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Effect of the Intake of a Traditional Mexican Beverage Fermented with Lactic Acid Bacteria on Academic Stress in Medical Students.
Márquez-Morales, L, El-Kassis, EG, Cavazos-Arroyo, J, Rocha-Rocha, V, Martínez-Gutiérrez, F, Pérez-Armendáriz, B
Nutrients. 2021;(5)
Abstract
Dysbiosis of the gut microbiota has been associated with different illnesses and emotional disorders such as stress. Traditional fermented foods that are rich in probiotics suggest modulation of dysbiosis, which protects against stress-induced disorders. The academic stress was evaluated in medical students using the SISCO Inventory of Academic Stress before and after ingestion of an aguamiel-based beverage fermented with Lactobacillus plantarum, Lactobacillus paracasei and Lactobacillus brevis (n = 27) and a control group (n = 18). In addition, microbial phyla in feces were quantified by qPCR. The results showed that the consumption of 100 mL of a beverage fermented with lactic acid bacteria (3 × 108 cfu/mL) for 8 weeks significantly reduced academic stress (p = 0.001), while the control group (placebo intervention) had no significant changes in the perception of academic stress (p = 0.607). Significant change (p = 0.001) was shown in the scores for environmental demands, and physical and psychological factors. Consumption of the fermented beverage significantly increased the phyla Firmicutes and Bacteroidetes but not Gammaproteobacteria. No significant changes were found in the control group, except for a slight increase in the phylum Firmicutes. The intake of this fermented beverage suggest a modulation of gut microbiota and possible reduction in stress-related symptoms in university students, without changing their lifestyle or diet.
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Effect of Supplementation with Saccharomyces Boulardii on Academic Examination Performance and Related Stress in Healthy Medical Students: A Randomized, Double-Blind, Placebo-Controlled Trial.
Karbownik, MS, Kręczyńska, J, Kwarta, P, Cybula, M, Wiktorowska-Owczarek, A, Kowalczyk, E, Pietras, T, Szemraj, J
Nutrients. 2020;(5)
Abstract
In recent years, bacterial probiotic dietary supplementation has emerged as a promising way to improve cognition and to alleviate stress and anxiety; however, yeast probiotics have not been tested. The aim of the present study was to determine whether 30-day supplementation with Saccharomyces boulardii enhances academic performance under stress and affects stress markers. The trial was retrospectively registered at clinicaltrials.gov (NCT03427515). Healthy medical students were randomized to supplement their diet with Saccharomyces boulardii CNCM I-1079 or placebo before sitting for an academic examination, which served as a model of stress. The grades of a final examination adjusted to subject knowledge tested in non-stressful conditions was used as a primary outcome measure. Psychometrically evaluated state anxiety, cortisol and metanephrine salivary levels, and pulse rate were tested at a non-stressful time point before the intervention as well as just before the stressor. Fifty enrolled participants (22.6 ± 1.4 years of age, 19 males) completed the trial in the Saccharomyces and placebo arms. Supplementation with Saccharomyces did not significantly modify examination performance or increase in state anxiety, salivary cortisol, and metanephrine. However, the intervention resulted in higher increase in pulse rate under stress as compared to placebo by 10.4 (95% CI 4.2-16.6) min-1 (p = 0.0018), and the effect positively correlated with increase in salivary metanephrine (Pearson's r = 0.35, 95% CI 0.09-0.58, p = 0.012). An intention-to-treat analysis was in line with the per-protocol one. In conclusion, supplementation with Saccharomyces boulardii CNCM I-1079 appears largely ineffective in improving academic performance under stress and in alleviating some stress markers, but it seems to increase pulse rate under stress, which may hypothetically reflect enhanced sympathoadrenal activity.
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How to tell a patient's story? Influence of the case narrative design on the clinical reasoning process in virtual patients.
Hege, I, Dietl, A, Kiesewetter, J, Schelling, J, Kiesewetter, I
Medical teacher. 2018;(7):736-742
Abstract
BACKGROUND Virtual patients (VPs) are narrative-based educational activities to train clinical reasoning in a safe environment. Our aim was to explore the influence of the design of the narrative and level of difficulty on the clinical reasoning process, diagnostic accuracy and time-on-task. METHODS In a randomized controlled trial, we analyzed the clinical reasoning process of 46 medical students with six VPs in three different variations: (1) patients showing a friendly behavior, (2) patients showing a disruptive behavior and (3) a version without a patient story. RESULTS For easy VPs, we did not see a significant difference in diagnostic accuracy. For difficult VPs, the diagnostic accuracy was significantly higher for participants who worked on the friendly VPs compared to the other two groups. Independent from VP difficulty, participants identified significantly more problems and tests for disruptive than for friendly VPs; time on task was comparable for these two groups. The extrinsic motivation of participants working on the VPs without a patient story was significantly lower than for the students working on the friendly VPs. CONCLUSIONS Our results indicate that the measured VP difficulty has a higher influence on the clinical reasoning process and diagnostic accuracy than the variations in the narratives.
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Are anti-stigma films a useful strategy for reducing weight bias among trainee healthcare professionals? Results of a pilot randomized control trial.
Swift, JA, Tischler, V, Markham, S, Gunning, I, Glazebrook, C, Beer, C, Puhl, R
Obesity facts. 2013;(1):91-102
Abstract
BACKGROUND Weight bias is an important clinical issue that the educators of tomorrow's healthcare professionals cannot afford to ignore. This study, therefore, aimed to pilot a randomized controlled trial of the effects of educational films designed to reduce weight stigmatization toward obese patients on trainee dietitians' and doctors' attitudes. METHODS A pre-post experimental design with a 6-week follow-up, which consisted of an intervention group (n = 22) and a control group (n = 21), was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias, and to test whether future, larger-scale studies among trainee healthcare professionals are feasible. RESULTS Participants at baseline demonstrated weight bias, on both implicit and explicit attitude measures, as well as strong beliefs that obesity is under a person's control. The intervention films significantly improved explicit attitudes and beliefs toward obese people, and participant evaluation was very positive. The intervention did not significantly improve implicit anti-fat bias. CONCLUSION The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films designed to reduce weight stigma on a larger cohort of trainee healthcare professionals, and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population.
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Effects of a Korean traditional herbal remedy on psychoneuroendocrine responses to examination stress in medical students: a randomized placebo-controlled trial.
Lee, MS, Park, KW, Moon, SR
Human psychopharmacology. 2004;(8):537-43
Abstract
The aim of this study was to investigate the efficacy of Ondamtanggamibang, a Korean traditional herbal remedy, as a treatment of stress-related psychophysiological variables in healthy medical students experiencing examination stress. Forty volunteers were randomly assigned to either an herbal remedy group (n = 20) or a placebo control group (n = 20). After treatment, systolic blood pressure and plasma concentrations of norepinephrine and cortisol concentrations decreased significantly in the herbal remedy group. The herbal remedy group also exhibited beneficial changes in psychological variables such as anxiety, depression, stress and emotional state. These results suggest that a Korean traditional herbal remedy may reduce systolic blood pressure and catecholamine levels, possibly by stabilizing the sympathetic nervous system. This herbal remedy also reduced the negative psychological symptoms, stress and heightened the emotional state experienced by medical students during examinations.