Public Speaking Anxiety, Test Anxiety, and Academic Achievement in Undergraduate Students

Public speaking anxiety and test anxiety are both psychological difficulties which may adversely influence academic achievement in undergraduate students. Previous research has indicated that both public speaking anxiety and test anxiety are negatively correlated with academic performance, usually measured by grade point average. The purpose of this study was to assess the prevalence of public speaking anxiety, test anxiety, and their effects on academic achievement in a sample of undergraduate students, and to determine if certain groups of students are more likely to be affected than others. Although test anxiety and public speaking anxiety were both found to be negatively correlated with grade point average, these correlations were not statistically significant. Potential reasons for the lack of statistical congruence with previous studies, as well as implications for future research and treatment, are discussed.

Panel Discussion - Local Finns in Illinois

Finnish North American labor contributions and involvement in strikes such as the 1913-14 Michigan Copper Strike are being restored to the historical record and even commemorated; yet some Finnish American communities’ labor history still goes untold. We contend that in the case of DeKalb, Illinois, the Finnish American labor and strike history has been, in part, overshadowed in contemporary remembrance by the city’s promotion of traditional history and commemoration focused on the barbed wire barons. Local Finnish American labor involvement and participation in strikes appears to have been marginalized in favor of a subsequent historical narrative surrounding the capitalist entrepreneurship of elites. However, counter memories of labor struggles may be lost for a variety of reasons. External and internal forces make it difficult for marginalized groups to offer alternatives to the construction of collective memories that exclude them. These forces include, but are not limited to gradual assimilation into dominant culture, internal conflict within social movements, and fear of, or experience with, governmental repression. In our archival research, surveys and interviews with 2nd and 3rd generation Finnish American residents reveal the many forces of “forgetting” that can influence the counter memory of Finnish American labor history in certain communities.

Preoperative corticosteroids. A contraindication to lung transplantation?

Regular preoperative application of corticosteroids has been considered as a contraindication to lung transplantation for fear of an increased risk of postoperative morbidity and mortality. Recently, however, we have accepted patients for transplantation in whom treatment with steroid medication could not be terminated preoperatively. Up to February 1991, 27 unilateral and bilateral transplantations in 26 patients were analyzed. Corticosteroid therapy was discontinued at least three months prior to transplantation in 13 patients (group 1), whereas in 14 cases, the patients continued their daily corticosteroid therapy to the time of transplantation (prednisolone, 0.1 to 0.3 mg/kg/day; group 2). There were no significant differences between the groups with respect to sex, age, diagnosis, or type of transplantation. One limited bronchial dehiscence occurred; the incidence of postoperative bronchial stenosis was identical in both cohorts; one patient died in each group. In conclusion, no increased morbidity or mortality could be found following lung transplantation with regular preoperative administration of prednisolone up to 0.3 mg/kg/day. Thus, patients who cannot be weaned from their steroid medication but who otherwise are acceptable candidates should not be excluded from lung transplantation.

Marginalized Youth. An Introduction.

The life conduct of marginalized groups has become subject to increasing levels of risk in advanced capitalist societies. In particular, children and young people are confronted with the harsh consequences of a “new poverty” in the contemporary era. The demographic complexion of today’s poverty is youthful, as a number of government reports have once again documented in recent years in Australia, Germany, France, Great Britain, the US or Scandinavian countries. Key youth studies have shown a growing fear of the future among young people – especially with regard to the threat of unemployment and poverty. However, these results have not yet produced any fundamental critical political reaction.

Neighborhood Violence and Adolescent Friendships

This paper investigates the social consequences of neighborhood violence. Using ego-centered friendship network data from the National Longitudinal Study of Adolescent Health, a survey of adolescents in the United States in the mid-1990s, it examines the relationship between neighborhood violence and the quantity, closeness, and composition of adolescent same sex friendships. Though neighborhood violence is unrelated to quantity and closeness net of individual and family characteristics, it predicts boys’ friendships with individuals who no longer attend school (who are presumably older or have dropped out of school) and predicts boys’ and girls’ friendships with individuals who attend other schools. These results are consistent with the theory that violence and fear of victimization focus adolescents’ social attention on their neighborhoods and lead them to develop friendships with individuals who can help them to stay safe. By structuring who adolescents interact with, neighborhood violence may play a role in determining the cultural messages and ideals to which they are exposed.

Amplatzer left atrial appendage occlusion through a patent foramen ovale

OBJECTIVES: To assess feasibility and outcomes of left atrial appendage (LAA) closure when using a patent foramen ovale (PFO) for left atrial access. Background: Because of the fear of entering the left atrium too high, using a PFO for left atrial access during LAA occlusion (LAAO) is generally discouraged. We report our single-center experience using a concomitant PFO for LAAO, thereby avoiding transseptal puncture. METHODS: LAAO was performed with local anesthesia and fluoroscopic guidance only (no echocardiography). The Amplatzer Cardiac Plug (ACP) was used in all patients. After LAAO, the PFO was closed at the same sitting, using an Amplatzer occluder through the ACP delivery sheath. Patients were discharged the same or the following day on dual antiplatelet therapy for 1-6 months, at which time a follow-up transesophageal echocardiogram (TEE) was performed. RESULTS: In 49 (96%) of 51 patients (35 males, age 70.9 ± 11.9 years), LAAO was successful using the PFO for left atrial access. In one patient, a long tunnel PFO precluded LAAO, which was performed via a more caudal transseptal puncture. In a second patient, a previously inserted ASD occluder precluded LAAO, which was abandoned because of pericardial bleeding. PFO closure was successful in all patients. Follow-up TEE was performed in 43 patients 138 ± 34 days after the procedure. It showed proper sitting of both devices in all patients. CONCLUSIONS: Using a PFO for LAAO had a high success rate and could be the default access in all patients with a PFO, potentially reducing procedural complications arising from transseptal puncture.

Gaze perception in social anxiety and social anxiety disorder

Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD). Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed.

Glucocorticoids enhance in vivo exposure-based therapy outcome in spider phobia

BACKGROUND: Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes. In particular, it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights. Here, we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia. METHODS: In a double blind, block-randomized, placebo-controlled, between-subject study design, 22 patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy. Cortisol (20 mg) or placebo was orally administered 1 hr before each therapy session. Patients returned for a follow-up assessment one month after therapy. RESULTS: Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire (FSQ) from pretreatment to immediate posttreatment and to follow-up. The administration of cortisol to exposure therapy resulted in increased salivary cortisol concentrations and a significantly greater reduction in fear of spiders (FSQ) as compared to placebo at follow-up, but not immediately posttreatment. Furthermore, cortisol-treated patients reported significantly less anxiety during standardized exposure to living spiders at follow-up than placebo-treated subjects. Notably, groups did not differ in phobia-unrelated state-anxiety before and after the exposure sessions and at follow-up. CONCLUSIONS: These findings indicate that adding cortisol to in vivo exposure-based group therapy of spider phobia enhances treatment outcome.

Emotions and Values

There are close links between emotions and values, or at least this is what our ordinary ways of talking suggest. For many, if not all, types of emotion it is thus possible to find a corresponding evaluative term, one often derived from the name of the emotion in question. These are for example evaluative terms such as ‘shameful’, ‘offensive, ‘annoying’, ‘dangerous’, ‘contemptible’, ‘admirable’, ‘amusing’, ‘exciting’, ‘boring’, and the like. Starting perhaps from these linguistic observations, the philosophical task is of course to elucidate the nature of the links between emotions and values, and attempts at doing so have traditionally revolved around the following three questions: first, what is the role of emotions in elucidating the nature of value? For example, should dangerousness be understood in term of the fear response? Second, what is the role of emotions in our getting access to values? For example, what may be the role of fear in becoming aware that a given animal is dangerous? Third, what value do emotions have? For example, is fear of special value because it helps behaving appropriately towards its object? We hall take up these questions in turn and survey the most important answers they have received in the literature. As we shall discover, answering the first question amounts to surveying a variety of theories according to which there is an ontological relation between values and emotions since the former should be elucidated in terms of the latter (Sec. 1). Addressing the second question consists in reviewing theories according to which there is an intentional relation between emotions and values because the former are apprehensions of value or evaluations (Sec. 2). Grappling with the third question, we shall explore some reasons for thinking that emotions can exemplify values (Sec. 3).

Thrombolysis in patients with prior stroke within the last 3 months

BACKGROUND AND PURPOSE Patients with prior stroke within 3 months have been mostly excluded from randomized thrombolysis trials mainly because of the fear of an increased rate of symptomatic intracerebral hemorrhage (sICH). The aim of this study was to compare baseline characteristics and clinical outcome of thrombolyzed patients who had a previous stroke within the last 3 months with those not fulfilling this criterion (comparison group). METHODS In all, 1217 patients were included in our analysis (42.2% women, mean age 68.8 ± 14.4 years). RESULTS Patients with previous stroke within the last 3 months (17/1.4%) had more often a basilar artery occlusion (41.2% vs. 10.8%) and less frequently a modified Rankin scale (mRS) score 0-1 prior to index stroke (88.2% vs. 97.3%) and a higher mean time lapse from symptom onset to thrombolysis (321 min vs. 262 min) than those in the comparison group. Stroke severity was not different between the two groups. Rates of sICH were 11.8% vs. 6%. None of the sICHs and only one asymptomatic intracerebral hemorrhage occurred in the region of the former infarct. At 3 months, favorable outcome (mRS ≤ 2) in patients with previous stroke within 3 months was 29.4% (vs. 48.9%) and mortality 41.2% (vs. 22.7%). CONCLUSIONS In patients with prior stroke within the last 3 months, none of the sICHs and only one asymptomatic intracerebral hemorrhage occurred in the region of the former infarct. The high mortality was influenced by four patients, who died until discharge due to acute major index stroke. It is reasonable to include these patients in randomized clinical trials and registries to assess further their thrombolysis benefit-risk ratio.

Patient and Informant Views on Visual Hallucinations in Parkinson Disease.

OBJECTIVE Visual hallucinations (VHs) are a very personal experience, and it is not clear whether information about them is best provided by informants or patients. Some patients may not share their hallucinatory experiences with caregivers to avoid distress or for fear of being labeled insane, and others do not have informants at all, which limits the use of informant-based questionnaires. The aim of this study was to compare patient and caregiver views about VHs in Parkinson disease (PD), using the North-East Visual Hallucinations Interview (NEVHI). METHODS Fifty-nine PD patient-informant pairs were included. PD patients and informants were interviewed separately about VHs using the NEVHI. Informants were additionally interviewed using the four-item version of the Neuropsychiatric Inventory. Inter-reliability and concurrent validity of the different measures were compared. RESULTS VHs were more commonly reported by patients than informants. The inter-rater agreement between NEVHI-patient and NEVHI-informant was moderate for complex VHs (Cohen's kappa = 0.44; 95% confidence interval [CI]: 0.13-0.75; t = 3.43, df = 58, p = 0.001) and feeling of presence (Cohen's kappa = 0.35; 95% CI: 0.00-0.70; t = 2.75, df = 58, p = 0.006), but agreement was poor for illusions (Cohen's kappa = 0.25; 95% CI: -0.07-0.57; t = 2.36, df = 58, p = 0.018) and passage hallucinations (Cohen's kappa = 0.16; 95% CI: -0.04-0.36; t = 2.26, df = 58, p = 0.024). CONCLUSION When assessing VHs in PD patients, it is best to rely on patient information, because not all patients share the details of their hallucinations with their caregivers.

Cochlear implant candidates with psychogenic hearing loss.

Abstract Conclusions: Specific requests for cochlear implantations by persons with psychogenic hearing loss are a relatively new phenomenon. A number of features seems to be over-represented in this group of patients. The existence of these requests stresses the importance of auditory brainstem response (ABR) measurements before cochlear implantation. Objective: To describe the phenomenon of patients with psychogenic hearing losses specifically requesting cochlear implantation, and to gain first insights into the characteristics of this group. Methods: Analysis of all cases seen between 2004 and 2013 at the University Hospital of Bern, Switzerland. Results: Four cochlear implant candidates with psychogenic hearing loss were identified. All were female, aged 23-51 years. Hearing thresholds ranged from 86 dB to 112 dB HL (pure-tone average 500-4000 Hz). ABRs and otoacoustic emissions (OAEs) showed bilaterally normal hearing in two subjects, and hearing thresholds between 30 and 50 dB in the other two subjects. Three subjects suffered from depression and one from a pathologic fear of cancer. Three had a history of five or more previous surgeries. Three were smokers and three reported other close family members with hearing losses. All four were hearing aid users at the time of presentation.

An investigation into the factors that encourage learner participation in a large group medical classroom

BACKGROUND: Effective lectures often incorporate activities that encourage learner participation. A challenge for educators is how to facilitate this in the large group lecture setting. This study investigates the individual student characteristics involved in encouraging (or dissuading) learners to interact, ask questions, and make comments in class. METHODS: Students enrolled in a Doctor of Veterinary Medicine program at Ross University School of Veterinary Medicine, St Kitts, were invited to complete a questionnaire canvassing their participation in the large group classroom. Data from the questionnaire were analyzed using Excel (Microsoft, Redmond, WA, USA) and the R software environment (http://www.r-project.org/). RESULTS: One hundred and ninety-two students completed the questionnaire (response rate, 85.7%). The results showed statistically significant differences between male and female students when asked to self-report their level of participation (P=0.011) and their confidence to participate (P<0.001) in class. No statistically significant difference was identified between different age groups of students (P=0.594). Student responses reflected that an "aversion to public speaking" acted as the main deterrent to participating during a lecture. Female participants were 3.56 times more likely to report a fear of public speaking than male participants (odds ratio 3.56, 95% confidence interval 1.28-12.33, P=0.01). Students also reported "smaller sizes of class and small group activities" and "other students participating" as factors that made it easier for them to participate during a lecture. CONCLUSION: In this study, sex likely played a role in learner participation in the large group veterinary classroom. Male students were more likely to participate in class and reported feeling more confident to participate than female students. Female students in this study commonly identified aversion to public speaking as a factor which held them back from participating in the large group lecture setting. These are important findings for veterinary and medical educators aiming to improve learner participation in the classroom. Potential ways of addressing this challenge include addition of small group activities and audience response systems during lectures, and inclusion of training interventions in public speaking at an early stage of veterinary and medical curricula.

How to prevent overdiagnosis.

Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and that patients have no benefit to be aware of. It is neither a misdiagnosis (diagnostic error), nor a false positive result (positive test in the absence of a real abnormality). It mainly results from screening, use of increasingly sensitive diagnostic tests, incidental findings on routine examinations, and widening diagnostic criteria to define a condition requiring an intervention. The blurring boundaries between risk and disease, physicians' fear of missing a diagnosis and patients' need for reassurance are further causes of overdiagnosis. Overdiagnosis often implies procedures to confirm or exclude the presence of the condition and is by definition associated with useless treatments and interventions, generating harm and costs without any benefit. Overdiagnosis also diverts healthcare professionals from caring about other health issues. Preventing overdiagnosis requires increasing awareness of healthcare professionals and patients about its occurrence, the avoidance of unnecessary and untargeted diagnostic tests, and the avoidance of screening without demonstrated benefits. Furthermore, accounting systematically for the harms and benefits of screening and diagnostic tests and determining risk factor thresholds based on the expected absolute risk reduction would also help prevent overdiagnosis.

Islamophobia as Reactive Co-Radicalization

Since 9/11, 2001, a new form of religious extremism has arguably emerged, one which paradoxically portrays itself as a counter to another perceived extremism regarded as a real and imminent threat. Within North America and Western Europe, as elsewhere, there is an upsurge of various forms of reactionary rhetoric and opposition expressed towards Islam and Muslims. An increase in extremist behaviour, even violence, is appearing from quarters opposed to, or varyingly fearful of, Islamic extremism if not Islam or Muslims. Islamophobia, as a manifestation of fear of an exclusionary Islam, manifests as exclusionary or negatively reactive behaviours with Muslims and Islam as the target. This article explores the idea that Islamophobia can be regarded as a manifestation of religious extremism and, further, that such extremism is construable as “reactive co-radicalization.” It focuses on two European cases – the 2009 Swiss ban on the building of minarets and the 2011 Norwegian massacre carried out by Anders Breivik – as examples of this “reactive co-radicalization.” This term, I suggest, is an apt denominator for the exclusionary reaction to the rising presence of Islam within otherwise secular, albeit nominally Christian, Western European and North American societies, among others.