Stress self-perception and burnout in chiropractic students in a lockdown situation due to COVID-19: A cross-sectional and comparative study.

OBJECTIVE: The purpose of this study was to investigate if COVID-19 lockdown affected stress-perception and burnout in chiropractic students from our institution. METHODS: Stress and burnout in students were assessed using the Perceived Stress Scale and the Maslach Burnout Inventory. The surveys were sent out electronically in March 2020 to chiropractic students enrolled at our college. Data were analyzed with descriptive statistics and t test or analysis of variance to determine statistically significant differences between variables. Data were compared with that obtained in 2018, under no lockdown conditions. RESULTS: The survey had an overall response rate of 48.94%. Women presented statistically significant higher values for stress (p = .002) and exhaustion (p = .007). Younger students tended to suffer more stress than their older peers. When comparing lockdown data with that of 2018, students presented significantly lower stress levels but higher cynicism. CONCLUSION: Women presented higher values for stress and exhaustion than the men. When comparing data with a prior study in 2018 with no lockdown situation, current students appeared to have lower levels of stress but increased cynicism.

Stress and burnout in chiropractic students of European chiropractic colleges.

OBJECTIVE: High levels of stress and burnout are known to negatively impact academic success, quality of life, and well-being of students. The purpose of this study was to investigate the degrees of stress and burnout levels of students from several European chiropractic colleges. METHODS: Stress and burnout were assessed using the Perceived Stress Scale (PSS-10) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Surveys were delivered electronically in November 2017 to chiropractic students from 4 different chiropractic colleges. Data were analyzed using t test and 1-way ANOVA to determine differences between demographic data. Scores in perceived stress and burnout subscales were compared to the general, chiropractic, and medical student populations. RESULTS: Both the MBI-SS and PSS had similar response rates (30%-34%) and demonstrated statistically significant differences between institutions, with C-3 demonstrating the highest levels of exhaustion (p < .001) and the highest levels of perceived stress (p = .012). MBI-SS results show that in the general chiropractic student population, 26.4% presented high emotional exhaustion, 18.2% high cynicism, and 43.8% low academic efficacy. Meanwhile, the PSS score indicated "moderate" levels of stress. CONCLUSIONS: European chiropractic students experience higher levels of perceived stress than the general population and they may suffer levels of burnout similar to those of medical students. These results suggest that colleges should monitor stress and burnout levels in their students. This may help to establish student support systems in order to improve students' quality of life and academic performance, as well as help new graduates transition to their professional lives.

Grit and chiropractic students' academic performance: a cross-sectional study.

OBJECTIVE: Previous investigations have studied the relationship between grit and academic performance, and it has been reported that grittier students perform better academically. The objectives of this study are to measure chiropractic students' grittiness and to explore the correlation between grit and academic performance. METHODS: We distributed the Short Grit Scale (Grit-S) questionnaire to chiropractic students in electronic form. We included questions about their previous grade point average and the number of times they had retaken examinations. We scored the overall Grit-S scale and the Consistency of Interest and Perseverance of Effort subscales. A 2-tailed t test and 1-way analysis of variance were used to determine differences between groups. RESULTS: The response rate was 87% (n = 110). The mean grit score (3.44 ± 0.60) was similar to the general population and slightly lower than other healthcare professionals. The students who had a grade point average between <80% but less than 90% obtained significantly higher grit scores compared to those who had a grade point average <60% but less than 70%. Similarly, students who had no examination retakes had higher grit scores compared to those who took 4 or more exam retakes. We observed these differences in the overall and subscales scores. No other group showed any difference. CONCLUSION: The results of this research showed that the grittier students performed better academically than the less gritty students. Grit scores can potentially be used to identify the students at risk of failing or dropping out. The role and potential application of grit in chiropractic education, student support, and admission procedures should be further evaluated.

Newly qualified chiropractors' perceptions of preparedness for practice: A cross-sectional study of graduates from European training programs.

OBJECTIVE: The purpose of this pilot study was to explore chiropractic graduates' perceived preparedness for practice in the 7 key competencies of the Canadian Medical Education Directives for Specialists. METHODS: An anonymous 5-point Likert scale electronic questionnaire was distributed to graduates from the 2014-2016 cohorts of 9 European chiropractic colleges accredited by the European Council of Chiropractic Education. For each group under 1 competency role, the mean overall score was calculated. Statistical differences were analyzed using a t test and analysis of variance. Cronbach's alpha was calculated for internal consistency. RESULTS: Results of 7 chiropractic colleges were analyzed (n = 121). Differences were found among colleges, competencies, and items. Overall, the graduates who responded scored the lowest in collaborator (3.76) and scholar (3.78) competencies. They scored the highest in professional (4.39) and chiropractic expert (4.13) competencies. In all colleges, a lower level of perceived preparedness was found in collaborator, scholar, and manager competencies. Statistical differences were found that compared the type of employment and cohorts. CONCLUSION: Our results show there may be a gap between education and professional practice regarding perceived preparedness, and graduates perceived themselves to be unprepared in some competencies. The preliminary results of this study could be used to improve curricula of chiropractic education.

Increased serum creatine kinase is a reliable marker for acute transplanted heart rejection diagnosis in rats.

Different molecules have been studied as biochemical markers in heart transplantation. However, their utility is under discussion as results in human and animal models are controversial. In this work, lactate dehydrogenase (LDH), creatine kinase (CK) and cardiac troponin I (TnI) were studied as serologic markers of acute rejection after heterotopical heart transplantation in rats. In predictable rejection experiments, animals were divided into three groups: nonoperated (Lewis rats), control group (Lewis-Lewis isografts) and rejection group (Brown Norway-Lewis allografts). Nonpredictable rejection experiments were performed using nonconsanguineous Sprague-Dawley allografts. In predictable rejection experiments, LDH activity was similar between control and rejection groups. TnI values were heterogeneous in control and rejection groups. In contrast, the rejection group showed CK activity increased 4.5-fold compared with the control group. In addition to these predictable studies, we also presented novel nonpredictable experiments in which rats were divided into groups based on low and high CK activity. Histologic studies in these rats showed that none of those with low CK activity presented rejection signs, while all animals with high CK levels showed grade 2R rejection. These results suggest that CK might be an excellent marker for prediction of rejection in heart transplantation.

A conditional model reveals that induction of hepatocyte nuclear factor-1alpha in Hnf1alpha-null mutant beta-cells can activate silenced genes postnatally, whereas overexpression is deleterious.

Humans with heterozygous loss-of-function mutations in the hepatocyte nuclear factor-1alpha (HNF1alpha) gene develop beta-cell-deficient diabetes (maturity-onset diabetes of the young type 3), indicating that HNF1alpha gene dosage is critical in beta-cells. However, whether increased HNF1alpha expression might be beneficial or deleterious for beta-cells is unknown. Furthermore, although it is clear that HNF1alpha is required for beta-cell function, it is not known whether this role is cell autonomous or whether there is a restricted developmental time frame for HNF1alpha to elicit gene activation in beta-cells. To address this, we generated a tetracycline-inducible mouse model that transcribes HNF1alpha selectively in beta-cells in either wild-type or Hnf1alpha-null backgrounds. Short-term induction of HNF1alpha in islets from adult Hnf1alpha(-/-) mice that did not express HNF1alpha throughout development resulted in the activation of target genes, indicating that HNF1alpha has beta-cell-autonomous functions that can be rescued postnatally. However, transgenic induction throughout development, which inevitably resulted in supraphysiological levels of HNF1alpha, strikingly caused a severe reduction of cellular proliferation, increased apoptosis, and consequently beta-cell depletion and diabetes. Thus, HNF1alpha is sensitive to both reduced and excessive concentrations in beta-cells. This finding illustrates the paramount importance of using the correct concentration of a beta-cell transcription factor in both gene therapy and artificial differentiation strategies.