Analysis Procedures in an Ultraendurance Mountain Race. J. Med. Syst. 2018, 42. [CrossRef]
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spelling Ramírez-Adrados, AnaMartínez-Pascual, BeatrizGonzález-de-Ramos, CristinaFernández Martínez, SilviaFernández-Elías, Valentín EmilioClemente-Suárez, Vicente Javier2021-05-27T18:27:25Z2021-05-27T18:27:25Z2021-04-121660-46011661-7827https://hdl.handle.net/11323/8288https://doi.org/10.3390/ijerph18084035Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.Ramírez-Adrados, Ana-will be generated-orcid-0000-0001-9146-879X-600Martínez-Pascual, BeatrizGonzález-de-Ramos, CristinaFernández Martínez, Silvia-will be generated-orcid-0000-0002-9093-4100-600Fernández-Elías, Valentín EmilioClemente-Suárez, Vicente Javier-will be generated-orcid-0000-0002-2397-2801-600application/pdfengCorporación Universidad de la CostaCC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2International Journal of Environmental Research and Public Healthhttps://www.mdpi.com/1660-4601/18/8/4035Autonomic modulationMulticulturalismHeart rate variabilityStressUniversityPhysiotherapy academic achievementThe impact of nationality on the psychophysiological stress response and academic fulfilment in the final degree dissertationArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersion1. Wächter, B. The Bologna Process: Developments and Prospects. Eur. J. Educ. 2004, 39, 265–273. [CrossRef]2. Powell, J.J.W.; Finger, C. The Bologna Process’s Model of Mobility in Europe: The relationship of its spatial and social dimensions. Eur. Educ. Res. J. 2013, 12, 270–285. [CrossRef]3. Todd, M.; Bannister, P.; Clegg, S. Independent inquiry and the undergraduate dissertation: Perceptions and experiences of final-year social science students. Assess. Eval. High. Educ. 2004, 29, 335–355. [CrossRef]4. Webster, F.; Pepper, D.; Jenkins, A. Assessing the undergraduate dissertation. Assess. Eval. High. Educ. 2000, 25, 71–80. [CrossRef]5. Bellido, A.; Ruisoto, P.; Beltran-Velasco, A.; Clemente-Suárez, V.J. State of the Art on the Use of Portable Digital Devices to Assess Stress in Humans. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]6. Clemente-Suárez, V.J.; Arroyo-Toledo, J.J. Use of Biotechnology Devices to Analyse Fatigue Process in Swimming Training. J. Med. Syst. 2017, 41, 513–516. [CrossRef] [PubMed]7. Fuentes, J.P.; Villafaina, S.; Collado-Mateo, D.; de la Vega, R.; Gusi, N.; Clemente-Suárez, V.J. Use of Biotechnological Devices in the Quantification of Psychophysiological Workload of Professional Chess Players. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]8. Beltrán-Velasco, A.I.; Ruisoto-Palomera, P.; Bellido-Esteban, A.; García-Mateos, M.; Clemente-Suárez, V.J. Analysis of Psychophysiological Stress Response in Higher Education Students Undergoing Clinical Practice Evaluation. J. Med. Syst. 2019, 43. [CrossRef]9. Sánchez-Conde, P.; Beltrán-Velasco, A.I.; Clemente-Suárez, V.J. Influence of psychological profile in autonomic response of nursing students in their first hospital clinical stays. Physiol. Behav. 2019, 207, 99–103. [CrossRef]10. Clemente-Suárez, V.J.; Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P. Autonomic Adaption to Clinical Simulation in Psychology Students: Teaching Applications. Appl. Psychophysiol. Biofeedback 2018, 43, 239–245. [CrossRef]11. Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P.; Clemente-Suárez, V.J. Use of Portable Digital Devices to Analyze Autonomic Stress Response in Psychology Objective Structured Clinical Examination. J. Med. Syst. 2018, 42. [CrossRef] [PubMed]12. Beltrán-Velasco, A.I.; Mendoza-Castejón, D.; Fuentes-García, J.P.; Clemente-Suárez, V.J. Behavioural, psychological, and physiological stress markers and academic performance in immigrant and non-immigrant preschool and school students. Physiol. Behav. 2020. [CrossRef]13. Delgado-Moreno, R.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Combat Stress Decreases Memory of Warfighters in Action. J. Med. Syst. 2017, 41. [CrossRef] [PubMed]14. Delgado-Moreno, R.; Robles-Pérez, J.J.; Aznar-Laín, S.; Clemente-Suárez, V.J. Effect of Experience and Psychophysiological Modification by Combat Stress in Soldier’s Memory. J. Med. Syst. 2019, 43, 1–8. [CrossRef] [PubMed]15. Kane, M.J.; Engle, R.W. The role of prefrontal cortex in working-memory capacity, executive attention, and general T. Wynn, F. Cool. J. Hum. Evol. 2002, 46, 341–365.16. Beltrán-Velasco, A.I.; Bellido-Esteban, A.; Ruisoto-Palomera, P.; Mendoza, K.H.; Clemente-Suárez, V.J. The Effect of Cultural Differences in Psychophysiological Stress Response in High Education Context: A Pilot Study. Appl. Psychophysiol. Biofeedback 2019. [CrossRef] [PubMed]17. Hoffman-Goetz, L.; Pedersen, B.K. Exercise and the immune system: A model of the stress response? Immunol. Today 1994, 15, 382–387. [CrossRef]18. Kitraki, E.; Soulis, G.; Gerozissis, K. Impaired neuroendocrine response to stress following a short-term fat-enriched diet. Neuroendocrinology 2004, 79, 338–345. [CrossRef] [PubMed]19. Redondo Flórez, L.; Tornero-Aguilera, J.F.; Clemente-Suárez, V.J. Could academic experience modulate psychophysiological stress response of biomedical sciences students in laboratory? Physiol. Behav. 2020. [CrossRef]20. Mendoza-Castejon, D.; Fraile-García, J.; Diaz-Manzano, M.; Fuentes-Garcia, J.P.; Clemente-Suárez, V.J. Differences in the autonomic nervous system stress status of urban and rural school teachers. Physiol. Behav. 2020. [CrossRef] [PubMed]21. Mendoza-castejón, D.; Clemente-suárez, V.J. Psychophysiological stress markers and behavioural differences between rural and city primary school students. Int. J. Environ. Res. Public Health 2020, 17, 3157. [CrossRef]22. Mendoza-Castejón, D.; Clemente-Suárez, V.J. Autonomic profile, physical activity, body mass index and academic performance of school students. Sustainability 2020, 12, 6718. [CrossRef]23. Beltrán-Velasco, A.I.; Sánchez-Conde, P.; Ramos-Campo, D.J.; Clemente-Suárez, V.J. Monitorization of Autonomic Stress Response of Nurse Students in Hospital Clinical Simulation. BioMed Res. Int. 2021, 2021. [CrossRef] [PubMed]24. Clemente-Suarez, V.J.; Herrera-Mendoza, K.; Montañez-Romero, M.; Navarro, M.C.; Crespo-Ribera, W.; Vargas, C.; Arroyo-Alvis, K.; Morales, M.; Fábregas, L.; Cadena-Díaz, I.; et al. Respuesta Autonómica de estrés en estudiantes de Doctorado. Cult. Educ. Soc. 2020, 12, 9–18. [CrossRef]25. Redondo-Flórez, L.; Fernández-Lucas, J.; Clemente-Suárez, V.J. Cultural differences in stress-related psychological, nutrition, physical activity and oral health factors of professors. Nutrients 2020, 12, 3644. [CrossRef] [PubMed]26. Zivojinovic, J.I. Gender differences in academic stress and burnout among medical students in final years of education. Psychiatr. Danub. 2018, 24, 175–181.27. Wang, H.F.; Yeh, M.C. Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam. J. Nurs. Res. 2005, 13, 106–116. [CrossRef]28. Clemente-Suárez, V.J.; Fernandes, R.J.; Arroyo-Toledo, J.J.; Figueiredo, P.; González-Ravé, J.M.; Vilas-Boas, J.P. Autonomic adaptation after traditional and reverse swimming training periodizations. Acta Physiol. Hung. 2015, 102, 105–113. [CrossRef] [PubMed]29. Clemente-Suárez, V.J.; Diaz-Manzano, M. Evaluation of Central Fatigue by the Critical Flicker Fusion Threshold in Cyclists. J. Med. Syst. 2019, 43. [CrossRef]30. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 2019, 208. [CrossRef]31. Clemente-Suárez, V.J. The Application of Cortical Arousal Assessment to Control Neuromuscular Fatigue During Strength Training. J. Mot. Behav. 2017. [CrossRef]32. Belinchón-deMiguel, P.; Tornero-Aguilera, J.F.; Dalamitros, A.A.; Nikolaidis, P.T.; Rosemann, T.; Knechtle, B.; Clemente-Suárez, V.J. Multidisciplinary Analysis of Differences Between Finisher and Non-finisher Ultra-Endurance Mountain Athletes. Front. Physiol. 2019, 10, 1507. [CrossRef] [PubMed]33. Uusitalo, A.L.T.; Uusitalo, A.J.; Rusko, H.K. Exhaustive endurance training for 6-9 weeks did not induce changes in intrinsic heart rate and cardiac autonomic modulation in female athletes. Int. J. Sports Med. 1998. [CrossRef] [PubMed]34. Diaz-Manzano, M.; Fuentes, J.P.; Fernandez-Lucas, J.; Aznar-Lain, S.; Clemente-Suárez, V.J. Higher use of techniques studied and performance in melee combat produce a higher psychophysiological stress response. Stress Health 2018, 34, 622–628. [CrossRef] [PubMed]35. Ramírez-Adrados, A.; Fernández-Martínez, S.; Martínez-Pascual, B.; Gonzalez-de-Ramos, C.; Fernández-Elías, V.E.; ClementeSuárez, V.J. Psychophysiological stress response of physiotherapy last year students in his final degree dissertation. Physiol. Behav. 2020, 222, 112928. [CrossRef]36. Clemente-Suárez, V.J.; Robles-Pérez, J.J. Psycho-physiological response of soldiers in urban combat. Anal. Psicol. 2013, 29, 598–603. [CrossRef]37. Clemente-Suárez, V.J. Multidisciplinary intervention in the treatment of mixed anxiety and depression disorder. Physiol. Behav. 2020. [CrossRef]38. Clemente-Suárez, V.J.; Robles-Pérez, J.J.; Fernández-Lucas, J. Psycho-physiological response in an automatic parachute jump. J. Sports Sci. 2017, 35, 1872–1878. [CrossRef] [PubMed]39. Belinchon-deMiguel, P.; Clemente-Suárez, V.J. Psychophysiological, Body Composition, Biomechanical and Autonomic Modulation Analysis Procedures in an Ultraendurance Mountain Race. J. Med. Syst. 2018, 42. 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