Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary.

Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.

Patients with chronic bipolar disorder show impairments in interpreting literary fiction - A preliminary explorative study with the short story task.

INTRODUCTION: Theory of mind (ToM) is a crucial skill in navigating and functioning in the social world. Significant ToM impairment was consistently found in bipolar disorder; it can be both a state and trait marker of the disorder. However, most of the ToM tests are not sensitive enough to detect subtle individual differences, which would be necessary for an individualized treatment plan. The Short Story Task (SST) is a new way to sensitively assess individual differences in ToM performance. The aim of the study was to test the feasibility of SST in patients with bipolar disorder. METHOD: 31 persons (11 male, 20 female) with bipolar I disorder and 31 healthy individuals (15 males and 16 females) as a control group were recruited. SST was used to evaluate ToM performance. The SST uses a Hemingway novel, in which the patient is presented with a realistic social situation, where the motivations of the characters and the underlying relationships of events are not explicitly described. RESULTS: In the explicit mental state reasoning questions the CG (M = 8.06) had significantly higher (p < 0.001) scores than the persons with bipolar I disorder (M = 5.03). There was no ceiling effect for explicit ToM scores in either group. Participants in CG (M = 8.03) also significantly outperformed (p = 0.006) the BG participants (M = 6.55) in the comprehension questions. The spontaneous mental state inference question was performed equally (M = 0.23) in both groups. Group assignment (t = -3.503, p < 0.001), comprehension score (t = 2.864, p = 0.006), and spontaneous mentalization (t = 2.846, p = 0.006) significantly predicted the explicit ToM performance. CONCLUSIONS: Overall, we found that the Short Story Task is a promising tool for measuring ToM in patients with bipolar disorder without ceiling effect. Primarily explicit ToM was found to be deficient, which corresponds well with the ToM literature in bipolar disorder. Contrary to our hypothesis we could not detect impairment in spontaneous ToM and found that patients living with bipolar disorder also showed deficits in comprehension. The lack of assessment of neurocognitive skills is a significant limitation of the current study.

Five times over: 42 new Angustopila species highlight Southeast Asia's rich biodiversity (Gastropoda, Stylommatophora, Hypselostomatidae).

The Southeast Asian genus Angustopila, currently comprising 13 nominal species, encompasses the world's tiniest land snails. This work shows that there are far more species than previously suspected, and that this genus is in fact, a very speciose group of tiny snails widely distributed in Southeast Asia. Angustopila is revised based on type material of known species as well as 211 samples newly collected in China, Laos, Myanmar, Thailand and Vietnam. Altogether, 53 species and one subspecies are recognised, of which 42 species and subspecies are new to science: A.akrodon Páll-Gergely & Hunyadi, sp. nov., A.apiaria Páll-Gergely & Hunyadi, sp. nov., A.apiostoma Páll-Gergely & Vermeulen, sp. nov., A.apokritodon Páll-Gergely & Hunyadi, sp. nov., A.antidomedon Páll-Gergely & Hunyadi, sp. nov., A.babel Páll-Gergely & Vermeulen, sp. nov., A.bathyodon Páll-Gergely & Hunyadi, sp. nov., A.bidentata Páll-Gergely & Jochum, sp. nov., A.cavicola Páll-Gergely & Dumrongrojwattana, sp. nov., A.cicatricosa Páll-Gergely & Vermeulen, sp. nov., A.coprologosuninodus Páll-Gergely & Grego, ssp. nov., A.erawanica Páll-Gergely & Dumrongrojwattana, sp. nov., A.fratermajor Páll-Gergely & Vermeulen, sp. nov., A.fraterminor Páll-Gergely & Vermeulen, sp. nov., A.gracilis Páll-Gergely & Hunyadi, sp. nov., A.halongensis Páll-Gergely & Vermeulen, sp. nov., A.hyron Páll-Gergely & Vermeulen, sp. nov., A.maasseni Páll-Gergely & Vermeulen, sp. nov., A.majuscula Páll-Gergely & Hunyadi, sp. nov., A.margaritarion Páll-Gergely & Hunyadi, sp. nov., A.megastoma Páll-Gergely & Vermeulen, sp. nov., A.occidentalis Páll-Gergely & Hunyadi, sp. nov., A.oostoma Páll-Gergely & Vermeulen, sp. nov., A.papaver Páll-Gergely & Hunyadi, sp. nov., A.parallela Páll-Gergely & Hunyadi, sp. nov., A.prolixa Páll-Gergely & Hunyadi, sp. nov., A.pusilla Páll-Gergely & Hunyadi, sp. nov., A.pustulata Páll-Gergely & Hunyadi, sp. nov., A.quadridens Páll-Gergely & Vermeulen, sp. nov., A.rara Páll-Gergely & Hunyadi, sp. nov., A.reticulata Páll-Gergely & Hunyadi, sp. nov., A.somsaki Páll-Gergely & Hunyadi, sp. nov., A.steffeki Páll-Gergely & Grego, sp. nov., A.tetradon Páll-Gergely & Hunyadi, sp. nov., A.thersites Páll-Gergely & Vermeulen, sp. nov., A.tonkinospiroides Páll-Gergely & Vermeulen, sp. nov., A.tridentata Páll-Gergely & Hunyadi, sp. nov., A.tweediei Páll-Gergely & Hunyadi, sp. nov., A.uvula Páll-Gergely & Hunyadi, sp. nov., A.vandevenderi Páll-Gergely & Jochum, sp. nov., A.vitrina Páll-Gergely & Hunyadi, sp. nov., A.vomer Páll-Gergely & Hunyadi, sp. nov., A.werneri Páll-Gergely & Hunyadi, sp. nov. Angustopilasubelevata Páll-Gergely & Hunyadi, 2015 is moved to the synonymy of Angustopilaelevata (F. G. Thompson & Upatham, 1997), and A.singuladentis Inkhavilay & Panha, 2016 is a junior synonym of A.fabella Páll-Gergely & Hunyadi, 2015. Three species, namely A.elevata, A.fabella and A.szekeresi, are widespread over several hundred kilometres while some other species (A.huoyani, A.parallelasp. nov., A.cavicolasp. nov.) are known from just two sites a few hundred kilometres apart. All others are small range or single-site endemics. The reproductive anatomy of A.erawanicasp. nov. is described.

The effect of reading literary fiction on the theory of mind skills among persons with schizophrenia and normal controls.

Introduction: Recent research data suggest that theory of mind (ToM) skills may improve after reading literary fiction. However, beside this short term favorable effect, regular long-term reading of literary fiction may also support ToM development or may improve ToM performance. The presence of impaired ToM abilities is well-documented in schizophrenia; however, the role of reading in these deficits is unknown. In the present study our aim was to assess the effect of prior reading experiences on theory of mind performance in patients with schizophrenia, and in healthy controls. Materials and methods: ToM assessment was done with the Short Story Task, which is based on the interpretation of a Hemingway short story. After reading the short story, questions were asked in an interview format regarding comprehension, explicit and implicit ToM skills, then comparative analysis of schizophrenia patients was performed (n = 47) and matched to a normal control (n = 48) group concerning deficits of ToM abilities. Participants were also stratified according to their prior reading experiences. Results: Previous reading experience was associated with better comprehension and explicit ToM performance both in patients with schizophrenia, and in healthy controls. However, the explicit ToM performance of patients with prior reading was still weaker compared to healthy controls with reading experiences. Path model analysis revealed that reading had a direct positive effect on ToM, and an indirect effect through improving comprehension. Conclusions: Prior reading experience is associated with better ToM performance not just in healthy controls but also in patients living with schizophrenia. Previous reading experience also improves comprehension, which in turn has a favorable impact on ToM. Our results support the idea that literary fiction reading may have a therapeutic potential in the rehabilitation of schizophrenia.

[The potential role of improvisation training to optimize communication in emergency care]. / Az improvizációs tréningek lehetséges szerepe a kommunikáció optimalizálására a sürgosségi ellátásban.

INTRODUCTION: One of the most common challenges in acute care is the time- and space-limited communication with patients, relatives and colleagues. There is ample evidence, however, that the quality of care, patient and staff satisfaction can be improved, measured and researched using simple communication tools (e.g., training). OBJECTIVE: This improvement was what we focused on when carrying out voluntary participation surveys with the staff of the Department of Emergency Medicine of the Clinical Centre of the University of Pécs. METHOD: With the help of a trained psychologist-actor and a senior specialist in medical communication, we investigated the potential impact of applied improvisation on medical communication by testing the participants in various situations simulating communication challenges after having completed an improv-based communication training full of exercises, games and tasks. After warm-up games taken from improv, the participants completed pre-defined tasks and finished every session with discussion and self-reflective feedback. Questionnaire (Interpersonal Confidence Questionnaire - ICQ) was used to check the potentially positive impact of improvisation on emergency communication. RESULTS: Our studies confirmed that the applied elements of medical improvisation, developing communication skills through play not only make participants more assertive and empathic, but also - after preparation - lead to a smoother and more effective exchange of information. Positive feedback from participants in the training sessions also confirms this. DISCUSSION: Our aim is to develop an improvisation-based communication training focused specifically on acute care providers, which, based on our initial experience, could optimize communication with patients, relatives and also between professionals. CONCLUSION: Application of improvisational techniques in this segment of acute care studied by us might open new perspectives to improve communication. Orv Hetil. 2023; 164(19): 739-746.

Winners and Losers: Cordulegaster Species under the Pressure of Climate Change.

(1) Bioclimatic factors have a proven effect on species distributions in terrestrial, marine, or freshwater ecosystems. Because of anthropogenic effects, the changes in these variables are accelerated; thus, the knowledge of the impact has great importance from a conservation point of view. Two endemic dragonflies, the Balkan Goldenring (Cordulegaster heros) and the Two-Toothed Goldenring (C. bidentata), confined to the hilly and mountainous regions in Europe, are classified as "Near Threatened" according to the IUCN Red List. (2) Modeling the potential occurrence of both species under present and future climatic conditions provides a more accurate picture of the most suitable areas. The models were used to predict the responses of both species to 6 different climate scenarios for the year 2070. (3) We revealed which climatic and abiotic variables affect them the most and which areas are the most suitable for the species. We calculated how future climatic changes would affect the range of suitable areas for the two species. (4) According to our results, the suitable area for Cordulegaster bidentata and C. heros are strongly influenced by bioclimatic variables and showed an upward shift toward high elevations. The models predict a loss of suitable area in the case of C. bidentata and a large gain in the case of C. heros.

High prevalence of suicide-related internet use among patients with depressive disorders - a cross-sectional study with psychiatric in-patients.

The association between Internet use and suicidal behavior is a subject of intense research. Internet use patterns of patients with depressive disorders were assessed to determine the prevalence and aim of browsing for suicide-related contents and its impact on help-seeking. Self-administered questionnaire among psychiatric in-patients treated for depression was used to assess suicidal behavior, characteristics of Internet use and help-seeking preferences. 113 psychiatric in-patients with depressive disorders participated in the study. One-third had a history of life-time suicide attempt and the majority had already encountered suicide-related contents while browsing the Internet. 27.4% reported intentional and specific search for suicidal contents. This suicide-related Internet user (SRIU) group was characterized by younger age, single status, more frequent suicidal ideations, and they more likely considered that they would attempt suicide in the future. Among patients with depressive disorders, a sub-group was identified with a potential higher suicide risk. The frequent use of the Internet and online help-seeking preference may provide an opportunity to prevent suicidal behavior in this high-risk sub-group. Further research is needed into the possibilities of using the Internet more effectively for suicide prevention.

[Text and behavior - analysis of farewell notes - pilot study].

Studying suicide notes, - last personal documents before a suicide act - as well as investigation of media and internet texts on self-destruction (including contents, "messages") can have a great significance. Individual and cultural valuations appear in the way farewell notes, media letters and other personal documents present self-destruction. These "messages", ideas about life, death and suicide are deeply embedded within the public context of culture too. In the present content analysis formal, syntactic and grammatical characteristic features, as well as speech patterns and verbal expressions of selected notes, samples have been investigated. Suicidal - fatal (n=49) and nonfatal group (n=31) of farewell letters were compared with the sample of a control group (n=33). Results have been discussed, interpreted and concluded. These appear to be useful and important not only in understanding of suicidal phenomenon and its psychodynamic background in clinical work or in suicide hotlines, but also in prevention, social-, and clinical intervention of self-destruction. The investigation of these new data may provide a much broader perspective in understanding suicidal process.

A review of the genus Laeocathaica Möllendorff, 1899 (Gastropoda, Pulmonata, Camaenidae).

In this paper an overview of the Laeocathaica species is provided, and the intraspecific variability of several Laeocathaica species demonstrated on multiple shells. Laeocathaicahisanoi Páll-Gergely, sp. nov. and L.minwui Páll-Gergely, sp. nov. are described based on specimens found in museum collections. Five new synonyms are recognized: L.prionotropisalbocincta Möllendorff, 1899 is a new synonym of L.prionotropis Möllendorff, 1899, L.stenochone Möllendorff, 1899 is a new synonym of Laeocathaicacarinifera (H. Adams, 1870). Laeocathaicadistinguenda Möllendorff, 1899, L.tropidorhaphe Möllendorff, 1899, and L.dangchangensis Chen & Zhang, 2004 are moved to the synonymy of Laeocathaicaamdoana Möllendorff, 1899. Furthermore, photos of paratypes of Cathaicabizonalis Chen & Zhang, 2004 are published for the first time.

[The significance, effects and potential therapeutic use of literary fiction].

No abstract available.

Persons With Schizophrenia Misread Hemingway: A New Approach to Study Theory of Mind in Schizophrenia.

INTRODUCTION: Theory of Mind (ToM) is a key component of social cognition. Recently the Short Story Task (SST) was developed as a new measurement of ToM. SST uses a short story of Ernest Hemingway to assess ToM skills. SST proved to be a suitable tool, and sensitive to individual differences among healthy subjects. Our aim was to test SST to evaluate the ToM skills of persons with schizophrenia. MATERIALS AND METHODS: SST was used to assess ToM skills. After reading the short story "The End of Something" a structured interview was done with 14 questions. Spontaneous mental state reasoning, explicit mental state inference and comprehension of nonmental aspects of the story were evaluated. 47 persons with schizophrenia in remission and 48 healthy controls were assessed and compared. RESULTS: Persons with schizophrenia performed significantly more poorly in the explicit mental state inference questions. Ceiling effect was not detectable in explicit ToM scores. Patients made less spontaneous mental state references as well, although the occurrence of spontaneous mental state terms was infrequent in both groups. Patients were also less accurate in answering comprehension questions, but the difference was not significant after Bonferroni correction. DISCUSSION: Our results lined up with the original findings and we found SST to be a sensitive tool to explore the individual differences in ToM performance, not only among healthy subjects, but also among persons with schizophrenia especially in explicit mental state inferences without observing the ceiling effect. We found, however, SST to be less sensitive to measure spontaneous mental state reasoning and also the lack of the use of another ToM test to assess convergent validity of SST for indicating ToM deficits in schizophrenia stands as a limitation of current study.

[The Papageno-Effect in suicidology].

No abstract available.

Social Cognition Analyzer Application-A New Method for the Analysis of Social Cognition in Patients Diagnosed With Schizophrenia.

Introduction: Because of the importance of the assessment of social cognitive impairments in schizophrenia in clinical settings, a new computer application called SCAN (Social Cognition Analyzer applicatioN) was developed. Our first aim was to examine if patients diagnosed with schizophrenia could be differentiated from healthy individuals based on the results of SCAN, taking into consideration both response rates and response times. Our second aim was to create Scanalizer, as part of SCAN, to produce social cognitive profiles of individual patients. Materials and Methods: 86 patients (SG) and 101 healthy participants (CG) were examined with SCAN. The domains were: ToM, irony, metaphor, emotion perception from prosody and social perception. SCAN displayed the tasks, recorded the answers and the response times. For the differentiation of the two groups a two-dimensional scatter plot was used. For the graphical presentation of the social cognitive profile of patients, the calculation of the distributions of CG's results was made with Kolmogorov-Smirnov Goodness-of-fit Test and with the sum of squared residuals (SSR). Results: We found that the SG's response rates were significantly lower and the SG's response times were significantly slower compared to the CG in every condition. With the two-dimensional comparison of the summary response rates and the summary response times of the participants, the SG could be differentiated from the CG and this differentiation worked irrespective of age and education. For the graphical representation of social cognitive functions of patients, distributions of the results of the CG were calculated. We found normal distributions in the response times of all conditions and in the response rates of the ToM condition. In the low-end tail of the irony condition, and in the metaphor, social perception and emotional prosody conditions, power-law distributions were found. We also found that the summary response rates of the lowest performing 10% of the CG was in the same range as the summary response rates of all examined patients. Discussion: Scanalizer enables clinicians to measure and analyse social cognitive profiles of patients diagnosed with schizophrenia. Moreover, SCAN could also be used to detect social cognitive disabilities of vulnerable individuals.

[Experiences of a Extreme, absolutist expressions may be marker-specific to depressive or anxious states and suicide].

No abstract available.

[A Narrative Review on the Efficacy Studies of Social Skills Training for Patients with Schizophrenia with Special Focus on the Relationship between Social Cognition and Social Skills].

No abstcarct available.

Minor physical anomalies and dermatoglyphic signs in affective disorders: A systematic review.

The increased prevalence of minor physical anomalies (MPAs) and the abnormalities of dermatoglyphic patterns may be physical manifestations of neurodevelopmental disruption in affective disorders. This paper aims to review the current state of knowledge on the frequency of MPAs and dermatoglyphic abnormalities in mood disorders. A MEDLINE, PsychInfo and Web of Science search was carried out to collect all publications on the frequency of MPAs and on dermatoglyphic traits in bipolar disorder and unipolar depression. 24 studies on MPAs, 19 on dermatoglyphics, and 5 dealing with both were found with discrepant findings. The relative contribution of neurodevelopmental retardation to the aetiology of affective disorders remains undetermined, the field is open for further research. Increased recognition of neurodevelopmental processes in the origin of affective disorders may allow for earlier and more effective intervention and prevention.

Spectral discomfort glare sensitivity investigations.

The main concern of car headlamp manufacturers is to provide better visibility. Unfortunately, by increasing the luminous intensity of the headlamp, the risk of increasing discomfort glare for the other road users increases. One possibility to increase visibility and decrease glare could be the selection of a spectral power distribution for the headlamp such that it emits in wavelength regions (if such wavelengths exist) where luminous sensitivity is high, and glare sensitivity is low. For this the spectral discomfort glare sensitivity of humans under low photopic conditions has to be determined. Spectral discomfort glare sensitivity was determined using ten young observers, requesting the observers to select medium glare settings of monochromatic radiations based on the de Boer glare rating scale, both at near-foveal and 10 degrees extra-foveal directions of the 2 degrees diameter glare source. It was found that the spectral discomfort glare sensitivity function could not be described by a simple addition of the photopic spectral luminous efficiency function and the short wavelength cone fundamental, but that the contribution of the chromatic channels of human vision may also have to be considered.