Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students / 보건의료교육평가

PURPOSE@#To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students.@*METHODS@#This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20–29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory–student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale–short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed.@*RESULTS@#The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= −0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= −0.32, P= 0.000), who exercised less (β= −0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= −0.18, P= 0.004) were related to engagement, but not to exhaustion.@*CONCLUSION@#Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.

Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students / 보건의료교육평가

PURPOSE: To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students. METHODS: This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20–29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory–student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale–short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed. RESULTS: The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= −0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= −0.32, P= 0.000), who exercised less (β= −0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= −0.18, P= 0.004) were related to engagement, but not to exhaustion. CONCLUSION: Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.

Performance of the Achutha Menon Centre Diabetes Risk Score in Identifying Prevalent Diabetes in Tamil Nadu, India

BACKGROUND: The Achutha Menon Centre Diabetes Risk Score (AMCDRS), which was developed in rural Kerala State, South India, had not previously been externally validated. We examined the performance of the AMCDRS in urban and rural areas in the district of Vellore in the South Indian state of Tamil Nadu, and compared it with other diabetes risk scores developed from India. METHODS: We used the data from 4,896 participants (30 to 64 years) of a cross-sectional study conducted in Vellore (2010 to 2012), to calculate the AMCDRS scores using age, family history, and waist circumference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), and the area under the receiver operating characteristic curve (AROC) were calculated for undiagnosed and total diabetes. RESULTS: Of the 4,896 individuals surveyed, 274 (5.6%) had undiagnosed diabetes and 759 (15.5%) had total diabetes. The AMCDRS, with an optimum cut-point of ≥4, identified 45.0% for further testing with 59.5% sensitivity, 60.5% specificity, 9.1% PPV, 95.8% NPV, and an AROC of 0.639 (95% confidence interval [CI], 0.608 to 0.670) for undiagnosed diabetes. The corresponding figures for total diabetes were 75.1%, 60.5%, 25.9%, 93.0%, and 0.731 (95% CI, 0.713 to 0.750), respectively. The AROC for the AMCDRS was not significantly different from that of the Indian Diabetes Risk Score, the Ramachandran or the Chaturvedi risk scores for total diabetes, but was significantly lower than the AROC of the Chaturvedi score for undiagnosed diabetes. CONCLUSION: The AMCDRS is a simple diabetes risk score that can be used to screen for undiagnosed and total diabetes in low-resource primary care settings in India. However, it probably requires recalibration to improve its performance for undiagnosed diabetes.

Intralobar pulmonary sequestration in right lower lobe with secondary infection in an adult male

Pulmonary sequestration is a rare congenital bronchopulmonary foregut malformation in which a segment of lung parenchyma is not connected to the tracheobronchial tree. This abnormal segment receives blood supply from the systemic circulation. Varying clinical techniques have been utilized to manage this disease process including surgical intervention, endovascular procedures and operative approaches. The most common presentation of this entity is involvement of the left lower lobe. We present a rare case of intralobar pulmonary sequestration in an adult male involving the right lower lobe with secondary infection

Dedifferentiated Chondrosarcoma of the Rib Masquerading as a Giant Chest Wall Tumor in a Teenage Girl: An Unusual Presentation

Chondrosarcoma of the chest wall is a rare primary neoplasm found to occur in elderly men. Patients present with an enlarging, painful, anterior chest wall mass arising from either the vicinity of the costochondral junction or the sternum. Treatment includes wide resection with appropriate chest wall reconstruction. We report an unusual presentation of this uncommon tumor occurring as a huge chest wall mass in a young teenage girl.

Coexistent pulmonary hydatid disease and tuberculosis in an adult male

Hydatid disease with pulmonary tuberculosis coexisting in a patient is an extremely rare occurrence. A patient presenting with nonspecific chest symptoms must be adequately investigated and hydatidosis must be ruled out. This case report presents the unusual coexistence of tuberculosis and hydatid disease in an adult male and its subsequent diagnosis and management