Factors affecting test anxiety: a qualitative analysis of medical students’ views

Background Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students’ insights into TA and their suggestions on how to reduce it. Methods We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines. Results Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The “students” theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, “academic recources” into heavy curriculum vs. facilitative curricular aids, and “examiner” into criticism vs. feedback and strict vs. kind approaches. Conclusion This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.

Stability-Indicating UHPLC Method for the Determination of Desvenlafaxine: Application to Degradation Kinetics

This study was aimed to investigate the degradation behavior and physicochemical stability of desvenlafaxine using reversed-phase ultra-high-performance liquid chromatography (RP-UHPLC) system. The chromatogram was developed on Eclipse XDB-C8 column (150 x 4.6 mm, 5μm). The eluents were monitored through a photo diode array plus (PDA+) detector at 210 nm using an isocratic method with a flow rate of 1.5 ml/min. Mobile phase composition was 30:70 v/v mixture of 0.1 % trifluoroacetic acid (TFA) in water and methanol. Forced degradation studies were performed on drug substance of desvenlafaxine as per International Conference on Harmonization (ICH) prescribed stressed conditions (Q1A(R2) and Q1B) using hydrolytic (acidic, basic, and neutral), oxidative and photolytic methods. The drug substance was found highly labile to acidic (0.5 N hydrochloric acid, 18.65 % degradation in 2 hours at 70°C), basic (1.0 N sodium hydroxide, 11.01 % degradation in 12 hours at 70°C) and oxidative (3 % hydrogen peroxide, 17.05 % degradation in 2 hours at 50°C) stressed conditions, but a great resistance was observed towards dry heat (maximum degradation 0.27 % in 10 days from ambient to higher temperature, 80°C), moist heat (maximum degradation 0.25 % in 2 hours at 80°C and 75 % relative humidity) as well as in photolytic degradation (maximum degradation 0.23 % in 10 days at UV light of 315 - 400 nm). A pseudo-first order kinetic was followed in acidic, basic and peroxide degradation methods which paved a way to calculate the half-life of the drug substance desvenlafaxine under ICH mentioned stressed conditions. The results were also statistically analyzed and the % RSD values were compared with recommended guidelines. Dhaka Univ. J. Pharm. Sci. 20(2): 167-176, 2021 (December)

Treatment Outside the Recommended Guidelines for Retinopathy of Prematurity (ROP): Prevalence, Characteristics, and Issues

This study aims to assess the prevalence and characteristics of preterm infants with retinopathy of prematurity (ROP) treated outside the recommended guidelines. In this retrospective monocentric cohort, we included all premature children treated in our department for ROP by laser photoablation or anti-VEGF intravitreal injection. The main outcome was treatment of both eyes for ROP less severe than pre-threshold type 1, treated outside ETROP guidelines. A total of 114 children received treatment for ROP in our department, among whom 32 (28.1%) children received treatment for indications outside the ETROP guidelines for both eyes. The indications outside the guidelines were persistent stage 2 or 3 ROP that showed no evidence of regression after 41 weeks of corrected gestational age (11 children; 34.4%), pre-plus stage (11; 34.4%), difficulties in disease staging (7; 21.9%), type 2 ROP with plus disease (2; 6.2 %), and treatment due to logistical difficulties (1; 3.1%; hospitalized in neonatal units hundreds of miles away from our department, with no fundus examination possible in the neonatal unit). To resume, in our cohort, 28.1% of children received treatment for ROP less severe than pre-threshold type 1 both eyes. The main indications for off-label treatment were the persistence of active ROP during follow-up and the presence of pre-plus-stage disease. Our data suggest the need to update ROP treatment criteria to reflect real-life practices. Additional studies are required in order to evaluate the long-term benefits and side effects of treatments outside the recommended indications, and to establish revised treatment guidelines.

New Construction of Functionalized CuO/Al2O3 Nanocomposite-Based Polymeric Sensor for Potentiometric Estimation of Naltrexone Hydrochloride in Commercial Formulations

Electrically conductive polymeric nanocomposites with nanoparticles are adaptable types of nanomaterials that are prospective for various applications. The extraordinary features of copper oxide (CuO) and aluminium oxide (Al2O3) nanostructures, encourages extensive studies to prospect these metal oxide nanocomposites as potential electroactive materials in sensing and biosensing applications. This study suggested a new CuO/Al2O3 nanocomposite-based polymeric coated wire membrane sensor for estimating naltrexone hydrochloride (NTX) in commercial formulations. Naltrexone hydrochloride and sodium tetraphenylborate (Na-TPB) were incorporated in the presence of polymeric polyvinyl chloride (PVC) and solvent mediator o-nitrophenyloctyl ether (o-NPOE) to form naltrexone tetraphenylborate (NTX-TPB) as an electroactive material. The modified sensor using NTX-TPB-CuO/Al2O3 nanocomposite displayed high selectivity and sensitivity for the discrimination and quantification of NTX with a linearity range 1.0 × 10−9–1.0 × 10−2 mol L−1 and a regression equation EmV = (58.25 ± 0.3) log [NTX] + 754.25. Contrarily, the unmodified coated wire sensor of NTX-TPB exhibited a Nernstian response at 1.0 × 10−5–1.0 × 10−2 mol L−1 and a regression equation EmV = (52.1 ± 0.2) log [NTX] + 406.6. The suggested modified potentiometric system was validated with respect to various criteria using the methodology recommended guidelines.

Urbanising Delta: What Lessons Dhaka Offers to Face Challenges

Cities built on deltaic regions are always prone to environmental risks like aggravated flooding, wetland reduction, compromised water quality, continuing water scarcity, and tainted air and these have been remarkable as the challenges while urbanizing deltas. On top of that, rapid urbanization adds more to the deterioration of ecosystem functions. Drawing insights from Bangladesh's capital Dhaka lying in the Ganges, Brahmaputra, and Meghna basin, this study basically appraises the common concerns of deltaic megapolises through a systematic literature review. The current literature has been brought up by analysing the status, factors, and impacts of the challenges and management by authorities. In addition, it is further updated with some urban experts' views, secondary records on groundwater levels, and remote sensing imageries. This paper also concludes with recommended guidelines from the reviews for more practical deltaic urbanization, especially when there is no turning back for urban transferability to a new region of the delta. Particularly, success demands (1) specifying current situation in quantifiable terms (e.g., numeric values, percentages, scores, indices), (2) practical but adaptive multi-objective plans/policies with a set of assessable targets, and (3) timely robust evaluation for tracking data for specific, measurable, and meaningful outcomes.

Factors Influencing Health Workers’ Compliance with the WHO Intermittent Preventive Treatment for Malaria in Pregnancy Recommendations in the Northern Region, Ghana

Background Although IPTp-SP is a lifesaving WHO recommended preventive intervention for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated factors will generate valuable pointers to be targeted at the program level. The study examined the factors influencing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region. Methods A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors and knowledge level. Data were collected on health workers’ compliance with the recommended practices through covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted logistic regression were used to determine predictors of health workers’ compliance, at 5% significance level adjusting for clustering. Results Of the 315 health workers studied, the median age was 29 years (26 – 34 years). Females constituted 252 (80.5%) of the 313 workers. The majority 148 (47.44%) of the 312 health workers were midwives. Overall, 56.2% (CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were recorded in health centers 15.6% (5.0 - 33.0) and CHPS compounds 21.2% (11.0 - 35.0). The factors associated with compliance included health workers’ knowledge (aOR = 7.64, 95% CI 4.21 - 13.87, p<0.001), job satisfaction (aOR 10.87, 95%CI 7.04 - 16.79, p<0.001), in-service training (aOR 10.11, 95%CI 4.53 - 22.56, p<0.001), supervision (aOR 4.01, 95%CI 2.09 - 7.68, p<0.001), availability of job aids (aOR 3.61, 95%CI 2.44 - 5.35, p<0.001), health workers experience (aOR = 10.64, 95% CI 5.99 - 18.91, p<0.001) and facility type (aOR 0.03, 95%CI 0.01 - 0.07, p<0.001). Conclusion Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level health facilities recording the least compliance levels. Health centers and CHPS facilities should be prioritized in distributing limited resources to improve health worker quality of care for antenatal care clients.

Using Technology for Prescription and Adherence in an Alzheimer’s Prevention Program

Healthy lifestyle change is difficult to adopt and maintain without support. Often physicians recommend exercise to their patients, but have limited means to support this change. A major goal of our study is to provide physicians with a simple method of referring patients to a program that supports adoption and maintenance of exercise that meets recommended guidelines for older adults. The Lifestyle Empowerment for Alzheimer’s Prevention program (LEAP! Rx) is a yearlong intervention to support cognitively normal older adults in adoption and maintenance of moderate to vigorous exercise, a key prevention factor for Alzheimer’s disease. The program uses the electronic medical record and builds relationships with physicians to identify patients eligible to participate. It electronically communicates about patients’ progress back to referring physicians to facilitate ongoing physician-patient interaction. Participants receive exercise coaching to reach their weekly exercise goals and have access to online lifestyle education classes (e.g., nutrition, sleep, stress management). The study is currently enrolling (n= 121 enrolled; mean age 71.4; 12% non-white, 4% Hispanic/Latino, and 83% female). Physician referrals originate from five clinics represented by 48 physicians. The study design will actively compare the physician referral process to self-referrals from the community (n=20). We have adapted the protocol to the conditions of the pandemic including online exercise coaching and support. This presentation will discuss successes and lessons learned from this novel method of recruitment and adherence to exercise.

Parents’ and Children’s (6–12 Years Old) Physical Activity Association: A Systematic Review from 2001 to 2020

Worldwide, studies reveal that a significant proportion of adults and children do not meet the recommended guidelines for physical activity (PA). Therefore, it is crucial that proxy determinants for child physical activity enhancement could be identified. Parents have been considered to have a key role in child adherence to physical activity. Thus, this systematic review aimed to identify association between parents’ and children’s PA. The search of scientific papers was conducted from 31 October 2020 until 31 January 2021, on the Web of Science, Scopus, Psycinfo, SportDiscus, and Pubmed databases. The PRISMA protocol was used. Findings indicate a consistent association between parents’ and children’s (6–12 years old) PA. Despite the imbalance of the number of assessed fathers and mothers with the latter clearly overrepresented, a trend towards the same gender dyads on PA significant and positive association (father/son, mother/daughter) was evidenced. Results support the relevant importance of parents’ PA as role modeling (either explicitly or implicitly) for children’s PA. Besides, results revealed the importance of promoting PA in family for the enhancement of children’s PA. Moreover, and given the positive impact of exerting PA with the children on children’s PA, parents should spend more time practicing PA with their children, especially on MVPA and meeting the recommended guidelines for PA. Future studies should highlight the role of mediator variables on this interaction process, extending the knowledge on the contribution of other factors to the requested enhancement of children adherence to PA practice.

Physical education and health enhancing physical activity – a European perspective

This article reviews recent literature on the contribution of curriculum physical education to health-enhancing physical activity within the context of European countries. Recommended goals for student physical activity are discussed within a curriculum framework based on five ‘forms’ (concept, designed, implemented, results and effects). The study used a 'rapid reviewing' method, in which sources were identified and analysed using systematic reviewing techniques, but subsequent stages were adapted to facilitate flexible and practical interpretation. Results show that physical education lessons tend not to reach a putative 50% threshold of moderate-to-vigorous intensity. Given that the average time allocated for physical education in Europe is 100 minutes per week, strategies are needed to increase the intensity and duration of physical activity in lessons if they are to make a more meaningful ‘direct’ contribution to the European and WHO daily target of sixty minutes of moderate to vigorous physical activity. The authors therefore consider the plausibility of introducing an 'Active Schools' concept, in which physical education lessons designed to equip students with the prerequisite knowledge, skills, attitudes, and values supportive of a physically active lifestyle are augmented by other school-based contexts which provide the opportunity to actually meet the recommended guidelines for physical activity participation.