35 research outputs found

    Self-rated health of primary care house officers and its relationship to psychological and spiritual well-being

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    <p/> <p>Background</p> <p>The stress associated with residency training may place house officers at risk for poorer health. We sought to determine the level of self-reported health among resident physicians and to ascertain factors that are associated with their reported health.</p> <p>Methods</p> <p>A questionnaire was administered to house officers in 4 residency programs at a large Midwestern medical center. Self-rated health was determined by using a health rating scale (ranging from 0 = death to 100 = perfect health) and a Likert scale (ranging from "poor" health to "excellent" health). Independent variables included demographics, residency program type, post-graduate year level, current rotation, depressive symptoms, religious affiliation, religiosity, religious coping, and spirituality.</p> <p>Results</p> <p>We collected data from 227 subjects (92% response rate). The overall mean (SD) health rating score was 87 (10; range, 40–100), with only 4 (2%) subjects reporting a score of 100; on the Likert scale, only 88 (39%) reported excellent health. Lower health rating scores were significantly associated (P < 0.05) with internal medicine residency program, post-graduate year level, depressive symptoms, and poorer spiritual well-being. In multivariable analyses, lower health rating scores were associated with internal medicine residency program, depressive symptoms, and poorer spiritual well-being.</p> <p>Conclusion</p> <p>Residents' self-rated health was poorer than might be expected in a cohort of relatively young physicians and was related to program type, depressive symptoms, and spiritual well-being. Future studies should examine whether treating depressive symptoms and attending to spiritual needs can improve the overall health and well-being of primary care house officers.</p

    Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

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    Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

    Are patients with schizophrenia impaired in processing non-emotional features of human faces?

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    It is known that individuals with schizophrenia exhibit signs of impaired face processing, however, the exact perceptual and cognitive mechanisms underlying these deficits are yet to be elucidated. One possible source of confusion in the current literature is the methodological and conceptual inconsistencies that can arise from the varied treatment of different aspects of face processing relating to emotional and non-emotional aspects of face perception. This review aims to disentangle the literature by focusing on the performance of patients with schizophrenia in a range of tasks that required processing of non-emotional features of face stimuli (e.g. identity or gender). We also consider the performance of patients on non-face stimuli that share common elements such as familiarity (e.g. cars) and social relevance (e.g. gait). We conclude by exploring whether observed deficits are best considered as face-specific and note that further investigation is required to properly assess the potential contribution of more generalised attentional or perceptual impairments

    Complexities of Emotional Responses to Social and Nonsocial Affective Stimuli in Schizophrenia

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    BACKGROUND: Adaptive emotional responses are important in interpersonal relationships. We investigated self-reported emotional experience, physiological reactivity, and micro-facial expressivity in relation to the social nature of stimuli in individuals with schizophrenia.METHOD: Galvanic skin response (GSR) and facial electromyography (fEMG) were recorded in medicated outpatients with schizophrenia (SZ) and demograph-ically-matched healthy controls (CO) while they viewed social and non-social im-ages from the International Affective Pictures System (IAPS). Participants rated the valence and arousal, and selected a label for experienced emotions. Symp-tom severity in the SZ, and schizotypy in CO were assessed.RESULTS: The two groups did not differ in their labeling of the emotions evoked by the stimuli, but individuals with schizophrenia were more positive in their va-lence ratings. Although self-reported arousal was similar in both groups, GSR was greater in schizophrenia, suggesting differential awareness or calibration of internal states. Both groups reported social images to be more arousing than non-social images but their physiological responses to nonsocial vs. social imag-es were different. Self-reported arousal to neutral social images was correlated with positive symptoms in schizophrenia. Negative symptoms in SZ and disor-ganized schizotypy in CO were associated with reduced fEMG. Greater corruga-tor fEMG activity for positive images in SZ indicates valence-incongruent facial expressions.CONCLUSIONS: The patterns of emotional responses differed between the two groups. While both groups were in broad agreement in self-reported arousal and emotion labels, their GSR and fEMG correlates of emotion diverged in relation to the social nature of the stimuli and clinical measures. Importantly, these results suggest disrupted self awareness of internal states in schizophrenia and under-score the complexities of emotion processing in health and disease

    Social Bodies : Preliminary Evidence That Awareness of Embodied Emotions Is Associated With Recognition of Emotions in the Bodily Cues of Others

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    Publisher Copyright: © 2023 American Psychological AssociationWe experience and express emotions via our bodies, and we are also able to infer the emotional states of others by observing their movements and postures. The ability to extract affective bodily cues in social contexts may be achieved via internal simulation, which is closely associated with experience and awareness of emotions in one’s own body. Here, we hypothesized that reports of one’s own bodily experiences of emotions would be associated with the ability to infer other people’s emotions from their bodily signals. Healthy individuals (n = 106) participated in two tasks. An emotional gait perception task was used to test the ability to extract emotional cues from other people’s body movements. Subjective bodily experience of emotions was visualized with a computerized mapping tool, which required participants to localize sensations on the body corresponding to specific emotions. Participants reported specific locations of body sensations for different emotions. Emotional gait perception accuracy was positively associated with participants’ reported intensity for bodily experiences of happiness and anger and with their tendency to report body mapping patterns similar to prototypes established in a much larger sample. Results suggest that awareness of emotions in one’s own body is related to our ability to perceive emotions in others. Implications for future work on the role of embodiment in social cognition and psychiatric disorders are discussed.Peer reviewe
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