Structure of the Children's Revised Impact of Event Scale (CRIES) with Children and Adolescents Exposed to Debris Flood

Aim

PTSD symptoms were pervasive among children and adolescents after experiencing or exposure to traumatic events. Screening and diagnosis of PTSD symptoms is crucial in trauma-related research and practice. The 13-item Children''s Revised Impact of Event Scale (CRIES) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 13-item CRIES in a sample of Chinese debris flood victims.

Methods

A total of 268 participants (145 girls, 123 boys) aged 8–18 years were recruited from an integral part of a service oriented project, supported by the Institute of Psychology, Chinese Academy of Sciences following the debris flood. The participants were given the 13-item CRIES 3 months after the debris flood.

Results

The results of confirmatory factor analysis indicated that a two-factor structure (intrusion+arousal vs avoidance) emerged as the model best fit in total sample, boys and girls subsamples, respectively. The scale was also demonstrated to have good internal consistency (Cronbach''s alpha = 0.83).

Conclusion

The study confirmed the good psychometric properties of the CRIES and its'' applicability to Chinese children and adolescents. Moreover, these findings imply that the CRIES factor structure is stable across age, gender, and different types of trauma.     

Gender sensitivity in medical curricula

Both sex--the biologic aspects of being female or male--and gender--the cultural roles and meanings ascribed to each sex--are determinants of health. Medical education, research and practice have all suffered from a lack of attention to gender and a limited awareness of the effects of the sex-role stereotypes prevalent in our society. The Women''s Health Interschool Curriculum Committee of Ontario has developed criteria for assessing the gender sensitivity of medical curricula. In this article, the effects of medicine''s historical blindness to gender are explored, as are practical approaches to creating curricula whose content, language and process are gender-sensitive. Specific areas addressed include ensuring that women and men are equally represented, when appropriate, that men are not portrayed as the prototype of normal (and women as deviant), that language is inclusive and that women''s health and illness are not limited to reproductive function. By eliminating or at least addressing the subtle and often unintentional gender stereotyping in lecture material, illustrations and problems used in problem-based learning, medical educators can undertake a much-needed transformation of curriculum.     

Students’ Perceptions of Peer-Organized Extra-Curricular Research Course during Medical School: A Qualitative Study

Early integration of research education into medical curricula is crucial for evidence-based practice. Yet, many medical students are graduating with no research experience due to the lack of such integration in their medical school programs. The purpose of this study was to explore the impact of a peer-organized, extra-curricular research methodology course on the attitudes of medical students towards research and future academic careers. Twenty one medical students who participated in a peer-organized research course were enrolled in three focus group discussions to explore their experiences, perceptions and attitudes towards research after the course. Discussions were conducted using a semi-structured interview guide, and were transcribed and thematically analyzed for major and minor themes identification. Our findings indicate that students’ perceptions of research changed after the course from being difficult initially to becoming possible. Participants felt that their research skills and critical thinking were enhanced and that they would develop research proposals and abstracts successfully. Students praised the peer-assisted teaching approach as being successful in enhancing the learning environment and filling the curricular gap. In conclusion, peer-organized extra-curricular research courses may be a useful option to promote research interest and skills of medical students when gaps in research education in medical curricula exist.     

Evaluation of extended training for general practice in Northern Ireland: qualitative study

Objective To evaluate participants'' perceptions of the impact on them of an additional six months'' training beyond the standard 12 month general practice vocational training scheme.Design Qualitative study using focus groups.Setting General practice vocational training in Northern Ireland.Participants 13 general practitioner registrars, six of whom participated in the additional six months'' training, and four trainers involved in the additional six months'' training.Main outcome measures: Participants'' views about their experiences in 18 month and 12 month courses.Results Participants reported that the 12 month course was generally positive but was too pressurised and focused on examinations, and also that it had a negative impact on self care. The nature of the learning and assessment was reported to have left participants feeling averse to further continuing education and lacking in confidence. In contrast, the extended six month component was reported to have restimulated learning by focusing more on patient care and promoting self directed learning. It developed confidence, promoted teamwork, and gave experience of two practice contexts, and was reported as valuable by both ex-registrars and trainers. However, both the 12 and 18 month courses left participants feeling underprepared for practice management and self care.Conclusions 12 months'' training in general practice does not provide doctors with the necessary competencies and confidence to enter independent practice. The extended period was reported to promote greater professional development, critical evaluation skills, and orientation to lifelong learning but does not fill all the gaps.     

Effect of Formant Frequency Spacing on Perceived Gender in Pre-Pubertal Children's Voices

Background

It is usually possible to identify the sex of a pre-pubertal child from their voice, despite the absence of sex differences in fundamental frequency at these ages. While it has been suggested that the overall spacing between formants (formant frequency spacing - ΔF) is a key component of the expression and perception of sex in children''s voices, the effect of its continuous variation on sex and gender attribution has not yet been investigated.

Methodology/Principal findings

In the present study we manipulated voice ΔF of eight year olds (two boys and two girls) along continua covering the observed variation of this parameter in pre-pubertal voices, and assessed the effect of this variation on adult ratings of speakers'' sex and gender in two separate experiments. In the first experiment (sex identification) adults were asked to categorise the voice as either male or female. The resulting identification function exhibited a gradual slope from male to female voice categories. In the second experiment (gender rating), adults rated the voices on a continuum from “masculine boy” to “feminine girl”, gradually decreasing their masculinity ratings as ΔF increased.

Conclusions/Significance

These results indicate that the role of ΔF in voice gender perception, which has been reported in adult voices, extends to pre-pubertal children''s voices: variation in ΔF not only affects the perceived sex, but also the perceived masculinity or femininity of the speaker. We discuss the implications of these observations for the expression and perception of gender in children''s voices given the absence of anatomical dimorphism in overall vocal tract length before puberty.     

Modulation of Self-Esteem in Self- and Other-Evaluations Primed by Subliminal and Supraliminal Faces

Background

Past research examining implicit self-evaluation often manipulated self-processing as task-irrelevant but presented self-related stimuli supraliminally. Even when tested with more indirect methods, such as the masked priming paradigm, participants'' responses may still be subject to conscious interference. Our study primed participants with either their own or someone else''s face, and adopted a new paradigm to actualize strict face-suppression to examine participants'' subliminal self-evaluation. In addition, we investigated how self-esteem modulates one''s implicit self-evaluation and validated the role of awareness in creating the discrepancy on past findings between measures of implicit self-evaluation and explicit self-esteem.

Methodology/Principal Findings

Participants'' own face or others'' faces were subliminally presented with a Continuous Flash Suppression (CFS) paradigm in Experiment 1, but supraliminally presented in Experiment 2, followed by a valence judgment task of personality adjectives. Participants also completed the Rosenberg Self-Esteem Scale in each experiment. Results from Experiment 1 showed a typical bias of self-positivity among participants with higher self-esteem, but only a marginal self-positivity bias and a significant other-positivity bias among those with lower self-esteem. However, self-esteem had no modulating effect in Experiment 2: All participants showed the self-positivity bias.

Conclusions/Significance

Our results provide direct evidence that self-evaluation manifests in different ways as a function of awareness between individuals with different self-views: People high and low in self-esteem may demonstrate different automatic reactions in the subliminal evaluations of the self and others; but the involvement of consciousness with supraliminally presented stimuli may reduce this dissociation.     

Gender Differences in Cooperation: Experimental Evidence on High School Students

The emergence of cooperation among unrelated human subjects is a long-standing conundrum that has been amply studied both theoretically and experimentally. Within the question, a less explored issue relates to the gender dependence of cooperation, which can be traced back to Darwin, who stated that "women are less selfish but men are more competitive". Indeed, gender has been shown to be relevant in several game theoretical paradigms of social cooperativeness, including prisoner''s dilemma, snowdrift and ultimatum/dictator games, but there is no consensus as to which gender is more cooperative. We here contribute to this literature by analyzing the role of gender in a repeated Prisoners'' Dilemma played by Spanish high-school students in both a square lattice and a heterogeneous network. While the experiment was conducted to shed light on the influence of networks on the emergence of cooperation, we benefit from the availability of a large dataset of more 1200 participants. We applied different standard econometric techniques to this dataset, including Ordinary Least Squares and Linear Probability models including random effects. All our analyses indicate that being male is negatively associated with the level of cooperation, this association being statistically significant at standard levels. We also obtain a gender difference in the level of cooperation when we control for the unobserved heterogeneity of individuals, which indicates that the gender gap in cooperation favoring female students is present after netting out this effect from other socio-demographics factors not controlled for in the experiment, and from gender differences in risk, social and competitive preferences.     

Neurotrophic Factors,Clinical Features and Gender Differences in Depression

Recent studies have evaluated the role of brain-derived neurotrophic factor (BDNF) in mood disorders; however, little is known about alterations in nerve growth factor (NGF) and glial cell line-derived neurotrophic factor (GDNF). The aim of this study was to evaluate differences among serum neurotrophic factors (BDNF, NGF and GDNF) in depressed patients and healthy controls and to verify the association between serum neurotrophic levels and clinical characteristics in a young, depressed population stratified by gender. This is a cross-sectional study with depressed patients and population controls 18–29 years of age. The concentrations of neurotrophic factors were determined by the ELISA method. The diagnosis of depression and the duration of the disease were assessed by the Structured Clinical Interview according to the diagnostic and statistical manual of mental disorders. Depression severity was measured with the 17-item Hamilton Rating Scale for Depression, and the severity of anxiety symptoms was measured using the Hamilton Anxiety Rating Scale. Serum BDNF and GDNF were lower in major depressive disorder (MDD) patients compared to controls (p ≤ 0.001). Serum NGF levels were higher in MDD patients versus controls (p ≤ 0.001). BDNF was associated with the duration of disease only in women (p = 0.005). GDNF was not associated with clinical characteristics in either gender. In women, NGF was associated with the severity of depressive symptoms (p = 0.009), anxiety (p = 0.011) and disease duration (p = 0.005). NGF was associated with disease duration in men (p = 0.026). Our results demonstrated that significant neurochemical differences in NGF and BDNF, but not in GDNF, were associated with the clinical features of MDD when patients were stratified by gender.     

Factors Associated with Primary School Teachers’ Attitudes Towards the Inclusion of Students with Disabilities

Objective

Teachers'' attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers'' attitudes towards inclusion of students with all disabilities in regular schools.

Method

Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers'' attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Bandura''s Teacher Efficacy scale respectively.

Results

Four teacher attributes—age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers'' attitude toward including students with disabilities.

Conclusion

The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools.     

Evaluation of the effect of systolic blood pressure and pulse pressure on cognitive function: the Women's Health and Aging Study II

Background

Evidence suggests that elevated systolic blood pressure (SBP) and pulse pressure (PP) in midlife is associated with increased risk for cognitive impairment later in life. There is mixed evidence regarding the effects of late life elevated SBP or PP on cognitive function, and limited information on the role of female gender.

Methods/Principal Findings

Effects of SBPand PPon cognitive abilities at baseline and over a 9-year period were evaluated in 337 non-demented community-dwelling female participants over age 70 in the Women''s Health and Aging Study II using logistic and Cox proportional hazards regression analyses. Participants aged 76–80 years with SBP≥160 mmHg or PP≥84 mmHg showed increased incidence of impairment on Trail Making Test-Part B (TMT, Part B), a measure of executive function, over time when compared to the control group that included participants with normal and pre-hypertensive SBP (<120 and 120–139 mmHg) or participants with low PP (<68 mmHg) (HR = 5.05 [95%CI = 1.42, 18.04], [HR = 5.12 [95%CI = 1.11; 23.62], respectively). Participants aged 70–75 years with PP≥71 mmHg had at least a two-fold higher incidence of impairment on HVLT-I, a measure of verbal learning, over time when compared to participants with low PP (<68 mmHg) (HR = 2.44 [95%CI = 1.11, 5.39]).

Conclusions/Significance

Our data suggest that elevated SBP or PP in older non-demented women increases risk for late-life cognitive impairment and that PP could be used when assessing the risk for impairment in cognitive abilities. These results warrant further, larger studies to evaluate possible effects of elevated blood pressure in normal cognitive aging.     

Can Score Databanks Help Teaching?

Background

Basic courses in most medical schools assess students'' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students'' grades.

Methodology/Principal Findings

We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378–4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495–3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern.

Conclusion/Significance

An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student''s performance.     

Biased Confidence in Risk Assessment Studies

The present research examined factors that influence laypeople's confidence in the results of risk assessment studies. A 2 (hazard; cell phone, base station) × 2 (study outcome; no risk, risk) × 2 (health effect; well-being, cancer) × 3 (risk perception prior to the manipulation; low, medium, high) design was used. Results showed that participants had more confidence in studies with results that were in line with their prior attitudes compared with studies that were at odds with their prior attitudes. In addition, participants had more confidence in studies showing a risk compared with studies showing no risk. Results suggest that these biases may be one of the reasons why laypeople are concerned about technological risks, even when risk assessment studies indicate that there is a low probability of adverse health effects.     

Psychological test performance during climatic heat stress from dessert winds

The influence of climatic heat stress (Sharav) on the performance of subjects tested routinely at the Industrial Psychology Laboratory was studied on two groups of subjects. Candidates for office jobs and candidates for technological jobs, or candidates for courses at technological institutes. It was found that subjects tested on Sharav days had higher scores on neuroticism and extraversion and scored significantly lower than controls on intelligence tests, substitution, mechanical comprehension, and instructions. Climatic heat stress did not seem to influence performance on arithmetic, clerical ability and visual perception tests.     

Mental Health Literacy of Depression: Gender Differences and Attitudinal Antecedents in a Representative British Sample

Background

Poor mental health literacy and negative attitudes toward individuals with mental health disorders may impede optimal help-seeking for symptoms of mental ill-health. The present study examined the ability to recognize cases of depression as a function of respondent and target gender, as well as individual psychological differences in attitudes toward persons with depression.

Methods

In a representative British general population survey, the ability to correctly recognize vignettes of depression was assessed among 1,218 adults. Respondents also rated the vignettes along a number of attitudinal dimensions and completed measures of attitudes toward seeking psychological help, psychiatric skepticism, and anti-scientific attitudes.

Results

There were significant differences in the ability to correctly identify cases of depression as a function of respondent and target gender. Respondents were more likely to indicate that a male vignette did not suffer from a mental health disorder compared to a female vignette, and women were more likely than men to indicate that the male vignette suffered from a mental health disorder. Attitudes toward persons with depression were associated with attitudes toward seeking psychological help, psychiatric skepticism, and anti-scientific attitudes.

Conclusion

Initiatives that consider the impact of gender stereotypes as well as individual differences may enhance mental health literacy, which in turn is associated with improved help-seeking behaviors for symptoms of mental ill-health.     

Integration of mental health into primary care in Sri Lanka

Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic “train the trainers” programme to integrate mental health into primary care in Sri Lanka''s public health system and private sector.Methods A 40 hour training programme was delivered to curriculum and teaching materials were adapted for Sri Lanka, and delivered to 45 psychiatrists, 110 medical officers of mental health and 95 registered medical practitioners, through five courses, each in a different region (Colombo, Kandy, Jaffna, Galle and Batticola). Participants were selected by the senior psychiatrist of each region, on the basis of ability to conduct subsequent roll out of the training. The course was very interactive, with discussions, role plays and small group work, as well as brief theory sessions.Results Qualitative participant feedback was encouraging about the value of the course in improving patient assessments and treatments, and in providing a valuable package for roll out to others. Systematic improvement was achieved between pre- and post-test scores of participants at all training sites. The participants had not had prior experience in such interactive teaching methods, but were able to learn these new techniques relatively quickly.Conclusions The programme has been conducted in collaboration with the Sri Lankan National Institute of Mental Health and the Ministry of Health, and this partnership has helped to ensure that the training is tailored to Sri Lanka and has the chance of long term sustainability.     

The Impact of Perceived Social Power and Dangerous Context on Social Attention

Past research has shown that position in a social hierarchy modulates one''s social attention, as in the gaze cueing effect. While studies have manipulated the social status of others with whom the participants interact, we believe that a sense of one''s own social power is also a crucial factor affecting gaze following. In two experiments, we primed the social power of participants, using different approaches, to investigate the participants'' performance in a subsequent gaze cueing task. The results of Experiment 1 showed a stronger gaze cueing effect among participants who were primed with low social power, compared to those primed with high social power. Our predicted gender difference (i.e., women showing a stronger gaze cueing effect than men) was confirmed and this effect was found to be dominated by the lower social power condition. Experiment 2 manipulated the level of danger in the context and replicated the joint impact of gender and one''s perceived social power on gaze cueing effect, especially in the low danger context, in comparison to the high danger context. These findings demonstrate that one''s perceived social power has a concerted effect on social attention evoked by gaze, along with other factors such as gender and characteristics of the environment, and suggest the importance of further research on the complex relationship between an individual''s position in the social hierarchy and social attention.     

Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study)

Purpose

Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI) and waist circumference (WC), and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics.

Methods

Participants in the RECORD Cohort Study (Paris Region, France, 2007–2008) were surveyed on the supermarket (brand and exact location) where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC.

Results

Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants'' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education), and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC.

Conclusion

A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.     

Emotions under Discussion: Gender,Status and Communication in Online Collaboration

Background

Despite the undisputed role of emotions in teamwork, not much is known about the make-up of emotions in online collaboration. Publicly available repositories of collaboration data, such as Wikipedia editor discussions, now enable the large-scale study of affect and dialogue in peer production.

Methods

We investigate the established Wikipedia community and focus on how emotion and dialogue differ depending on the status, gender, and the communication network of the editors who have written at least 100 comments on the English Wikipedia''s article talk pages. Emotions are quantified using a word-based approach comparing the results of two predefined lexicon-based methods: LIWC and SentiStrength.

Principal Findings

We find that administrators maintain a rather neutral, impersonal tone, while regular editors are more emotional and relationship-oriented, that is, they use language to form and maintain connections to other editors. A persistent gender difference is that female contributors communicate in a manner that promotes social affiliation and emotional connection more than male editors, irrespective of their status in the community. Female regular editors are the most relationship-oriented, whereas male administrators are the least relationship-focused. Finally, emotional and linguistic homophily is prevalent: editors tend to interact with other editors having similar emotional styles (e.g., editors expressing more anger connect more with one another).

Conclusions/Significance

Emotional expression and linguistic style in online collaboration differ substantially depending on the contributors'' gender and status, and on the communication network. This should be taken into account when analyzing collaborative success, and may prove insightful to communities facing gender gap and stagnation in contributor acquisition and participation levels.     

Prior Knowledge, Older Age, and Higher Allowance Are Risk Factors for Self-Medication with Antibiotics among University Students in Southern China

Background

Self-medication with antibiotics (SMA) has been reported among university students in many countries, but little research has been done on this issue in China. The objective of this study was to evaluate knowledge and behaviors of university students and risk factors concerning SMA.

Methodology/Principal Findings

Using a novel questionnaire-based data collection instrument, an anonymous online survey was conducted with the students of Shantou University (STU), a university comprising 8 schools/colleges in eastern Guangdong, China. Of 1,300 respondents (13.8% of total eligible participants), 47.8% had self-treated with antibiotics. Logistic regression analysis identified prior knowledge of antibiotics (PKA), older age, and higher monthly allowance as independent risk factors for SMA. PKA significantly influenced students'' knowledge about antibiotics, their uses, and common adverse reactions (all p<0.05). Among self-medicated students, 61.7% used antibiotics at least twice in the previous year. Community pharmacies were the major source of self-prescribed antibiotics. Reported common indications for SMA were sore throat (59.7%), fever (38.2%), cough (37.4%), runny nose (29.3%), and nasal congestion (28.7%). While 74.1% of self-medication episodes were based on students'' own experiences, only 31.1% of students claimed to understand the package insert. Alteration of antibiotics and dosage during the course of self-treatment was made by 63.8% and 55.6% of students, respectively. At least two kinds of antibiotics were simultaneously taken by 82.6% of students. The majority of self-medicated students failed to complete the course of antibiotics. Adverse reactions were reported by 16.3% of students. Amoxicillin was the most common antibiotic used for self-medication.

Conclusions

High prevalence of SMA was noted among STU students. Presence of risk factors and risk-associated behaviors/attitudes in the study population calls for focused educational intervention and stricter governmental legislation and regulation of antibiotic use and sale in pharmacies.     

Lifting without Seeing: The Role of Vision in Perceiving and Acting upon the Size Weight Illusion

Background

Our expectations of an object''s heaviness not only drive our fingertip forces, but also our perception of heaviness. This effect is highlighted by the classic size-weight illusion (SWI), where different-sized objects of identical mass feel different weights. Here, we examined whether these expectations are sufficient to induce the SWI in a single wooden cube when lifted without visual feedback, by varying the size of the object seen prior to the lift.

Methodology/Principal Findings

Participants, who believed that they were lifting the same object that they had just seen, reported that the weight of the single, standard-sized cube that they lifted on every trial varied as a function of the size of object they had just seen. Seeing the small object before the lift made the cube feel heavier than it did after seeing the large object. These expectations also affected the fingertip forces that were used to lift the object when vision was not permitted. The expectation-driven errors made in early trials were not corrected with repeated lifting, and participants failed to adapt their grip and load forces from the expected weight to the object''s actual mass in the same way that they could when lifting with vision.

Conclusions/Significance

Vision appears to be crucial for the detection, and subsequent correction, of the ostensibly non-visual grip and load force errors that are a common feature of this type of object interaction. Expectations of heaviness are not only powerful enough to alter the perception of a single object''s weight, but also continually drive the forces we use to lift the object when vision is unavailable.