Since medical education is expensive, healthcare professional students in many countries must take out loans to pay for their studies. The resultant levels of debt have created concerns at both the beginning and the end of undergraduate education. How should medical educators respond to these concerns? If educators are to look at medical education from the perspective of their students who are most in need, then they should think about this. Educators should think about their response when current or prospective students ask them about mitigating the costs of medical education. This may include questions about working during undergraduate studies, the costs of living in different locations, and the availability of bursaries that offer financial aid to students. Medical students should be encouraged to "think like an investor" when making decisions related to their medical education. Senior medical educators should be well placed to advise them in this regard.
The relationship between economics and health has been of great interest throughout the years. The accumulated data is not sufficient enough to carry out long-term studies from the viewpoint of morbidity, although Korea National Health and Nutrition Examination Survey (KNHANES) was carried out yearly since 1998 in Korea. Thus, we investigated the effect of the 2008 global economic crisis on health indicators of Korea.
Health indicators were selected by paired t-test based on 2007 and 2009 KNHANES data. Age, gender, body mass index (BMI), smoking, drinking, exercise, education, income, working status, and stress were used as confounding factors, which were analyzed with logistic and probit analyses. Validation was done by comparing gross domestic product (GDP) growth rates and probit analyses results of 2007-2012 KNHANES data.
Among several health indicators, the prevalence of hypertension and stress perception was higher after the economic crisis. Factors related with higher hypertension prevalence include older age, male gender, higher BMI, no current tobacco use, recent drinking, lower education levels, and stress perception. Factors related with more stress perception were younger age, female gender, current smoking, lower education levels, and lower income. GDP growth rates, a macroeconomic indicator, are inversely associated with hypertension prevalence with a one-year lag, and also inversely associated with stress perception without time lag.
The economic crisis increased the prevalence of hypertension and stress perception. In the case of GDP growth rate change, hypertension was an inversely lagging indicator and stress perception was an inversely-related coincident indicator.
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Directly measured low density lipoprotein cholesterol (DLDLC) has been reported to be more accurate than calculated low density lipoprotein cholesterol (CLDLC) using the Friedewald equation. However, some limitations of DLDLC have been reported. In this study, we evaluated differences between CLDLC and DLDLC measured using HiSens reagents.
Data were collected from 582 persons undergoing routine physical examinations at a general hospital. LDLC measurements were made directly or estimated using the Friedewald formula, and were classified according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines. The relationship between these differences and other clinically relevant factors, such as triglyceride (TG) levels, were examined using multiple logistic regression analysis.
The DLDLC and CLDLC were strongly correlated according to simple linear regression analysis (r=0.917, P<0.001) but the mean difference between measurements was -11.0±15.3 (-62 to 90.5) mg/dL (P<0.001). For more than 10 mg/dL of their absolute differences, the DLDLC was typically lower than the CLDLC. The highest discrepancies in LDLC measurements occurred when LDLC was more than 160 mg/dL and less than 190 mg/dL. Differences in LDLC measurements were prone to striking negative and positive biases dependent on CLDLC and TG concentrations, respectively (all r>0.5).
Unlike other studies, DLDLC was significantly lower than CLDLC and the large differences in LDLC concentrations were not dependent on TG concentration. Our work suggests that verification of DLDLC accuracy is needed and differences in LDLC measurements should be accounted for in making clinical decisions.
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Given the importance of test anxiety among gifted students, the present study was conducted to assess the intervening role of alexithymia in the relationship between test anxiety and attachment styles.
By means of simple random sampling, 300 participants were selected out of all the students at two high schools in Khorramabad, which are affiliated with the Iranian National Organization for Development of Exceptional Talents (SAMPAD). Test anxiety, alexithymia, and attachment style questionnaires were used for data collection. Pearson correlation and path analysis tests were used to analyze the data.
The results showed a positive relationship between test anxiety and avoidant and anxious attachment styles. Alexithymia and test anxiety were also positively related. Moreover, the results indicated that 12% of changes in test anxiety were explained by avoidant and anxious attachment styles as well as alexithymia. The relationship between the avoidant attachment style and test anxiety was 0.06 through alexithymia. However, no significant relationship between anxious attachment and test anxiety through alexithymia was found.
The avoidant attachment style leads to test anxiety when the level of alexithymia increases in an individual.
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Despite providing insufficient medical evidence of the existence of a real cardiac condition, patients with non-coronary chest pain still interpret their pain incorrectly. The present study, therefore, sought to compare the irrational beliefs in non-coronary patients with mild chest pain against those with severe chest pain.
A cross-sectional design was used. The statistical population comprised non-coronary patients who presented to the Heart Emergency Center of Kermanshah city, Iran. Using a matching method, 96 participants were selected and studied in two groups of 48. The instruments used were the Comorbidity Index, Brief Pain Index, and the Jones Irrational Beliefs Test (short-form). The multivariate analysis of variance, chi-square test, and t-test were used for data analysis.
Controlling for the effects of age and comorbid conditions, the severity of three types of irrational beliefs, including emotional irresponsibility (P<0.001), hopelessness changes (P<0.001), and problem avoiding (P=0.002) was higher among patients with severe chest pain (according to effect level). However, in terms of demand for approval, no difference was seen between the two groups (P=0.180).
Non-coronary patients with severe chest pain showed a greater number of irrational beliefs in comparison to patients with mild pain. Irrational beliefs are common mental occurrences in patients with non-coronary chest pain, and they should be attended to by health professionals, especially in severe non-coronary chest pain. Further investigation to determine the association between irrational beliefs and non-coronary chest pain is necessary.
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This study aimed to investigate the association between living arrangements and influenza vaccination among elderly South Korean subjects.
We used data from the fifth Korean National Health and Nutrition Examination Survey. Participants older than 65 years were included and categorized into 4 groups according to the type of living arrangement as follows: (1) living alone group; (2) living with a spouse group; (3) living with offspring (without spouse) group; and (4) living with other family members group. A total of 1,435 participants were included in this cross-sectional analysis.
A lower vaccination rate was observed in the living with offspring (without spouse) group, whereas the living with a spouse group had higher rates of both seasonal and H1N1 influenza vaccination. After adjusting for age, sex, region, education level, income level, and number of comorbidities, the living with offspring (without spouse) group had a higher H1N1 vaccination non-receipt rate than the living alone group (odds ratio, 2.03; 95% confidence interval, 1.08-3.82).
Influenza vaccination rates differed according to the type of living arrangement. Particularly, those living with offspring (without spouse) had the lowest H1N1 influenza vaccination rate compared to those with other living arrangements, and this difference was significant. Interventions to improve influenza vaccination coverage should target not only elderly persons who live alone, but also those living with offspring.
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Infection with carbapenem-resistant
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