RESUMO
Background The increasing production, distribution, promotion, and availability of substances contemporaneous with the changing values of society have resulted in rising substance abuse as an emerging public health concern in India. A prevalence of 32-37% has been reported for substance abuse in various studies conducted in Uttarakhand but there is a dearth of data on socio-epidemiological factors affecting substance abuse. Materials & methods A facility-based observational cross-sectional study was conducted in selected de-addiction and rehabilitation centers of district Dehradun. Data were collected using multistage systematic random sampling from clients admitted to the facility. Results The mean age of in-facility participants was 28 ± 8 years and most of them started taking drugs after the age of 18 years. The most common substance of abuse was alcohol (61.7%) followed by tobacco smoking (15.6%). Both 'peer pressure' and 'curiosity' play a major role in predisposition to substance use. Further, we found that age (p=0.002), and level of education (p <0.001) were important determinants for substance abuse. At the same time, among other factors, the influence of occupation notably did not have a statistically significant association. Conclusion Sensitization and capacity building of both providers and the community is integral to effective strategizing for the prevention and control of substance abuse. Regional studies including the current study can be of help in framing drug policies and management guidelines including prioritizing the importance of the establishment of de-addiction and rehabilitation centers at the district level.
RESUMO
BACKGROUND: COVID-19 pandemic has forced medical education to undergo sudden metamorphosis from the traditional face-to-face education to distance online learning. This transition was dealt with a lot of infrastructure and technical difficulties from both teacher and learner ends, especially in a developing country like India. This study was conducted with the aim of analyzing students' perspective and problems faced in the live online teaching. MATERIALS AND METHODS: This was a prospective longitudinal study conducted on medical students enrolled in the 1st, 2nd, and 3rd years of Bachelor of Medicine and Bachelor of Surgery courses at a government medical college located in hilly state Uttarakhand, India. Clearance from the institutional ethical committee was obtained. The students were invited to voluntarily participate in online survey by filling Google Forms which was E-mailed as well as shared in social media platform. A total of 237 medical students participated. The first survey was conducted at the time of initiation of online mode of teaching, during May 1-7, 2020, and second, after completion of 6 months of regular online teaching, during November 1-7, 2020. The questionnaire comprised initial section on demographic details and consent followed by 27 and 30 sets of statements pertaining to online medical education experience in the first and second questionnaires, respectively. A 5-point Likert scale was used. Data were analyzed using IBM SPSS version 24.0. Chi-square test was applied for association, and P ≤ 0.05 was considered statistically significant. RESULTS: A total of 237 students participated in the study. The response rate was 52.7%. Majority of respondents had suitable devices (89.1%) and Internet facilities (62%) for online classes. The students accepted the new method of teaching very well, but for practical sessions and clinics, traditional classes were necessary. Long screen time, lack of student-teacher interaction, and interaction with peers were major concerns of students. However, over the study period, the availability of resources, friendliness toward technology, and inclination toward virtual classes increased. CONCLUSIONS: The pandemic has introduced to a new normal where online teaching cannot be ignored. Despite challenges faced during online learning, 65.5% of students preferred hybrid teaching in future for delivering medical education. Acceptance for online education by students increased over time in the study.