Background: Medical students are subjected to various stressors throughout their training, which has a considerable impact on their physical and mental health. Some students have positive ways of coping, while others take to maladaptive coping measures. This study aims to assess severity, sources of stress, and coping strategies among medical students of a non-Western low-income country from South Asia. Methods: A self-administered questionnaire-based cross-sectional study was carried out. Demographic variables were collected and stress level was assessed using PSS 14 (Perceived Stress Scale 14). The sources of stress were assessed using MSSQ (Medical Student Stressor Questionnaire) and coping strategies were evaluated using the Brief-Coping Orientation to Problems Experienced 28. Results: The response rate was 95%. The mean PSS score was 27.85. Overall, 55% of students were stressed (male 52%, female 60%), the difference among gender was not significant. Basic science students perceived higher levels of stress than clinical clerkship students. Academic related stressors caused higher stress, whereas other variables caused moderate stress. The major stressors were examinations, inadequate time to study, poor marks, extensive amount of learning content, and the need to performing well in the exam. The five most common coping strategies used were active coping, acceptance, planning, self-distraction, and instrumental support. The least common coping mechanism was substance use. All MSSQ domains positively correlated with the total PSS score. Students with higher PSS scores were likely to use behavioral disengagement, venting, and self-blame as the primary coping strategies. Conclusions: Stress level among the medical students is high and mainly in relation to academia. Inadequate guidance from teachers contributed significantly. Stressed students were likely to use maladaptive coping strategies. Strategies to enhance teacher-student communication and adaptive coping measures should be implemented. Further studies should be done to evaluate the effects of stress on the academic outcomes of students.
Introductions: Studies have shown inadequate use of prophylaxis for venous thromboembolism (VTE) in hospital admitted medical patients. This study aims to evaluate the use of VTE prophylaxis in admitted medical patients in a tertiary care teaching hospital. Methods: This was a cross sectional observational study for three weeks from 19 March to 8 April 2017 in patients admitted in the medical ward of Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Patient charts were reviewed for appropriate VTE prophylaxis as per modified Padua risk Assessment model. Risks of VTE, presence of bleeding risks, demographics (age, BMI), hospital stay were descriptively analysed. Results: Out of 122 patients, 81 (66.4%) were at risk of VTE. Among 81 at risk, 69 were eligible for VTE pharmacoprophylaxis with no risk of bleeding only 29 (42%) received pharmacoprophylaxis and 12 eligible for prophylaxis but with the risk of bleeding did not receive any prophylaxis. Reduced mobility was the most common indication of thromboprophylaxis in 79 (64%), followed by acute infection 50 (41%). Conclusions: There was suboptimal use of thromboprophylaxis in hospital admitted medical patients at risk of venous thromboembolism, VTE.
ObjectivesTo determine the prevalence of, and understand the factors associated with, hypertension among the nomadic Raute hunter-gatherers of Western Nepal.DesignA mixed-method study.SettingThe study was carried out at Raute temporary campsites in the Surkhet District of Karnali Province between May and September 2021.ParticipantsThe questionnaire-based survey included all males and non-pregnant females of the nomadic Raute group aged 15 years and above. In-depth interviews were conducted among purposively selected 15 Raute participants and four non-Raute key informants to help explain and enrich the quantitative findings.Outcome measuresThe prevalence of hypertension (defined as brachial artery blood pressure of systolic ≥140 mm Hg and/or diastolic ≥90 mm Hg) and its sociodemographic, anthropometric and behavioural covariates.ResultsOf the 85 eligible participants, 81 (median age 35 years (IQR: 26–51), 46.9% female) were included in the final analysis. Hypertension was found in 10.5% of females, 48.8% of males and 30.9% of the total population. Current alcohol and tobacco use were high (91.4% and 70.4%, respectively), with concerning high rates among youths. Males, older people, current drinkers and current tobacco users were more likely to have hypertension. Our qualitative analysis suggests that the traditional forest-based Raute economy is gradually transitioning into a cash-based one that heavily relies on government incentives. Consumption of commercial foods, drinks and tobacco products is increasing as their market involvement grows.ConclusionThis study found a high burden of hypertension, alcohol and tobacco use among nomadic Raute hunter-gatherers facing socioeconomic and dietary transitions. Further research is needed to assess the long-term impact of these changes on their health. This study is expected to help appraise concerned policymakers of an emerging health concern and formulate context-specific and culturally sensitive interventions to limit hypertension-related morbidities and mortalities in this endangered population.
Objectives This study aimed to determine the prevalence of, and understand the factors associated with, hypertension among the Raute nomadic hunter-gatherers of Western Nepal. Design A mixed-method study with quantitative and qualitative analyses. Setting Household survey at Raute temporary camps in the Surkhet District of Karnali Province, Nepal between the period of May to September 2021. Primary and secondary outcome measures The presence of hypertension and its socio-demographic, anthropometric, and behavioral covariates among the participants. Participants For quantitative analysis, all men and non-pregnant women of the nomadic Raute community aged 15 years above were evaluated for hypertension and its covariates. For the qualitative analysis, we purposively selected both Raute and Non-Raute key informants for in-depth interviews to understand, explain and enrich the quantitative findings. Results Of the 85 total eligible participants, 81 [median age 35 years (Interquartile range: 26-51), 46.9% female] were included in the final analysis. The prevalence of hypertension among men, women, and overall was 48.8% (95% confidence interval (CI): 34.4-63.4), 10.5% (95% CI: 3.7-23.1), and 30.9% (95% CI: 21.6-41.5) respectively. Male sex [adjusted Odds Ratio (aOR)=8.05 (95%CI: 2.15-30.11), p=0.002] and increasing age [aOR=1.05 (95% CI: 1.01-1.09), p=0.025] were found significantly associated with hypertension. A large proportion of the participants were current drinkers (91.4%) and tobacco users (70.4%), yet neither of these factors had a significant association with hypertension. Effect of socio-economic transition; changing patterns of alcohol and tobacco use, changing diet and food security; and traditional health care practices were the themes identified in the qualitative analysis. Conclusion This study found a high prevalence of hypertension, alcohol, and tobacco use among Raute nomadic hunter-gatherers facing socio-economic and nutritional transition. Further longitudinal studies and effective culture-centered community-based interventions are urgently needed to reduce the morbidity and mortality associated with hypertension in this endangered indigenous population. Keywords Hunter-gatherers, Foragers, Hypertension, Blood pressure, Socio-economic transition, Raute
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.