Psychological Distress, Burnout, and Academic Performance in First Year College Students.

BACKGROUND: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. METHODS: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students' grades for the first semester were collected. RESULTS: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. CONCLUSIONS: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.

Usefulness of knockout mice to clarify the role of the opioid system in chronic pain.

Several lines of knockout mice deficient in the genes encoding each component of the endogenous opioid system have been used for decades to clarify the specific role of the different opioid receptors and peptide precursors in many physiopathological conditions. The use of these genetically modified mice has improved our knowledge of the specific involvement of each endogenous opioid component in nociceptive transmission during acute and chronic pain conditions. The present review summarizes the recent advances obtained using these genetic tools in understanding the role of the opioid system in the pathophysiological mechanisms underlying chronic pain. Behavioural data obtained in these chronic pain models are discussed considering the peculiarities of the behavioural phenotype of each line of knockout mice. These studies have identified the crucial role of specific components of the opioid system in different manifestations of chronic pain and have also opened new possible therapeutic approaches, such as the development of opioid compounds simultaneously targeting several opioid receptors. However, several questions still remain open and require further experimental effort to be clarified. The novel genetic tools now available to manipulate specific neuronal populations and precise genome editing in mice will facilitate in a near future the elucidation of the role of each component of the endogenous opioid system in chronic pain. LINKED ARTICLES: This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.

The endocannabinoid system and neuropathic pain.

The research of new therapeutic strategies for neuropathic pain represents a major current priority. Important drawbacks to advance in the development of these therapies are the limited translational value of the animal models now available and the elucidation of the complex neuronal and immune pathophysiological mechanisms underlying neuropathic pain. One of the neurotransmitter systems participating in neuropathic pain control that has recently raised a particular interest is the endocannabinoid system. This system is highly expressed in neurons and immune cells, and it plays a crucial role in the development of neuropathic pain. Preclinical studies have provided important findings, revealing the potential interest of the endocannabinoid system for the treatment of neuropathic pain. These studies have reported the analgesic effects of cannabinoid agonists in multiple neuropathic pain models, and they have identified specific targets within this system to develop more effective and safe analgesic compounds. However, further studies using more relevant neuropathic pain animal models are required to confirm these interesting results. Several clinical studies suggest that cannabinoids significantly reduced neuropathic pain, although most of these trials fail the required standards of quality. The different pain patient populations included in the systematic reviews also make it difficult to get adequate conclusions. Therefore, additional clinical trials that consider an adequate number of patients, the use active treatments as controls, and longer duration of administration are required to have an adequate profile of the effectiveness and safety of cannabinoids in neuropathic pain.

Benefits of using a hybrid problem-based learning curriculum to improve long-term learning acquisition in undergraduate biology education.

Although problem-based learning (PBL) has been used for over 40 years, with many studies comparing the benefits of PBL versus other educational approaches, little attention has been paid to the effectiveness of hybrid PBL (H-PBL) curricula. Here we aimed to compare the learning outcomes of two groups of undergraduate biology students working towards a bachelor's degree: one group used an H-PBL approach, while the second used a lecture-based learning (LBL) approach. Specifically, the H-PBL group used a PBL module with interdisciplinary problems, which represented 20% of the entire curriculum. The main outcomes of evaluation were the long-term acquisition of factual knowledge and the problem-solving skills at the end of the bachelor's degree. The sample included 85 students, 39 in the H-PBL group and 46 in the LBL group. We found that an H-PBL curriculum can improve the students' learning outcomes such as long-term knowledge acquisition, problem solving skills and generic competences.

How does the general population treat their pain? A survey in Catalonia, Spain.

Several epidemiological studies have shown that pain is a very common complaint in patients who seek medical care. However, the characteristics of how pain is treated in the general population have been studied less. The present survey was conducted to describe and analyze how the general population of Catalonia (Spain) approaches the treatment of their pain complaints. The study was carried out in 1964 adults who were surveyed by phone about the presence of painful events in the last six months, the intensity and location of their pain, what they did to treat their pain, and their resulting level of relief. Data were compared by age and gender. Pain prevalence was high (78.6%) and more frequent in women. The therapeutic strategy most commonly used was a visit to the physician (66.3%), followed by self-medication (27.6%) and alternative medicines (20.5%). Drugs were the primary treatment used by physicians (86.5%), followed by physical therapy (18.1%). Pain in the extremities, back and neck pain were often unsuccessfully treated. Self-medication was often performed with acetylsalicylic acid and paracetamol (acetaminophen), and was commonly used in conjunction with other therapeutic approaches (51.9%). Age (low use of paracetamol in the elderly) and gender (low use of paracetamol in men) were related to the type of drug used in self-medication. Older men, and those with severe pain located in the chest, required hospital admission more commonly. In conclusion, pain is a common reason for seeking medical care and using drugs. Therapeutic approaches are often related to the type of pain, but also to age or gender. Knowledge of these characteristics may allow for a more efficient use of available resources.

[Nocebo effect: the other side of placebo]. / Efecto nocebo: la otra cara del placebo.

Administration of drugs is often followed by beneficial (placebo effects) and harmful (nocebo effects) effects that are not always related to their mechanism of action. Nocebo effects are rather unknown even when may be the source of many adverse reactions which could be erroneously attributed to drug therapy. Some mechanisms have been postulated which might be associated with the development of nocebo effects. Expectancy, learning and classical conditioning are probably important in the psychological domain. The neuropharmacological substrate is much less known yet an opioid peptide-cholecystokinin interaction has been suggested. At the clinical setting, a nocebo effect should be suspected in those patients who present common unspecific symptoms after drug administration and have a tendency to somatize. An early detection of these patients may contribute to the prevention of the nocebo effect.

Neuropathic pain is enhanced in delta-opioid receptor knockout mice.

We have evaluated the possible involvement of delta-opioid receptor (DOR) in the development and expression of neuropathic pain. For this purpose, partial ligation of the sciatic nerve was performed in DOR knockout mice and wild-type littermates. The development of mechanical and thermal allodynia, as well as thermal hyperalgesia was evaluated by using the von Frey filament model, the cold-plate test and the plantar test, respectively. In wild-type and DOR knockout mice, sciatic nerve injury led to a neuropathic pain syndrome revealed in these nociceptive behavioural tests. However, the development of mechanical and thermal allodynia, and thermal hyperalgesia was significantly enhanced in DOR knockout mice. These results reveal the involvement of DOR in the control of neuropathic pain and suggest a new potential therapeutic use of DOR agonists.