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Medical students’ early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd-year medical students on required clinical rotations. Using content analysis, the authors analyzed the essays’ thematic content. The authors then used chi-squared analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. One hundred twenty out of 802 essays described a geriatric patient. The most common geriatric themes were (1) death and dying, (2) decision making, (3) meaningful physician-patient interactions, (4) quality of care, and (5) professional development. Geriatric essays were more likely to discuss death/dying and risk-benefit themes and less likely to discuss abuse. Geriatric essays were more likely to describe students’ moral distress. Geriatric essays with moral distress were more likely to include empathy themes compared to geriatric essays without moral distress. Geriatric patients may pose unique ethical challenges for early clinical students. [ABSTRACT FROM AUTHOR]

Theory: We explored the theory that measures of medical students’ well-being and stress from different types of preclinical curricula are linked with performance on standardized assessment.Hypotheses: Self-reported stress and quality of life among sophomore medical students having different types of preclinical curricula will vary in their relationships to USMLE Step 1 scores.Method: Voluntary surveys in 2010 and 2011 compared self-reported stress, physical and mental health, and quality of life with Step 1 scores for beginning sophomore students in the final year of a traditional, discipline-based curriculum and the 1st year of a revised, systems-based curriculum with changed grading system. Wilcoxon rank sum tests and Spearman rank correlations were used to analyze data, significant atp<.05.Results: New curriculum students reported worse physical health, subjective feelings, leisure activities, social relationships and morale, and more depressive symptoms and life stress than traditional curriculum students. However, among curriculum-related stressors, few differences emerged; revised curriculum sophomores reported less stress working with real and standardized patients than traditional students. There were no class differences in respondents’ Step 1 scores. Among emotional and physical health measures, only feelings of morale correlated negatively with Step 1 performance. Revised curriculum students’ Step 1 scores correlated negatively with stress from difficulty of coursework.Conclusions: Although revised curriculum students reported worse quality of life, general stress, and health and less stress from patient interactions than traditional students, few measures were associated with performance differences on Step 1. Moreover, curriculum type did not appear to either hinder or help students’ Step 1 performance. To identify and help students at risk for academic problems, future assessments of correlates of Step 1 performance should be repeated after the new curriculum is well established, relating them also to performance on other standardized assessments of communication skills, professionalism, and later clinical evaluations in clerkships or internships. [ABSTRACT FROM AUTHOR]

This study examined hippocampal volume as a putative biomarker for psychotic illness in the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) psychosis sample, contrasting manual tracing and semiautomated (FreeSurfer) region-of-interest outcomes. The study sample (n = 596) included probands with schizophrenia (SZ, n = 71), schizoaffective disorder (SAD, n = 70), and psychotic bipolar I disorder (BDP, n = 86); their first-degree relatives (SZ-Rel, n = 74; SAD-Rel, n = 62; BDP-Rel, n = 88); and healthy controls (HC, n = 145). Hippocampal volumes were derived from 3Tesla T1-weighted MPRAGE images using manual tracing/3DSlicer3.6.3 and semiautomated parcellation/FreeSurfer5.1,64bit. Volumetric outcomes from both methodologies were contrasted in HC and probands and relatives across the 3 diagnoses, using mixed-effect regression models (SAS9.3 Proc MIXED); Pearson correlations between manual tracing and FreeSurfer outcomes were computed. SZ (P = .0007–.02) and SAD (P = .003–.14) had lower hippocampal volumes compared with HC, whereas BDP showed normal volumes bilaterally (P = .18–.55). All relative groups had hippocampal volumes not different from controls (P = .12–.97) and higher than those observed in probands (P = .003–.09), except for FreeSurfer measures in bipolar probands vs relatives (P = .64–.99). Outcomes from manual tracing and FreeSurfer showed direct, moderate to strong, correlations (r = .51–.73, P < .05). These findings from a large psychosis sample support decreased hippocampal volume as a putative biomarker for schizophrenia and schizoaffective disorder, but not for psychotic bipolar I disorder, and may reflect a cumulative effect of divergent primary disease processes and/or lifetime medication use. Manual tracing and semiautomated parcellation regional volumetric approaches may provide useful outcomes for defining measurable biomarkers underlying severe mental illness. [ABSTRACT FROM PUBLISHER]

This study explored television viewing of the September 11 attacks in 99 survivors of the Oklahoma City bombing and examined the relationships of event-related television viewing with concerns about safety and danger in survivors with and without bombing-related posttraumatic stress disorder. The number of hours of viewing September 11 television coverage was related to worry about personal and family danger and to increased checking on loved ones but not to September 11–related posttraumatic responses. Some bombing survivors discontinued September 11 media contact due to fear. The findings suggest the importance of monitoring television viewing in survivors of prior incidents. [ABSTRACT FROM PUBLISHER]