Background The mental health of current medical students is predictive of their mental health as future doctors.The prevalence of anxiety,depression and burnout is high among medical students,but less is known about t...Background The mental health of current medical students is predictive of their mental health as future doctors.The prevalence of anxiety,depression and burnout is high among medical students,but less is known about the occurrence of other mental ill-health symptoms,such as eating or personality disorders,and factors contributing to mental ill-health.Aims(1)To explore the prevalence of various mental ill-health symptoms in medical students and(2)to investigate what medical school factors and students’attitudes contribute to these mental ill-health symptoms.Methods Between November 2020 and May 2021,medical students from nine geographically spread medical schools in the UK participated by completing online questionnaires at two points in time,approximately 3 months apart.Results Of the 792 participants who filled in the questionnaire at baseline,over half experienced medium to high somatic symptoms(50.8%;402)and drank alcohol at hazardous levels(62.4%;494).Adjusted longitudinal data analysis of 407 students who completed the follow-up questionnaire demonstrated that less supportive educational climates that were more competitive and less centralised around the students,lower feelings of belongingness,greater stigma towards mental ill-health and lower intentions to seek help for mental ill-health,all contributed to students’mental ill-health symptoms.Conclusions Medical students experience a high prevalence of various mental ill-health symptoms.This study suggests that medical school factors and students’attitudes towards mental ill-health are significantly associated with students’mental health.展开更多
BackgroundFor the treatment of chronic heart failure （HF）, both pharmacological and non-pharmacological treatment should be em-ployed in HF patients. Although HF is highly prevalent in nursing home residents, it is ...BackgroundFor the treatment of chronic heart failure （HF）, both pharmacological and non-pharmacological treatment should be em-ployed in HF patients. Although HF is highly prevalent in nursing home residents, it is not clear whether the recommendations in the guide-lines for pharmacological therapy also are followed in nursing home residents. The aim of this study is to investigate how HF is treated in nursing home residents and to determine to what extent the current treatment corresponds to the guidelines.MethodsNursing home resi-dents of five large nursing home care organizations in the southern part of the Netherlands with a previous diagnosis of HF based on medical records irrespective of the left ventricle ejection fraction （LVEF） were included in this cross-sectional design study. Data were gathered on the （medical） records, which included clinical characteristics and pharmacological- and non-pharmacological treatment. Echocardiography was used as part of the study to determine the LVEF.ResultsOut of 501 residents, 112 had a diagnosis of HF at inclusion. One-third of them received an ACE-inhibitor and 40% used aβ-blocker. In 66%, there was a prescription of diuretics with a preference of a loop diuretic. Focusing on the residents with a LVEF￡ 40%, only 46% of the 22 residents used an ACE-inhibitor and 64% aβ-blocker. The median daily doses of prescribed medication were lower than those that were recommended by the guidelines. Non-pharmacological interventions were recorded in almost none of the residents with HF.ConclusionsThe recommended medical therapy of HF was often not prescribed; if pre-scribed, the dosage was usually far below what was recommended. In addition, non-pharmacological interventions were mostly not used at all.展开更多
基金funded by the British Medical Association(BMA)Foundation(Scholarship grant).
文摘Background The mental health of current medical students is predictive of their mental health as future doctors.The prevalence of anxiety,depression and burnout is high among medical students,but less is known about the occurrence of other mental ill-health symptoms,such as eating or personality disorders,and factors contributing to mental ill-health.Aims(1)To explore the prevalence of various mental ill-health symptoms in medical students and(2)to investigate what medical school factors and students’attitudes contribute to these mental ill-health symptoms.Methods Between November 2020 and May 2021,medical students from nine geographically spread medical schools in the UK participated by completing online questionnaires at two points in time,approximately 3 months apart.Results Of the 792 participants who filled in the questionnaire at baseline,over half experienced medium to high somatic symptoms(50.8%;402)and drank alcohol at hazardous levels(62.4%;494).Adjusted longitudinal data analysis of 407 students who completed the follow-up questionnaire demonstrated that less supportive educational climates that were more competitive and less centralised around the students,lower feelings of belongingness,greater stigma towards mental ill-health and lower intentions to seek help for mental ill-health,all contributed to students’mental ill-health symptoms.Conclusions Medical students experience a high prevalence of various mental ill-health symptoms.This study suggests that medical school factors and students’attitudes towards mental ill-health are significantly associated with students’mental health.
文摘BackgroundFor the treatment of chronic heart failure （HF）, both pharmacological and non-pharmacological treatment should be em-ployed in HF patients. Although HF is highly prevalent in nursing home residents, it is not clear whether the recommendations in the guide-lines for pharmacological therapy also are followed in nursing home residents. The aim of this study is to investigate how HF is treated in nursing home residents and to determine to what extent the current treatment corresponds to the guidelines.MethodsNursing home resi-dents of five large nursing home care organizations in the southern part of the Netherlands with a previous diagnosis of HF based on medical records irrespective of the left ventricle ejection fraction （LVEF） were included in this cross-sectional design study. Data were gathered on the （medical） records, which included clinical characteristics and pharmacological- and non-pharmacological treatment. Echocardiography was used as part of the study to determine the LVEF.ResultsOut of 501 residents, 112 had a diagnosis of HF at inclusion. One-third of them received an ACE-inhibitor and 40% used aβ-blocker. In 66%, there was a prescription of diuretics with a preference of a loop diuretic. Focusing on the residents with a LVEF￡ 40%, only 46% of the 22 residents used an ACE-inhibitor and 64% aβ-blocker. The median daily doses of prescribed medication were lower than those that were recommended by the guidelines. Non-pharmacological interventions were recorded in almost none of the residents with HF.ConclusionsThe recommended medical therapy of HF was often not prescribed; if pre-scribed, the dosage was usually far below what was recommended. In addition, non-pharmacological interventions were mostly not used at all.
