Topic: Health & Medicine

Last updated: April 6, 2019

1.0 Introduction
There are a variety of reasons for some people to chewing the gum including to balance the psychological states. There have been many studies that investigate the effects of chewing the gum have given an effect on cognition and mood for example help to reduce stress. Even though the observation provides a lot of useful information on effects of chewing gum to reduce or relieve the stress, there have a limitation number of findings on clinical usage of chewing gum in reducing the stress and depression. Chewing the gum also shown to be associated with significantly higher self-related levels of alertness, reduce the anxiety and stress and decrease the concentration of saliva cortisol. Increased the neural activation is one of the possible mechanisms for this stress reduction, which can facilitate task performance and reduce stress. However, one of the studies that using the anagram stressor task state that chewing the gum cannot decrease the stress levels. (Scholey, Haskel, Robertson, Kennedy, Milne and Watherell, 2009).
Problems that relate with stress are associated to mental dysfunction which can happen in the distant future. Mental health impairing disorder also known as depression is the one of the conditions that can make stress to reach to the maximum levels and cause a cognitive disintegration if does not give a treatment. Unfortunately, many of the untreated case of depression finally result in suicide. (Smith& woods, 2012)
An alternative observation for releasing the stress associated with chewing gum suggests it is epiphenomenal to task facilitation include improve the mood and stress are secondary to a gum-induced benefits to task performance. Consideration state significantly higher task performance for the chewing gum condition compared to the no gum condition. It is reasonable to observe on the mood and stress were consequence of the chewing gum-facilitated reduction in task difficulty. (Zibell& Madansky, 2009)

The suggest that the chewing gum effects on stress and mood must be analog with the intermittent effects study with memory. If chewing the gum does efficient to reduce the stress and improve the mood under condition of multi-task cognitive stress, the current study should replicate the effects. That’s why, the purpose of the study is to observe the relationship between experimental stage and chewing gum, such as mood increase and stress reduction are apparent uniquely for the chewing gum condition but only following the stressor. ( Sasaki-Otomaru, Sakuma, Mochizuki, Ishida, Kanoya; Sato, 2011)
2.0 Problem statement
This study have a certain limitations. First, the limitation of the ability to extrapolate these findings to the general population because of the number of subjects of UiTM Perlis was to small. Second is, this study did not evaluate the level of stress using the salivary cortisol. Third, it is hard to generalized the results because of only one type of gum was used. Other type of gum which is different flavor and hardness may give some useful information. ( Ekuni, Tomofuji, Takeuchi; Morita, 2012)
Many people have experienced stress or anxiety in their life and if left untreated it can lead to death or suicide. they don’t know how to reduce the stress and improve their mood, so the purpose of the study is to observe either chewing the gum could reduce the stress levels and improve the mood.

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3.0 References
Ekuni, D., Tomofuji, Takeuchi, N., & Morita, M. (2012). T., Gum chewing modulates heart rate variability under noise stress. Acta Odontologica Scandinavica, 70(6), 491-496.
Sasaki-Otomaru, A., Sakuma, Y., Mochizuki, Y., Ishida, S., Kanoya, Y., & Sato, C. (2011). Effect of regular gum chewing on levels of anxiety, mood, and fatigue in healthy young adults. Clinical practice and epidemiology in mental health: CP & EMH, 7, 133.
Scholey, A., Haskell, C., Robertson, B., Kennedy, D., Milne, A., & Wetherell, M. (2009). Chewing gum alleviates negative mood and reduces cortisol during acute laboratory psychological stress. Physiology & behavior, 97(3-4), 304-312.
Smith, A. P., & Woods, M. (2012). Effects of chewing gum on the stress and work of university students. Appetite, 58(3), 1037-1040.
Zibell, S., & Madansky, E. (2009). Impact of gum chewing on stress levels: online self-perception research study. Current Medical Research and Opinion, 25(6), 1491-1500.

3.0 Research Questions
1. What are the difference of chewing different amount of gum to stress levels?

4.0 Research Objective
The purpose of this study is to investigate the effectiveness of chewing gum on reducing the stress levels.
5.0 Research Hypothesis
H1: There will be a significant between effect of chewing gum with large amount of gum and small amount of gum on reducing stress levels
H0: There will be no a significant between effect of chewing gum with large amount of gum and small amount of gum on reducing stress level.
6.0 Significance of Study
The primordial purpose of this study is commonly to investigate the effects of chewing gum under acute stress. The results of this study can give benefits to the people especially those have experienced the stress condition because this study showed chewing gum could be the easiest ways or method to reduce the stress level without spend much of their time and also can increase the alertness of the people. By this study, it can help some people to overcome or practice the easiest method to reduce theirs stress level and anxiety.
This study also can give the students and lecturer of the University Teknologi Mara, Arau to have a better understanding and knowledge about stress and the method how to reduce stress level by using chewing gum and they can use this study as their guide to reduce the stress levels.
This study will not only give benefits to people who got stress, but also for other people as it will create a awareness about the stress effect on our psychological. Furthermore, this study will serve as a theoretical model for future studies of the same mature if ever the existing problem has penetrated in this case in the future.

7.0 Definition of Terms
7.1 Stress
Stress is described as a feeling of being overburden, worried or rundown. It can affects of all people by all ages, genders and cause a physical and psychological health issues.
7.2 State-Trait Anxiety Inventory
State- Trait Anxiety Inventory Commonly used instruments for measuring vary levels of anxiety (Scholley, A., Haskell, C. 2009)
7.3 Anxiety
Anxiety describes as a term for several disorders that can lead to the nervousness, fear, and worrying. This disorders can effect the feelings and lead to physical symptom.
7.4 Gum chewing
Gum is the substance that is made from chicle and flavour and sweetened for chewing. Chewing can be describes as a bite or work the food in the mouth using the teeth to make it easy to swallow the food.

References
Scholey, A., Haskell, C., Robertson, B., Kennedy, D., Milne, A., & Wetherell, M. (2009). Chewing gum alleviates negative mood and reduces cortisol during acute laboratory psychological stress. Physiology & behavior, 97(3-4), 304-312.

9.0 RESEARCH METHODOLOGY

9.1 Research Conceptual Framework

Independent variables Dependent variable

9.2 Research Design
Chewing condition was a between subject variable. In order to test both the difference between answer the question in a noise stress environment with chewing the gum and no chewing the gum and dose response. The chewing group were sub- divided into those who chewed a small amount ant those who chewed more in the 14 day period given. The pre-intervention measures of stress level,. The dependent variables were the post- intervention measures of stress and amount of gum regularly chewed.

9.3 Subjects
14 participants who was randomly pick in Uitm Perlis will be involved in this study. All subjects who had a different background and age are volunteer to participated in this study. A set of test on State- Trait Anxiety Inventory will be distributed to each of the 14 subjects. The procedure and the potential benefits of the participants will be explain clearly to the participants. Subjects are prohibited to chew the gum before the test 1 session. After complete the test 1 session, the participants will be given the chewing gum and all of the participants need to chew the gum for 2 weeks until the 2nd test session.
9.4 Procedures
A cross-over study was carried out 14 participants received a stress procedure with gum and without gum. Two experimental test will be held on 2 weeks which each of the test will be separated by 2 weeks gaps. (Ekuni, Tomofuji, Takeuchi& Morita. 2012). Test 1 session will be completed in one day and separately by a 2 weeks gap to giving a time for participants to chew the gum before the 2nd test session. To induce the stress among the participants, they will be answer the question using State-Trait Anxiety Inventory (STAI) while being exposed to the noise for 5 minutes using the headphone for each test session. The test 1 session will be conducted without the gums and the 2nd test session will be conducted after 2 weeks chewing the gum. This test will be conducted in the morning of indoor hall to control the stress during the test.

9.5 Chewing gum and Solution Protocol
The study will be conducted in double blind and cross-over experimental design. The subject will be randomly picked and being told to do a State-Trait Anxiety Inventory (STAI) where the external researcher will prepare the test. The subject will be randomly picked and must to answer to test, the pre- test and post test. In the pre- test, the subject will do the test without chewing any gum in a noise environment, and them the researcher will given the gum to the subjects for 2 weeks until the post-test. In the post test, the same subject will come to the studio in UiTM Perlis and fill the form where the researcher want to know how many gums the subjects have chew in the past 2 weeks. After finish fill the form, the researcher will start the the post- test with the same protocol in the pre-test where the subjects need to answer the STAI test in a noise environment. The subjects will be evaluate by their scale answer and polar heart rate to check their heart rate and their stress level.

9.6 State-Trait Anxiety Inventory
The State- Trait Anxiety Inventory will be conducted in the studio at UiTM Perlis to control the temperature and to make the subjects comfortable to answer the test without any distraction. Subjects will be completed the STAI test consisting of 40 items. The state sub- scale is the instrument that be widely used to measuring fluctuating levels of anxiety. Each of the test, pre- test and post- test will be conducted 5 minutes duration for each subjects. The meaning of state anxiety is a degree or levels of stress at a particular time. The STAI that be used for this study was a true and subjective marker for evaluate the stress levels.

9.7 Chewing gum and Testing Program
1. The subjects will be the students of UiTM Arau, Perlis and randomly picked for this study.
2. Subjects will be told to get involve with this study where they need to answer the STAI for the next day.
3. Upon subjects arrived in the hall, the subject will have to filled the form that require their age, and their gender.
4. The subjects will be given a bread and a bottle of mineral water to standardized the mood.
5. They will be briefly explain by an examiner about the procedure of the test.
6. The subjects will be divided into 2 groups consist of 7 people to easier the examiner to supervise the test.
7. The test will be conducted 5 min for each group.
8. The subjects will be provide the STAI question and each of the subjects need to answer the test for 5 minutes using the earphone.
9. The measurement of heart rate, rating perceived scale and polar heart rate will be recorded for pre and post of the experimental trials.
10. For the post- test, the subjects will be given the gum and need to chew the gum for a 2 weeks after finish the pre- test.
11. After 2 weeks gap, the subjects need to come to the studio to take the post test.
12. They need to fill up the form that require them to state how many gums they eat for 2 weeks.
13. After finish the form, the post test will be conducted with the same protocol in the pre- test where the subjects need to answer the STAI in a noise while chewing the gum.
14. The amount of gum, degree of anxiety and level of stress will be taken to record the performance of the subjects.

9.8 Treatment Program
Table 1: Different mouth rinse protocols and testing program.

Pre-Test Gap Post- test

Protocols 1 day 2 weeks
(rest) 1 day

Gums
? ?

10.0 Stastical Analysis
The unpaired t-test had been used to compare the parameter between the GS and S groups or between the GS and S groups. Besides that, the phase 2 score was compared using the analysis of covariance (ANCOVA) (baseline score as the covariate; gum conditions and noise conditions as the independent variables). A p-value < 0.05 was considered significant. All data were analysed using SPSS 15.0 J for Windows (SPSS Japan, Tokyo, Japan). (Ekuni, Tomofuji, Takeuchi & Manabu Morita, 2012)

11.0 References

Ekuni, D., Tomofuji, Takeuchi, N., & Morita, M. (2012). T., Gum chewing modulates heart rate variability under noise stress. Acta Odontologica Scandinavica, 70(6), 491-496.

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