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Background: Across the globe it has been observed a high reluctance among doctors to engage with social media. The hereby research aims to analyze how physicians circulate medical information using social media. Material and method: The targeted sample population was represented by family physicians and dentists who during 2017 had a contract with the Romanian National Health Insurance House. From the website of the Romanian National Health Insurance House were collected the available e-mail addresses (8,497) and phone numbers (5,422). The call to complete in the research contained a link to the online questionnaire. The request to partake was sent via SMS, WhatsApp and / or e-mail from 24 May to 14 July 2017. For comparison purposes the responders were split in 3 age groups. Millennials were defined as below 38 years old. Generation X represented people between 38 and 51 years old. Baby Boomers were the group aged above 51 years old. Results: The described methodology generated 120 valid questionnaires. The majority of them came from women (61%) living in urban areas (71%) working in private practices using Facebook (85%). Generation X connect more to SM from public places as compared to Baby Boomers (p=0.007). Doctors seek medical information on SM monthly (83%) but rarely give advice through SM to colleagues (28%) or contribute to patients’ medical education (32%). Most physicians interact with their patients through SM (59%), but do not discuss with them about how to search for health information. Conclusion: This research highlighted a low SM usage among Romanian physicians. As anticipated, doctor’s awareness of the SM’s versatile environment was strongly influenced by their age. While doctors acknowledged SM as a resource for medical information they did not engage in cultivating patient’s medical education through these platforms.

"The current paper presents the translation and validation for Romanian non-clinical population of Comprehensive Assessment of ACT Processes – CompACT (Francis et al., 2016), an instrument that evaluates three dimensions of psychological flexibility: openness to experience, present moment awareness (mindfulness) and valued action. The psychometric properties of the Romanian version of the instrument were investigated, convergent validity in relation with AQQ-II and concurrent validity in relation with DASS-21 (with comparable results with ones reported for the original instrument). Considering modest model fit with theoretical factor structure of the instrument, current paper proposes a shorter, more stable Romanian Version, and tests its psychometric properties."

Theoretical models of ability-based emotional intelligence (EI) present the ability to regulate other’s emotion as part of the emotion regulation facet, but in existing ability-based self-report EI measures, this ability is often not evaluated (e.g., Wong and Law Emotional Intelligence Scale, WLEIS, 2004) or is evaluated as a separate facet, in the work context (e.g., Workgroup Emotional Intelligence Profile WEIP-3, 2002). This consideration led to the development of a new self-report EI measure to assess EI abilities (Cluj Emotional Intelligence Scale, CEIS); the process of development and validation is presented in the current paper, across four different studies. Study 1 (n = 218) used item- analysis and exploratory factor analysis to select relevant items. Study 2 (n = 215) tested the factorial structure, convergent and discriminant validity and test-retest reliability (in sub-sample n = 75). Study 3 (n = 164) cross-validates the factorial structure and assesses concurrent validity of new instrument with well-being. Study 4 (n= 136) presents the translation of the new instrument from its original Romanian language into English and the evaluation of its psychometric properties.

The present study aimed to evaluate the students’ progress in evaluating ultrasound (US) and cadaveric cardiac images and long-time retention of information. First-year medical students were invited to participate in four two-hour online lectures during one week voluntarily. The students were trained to recognize cardiovascular anatomical structures on US and cadaveric images during the intervention. The participants’ abilities to identify specific anatomical structures were tested before, immediately after and six months after the training. A group of second-year students without US training participated as a control group and filled the same test once. Ninety-one first-year students agreed to participate, and forty-nine completed all three tests. The performances in the correct identification of cardiovascular structures on the US images significantly improved after the training but significantly decreased after six months. In the intervention group, the accurate identification of cardiovascular structures was significantly higher on cadaveric images (80% vs. 53%, p-value < 0.0001, n = 91 at post-training; 70% vs. 33%, p-value < 0.0001, n = 49 at 6 months after training). The correct answers percentage score in the control group varied from 6.7% to 66.7% for US cardiovascular anatomical without a significant difference than the intervention group (p-value = 0.7651). First-year students’ knowledge of heart US anatomy proved less effective than cadaveric images, significantly improved after training and decreased over time, indicating the need for repetition reinforcement.

A better understanding of the mechanisms that facilitate emotional resilience and well-being among physician is needed due to their high risk for burnout. Present study investigates if perceived ability to self-regulate emotions is one of the factors that impact student’s level of negative affect (depression, anxiety, stress) and well-being and its components. A sample of 151 medicine students volunteered to fill in online questionnaires evaluating the variables: RESE - Regulatory Emotional Self-Efficacy, PERMA and DASS 21 - Depression, Anxiety and Stress. SPSS correlational and linear regression analysis has been performed in order to determine the relationship between variables. Medium to strong positive correlations were found between self-efficacy to regulate emotions and well-being (.37 to .59, p< .005) and negative ones with depressions, anxiety and stress (-.31 to -.51, p< .005). Linear regression revealed that regulatory emotional self-efficacy explains up to 43% of variations in well-being and up to 36% variations in depression, anxiety and stress. Results of present study are promising and they should be replicated on larger samples. Enhancing regulatory emotional self-efficacy reduces the risk for mood disorders and enhances well-being.

Background: Ingrained assumptions about clinical placements (clerkships) for health professions students pursuing primary basic qualifications might undermine best educational use of mobile devices. Question: What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements? Methods: A Best Evidence Medical Education (BEME) effectiveness-review of ‘justification’ complemented by ‘clarification’ and ‘description’ research searched: MEDLINE, ERIC (Educational Resource Information Center), Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycInfo, Cochrane Central, Scopus (1988-2016). Reviewer-pairs screened titles/abstracts. One pair coded, extracted, and synthesized evidence, working within the pragmatism paradigm. Summary of results: From screening 2,279 abstracts, 49 articles met inclusion-criteria, counting four systematic reviews for context. The 45 articles of at least Kirkpatrick K2 primary research mostly contributed K3 (39/45, 86.7%), mixed methods (21/45, 46.7%), and S4-strength (about one-half) evidence. Mobile devices particularly supported student: assessment; communication; clinical decision-making; logbook/notetaking; and accessing information (in about two-thirds). Informal and hidden curricula included: ---concerns about: disapproval; confidentiality and privacy; security ---distraction by social connectivity and busy clinical settings; ---mixed messages about policy. Discussion & Conclusion: This idiosyncratic evidence-base of modest robustness suggested that mobile devices provide potentially powerful educational support on clinical placement, particularly with student transitions, metalearning, and care contribution. Explicit policy must tackle informal and hidden curricula though, addressing concerns about transgressions.

Background: Melanoma patients stop responding to targeted therapies mainly due to mitogen activated protein kinase (MAPK) pathway re-activation, phosphoinositide 3 kinase/the mechanistic target of rapamycin (PI3K/mTOR) pathway activation or stromal cell influence. The future of melanoma treatment lies in combinational approaches. To address this, our in vitro study evaluated if lower concentrations of Celecoxib (IC50 in nM range) could still preserve the chemopreventive effect on melanoma cells treated with trametinib. Materials and Methods: All experiments were conducted on SK-MEL-28 human melanoma cells and BJ human fibroblasts, used as co-culture. Co-culture cells were subjected to a celecoxib and trametinib drug combination for 72 h. We focused on the evaluation of cell death mechanisms, melanogenesis, angiogenesis, inflammation and resistance pathways. Results: Low-dose celecoxib significantly enhanced the melanoma response to trametinib. The therapeutic combination reduced nuclear transcription factor (NF)–kB (p &lt, 0.0001) and caspase-8/caspase-3 activation (p &lt, 0.0001), inhibited microphthalmia transcription factor (MITF) and tyrosinase (p &lt, 0.05) expression and strongly down-regulated the phosphatidylinositol-3-kinase/protein kinase B (PI3K/AKT) signaling pathway more significantly than the control or trametinib group (p &lt, 0.0001). Conclusion: Low concentrations of celecoxib (IC50 in nM range) sufficed to exert antineoplastic capabilities and enhanced the therapeutic response of metastatic melanoma treated with trametinib.

Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

Introduction: The potential oncogenic effect of some heavy metals in people occupationally and non-occupationally exposed to such heavy metals is already well demonstrated. This study seeks to clarify the potential role of these heavy metals in the living environment, in this case in non-occupational multifactorial aetiology of malignancies in the inhabitants of areas with increased prevalent environmental levels of heavy metals. Methods: Using a multidisciplinary approach throughout a complex epidemiological study, we investigated the potential oncogenic role of non-occupational environmental exposure to some heavy metals [chrome (Cr), nickel (Ni), copper (Cu), zinc (Zn), cadmium (Cd), lead (Pb) and arsenic (As)—in soil, drinking water, and food, as significant components of the environment] in populations living in areas with different environmental levels (high vs. low) of the above-mentioned heavy metals. The exposures were evaluated by identifying the exposed populations, the critical elements of the ecosystems, and as according to the means of identifying the types of exposure. The results were interpreted both epidemiologically (causal inference, statistical significance, mathematical modelling) and by using a GIS approach, which enabled indirect surveillance of oncogenic risks in each population. Results: The exposure to the investigated heavy metals provides significant risk factors of cancer in exposed populations, in both urban and rural areas [χ² test (p < 0.05)]. The GIS approach enables indirect surveillance of oncogenic risk in populations. Conclusions: The role of non-occupational environmental exposure to some heavy metals in daily life is among the more significant oncogenic risk factors in exposed populations. The statistically significant associations between environmental exposure to such heavy metals and frequency of neoplasia in exposed populations become obvious when demonstrated on maps using the GIS system. Environmental surveillance of heavy metals pollution using GIS should be identified as an important element of surveillance, early detection, and control of neoplastic risks in populations, at the level of a single locality, but even on a wider geographical scale.

The paper aims to investigate the extent to which the use of virtual patient (VP) improves the level of theoretical knowledge and students’ confidence (self-efficacy) of psychology and medicine students to perform clinical diagnostic. We created two classes on an e-learning Moodle platform, presenting, as virtual patient, the evaluation of the same panic disorder case. One class uses a linear VP , the other, a branched VP (a decisional tree type). The sample consisted of 159 volunteer participants, psychology and medicine students, randomly assigned to one of three conditions : control, linear virtual patient ( PVL) and branched virtual patient (PAD). Before and after the training with the virtual patient sequence, a questionnaire investigates the theoretical knowledge and the self-efficacy levels. For self-efficacy evaluation we used the Session Management sub-scale of Counsellor Activity Self-Efficacy Scales, by Robert W. and Clara E. Hill.Both types of VPs are associated with a statistically significant increase of knowledge about panic disorder diagnostic criteria, reinforcing the fact that the virtual patient has an impact on the cognitive profile (declarative knowledge) and on self-efficacy (related to procedural knowledge). Still, the study does not prove that one of the two types of virtual patient has a significant better outcome .