Enhanced dietary awareness and lifestyle changes in first-year medical students following exposure to problem-based nutrition education

BackgroundThe ever-increasing prevalence of chronic lifestyle-associated diseases has resulted in greater awareness of the importance of preventative medicine and its incorporation as an integral component of modern undergraduate medical curricula. As excessive dietary intake and physical inactivity are widely acknowledged as leading risk factors for the onset of chronic lifestyle-associated diseases, the promotion of a healthy lifestyle is regarded as a priority for today's primary care physicians. For this reason, it was deemed appropriate by the designers of the problem-based learning (PBL) curriculum, which was introduced at the Nelson R. Mandela School of Medicine in 2001, to include a six-week Nutrition theme early in the medical students' five-year curriculum. This study set out to determine the impact of this theme, which included a specific focus on the importance of nutrition in avoiding lifestyle-associated disorders, on the dietary awareness and lifestyle of the 2004 intake of medical students.MethodsFirst-year medical students (n = 213) spent the first six weeks of their curriculum (following an orientation period) engaged in a problem-based learning Nutrition theme, which included active, personalised learning experiences such as analysing their own dietary intakes and recording their personal anthropometric measures. They were questioned two weeks after conclusion of the theme regarding (i) the impact of the theme on their dietary awareness and lifestyles, (ii) whether they had, since the start of the theme, shared their newly acquired insights with others, and (iii) the extent to which they recalled their personal measured anthropometric data and calculated kilojoule (kJ) intakes derived during the practical sessions.ResultsNearly 84% of the students responded to the anonymous survey (n = 178). A greater awareness of their personal dietary intake following the completion of the Nutrition theme was acknowledged by 88.2% (n = 157), while 65.1% (n = 116) reported improvements to their general lifestyle. Eighty-five percent reported having counselled family members and friends about diet and lifestyle-related issues in the eight-week period since the start of the theme. While recall of body mass indices was higher (p >0.01) in females (85.8 %) than in males (61.5 %), recall of daily kJ intakes was independent of gender. Unsolicited mention by the students surveyed in this study of components of the South African Food-based Guidelines and recent alternative food pyramids suggests that these models were recognised as health priority areas by this student cohort.ConclusionThe introduction of a Nutrition theme at the start of the problem-based medical learning curriculum appeared to have impacted significantly on the dietary awareness and lifestyles of the students surveyed, with a tendency among students to share this awareness with others. From the open-ended responses of the students, the findings of this study appear to confirm that medical students appreciated learning about their own health factors, and that personalising the information made the learning experience more valuable to them. Attitudinal changes and apparent internalisation of the newly acquired nutritional awareness were reflected by the high percentage of students who acknowledged that they had advised others within the two-week period following the completion of the theme. This augurs well for the potential preventative counselling practices of these future medical graduates. It will, however, be of interest to survey this student cohort longitudinally to establish whether their changed perceptions have a longer term impact and result in attitudes and practices that support preventative health care.For full text, click here:SA Fam Pract 2006;48(7):15-15

Perceptions of final-year medical students towards the impact of gender on their training and future practice

Jacqueline M Van Wyk,1 Soornarain S Naidoo,2 Kogie Moodley,1 Susan B Higgins-Opitz3 1Nelson R. Mandela School of Medicine, University of KwaZulu‑Natal, 2Faculty of Health Sciences, Durban University of Technology, 3School of Health Sciences, University of KwaZulu‑Natal, Durban, South Africa Introduction: Following policy implementations to redress previous racial and gender discrepancies, this study explored how gender impacted on the clinical experiences of final-year medical students during their undergraduate training. It also gathered their perceptions and expectations for the future.Methods: This cross-sectional, mixed-method study used a purposive sampling method to collect data from the participants (n=94). Each respondent was interviewed by two members of the research team. The quantitative data were entered into Excel and analyzed descriptively. The qualitative data were transcribed and thematically analyzed.Results: The majority of the respondents still perceived clinical practice as male dominated. All respondents agreed that females faced more obstacles in clinical practice than males. This included resistance from some patients, poor mentoring in some disciplines, and less support from hostile nurses. They feared for their personal safety and experienced gender-based stereotyping regarding their competency. Males thought that feminization of the profession may limit their residency choices, and they reported obstacles when conducting intimate examinations and consultations on female patients. Both males and females expressed desire for more normalized work hours to maintain personal relationships.Conclusion: Social redress policies have done much to increase equal access for females to medical schools. Cultural values and attitudes from mentors, peers, and patients still impact on the quality of their clinical experiences and therefore also their decisions regarding future clinical practice. More mentoring and education may help to address some of the perceived obstacles. Keywords: South Africa, opportunities, challenges, stigma, racial stereotypes, student

IgG Antibody responses in mice coinfected with Toxocara canis and other helminths or protozoan parasites

The immune response expressed by IgG antibodies in BALB/c mice experimentally infected with Toxocara canis, was studied with the aim of verifying the possible in vivo cross-reactivity between antigens of T. canis and other parasites (Ascaris suum, Taenia crassiceps, Schistosoma mansoni, Strongyloides venezuelensis and Toxoplasma gondii). Experiments included three groups of mice: one infected only by T. canis, another with one of the other species of parasites and a third concomitantly infected with T. canis and the other species in question. Animals were bled by orbital plexus at 23, 38 and 70 days post infection (p.i.). Sera were analyzed for anti-Toxocara antibodies by ELISA and Immunoblotting, using excretion-secretion antigens (ES), obtained from culture of third-stage larvae of T. canis. For all experiments a control group comprised by ten non-infected mice was used. Only in the case of A. suum infection, in these experimental conditions, the occurrence of cross-reactivity with T. canis was observed. However, in the case of co-infection of T. canis - S. mansoni, T. canis - S. venezuelensis and T. canis - T. crassiceps the production of anti-Toxocara antibodies was found at levels significantly lower than those found in mice infected with T. canis only. Co-infection with S. mansoni or S. venezuelensis showed lower mortality rates compared to what occurred in the animals with single infections. Results obtained in mice infected with T. canis and T. gondii showed significant differences between the mean levels of the optical densities of animals infected with T. canis and concomitantly infected with the protozoan only in the 23rd day p.i