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Feels Not Right Stabbing a Child

Goh ZNL, Khoo EJ

Acad Pediatr, 2018 07;18(5):481-482.
PMID: 29331344 DOI: 10.1016/j.acap.2018.01.001
Matched MeSH terms: Students, Medical
Fulltext Association between Leptin (G2548A) and Leptin Receptor (Q223R) Polymorphisms with Plasma Leptin, BMI, Stress, Sleep and Eating Patterns among the Multiethnic Young Malaysian Adult Population from a Healthcare University

Mohanraj J, D'Souza UJA, Fong SY, Karkada IR, Jaiprakash H

Int J Environ Res Public Health, 2022 Jul 21;19(14).
PMID: 35886710 DOI: 10.3390/ijerph19148862

Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction−Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age.

Matched MeSH terms: Students, Medical
Fulltext Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study

Chew KS, Durning SJ, van Merriënboer JJ

Singapore Med J, 2016 Dec;57(12):694-700.
PMID: 26778635 DOI: 10.11622/smedj.2016015

INTRODUCTION: Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.
METHODS: Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.
RESULTS: The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.
CONCLUSION: The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.

Matched MeSH terms: Students, Medical
Fulltext Should clinical normality be examined in medical course?

Tiong TS

Singapore Med J, 2008 Apr;49(4):328-32.
PMID: 18418526

INTRODUCTION: In medical practice, some patients consult doctors for reassurance of normality, e.g. patients with throat discomfort. Therefore, medical graduates should be competent in diagnosing clinical normality. One way to assess clinical competence is by the objective structured clinical examination (OSCE).
METHODS: In 2002-2006, five batches of medical students who completed their otorhinolaryngology posting in Universiti Malaysia Sarawak were examined with the same OSCE question on clinically normal vocal cords. There were five subquestions concerning structures, clinical features, diagnosis and management. All students had prior slide show sessions regarding normal and abnormal laryngeal conditions.
RESULTS: The total number of students in 2002, 2003, 2004, 2005 and 2006 was 25, 41, 20, 30 and 16, respectively, and 100 percent responded. The average percentage of students with correct answers was 19.4, 2.4, 2.2, 21.2, and 2.4, in the subquestions 0.1 to 0.5, respectively, leaving the remaining relatively larger percentages with incorrect answers of various clinical abnormalities. A reason for these findings is examination fever by the students, who also assumed that all the stations had clinical abnormalities and required differentiating abnormalities from abnormalities, and not from normality. Without clinical normality OSCE questions, the assessment of the undergraduates' clinical competence in real life would seem incomplete.
CONCLUSION: This study showed that a significantly large percentage of students answered incorrectly in the clinical normality OSCE. This may mean that more clinical normality OSCE questions should be included in the undergraduate medical examination to help undergraduates practise the need to look for, and become competent in, clinical normality in real life.

Matched MeSH terms: Students, Medical
Fulltext Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study

Lin Y, Hu Z, Alias H, Wong LP

J Med Internet Res, 2020 Jul 20;22(7):e19982.
PMID: 32584779 DOI: 10.2196/19982

BACKGROUND: An extensive amount of information related to the novel coronavirus (COVID-19) pandemic was disseminated by mass and social media in China. To date, there is limited evidence on how this infodemic may influence psychobehavioral responses to the crisis.
OBJECTIVE: The aim of this study is to assess the psychobehavioral responses to the COVID-19 outbreak and examine their associations with mass and social media exposure.
METHODS: A cross-sectional study among medical and health sciences students from the Fujian Medical University in Fuzhou, China, was conducted between April 6-22, 2020.
RESULTS: A total of 2086 completed responses were received. Multivariable analyses demonstrated that four constructs of the Health Belief Model (HBM)-higher perception of susceptibility (odds ratio [OR] 1.44; 95% CI 1.07-1.94), severity (OR 1.32; 95% CI 1.10-1.59), self-efficacy (OR 1.61; 95% CI 1.21-2.15), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.09-1.59)-were significantly associated with a higher mass media exposure score, whereas only three constructs-higher perception of severity (OR 1.43; 95% CI 1.19-1.72), self-efficacy (OR 1.85; 95% CI 1.38-2.48), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.08-1.58)-were significantly associated with a higher social media exposure score. Lower emotional consequences and barriers to carry out prevention measures were also significantly associated with greater mass and social media exposure. Our findings on anxiety levels revealed that 38.1% (n=795; 95% CI 36.0-40.2) of respondents reported moderate-to-severe anxiety. A lower anxiety level was significantly associated with higher mass and social media exposure in the univariable analyses; however, the associations were not significant in the multivariable analyses.
CONCLUSIONS: In essence, both mass and social media are useful means of disseminating health messages and contribute to the betterment of psychobehavioral responses to COVID-19. Our findings stress the importance of the credibility of information shared through mass and social media outlets and viable strategies to counter misinformation during a pandemic.

Matched MeSH terms: Students, Medical
Demodicosis among university medical students in Malaysia and the effects of facial cleanser and moisturizer usage

Isa NH, Loong LW, Fang GH, Mohamad AM, Razali N, Rani NI, et al.

Southeast Asian J Trop Med Public Health, 2011 Nov;42(6):1375-80.
PMID: 22299405

Demodicosis is an infestation of the skin with Demodex, an ectoparasite commonly found on the face. A cross-sectional study was conducted to detect the presence of the ectoparasite and the outcome of facial cleanser and moisturizer usage on its infestation. Universal sampling was performed among 390 medical students, age 20-25 years old in the Klang Valley of Malaysia. The biodata of the participants and information on the use of facial cleanser and moisturizer were obtained through questionnaire. Skin samples were obtained using both skin scraping and cellophane tape method and were subsequently examined directly by microscopy. The results show an overall prevalence of 17.2%. Males (21.5%) were affected more often than females (12.8%) (p = 0.022). There were no significant differences in the prevalence of the ectoparasite among different ethnic groups, age-groups and the presence of existing facial problems among the subjects. A lower infestation rate (11.45%) was found to be associated with the use of a moisturizer (p = 0.033). Both species of ectoparasites that infest man, Demodexfolliculorum and D. brevis, were detected in this study either as single or mixed infestations.

Matched MeSH terms: Students, Medical
The Clinical Interview Schedule-Revised (CIS-R)-Malay Version, Clinical Validation

Subramaniam K, Krishnaswamy S, Jemain AA, Hamid A, Patel V

Malays J Med Sci, 2006 Jan;13(1):58-62.
PMID: 22589592

Use of instruments or questionnaires in different cultural settings without proper validation can result in inaccurate results. Issues like reliability, validity, feasibility and acceptability should be considered in the use of an instrument. The study aims to determine the usefulness of the CIS-R Malay version in detecting common mental health problems specifically to establish the validity. The CIS-R instrument (PROQSY* format) was translated through the back translation process into Malay. Inter rater reliability was established for raters who were medical students. Cases and controls for the study were psychiatric in patients, out patient and relatives or friends accompanying the patients to the clinic or visiting the inpatients. The Malay version of CIS-R was administered to all cases and controls. All cases and controls involved in the study were rated by psychiatrists for psychiatric morbidity using the SCID as a guideline. Specificity and sensitivity of the CIS-R to the assessment by the psychiatrist were determined. The Malay version of CIS-R showed 100% sensitivity and 96.15% specificity at a cut off score of 9. The CIS-R can be a useful instrument for clinical and research use in the Malaysian population for diagnosing common mental disorders like depression and anxiety.

Matched MeSH terms: Students, Medical
Fulltext Assessing oral cancer knowledge and awareness among Malaysian dental and medical students

Awan KH, Khang TW, Yee TK, Zain RB

J Cancer Res Ther, 2014 Oct-Dec;10(4):903-7.
PMID: 25579526 DOI: 10.4103/0973-1482.138011

BACKGROUND:
Oral cancer is a foremost health dilemma in several regions of the world. General dental practitioners and general medical practitioners play a major role in recognition of oral mucosal changes that may lead to malignancy. Their knowledge in oral cancer itself and the risk factors associated with the disease need to be sufficient.

OBJECTIVE:
The objective of the present study was to investigate awareness and knowledge of undergraduate dental and medical students in early detection and prevention of oral cancer.

MATERIALS AND METHODS:
Dental and medical students were invited to participate by answering a questionnaire on their habits of the oral mucosa examination and history taking, knowledge on risk factors and changes related with oral cancer, referral of patients as well as their desire to receive further information on oral cancer. Chi-square test was carried out to analyze knowledge and awareness between undergraduate dental and medical students.

RESULTS:
Undergraduate dental students were more likely to examine oral mucosa (96.7%) and advice risk habits to patients (93.9%) compared to medical students (60.6% and 79.8% respectively). Significantly more dental students considered smoking (84.4%), betel quid chewing (76.1%), and alcohol drinking (35%) as risk factors. Clinical changes of oral cancer were better identified by dental students (leukoplakia-52.8%, erythroplakia-45%, and non-healing ulcer-40%) compared to medical students (leukoplakia-12.9%, erythroplakia-4.6%, and non-healing ulcer-10.3%). Both dental and medicals students reported the desire to receive further information in relation to oral cancer.

CONCLUSION:
Dental students have better knowledge and awareness in prevention and early detection of oral cancer compared to medical students.

Matched MeSH terms: Students, Medical
Fulltext Effectiveness of peer-led education on knowledge, attitude and risk behavior practices related to HIV among students at a Malaysian public university--a randomized controlled trial

Ibrahim N, Rampal L, Jamil Z, Zain AM

Prev Med, 2012 Nov;55(5):505-10.
PMID: 22982947 DOI: 10.1016/j.ypmed.2012.09.003

OBJECTIVE: Develop, implement and evaluate the effectiveness of a peer-led education program related to HIV/AIDS among university students.
METHOD:
DESIGN: randomized controlled trial with 276 university students at Faculty of Medicine and Health Sciences University Putra Malaysia (UPM), Serdang in 2011.
INTERVENTION: A peer-led education program on HIV prevention by university students.
OUTCOME: differences in knowledge, attitude and risk behavior practices related to HIV between baselines, immediate follow-up after intervention and after three months.
RESULTS: Significant improvement in sound knowledge in the intervention group as compared to the control group (Odds ratio, 1.75; 95% CI 1.01, 3.00; p=0.04) and improvement in good attitude related to HIV (Odds ratio 2.22; 95% CI 1.37, 3.61; p=0.01). The odds of high substance risk behavior was significantly reduced in the intervention group as compared to the control group (Odds ratio 0.07; 95% CI 0.02, 0.34; p=0.01). The association between good knowledge and intervention was modified by the different time points (baseline, immediately after intervention and 3 months after intervention), ethnicity and gender.
CONCLUSION:
Peer-led education program in HIV prevention improves knowledge, attitude and substance risk behavior. Changes in sexual risk behavior may require a longer follow-up.

Matched MeSH terms: Students, Medical
Fulltext A cost-effectiveness analysis of blended versus face-to-face delivery of evidence-based medicine to medical students

Maloney S, Nicklen P, Rivers G, Foo J, Ooi YY, Reeves S, et al.

J Med Internet Res, 2015;17(7):e182.
PMID: 26197801 DOI: 10.2196/jmir.4346

Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear.

Matched MeSH terms: Students, Medical
Fulltext Perceptions and opinions towards skin cancer prevention in Malaysia: a qualitative approach

Al-Naggar RA, Al-Naggar TH, Bobryshev YV

Asian Pac J Cancer Prev, 2011;12(4):995-9.
PMID: 21790240

INTRODUCTION: Malignant melanoma in particular is one of the few remaining cancers with an increasing incidence.

OBJECTIVES: The objective of this study is to explore the perceptions and opinions of young Malaysians towards skin cancer prevention.

METHODOLOGY: Focus group discussions were conducted among 33 medical science students from Management and Science University (MSU), Shah Alam, Malaysia, using convenience sampling. Students were divided into 4 focus groups consisting of 8, 8, 9 and 8 students respectively. The facilitator wrote down the conversations and data obtained were classified into various categories and analyzed manually.

RESULTS: The majority of the participants mentioned that overexposure to ultraviolet light is the commonest cause of skin cancer but also that the most benefit we get from sun ight is vitamin D synthesis. The majority mentioned that the best prevention measure for skin cancer is using a sunscreen, followed by limit exposure to the sun.

CONCLUSION: The present study demonstrated there is a lack of knowledge regarding screening methods and prevention measures of skin cancer. Therefore, there is a need to establish health education unit in all universities to educate all university students regarding various health problems including skin cancer prevention.

Matched MeSH terms: Students, Medical
Fulltext Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis

Nathavitharana RR, Bond P, Dramowski A, Kotze K, Lederer P, Oxley I, et al.

Presse Med, 2017 Mar;46(2 Pt 2):e53-e62.
PMID: 28256382 DOI: 10.1016/j.lpm.2017.01.014

Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission.

Matched MeSH terms: Students, Medical

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