Orientations to Wellbeing in the Context of Medicine and Nursing-A Preliminary Study on Students' Perspective in Their Early University Years.

Medicine in the 21st century needs to be patient-or, rather, person-centered. Accordingly, medical education needs to adopt an authentic student-centered stance and also include an emphasis on wellbeing and quality of life-starting in medical students` university years. Studies on eudaimonic and hedonic aspects of wellbeing in academic contexts might offer valuable insights for conceptualizing and implementing medical teaching. Our research aimed at exploring eudaimonic and hedonic orientations in students in their first years of medical and nursing studies, in relation to outcomes like satisfaction, subjective meaning experience and engagement with university studies. We also wanted to evaluate the feasibility of using a translated version of HEMA (Hedonic and Eudaimonc Motives for Action) Scale in our university students. 120 1st and 2nd year students of our university completed HEMA and questionnaires evaluating the above-mentioned outcomes, in one session. The instrument demonstrated good reliability (assessed by Cronbach`s alpha coefficients) and also captured valuable correlations with students satisfaction, subjective sense of meaning and engagement with their studies. Importantly, eudaimonic subscores were moderately but significantly correlated with Hedonic enjoyment ones, as previously reported. Exploratory Principal Component Analysis suggested two or three factors, but a larger group would be needed to confirm the factor structure of the Romanian version of the test. Conclusions: HEMA is applicable in this academic context, in Romanian, has good reliability and promises to offer valuable insights into students` orientations, helping us support their aspirations and shape our teaching so that they could benefit the most from it.

Imaging cognitive fatigability in multiple sclerosis: objective quantification of cerebral blood flow during a task of sustained attention using ASL perfusion fMRI.

Cognitive fatigability (CF) can be defined as an inability to maintain performance throughout a sustained cognitive task. Individuals with multiple sclerosis (MS) are more susceptible to CF than healthy controls (HCs); however, the neural correlates underlying CF are still under investigation. Arterial spin labeling (ASL) perfusion imaging provides a non-invasive method of objectively quantifying cerebral blood flow (CBF) during sustained attention tasks. To date, no study has yet evaluated CF in MS using this methodology. 10 MS and 10 HCs completed a 20-min psychomotor vigilance task (PVT). CF was evaluated by dividing the PVT into quintiles and examining performance from the 1st to the last. Mean reaction times (RTs) and number of lapses were recorded. Global and regional CBF changes were evaluated throughout the PVT as well as during pre- and post-task rest. Increased susceptibility to CF was noted in the MS group. Distinct patterns of CBF activation were observed in areas comprising fronto-parietal, cortico-striatal, cerebellar, and basal ganglia regions; however, when and how these regions were engaged differed between the MS and HC groups. In particular, dysfunction in CBF to the middle frontal gyrus may underlie the CF effects observed. In addition, individuals with MS appear to struggle with "switching off" regions of the attentional network at rest following sustained cognitive effort. Findings support the use of ASL as an appropriate methodology for evaluating CF in MS with an overall pattern of attentional network dysfunction being observed. Objectively quantifying CF in this manner can help validate patients' subjective complaints.

Designing an on-line database for morphological studies of three-dimensional liver tumors.

INTRODUCTION: Primary liver and pancreatic malignancies still make up for an increasing number of deaths worldwide. Diagnostic procedures are constantly evolving, with variable availability depending on referral center. Integrating and transmitting relevant medical data is becoming more necessary, for both medical learning and patient management. PATIENTS, MATERIALS AND METHODS: We selected a sample cohort from our larger study involving patients with liver and pancreatic primary malignancies. All patients provided informed consent and procedures were performed in accordance with usual regulations. Clinical and laboratory data of the selected patients were used to populate a database that also contained multimedia files presenting an interactive three-dimensional (3D) model of liver or pancreatic tumors. RESULTS: The on-line interface developed to access the database had two levels of access. The public webpage only allowed interaction with the reconstructed model. The secured module allowed viewing of medical data, interaction with the complete tumor model as well as the ability to download the anonymized digital file containing the tumor reconstruction. This allowed fast printing, with a standard 3D printer, of the complete model with different levels of stiffness, for complete interaction for both teaching purposes and pre-operatory planning. CONCLUSION: This is the first attempt to implement a full-scale on-line solution for 3D tumor representation and manipulation, corroborated with clinical and laboratory data. This technology may bring important additional information for pre-operatory evaluation, treatment planning or medical training.

Cognitive impact of anticholinergic medication in MS: Adding insult to injury?

BACKGROUND: Cognitive impairment in Multiple Sclerosis (MS) is well recognized, being documented even in the earliest stages of the disease. Anticholinergic drugs (ACD) are frequently used to address bladdder symptoms in this population. ACD are known for their deleterious cognitive effects in older individuals; however their potential impact on cognition has received less attention in the context of MS. OBJECTIVE: To explore possible detrimental effects of bladder-directed ACD on cognitive functioning in MS. METHODS: 42 MS patients who had been on classical, bladder-directed ACD for ≥6 months were compared to 46 patients not receiving ACD, in terms of their scores on Symbol Digit Modality Test (SDMT) and Selective Reminding Test (SRT). Patients also completed questionnaires for fatigue (Modified Fatigue Impact Scale - MFIS) and depression (Beck Depression Inventory-Fast Screen - BDIFS). RESULTS: Patients using ACD showed significantly lower SDMT and SRT scores compared to those not using ACD (p<0.001; t-test). The association of lower cognitive test performance with ACD usage was robust, even when other variables (like age, gender, EDSS, etc.) were considered. CONCLUSION: Our results suggest that chronic use of classical ACD for bladder symptoms may have a negative impact on cognitive functioning in MS patients. These potential cognitive side effects need to be considered both in clinical practice and research settings.