Tag: pubmed

Can Med Educ J. 2024 Jul 12;15(3):116-118. doi: 10.36834/cmej.77055. eCollection 2024 Jul.

ABSTRACT

Medical student-led walk and talk programs, such as Walk with a Future Doc (WWAFD), provide a means for the medical community and community at-large to interact in a non-clinical setting. This environment can increase attendance accountability, enhance patient-provider relationships, and allow medical professionals to be leading examples of healthy, active living. We demonstrate the positive interest for this program, rationale of participants for joining, and the feasibility of its setup. As one of the only WWAFD programs in Canada, we encourage other medical schools to implement this program to promote continuity of hands-on, community-engaged learning amongst their students.

PMID:39114786 | PMC:PMC11302763 | DOI:10.36834/cmej.77055

Can Med Educ J. 2024 Jul 12;15(3):37-44. doi: 10.36834/cmej.77088. eCollection 2024 Jul.

ABSTRACT

INTRODUCTION: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors.

METHODS: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman’s correlation assessed associations between scales. Significance was p < 0.05.

RESULTS: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4%reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores.

CONCLUSION: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey.

PMID:39114776 | PMC:PMC11302766 | DOI:10.36834/cmej.77088

Can Med Educ J. 2024 Jul 12;15(3):18-25. doi: 10.36834/cmej.77580. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: Although medical courses are frequently evaluated via surveys with Likert scales ranging from “strongly agree” to “strongly disagree,” low response rates limit their utility. In undergraduate medical education, a new method with students predicting what their peers would say, required fewer respondents to obtain similar results. However, this prediction-based method lacks validation for continuing medical education (CME), which typically targets a more heterogeneous group than medical students.

METHODS: In this study, 597 participants of a large CME course were randomly assigned to either express personal opinions on a five-point Likert scale (opinion-based method; n = 300) or to predict the percentage of their peers choosing each Likert scale option (prediction-based method; n = 297). For each question, we calculated the minimum numbers of respondents needed for stable average results using an iterative algorithm. We compared mean scores and the distribution of scores between both methods.

RESULTS: The overall response rate was 47%. The prediction-based method required fewer respondents than the opinion-based method for similar average responses. Mean response scores were similar in both groups for most questions, but prediction-based outcomes resulted in fewer extreme responses (strongly agree/disagree).

CONCLUSIONS: We validated the prediction-based method in evaluating CME. We also provide practical considerations for applying this method.

PMID:39114774 | PMC:PMC11302746 | DOI:10.36834/cmej.77580

Can Med Educ J. 2024 Jul 12;15(3):121-122. doi: 10.36834/cmej.77077. eCollection 2024 Jul.

NO ABSTRACT

PMID:39114771 | PMC:PMC11302765 | DOI:10.36834/cmej.77077

S Afr J Psychiatr. 2024 Jul 30;30:2217. doi: 10.4102/sajpsychiatry.v30i0.2217. eCollection 2024.

ABSTRACT

BACKGROUND: Adolescent pregnancy carries significant global ramifications. Community health workers (CHWs) play a role in empowering adolescents through counselling skills, thereby promoting informed decision-making for better outcomes.

AIM: The study aims to evaluate the counselling skills of CHWs in their efforts to support pregnant adolescents (PA) in Limpopo province.

SETTING: The research was carried out with CHWs in the Mopani and Vhembe districts of the Limpopo province.

METHODS: A quantitative descriptive approach was used to evaluate CHWs’ counselling skills for PAs in Limpopo. A sample of 81 respondents was selected using simple random sampling. Ethical approval was obtained. Data were collected using a questionnaire guided by the Theory of Reasoned Action. Descriptive statistics were analysed using Statistical Package for Social Scientists version 24. The questionnaire’s validity was assessed using Cronbach’s alpha, resulting in a correlation coefficient of 0.710.

RESULTS: The study identified significant variations in counselling recommendations. Preparation: Using private space with fewer distractions showed considerable variability (standard deviation = 0.218). Introduction: High variability was observed in using the SOLER method (standard deviation = 0.316). Working phase: Suggesting rather than advising had notable variability (standard deviation = 0.396). Termination: Avoiding abrupt endings and informing clients about the session’s conclusion demonstrated variability (standard deviation = 0.283). Additionally, the majority (64%) of the participants found record-keeping unnecessary, which demonstrated the highest variability (standard deviation = 0.482).

CONCLUSION: The study revealed CHWs’ proficiency in counselling techniques and emphasised the importance of following the counselling stages.

CONTRIBUTION: The research highlights the importance of evaluating the counselling skills of CHWs and identifying areas for improvement to develop targeted interventions and enhancing health outcomes for PAs.

PMID:39114755 | PMC:PMC11304368 | DOI:10.4102/sajpsychiatry.v30i0.2217

S Afr J Psychiatr. 2024 Jul 16;30:2275. doi: 10.4102/sajpsychiatry.v30i0.2275. eCollection 2024.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had a profound global impact, affecting individuals, including those with mental illness, through early and widespread information dissemination. Although the neurobiological basis of delusions remains unclear, external stimuli and historical events are known to influence them. The pandemic provided a unique opportunity to explore this phenomenon.

AIM: To determine the prevalence of COVID-19-related delusional content, among individuals presenting for treatment of psychosis during the peak of the COVID-19 pandemic and investigate associated clinical and demographic factors.

SETTING: Chris Hani Baragwanath Academic Hospital in-patient psychiatry department.

METHODS: Data were extracted retrospectively from adult psychiatric admissions spanning April to September 2020 on patients whose presenting complaints included delusions. Demographic factors, symptoms, psychiatric, medical and substance use history, and a documented Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis by the attending psychiatrist were collected.

RESULTS: The prevalence of COVID-19-related delusional content was 25.5%. Significant demographic association was observed with education level of Grade 12 and above (p = 0.000338). The odds of a diagnosis of schizophrenia and related disorders were 2.72 times greater than mood and psychotic disorder due to another medical condition in those with COVID- 19-related delusional content (OR 2.19, 95% CI: [1.4-3.4]).

CONCLUSION: The presence of COVID-19-related delusional content in patients admitted to hospital with psychosis provides further evidence of the role of external stimuli in the formation of delusions.

CONTRIBUTION: This study underscores the influence of socio-cultural factors on delusions and advocates for interventions and expanded research to address mental health outcomes.

PMID:39114754 | PMC:PMC11304377 | DOI:10.4102/sajpsychiatry.v30i0.2275

S Afr J Psychiatr. 2024 Jul 26;30:2244. doi: 10.4102/sajpsychiatry.v30i0.2244. eCollection 2024.

ABSTRACT

BACKGROUND: Cannabis is the most widely used substance worldwide, and its use is much higher among adolescents. However, adolescents are at higher risk of negative sequelae secondary to this use, including the possible development of mental disorders. On 31 March 2017, the South African High Court ruled that cannabis use by an adult in a private dwelling should be decriminalised.

AIM: This study aimed to determine the clinical profile of adolescents who use cannabis, who use, who present to a tertiary hospital in Cape Town, South Africa, before and after the high court ruling in 2017.

SETTING: Folder review of adolescents admitted at Groote Schuur Hospital (GSH) in the Emergency Psychiatric Unit.

METHODS: This study was a retrospective folder review of adolescents admitted from April 2015 to March 2019.

RESULTS: Cannabis was the most commonly used substance in the study, with increased use seen post-ruling. The most common frequency of cannabis use reported was daily. A significantly higher proportion of patients who used cannabis pre-ruling had psychotic disorder (p < 0.001) and cannabis use disorder (p = 0.01). Post-ruling, the results were statistically significant (p < 0.001) for both.

CONCLUSION: The study showed an increasing prevalence of cannabis use in adolescents admitted with mental illness after the high court ruling in 2017. This study also demonstrates that adolescents remain a vulnerable population to the effects of cannabis and highlights the need for further research.

CONTRIBUTION: The findings of this study call for more focussed adolescent interventions and services.

PMID:39114753 | PMC:PMC11304362 | DOI:10.4102/sajpsychiatry.v30i0.2244

Afr J Lab Med. 2024 Jul 17;13(1):2286. doi: 10.4102/ajlm.v13i1.2286. eCollection 2024.

ABSTRACT

BACKGROUND: Recent evidence has linked changes in plasma lecithin-cholesterol acyltransferase (LCAT) and paraoxonase-1 (PON-1) levels with increased risk for development of premature atherosclerotic cardiovascular disease (ASCVD) in different populations. However, studies on this in Nigeria and sub-Saharan Africa are scarce.

OBJECTIVE: This study assessed the association between reduced plasma LCAT and PON-1 levels and an increased risk of ASCVD, and their potential as biomarkers for ASCVD.

METHODS: Atherosclerotic cardiovascular disease patients and healthy controls were randomly selected for this cross-sectional case-control study from the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria, between March 2022 and March 2023. Plasma LCAT and PON-1 were determined by sandwich enzyme-linked immunosorbent assay, while the lipid profile was measured by spectrophotometry.

RESULTS: A total of 153 ASCVD patients (mean age: 52.92 ± 10.24 years) and 50 healthy controls (mean age: 46.96 ± 11.05 years) were included in the analyses. Stastistically significant increases were observed in the mean body weight, hip circumference, waist circumference, waist-to-hip ratio, body mass index, diastolic and systolic blood pressure (all p ≤ 0.001), and pulse rate (p = 0.003) compared to the control values. Statistically significant increases were also observed in the mean plasma total cholesterol, triglycerides, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol (all p ≤ 0.001). In contrast, the mean plasma high-density lipoprotein cholesterol, LCAT, and PON-1 (p ≤ 0.001) were notably reduced compared to the control values.

CONCLUSION: The present study provides supportive evidence that changes in plasma LCAT and PON-1 could predispose individuals to risk of premature ASCVD.

WHAT THIS STUDY ADDS: Plasma LCAT and PON-1 may serve as independent markers or complement other established cardiovascular disease markers to discriminate the risk of ASCVD when it is unclear.

PMID:39114750 | PMC:PMC11304125 | DOI:10.4102/ajlm.v13i1.2286

Afr J Lab Med. 2024 Jul 16;13(1):2374. doi: 10.4102/ajlm.v13i1.2374. eCollection 2024.

ABSTRACT

BACKGROUND: Altered lipid levels may be associated with the development of a number of malignancies, including cancer of the cervix. However, there is limited understanding of this relationship in the rural Ugandan context.

OBJECTIVE: We investigated the connection between dyslipidaemias and cervical intraepithelial neoplasia (CIN) among women attending the cervical cancer clinic at Mbarara Regional Referral Hospital in south-western Uganda.

METHODS: This unmatched case-control study was conducted between December 2022 and February 2023 and included women with CIN (cases) and women without intraepithelial lesions (controls) in a 1:1 ratio. Participants were selected based on cytology and/or histology results, and after obtaining written informed consent. Demographic data were collected, and venous blood was drawn for lipid profile analysis. Dyslipidaemia was defined as: total cholesterol > 200 mg/dL, low-density lipoprotein > 160 mg/dL, triglycerides > 150 mg/dL, or high-density lipoprotein < 40 mg/dL. At diagnosis, cases were categorised as either CIN1 (low grade) or CIN2+ (high grade).

RESULTS: Among the 93 cases, 81 had CIN1, while 12 had CIN2+. Controls had a 13.9% (13/93) prevalence of high triglycerides and cases had a prevalence of 3.2% (3/93; p = 0.016). Reduced high-density lipoprotein was the most prevalent dyslipidaemia among cases (40.9%; 38/93). Statistically significant associations were found between high serum triglycerides and CIN (odds ratio: 1.395, 95% confidence interval: 0.084-1.851, p = 0.007).

CONCLUSION: A notable association was observed between triglyceride dyslipidemia and CIN. Further studies into biochemical processes and interactions between lipids and cervical carcinogenesis are recommended through prospective cohort studies.

WHAT THIS STUDY ADDS: This research provides additional information on the potential role of lipids in cervical carcinogenesis among women in rural Uganda. It also presents the possible prevalence of multimorbidity involving cervical cancer and cardiovascular diseases, particularly in low-resource settings lacking preventive measures against the increasing prevalence of dyslipidaemia.

PMID:39114748 | PMC:PMC11304215 | DOI:10.4102/ajlm.v13i1.2374

Arch Public Health. 2024 Aug 7;82(1):118. doi: 10.1186/s13690-024-01341-1.

ABSTRACT

BACKGROUND: Outreach clinics were part of efforts to maximise uptake in COVID-19 vaccination.

METHODS: We used controlled interrupted time series, matching on age, sex, deprivation and vaccination eligibility date, to determine the effect of outreach clinics on time to first COVID-19 vaccine, using a population-based electronic health record database of 914,478 people, from December 2020 to December 2021; people living within 1 mile of each outreach clinics were exposed.

RESULTS: 50% of 288,473 exposed citizens were white British, and 71% were aged 0-49 years. There was no evidence for an overall statistically significant increase in cumulative percentage vaccinated due to the outreach clinic at 6 weeks, with an overall pooled effect estimate of -0.07% (95% CI: -1.15%, 1.02%). The pooled estimate for increased cumulative vaccine uptake varied slightly depending on how the analysis was stratified; by ethnic group it was – 0.12% (95% CI: -0.90%, 0.66%); by age group it was – 0.06% (95% CI: -0.41%, 0.28%); and by deprivation it was 0.03% (95% CI: -0.74%, 0.79%).

CONCLUSIONS: Living within a mile of an outreach clinic was not associated with higher vaccine uptake. Evaluation of future outreach clinics should consider the relative importance of travel amongst other barriers to accessing vaccines.

PMID:39113156 | DOI:10.1186/s13690-024-01341-1