An update on British medical students' lifestyles

Different sedentary behavior domains present distinct associations with eating-related indicators

BACKGROUND

Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults.

METHODS

Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA.

RESULTS

The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile.

CONCLUSIONS

Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Factors affecting medical students’ academic burnout: a moderation analysis

Background. Burnout syndrome may threaten medical students’ professional life through negative effects on their academic work and personal life. Therefore, it is very important to identify the risk and protective factors of burnout syndrome in this group of subjects. The present study aimed to determine the association of socio-demographic characteristics, current substance/medication abuse, and personality dimensions with academic burnout among medical students, and examine physical activity as a potential moderator of the personality dimensions-academic burnout relationship. Materials and Methods. In this cross-sectional study, a total of 400 medical students from the four courses of basic sciences, physiopathology, stagers, and internship (100 people at each course) in Zahedan, Iran, in 2018, were selected by stratified sampling method and evaluated using the socio-demographic information form, Baecke physical activity questionnaire, Temperament and character inventory, and Breso’s academic burnout questionnaire. Finally, descriptive statistical methods, the Kruskal-Wallis test, Spearman’s rank correlation coefficient, and hierarchical linear regression were implemented for data analysis. Results. The participants included 156 men and 244 women. The overall frequencies for current substance/medication abuse, exhaustion, cynicism, inefficacy, and academic burnout were reported to be 27.5, 10.3, 12.3, 6.5, and 25.8 percent, respectively. The study results showed that physical activity, persistence, and cooperativeness were negative, and the years in medical school, current substance/medication abuse, and novelty seeking were positively associated with academic burnout. Also, the regression analysis results revealed the moderating effect of physical activity in the novelty-seeking-academic burnout link. Conclusions. These findings are an important contribution to the current literature on academic burnout as they can provide a meaningful guide to integrating treatment protocols designed to reduce both frequency and severity of this syndrome among medical students. However, the etiology of academic burnout among this highly sensitive group should be further investigated in depth.

Effects of personal and interpersonal factors on changes of food choices and physical activity among college students

BACKGROUND

Health behaviors developed in the college years tend to persist in adulthood. However, distinct changing patterns of food choices and physical activity (PA) and their predictors are still less clear among college students. The current study sought to explore changes of food choices and PA, as well as the effects of personal and interpersonal factors.

METHOD

Two-wave longitudinal data was collected from a sample of 431 Chinese college students (Mean baseline age = 19.15 ± 0.61 years; 45.7% male). A validated self-reported food frequency questionnaire was used to assess the frequency of food choices. The Chinese revised version of physical activity rating scale was used to assess physical activity. Latent profile analysis, latent transition analysis, and multinomial logistic regression analysis were used to analyze the data.

RESULTS

Two profiles of food choices, i.e., Avoiding staples (5.1% at Time 1) and Varied diet (94.9% at Time 1), were identified at both timepoints. 90.9% remained the same profiles over time, 63.6% participants in the Avoiding staples profile shifted to the Varied diet profile, and only 6.3% of those in the Varied diet profile shifted to the Avoiding staples profile. Negative body shape-related belief was related to the translation from the Varied diet profile to the Avoiding staples profile. Further, four profiles of PA, i.e., Inactives (51.0% at Time 1), Low activies (26.0% at Time 1), Moderate activies (15.3% at Time 1), and Activies (7.7% at Time 1), were identified at both timepoints. 50.8% remained the same profiles over time, 38.6% Inactivies shifted to the other profiles, and 48.5% Activies shifted to the other profiles over time. Participants with higher self-efficacy showed an increase in PA over time, and those with lower self-efficacy and lower peer support showed a decrease in PA over time.

CONCLUSIONS

Overall, most of college students remained the same food choices profiles, and body shape-related belief contributed to changes in food choices profiles. About half of college students experienced changes in PA, and the predictors of such changes were peer support and self-efficacy. The findings extend the understanding of the personal and interpersonal predictors of health behaviors among college students from a dynamic perspective.

Cannabis Use in Physicians: A Systematic Review and Meta-Analysis

Background: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. Method: PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. Results: We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‱) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, p < 0.001), the past year (24% vs. 5%, p < 0.001), and the past month (10% vs. 2%, p < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. Conclusions: If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‱). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.

Illicit drug use in university students in the UK and Ireland: a PRISMA-guided scoping review

BACKGROUND

Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy.

METHOD

We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source.

RESULTS

The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms.

CONCLUSION

The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base.

Burnout among Iranian medical students: Prevalence and its relationship to personality dimensions and physical activity

Several studies have shown the association between personality traits and academic burnout. But the main goal of the present study was to find out an experimental answer to the following question: Does the relationship between personality dimensions and academic burnout is a simple relationship or physical activity can influence this relationship. In this cross-sectional correlational study, 417 medical students were selected from three major cities of Iran through stratified multistage sampling and assessed by demographic information form, Baecke Physical Activity Questionnaire, Temperament and Character Inventory, and Breso’s Academic Burnout Questionnaire. Bivariate Pearson correlations and hierarchical linear regression were used to examine the relationships between academic burnout, personality traits, and physical activity. In this study, 400 medical students (39% male and 61% female) filled the questionnaires correctly. The total prevalence of academic burnout was 25.5% (n=102), with heterogeneous levels. Regression analysis indicated that in a multivariate model, being male (β=0.08, p=0.013), higher years of medical school (β=0.18, p˂0.001), and lower scores in novelty seeking (β=-0.53, p=0.006), cooperativeness (β=-0.55, p=0.010), and physical activity (β=-1.22, p˂0.001) could be attributed to higher scores of academic burnout. Furthermore, physical activity had a moderating role in “novelty seeking-academic burnout” (β=-0.47, p=0.044) and “cooperativeness-academic burnout” (β=-0.89, p=0.001) relationships (∆R2=0.02, p˂0.001). The results suggested that male gender, higher years of medical school, and lower levels of novelty seeking, cooperativeness, and physical activity are associated with higher levels of academic burnout among Iranian medical students. Therefore, paying attention to male gender and individual difference factors, as well as planning for physical education classes during the medicine courses (especially in the last years of medical school), seems essential. However, more extensive investigations need to be carried out in this field through longitudinal studies.

Burnout among Iranian medical students: Prevalence and its relationship to personality dimensions and physical activity

Several studies have shown the association between personality traits and academic burnout. But the main goal of the present study was to find out an experimental answer to the following questions: Is there a simple relationship between personality dimensions and academic burnout? Can physical activity affect this relationship?. In this cross-sectional correlational study, 417 medical students were selected from three major cities of Iran through stratified multistage sampling and assessed by demographic information form, Baecke Physical Activity Questionnaire, Temperament and Character Inventory, and Breso's Academic Burnout Questionnaire. Bivariate Pearson correlations and hierarchical linear regression were used to examine the relationships between academic burnout, personality traits, and physical activity. In this study, 400 medical students (39% male and 61% female) filled the questionnaires correctly. The total prevalence of academic burnout was 25.5% (n=102), with heterogeneous levels. Regression analysis indicated that in a multivariate model, being male (β=0.08, p=0.013), higher years of medical school (β=0.18, p˂0.001), and lower scores in novelty seeking (β=-0.53, p=0.006), cooperativeness (β=-0.55, p=0.010), and physical activity (β=-1.22, p˂0.001) could be attributed to higher scores of academic burnout. Furthermore, physical activity had a moderating role in "novelty seeking-academic burnout" (β=-0.47, p=0.044) and "cooperativeness-academic burnout" (β=-0.89, p=0.001) relationships (ΔR2=0.02, p˂0.001). The results suggested that male gender, higher years of medical school, and lower levels of novelty seeking, cooperativeness, and physical activity are associated with higher levels of academic burnout among Iranian medical students. Therefore, paying attention to male gender and individual difference factors, as well as planning for physical education classes during the medicine courses (especially in the last years of medical school), seems essential. However, more extensive investigations need to be carried out in this field through longitudinal studies.

Affective Temperament Traits and Age-Predicted Recreational Cannabis Use in Medical Students: A Cross-Sectional Study

The use of cannabis among college students is increasing. Cannabis abuse has been proposed to be associated with personality dimensions. However, there are currently no known studies on the relationship of temperament traits and recreational cannabis use among college students. This is a cross-sectional study that investigated 328 students at a Podiatric Medical College. We evaluated the association between temperament and recreational cannabis use by the students. Temperament was investigated using the Memphis, Pisa, Paris and San Diego Auto- Questionnaire (TEMPS-A (short version)). Additionally, we assessed demographics variables and perceived stress in the context of cannabis use, and analyzed the findings using logistic regression. The prevalence of recreational cannabis use was 8.45%. Recreational cannabis use among these students was highly associated with irritable and cyclothymic temperament traits. There was no association between recreational cannabis use and perceived stress, and demographic variables or other substance use. Furthermore, logistic regression analysis indicated that higher scores in cyclothymic or irritable temperament traits are significant predictors for recreational cannabis use. Our study has identified key temperament traits, with a strong association with recreational use of cannabis of the studied student population. Our findings are useful in designing screening and educational strategies directed towards increasing the wellbeing of medical students.

A Study to Evaluate the Lifestyle of Medical Students in Lahore, Pakistan

Introduction Medical school is a challenging period that may bring about undesired changes in health and lifestyle habits. In order to thrive both mentally and physically, students must maintain a balanced routine and adopt healthy lifestyles. Scientific evidence confirms that unhealthy life habits play an important role in the development of many disorders in all age groups. Our aim was to evaluate the prevalence of these lifestyle habits among medical students of a renowned private sector medical school based in Lahore, Pakistan, and to identify their association with variables such as socio-demographic characteristics, year of medical school, and personal beliefs. Methodology This cross-sectional study of 300 medical students included a self-administered questionnaire comprising (in addition to socio-demographic characteristics) information about healthy lifestyle practices in the following areas: gender, age, sleep, dietary habits, addictions, physical activity, and hygiene practices. The students were undergraduates in the first to fifth years of M.B.B.S, aged ≥18 years, and gave informed consent. Data were analyzed using SPSS 16 (IBM Corp, Armonk, NY, US). The chi-squared test was used to determine the association. Results The frequencies of healthy, fairly healthy, and unhealthy lifestyles were 30.7%, 62.3%, and 7%, respectively. In a sample of 33.3% males and 66.7% females, the fairly healthy lifestyle was most prevalent (62.3%) followed by the healthy lifestyle (30.7%) and unhealthy lifestyle (7.0%). Third-year MBBS had the highest prevalence of healthy lifestyle (n=20, 40.8%). Fourth-year MBBS had the highest prevalence of a fairly healthy lifestyle (n=70, 75.3%). Whereas, second-year MBBS had the highest prevalence of unhealthy lifestyle (n=9, 11%). This difference between classes was statistically significant (p=0.006). Conclusion In order to combat the low level of healthy lifestyles in medical students, it is recommended that measures such as awareness programs and seminars be put in place.

Prevalence of Cannabis Use Among Medical Students: A Systematic Review and Meta-analysis

OBJECTIVE

Cannabis is reported to be the most common illicit substance used among medical students; however, the number of related studies is limited and their results are not systematically reviewed. The aim of our study was to analyze the prevalence of lifetime and current use of cannabis among medical students worldwide.

METHODS

A systematic review and meta-analysis was performed with adherence to the PRISMA guidelines. The electronic databases PubMed, Scopus, and Cochrane library were searched for studies on the prevalence of cannabis use among medical students. Prevalence of lifetime, past-year, and past-month cannabis use was extracted. Pooled prevalence and relative risk for sex were calculated using the random effects model and subgroup analyses were conducted.

RESULTS

A total of 38 observational (cross-sectional and cohort) studies were included (total number of participants 19 932), and most of them were conducted in Europe, Central and Southern America, and the United States. Overall pooled prevalence of lifetime cannabis use was 31.4% (95% confidence interval [CI]: 23.7%-39.6%), past-year use was 17.2% (95% CI: 10.8%-24.6%), and past-month use was 8.8% (95% CI: 5.6%-12.5%). Men displayed higher rates of cannabis use with a pooled relative risk of 1.55 (95% CI: 1.32-1.81). Heterogeneity was high (I 2 > 75%) and there were differences among continents in all outcomes (P < .001).

CONCLUSIONS

In conclusion, 1 in 3 medical students has used cannabis, whereas 8.8% were current users. Significant differences among continents were observed, but common finding was that male students tend to consume cannabis more often than female students.

Beyond deficit and harm reduction: Incorporating the spectrum of wellness as an interpretive framework for cannabis consumption

The cannabis academic literature is informed by dominant deficit, public health and harm reduction frameworks. However, a large majority of cannabis consumption appears to place outside the scope of these models that prioritise the identification and limitation of negative impacts. As such there are apparent analytical blind spots pertaining to: non-problematic use of cannabis (as defined by Global Commission on Drug Policy); the intersection of medical and recreational intents of use; and pleasure. This paper explores the academic and grey literature relating to the spectrum of wellness to assess its suitability as a framework for cannabis scholars. For millennia cannabis use has been associated with wellness models, particularly at the nexus of mind, body, and spirit. Despite this seemingly obvious match, the academic literature that incorporates cannabis consumption patterns into wellness conceptions is thin. The spectrum of wellness has both advantages and disadvantages compared to existing models and may be useful as a complementary framework that allows for broader examination of cannabis consumer activity.

Experiences with a universal mindfulness and well-being programme at a UK medical school

Purpose

The purpose of this paper is to examine the evaluation of a universal, mental well-being and mindfulness programme in a UK graduate entry medical school.

Design/methodology/approach

Mixed methods used in the paper were the measurement of mental well-being and mindfulness in two cohorts at three time points over 15 months; descriptive, regression and repeated measures analysis with post hoc pairwise comparisons; qualitative interviews with purposive sample of 13 students after one year analysed thematically; and spontaneous anonymous feedback on the course.

Findings

The course was a surprise to students, and reactions were mixed. Respect for its contents grew over the first year. Most students had actively implemented a well-being strategy by the end of the course, and an estimated quarter was practicing some mindful activity. In the context of an overall decline in well-being and limited engagement with mindfulness practice, increases in mindfulness were protective against this decline in both cohorts (p<001). A small minority of students thought that the course was a waste of time. Their attitudes influenced engagement by their peers. The mindfulness and well-being practices of the facilitators were evident to students and influenced perceived effects.

Research limitations/implications

The uncontrolled nature of this observational study and low response rates to the survey limit conclusions. Further research in other medical education settings is needed.

Practical implications

Results are encouraging, suggesting modest benefit in terms of changing attitudes and practices and a modest protective effect on the well-being of students who engaged.

Originality/value

This is the first study of a universal well-being and mindfulness programme in a UK medical school. Universal programmes are rare and evaluation studies are scarce.

Prevalence rates of childhood trauma in medical students: a systematic review

BACKGROUND

It is known that medical students suffer from high rates of mental health difficulties. In recent years there has been an increasing focus on the need to improve support and treatment services for those in difficulty. In order to meet these needs it is important to clarify the relevant aetiological factors. There is robust evidence from general population studies that a history of childhood trauma (including physical and sexual abuse and emotional neglect) predisposes to the subsequent development of mental health difficulties in adult life. It has previously been speculated that students with a history of such trauma might preferentially apply to study medicine.

METHODS

This systematic review seeks to examine the existing evidence base with regard to rates of childhood trauma in medical student populations. Articles were identified through a literature search of psychINFO, web of science, Embase and medline.

RESULTS

This search generated 11 articles which were deemed to meet criteria for inclusion in this review. There is a wide range of results given for rates of childhood trauma in these studies.

CONCLUSIONS

The published research which examines rates of childhood trauma affecting medical students is limited and difficult to generalise from, or to use to draw firm conclusions. Given the possible negative outcomes of a history of childhood trauma in medical students, including that such a history may be associated with difficulties in a student progressing in their undergraduate and postgraduate examinations, well-organised prospective studies are required.

The legal and moral perceptions of clinical and non-clinical undergraduates regarding substance use: a pilot project

Introduction Heavy alcohol and illicit drug use has been documented amongst medical and dental professionals and educational programs have been developed to attempt to reduce such behaviour in clinical undergraduates. This pilot study aims to investigate the legal and moral perceptions of substance use in clinical and non-clinical undergraduates.Method A cross-sectional self-report questionnaire was administered to 107 clinical and non-clinical undergraduates to investigate their moral and legal perceptions of alcohol and illicit substance use.Results More clinical (72.5%) than non-clinical students (66%) drink alcohol regularly. Both groups perceive ecstasy, cocaine and ketamine as 'high risk' drugs. A third of both clinical (34%) and non-clinical (36%) students support the legalisation of illicit drugs. Forty-seven percent of non-clinical students would consider changing their behaviour if illicit substances were legalised compared to 32% of clinical students. Clinical students believe the legal punishment for Class A drugs is appropriate, but disagree with that for Class C drug use. Personal values of clinical students differ regarding some immoral activities. Social perceptions of illicit substance users are similar for both clinical and non-clinical students with those who use heroin perceived most negatively by 86.5% of all undergraduates.Conclusion Individual substance use behaviours may be influenced by legal perceptions of illicit substance use. Personal values and social norms are also likely to be important. Further research is required to investigate how these perceptions affect a clinical student's decision to participate in excessive alcohol and illicit substance use behaviours.

"Peer2Peer" - A university program for knowledge transfer and consultation in dealing with psychosocial crises in med-school and medical career

OBJECTIVE

Medical students are exposed to various psychosocial problems and challenges. Specific consultations services and programs can support them. "Peer2Peer" is such a consultation program and was implemented at the Medical University of Graz. It focusses on crisis intervention, psychosocial stress management, junior mentoring as well as student education in this field. Besides, it also offers student tutors of the program practical skills trainings. The program was restructured in winter term 2014/15.

METHODS

On the one hand, "Peer2Peer" gives insights into topics such as the current state of research concerning the students' psychological strain and psychosocial crises in acutely stressful situations and preventive approaches for coping with these kinds of situations on the other hand. These aspects are taught by means of elective courses, lectures and workshops. Furthermore, "Peer2Peer" provides consultation services by student tutors who give face-to-face advice if required. These tutors receive ongoing training in organizational and professional issues.

RESULTS

Since the summer term of 2015, 119 students have been trained (via lectures and elective courses), while 61 contacts (short consultation) and 33 contacts (full consultation) have been supervisied. In total, two psychotherapeutic and one psychosocial follow ups were recommended. There are seven students who participate as tutors in the program.

CONCLUSIONS

The "Peer2Peer" program is intended to enable a low-threshold access for medical students facing psychosocial crises situations and to help them in dealing with stress and learning problems. An increase in support contacts from the summer term of 2015 to the winter term of 2015/16 can be considered a success. A first evaluation of the different components of the program started in the winter semester of 2015/16. The student tutors have not only acquired practical skills in dealing with students in crises situations but also various organizational skills.

Factors Influencing Changes in Eating Patterns Among Hong Kong Young Adults Transitioning to Tertiary Education

Transitioning to tertiary education is a significant life course event that has the potential to influence lifelong eating patterns. This study used a theoretic model developed from a life course perspective to examine factors influencing the change of food choices among 31 young adults in Hong Kong after they moved on to tertiary education. Qualitative analysis of transcripts based on the constant comparative method revealed that present life course experiences, especially increased autonomy, and social-environmental factors strongly influenced young adults' present food choices. A model was developed from life course theory and social-ecological theory to reflect the factors that led to change of food choices among participants. The model provides unique insights on food choices of the future adult population. It could also be used as a reference for the development of nutrition education interventions targeting tertiary students as they experience increased autonomy. In conclusion, food choices of young adults on transitioning to tertiary education are strongly influenced by increased autonomy and change of social and environmental factors.

A randomized control trial: training program of university students as health promoters

BACKGROUND

Several studies have reported the following as determining factors for the adoption of healthy lifestyles among undergraduate students: gender, socioeconomic level, prior lifestyles, environment, parental lifestyles and health status, career choice, and healthy support networks. However, these factors are influenced by students' knowledge about healthy lifestyles.

METHODS/DESIGN

We will carry out a randomized trial in a sample of 280 new undergraduate students at the National Autonomous University of Mexico's Faculty of Higher Studies-Zaragoza (FES-Zaragoza, UNAM). There will be an experimental group (n = 140), comprising 20 students from each of the seven university departments (careers); these students will receive training as university student health promoters through an e-learning course. This course will allow the topics necessary for such promoters to be reviewed. There will be a control group (n = 140), comprising 20 students from each of the seven departments (careers); these students will not undergo the training. Later, the students who comply satisfactorily with the e-learning course will replicate the course to 10 of their classmates. A healthy-lifestyle questionnaire will be given to all the participants, and the parameters established in the self-care card will be recorded before and after the training. The study variables are as follows: (i) independent variable-compliance with the e-learning course; (ii) dependent variables-lifestyles changes prior to the educative intervention (including healthy eating, physical activity, and addiction prevention) and parameters related to health status established in self-care (including weight, body mass index, waist circumference, and hip circumference). Data will be analyzed using Student's t test and logistic regression analysis odds ratios with 95% confidence intervals. The analysis of the open answers will be carried out with ATLAS. ti 5.5 software.

DISCUSSION

Health promotion among university students should incorporate options that are feasible for and attractive to students. Thus, as proposed in the present protocol, e-learning courses offer excellent possibilities because they allow students to program their learning in their available time without affecting their academic studies.

TRIAL REGISTRATION

http://ISRCTN77787889.

Personalised normative feedback for preventing alcohol misuse in university students: Solomon three-group randomised controlled trial

BACKGROUND

Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse.

METHODOLOGY

Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers.

PRINCIPAL FINDINGS

Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis.

CONCLUSIONS

We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population.

REGISTRATION

Controlled-Trials.com ISRCTN30784467.

Social and psychological factors affecting eating habits among university students in a Malaysian medical school: a cross-sectional study

Background

Eating habits have been a major concern among university students as a determinant of health status. The aim of this study was to assess the pattern of eating habits and its associated social and psychological factors among medical students.

Methods

A cross sectional study was conducted among 132 medical students of pre-clinical phase at a Malaysian university. A self-administered questionnaire was used which included questions on socio-demography, anthropometry, eating habits and psychosocial factors.

Results

Mean (±SD) age of the respondents was 22.7 (±2.4) years and (the age) ranged from 18 to 30 years. More than half had regular meals and breakfast (57.6% &, 56.1% respectively). Majority (73.5%) consumed fruits less than three times per week, 51.5% had fried food twice or more a week and 59.8% drank water less than 2 liters daily. Eating habits score was significantly low among younger students (18–22 years), smokers, alcohol drinkers and those who did not exercise. (p<0.05). Four psychological factors out of six, were significantly associated with eating habits (p<0.05). In multivariate analysis, age and ‘eating because of feeling happy’ were significantly associated with eating habits score (p<0.05).

Conclusion

Most of the students in this study had healthy eating habits. Social and psychological factors were important determinants of eating habits among medical students.

Consumo de álcool entre estudantes universitários

O consumo de álcool é estimulado pela mídia apesar dos riscos inerentes à saúde. Estudantes da área de saúde serão os futuros profissionais a orientar a população ou servir de exemplo. O objetivo deste estudo foi analisar o consumo de álcool e fatores relacionados nestes estudantes. Participaram 608 estudantes universitários de Maceió, Alagoas, Brasil, de ambos os sexos, mediante a aplicação de um questionário autopreenchível. Foram empregados modelos de regressão de Poisson e logística multinomial. A prevalência de uso na vida de álcool foi de 90,4%. O abuso de álcool teve uma prevalência de 18,3% nos homens e 6,1% nas mulheres. Os que apresentaram maior consumo e abuso de álcool foram os do sexo masculino, de maior idade, naturais de outras cidades, fumantes e os expostos à publicidade do álcool. Os resultados deste estudo indicam uma vulnerabilidade destes jovens para condutas com risco para a saúde. Seu papel social futuro suscita necessidades distintas de formação universitária para que possam atuar profissionalmente nesta área.

Prevalence and factors associated with Ecstasy use among college undergraduates in north of Iran-2005

We conducted a cross sectional study of 3958 college students in north of Iran in 2005 with an anonymous questionnaire that was adapted from the questionnaires used in "Monitoring the future". Three thousand seven hundred students responded (93.5%). Lifetime prevalence use of ecstasy, opium and cannabis was 4.3%, 2.7% and 2.4% respectively. The prevalence of current cigarette smoking was 19.5%. After the logistic regression, the factors influencing ecstasy use were use of other illicit drugs, alcohol and cigarette smoking (P<0.000), widow or divorced (ρ=0.007) and higher educational background of mother (ρ=0.019).

Enhancing the health of medical students: outcomes of an integrated mindfulness and lifestyle program

Medical students experience various stresses and many poor health behaviours. Previous studies consistently show that student wellbeing is at its lowest pre-exam. Little core-curriculum is traditionally dedicated to providing self-care skills for medical students. This paper describes the development, implementation and outcomes of the Health Enhancement Program (HEP) at Monash University. It comprises mindfulness and ESSENCE lifestyle programs, is experientially-based, and integrates with biomedical sciences, clinical skills and assessment. This study measured the program's impact on medical student psychological distress and quality of life. A cohort study performed on the 2006 first-year intake measured effects of the HEP on various markers of wellbeing. Instruments used were the depression, anxiety and hostility subscales of the Symptom Checklist-90-R incorporating the Global Severity Index (GSI) and the WHO Quality of Life (WHOQOL) questionnaire. Pre-course data (T1) was gathered mid-semester and post-course data (T2) corresponded with pre-exam week. To examine differences between T1 and T2 repeated measures ANOVA was used for the GSI and two separate repeated measures MANOVAs were used to examine changes in the subscales of the SCL-90-R and the WHOQOL-BREF. Follow-up t-tests were conducted to examine differences between individual subscales. A total of 148 of an eligible 270 students returned data at T1 and T2 giving a response rate of 55%. 90.5% of students reported personally applying the mindfulness practices. Improved student wellbeing was noted on all measures and reached statistical significance for the depression (mean T1 = 0.91, T2 = 0.78; p = 0.01) and hostility (0.62, 0.49; 0.03) subscales and the GSI (0.73, 0.64; 0.02) of the SCL-90, but not the anxiety subscale (0.62, 0.54; 0.11). Statistically significant results were also found for the psychological domain (62.42, 65.62; p < 0.001) but not the physical domain (69.11, 70.90; p = 0.07) of the WHOQOL. This study is the first to demonstrate an overall improvement in medical student wellbeing during the pre-exam period suggesting that the common decline in wellbeing is avoidable. Although the findings of this study indicate the potential for improving student wellbeing at the same time as meeting important learning objectives, the limitations in study design due to the current duration of follow-up and lack of a control group means that the data should be interpreted with caution. Future research should be directed at determining the contribution of individual program components, long-term outcomes, and impacts on future attitudes and clinical practice.

The use of psychoactive substances among medical students in southern Brazil

The objective of our study was to investigate the patterns of use of psychoactive substances among students of a medical school in Southern Brazil and to explore a putative role of discrete behavioral and social variables in their drug use. This is a descriptive and transversal cut study. All regularly enrolled medical students at the University of Caxias do Sul were invited to participate in the study. A self-administered questionnaire, which analyses lifetime drug use as well as drug use in the previous 30 days and 12 months was utilized to collect data. From a total of 318 regularly enrolled students, 183 (57.5%) completed and returned the questionnaires. The highest prevalence rates of lifetime drug use, drug use in the last 12 months and drug use in the last 30 days were observed, according to drug type, as follow in descending order: alcohol, tobacco, marijuana, inhalants, tranquilizers, amphetamine and cocaine. A multivariate analysis indicated that research respondents who live with their parents as well as those whose parents live together harmoniously, those who deny close ties to drug users, those who disapprove drug use, those who are not tobacco smokers and those who manifest religious beliefs and practice presented the most reduced levels of illicit drug use. The use of psychoactive substances among medical students in the University of Caxias do Sul is a significant problem. Appropriate and timely initiatives are needed to prevent and curb drug use among medical students.

The health enhancement program at monash university medical school

Content on integrative healthcare and complementary and alternative medicine is being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions they can adapt into new or ongoing educational efforts at their institution or programs. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr Sierpina at vssierpi@utmb.edu or Dr Kreitzer at kreit003@umn.edu. Submissions should be no more than 500 to1,500 words. Please include any Web site or other resource that is relevant, as well as contact information.

Changes in undergraduate student alcohol consumption as they progress through university

Background

Unhealthy alcohol use amongst university students is a major public health concern. Although previous studies suggest a raised level of consumption amongst the UK student population there is little consistent information available about the pattern of alcohol consumption as they progress through university. The aim of the current research was to describe drinking patterns of UK full-time undergraduate students as they progress through their degree course.

Method

Data were collected over three years from 5895 undergraduate students who began their studies in either 2000 or 2001. Longitudinal data (i.e. Years 1–3) were available from 225 students. The remaining 5670 students all responded to at least one of the three surveys (Year 1 n = 2843; Year 2 n = 2219; Year 3 n = 1805).

Results

Students reported consuming significantly more units of alcohol per week at Year 1 than at Years 2 or 3 of their degree. Male students reported a higher consumption of units of alcohol than their female peers. When alcohol intake was classified using the Royal College of Physicians guidelines [1] there was no difference between male and females students in terms of the percentage exceeding recommended limits. Compared to those who were low level consumers students who reported drinking above low levels at Year 1 had at least 10 times the odds of continuing to consume above low levels at year 3. Students who reported higher levels of drinking were more likely to report that alcohol had a negative impact on their studies, finances and physical health. Consistent with the reduction in units over time students reported lower levels of negative impact during Year 3 when compared to Year 1.

Conclusion

The current findings suggest that student alcohol consumption declines over their undergraduate studies; however weekly levels of consumption at Year 3 remain high for a substantial number of students. The persistence of high levels of consumption in a large population of students suggests the need for effective preventative and treatment interventions for all year groups.

Peer-group and price influence students drinking along with planned behaviour

AIMS

To examine the theory of planned behaviour (TPB), as a framework for explaining binge drinking among young adults.

METHODS

One hundred and seventy-eight students in a cross-sectional design study completed self-report questionnaires examining attitudes to drinking, intention to drink and drinking behaviour in university. Binge drinking was defined for females (and males) as consuming 'four (males-five) or more pints of beer/glasses of wine/measures of spirits' in a single session.

RESULTS

Drinking alcohol was common; 39.6% of males and 35.9% of females reported binge drinking. The TPB explained 7% of the variance in intention to drink. Overall, 43% of the variance in intention, 83% of the variance in total weekly consumption and 44% of the variance in binge drinking was explained. The frequency of drinking and the drinking behaviour of friends significantly predicted intention to drink and binge drinking, respectively. Binge drinkers were influenced by peers and social-situational factors. Pressure to drink was greater for males; undergraduates were influenced by the size of the drinking group, 'special offer' prices, and the availability of alcohol.

CONCLUSIONS

The TPB appeared to be a weak predictor of student drinking but this may be a result of how constructs were measured. With friends' drinking behaviour emerging as a significant predictor of alcohol consumption, interventions seeking to reduce excessive drinking should target the role of peers and the university environment in which drinking occurs.

Recreational use of PDE5 inhibitors by young healthy men: recognizing this issue among medical students

INTRODUCTION

In recent years, recreational use of phosphodiesterase type 5 (PDE5) inhibitors has become popular as a sexual enhancement aid among some men without erectile dysfunction (ED) and even among women.

AIM

The aim of the present study, therefore, was to investigate the recreational use of PDE5 among young and healthy men.

MAIN OUTCOME MEASURES

We evaluated the use of PDE5 inhibitors among young and healthy men, their main reasons for using these drugs, and their expectations regarding its effects.

METHODS

A survey was carried out among 167 male medical students (21.2 +/- 2.3 years, range 17-31). The surveys were divided into domains, assessing epidemiological data, use of PDE5 inhibitor, and the simplified International Index of Erectile Function (IIEF-5).

RESULTS

All men considered themselves with perfect erectile function. However, 9% reported previous use of PDE5 inhibitors. Of these, 46.7% had used PDE5 inhibitors more than three times, and 71.4% had mixed them with alcohol. Among this group of men, 13.3% had ED according to the IIEF-5. ED occurring with condom use, however, was twice more common, and 71.4% of the men who had taken PDE5 inhibitors thought that the drug had potential to facilitate condom use.

CONCLUSION

In conclusion, the use of PDE5 inhibitors by young men is more frequent than previously reported. Condom-related ED seems to be an underestimated problem, frequently solved with PDE5 inhibitors. However, potential deleterious effects might exist. Because PDE5 inhibitors are being used as non-prescribed drugs by as much as 9% of young men, further studies must evaluate the effects of these drugs in young and healthy men.

Satisfaction with life and opioid dependence

Background

Serious substance misuse and dependence is widely seen as damaging to an individual and to society in general. Whereas the medical and society effects of substance misuse are widely described, some commentators suggest substance misuse may be an "alternative lifestyle".

Aim

To assess general life satisfaction amongst treatment-seeking people with substance dependence.

Methods

The Satisfaction With Life Scale (SWLS) was administered to a sample of opioid-dependent people receiving substitute medication.

Results

105 subjects and 105 age-sex matched subjects in a comparison group completed the questionnaire. The mean SWLS score was 7.12 (SD = 10.6; median = 6) for patients compared to 22.6 (SD = 6.8) in the comparison group. (Two sided p < 0.0001; Median difference = -13.5; Wilcoxon signed rank test.)

Conclusion

The study used a validated instrument and objective reports to confirm significantly higher rates of dissatisfaction with life among opioid dependent people in treatment when compared to members of the general population.

Binge drinking and health behavior in medical students

OBJECTIVES

The objective of this study was to assess the prevalence of binge drinking and its relation to other health behaviors, drinking-related attitudes and perceived social norms among German medical students.

METHODS

271 first-year German medical students completed a cross-sectional, self-administered survey. A total of 252 (62% female and 38% male) students provided useable surveys. The mean age was 20.6years (S.D.=1.7).

RESULTS

Most students reported heavy drinking with 24% having one episode in the past 2 weeks (Infrequent Bingers) and 28% having two or more episodes (Frequent Bingers). Men were more likely than women to have had a binge drinking episode. Frequent binge drinkers saw more pros of drinking and reported a higher temptation to drink than students in the other groups. Additionally, they were more likely to smoke, use cannabis, not exercise and not eat fruits and vegetables. All students overestimated their peers' alcohol intake and binge drinking frequency.

CONCLUSIONS

Binge drinking was highly prevalent in this sample and clearly related to other health risk behaviors. Drinking rates were similar to college students in other Western countries. Future research needs to assess the consequences of this multiple risk behavior among medical students regarding academic and professional performance as well as personal health.

Alcohol use in Czech pharmacy students

In academic years 2002/3-2004/5, the use of alcohol was investigated by anonymous questionnaire in 1,032 first and third year pharmacy students in the Czech Republic. Frequencies of beer, wine and spirits use, the age of the first contact with alcoholic beverages, the age of the first drunkenness and the frequency of drunkenness in the last month were ascertained. Average age of the first contact with alcoholic beverages was 12.9 years. 40.5% and 10.9% of students reported regular and hazardous drinking, respectively, with significantly higher proportion of men than women. Hazardous alcohol drinking significantly increased between academic years 2002/3 and 2004/5, no significant differences were found in the proportion of non-drinkers and regular alcohol drinkers over the 3-year-period of the survey. Both regular and hazardous drinking patterns were significantly related to the financial situation of the students. Significant associations were also found between alcohol consumption and using of both licit and illicit drugs of abuse.

A comparison of alcohol and drug use among dental undergraduates and a group of non-medical, professional undergraduates

OBJECTIVE

To compare the alcohol and drug use of dental and law undergraduates.

DESIGN

Anonymous self-report questionnaire.

SUBJECTS AND METHODS

All dental undergraduates (n = 263) and a randomly selected group of law undergraduates (n = 180) from the same university were questioned on their use of alcohol, tobacco and illicit drugs.

RESULTS

Current tobacco use was reported by 7% of dental students and 19% of law students. Alcohol use was reported by 86% of dental students and 88% of law students, with 44% of dental students and 52% of law students estimating they drank above recommended safe limits (14 units for females, 21 units for men). Binge drinking was reported by 71% of dental students and 75% of law students, with weekly binge drinking reported by 27% and 34% of dental and law students respectively. Cannabis experience was reported by 44% of dental students and 52% of law students, with current use reported by 12% and 25% of dental and law students respectively. A small proportion of dental and law students reported using other class A and B drugs including ecstasy, amphetamines and cocaine.

CONCLUSIONS

Dental students appear to be indulging in similar levels of alcohol and illicit drug use when compared to students of a different, non-medical faculty. Binge drinking may be more prevalent than previously thought, with potential risks to health, patient safety and professional status.

Trends in medical student use of tobacco, alcohol and drugs in an Irish university, 1973-2002

Questionnaire surveys of medical students in an Irish university were carried out in 1973 (n=765), 1990 (n=522) and 2002 (n=537), with differentiation of western students (e.g., from the Republic of Ireland, the UK, or Australia) and non-western students (e.g., Malaysia). We report on changes in tobacco smoking, drinking and drug-taking over three decades, and we note that, among western students, estimated prevalence of being a current smoker has declined overall from 28.8% in 1973 to 15.3% in 1990 to 9.2% in 2002 (p<0.001), falling in both males (p<0.001) and females (p<0.01). Ex-smokers rose from 5.9% to 15.1% between 1990 and 2002, corresponding with the decline in current smokers. The prevalence of current drinkers has risen over the period, to 82.5% among western students in 2002 (p<0.05); female drinking has increased steadily since 1973 (p<0.001), and the overall proportion of CAGE-positive drinkers has risen since 1990 (p<0.001). The mean weekly alcohol consumption has risen in both sexes since 1990 (males 14.3 units to 19.4, p<0.01; females 6.0 to 9.5, p<0.001). There was an increase in the proportion of students ever offered drugs between 1973 and 2002 (p<0.001). Although smoking rates have fallen, our findings show a marked increase in alcohol and drug consumption between 1973 and 2002. Personal misuse of addictive substances by doctors may mean that doctors will fail to take misuse by patients seriously. A need for preventative and ameliorative action during the medical school years is clear.

The incidence of smoking and risk factors for smoking initiation in medical faculty students: cohort study

BACKGROUND

Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate the yearly smoking prevalence and incidence rates of medical faculty students and to identify the risk factors for adopting smoking behaviour.

METHODS

This is a cohort study in which every student was asked about their smoking habits at the time of first registration to the medical faculty, and was monitored every year. Smoking prevalence, yearly incidence of initiation of smoking and average years of smoking were calculated in analysis.

RESULTS

At the time of registration, 21.8% of the students smoked. At the end of six years, males had smoked for an average of 2.6 +/- 3.0 years and females for 1.0 +/- 1.8 years (p < 0.05). Of the 93 medical students who were not smokers at the time of registration, 30 (32.3%) were smokers at the end of the 6 years of the course.

CONCLUSION

The first 3 years of medical education are the most risky period for initiation of smoking. We found that factors such as being male, having a smoking friend in the same environment and having a high trait anxiety score were related to the initiation of smoking. Targeted smoking training should be mandatory for students in the Medical Faculty.

Substance use in a sample of Turkish medical students

This study identifies the prevalence of smoking, alcohol, and illicit drug use in a sample of Turkish medical students. Information about substance use was obtained from 304 first-year, and 143 sixth-year medical students from three different medical schools in Turkey. Nearly half of the students (53.9%) were non-drinkers. Risky alcohol use was 7.4%. Lifetime smoking prevalence was 39.9 and 26.4% of the junior and 44.1% of the senior medical students (mean consumption of 13.9 and 15.5 cigarettes a day, respectively) reported regular smoking. Nicotine dependence was present in 3.1%. Only 4% of the students reported using illicit drugs (cannabis, ecstasy, cocaine) at least once in their lifetime. The mean ages of first use of cigarettes, alcohol and illicit drugs were earlier for junior medical students than senior students. Of the students, 25.5% had anxiety and 36.8% had depression scores in the clinically significant range. Our results suggest that although Turkish medical students are not at a high risk of substance abuse it should not be underestimated, and the risk factors as well as the protective factors must be identified in nation-wide studies.

'I wouldn't want it on my CV or their records': medical students' experiences of help-seeking for mental health problems

BACKGROUND

Medical education is reported to be demanding and stressful and previous work with doctors suggests that there is a resistance within the profession to help-seeking and an ad hoc approach to dealing with stress and distress.

AIM

To explore the attitudes of medical students at the University of Manchester, UK to the causes of stress and to examine their views on help-seeking.

STUDY DESIGN

A qualitative study using semistructured interviews, with analysis of the data using the technique of constant comparison.

METHODS

Medical students at the University of Manchester were invited to participate in the study. Sampling made the research representative of medical students in terms of gender, ethnicity and UK/overseas students. Semistructured interviews, with open questions, were conducted and audio-taped with consent. The tapes were transcribed verbatim. The schedule was revised in the light of the emerging themes.

RESULTS

Medical students recognised that studying medicine contributes to stress, as experienced in their undergraduate careers. Students reported that perceptions of stigma associated with mental illness, including stress, were prevalent in the student body and were perceived to continue throughout the medical profession. Avoidance of appropriate help-seeking behaviour starts early and is linked to perceived norms which dictate that experiencing a mental health problem may be viewed as a form of weakness and has implications for subsequent successful career progression.

CONCLUSION

The preparation of medical students for life as doctors involves more than facilitation of the acquisition of knowledge and skills, so that new doctors can conform to the principals of professional conduct. Support and mentoring are required so that stress can be identified early and dealt with appropriately.

Altered states: the clinical effects of Ecstasy

Ecstasy is the second most widely abused illegal drug in Europe. Ecstasy is the colloquial name for 3,4-methylenedioxymethamphetamine (MDMA), but not all Ecstasy tablets contain MDMA. When taken in hot, crowded environments, Ecstasy/MDMA users have developed acute complications that have had fatal consequences. Epidemiological evidence indicates that adverse reactions to Ecstasy/MDMA intoxication are rare and idiosyncratic. Potential mechanisms of action are reviewed. In animal studies, MDMA damages serotonergic fibres and reduces the number of serotonin transporter sites within the CNS. Demonstration of neurotoxicity in human users of Ecstasy is hampered by a number of confounds that the majority of published studies have failed to address. These confounds are reviewed and their impact is discussed.

The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: a longitudinal study

OBJECTIVE

To investigate alcohol and illicit drug use in a cohort of dental undergraduates through to VT year.

SETTING

A UK dental school (with a medical school comparison group).

SUBJECTS AND METHODS

A cohort of dental students anonymously completed a lifestyle questionnaire about drinking and smoking, illicit drug use, stress, anxiety and depression in the spring of 1995 and 1998 as second and final year undergraduate students respectively, and in the summer of 1999 after one year working as qualified dentists. A parallel cohort of medical students also anonymously completed the questionnaire at the same time points in their undergraduate course as for the dental students, and at the end of a year working as Pre-Registration House Officers (PRHOs).

RESULTS

The proportion of dental students in Newcastle drinking above the recommended low risk limits of alcohol declined from 47% as second year students to 25% as final year students and then it increased to 41% as qualified dentists, whilst in medical students it steadily increased over the three time points of the survey (33% to 43% to 54%). A greater proportion of dental students were drinking at hazardous levels at all three time-points, compared with medical students. Experimentation with illicit drugs ranged from 47% as second year students to 54% as final year students and to 51% as dentists. The prevalence of illicit drug use in medical students was similar to that in dental students. Forty seven per cent of the dental student cohort as second year students, 67% as final year students and 16% as dentists suffered from possible pathological anxiety, compared with 47%, 26% and 30% in the medical student cohort. The proportion of dentists suffering from stress decreased from 72% as final year students to 19% as dentists. In the medical student group, the proportion increased from 32% as final year students to 39% as PRHOs.

CONCLUSION

This longitudinal study revealed that a high proportion of dental students from Newcastle continue to drink excessively and experiment with illicit drugs both as undergraduates and as practising dentists. A significant proportion also suffer from anxiety and stress. Further measures are needed in order to reduce alcohol and substance misuse and stress and anxiety among dental students and dentists.

Drink and drugs: from medical students to doctors

Drinking and illicit drug use were assessed longitudinally in a cohort of medical students who were surveyed in the second and fifth year of their undergraduate studies and after 1 year as PRHOs. Mean alcohol consumption had increased significantly (P<0.015) over the three time points; 15.2-16.0-18.8 units/week. Experimentation with illicit drugs had increased from 50 to 63 to 65%. Although education on alcohol and illicit drugs should be part of core curriculum in medical schools, support and intervention in the workplace is also needed for individuals with alcohol and/or drug problems.

Preliminary study of chronic pain patients' concerns about cannabinoids as analgesics

OBJECTIVE

This was a preliminary investigation of patients' beliefs about cannabinoids and the associations between those beliefs, beliefs about medication, and personal and pain variables with regard to patients' willingness to try cannabinoids as analgesics.

DESIGN

A self-completion questionnaire was used.

SETTING

The investigation took place in an outpatient pain clinic.

PATIENTS

Sixty-seven patients with chronic pain were involved.

OUTCOME MEASURES

The outcome measures were patients' stated willingness to use cannabinoids and the extent of their agreement or disagreement with statements concerning cannabinoids and medicines in general.

RESULTS

Fifty-two percent of patients were doubtful about taking cannabinoids: unwillingness was strongly associated with specific concerns about side effects, addiction, tolerance, and losing control but not with general beliefs about medication or personal or medical variables other than age.

CONCLUSIONS

The concerns of patients with chronic pain about taking cannabinoids as analgesics may reduce their utility and efficacy; accurate information is required to counter this effect.

Pharmacology and effects of cannabis: a brief review

BACKGROUND

Increasing prevalence of recreational cannabis use among the young population has stimulated debate on the possible effects of acute and longterm use.

AIMS

To highlight recent knowledge of mechanisms of action, effects on psychomotor and cognitive performance, and health risks associated with cannabis consumption.

METHOD

A brief review of recent literature on the prevalence of recreational cannabis use, the potency of modern cannabis preparations and the pharmacological actions of cannabis.

RESULTS

Cannabinoids derived from herbal cannabis interact with endogenous cannabinoid systems in the body. Actions on specific brain receptors cause dose-related impairments of psychomotor performance with implications for car and train driving, aeroplane piloting and academic performance. Other constituents of cannabis smoke carry respiratory and cardiovascular health risks similar to those of tobacco smoke.

CONCLUSIONS

Cannabis is not, as widely perceived, a harmless drug but poses risks to the individual and to society.

Factors influencing alcohol and illicit drug use amongst medical students

Alcohol, illicit drug use, and other lifestyle variables, as well as stress, anxiety and personality were evaluated in 194 first year medical students. 45% of the students reported drinking above the recommended UK limits for alcohol consumption. The age at which the first full drink of alcohol was taken was predictive of the current level of alcohol use. Cannabis was the most frequently used illicit drug (45%). There were significant positive associations between alcohol consumption and experiences such as missing study, becoming more sexually involved and getting into a physical fight or argument. There were also significant positive associations between the personality characteristic of psychoticism and alcohol and illicit drug consumption. The effectiveness of current health education on alcohol and illicit drugs is questioned.

Can doctors self-manage stress?

The NHS has expressed concern about stress in its workforce and is taking steps to reduce it. This paper reviews the factors associated with stress and burnout throughout a medical career. Clear messages emerge for all doctors and their employers.

Alcohol and drug use in second-year medical students at the University of Leeds

OBJECTIVE

In view of recent media attention concerning the high level of alcohol and drug use reported in a group of newly qualified junior doctors, the aim of the present study was to assess the alcohol and drug habits of a group of current medical students.

METHODS

Information about alcohol and illicit drug use was obtained from 136 second-year medical students (46 men, 90 women) at the University of Leeds by means of a personally administered questionnaire. Levels of anxiety and depression were also assessed.

RESULTS

86% of the students drank alcohol and among those who drank, a high proportion (52.6% of the men and 50.6% of the women), exceeded the recommended weekly limit of alcohol consumption of 21 units for men and 14 units women per week). Illicit drug use was reported by 33.1% of students (28.3% of men, 35.6% of women). The drug most commonly used was cannabis. According to the Hospital Anxiety and Depression (HAD) scale, 41.2% of the students (37% of men, 43.3% of women) had anxiety ratings within the clinically significant range (HAD scale> 8); 9.5% of students demonstrated clinically significant levels of depression (HAD scale> 8). However, these high levels of anxiety and depression did not correlate with high levels of alcohol consumption or drug use.