Student perceptions of an online surgical teaching programme during the COVID-19 pandemic at the University of KwaZulu-Natal: A short report

Background. The COVID-19 pandemic has led to an unprecedented global health crisis, with impacts on many facets of the health system, including lack of access to regular training wards and the need for social distancing, which posed particular challenges to undergraduate teaching. Objectives. To explore the perceptions of students of the online surgical programme at the University of KwaZulu-Natal (UKZN). Methods. An online survey was administered to 258 final-year students. Data were collected on student demographics, the impact of COVID-19 restrictions on the teaching programme, engagement and learning from live Zoom sessions, overall perceptions about the module and general feedback on students' experience of the programme. Results. Most students (84%, 77/91) supported the need to change to the virtual programme. The module was perceived as well-structured (89%, 81/91). Most students (87%, 79/91) regarded the online resource materials as beneficial. Analysis of open-ended responses showed that asynchronous delivery allowed students to review and revisit resources in their own time. Student challenges included poor internet connectivity, difficulty in concentrating where live sessions exceeded an hour, and lack of clinical exposure. Conclusion. Online teaching in medical education is a feasible option for remote learning. However, it cannot replace the benefits gained during clinical exposure. Findings from this study will help to set a benchmark for online surgical training at UKZN and develop best practices for blended teaching models. As we adapt to a new normal in the era of COVID-19, the disruptions and results of innovative teaching methods have the potential to change the future of medical education

Differences in consumption of food items between obese and normal-weight people in India.

Background. There is a rising prevalence of obesity in India, and diet may be a major determinant of this. We aimed to assess differences in types and quantities of food items consumed by obese and normal-weight people in India. Methods. Cross-sectional data of 7067 factory workers and their families were used from the Indian Migration Study, conducted in four cities across northern, central and southern India. Food frequency questionnaire data were used to compare the quantities of consumption of 184 food items between 287 obese (body mass index >30 kg/m2) and 1871 normalweight (body mass index 18.50–22.99 kg/m2) individuals, using t tests and ANCOVAs. Individuals with diabetes, hypertension and cardio-vascular disease were excluded. SPSS 16.0 was used for analysis. Results. After adjusting for age, sex, location and socioeconomic status, obese individuals were found to eat significantly larger quantities of 11 food items compared with normalweight individuals. These included phulkas, chapatis/parathas/ naan, plain dosa, mutton/chicken pulao/biryani, chicken fried/ grilled, rasam, mixed vegetable sagu, vegetable raitha, honey, beetroot and bottlegourd (p<0.01). Consumption of plain milk was higher among normal-weight than among obese individuals (p<0.05). Consumption of some of these food items was also found to increase by socioeconomic status, decrease by age, and be higher among men relative to women. Conclusion. Obese individuals were found to consume larger quantities of certain food items compared with normal-weight individuals. Interventions should aim at limiting overall food consumption among obese individuals.

Stress and Its Effects on Medical Students: A Cross-sectional Study at a College of Medicine in Saudi Arabia.

Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. All the medical students from year one to year five levels from the College of Medicine, King Saud University, were enrolled in the study. The study was conducted using Kessler10 psychological distress (K10) inventory, which measures the level of stress according to none, mild, moderate, and severe categories. The prevalence of stress was measured and compared with the five study variables, such as gender, academic year, academic grades, regularity to course attendance, and perceived physical problems. The response rate among the study subjects was 87% (n=892). The total prevalence of stress was 63%, and the prevalence of severe stress was 25%. The prevalence of stress was higher (p<0.5) among females (75.7%) than among males (57%) (odds ratio=2.3, χ2=27.2, p<0.0001). The stress significantly decreased as the year of study increased, except for the final year. The study variables, including being female (p<0.0001), year of study (p<0.001), and presence of perceived physical problems (p<0.0001), were found as independent significant risk factors for the outcome variables of stress. Students’ grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress levels. Preventive mental health services, therefore, could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrence.

A profile of hypertension among rural elderly Malaysians.

The main objective of this study was to survey the prevalence of hypertension in Malaysians aged 55 years and above who responded to a public health screening campaign in Kuala Langat district, Selangor, Malaysia. The relationship between the detection, treatment and control in the study population was also examined. An epidemiological survey of the elderly was conducted in Kuala Langat, a rural district in Malaysia for a consecutive period of six weeks. The survey was conducted using a standardized questionnaire and interview by trained research assistants. The medical students and nurses were trained on the correct protocol of measuring blood pressure based on the recommendations of the British Hypertension Society. Newly detected persons with blood pressure readings 160/95 mmHg and above, were given a green card to return to the nearest health center for a further 2 visits to check his/her blood pressure. A total of 1,392 people with a mean age of 65 years and comprising of 53.1% males and 46.9% females responded to the health survey. Based on the history 335 (24.1%) of the respondents were known hypertensives and 82.1% of this hypertensive group were on regular treatment. However good control of hypertension was achieved only in 161 (48.1%) of them. Newly detected hypertension was found in 204 (14.6%) of the respondents. The overall prevalence of hypertension in our sample of respondents was 25.6%. There was no significant difference between the sexes and the races in terms of their detection, treatment and control. However there was a significant difference between the persons aged less than 65 years of age and those older than 65 years. There was a large proportion of previously known hypertensives among the survey population. Of those detected, not all were on regular medications and the majority on medications were not well controlled. Education of the public through intensive public health campaigns is vital to improve their knowledge on hypertension and the need for effective control. More community studies are needed to formulate better methods in the detection, treatment and control of hypertension.

Effectiveness and cost analysis of community-based rehabilitation service in Bangkok.

This paper aimed to clarify the effectiveness and the cost of the community-based rehabilitation service in Klong Toey slum after a three year study period. One hundred and seventy eight patients used community-based rehabilitation during the three year period. One hundred and fifty-seven patients (86.5%) reported that their problems/conditions were cured or improved. Only nine patients (5.1%) reported that they stopped using community-based rehabilitation because their problems/conditions did not improve. A statistically significant improvement in pain level and walking velocity assessment, in 105 and 78 patients respectively, was demonstrated. Total cost and cost per patient-day of the community-based rehabilitation were Bt 559,920 and Bt 111.1 respectively. Cost per-patient-day of this community-based rehabilitation service was compared with an estimated cost per patient-day of using rehabilitation services at Chulalongkorn University Hospital and was found to be cheaper. This study supported the role of community-based rehabilitation in Thailand. The need for a health service study in rural areas was also noted.

Elderly bed-blockers in a Thai teaching hospital: is it a problem?

Elderly patients suffer from a wide range of chronic disabling diseases and social problems. These conditions often lead to increased lengths of hospital stay for acute medical and surgical problems--"bed-blocking". By means of a one-day census of all inpatients at Chulalongkorn Thai Red Cross Hospital the number and reasons for continued hospital stay of all patients, classified by age (less than 60, and 60+ years), were measured. Of 191 medical inpatients surveyed, 34 per cent were 60 years and over. More older than younger patients were still in hospital for non-medical reasons (35% vs 21%, Chi-square = 4.89, p < 0.01). Durations of hospital stay were longer for older patients: median stay 8 and 11 days respectively for those less than 60 and those 60+ years. Early discharge of disabled elderly people to their families was achieved by vigorous social work, thus reducing the extent to which elderly patients become bed-blockers. Further demographic trends, coupled with a breakdown of the extended family structure, will make bed-blocking a very likely problem. The present patterns of care may lead to poor long-term outcomes for the elderly.