Investigating the Protective Role of Mastery Imagery Ability in Buffering Debilitative Stress Responses.

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery's effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery's effectiveness in response to actual competition. This study examined (a) whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, and (b) the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images.

Identification of training opportunities in medical education for academic faculty.

Introduction: Clinician-educators are responsible for providing education to trainees in medical centers. There is no clear overview of what opportunities exist for training clinician-educators in medical education related skills and techniques. Methods: We conducted a systematic review of multiple websites and a medical educator listserve to identify medical education training opportunities for clinician-educators. We included certificate level programs or programs with comparable recognition and excluded masters programs, programs specific to one medical specialty or institution, and brief modules/sessions. We categorized results by training/focus area(s) and program details relevant for faculty. Results: We identified 53 programs. Most focus on general medical education skills (N = 19, 36%), leadership (N = 18, 34%), or learner assessment (N = 16, 30%). Fourteen programs (26%) were exclusively online, 27 (56%) exclusively in-person, and 12 (23%) require in-person and distance components. Time requirements for completion vary greatly, ranging from 1 day to 3 years, as did program costs, ranging from $327 to $15,000. Conclusions: Although training programs in medical education for clinical faculty exist, most focus on general medical education, leadership, and assessment. More programs focused on other topics, such as simulation or educational research, may be needed. Future investigations to understand the needs of this population would be valuable.

An algorithm developed using the Brighton Collaboration case definitions is more efficient for determining diagnostic certainty.

The Brighton Collaboration is a global research network focused on vaccine safety. The Collaboration has created case definitions to determine diagnostic certainty for several adverse events. Currently nested within multi-page publications, these definitions can be cumbersome for use. We report the results of a randomized trial in which the case definition for anaphylaxis was converted into a user-friendly algorithm and compared the algorithm with the standard case definition. The primary outcomes were efficiency and accuracy. Forty medical students determined the Brighton Level of diagnostic certainty of a sample case of anaphylaxis using either the algorithm or the original case definition. Most participants in both groups selected the correct Brighton Level. Participants using the algorithm required significantly less time to review the case and determine the level of diagnostic certainty [mean difference=107 s (95% CI: 13-200; p=0.026)], supporting that the algorithm was more efficient without impacting accuracy.

Immediate hypersensitivity reactions following monovalent 2009 pandemic influenza A (H1N1) vaccines: reports to VAERS.

BACKGROUND: Hypersensitivity disorders following vaccinations are a cause for concern. OBJECTIVE: To determine the type and rate by age, gender, and vaccine received for reported hypersensitivity reactions following monovalent 2009 pandemic influenza A (H1N1) vaccines. DESIGN: A systematic review of reports to the Vaccine Adverse Event Reporting System (VAERS) following monovalent 2009 pandemic influenza A (H1N1) vaccines. SETTING/PATIENTS: US Civilian reports following vaccine received from October 1, 2009 through May 31, 2010. MEASUREMENTS: Age, gender, vaccines received, diagnoses, clinical signs, and treatment were reviewed by nurses and physicians with expertise in vaccine adverse events. A panel of experts, including seven allergists reviewed complex illnesses and those with conflicting evidence for classification of the event. RESULTS: Of 1984 reports, 1286 were consistent with immediate hypersensitivity disorders and 698 were attributed to anxiety reactions, syncope, or other illnesses. The female-to-male ratio was ≥4:1 for persons 20-to-59 years of age, but approximately equal for children under 10. One hundred eleven reports met Brighton Collaboration criteria for anaphylaxis; only one-half received epinephrine for initial therapy. The overall rate of reported hypersensitivity reactions was 10.7 per million vaccine doses distributed, with a 2-fold higher rate for live vaccine. LIMITATIONS: Underreporting, especially of mild events, would result in an underestimate of the true rate of immediate hypersensitivity reactions. Selective reporting of events in adult females could have resulted in higher rates than reported for males. CONCLUSIONS: Adult females may be at higher risk of hypersensitivity reactions after influenza vaccination than men. Although the risk of hypersensitivity reactions following 2009 pandemic influenza A (H1N1) vaccines was low, all clinics administering vaccines should be familiar with treatment guidelines for these adverse events, including the use of intramuscular epinephrine early in the course of serious hypersensitivity reactions.

Exploring relationships over time between psychological distress, perceived stress, life events and immature defense style on disordered eating pathology.

BACKGROUND: Perceived stress, immature defense style, depression and anxiety and negative life events all are known to be associated with eating disorders. The present study aimed to investigate the relationships between these factors and their relative strength of association with eating disorder symptoms over time. METHODS: This research was embedded in a longitudinal study of adult women with varying levels of eating disorder symptoms and who were initially recruited from tertiary educational institutions in two Australian states. Four years from initial recruitment, 371 participants completed the Eating Disorder Examination- Questionnaire (EDE-Q) for eating disorder symptoms. Kessler-10 Psychological Distress Scale (K-10) as a measure of depression and anxiety, a Life Events Checklist as a measure of previous exposure to potentially traumatic events, the Defense Style Questionnaire (DSQ) and the Perceived Stress Scale (PSS) to determine perceived stress. One year later, in year 5, 295 (878.7%) completed follow-up assessments including the EDE-Q. The questionnaires were completed online or returned via reply paid post. RESULTS: All four independent factors were found to correlate significantly with the global EDE-Q score in cross-sectional analyses (all Spearman rho (rs) >0.18, p < 0.01) and at one year follow-up (all rs > 0.15, all p < 0.05). In multivariate linear regression modeling adjusted for age and year 4 global EDE-Q scores, perceived stress and psychological distress scores were significantly associated with year 5 global EDE-Q scores (p = 0.046 and <0.001 respectively). CONCLUSIONS: Psychological distress, and to a lesser degree perceived stress had the strongest association with eating disorder symptoms over time The findings support further investigation of interventions to reduce distress and perceived stress in adult females with disordered eating.