December 2014 Health Bulletins

	Ask the Doc Dr. Pierre-Paul Tellier is Associate Professor of Family Medicine and Director of Student Health Services at McGill University in Quebec.

“What are the effects of stress on a student?”
— Chanelle B., University of Manitoba, Winnipeg
*Name changed for privacy

What is stress, anyway?
Stress is “a non-specific response of the body to a demand,” according to Hans Selye, an endocrinologist who studied stress extensively. Here’s how he broke it down:

• A stressor is a stimulus that causes stress.
• Eustress is positive stress that helps us perform at a higher level and achieve our goals.
• Distress is negative stress that is overwhelming, and undermines our performance and wellbeing. 

The impact of stress on the body
When faced with a stressor, our body secretes adrenaline. This can lead to an increased heart rate and blood pressure, agitation, sweating, insomnia, and that “pit in your stomach” feeling. In addition, your body produces more cortisol, a stress hormone that affects many organs and functions.

This is okay for a short while. If your stress is chronic, however, your body produces these hormones continuously. The body wears itself out, causing physical health problems.

Physical outcomes of stress
The list is long. A sampling:

• High blood pressure and/or heart disease
• Gastro-intestinal problems
• Respiratory issues, e.g., asthma
• Diabetes
• Back problems and/or headaches
• Increased frequency of accidents
• Rashes
• Mood issues, e.g., anxiety, depression, and suicide
• Abuse of others
• Use of tobacco, alcohol, and other substances
• Insomnia
• Sexual problems

In other words: When you are stressed for too long, you are miserable. 

How to deal with stress

1. Identify the stressor and minimize it. 
This is easier said than done. Ask yourself what recently occurred. When did the symptoms start? What happened then? Keep a log. Look for recurring patterns. You might need help, perhaps from a friend who may have noticed a change in you, or a counsellor who can help you analyze what is happening.

2. Manage your stress symptoms.
Various behaviours and treatments have been shown to positively affect the brain’s pleasure, reward, and motivation circuits, alleviating stress.

Physical activity is associated with reduced depression and anxiety (two potential consequences of stress) and improved physical and psychological health, according to a 2011 review of the evidence.

Mindfulness-based stress reduction (MBSR), a form of meditation, and standard relaxation training can effectively reduce stress. In addition, MBSR seems to reduce anxiety and obsessive thinking about the causes of stress, according to a 2009 review of studies.

Massage therapy is difficult to study, but the consensus is that it reduces depression and anxiety, according to a 2008 review. It can help relieve state anxiety (temporary apprehension and tension related to specific experiences) and also trait anxiety (the general tendency to stress that is characteristic of any individual).

3. Work with a counsellor to learn how to stress-proof yourself for the long term.
This includes becoming a positive thinker, disputing irrational beliefs, seeing problems as opportunities, relabelling emotions, building skills (e.g., time management), and talking things out with someone. That might be a counsellor, who may use such techniques as cognitive behavioural therapy (CBT). 

Now, I have a headache. Time to go for a jog.

See Capture your calm: 8 small steps to stress less, in this issue.

	Ask the Trainer Frankie Romeo is a certified personal trainer, small group training coach, and graduate student at Lipscomb University in Nashville, Tennessee

“How do you break a plateau when lifting weights?”
— Kyle L., Cazenovia College, New York

Resistance training is the most effective method for building muscular strength. However, it’s not uncommon to experience a plateau—a delay in progress. For example, someone who is new to weightlifting might initially raise their bench press 4.5 kg (10 pounds) each month, but on the fourth month be unable to add additional weight. Plateaus are the result of our bodies’ adaptation to specific exercises and intensity levels.

To overcome these plateaus, it’s important to diversify our workouts and modify our exercises. In other words, keep the body guessing. Here are three proven ways to do just that:

1. Change the grip

• Are your hands always in the same position? Depending on the exercise, you may want to move your hands closer together or farther apart. For example, performing the close-grip bench press with hands about one foot apart will help engage the triceps, whereas performing the standard, wide-grip bench press with hands slightly past shoulder-width apart uses primarily the chest and shoulders.
• Train the muscles you feel are weaker and that may be inhibiting progress.
• Alternating a supinated (palms facing out), pronated (palms facing in), and neutral (palms facing each other) grip can change some exercises. This is most suitable for pull-ups, bicep curls, and shoulder raises.

2. Alternate the load

• Incorporate both low resistance and high resistance into your routine, even for the same exercises. For example, if you back squat twice a week, you might benefit from having a “light” day and “heavy” day rather than focusing on one or the other.
• The number of sets and repetitions will vary depending on the level of resistance. Don’t train the same muscle group within the same 48—72 hour timeframe.

3. Vary the tempo
Don’t forget about the speed and pace of your training.

• An isotonic muscle contraction has a concentric (muscle shortening) phase and eccentric (muscle lengthening) phase. Instead of lifting a weight and quickly lowering it before the next repetition, try slowing down.
  
• For instance, a bodyweight squat could have a tempo that includes a three-second eccentric contraction. This means you take three seconds to lower into the squat.
  
• There is also an isometric contraction; i.e., holding an exercise in one position without moving. You could pause at the bottom of the squat for two seconds before raising and finishing the repetition. A technique like this can help you better stabilize the body at what is usually the most difficult point in the lift—which makes the workout easier at regular speed. 

	Ask the Relationship Educator Joleen M. Nevers, MAEd., CHES, AASECT, is a certified sexuality educator and the health education coordinator at the University of Connecticut.

“How many condoms are too many condoms?”
— Jose R.,* Eastern Kentucky University, Richmond
* Name changed for privacy

Optimum number of condoms each time = 1
Great question. Students might think that using more than one condom for sexual activity will provide more protection. That is not the case. Using more than one condom at the same time causes friction and may lead to a condom breaking. This is true also for the use of male and female condoms together. Don’t double up.

Pleasure it up
To increase pleasure and reduce friction when using either one male condom or one female condom—lubricate! Water-based and silicone-based lubricants are:

• Compatible with latex, polyisoprene, polyurethane, and nitrile, the materials condoms are made of.
• Absorbed by the body and not dangerous to ingest (though I don’t suggest eating it; I’m talking about ingesting small amounts of lube via sexual activity).
• Most condoms today incorporate a silicone-based lube.

Preventing pregnancy
For pregnancy prevention, combine another form of contraception with either a male or female condom. For example, while a man uses a male condom, his female partner might use hormonal contraception (such as the Pill, the Ring, the Patch, the Shot, or a hormonal IUD). Or the female partner might use the female condom and hormonal contraception.

	Ask the Professor Amy Baldwin, MA, is the director of university studies at the University of Central Arkansas.

“Is it better to read the whole passage, or skim and pick up important points?”
— Trenton B., Suffolk University, Boston, Massachusetts
* Name changed for privacy

I imagine I know what answer you want to hear. I would love to say that all you need to do is skim your reading in college and you’ll be just fine. But that wouldn’t be true. So read this answer thoroughly.

Skimming vs. not reading at all
If your choice is between not doing the reading at all and skimming, then you are better off at least touching the material.

Skimming vs. reading
There is no substitute for reading the whole assignment from beginning to end.

But if sometimes you just can’t swing it…
Maximize the time you have. These strategies work, too, for previewing the material before you read it in its entirety.

Headings
If you’re reading a lengthy text, look for headers within the material that signal the main ideas.

Topic sentences
Read all the topic sentences for each paragraph. Often, they are located at the beginning or end of the paragraph.

First and last paragraphs
The first and last paragraphs of a reading assignment often contain a lot of valuable information and summarize the main points.

Preface or introduction
If you have a book to read and not a lot of time, read the introductory material or preface, which will often give you information about major themes and events.

What makes us creative—and what kind of creative?

Find your type

Creativity is prevalent in Psychology research, and researchers are finding creative ways to explore it. They’ve shown that openness to experience is the key personality trait associated with creativity. But what does this mean?

There are many ways to be open to experience, wrote Dr. Scott Barry Kaufman, a
Cognitive Psychologist who focuses on intelligence, creativity, and personality, in Scientific American. Maybe you’re intellectually curious or have a wicked imagination. Perhaps you immerse yourself in complex problem solving. Or maybe you’re more interested in emotional experience.

Four types of openness
Openness to experience can be broken down into four types, which manifest creatively in different ways, according to Dr. Kaufman’s study in the Journal of Creative Behavior (2013). The research involved 146 high-achieving British students aged 16—18.

FIND YOUR CREATIVE TYPE

You score highly on IQ tests
Traditional measures of intelligence (i.e., IQ tests), including scores for verbal reasoning and working memory, reflect explicit cognitive ability. They don’t seem to represent particular personality types. Explicit cognitive ability is more relevant to creative achievement in the sciences than the arts.

You’re driven to engage in ideas, rational thought, and the search for truth
You goal-directed types tend to be industrious, assertive, and persevering. Those traits represent your intellectual engagement. Intellectual engagement is more relevant to creative achievement in the sciences than the arts. It seems a better predictor than explicit cognitive ability of scientific creative achievement.

Your decisions are based on emotions, gut feelings, and empathy
You might be more volatile, compassionate, enthusiastic, assertive, and impulsive than the average dude. That’s affective engagement in action. Affective engagement is more relevant to creative achievement in the arts than the sciences. Actually, it might even be detrimental to scientific creativity. (Don’t let that make you drop Physics. This is a generalization, and people are complicated.)

You’re into aesthetics, fantasy, art, and culture
Are you searching for beauty? Are you more compassionate, enthusiastic, assertive, and impulsive than most of us? Maybe also less industrious and orderly? That’s what aesthetic engagement looks like. This is more relevant to creative achievement in the arts than the sciences.

Get thee to a theater

Plenty of learning (and becoming better people) occurs outside the classroom. Now we’re getting a sense of how effectively it can happen inside a theatre. We’re better off seeing a play performed live than reading it or watching the movie version, new research suggests. Live theatre seems to make us more tolerant and empathic, too.
In the first randomized study of the effects of live theatre on students, high schoolers were assigned by lottery to see stage productions of Hamlet or A Christmas Carol, or no live theatre, by researchers at the University of Arkansas in the US. Here’s what they found:

Knowledge and vocabulary
Students who saw a play performed live demonstrated considerably better knowledge of its plot and vocabulary than did students who had read the same play or had seen it performed on screen. “Plays are meant to be seen performed live,” wrote Dr. Jay Greene, Professor of Education Reform, who led the study, in Education Next. “The story can be conveyed in a movie, but it doesn’t engage the viewer in the same way.”

Tolerance for others
Students who attended live theatre later demonstrated greater tolerance for human diversity and difference. Here’s how students responded to statements relating to tolerance:

• “Plays critical of America should not be allowed to be performed in our community.”
• Students who saw a live play: 9 percent said yes.
• Students who did not see a live play: 21 percent said yes.

• “People who disagree with my point of view bother me.”
• Students who saw a live play: 22 percent said yes.
• Students who did not see a live play: 30 percent said yes.

Understanding others
Students who saw live theatre seemed to have an improved ability to read the emotions of others. They scored higher than non-theatre-going students on the Reading the Mind in the Eyes Test, which is thought to measure the ability to infer other people’s thoughts and feelings by looking at their eyes.

In a previous study, the researchers found that students who participated in a field trip to an art museum demonstrated increased knowledge, tolerance, historical empathy, and critical thinking than students who didn’t.