Assessment of need for lower level acuity critical care services at a tertiary acute care hospital in Canada: A prospective cohort study.

PURPOSE: Critical care beds are commonly described in three levels (highest level 3, lowest level 1). We aimed to describe the actual level of care for patients assigned to level 2 in a tertiary hospital with inadequate level 1 bed capacity. MATERIALS AND METHODS: Prospective cohort study with daily assessment of level of care. The primary outcome was the proportion of patients who could be triaged to level 1 for the entirety of their ICU stay. Secondary outcomes included the percentage of patients who could receive level 1 care on any given day. RESULTS: 289 patients originally classified as level 2 were assessed for the primary, and 335 for the secondary outcomes. 14.9% could be level 1 for their entire ICU stay. 20.6%, once appropriate for level 1, remained in that level for the rest of their ICU stay. 23.6% of the assessments were suitable for level 1 on any given day. CONCLUSION: In a single centre, 14.9% of level 2 patients could have been cared for in a lower acuity bed for the entirety of their ICU stay. We believe this methodology is reproducible and can help resource allocation with regard to the high demand for critical care beds.

Facial attractiveness, weight status, and personality trait attribution: The role of attractiveness in weight stigma.

The current study examined the influence of facial attractiveness and weight status on personality trait attributions (e.g., honest, friendly) among more and less facially attractive as well as thin and overweight models. Participants viewed pictures of one of four types of models (overweight/less attractive, overweight/more attractive, thin/less attractive, thin/more attractive) and rated their attractiveness (facial, body, overall) and personality on 15 traits. Facial attractiveness and weight status additively impacted personality trait ratings. In mediation analyses, the facial attractiveness condition was no longer associated with personality traits after controlling for perceived facial attractiveness in 12 personality traits. Conversely, the thin and overweight condition was no longer associated with personality traits after controlling for perceived body attractiveness in only 2 personality traits. Post hoc moderation analysis indicated that weight status differently influenced the association between body attractiveness and personality trait attribution. Findings bear implications for attractiveness bias, weight bias, and discrimination research.

Patterns of Use, Acute Subjective Experiences, and Motivations for Using Synthetic Cathinones ("Bath Salts") in Recreational Users.

Given the variety and potential toxicity of synthetic cathinones, clinicians and educators would benefit from information about patterns of and motivations for use, frequency of psychosocial consequences, and experience of acute subjective effects. We administered a comprehensive, web-based survey to 104 recreational users of synthetic cathinones. Sixty percent of respondents consumed synthetic cathinones once or more per month, usually snorting or swallowing these drugs, typically at home, usually with others, customarily during the evening and nighttime hours, and often in combination with another drug such as alcohol or marijuana. Acute subjective effects attributed to synthetic cathinones were similar to those of other psychostimulants, including increased energy, rapid heartbeat, racing thoughts, difficulty sleeping, euphoria, decreased appetite, open-mindedness, and increased sex drive. Reported reasons for using synthetic cathinones included its stimulating effects, curiosity, substitution for another drug, and being at a party/music event. Respondents had experienced an average of six negative consequences of using synthetic cathinones during the previous year (e.g., tolerance, neglecting responsibilities, personality change). In combination with previously published investigations, these findings increase our understanding of the reported rationales and outcomes of recreational use of synthetic cathinones.

Self-Medication of Somatic and Psychiatric Conditions Using Botanical Marijuana.

As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users' self-reports of the symptoms and conditions for which they use marijuana without a physician's recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician's recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana.

Changes in weight bias and perceived employability following weight loss and gain.

BACKGROUND: The present weight stigma study examined whether attitudes toward and employability of a normal weight person can change after learning that the person had been obese. METHODS: Participants (N = 154) viewed an image of a normal weight woman and rated their impression of her. Next, participants rated their impression of her overweight image after learning how she had previously gained and subsequently lost weight. RESULTS: Participants rated the model far less favorably including perceived employability if they thought the once overweight model lost weight through surgery vs. diet and exercise. How the model initially gained the weight had little impact on participant ratings. CONCLUSIONS: Surgical weight loss had a significant impact on personality judgments. These negative views extended to hiring decisions.

Psychometric evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale with young recreational marijuana users.

INTRODUCTION: This study evaluated the cue-reactivity and several psychometric properties of a questionnaire designed to assess marijuana users' self-efficacy to employ 21 specific cognitive-behavioral strategies to reduce their marijuana use. METHOD: Using a web-based recruitment and data-collection procedure, 513 regular marijuana users completed dependent measures following marijuana-related or control cue exposure. RESULTS: Although exposure to marijuana-related stimuli significantly increased reported craving, mean reduction-strategy self-efficacy scores did not differ as a function of cue exposure. Reliability analyses supported retaining all 21 items as a single scale. Reduction-strategy self-efficacy was positively associated with marijuana-refusal self-efficacy and with recent past use of reduction strategies, was negatively associated with quantity and frequency of marijuana use and marijuana-related problems, and was positively but weakly associated with general self-efficacy. The most frequently reported strategies that were employed reflected restricting marijuana use to once per day, not keeping a large stash available, turning down unwanted hits, and not obtaining more marijuana right away if one's supply runs out. CONCLUSIONS: These findings further support the reliability and validity of the questionnaire when administered to a diverse sample of regular marijuana users.

Development and evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale.

To evaluate several psychometric properties of a questionnaire designed to assess college students' self-efficacy to employ 21 cognitive-behavioral strategies intended to reduce the amount and/or frequency with which they consume marijuana, we recruited 273 marijuana-using students to rate their confidence that they could employ each of the strategies. Examination of frequency counts for each item, principal components analysis, internal consistency reliability, and mean interitem correlation supported retaining all 21 items in a single scale. In support of criterion validity, marijuana use-reduction self-efficacy scores were significantly positively correlated with cross-situational confidence to abstain from marijuana, and significantly negatively correlated with quantity and frequency of marijuana use and marijuana-related problems. In addition, compared with respondents whose use of marijuana either increased or remained stable, self-efficacy was significantly higher among those who had decreased their use of marijuana over the past year. This relatively short and easily administered questionnaire could be used to identify college students who have low self-efficacy to employ specific marijuana reduction strategies and as an outcome measure to evaluate educational and skill-training interventions.

Further evaluation of the construct, convergent and criterion validity of the Gambling Urge Scale with university-student gamblers.

BACKGROUND: Research has documented the prevalence of problem gambling among university students, and craving is one factor that may provoke and maintain episodes of gambling. OBJECTIVES: We designed this study to assess elements of construct, convergent and criterion validity of the Gambling Urge Scale (GUS) when administered to regularly gambling university students. METHODS: Students (n = 250) recruited from three universities during the spring semester, 2012, were randomly assigned to one of four conditions to test the impact of cue exposure to one of two types of stimuli (gambling versus non-gambling activity), and two types of presentation format (photographic versus imagery scripts), on current craving to gamble. RESULTS: Self-reported craving increased significantly following exposure to gambling cues, but not following exposure to engaging non-gambling cues, regardless of the format by which cues were presented. Among those exposed to gambling cues, GUS craving scores were significantly correlated with all three subscales of another measure of craving to gamble, gambling-related problems, passionate attachment to gambling, distorted gambling beliefs and gambling refusal self-efficacy. CONCLUSIONS: These findings provide further support for the construct, convergent and criterion validity of the GUS as a measure of subjective craving in university student gamblers.

Prospective prediction of college adjustment using self- and informant-rated personality traits.

Studies that relate normal personality traits to students' adjustment to college have relied heavily on self-rating methods, concurrent designs, and academic performance indicators as criteria. We conducted a prospective study of high school seniors with a follow-up assessment made near the end of their freshman year of college. Self-ratings of personality traits and college adjustment were obtained from 90 students using the revised NEO personality inventory (NEO PI-R; Costa & McCrae, 1992) and the student adaptation to college questionnaire (SACQ; Baker & Siryk, 1989 ). Ratings of personality were also obtained from parents (n = 66) and same-sex peers from the college setting (n = 78) using the NEO five-factor inventory (NEO-FFI; Costa & McCrae, 1992 ). SACQ academic adjustment was correlated with conscientiousness ratings by all three sources and with openness ratings by parents and peers. SACQ Social Adjustment was correlated with self-ratings of neuroticism and peer ratings of extraversion. SACQ personal-emotional adjustment was correlated with self-ratings and parent ratings of neuroticism. Ratings by parents and peers showed significant incremental validity over self-ratings in the prediction of certain trait-adjustment relationships.

Neurologic complications of radiation therapy.

Injury to the central and peripheral nervous systems is an increasingly frequent consequence of standard radiation treatment protocols for tumors involving or adjacent to nervous system structures. Characteristic temporal, clinical, radiographic, and laboratory features distinguish a number of specific radiation injury syndromes, but meticulous and repeated evaluations over time are often required to establish a diagnosis. These syndromes vary with regard to prognosis and therapeutic options, and competing diagnoses with very different natural histories and therapies often mask or mimic the signs and symptoms of radiation-related nervous system injury. The ability to efficiently negotiate this complicated differential diagnostic landscape allows for early diagnosis of tumor recurrence or an alternative etiology, prompt institution of appropriate therapy, avoidance of unnecessary diagnostic studies, and confident prognostication for patients and families. Even after the diagnosis of a radiation-related complication is made, continued vigilance for additional sites or manifestations of radiation injury is mandatory. Meanwhile, further research into treatment, prevention, and the causes of individual susceptibility to radiation injury are essential.