Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians

Medical practice is inherently ambiguous and uncertain. The physicians' ability to tolerate ambiguity and uncertainty has been proved to have a great impact on clinical practice. The primary aim of the present study was to test the hypothesis that higher degree of physicians' ambiguity and uncertainty intolerance and higher need for cognitive closure will predict higher work stress. Two hundred and twelve physicians (mean age = 42.94 years; SD = 10.72) from different medical specialties with different levels of expertise were administered a set of questionnaires measuring perceived levels of work-related stress, individual ability to tolerate ambiguity, stress deriving from uncertainty, and personal need for cognitive closure. A linear regression analysis was performed to examine which variables predict the perceived level of stress.The regression model was statistically significant [R2=.32; F(10,206)= 8.78, p<001], thus showing that, after controlling for gender and medical specialty, ambiguity and uncertainty tolerance, decisiveness (a dimension included in need for closure), and the years of practice were significant predictors of perceived work-related stress. Findings from the present study have some implications for medical education. Given the great impact that the individual ability to tolerate ambiguity and uncertainty has on the physicians' level of perceived work-related stress, it would be worth paying particular attention to such a skill in medical education settings. It would be crucial to introduce or to empower educational tools and strategies that could increase medical students' ability to tolerate ambiguity and uncertainty

A Comparison of Divergent Thinking Abilities Between Healthy Elderly Subjects and MCI Patients: Preliminary Findings and Implications

Objective: Divergent thinking (DT) has attracted research interest because of its potential role in early diagnosis and rehabilitation programs for patients affected by neurodegenerative diseases. Recently, DT has received even more attention because of its proven relationship with cognitive reserve (CR) and the possibility of a standardized assessment. However, few studies have investigated this ability in dementia patients, and even less is known about patients affected by Mild Cognitive Impairment (MCI). Thus, this study aims to investigate DT abilities in MCI patients. Methods: A total of 25 MCI patients and 25 healthy controls subjects (HC; from a random selection of 50) matched for age, gender, and educational level were enrolled. General cognitive functioning was measured by the Montreal Cognitive Assessment (MoCA), while the Abbreviated Torrance Test for Adults (ATTA) was selected to measure DT. Results: MANOVA analysis did not reveal any significant differences in DT abilities between MCI patients and HC except for the figural indicator score. A logistic hierarchical regression analysis revealed that the figural indicator score added an 8% of accuracy in the prediction of the group variable over the general cognition measure (MoCA). Conclusion: MCI patients seem to perform significantly worse than HC only in the figural DT score and this evidence has significant practical implications. First, that figural DT seemed to decrease even earlier than verbal DT and could therefore be taken into account for early diagnosis of MCI patients. On the contrary, the sparing of all the other DT skills (such as verbal DT skills, fluency, flexibility, originality, and elaboration) may suggest that, given its relationship with CR, verbal DT could instead be considered a possible target for prevention or early cognitive stimulation interventions

A telerehabilitation platform for cognitive, physical and behavioural rehabilitation in elderly patients affected by dementia

Dementia is one of the main causes of disability in elderly people and its treatment becomes, year after year, an increasingly compelling priority for the public health system. In the last years, home assistance and telemedicine have paved the way to decrease the treatments’ costs and to improve the patients and caregivers quality of life quality. In this framework, the aim of ABILITY project is to design, develop and validate an integrated platform of services aimed at supporting and enhancing the rehabilitation process for patients with dementia at their homes. ABILITY platform allows the clinician to assign rehabilitation plans with a strong compliance monitoring, enabled by the technological solutions integrated, and the holistic approach to rehabilitation, as the plan includes physical, cognitive and behavioral therapies/exercises. The ABILITY platform will be assessed through a set of validation activities, involving a small group of pilot patients, and a Randomized Control Trial. In conclusion, the ABILITY project generates a series of assistive services inside a modular and flexible platform, adaptable to the single patient and his/her needs, increasing the treatment efficiency and efficacy with respect to the state of the art

Causal and associational language in observational health research: a systematic evaluation

We estimated the degree to which language used in the high profile medical/public health/epidemiology literature implied causality using language linking exposures to outcomes and action recommendations; examined disconnects between language and recommendations; identified the most common linking phrases; and estimated how strongly linking phrases imply causality. We searched and screened for 1,170 articles from 18 high-profile journals (65 per journal) published from 2010-2019. Based on written framing and systematic guidance, three reviewers rated the degree of causality implied in abstracts and full text for exposure/outcome linking language and action recommendations. Reviewers rated the causal implication of exposure/outcome linking language as None (no causal implication) in 13.8%, Weak 34.2%, Moderate 33.2%, and Strong 18.7% of abstracts. The implied causality of action recommendations was higher than the implied causality of linking sentences for 44.5% or commensurate for 40.3% of articles. The most common linking word in abstracts was “associate” (45.7%). Reviewer’s ratings of linking word roots were highly heterogeneous; over half of reviewers rated “association” as having at least some causal implication. This research undercuts the assumption that avoiding “causal” words leads to clarity of interpretation in medical research