Health behaviors, care needs and attitudes towards self-prescription: a cross-sectional survey among Dutch medical students

Are doctors using more preventive medication for cardiovascular disease? A Swedish cross-sectional study

BACKGROUND

Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.

AIM

To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.

DESIGN AND SETTING

This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45-74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.

METHOD

Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.

RESULTS

MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59-1.72).

CONCLUSION

We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.

Status of Substance use among Undergraduate Medical Students in a Selected Government Medical College in Puducherry - An Explanatory Mixed Method Study

Background

Studies have shown increase in health-risking behavior and a decline in health-promoting behavior among medical students during their stay in medical school. This study aims to determine the prevalence and reason for substance abuse among the undergraduate medical students in a selected medical college in Puducherry.

Material and Methods

This was a facility-based explanatory mixed method study conducted from May 2019 to July 2019. Assessment of their substance abuse was done using ASSIST questionnaire. Substance use was summarized as proportions with 95% CI.

Results

A total of 379 participants were included in the study. The mean age of the study participants was 20 years (± 1.34). The most prevalent substance use was alcohol (10.8%). About 1.9% and 1.6% of students surveyed consume tobacco and cannabis, respectively.

Conclusion

Facilitating factors for substance use as perceived by the participants were stress, peer pressure, easy availability of substances, socialization, curiosity, and awareness knowledge about safe limits of alcohol and tobacco.

Assessment of Health-Seeking Behavior among Undergraduate Students at a University

Background Students studying at a university of health sciences may have different perceptions regarding illness and treatment. Moreover, as they have access to healthcare, it may influence their health-seeking behavior. It is important to identify the health-seeking behavior of the students and to guide them accordingly.

Methods The present study was designed to assess the health-seeking behavior of undergraduate students. It was a cross-sectional descriptive study. A total of 236 students pursuing undergraduate courses in medicine, dentistry, nursing, and physiotherapy participated in the study. Checklist and perception scales were used to collect data that were then analyzed using descriptive and inferential statistics.

Results Use of the Internet to get information about illness, treatment, and medications (60.3%; 139), self-investigations (50.6%; 122) as well as self-medication practices (54.4%; 130) was commonly seen in students. Among the self-medications, antibiotics (63.7%; 152), antipyretics (45.6%; 109), analgesics (43.9%; 104), and cough syrup (48.9%; 116) were common. Regarding perception on health-seeking behavior, the majority (49.3%; 118) opined neutral for the statement that self-diagnosis is not wrong, (49.4%; 120) reported that over-the-counter medications can be taken, (66.5%; 157) agreed that keeping healthy by eating healthy can keep you away from the hospital. The barriers for health-seeking behavior, stigma, fear of confidentiality issues, fear of unwanted intervention, and unaware where to seek help were more commonly reported for mental healthcare-seeking behavior (odds ratio [OR]: 29.33, 23.18, 34.16, and 11.96, respectively), whereas issues relating to high cost, the long waiting hour in healthcare facility, and fear of side effects were reported for physical healthcare-seeking (OR: 9.80, 7.15, and 18.66, respectively) behavior.

Conclusion Self-investigation, self-medications, and use of the Internet to seek healthcare information are evident among students of university. Students exhibited different health-seeking behavior for physical and mental illnesses. Barriers to health-seeking also differed. Institutions should use this information for the effective usage of healthcare services by students.

Self-medication among medical students at the Copperbelt University, Zambia: A cross-sectional study

BACKGROUND

Self-medication is a common practice and cause for concern globally. There is a paucity of information regarding students' self‑medication in Zambia. Therefore, this study aimed at determining the self‑medication practices among the medical students at Copperbelt University.

METHODS

A descriptive cross-sectional study was conducted among 334 students. Data was collected using a semi-structured questionnaire, entered in excel, cleaned, and exported to SPSS version 21 for statistical analysis. Univariate analysis using Chi-Square or Fishers Exact test was performed. Independent predictors of self-medication practices were determined using logistic regression. Adjusted Odds ratios (AOR) and their 95% confidence intervals are reported.

RESULTS

A total of 334 medical students, with slightly more females (50.3%, n = 168), participated in the study. Of these 61.1% (n = 204) reported self-medicating. Reasons for self-medicating were the presence of long queues at health facilities and lack of time to visit the hospital. Only the year of study was independently associated with self-medicating with those in their 4th year of study being more likely to self-medicate [AOR:3.43, 95% CI: 1.52-7.73].

CONCLUSION

Students should be educated on the consequences of self-medication practices especially the rational use of antibiotics.

Mental health symptoms in electronic football players

Background

The escalated competitive pressure and professionalisation of esports players could predispose them to mental health symptoms. We aimed to develop a model to explore the association between distress and anxiety/depression symptoms and potential associations between adaptive or maladaptive coping strategies, sleeping disturbance, alcohol consumption and eating habits in electronic football players.

Methods

The present exploratory cross-sectional study includes the Distress Screener, General Health Questionnaire, Brief Cope, Sleep Disturbance Domain of the Patient-Reported Outcomes Measurement Information System, Alcohol Use Disorders Identification Test Consumption and a set of questions regarding eating habits. A two-step robust maximum likelihood method of the Structural Equation Modelling approach was used.

Results

Both measurement model (χ²/df=1065.04 (637), p<0.001; Tucker-Lewis Index (TLI)=0.91, Comparative Fit Index (CFI)=0.92, standardised root mean residual (SRMR)=0.07 and root mean square error of approximation (RMSEA)=0.05; 95% CI 0.043 to 0.053) and hypothesised structural model (χ²/df=1131.98 (648); p<0.001; TLI=0.90, CFI=0.91, SRMR=0.07 and RMSEA=0.05; 95% CI 0.054 to 0.06) showed an adequate fit to the data. Stress was positively related with depression and anxiety symptoms. Only anxiety symptoms were linked with coping strategies. Maladaptive coping strategies were related to sleep disturbance, alcohol consumption and poor eating habits, whereas adaptive coping strategies were associated with less sleep disturbance, reduced alcohol consumption and better eating habits.

Conclusion

An integrative approach to help electronic football players when early signs of distress are present might help avoid other mental health symptoms that interfere with players’ well-being and overall health. Additionally, adequate coping strategies to manage anxiety symptoms due to distress may help counteract potential negative consequences for lifestyle habits in electronic football players.

Health behaviors of medical students decline towards residency: how could we maintain and enhance these behaviors throughout their training

BACKGROUND

We examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians.

METHODS

This cross-sectional study was performed among second-year medical students (2015-2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed.

RESULTS

Significantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress.

CONCLUSIONS

The healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them to adopt healthier lifestyles, allowing students and physicians to be better role models and the healthcare system to perform better.

Pharmacology education and antibiotic self-medication among medical students: a cross-sectional study

OBJECTIVE

Pharmacology teaches rational prescribing. Self-medication among medical students is recognised as a threat to rational prescribing. Antibiotic self-medication could cause antibiotic resistance among medical students. We aimed to find an association between pharmacology education and antibiotic self-medication.

RESULTS

Overall, 39% [(110/285) 95% CI 32.9-44.3] of students were found to have antibiotic self-medication. The percentage for antibiotic self-medication progressively increased with the year of study. The percentage of antibiotic self-medication was significantly high in the "Formal Pharmacology Education" group (47%-77/165) in comparison to the "No Formal Pharmacology Education" group (28%-33/120) (P = 0.001032). Overall, the most common self-prescribed antibiotic was amoxicillin (56%-62/110).

Are Level of Education and Employment Related to Symptoms of Common Mental Disorders in Current and Retired Professional Footballers?

BACKGROUND

Mental disorders have become a topic of increasing interest in research due to their serious consequences for quality of life and functioning.

OBJECTIVES

The objective of this study was to explore the relationship of level of education, employment status and working hours with symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, adverse alcohol behaviour, smoking, adverse nutritional behaviour) among current and retired professional footballers.

MATERIALS AND METHODS

Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among current and retired professional footballers. Based on validated scales, an electronic questionnaire was set up and distributed by players' unions in 11 countries across three continents.

RESULTS

A total of 607 current professional footballers (mean age of 27 years) and 219 retired professional footballers (mean age of 35 years) were involved in the study. Among retired professional footballers, statistically significant negative correlations were found between employment status and symptoms of distress and anxiety/depression (P < 0.05), as well as between number of working hours and symptoms of anxiety/depression (P < 0.05). No other statistically significant associations were found among retired players. Among current professional footballers, level of education was not associated with symptoms of common mental disorders.

CONCLUSIONS

Among retired professional footballers, employment status as well as a higher number of working hours was weakly correlated to symptoms of distress and anxiety/depression. Combining a football career with sustainable attention for educational and career planning might be important and of high priority.

Modifiable Risk Factors for Major Non-communicable Diseases Among Medical Students in Nepal

The objective of this study was to assess the prevalence of modifiable risk factors of the major non-communicable diseases (NCDs) among medical students. A cross sectional study was conducted at three randomly selected medical colleges in the Kathmandu Valley in Nepal. All third-year medical students (n = 191) participated in the study. A total of 62.3% of the respondents were male, and 37.7% were female. The mean age of the respondents was 21.5 ± 1.0 (SD) years. A total of 20.4% (n = 39) of the medical students were current tobacco users and 50.8% (n = 97) have ever consumed alcohol. The majority (85.6%) of the medical students did not consume the daily recommended amount of fruits and vegetables. A total of 30.9% (n = 59) of the medical students were involved in low level of physical activity and 42.9% (n = 82) were involved in moderate level of physical activity. This study showed a high prevalence of risk factors of major NCDs among medical students and interventions are needed to change the unhealthy behaviour of medical students being role models in society.

Are severe musculoskeletal injuries associated with symptoms of common mental disorders among male European professional footballers?

PURPOSE

To explore the associations of severe musculoskeletal injuries (joint and muscles) and surgeries with symptoms of common mental disorders (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour , smoking, adverse nutrition behaviour) among male European professional footballers.

METHODS

Cross-sectional analyses were conducted on electronic questionnaires completed by professional footballers recruited from the national players' unions of Finland, France, Norway, Spain or Sweden. The number of severe (time loss of more than 28 days) musculoskeletal injuries (total, joint, muscle) and surgeries during a professional football career was examined through four questions, while symptoms of common mental disorders were evaluated through validated scales.

RESULTS

A total of 540 professional footballers (mean age of 27 years; 54 % playing in the highest leagues) participated in the study. Sixty-eight per cent of the participants had already incurred one or more severe joint injuries and 60 % one or more severe muscle injuries. Prevalence of symptoms of common mental disorders ranged from 3 % for smoking to 37 % for anxiety/depression and 58 % for adverse nutrition behaviour. The number of severe musculoskeletal injuries during a football career was positively correlated with distress, anxiety and sleeping disturbance, while the number of surgeries was correlated with adverse alcohol behaviour and smoking. Professional footballers who had sustained one or more severe musculoskeletal injuries during their career were two to nearly four times more likely to report symptoms of common mental disorders than professional footballers who had not suffered from severe musculoskeletal injuries.

CONCLUSION

It can be concluded that the number of severe musculoskeletal injuries and surgeries during a career is positively correlated and associated with symptoms of common mental disorders among male European professional footballers. This study emphasises the importance of applying a multidisciplinary approach to the clinical care and support of professional footballers, especially when a player faces lengthy periods without training and competition as a consequence of recurrent severe joint or muscle injuries.

LEVEL OF EVIDENCE

III.

The Evidence in Support of Physicians and Health Care Providers as Physical Activity Role Models

Physical inactivity constitutes the fourth leading cause of death worldwide. Health care providers (HCPs) should play a key role in counseling and appropriately referring their patients to adopt physical activity (PA). Previous reports suggest that active HCPs are more likely to provide better, more credible, and motivating preventive counseling to their patients. This review summarizes the available evidence on the association between HCPs' personal PA habits and their related PA counseling practices. Based on relevant studies, a snowball search strategy identified, out of 196 studies screened, a total of 47 pertinent articles published between 1979 and 2012. Of those, 23 described HCPs' PA habits and/or their counseling practices and 24 analytic studies evaluated the association between HCPs' personal PA habits and their PA counseling practices. The majority of studies came from the United States (n = 33), and 9 studies included nonphysicians (nurses, pharmacists, and other HCPs). PA levels were mostly self-reported, and counseling was typically assessed as self-reported frequency or perceived self-efficacy in clinical practice. Most (19 out of 24) analytic studies reported a significant positive association between HCPs' PA habits and counseling frequency, with odds ratios ranging between 1.4 and 5.7 (P < .05), in 6 studies allowing direct comparison. This review found consistent evidence supporting the notion that physically active physicians and other HCPs are more likely to provide PA counseling to their patients and can indeed become powerful PA role models. This evidence appears sufficient to justify randomized trials to determine if adding interventions to promote PA among HCPs, also results in improvements in the frequency and quality of PA preventive counseling and referrals, delivered by HCPs, to patients in primary care settings. Future studies should also aim at objectively quantifying the effect of HCPs' PA role-modeling and how it influences patients' PA levels. More evidence from low-to-middle income countries is needed, where 80% of the deaths due to inactivity and related noncommunicable diseases already occur.

Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players' unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population.

Symptoms of Common Mental Disorders in Professional Football (Soccer) Across Five European Countries

Evidence on the prevalence of symptoms related to distress, anxiety/depression or substance abuse/dependence, - typically referred to as symptoms of common mental disorders (CMD) - is lacking in European professional football (soccer). The aims of the present study were to investigate the prevalence of symptoms related to CMD (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour, and adverse nutrition behaviour) in professional footballers from five European countries, and to explore associations of the outcome measures under study with life events and career dissatisfaction. A cross-sectional design was used. Questionnaires were distributed among professional footballers by the national players' unions in Finland, France, Norway, Spain and Sweden. The highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway). In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour. Results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team. Key pointsThe highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway).In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour.Our results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team.Further research based on longitudinal design should be conducted in order to acquire an insight into the causal relationship between symptoms related to common mental disorders and risk factors.

Prevalence and determinants of symptoms of common mental disorders in retired professional Rugby Union players

The primary aim of this study was to determine the prevalence of symptoms of common mental disorders (CMD) (distress, anxiety/depression, sleeping disturbance, adverse nutrition behaviour, adverse alcohol behaviour and smoking) among retired professional Rugby Union players. The secondary aim was to explore the associations between stressors (life events, Rugby Union career dissatisfaction) and the health conditions under study. Therefore, cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study of retired professional Rugby Union players. An electronic questionnaire was established using validated questionnaires to assess symptoms of CMD and stressors. The electronic questionnaire was subsequently distributed to retired players by the national Rugby Union players' associations in France, Ireland and South Africa. Among 295 retired professional Rugby Union players (mean age of 38 years), prevalence rates were 25% for distress, 28% for anxiety/depression, 29% for sleeping disturbance, 62% for adverse nutrition behaviour, 15% for smoking and 24% for adverse alcohol behaviour. A higher number of life events were associated with distress (OR = 1.2; 95% CI 1.1-1.4), anxiety/depression (OR = 1.6; 95% CI 1.2-2.1), sleeping disturbance (OR = 1.6; 95% CI 1.2-2.1) and adverse nutrition behaviour (OR = 1.8; 95% CI 1.3-2.5). A higher level of dissatisfaction of the player's Rugby Union career was associated with distress (OR = 0.9; 95% CI 0.8-1.0), sleeping disturbance (OR = 0.9; 95% CI 0.9-1.0), smoking (OR = 0.9; 95% CI 0.9-1.0) and adverse nutrition behaviour (OR = 0.9; 95% CI 0.8-0.9). In conclusion, our study suggests that prevalence of symptoms of CMD is high among retired professional Rugby Union players, being associated with both a higher number of life events and a higher level of Rugby Union career dissatisfaction.

Mental and psychosocial health among current and former professional footballers

BACKGROUND

In common with elite athletes from other sport disciplines, severe or recurrent injuries in professional footballers are considered to be major physical and psychosocial stressors, which may predispose to mental health problems during and after their career.

AIMS

To determine the prevalence of mental health problems and psychosocial difficulties in current and former professional footballers, and to explore the association between psychosocial stressors and the health conditions studied.

METHODS

Based on validated scales, a paper and electronic questionnaire was developed for current and former professional footballers and distributed by the World Footballers' Union (FIFPro) and players' unions in six countries. Prevalence was calculated and cross-sectional analyses were conducted.

RESULTS

The response rate was 29% with 253 responses available for analysis. The prevalence of mental health complaints ranged from 5% (burnout) to 26% (anxiety/depression) in 149 current players and from 16% (burnout) to 39% (anxiety/depression) in 104 former footballers. The prevalence of psychosocial problems ranged from 3% (low self-esteem) to 26% (adverse nutrition behaviour) in current players and from 5% (low self-esteem) to 42% (adverse nutrition behaviour) in former footballers. In both current and former players, mental health problems were significantly associated with low social support (odds ratio [OR] = 1.1) and recent life events (OR = 1.4-1.6). In former players, previous surgery was significantly associated with smoking (OR = 1.9).

CONCLUSIONS

The prevalence of mental health problems and/or psychosocial difficulties in current and former professional footballers was found to be high. The presence of mental health problems was associated with low social support and recent life events.

Self-medication practices and risk factors for self-medication among medical students in Belgrade, Serbia

Introduction

Self-medication among future health care professionals can represent a serious threat to professionalism in medicine and it has potential to put at risk public trust into this profession. The aim of this research was to investigate prevalence and risk factors for self-medication among population of medical students, because it was previously shown that their attitudes towards pharmacotherapy could affect the way they could prescribe medication in the future.

Material and Methods

Research was performed as a cross-sectional study and it included 1296 (84.1%) 1st, 3rd and 6th year students of School of Medicine, University of Belgrade. Students filled out a demographic and self-medication questionnaire created for the purpose of this research and the Physical Health Questionnaire – 9 (PHQ-9). Questions about self-medication were related to the period of the previous year.

Results

Self-medication was reported by 79.9% students. The most frequently self-prescribed medications were analgesics (55.4%). Independent risk factors for self-medication were possession of home-pharmacies (OR = 5.3, CI 95% 3.89–7.23), lower level of father's education (OR = 1.6, CI 95% 1.18–2.25), consumption of alcoholic beverages (OR = 1.5, CI 95% 1.13–2.08), less than 1 hour spent in physical activity per week (OR = 1.4, CI 95% 1.00–2.02), female gender (OR = 1.4, CI 95% 1.02–1.89), older age (OR = 1.1, CI 95% 1.07–1.21) and higher PHQ-9 score (OR = 1.09, CI 95% 1.05–1.12).

Conclusions

Self-medication is an important issue among population of medical students. Prevalence of self-medication could be controlled through regulatory authorities and further education.

Nível de atividade física e acúmulo de tempo sentado em estudantes de medicina

OBJETIVO: Verificar, no período de dez anos, o comportamento do nível de atividade física e do acúmulo de tempo sentado em estudantes de Medicina.MÉTODOS: A amostra foi composta por 186 estudantes do terceiro ano em 2000-2001 (grupo I) e em 2011 (grupo II) com média de idade de 21,23 ± 1,38 anos. Os dados do nível de atividade física e do tempo sentado foram coletados através do questionário IPAQ (versões curta e longa). Os questionários foram aplicados individualmente e foram autopreenchidos.ANÁLISE ESTATÍSTICA: Os resultados foram descritos através de frequência e porcentagem do nível de atividade física e média e desvio padrão para o acúmulo de tempo sentado. A comparação foi feita através do teste do qui-quadrado e do teste t para amostras independentes, sendo o nível de significância adotado de p < 0,05.RESULTADOS: No período de dez anos foi encontrada uma diminuição acentuada e significante de 27,4% entre os indivíduos que atingiram as recomendações no grupo I (75,2%) em relação aos que atingiram no grupo II (47,8%). O acúmulo de tempo sentado não apresentou diferenças significantes, sendo as médias encontradas de =8,92 e =8,72 horas para dias de semana e de =7,27 e =7,70 horas para dias do fim de semana.CONCLUSÃO: Após dez anos, os estudantes de medicina apresentaram menor nível de atividade física sendo que não houve mudança no acúmulo de tempo sentado.

'Being sick a lot, often on each other': students' alcohol-related provocation

CONTEXT

Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent (n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK.

METHODS

A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation.

RESULTS

Seventy-five per cent (n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% (n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred.

CONCLUSIONS

Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption.