Background Medical school is a challenging time, with many medical students reporting symptoms of burnout, depression, anxiety, suicidal ideation, and psychological distress during pre-clinical and clinical years. First-generation college and first-generation medical students may be two groups of students at increased risk for the negative psychosocial effects of medical school. Importantly, grit, self-efficacy, and curiosity are protective factors against the negative psychosocial effects of medical school, whereas intolerance of uncertainty is a risk factor. Thus, research examining the associations among grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation medical students is needed. Methods We conducted a cross-sectional, descriptive study to assess medical students’ grit, self-efficacy, curiosity, and intolerance of uncertainty. We conducted independent samples t-tests and regression analyses using SPSS statistical software version 28.0. Results A total of 420 students participated in the study for a response rate of 51.5%. One-fifth of participants (21.2%, n = 89) identified as first-generation students, 38.6% (n = 162) participants reporting having a physician relative, and 16.2% (n = 68) reported having a physician parent. Grit, self-efficacy, and curiosity and exploration scores did not differ by first-generation college status, physician relative(s), or physician parent(s). However, total intolerance of uncertainty scores differed by physician relative(s) (t= -2.830, p = 0.005), but not by first-generation status, or physician parent(s). Further, subscale scores for prospective intolerance of uncertainty differed by physician relative(s) (t= -3.379, p = 0.001) and physician parent(s) (t= -2.077, p = 0.038), but not by first-generation college student status. In the hierarchical regression models, first-generation college student status and first-generation medical student status were not predictive of grit, self-efficacy, curiosity and exploration, or intolerance of uncertainty, although statistical trends were observed with students with physician relative(s) predicting lower intolerance of uncertainty scores (B= -2.171, t= -2138, p = 0.033) and lower prospective intolerance of uncertainty (B= -1.666, t= -2.689, p = 0.007). Conclusions These findings suggest that first-generation college students did not differ by grit, self-efficacy, curiosity, or intolerance of uncertainty. Similarly, first-generation medical students did not differ by grit, self-efficacy, or curiosity; however, first-generation medical students showed statistical trends in higher total intolerance of uncertainty and higher prospective intolerance of uncertainty. Additional research needs to confirm these findings in first-generation medical students.

Background First generation students report more symptoms of burnout, depression, and psychological distress in medical school. Grit, self-efficacy, and curiosity are protective factors against the negative psychosocial effects of medical school, whereas intolerance of uncertainty is a risk factor. What is not known is the association among grit, self-efficacy, curiosity, and intolerance of uncertainty and first-generation students. Thus, we examined grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation medical students. Methods We conducted a cross-sectional, descriptive study to assess medical students’ grit, self-efficacy, curiosity, and intolerance of uncertainty. We conducted independent samples t-tests and regression analyses using SPSS statistical software version 28.0. Results A total of 420 students participated in the study for a response rate of 51.5%. One-fifth of participants (21.2%, n = 89) identified as first-generation students, 38.6% (n = 162) participants reporting having a physician relative, and 16.2% (n = 68) reported having a physician parent. Grit scores did not differ by first-generation college status, physician relative(s), or physician parent(s). Similarly, self-efficacy scores did not differ by first-generation college status, physician relative(s), or physician parent(s), and curiosity scores did not differ by first-generation college status, physician relative(s), or physician parent(s). However, total intolerance of uncertainty scores differed by physician relative(s) (t= -2.830, p = .005), but not by first-generation status, or physician parent(s). Further, subscale scores for prospective anxiety differed by physician relative(s) (t= -3.379, p = .001) and physician parent(s) (t= -2.077, p = .038), but not by first-generation status. In the final regression model, both grit and self-efficacy were independently associated with intolerance of uncertainty, such that higher scores of grit (b = − .159, p = .003) and self-efficacy (b=-.316, p < .001) were associated with lower scores of intolerance of uncertainty. Having a physician in the family (b=-5.238, p = .003) was a protective factor against higher scores of intolerance of uncertainty. Conclusions These findings suggest that first-generation college students did not differ by grit, self-efficacy, curiosity, or intolerance of uncertainty. Similarly, first-generation medical students did not differ by grit, self-efficacy, or curiosity; however, first-generation medical students reported higher total intolerance of uncertainty and higher prospective anxiety. Additional research needs to confirm these findings in first-generation medical students.

Aims To explore the lived experiences of diabetes distress (DD) in adults with type 1 and type 2 diabetes, and to identify similarities and differences in these experiences. Methods We conducted in‐depth interviews with people with type 1 (n = 19) and type 2 diabetes (n = 29). We conducted thematic analysis using NVivo 12 software. Results We identified three themes: (1) Experiencing Diabetes Distress as a Lack of Control – Similarities: All participants voiced a perceived lack of control with their glucose levels and other peoples' misconceptions about diabetes. Differences: Nearly all type 1 participants described a “lack of control” over emotional reactions to hypo‐ and hyperglycaemia as opposed to only one type 2 participant. (2) Experiencing Diabetes Distress as a Burden of Constant Management – Similarities: All participants emphasized the nonstop, relentless nature of diabetes management. Differences: type 1 participants described self‐care as vital, with life‐threatening consequences if not performed, while type 2 participants did not perceive such dangerous consequences. (3) Understanding the Value of Social Support in Diabetes Distress – Similarities: All participants acknowledged the importance of having others recognize the difficulties of living with diabetes. Differences: type 1 participants noted actual experiences where peers and health care professionals acknowledged that burden, whereas type 2 participants expressed a desire for this support that was not present in their lives. Conclusions Findings revealed subtle differences in perceptions of DD among adults with type 1 and type 2 diabetes, which suggest a need to tailor treatment for people with each type of diabetes.

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Objective Previous studies have suggested that patients with aspirin‐exacerbated respiratory disease (AERD) have a high likelihood of alcohol intolerance. The purpose of this systematic review is to identify if there is sufficient evidence to confirm this correlation and the impact of medical therapy on subsequent alcohol tolerance. Data Sources PubMed, EMBASE, SCOPUS, EBSCO, Google Scholar, Cochrane Library, and Grey literature. We also performed snowballing on the identified observational studies (OS) for additional data. Review Methods A systematic review was conducted from 1968 to 2022 to identify those studies describing AERD symptomatology triggered by alcohol intake. The primary outcome was to analyze the current literature for the association between alcohol intolerance and AERD symptoms. The secondary outcome looked for improvement in alcohol tolerance after aspirin desensitization or biological therapy. Results A total of 775 studies were identified and 40 abstracts were evaluated. From these, 5 studies met the inclusion criteria. Of the 5 manuscripts, there was 1 case‐control, 2 cohort, and 2 cross‐sectional studies. A total of 522 participants with AERD and a history of alcohol consumption were included, with 52.8% reporting at least 1 sinopulmonary exacerbation after alcohol intake. One of 3 studies noted improvement in alcohol tolerance after medical therapy with aspirin desensitization. Conclusion The current literature suggests that patients with AERD have a high risk of alcohol intolerance. Additionally, aspirin desensitization may improve alcohol tolerance in this patient population.