Large Student Cohorts Research Articles

Feasibility and sustainability of a school-based platform for integrated delivery of HPV vaccination with adolescent health services in Tanzania: qualitative insights from stakeholders.

To meet lofty human papillomavirus (HPV) immunization goals in Tanzania, the Ministry of Health integrated HPV vaccination with adolescent health services using a school-based approach. A qualitative study was conducted in June-July 2021, examining the feasibility and sustainability of an integrated service package, HPV Plus. In-depth interviews with 46 programme implementers (i.e. health-care workers and teachers) and planning stakeholders (i.e.government officials and school administrators) in Dar es Salaam and Njombe Regions explored enablers and constraints to HPV Plus programme implementation, including resource and staffing requirements. Two facilitators and three barriers to HPV Plus feasibility and sustainability were identified from thematic analysis of interviews. Interviewed stakeholders emphasized the programme's feasibility, especially if the efficiencies offered by a school-based platform were optimized. Implementation facilitators included (1) optimized service delivery efficiency through a school-based platform and (2) resources saved by combining adolescent health services and HPV immunization into a single programme package. Key barriers to HPV Plus feasibility and sustainability were (1) time, space and resource constraints (e.g. commodity stockouts and challenges delivering the complete service package to large cohorts of students within allotted times); (2) human resource gaps and increased workloads within the health workforce and (3) insufficient referral mechanisms linking schools to health facilities. Scaling up HPV Plus will require proactive commodity procurement and security; resource mobilization to reach ambitious service delivery targets and close co-ordination of programme implementation with school administrators.

Interprofessional team-based education: A comparison of in-person and online learner experiences by method of delivery and health profession.

Building capacity for teamwork, communication, role clarification and recognition of shared values is essential for interprofessional healthcare workforce development. Requirements to demonstrate interprofessional practice competencies have coincided with pivots to online delivery. Comparison of in-person and online delivery models for interprofessional education is important for future curriculum design. This article presents an evaluation of in-person and online delivery modes for interprofessional team-based education and compares learner experiences across different health professions. Students from 13 health professions (n=2236) participated between Spring 2020 and Fall 2021. In-person and online delivery models were compared, assessing learner perceptions of efficacy for interprofessional practice, using reflective pre-post responses to the Interprofessional Collaborative Competency Attainment Scale (ICCAS). Mean ICCAS scores improved for in-person and online delivery (0.79 vs 0.66), with strong effect (Cohen's D 2.03 and 1.31 respectively; p<0.001). Statistically significant differences were observed across professions, although all experienced ICCAS score improvements. Logistical benefits were evident for online delivery. In-person and online interprofessional team-based education can provide valuable learner experiences for large student cohorts from multiple professions. ICCAS score differences should be weighed against potential logistical benefits of online delivery. Timing of delivery and determinants of differences in student response across professions warrant evaluation for future curriculum design.

The use of multimodal educational tools for large scale simulated practice

Due to the current placement capacity issues for nursing students [1] within the West Midlands and the continuation of the Nursing and Midwifery recovery standards [2], this enabled academic institutions to utilise up to 300hours of practice learning utilising a range of innovative practice-based simulations. At Birmingham City University (BCU) we were faced with providing simulation to large cohorts of students in excess of 500, reduced staffing and resources. The aim was to provide simulation based on the Nursing and Midwifery Council annexes A and B proficiencies [3] in large groups and still maintain an element of clinical realism and immersion. The skills and simulation team developed several simulations which incorporated films, live actors, low-fidelity simulation, and problem-solving activities for students within the Future Nurse Course. Each simulation had pre- and post-work to be completed which was monitored and recorded via our online learning platform. The simulations developed and tested were: Breaking bad news- A traumatic below knee amputation of a young farm worker which looks at issues with partner/autistic child/overprotective mother. Hypoglycaemia- Adult hypoglycaemic patient within a General Practice setting with Paramedic input/Child hypoglycaemia/digital healthcare through use of Libre sensor. Conflict Resolution- Case study around the care of a patient with dementia who keeps falling and a Matron who does not have time. Pre-operative simulation- A 13-year-old high functioning Autistic child with torte teste requiring surgery and preoperative checking and Practice Assessor input. Allergies and Sensitivities- Management of allergies and sensitivities, Use of EpiPen for anaphylaxis. Hygiene- Shaving oral care/eyecare/female and male genitalia cleansing. The deteriorating patient- A to E assessment. Mobility and access- Use of equipment simulating frailty and disability. Assistance dogs for medical and neurodevelopmental conditions. Safeguarding- Looking at Trans/same sex couples/heterosexual domestic violence. Female genital mutilation. The simulations were evaluated by the students (N=550) and conclusions drawn from the feedback received. The large size of the groups being around 60 students is an issue both with staff and students, but it was recognised that this was beyond our control and that the large-scale sessions were ‘immersive in nature’ and reproduced substantial aspects of the real world interactively. Several students highlighted in their evaluation that they found the simulation content relevant to their clinical practice due to it demonstrating difficult situations that allowed them to practise their skills in a safe environment, promoting patient safety, and enhancing their situational awareness through guided experience. Learners appreciate the relevance of the simulations to their developing clinical skills and recognised that the learning could be more targeted than within the practice setting although did not recognise it as clinical practice time. 1. Ford S. (2022) Placement delivery is vital for the future of nursing. Nursing Times. 2. Nursing and Midwifery Standards (2020 updated January 2022) Current Recovery programme Standards. NMC, London. 3. Nursing and Midwifery (2018) Future nurse: Standards of proficiency for registered nurses. NMC, London.

Exploring the dynamic transitions of polysubstance use patterns among Canadian youth using Latent Markov Models on COMPASS data

Understanding what factors lead to youth polysubstance use (PSU) patterns and how the transitions between use patterns can inform the design and implementation of PSU prevention programs. We explore the dynamics of PSU patterns from a large cohort of Canadian secondary school students using machine learning techniques. We employed a multivariate latent Markov model (LMM) on COMPASS data, with a linked sample (N=8824) of three-annual waves, Wave I (WI, 2016-17, as baseline), Wave II (WII, 2017-18), and Wave III (WIII, 2018-19). Substance use indicators, i.e., cigarette, e-cigarette, alcohol and marijuana, were self-reported and were categorized into never/occasional/current use. Four distinct use patterns were identified: no-use (S1), single-use of alcohol (S2), dual-use of e-cigarettes and alcohol (S3), and multi-use (S4). S1 had the highest prevalence (60.5%) at WI, however, S3 became the prominent use pattern (32.5%) by WIII. Most students remained in the same subgroup over time, particularly S4 had the highest transition probability (0.87) across the three-wave. With time, those who transitioned typically moved towards a higher use pattern, with the most and least likely transition occurring S2→S3 (0.45) and S3→S2 (<0.01), respectively. Among all covariates being examined, truancy, being measured by the # of classes skipped, significantly affected transition probabilities from any low→high (e.g., ORS2→S4=2.41, 95% CI [2.11, 2.72], p < 0.00001) and high→low (e.g., ORS3→S1=0.38, 95% CI [0.33, 0.44], p < 0.00001) use directions over time. Older students, blacks (vs. whites), and breakfast eaters were less likely to transition from low→high use direction. Students with more weekly allowance, with more friends that smoked, longer sedentary time, and attended attended school unsupportive to resist or quit drug/alcohol were more likely to transition from low→high use direction. Except for truancy, all other covariates had inconsistent effects on the transition probabilities from the high→low use direction. This is the first study to ascertain the dynamics of use patterns and factors in youth PSU utilizing LMM with population-based longitudinal health surveys, providing evidence in developing programs to prevent youth PSU. The Applied Health Sciences scholarship; the Microsoft AI for Good grant; the Canadian Institutes of Health Research, Health Canada, the Canadian Centre on Substance Abuse, the SickKids Foundation, the Ministère de la Santé et des Services sociaux of the province of Québec.

Longitudinal Associations of Cardiorespiratory Fitness and Poverty With Academic Performance Among Youth.

Cardiorespiratory fitness (CRF) plays a significant role in health and academic performance in youth. The purpose of this study was to examine the longitudinal relationship between CRF and academic performance from fifth to eighth grade among a large, diverse, and state-wide cohort of students, and to determine the extent to which the relationship between change in CRF and academic performance is moderated by poverty status. CRF and academic performance data were obtained for a retrospective state-wide cohort of 11,013 students with baseline (fifth grade, school year 2015-2016) and follow-up (eighth grade, school year 2018-2019) data. Analysis of covariance was used to examine the association between changes in CRF over a 3-year follow-up period and eighth grade academic performance. After adjusting for covariates, change in CRF and poverty status were positively and significantly associated with eighth grade academic performance. Poverty status did not significantly moderate the association between changes in CRF and academic performance. Schools should prioritize evidence-based policies and programs that optimize students' access to high quantity and quality physical activity throughout the school day. Such efforts can improve and maintain student CRF and thus academic performance outcomes.

Evaluating a pedagogical approach to promoting academic integrity in higher education: An online induction program.

Academic integrity is at the heart of excellent education. However, resources explaining the concept tend to be definition-driven, while using complex language and sometimes even an austere tone designed to discourage students from breaches. This study aims to design and evaluate an online module at a UK University across 2 years, designed to improve students’ understanding of concepts of academic integrity and practice. The module includes a range of interactive resources (e.g., gamified quizzes and e-booklets) and was made available to a large cohort of postgraduate students (448). The study adopts a mixed-methods approach composed of three sequential phases involving first collecting students’ views on existing academic integrity resources (7 students participating in a focus group and 39 competing a questionnaire), then developing a range of new ones based on students’ feedback to form the content of the module, and finally gathering students’ evaluation on the newly created resources (sample size: 361 students). Results illustrate a clear improvement in relation to the accessibility, usefulness and understandability of new resources. Results also highlight a remarkable increase in student confidence levels regarding academic integrity. Students also considered the new module as more appealing and informative. This manuscript offers a good example of a pedagogical approach aimed at promoting academic integrity in an innovative and engaging fashion.

Personalising medical education: ePortfolios for workplace- based assessment

&#x0D; &#x0D; &#x0D; There is much literature on the challenges of designing for and implementing ePortfolios. Issues include technology management and overcoming barriers to acceptance and usability. Yet as higher education practitioners we find ourselves continually stumbling over these issues. Through discussion of a work-in progress case study at a large Australian medical school, we raise some of the design and implementation issues that impacted integration and facilitation of an ePortfolio system. The system was created to support students’ personal learning, and evidencing and assessment of clinical competence. Recognising the importance of context, we focus on a Workplace Learning Portfolio (WLP) course, in which an ePortfolio system was adopted to support and deliver workplace-based assessments for students in Years 3 and 4 of a Doctor of Medicine (MD) program. Discussion centres around the promise and reality of concurrently implementing curriculum and technological change with a large cohort of domestic and international students. The complexity of using an ePortfolio system to identify students at risk of academic failure is raised, as is an example of unexpected student engagement with personalised learning.&#x0D; &#x0D; &#x0D;

A study to determine students study habits, clinical experiences, and attitudes related to their knowledge and behaviour intentions in the healthcare profession.

Study habits and attitudes are thought to have a significant impact on students' academic performance, and it is assumed that "excellent" study habits will result in "good" academic results. As medical students prepare to become physicians, having the right attitudes can have an influence on the standard of care they provide to their patients. Few longitudinal research studies have examined the degree to which the attitude of pupil’s ratings change as they progress through medical school. This study looked at how a large student cohort's attitude ratings changed as they advanced through medical school. It was also looked into whether student gender affected attitude change. This research included medical trainees from three successive classes (1999-2001). The Medical Skills Questionnaire, an internal tool, and the Attitudes Toward Social Issues in Medicine (ATSIM) survey were both completed by students. Total and subscale attitudinal score reliability estimations fell within a reasonable range. A sustained reduction in various attitude scores was seen as pupils moved through means of the medical education programme, based on multivariate studies of the variation of the mean attitudinal ratings. Compared to men, women scored better on attitudes. As a consequence, as medical school students progress, their attitude ratings decline. Although the causes of the change in terms of attitude are not entirely evident, they may be related to a ceiling of excellent attitude ratings upon admission, a decline in idealism, and the effects of the unanticipated curriculum. More research is needed to determine how medical education affects students' opinions.

Fostering Motivation toward Chemistry through Augmented Reality Educational Escape Activities. A Self-Determination Theory Approach

There is little doubt that motivation influences the extent to which individuals engage with online learning experiences. With the increasing role of digital technologies within chemistry higher education, this study illustrates how an augmented reality (AR)-supported educational escape activity (EEA), based on topics of inorganic stereochemistry, can be employed within an online environment. The design aspects of our activity were guided by principles of Self-Determination Theory (SDT)─an intrinsic-extrinsic theory of motivation. We sought to actively support the fundamental needs of competency, autonomy, and relatedness. Our control group was provided with a copy of our EEA that utilized two-dimensional drawings. Reported measures of competency were seen as a positive predictor of intrinsic motivation. However, in this study, this was not observed to be a positive predictor of academic performance. The introduction of AR, over and above the EEA, did not result in any significant differences in reported intrinsic motivation or post-test scores on our stereochemistry test instrument. Collected qualitative data suggest that participants found the activity to be useful and engaging. Through students’ discussions, we have provided evidence of how design aspects of the EEA support the psychological needs satisfaction outlined by SDT. The design of our EEA provides one approach to implementing this style of learning activity, in a way that supports virtual presence and is scalable to large student cohorts.

Dialogue matters a lot: Autoethnographic reflections of an Australian teaching team managing first-year undergraduate students

The shift away from traditional teaching approaches in higher education towards the new ‘traditional model’ of teaching using blended learning is driven by the need to accommodate student learning needs in a digital era. Through the lens of Transactional Distance Theory, this paper aims to understand 1) how to reduce the transactional distance within a blended learning environment to foster active learning and 2) how dialogue and collaboration between instructors impact the teaching practices, and achievement of learning outcomes enable greater learner autonomy. Using an autoethnographic account of the lived experiences of a multiple instructor team, this study focused on a subject delivered to first-year students transitioning to the university during pre-COVID and post-COVID (two teaching semesters in 2019 and two teaching semesters in 2020). Despite higher levels of assumed digital literacy, we found that first-year university students of the digital generation required more structure than autonomy. We argue that instructor collaboration ensures consistency of a team approach to teaching in a BL environment and improves student transition to autonomous learning. We suggest practices and policies for teaching large student cohorts involving multiple instructors and offer insight to explore further TDT can be considered in this regard.

High five! – the big 5 personality traits, locus of control, and impulsivity and their relationship to substance use in a large cohort of university students in Berlin

Background Research suggests that university students are at high risk of using licit and illicit substances and that there has been an increase over the last decade in substance use among university students in Berlin, Germany. The present study aims to investigate the relationship between personality and substance use among university students in the city of Berlin. Method A sample of 8778 students from 17 Berlin universities completed an online questionnaire. Short versions of the Big Five Inventory and the Barratt Impulsivity Scale as well as the SOEP-scale (German socioeconomic panel) for the concept of locus of control were used to assess personality traits. Four different user groups and six specific substances were studied using multinomial logistic and logistic regression models. Results Participants regularly using substances scored higher on impulsivity and openness and lower on conscientiousness compared to the other user groups. Further, they scored higher on extraversion and external locus of control compared to participants not using substances or exclusively drinking alcohol. Out of the personality dimensions examined, the relationship between substance use and impulsivity was strongest and had the highest effect size (medium) in our sample. Conclusions Despite increasing prevalence among the high-risk group of university students in Berlin, universities have not yet sufficiently adopted prevention programs. These programs should be adapted to meet the needs of the target group which may be complemented with the findings of the study (e.g. emotional regulation training and goal management training).

Childhood Adversity and Mental Health Outcomes Among University Students: A Longitudinal Study.

Mental health concerns are common among university students and maybe elevated among those with specific risk exposures. The study examined the association between childhood adversities and mental health outcomes among undergraduate university students and assessed whether psychosocial and behavioral factors mediate those associations. The Queen's University Student Well-Being and Academic Success Survey identified two large cohorts of first-year undergraduate students entering university in Fall 2018 and 2019 (n = 5,943). At baseline, students reported sociodemographic information, family-related mental health history, childhood physical abuse, sexual abuse, peer bullying, and parental separation or divorce. Baseline and follow-up surveys in Spring 2019, Fall 2019, and Spring 2020 included validated measures of anxiety (7-item Generalized Anxiety Disorder) and depressive symptoms (9-item Patient Health Questionnaire ), non-suicidal self-harm, and suicidality, along with psychological processes and lifestyle variables. Repeated measures logistic regression using Generalized Estimating Equations was used to characterize the associations between childhood adversities and mental health outcomes and examine potential mediation. Adjusting for age, gender, ethnicity, familial mental illness, and parental education, any childhood abuse (odds ratio: 2.89; 95% confidence interval, 2.58 to 3.23) and parental separation or divorce (odds ratio: 1.29; 95% confidence interval, 1.12 to 1.50) were significantly associated with a composite indicator of mental health outcomes (either 9-item Patient Health Questionnaire score ≥10 or 7-item Generalized Anxiety Disorderscore ≥10 or suicidality or self-harm). The association with childhood abuse weakened when adjusted for perceived stress, self-esteem, and insomnia (odds ratio: 2.05; 95% confidence interval, 1.80 to 2.34), and that with parental divorce weakened when adjusted for self-esteem (odds ratio: 1.17; 95% confidence interval, 1.00 to 1.36). Childhood abuse and parental separation or divorce were associated with mental health concerns among university students. Childhood adversities may impact later mental health through an association with stress sensitivity, self-esteem, and sleep problems. The findings suggest that prevention and early intervention focusing on improving sleep, self-esteem, and coping with stress while considering the individual risk profile of help-seeking students may help support student mental health.

Indicators of recent COVID-19 infection status: findings from a large occupational cohort of staff and postgraduate research students from a UK university

BackgroundResearchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators.MethodsWe described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators.ResultsCore symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%).ConclusionsOur results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results.

A guided search: Formulating a PICOT from assigned areas of inquiry.

The evidence-based practice (EBP) competencies of cultivating inquiry and formulation of Population, Intervention, Outcome, and Time (PICOT) questions are essential to quality improvement, healthcare outcomes, and the development of Doctor of Nursing Practice (DNP) scholarly projects. Education and assessment of EBP competencies into the DNP curriculum, particularly formulation of PICOT questions, provide guidance and evaluate mastery of students' individual skills and group work. Utilization of a PICOT template is an approach to aid large cohorts of students in writing healthcare-specific PICOTs to guide them in search of quality evidence. Guided inquiry through collaboration with community partners can aid in identifying community needs. Assigning an area of inquiry allows stakeholders, community partners, and nursing students an opportunity to ask the necessary questions to improve health care, and simultaneously meet the need for evidence-based quality improvement.

Association of parental death and illness with offspring suicidal ideation: cross-sectional study in a large cohort of university students.

The aim of this study was to (1) investigate the association of parental death and illness with suicidal ideation using a large sample of university students and (2) test whether associations were moderated by perceived family support. We used data from N = 15,008 French university students enrolled in the i-Share cohort (mean age, 20.5years; 77% women). Students self-reported information on parental death, including the cause, parental illness (cardiovascular, stroke, cancer, depression/anxiety, alcohol abuse), and perceived family support during childhood/adolescence. Twelve-month suicidal ideation was self-reported and categorized into no, occasional, and frequent ideation. Occasional and frequent suicidal ideation were, respectively, reported by 2692 (17.5%) and 699 (4.6%) students. After adjustment for age, gender, and parental education, we found associations between parental death and risk of occasional and frequent suicidal ideation (respectively, RR = 1.98 [1.81-2.17] and RR = 2.73 [2.30-3.24]). Parental deaths from illness, accidents, and suicides had the strongest associations. We also found associations for parental depression/anxiety (occasional, RR = 1.98 [1.81-2.17]; frequent, RR = 2.73 [2.30-3.24]), alcohol use problems (occasional, RR = 1.71 [1.5-1.94]; frequent, RR = 2.33 [1.89-2.87]), and cardiovascular diseases (occasional, RR = 1.22 [1.06-1.40]; frequent, RR = 1.83 [1.47-2.27]). For participants who experienced parental death and stroke, associations with occasional and frequent suicidal ideation (respectively) increased as perceived family support increased (Psinteraction ≤ 0.005). Students who experienced parental death and common parental illnesses were at risk of reporting suicidal ideation, especially if their family were perceived as an important source of support. As information on parental death or illness can be routinely collected during health visits, attention should be paid to students reporting such experiences.

Assessment of energy and nutrient intakes among undergraduate students attending a University in the North of England.

Background: Unhealthy diets are typical of university students and are often thought to be unrepresentative of the general population. The main aim was to determine the energy and nutrient intakes of a large cohort of undergraduate university students; and to compare to gender-specific dietary reference values (DRVs) and nutrient data from the general population. Methodology: Data was collected from 639 university students aged 18-24 years who completed 4-day diet diaries. The energy and nutrient intake was determined and percentage energy values calculated and compared with dietary reference values (DRVs) and the National Diet and Nutrition Survey (NDNS) and Family Food Statistics. Logistic regression methods were used to identify micronutrients functioning as predictors of exceeding DRVs. Results: Energy intakes were lower than the DRV. The percentage total energy values for protein, fat, saturated fat and carbohydrate exceeded DRVs but the percentage energy from alcohol was below the maximum 5%. The DRVs were met for vitamin C, thiamin, and sodium/salt. Iron and calcium intakes were met in males but not in females. Intakes for fibre and vitamin A were below the DRV. Student data was comparable to the NDNS, with the exception of alcohol, fibre, vitamin A, calcium and sodium/salt, which were all lower than the NDNS. Conclusions: This study contradicts the stereotypical assumption that students are following a high energy, fat, saturated fat, total sugars, salt and alcohol diet compared with the general population.

Neural Correlates of Facial Emotion Recognition in Non-help-seeking University Students With Ultra-High Risk for Psychosis.

BackgroundSince the introduction of the neurodevelopmental perspective of schizophrenia research on individuals at ultra-high risk for psychosis (UHR) has gained increasing interest, aiming at early detection and intervention. Results from fMRI studies investigating behavioral and brain functional changes in UHR during facial emotion recognition, an essential component of social cognition, showed heterogenous results, probably due clinical diversity across these investigations. This fMRI study investigated emotion recognition in a sub-group of the UHR spectrum, namely non-help-seeking, drug-naïve UHR with high cognitive functioning to reveal the neurofunctional underpinnings of their social functioning in comparison to healthy controls.MethodsTwo large cohorts of students from an elite University (n1 = 4,040, n2 = 4,364) were screened firstly with the Prodromal Questionnaires and by surpassing predefined cut-offs then interviewed with the semi-structured Interview for Psychosis-Risk Syndromes to verify their UHR status. Twenty-one identified non-help-seeking UHR and 23 non-UHR control subjects were scanned with functional magnetic resonance imaging while classifying emotions (i.e., neutral, happy, disgust and fear) in a facial emotion recognition task.ResultsBehaviorally, no group differences were found concerning accuracy, reaction times, sensitivity or specificity, except that non-help-seeking UHR showed higher specificity when recognizing neutral facial expressions. In comparison to healthy non-UHR controls, non-help-seeking UHR showed generally higher activation in the superior temporal and left Heschl's gyrus as well as in the somatosensory, insular and midcingulate cortex than the control subjects during the entire recognition task regardless of the emotion categories. In an exploratory analysis, in the non-help-seeking UHR group, functional activity in the left superior temporal gyrus was significantly correlated with deficits in the ability to experience emotions at uncorrected statistical thresholds.ConclusionsCompared to healthy controls, non-help-seeking UHR show no behavioral deficits during facial emotion recognition, but functional hyperactivities in brain regions associated with this cognitive process. Our study may inspire future early intervention and provide loci for treatment using neural stimulation.

Prevalence and perception of substance abuse and associated economic indicators and mental health disorders in a large cohort of Kenyan students: towards integrated public health approach and clinical management

BackgroundThe earlier younger people begin to use drugs, the more vulnerable they become to both their short term and long-term harmful effects. The overall aim of this study is to determine the prevalence of alcohol and drug abuse, the socio-demographic characteristic, perception of abuse and associated economic indicators and mental disorders and how they inform potential intervention in a cohort of Kenyan students.MethodsThis was a cross-sectional study on a total of 9742 high school, college and university students. We used tools to document socio-demographic characteristics, economic indicators, drug and alcohol use and related perceptions and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) related psychiatric disorders. Basic descriptive statistics (means and standard deviations for numerical variables and frequencies for nominal and ordinal variables) were done. Logistic regression models were used to assess the association and odds ratios between the use of a given substance and the use of the other substances, as well as associations with the various available socio-demographic factors and economic indicators. Chi-squared tests were used in socio-economic characteristics disaggregated by current alcohol use.ResultsThe mean age was 21.4 ± 2.4; median = 21.3 (range 15–43) years. We found a wide range of different drugs of abuse. Alcohol abuse was the commonest and inhalants were the least, with different perceptions.Both alcohol and drug abuse were associated with various economic indicators and various mental disorders.ConclusionThis study has established for the first time in Kenya the multifaceted associations and predictors of alcohol and drug abuse in a cross-sectional student population ranging from high school to college and university levels. In the process, the study contributes to global data on the subject. These associations call for an integrated and multifaceted approach in addressing alcohol and substance abuse. This approach should take into account various associations and predictors as part of holistic approach in both public awareness and clinical interventions.

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?

Virtual OSCE: Experience and challenges with a large cohort of pharmacy students

In response to the inability to conduct conventional face-to-face objective structured clinical examination (OSCE) due to the COVID-19 lockdown, this study explored options to design virtual OSCE (vOSCE) that meets the objectives and standards of effective competency-based assessment for a large cohort of pharmacy students. The vOSCE required advanced planning of the actual assessment and technical conduct. The development of a master plan consisting of the types of competencies to test, topics and number of cases, and assessment rubrics, guided the team members to develop an adequate OSCE assessment module. Technical aspects included recruitment of examiners, simulated patients (SP), technical support, and a platform for vOSCE. The main challenges were to ensure well-ordered vOSCE and a stable internet connection for examiners, SP, and students. Google Meet was utilised due to its functionality, familiarity, and low internet consumption to all parties involved. Feedback was obtained from stakeholders to improve future OSCE conduct.