Strategies for Enhancing Resilience in Medical Students: a Group Concept Mapping Analysis.

OBJECTIVE: Research has consistently shown that medical students have greater rates of stress and mental-ill health in comparison with non-medical students. The objective of this study was to investigate the resilience strategies employed by medical students in an Irish medical school to inoculate themselves against the deleterious effects of stress on health and wellbeing. METHODS: Group concept mapping was utilized incorporating qualitative and quantitative methodologies. The stages undertaken by year 3 students at an Irish medical school involved brainstorming/idea generation, categorization, and rating of resilience strategies students employed to manage stress during medical school. The data was analyzed utilizing The Concept System® software through multidimensional scaling and hierarchical clustering. RESULTS: Categories of resilience strategies employed included "friends and family," "de-stress through exercise/sport," "extra-curricular non-medical activities," "self-enabled distraction," "organization," and "enhancing emotional and mental wellbeing." Students rated spending time with "friends and family" to be most effective when seeking to relieve stress, whereas students rated "de-stressing through exercise/sport" as being of greatest importance in relation to inclusion in a resilience-based intervention. Students recognized the value of incorporating strategies to enhance emotional and mental wellbeing into a resilience-promoting program. "Self-enabled distraction" rated poorly on both scales. CONCLUSIONS: Strategies rated by students to be important to incorporate in a stress reduction management program are accessible, are feasible, and can be implemented into the medical curriculum.

The Yo-Yo intermittent recovery test level 1 as a high intensity training tool: aerobic and anaerobic responses.

OBJECTIVE: The aim of this study was to investigate the effects of using the Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) as a high intensity training tool for sedentary university female students. METHODS: Baseline measures were recorded for body fat percentage, Wingate Anaerobic Test (WAnT) peak power and mean power, and Yo-Yo IR1 performance. Subjects were matched in pairs for body fat percentage and then randomly allocated to the intervention group (INT) (n=12) or control group (CON) (n=13). The INT undertook a 6-week training programme twice a week using the Yo-Yo IR1. The CON undertook no training. RESULTS: The INT increased their Yo-Yo IR1 performance (230±38m baseline vs 403±152m post-training), WAnT peak power (970±176 Watts baseline vs 1148±159 Watts post-training), and WAnT mean power (399±55 Watts baseline vs 439±53 Watts post-training) (p<0.05). No changes were observed in the CON (p>0.05). CONCLUSION: The results of this study show that a 6-week high intensity intermittent training programme using the Yo-Yo IR1 as a training intervention increases both aerobic and anaerobic capacity in a sedentary female population.

To what extent can response shift theory explain the variation in prostate cancer patients' reactions to treatment side-effects? A review.

BACKGROUND: There appears to be a conflict between published literature and in vitro evidence concerning the effects of treatment-induced side-effects on prostate cancer patients. There is an existing body of research which indicates evidence for a phenomenon whereby quality-of-life scores of patients' post-treatment reflect no difference to healthy controls and are perhaps even higher than before treatment, despite the substantial side-effects such as sexual and urinary dysfunction. However, when observing clinical patients at Good Hope Hospital urology clinic, it appears that whilst patients are seemingly unaffected by the threat of sexual and urinary side-effects of treatment at diagnosis, they become increasingly concerned about these consequences following treatment, indicating evidence for a response shift in the opposite direction. This phenomenon is investigated here. METHODS: Thirteen papers were selected for review and considered in terms of their contribution to research into response shift as a coping process and in particular, response shift in prostate cancer. RESULTS AND CONCLUSIONS: Based on the existing literature, an underlying model is formulated for the moderation of the extent and direction of prostate cancer patients' response shift, incorporating the function of external influences such as perceived social support.

Focusing on food during lunch enhances lunch memory and decreases later snack intake.

We investigated whether eating lunch mindfully, in contrast to eating with distractions or no particular focus, reduces later snack intake and if this is related to a measure of meal memory. The design was between-subjects with three conditions. Twenty-nine female undergraduate students either ate a fixed lunch while (1) focusing on the sensory characteristics of the food as they ate (food focus group), (2) reading a newspaper article about food (food thoughts control group) or (3) in the absence of any secondary task (neutral control group). Cookie intake later that afternoon was measured as well as rated vividness of memory of the lunch. Participants ate significantly fewer cookies in the food focus group than in both the food thoughts control group or the neutral control group. Rated appetite before the snack session was lower in the food focus group than in the other two groups and rated vividness of lunch memory was higher. Rated vividness of lunch memory was negatively correlated with snack intake. These results suggest that enhancing meal memory by paying attention to food while eating can reduce later intake and are consistent with the suggestion that memory plays an important role in appetite control.

Transition to clinical practice during the COVID-19 pandemic: a qualitative study of young doctors' experiences in Brazil and Ireland.

OBJECTIVES: To explore and compare the perspectives of junior doctors in Brazil and Ireland regarding transition and professional socialisation during the COVID-19 pandemic, with the purpose of identifying better ways to support doctors as they assume their new professional role. DESIGN: 27 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. Cruess' framework of professional socialisation in medicine supported the interpretation of these data. SETTING: Public health hospitals across four Brazilian states (Santa Catarina, São Paulo, Ceará, Paraíba) and County Cork in the South of Ireland. PARTICIPANTS: Twenty-seven male and female medical junior doctors who had graduated between November 2019 and April 2020. RESULTS: Fourteen Brazilian and 13 Irish junior doctors were interviewed for this study. Entry to clinical practice during the pandemic had a significant impact on factors influencing the professional socialisation of junior doctors. This impact was reflected across the following six thematic areas: lack of preparedness; disrupted trajectory of role adaptation; fewer opportunities for experiential learning; solidarity and isolation; altered interactions with patients; challenges to health and well-being. CONCLUSIONS: Transition to clinical practice is an important stage in junior doctors' professional socialisation and identity formation. The COVID-19 pandemic created the opportunity for medical graduates to enter the workforce earlier than usual. Entering the workforce during this period created a lack of confidence among junior doctors concerning the boundaries of their new role and responsibilities, while simultaneously disrupting their social integration. Priorities to mitigate the impact of COVID-19 and future pandemics on this transition are presented.

Predicting successful introduction of novel fruit to preschool children.

BACKGROUND: Few children eat sufficient fruits and vegetables despite their established health benefits. The feeding practices used by parents when introducing novel foods to their children, and their efficacy, require further investigation. OBJECTIVE: We aimed to establish which feeding strategies parents commonly use when introducing a novel fruit to their preschool-aged children and assess the effectiveness of these feeding strategies on children's willingness to try a novel fruit. DESIGN: Correlational design. PARTICIPANTS/SETTING: Twenty-five parents and their children aged 2 to 4 years attended our laboratory and consumed a standardized lunch, including a novel fruit. Interactions between parent and child were recorded and coded. STATISTICAL ANALYSES PERFORMED: Pearson's correlations and multiple linear regression analyses. RESULTS: The frequency with which children swallowed and enjoyed the novel fruit, and the frequency of taste exposures to the novel fruit during the meal, were positively correlated with parental use of physical prompting and rewarding/bargaining. Earlier introduction of solids was related to higher frequency of child acceptance behaviors. The child's age at introduction of solids and the number of physical prompts displayed by parents significantly predicted the frequency of swallowing and enjoying the novel fruit. Age of introduction to solids and parental use of rewards/bargaining significantly predicted the frequency of taste exposures. CONCLUSIONS: Prompting a child to eat and using rewards or bargains during a positive mealtime interaction can help to overcome barriers to novel fruit consumption. Early introduction of solids is also associated with greater willingness to consume a novel fruit.