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Frontiers in Psychiatry 2024International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of...
INTRODUCTION
International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden.
METHODS
Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7).
RESULTS
Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively.
DISCUSSION
Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.
PubMed: 38757136
DOI: 10.3389/fpsyt.2024.1358173 -
International Journal of Particle... Mar 2024To report the current practice pattern of the proton stereotactic body radiation therapy (SBRT) for prostate treatments.
PURPOSE
To report the current practice pattern of the proton stereotactic body radiation therapy (SBRT) for prostate treatments.
MATERIALS AND METHODS
A survey was designed to inquire about the practice of proton SBRT treatment for prostate cancer. The survey was distributed to all 30 proton therapy centers in the United States that participate in the National Clinical Trial Network in February, 2023. The survey focused on usage, patient selection criteria, prescriptions, target contours, dose constraints, treatment plan optimization and evaluation methods, patient-specific QA, and image-guided radiation therapy (IGRT) methods.
RESULTS
We received responses from 25 centers (83% participation). Only 8 respondent proton centers (32%) reported performing SBRT of the prostate. The remaining 17 centers cited 3 primary reasons for not offering this treatment: no clinical need, lack of volumetric imaging, and/or lack of clinical evidence. Only 1 center cited the reduction in overall reimbursement as a concern for not offering prostate SBRT. Several common practices among the 8 centers offering SBRT for the prostate were noted, such as using Hydrogel spacers, fiducial markers, and magnetic resonance imaging (MRI) for target delineation. Most proton centers (87.5%) utilized pencil beam scanning (PBS) delivery and completed Imaging and Radiation Oncology Core (IROC) phantom credentialing. Treatment planning typically used parallel opposed lateral beams, and consistent parameters for setup and range uncertainties were used for plan optimization and robustness evaluation. Measurements-based patient-specific QA, beam delivery every other day, fiducial contours for IGRT, and total doses of 35 to 40 GyRBE were consistent across all centers. However, there was no consensus on the risk levels for patient selection.
CONCLUSION
Prostate SBRT is used in about 1/3 of proton centers in the US. There was a significant consistency in practices among proton centers treating with proton SBRT. It is possible that the adoption of proton SBRT may become more common if proton SBRT is more commonly offered in clinical trials.
PubMed: 38757080
DOI: 10.1016/j.ijpt.2024.100020 -
JPGN Reports May 2024Pediatric inflammatory bowel disease (IBD) is a chronic illness with various treatments, including ostomy surgery. Ostomy-related medical decision-making (MDM) is...
OBJECTIVES
Pediatric inflammatory bowel disease (IBD) is a chronic illness with various treatments, including ostomy surgery. Ostomy-related medical decision-making (MDM) is complex for multidisciplinary healthcare professionals (HCPs). This study sought to understand national multidisciplinary HCPs' perceptions about pediatric IBD ostomy surgery in the United States.
METHODS
This cross-sectional REDCap survey recruited HCPs in pediatric IBD HCP roles from the ImproveCareNow (ICN) Learning Health System. The survey gathered data on, (1) demographics, (2) participants' perspectives on patients/families' ostomy perceptions, (3) participants' own perspectives on ostomies, and (4) participants' perspectives on multidisciplinary collaboration in ostomy surgery.
RESULTS
Participants ( = 69, across = 30 American ICN sites) were 84% White, 62% female, and 54% gastroenterologists. In reflecting on patients/families' perceptions, participants endorsed most (86%) view ostomies as a "failure," various psychosocial concerns (e.g., 97% endorsed body image concerns), and most (81%) have moderate to significant stigma about ostomies. In reflecting on their own perceptions, nearly half (44%) endorsed some to moderate stigma about ostomies and felt ostomy discussions were difficult when families had negative perceptions (88%). Over half (54%) endorsed currently having multidisciplinary care for pediatric IBD surgery. Most (70%) endorsed variability in the amount and/or quality of multidisciplinary collaboration.
CONCLUSION
MDM related to pediatric IBD ostomy surgery presents nuanced clinical complexities for HCPs. This work underscores interest in multidisciplinary care, notable ostomy-related psychosocial needs, and ostomy-related stigma. Future work should develop systematic approaches to multidisciplinary pediatric IBD ostomy care, bolster psychosocial support, and evaluate how systematic care may impact psychosocial, and healthcare utilization outcomes.
PubMed: 38756109
DOI: 10.1002/jpr3.12044 -
Global Spine Journal May 2024Retrospective cohort study.
Trabecular Bone Remodeling after Posterior Lumbar Interbody Fusion: Comparison of the Osseointegration in Three-Dimensional Porous Titanium Cages and Polyether-Ether-Ketone Cages.
STUDY DESIGN
Retrospective cohort study.
OBJECTIVES
Imaging changes in the vertebral body after posterior lumbar interbody fusion (PLIF) are determined to be trabecular bone remodeling (TBR). This study aimed to investigate the influence of cage materials on TBR and segment stabilization in PLIF by studying image changes.
METHODS
This was a retrospective study reviewing 101 cases who underwent one-level PLIF with three-dimensional porous titanium (3DTi) cages (53 patients) or polyether-ether-ketone (PEEK) cages (48 patients). Computed tomography images obtained 3 months, 1 year, and 2 years postoperatively were examined for TBR, vertebral endplate cyst formation as an instability sign, cage subsidence, and clear zone around pedicle screw (CZPS).
RESULTS
No significant differences in the TBR-positivity rates were observed between the two cages at 3 months, 1 year, and 2 years postoperatively. However, all 3DTi cage segments that were TBR-positive at 3 months postoperatively showed no CZPS and fewer final instability segments than the TBR-negative segments (0% vs 9%). In contrast, although the PEEK cage segments that were TBR-positive at 3 months postoperatively were not associated with future segmental stabilization, those that were TBR-positive at 1 year postoperatively had fewer final instability segments than the TBR-negative segments (0% vs 33%).
CONCLUSIONS
The 3DTi cage segments with TBR 3 months postoperatively showed significant final segmental stabilization, whereas TBR at 1 year rather than 3 months postoperatively was useful in determining final segmental stabilization for the PEEK cage segments. The timing of TBR, a new osseointegration assessment, were associated with the cage material.
PubMed: 38752287
DOI: 10.1177/21925682241255686 -
Frontiers in Nutrition 2024Adolescent growth and development is a period of very specific nutritional problems. As a result of poor growth and development, 36.3% of adolescents in Indonesia are at...
BACKGROUND
Adolescent growth and development is a period of very specific nutritional problems. As a result of poor growth and development, 36.3% of adolescents in Indonesia are at risk of developing CED. The purpose of this study was to determine the description of body image, the incidence of Chronic Energy Deficiency (CED), and nutritional intake in adolescents in urban and rural areas.
METHODS
This study used a descriptive quantitative design with a cross-sectional study conducted in Bandung and Sumedang on 387 adolescents aged 13-15 years. The instruments used in this study were body image questionnaire Figure Rating Scale (FRS) method, 2 × 24-h food recall, and anthropometry for Measuring mid upper arm circumference (MUAC).
RESULTS
Results of this study showed that more than half of adolescents in urban (54.0%) and rural areas (61.7%) were at risk of CED, had negative body image perceptions in urban (69.1%) and rural areas (62.3%), and underconsumption of macronutrients in both urban and rural adolescents.
CONCLUSION
Most adolescents in urban and rural areas still consume less energy, carbohydrates, and protein. Perceived body image and nutrient intake contribute to the incidence of CED in adolescents.
PubMed: 38751738
DOI: 10.3389/fnut.2024.1346929 -
Frontiers in Nutrition 2024
PubMed: 38751737
DOI: 10.3389/fnut.2024.1406345 -
Scientific Reports May 2024Anorexia nervosa is an often-severe psychiatric illness characterized by significantly low body weight, fear of gaining weight, and distorted body image. Multiple...
Anorexia nervosa is an often-severe psychiatric illness characterized by significantly low body weight, fear of gaining weight, and distorted body image. Multiple neuroimaging studies have shown abnormalities in cortical morphology, mostly associated with the starvation state. Investigations of white matter, while more limited in number, have suggested global and regional volume reductions, as well as abnormal diffusivity in multiple regions including the corpus callosum. Yet, no study has specifically examined thickness of the corpus callosum, a large white matter tract instrumental in the inter-hemispheric integration of sensory, motor, and cognitive information. We analyzed MRI data from 48 adolescents and adults with anorexia nervosa and 50 healthy controls, all girls/women, to compare corpus callosum thickness and examined relationships with body mass index (BMI), illness duration, and eating disorder symptoms (controlling for BMI). There were no significant group differences in corpus callosum thickness. In the anorexia nervosa group, severity of body shape concerns was significantly, positively correlated with callosal thickness in the rostrum, genu, rostral body, isthmus, and splenium. In addition, there were significant positive correlations between eating disorder-related obsessions and compulsions and thickness of the anterior midbody, rostral body, and splenium. There were no significant associations between callosal thickness and BMI or illness duration. In sum, those with AN with worse concerns about bodily appearance and worse eating disorder-related obsessive thought patterns and compulsive behaviours have regionally thicker corpus callosum, independent of current weight status. These findings provide important neurobiological links to key, specific eating disorder behavioural phenotypes.
Topics: Humans; Anorexia Nervosa; Corpus Callosum; Female; Magnetic Resonance Imaging; Adolescent; Adult; Young Adult; Phenotype; Body Mass Index; Case-Control Studies; White Matter
PubMed: 38750237
DOI: 10.1038/s41598-024-61841-6 -
PloS One 2024The aim of the study was to compare the mental health and cardiorespiratory fitness (CRF) of adolescents in two cross-sectional cohorts, one measured in 2003 and the... (Comparative Study)
Comparative Study
The aim of the study was to compare the mental health and cardiorespiratory fitness (CRF) of adolescents in two cross-sectional cohorts, one measured in 2003 and the other in 2015, both at age 15 and across sexes. The study also sought to estimate the association between mental health and CRF in the two cohorts and examine the relationship between the level of CRF and mental health in each cohort overall and by sex. Data from 443 participants born in 1988 (228 males, 215 females) and 303 participants born in 1999 (126 males, 177 females) were analyzed. Mental health was assessed using self-reports of body image, self-esteem, and symptoms of depression and anxiety. CRF was estimated using a maximal cycle ergometer test. From 2003 to 2015, body image scores improved (p = .043), self-esteem remained stable, and CRF declined significantly (p < .001). No self-esteem differences were observed between sexes in any cohort. Males had higher CRF and body image scores than females in both cohorts (p < .001 for all comparisons). Higher CRF correlated with fewer depressive symptoms across sexes and cohorts. Specifically, higher CRF was associated with anxiety in females and improved body image in males (2003) and both sexes (2015). Increased CRF was linked to higher self-esteem in females but not in males. Overall, higher CRF levels were associated with better mental health outcomes for both sexes. These results highlight the potential of improving adolescent mental health through increased physical fitness.
Topics: Humans; Male; Female; Adolescent; Cardiorespiratory Fitness; Mental Health; Cross-Sectional Studies; Depression; Anxiety; Self Concept; Body Image; Cohort Studies
PubMed: 38748628
DOI: 10.1371/journal.pone.0300810 -
Ciencia & Saude Coletiva May 2024A negative perception of body image is related to worsening of physical and mental health. This cross-sectional study sought to describe the relationship between body...
A negative perception of body image is related to worsening of physical and mental health. This cross-sectional study sought to describe the relationship between body image and demographic, socioeconomic and behavioral factors in ninth grade students from 25 municipal elementary schools in Pelotas, Rio Grande do Sul. A total of 810 students participated (85% of those eligible), aged 13 to 22 years (mean age 14.9 years). Data were collected through a standardized and pre-coded questionnaire and the relationship between the outcome (satisfied/indifferent or dissatisfied with body image), and independent variables were analyzed using Multinomial Logistic Regression. The prevalence of body dissatisfaction of 31%, higher among girls who tried smoking or alcohol, suffered bullying, perceived themselves as fat/thin and tried to lose/gain weight. There was greater indifference among those who attributed little or no importance to image. In boys, there was a higher incidence of dissatisfaction among those who tried smoking, suffered bullying, gave little/no importance to image, saw themselves as fat and tried to gain weight. There was greater indifference in boys who attributed little importance to image and were obese. A third of the sample were dissatisfied, which was associated with various behavioral factors.
Topics: Humans; Brazil; Adolescent; Female; Cross-Sectional Studies; Male; Body Image; Students; Schools; Bullying; Young Adult; Surveys and Questionnaires; Prevalence; Sex Factors; Smoking
PubMed: 38747761
DOI: 10.1590/1413-81232024295.01542023 -
Frontiers in Psychology 2024The popularity of social media platforms, such as Instagram, has given rise to a surge in photo editing and filtering practices among users. Understanding the underlying...
The popularity of social media platforms, such as Instagram, has given rise to a surge in photo editing and filtering practices among users. Understanding the underlying psychological factors that drive individuals to employ filters is crucial in comprehending the impact of such behavior on self-perception and online interactions. This study aims to investigate the influence of self-esteem on the importance attributed to the use of Instagram filters, with a particular focus on the mediating role played by the fear of negative evaluation. A sample of participants ( = 2,657) from diverse demographic backgrounds has been recruited to complete a series of questionnaires measuring self-esteem, fear of negative evaluation, and Instagram filter usage patterns. Mediation analysis has been employed to assess the extent to which the fear of negative evaluation mediates the relationship between self-esteem and filter usage importance. In line with the hypotheses, the results revealed that participants self-esteem negatively predicted fear of negative evaluation, which in turn had a positive effect on use of filters. Furthermore, fear of negative evaluation fully mediated the relationship between self-esteem and use of filters. Overall, the implications of this research extend to both theoretical and practical domains. The findings can contribute to the existing literature on self-esteem, social media behavior, and body image by shedding light on the factors influencing digital self-presentation.
PubMed: 38746921
DOI: 10.3389/fpsyg.2024.1302662