Negotiating the Maze: Case based, Collaborative Distance Learning in Dentistry

The module was developed as an elective to give motivated senior dental students an opportunity to expand their horizons in planning oral rehabilitation. It comprised one tutor and 12 students, from five universities world-wide, communicating on the World Wide Web (WWW), to develop oral rehabilitation plans for simulated patients. Trigger material came from one of two Case Profiles and consisted of diagnostic casts and details of the clinical and radiographic examination in WWW/CD-ROM form. No background material was supplied as to the "patient's" age, sex, history or main concern(s). Students worked in groups of three, each student from a different location. Individual students were given a role within the group: "Patient", who developed a "personal background" belonging to the trigger examination material, "Academic" who identified state-of-the-art treatment options available for the dental treatment needs identified by the group and "General Practitioner" who tailored these options to the "patient's" needs and wants. Student feedback focused on their perception of their experience with the program in response to a questionnaire comprising 11 structured and four "open" questions. All students felt that the program increased their confidence in planning oral rehabilitation. Ten students felt that the "best thing about the program" was the interaction with students from other universities and the exposure to different philosophies from the different schools. Eight students mentioned their increased awareness of the importance of patient input into holistic planning. Under the heading "What was the worst thing", students cited some technical hitches and the snowball effect of two sluggish students who were not identified early enough and thus impacted negatively on the working of their groups. Student feedback showed that the module succeeded in its aims but needed modification to improve the logistics of working with an extended campu

Catastrophizing and fear of tinnitus predict quality of life in patients with chronic tinnitus

Objectives: It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was expected to act as a mediator in reduced quality of life. Design: Sixty-one tinnitus patients from an outpatient ENT department of the University Hospital of Antwerp (Belgium) completed a number of questionnaires about their tinnitus. Hierarchical regression analyses were performed to test hypothesized associations and to assess mediation by tinnitus-related fear. Results: Analyses revealed significant associations between catastrophizing and fear and between catastrophizing and increased attention toward the tinnitus. Furthermore, both tinnitus-related catastrophizing and fear were negatively associated with quality of life; moreover, tinnitus-related fear fully mediated the association between catastrophizing about the tinnitus and quality of life. Conclusions: The findings confirm earlier suggestions that tinnitus-related concerns and fears are associated with impaired quality of life, which is in line with a cognitive behavioral account of chronic tinnitus. Future research avenues and clinical applications are discussed

Implicit Attitudes Reflect Associative, Non-associative, and Non-attitudinal Processes

It is a common assumption that responses on implicit measures are proxies for automatically activated associations stored in memory. Consequently, explanations for implicit attitude malleability, variability, and prediction have assumed differences in underlying associations. However, a growing body of evidence challenges the assumption that implicit attitude change is driven only by associative processes. This paper reviews evidence from research with the Quadruple Process model on the influence of associative and non-associative processes on implicit task performance. We also describe recent research on non-attitudinal processes that do not pertain directly to the attitude object of interest but that, nevertheless, influence implicit task performance. Implications for the interpretation of implicit measures and implicit attitude change are discussed. © 2013 John Wiley & Sons Ltd

Irritable bowel syndrome is significantly associated with somatisation in 840 patients, which may drive bloating

Background Psychological factors may influence persistence and perceived severity of symptoms in irritable bowel syndrome (IBS). Literature suggests that somatisation is associated with IBS. However, the relationship between IBS subtype, symptoms of IBS and somatisation is unclear. Aim To examine this issue in a large cohort of secondary care patients. Methods Demographic and gastrointestinal (GI) symptom data were collected from 4224 adult patients via the Rome III questionnaire. Somatisation data were collected using the patient health questionnaire-12. Mean somatisation score and number of somatic symptoms were compared between IBS patients and controls with minimal GI symptoms, and between IBS subtypes using analysis of variance. Effect of level of somatisation on symptom frequency was compared according to IBS subtype using a χ2 test. Results 840 patients met Rome III criteria for IBS, controls were 2137 patients with GI symptoms without IBS. Mean somatisation scores and number of somatic symptoms were higher in IBS vs. controls (P < 0.001), and in mixed stool pattern IBS (IBS-M), vs. IBS with constipation (IBS-C) or diarrhoea (IBS-D) (P < 0.001). High levels of somatisation were more prevalent in IBS-M (31.7%) vs. IBS-C (22.5%) or IBS-D (20.8%) (P = 0.003). For all IBS subtypes, high levels of somatisation were associated with a greater frequency of bloating or abdominal distension prior to logistic regression. Conclusions IBS is strongly associated with higher levels of somatisation, particularly IBS-M. Bloating may be associated with higher levels of somatisation, perhaps explaining why it can be difficult to treat

Post-Infectious Irritable Bowel Syndrome, an Inflammation-Immunological Model with Relevance for Other IBS and Functional Dyspepsia

This review presents studies that support an inflammation-immunological model for the pathogenesis of post-infectious irritable bowel syndrome (IBS), and highlights recent studies that support a similar disease model in non-post-infectious IBS, in particular, diarrhoea-predominant IBS, as well as in post-infectious functional dyspepsia. These recent studies are highlighted to demonstrate that one line of research in functional gastrointestinal disorders has moved away from the old psychosomatic concepts. It is hoped that this will encourage future students of this field to explore the role of immunological events

Counter-prejudicial training reduces activation of biased associations and enhances response monitoring

Although implicitly measured bias was once assumed to be highly stable, subsequent research has shown that it is, in fact, malleable. One technique for altering implicit bias is through counter-prejudicial training. At least two broad mechanisms may drive this effect. First, training people to respond in counter-prejudicial ways may diminish the extent to which biased associations are activated in memory. Second, training may strengthen processes that reduce the influence of biased associations on responses. Participants received either counter-prejudicial, pro-prejudicial, or no training and then completed an implicit measure of bias. Application of the quadruple process model revealed support for both mechanisms: Counter-prejudicial training produced less activation of biased associations as well as enhanced detection of appropriate responses compared with pro-prejudicial or no training. Implications for the development of bias-reduction training are discussed. © 2013 John Wiley &amp; Sons, Ltd

Constructing and contesting threat: representations of white British muslims across British national and muslim newspapers

White British Muslims pose a challenge to racialised representations of British Muslims as non-white, foreign and Other. By drawing on tools from Critical Discourse Analysis to develop Social Representations Theory on a micro-analytic level, and making connections with other relevant social psychological theories on intergroup relations, this article examines the constructions of white British Muslims as a threat in six national and two Muslim British newspapers. It looks at how discourses are used to create, perpetuate and challenge the ‘hegemonisation’ of social representations in majority and minority press. The findings show that white British Muslims are portrayed as a threat not just despite, but because of, their position as part of the ‘white British’ ingroup. Consequently, the threat they pose often leads to their Muslimness being emphasised. This was, at times, contested, however, either through direct challenges, or by making the threat ambivalent by drawing on their whiteness

Development of an educational intervention for patients with Irritable Bowel Syndrome (IBS) – a pilot study

<p>Abstract</p> <p>Background</p> <p>Many IBS patients experience that they receive limited information and that the health care system does not take their complaints seriously. We aimed to develop a structured patient education, an 'IBS school', and investigate if the efficacy could be evaluated in terms of improved knowledge, symptom severity and health related quality of life (HRQOL).</p> <p>Methods</p> <p>The IBS school consisted of six weekly two hour sessions in a group setting. Five different health care professionals were responsible for one session each. Questionnaires covering patients' experience of the education, perceived knowledge about IBS, gastrointestinal symptoms, and HRQOL, were used for evaluation at baseline and at three, six, and twelve months after education.</p> <p>Results</p> <p>Twelve IBS patients were included. The patients were overall satisfied with the IBS school. In line with this, the gastrointestinal symptoms, HRQOL, and perceived knowledge about IBS improved significantly after the education.</p> <p>Conclusion</p> <p>An IBS school seems to be a proper method to meet the patients' need of information about IBS and also to improve the patients' gastrointestinal symptoms, HRQOL, and knowledge about IBS. Further controlled studies are now needed in larger numbers of patients to confirm these preliminary results in order to implement this intervention in clinical practice.</p