The dimensional structure of medical students' perceptions of diseases

First- and second-year medical students rated 35 diseases (e.g., cancer, heart attack, herpes, schizophrenia, alcoholism) on nine different rating scales (e.g., prognosis, ease of management). In order to uncover the underlying dimensional structure, mean ratings were subjected to multidimensional scaling analyses in which both diseases and rating scales were placed in the same configuration. The results indicated that a two-dimensional solution, accounting for 97% of the variance, was most appropriate. The first dimension distinguishes between diseases that appear to be more physiological in nature and those that have some psychological involvement as well. The second dimension seems most related to fear, seriousness, prognosis, patient desirability, and ease of management.The research reported in this paper was supported in part by Grant CA 18002-08 from the National Cancer Institute.     

The impact of contextual cues on the interpretation of and response to physical symptoms: A vignette approach

This study examined the impact of two contextual cues—stress and aging—on conceptualizations of, and health care responses to, physical symptoms. Eighty-three undergraduates each read four vignettes describing a woman experiencing physical symptoms indicative of either heart attack, depression, ulcer, or flu. Subjects were randomly assigned to one of six age/stress cue combinations. Consistent with predictions, physical symptoms presented with stress cues were less likely to be attributed to acute illness and were seen as more variable. The effect was most pronounced for heart attack symptoms, which, when presented with stress cues, were also less likely (1) to be identified as a heart attack, (2) to be attributed to chronic illness, (3) to elicit recommendations to seek medical care, (4) and to be regarded as serious. The age manipulation did not exert an effect. Implications of these findings and limitations of the vignette approach are discussed.Portions of this article were presented at the meetings of the Society for Behavioral Medicine, Chicago, 1990, and the Canadian Psychological Association, Ottawa, June 1990. This project formed the basis of the second author's honours thesis.     

Menstrual symptoms in college students: A controlled study

Thirty-five male and thirty-five female subjects completed daily a checklist consisting of 15 symptoms commonly associated with menstrual distress. Premenstrual, menstrual, and midcycle days' ratings were compared within and across groups. Males and females did not differ in symptom ratings during the premenstrual and midcycle periods. Females reported experiencing more sharp cramps, dull cramps, stomach pain, and bloating during the menstrual period: Females reported these symptoms to be only modestly distressing.     

Medical students' perceptions of their housestaffs' ability to teach physical examination skills.

PURPOSE: To evaluate the amount of time housestaff spent at the bedside on physical examination skills with third-year medical students and whether housestaff enhanced physical examination skills. METHOD: All Albert Einstein College of Medicine students who completed the third-year medicine inpatient clerkship at one of five participating sites evaluated housestaff (interns and residents) with whom they spent at least ten days. The students quantified the amount of time housestaff spent with them at the bedside and used a modified five-point Likert scale to evaluate housestaff's enhancement of students' physical examination skills. Data were analyzed separately for interns, but pooled for residents (years two and three). Differences between groups were tested using Wilcoxon rank-sum and by Mantel-Haenszel chi-square tests. RESULTS: Totals of 191 responses for interns and 166 responses for residents were collected from October 1999 to October 2000. Fifteen (8%) of the intern group and 59 (36%) of the resident group spent no time at the bedside (p <.0001). Students were most satisfied with enhancement of pulmonary, cardiovascular, and gastrointestinal skills and least satisfied with enhancement of ENT, eye, and genitourinary skills (p <.0001). CONCLUSIONS: Interns spent more time with students than did residents. Almost one third of the residents spent no time on physical examination skills with students. Training programs should re-emphasize the importance of housestaff's teaching at the bedside and address areas of deficiency.     

粤西地区高校大学生体质与体育成绩的关系研究

目的对粤西地区高校大学生体质现状进行研究,为体育选材、体育锻炼提供依据。方法按田径竞赛规则和教学大纲进行测试。结果得出了粤西地区高校大学生身高分类、马氏躯干腿长指数、劳雷尔指数及100米跑成绩、立定跳远、男引体向上、女仰卧起坐、男1000米跑、女800米跑的成绩。身高以马丁六段为多,高身材青少年躯干高、重心上移,腿长、身体负重轻。结论粤西地区高校大学生在立定跳远、短跑等素质方面拥有一定优势,在体力、劳动能力方面拥有较大的发展潜力。     

Changes in physical symptoms during the menopause transition

This article analyzes physical symptoms experienced by mid-age Australian women in different stages of the menopause transition. A total of 8,623 women, aged 45 to 50 years in 1996, who participated the mid-age cohort of the Australian Longitudinal Study on Women’s Health, completed Survey 1 in 1996 and Survey 2 in 1998. Women were assignedto 1 of6menopause groups according totheir menopausal status at Surveys 1 and 2, and compared on symptoms experienced at Surveys 1 and 2, adjusted for lifestyle, behavioral and demographic factors. At Survey 1, the most commonly reported symptoms were headaches, back pain, stiff joints, tiredness, and difficulty sleeping. Perimenopausal women were more likely than premenopausal or postmenopausal women to report these symptoms. Hot flushes and night sweats were more common among postmenopausal women. Compared with those who remained premenopausal, women who were in the early stages of menopause or perimenopausal were more likely to report tiredness, stiff joints, difficulty sleeping, and hot flushes at Survey 2. Women who remained perimenopausal were also more likely to report back pain and leaking urine. Compared with premenopausal women, odds ratios for night sweats increased for women in consecutive stages of the menopause transition and remained high in the postmenopausal women. The Women’s Health Australia project, which was conceived and developedby groups ofinterdisciplinary researchers at the Universities of Newcastle and Queensland, is funded by the Commonwealth DepartmentofHealth and Aged Care. The supportofEli Lilly for partofthe analysis costs for this article is gratefully acknowledged. Finally, we would like to thank all the participants for their valuable contribution to this project.     

University students' perceptions and factors contributing to obesity and overweigh in Southern of Morocco

BackgroundWeight load is a cosmopolitan health problem. In Morocco, women are the most affected by the phenomenon since obesity has risen from 26.8% to 29.0%.ObjectiveTo determine the prevalence of weight load and associated factors among female students in higher education.MethodsData were collected by a questionnaire. Anthropometric measurements were made using a scale and a wall-mounted scale. Data were analysed by the statistical software SPSS version 13.0. Quantitative variables were described in mean ± standard deviation. Factors associated with obesity were determined by binary logistic regression.ResultsAbout two-thirds of the students had a normal weight, 21% were overweight and 3% were obese. In addition, 58% of students were physically inactive and 77% ate cake and fast food. In addition, 63% of students were dissatisfied with their weight. A significant relationship is found between level of primary education, type of establishment, cake and fast food consumption and weight load.ConclusionThe results revealed that 24% of participants were weight load and had behavioral risk factors such as a sedentary lifestyle and an unbalanced diet, which requires the promotion of a healthy lifestyle among these students as well as psychological support for those dissatisfied with their body image.     

粤西大学生体质发育的研究

目的对粤西大学生进行体质发育的研究,了解其体质发育状况规律,为体育学、运动员选材、法医学、营养学、医学、人类学、运动人体科学提供基本的研究资料。方法采用邵象清的《人体测量手册》方法,对其身高、体重、臂围、小腿围4项体质发育指标进行测量分析。结果获得了体质发育指标和体质指数,并对男女均值进行比较,身高、体重、臂围、小腿围等4项体质发育指标男女间有显著差异(P<0.01)。结论粤西大学生男性身高属于超中等型,女性身高属于高身材型,发育充实程度中等,男女体形均属瘦长型。     

Comparing physical and behavior therapy for chronic low back pain on physical abilities,psychological distress,and patients' perceptions

A treatment-outcome study was conducted to study the impact of behavior and physical therapy on components of the chronic low back pain syndrome. Eighteen patients received behavior therapy and 15 patients received physical therapy. All patients had at least a 6-month history of seeking treatment for chronic low back pain. Prior to treatment patients were assessed in four principal areas of functioning: (1) physical abilities; (2) current physical functioning; (3) psychological and psychosocial functioning; and (4) pain intensity and pain perception. Treatments were conducted in a group (five to eight patients) outpatient setting. Both behavior therapy and physical therapy groups met for 10-weekly sessions, each lasting 2 hr. Behavior therapy was designed to address the environmental, social, and emotional components of the low back pain syndrome as well as the depression and decreased activity that result from chronic low back pain. Physical therapy was based upon traditional rehabilitation theory and was designed to improve low back function. Patients were reevaluated at posttreatment, 6 months, and 1 year. The results showed a general improvement for patients in both groups and a few treatment-specific differences in outcome measures.This research was supported by the Veterans Administration Medical Research Program. Portions of this paper were read at the Annual Meeting of the American Pain Society, New York, September 1980.     

粤西大学生健康状况调查研究

目的对粤西地区大学生健康状况的研究,为营养学、医学、人类学、体育训练、体育选材提供基础研究资料。方法采用邵象清编写的《人体测量手册》的方法,对其身高、体重、胸围三项体质发育指标进行测量分析,计算身高体重指数、身高胸围指数、皮弗指数(Verv指数)、罗氏指数(Rohr指数)、达氏指数及皮氏指数等六项体质指数。结果根据测量资料,分别统计三项体质发育指标的平均值及标准差,六项体质指数的平均值及标准差,进行体型分类。结论粤西地区大学生三项体质发育指标显示发育状况良好,男女体型分类Verv指数属中间型,Rohr指数属中间型,达氏指数属中间型,胸围指数属中胸型,皮氏指数属中间型。该结果可为高校加强体育管理及体育课程改革提供参考资料。     

Illness causal attributions: an exploratory study of their structure and associations with other illness cognitions and perceptions of control

Two studies were conducted to investigate the cognitive organization and psychological meaning of illness causes. Using a direct similarity judgment method (Study 1), illness causes were found cognitively organized in a hierarchical configuration that could meaningfully be represented as a tree with three main branches—environmental, behavioral, and hidden causes—that further divided into subcategories. This classification of illness causes was associated with other components of the illness schema, namely, the consequences and control/cure dimensions, but not with timeline perceptions (Study 2). Perceptions of control were significantly associated with the cognitive organization of illness causal attributions. Personal relevancy was found as a moderator of illness causal attributions, influencing the relationships between attributions and other illness cognitions.     

Participant experiences and perceptions of physical activity-enhancing interventions for people with physical impairments and mobility limitations: a meta-synthesis of qualitative research evidence

Disabled people face multiple personal, environmental and social barriers that interfere with leading a physically active lifestyle. Thus, there is an urgent need for behaviour change interventions to increase physical activity (PA) by specifically addressing the situations of disabled people, and barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants’ experiences and perceptions of PA-enhancing interventions for adults with physical impairments resulting in mobility limitations. Published articles were identified through a rigorous systematic search. Based on the inclusion/exclusion criteria, 10 articles were included for review. Following a critical appraisal of the articles, methods of thematic synthesis were drawn upon to generate overarching concepts through interpretation and conceptual synthesis. Seven interrelated concepts were constructed representing both components and outcomes of the interventions. These were (i) Diversity of interventions; (ii) Importance of communication; (iii) Need for social support; (iv) Behavioural strategies; (v) Gaining knowledge; (vi) Re-framing thoughts about exercise and the self and (vii) Health and well-being. The results revealed that a combination of informational, social and behavioural interventions is perceived as crucial for PA initiation and maintenance. Furthermore, key elements of effective intervention design and implications for policies and practices to increase PA participation are proposed.     

Alexithymia,empathy, negative affect and physical symptoms in patients with asthma

Although alexithymia has been found to be associated with physical symptoms in psychosomatic disorders such as asthma, mechanisms linking this association are unknown. However, affective alexithymic features may be associated with physical symptoms in the presence of deficits in affective characteristics such as low empathy and high negative affect. This study aimed to assess direct effects of alexithymic traits on physical symptoms and indirect effects of these subscales through empathy and negative affect (e.g. depressive, anxious and stress symptoms) by controlling for asthma severity in patients with asthma. Three hundred patients with asthma completed the Toronto Alexithymia Scale‐20 (TAS‐20), the Basic Empathy Scale (BES), the Depression Anxiety Stress Scales‐21 (DASS‐21) and the Physical Symptoms Inventory (PSI). After controlling for asthma severity, the results showed that alexithymia subscales of the TAS‐20 had no direct effects on physical symptoms, but the difficulty in identifying feelings (DIF) subscale of the TAS‐20 was associated with affective empathy and negative affect. Affective empathy was significantly related to negative affect. Affective empathy and negative affect were associated with physical symptoms. The affective subscale of alexithymia on the TAS‐20, that is DIF, indirectly affected physical symptoms through affective empathy and negative affect. Findings suggest that patients with asthma who have high levels of DIF may show high physical symptoms in the presence of low affective empathy and high negative affect.     

Comorbid painful physical symptoms and anxiety: prevalence, work loss and help-seeking

BACKGROUND: There is evidence that painful physical symptoms (PPS) are increased in patients with anxiety disorder (AD). This survey reports the 12-month prevalence and sociodemographic characteristics of PPS in subjects with and without AD, taking into account somatic comorbidity. In addition, the impact of PPS on work loss days (WLDs) and help-seeking was examined. METHODS: In a cross-sectional, population-based study, a representative random sample of non-institutionalised adults from Belgium, France, Germany, Italy, The Netherlands and Spain (N=21,425) was interviewed using the World Mental Health Composite Diagnostic Interview (CIDI 3.0 of the WHO). 8296 respondents provided data on the occurrence of PPS, from which 5489 respondents reported the number of work loss days. RESULTS: PPS were reported by 28% of respondents without AD and by 45% in those with AD. Female gender, higher age and lower educational level were predictive of PPS. No additive effect of AD and PPS was found on the WLD score, neither did the presence or not of a comorbid somatic disorder change the findings. Finally, respondents with both AD and PPS had numerically higher rates of help-seeking for emotional reasons (20.8% vs. 15.0% for respondents with AD but not PPS) and delayed their help-seeking for a numerically shorter period of time (289 vs. 413 days, respectively). LIMITATIONS: The most important limitation of this study was its reliance on self-reported data about somatic disorders. CONCLUSION: Approximately 45% of persons with anxiety disorder also reported the presence of PPS. No additive effect of AD and PPS was found on the WLD score, and the presence of PPS in AD does not delay help-seeking for emotional problems.     

Efficacy of short-term psychotherapy for multiple medically unexplained physical symptoms: a meta-analysis

Multiple medically unexplained physical symptoms (MUPS) are considered to be difficult and costly to treat. The current meta-analysis therefore investigates the efficacy of short-term psychotherapy for MUPS. Based on a multiple-phase literature search, studies were selected according to a-priori defined inclusion criteria. The standardized mean gain was used as the effect size index. Separate data aggregation of between- and within-group contrasts was performed on the basis of a mixed effects model. Outcome variables were physical symptoms, disorder specific emotions, cognitions and behaviors, depressive symptoms, general psychopathology, functional impairment, and health care utilization. Based on 27 included studies, small between-group effect sizes (range: d₊ = 0.06-d₊ = 0.40) and small to large within-group effect sizes (range: d₊ = 0.36-d₊ = 0.80) were found for post-treatment and follow-up assessments for the different outcome variables. Significant moderator variables were identified as the type, mode, and setting of therapy, number of therapy sessions, profession of therapist, age and sex of patients, quality of diagnostic procedure, and the control of concomitant treatments. Implications of the results for clinical practice and future research are discussed.     

Personal Space as a Function of Infant Illness: An Application of Multidimensional Scaling

This study compares the impact that chronic or acutely ill infantshave upon the personal space perception of their mothers. Subjectswere mothers of healthy infants and mothers of infants witheither a ventricular septal defect or a hernia. Mothers wereasked to position family and medical support figures arounda hospital bed containing a figure representing their infant.A distance measure was obtained between all pairs of figures.Multidimensional scaling and hierarchical clustering analysesrevealed intrapersonal relationships unique to the three differenthealth conditions. Compared to the mothers of healthy infants,mothers of infants with ventricular septal defect emphasizedlong-term and overall medical/spiritual support. The mothersof infants with hernias emphasized immediate caretaking action;long-term support was not as yet a primary concern.     

Medical students' perceptions of children: modifying a childhood cancer stereotype

To assess whether an educationally based intervention could mitigate the negative effects of a childhood cancer stereotype, 168 first-year and fourth-year medical students were randomly assigned to view a healthy child described with either a healthy label (HL) or an in remission from leukemia label (RLL). One half of the 1st-year students also were given information summarizing the psychosocial sequelae of child survivors of cancer and one half were not given information. MANOVAs revealed that medical students in the information condition did not evidence any biases toward RLL children. However, RLL children were rated more negatively than HL children on several dimensions by 1st- and 4th-year students who did not participate in the intervention. The results suggest that a childhood cancer stereotype can be eliminated; however, standard medical training does not reduce the negative expectations health care providers hold toward children diagnosed with cancer.     

Cognitive correlates of mania risk: are responses to success,positive moods,and manic symptoms distinct or overlapping?

Several measures of cognitive style have been shown to be elevated among persons diagnosed with bipolar disorder and those at risk for bipolar disorder. Several of these scales capture responses to positive affect, success, and hypomanic symptoms. We had two goals: (a) to use factor analyses to assess whether the constructs within these scales were statistically independent and (b) to examine whether the factors identified uniquely related to mania risk. A cross‐national sample of 638 participants completed measures of cognitive style, including the Responses to Positive Affect scale, the Positive Overgeneralization Scale, and the Hypomanic Interpretations Questionnaire. To assess whether these measures might simply reflect more impulsive reactions to positive mood states, participants also completed the Barratt Impulsivity Scale. To measure risk of mania, participants completed the Hypomanic Personality Scale (HPS). Factor analyses suggested seven factors of cognitive style and impulsivity. Four factors uniquely correlated with HPS. That is, risk for mania related to higher scores on separable factors of acting before thinking, being overly positive in interpreting manic symptoms, being overly confident in response to success, and tendencies to dampen positive affect. Current findings suggest the need to consider multifaceted aspects of cognition in refining psychological treatments of bipolar disorder. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1–15, 2009.     

Measuring life event stress in the lives of college students: The Undergraduate Stress Questionnaire (USQ)

We describe the development of the Undergraduate Stress Questionnaire (USQ), a life events checklist designed to measure stress among undergraduates. Several studies demonstrate the USQ's validity. The USQ correlates positively with physical symptoms and negatively with mood. Students rated the USQ as the most complete and accurate of four different life events questionnaires. In a panel study, the USQ closely tracked subjective reports of stress, both during the term and finals week. The USQ predicted symptoms more reliably than three other stress measures, controlling for negative affect. Students waiting in the college infirmary score higher on the USQ than students socializing on campus. Finally, we compare the checklist format to subjective scaling, and show the superiority of the checklist version. We discuss the usefulness of the USQ in terms of validity, representativeness, adaptability, brevity, and low confounding with negative affect.     

HCMV既往感染对大学生神经行为的影响

目的探讨巨细胞病毒（HCMV）既：往感染与大学生神经行为特征之间的关系。方法招募87名在校大学生,采用伯乐．神经行为测试评价系统（B．NES）进行测试,同时采血分离血清检测受试对象的HCMVIgG抗体,采用SPSS软件对B．NES测试结果进行统计分析。结果有76人既往感染过巨细胞病毒,11人未感染过,巨细胞病毒的感染率为87．36％。既往感染HCMV的大学生在情感状态测试的“忧郁沮丧”方面得分为8．89±6．60,低于未感染的大学生组（15．73±9．00）,差异有统计学意义（P〈0．05）;在情感状态测试的其他方面、学习记忆、感知与心理运动方面感染组和对照组均差异无统计学意义（P〉0．05）。结论既往感染HCMV与抑郁的情感状态水平的降低存在关联。