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1.
BMJ Open ; 11(4): e044397, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33849850

RESUMEN

OBJECTIVES: To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. PARTICIPANTS: 395 HCWs aged ≥18 years. MAIN OUTCOME MEASURES: Depression, anxiety and stress scores. RESULTS: Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI -5.233 to -1.692) and stress, p<0.001 (95% CI -5.364 to -1.591). CONCLUSIONS: This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.


Asunto(s)
Ansiedad/epidemiología , COVID-19/psicología , Depresión/epidemiología , Personal de Salud/psicología , Estrés Laboral/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología
2.
Phys Occup Ther Pediatr ; 41(6): 637-654, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33745416

RESUMEN

AIMS: Describe the pre-operative and post-operative stages of physical therapy examination, rehabilitation interventions and outcomes in craniopagus conjoined twins (CCT). METHODS: 27-months old total vertical types III CCT were admitted for surgical treatment. A structured rehabilitation program (functional mobility, balance training, sensory stimulation, communication, orthotic management, and caregiver education) was delivered post-operatively at different stages of surgery. The total duration of post-separation rehabilitation was 15 months for Twin A and 23 months for Twin B. RESULTS: Pre-operative WeeFIM was 67/126 for both the twins. Post-separation, Twin A improved to a state of complete independence in walking, step climbing, and hand function with a discharge WeeFIM score of 84/126. However, Twin B was completely dependent in bed mobility and transfer activities during discharge (WeeFIM-18/126). Minimal change in functional status was noted in Twin B (discharge FSS score-19/30). Both the twins were transferred to a regional hospital for long-term care. At 67 months of age, Twin B lost his life due to chest infection. CONCLUSIONS: Vestibular based therapies, balance, and postural control may be prioritized in the rehabilitation process of CCT. Greater communication and coordination among physical, occupational therapists and other rehabilitation professionals are recommended for successful outcome in these unique cases.

3.
Psychol Health Med ; : 1-6, 2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33719750

RESUMEN

Depression, anxiety and stress are the most prevalent mental health problems among health professions' students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions' students. Using non-random purposeful sampling, 366 health professions' students studied in 2018/19 were surveyed via a self-reported questionnaire that included Depression, Anxiety and Stress Scale (DASS-21) and questions on sociodemographic and educational characteristics. The majority of respondents were from the School of Medicine (59.8%), with 116 males and 250 females. Sleep duration, communication problems with teaching staff, feelings of inferiority to friends and family problems were determined to be independent predictors of depression in the current study. Communication problems with teaching staff, feelings of inferiority to friends and family problems were important predictors of anxiety. Further, we found that feelings of inferiority to friends and family problems were found to be important risk factors for stress. Our results suggest that the overall prevalence of depression, anxiety and stress among health professions' students were considerably high. All students having a severe mental health issues should be supported by the student counselling centre and expert clinicians in order to confirm the diagnosis and implement subsequent treatment strategies.

4.
Res Dev Disabil ; 107: 103790, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33091712

RESUMEN

BACKGROUND: While COVID-19 outbreak has had adverse psychological effects in children with special needs, the mental state and burden on their caregivers during this pandemic has yet to be reported. AIMS: The objectives of this study were to describe the mental health status and the change in perceived strain among caregivers during the COVID-19 outbreak. METHODS AND PROCEDURES: Two hundred sixty four caregivers completed an online survey that assessed demographics, use and perspective on tele-rehabilitation, homecare therapy, caregiver's strain and mental health. OUTCOMES AND RESULTS: The prevalence of depression, anxiety and stress symptoms were found to be 62.5 %, 20.5 % and 36.4 % respectively. A significant difference in caregiver strain (p <  0.001, effect size = 0.93) was observed during the outbreak compared to levels pre-outbreak (pre-outbreak strain was measured retrospectively). Caregivers not using tele-rehabilitation along with a perception of it being a poor medium for rehabilitation were at greater risks for poor mental health whereas a negative perception on homecare therapy were strongly associated with higher psychological symptoms and strain. CONCLUSIONS AND IMPLICATIONS: This study identified a high prevalence of depression and significant change in strain displayed by caregivers during the COVID-19 outbreak. We identified several factors associated with poor mental health and perceived strain that can be used to help safeguard caregivers.


Asunto(s)
Ansiedad/psicología , COVID-19 , Carga del Cuidador/psicología , Cuidadores/psicología , Depresión/psicología , Trastornos del Neurodesarrollo/rehabilitación , Padres/psicología , Estrés Psicológico/psicología , Telerrehabilitación , Factores de Edad , Ansiedad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/rehabilitación , Actitud Frente a la Salud , Trastorno del Espectro Autista/fisiopatología , Trastorno del Espectro Autista/rehabilitación , Carga del Cuidador/epidemiología , Cuidadores/estadística & datos numéricos , Parálisis Cerebral/fisiopatología , Parálisis Cerebral/rehabilitación , Niño , Preescolar , Depresión/epidemiología , Discapacidades del Desarrollo/fisiopatología , Discapacidades del Desarrollo/rehabilitación , Síndrome de Down/fisiopatología , Síndrome de Down/rehabilitación , Femenino , Estrés Financiero , Estado Funcional , Servicios de Atención de Salud a Domicilio , Humanos , Renta , India/epidemiología , Discapacidades para el Aprendizaje/fisiopatología , Discapacidades para el Aprendizaje/rehabilitación , Masculino , Salud Mental , Trastornos del Neurodesarrollo/fisiopatología , Prevalencia , Disrafia Espinal/fisiopatología , Disrafia Espinal/rehabilitación , Estrés Psicológico/epidemiología , Teletrabajo , Carga de Trabajo
5.
Med Sci (Basel) ; 8(2)2020 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-32527019

RESUMEN

Quality of life (QOL) is a broader concept which represents experiences, states, appraisals, behaviors, capacities and emotional reactions to circumstances. The study aimed to evaluate the differences in various domains of QOL among the students of five schools (medicine, dentistry, veterinary medicine, pharmacy and nursing) and an optometry unit in the Faculty of Medical Sciences, Trinidad and Tobago. Further, the study evaluated the factors (sociodemographic variables and academic performance) predictive of physical, psychological, social and environment domains of quality of life. The research tool consisted of a validated questionnaire which had two sections; (1) sociodemographics inclusive of students' cumulative grade point average and (2) the shorter version of WHO quality of life (WHOQOL-BREF). The data were transformed into a linear scale and exported into the IBM SPSS version 24 where t-tests, one-way ANOVA and stepwise regression were performed. Of the total 535 participants, most 383 (71.6%) were females. While comparing the differences in the domains of QOL that existed based on the schools (professions) they were enrolled, significant differences were recorded for physical (p < 0.05), psychological (p < 0.05) social (p < 0.05) and environmental domains (p < 0.05). Though the domains of physical health, psychological health and environment showed a significant association with the academic performance of students, the social domain had no such relationship. The overall quality of life has a positive connection with the academic performance of students in medical and health professions. Therefore, universities and all stakeholders involved in health professions need to play a critical role to ensure the students in health professions maintain a high QOL. At the same time, there is a great need for extra attention for students who showed poor academic performance in the previous semester to bring them on track.

6.
J Vet Med Educ ; 47(6): 668-677, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32053048

RESUMEN

Educational environment has a significant impact on students' learning and academic achievement. The aim of this article was to explore the perception of veterinary school students' regarding their educational environment at the University of the West Indies. In this cross-sectional study, the Dundee Ready Education Environment Measure (DREEM) was administered to veterinary undergraduate students from year 2 to year 5. The DREEM questionnaire consists of 50 items with five subscales: students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of atmosphere, and students' social self-perceptions. Each item was scored on a 5-point Likert scale ranging from strongly disagree (0) to strongly agree (4). The Cronbach's alpha for the overall DREEM score was 0.92, and for the five subscales, it ranged from 0.66 to 0.83. A total of 99 students responded (response rate: 86%). The students' overall DREEM mean score was 106.59 out of the global mean score of 200, indicating that students' perception of the educational environment was generally more positive than negative. In the five DREEM subscales, students were found to have a more positive perception of learning (55.15%); students' perception of teachers was generally positive (61.41%); and their perception of academic atmosphere was also positive (57.75%). Conversely, students' academic self-perception (51.41%) and social self-perception (42.61%) trended negatively. The findings suggest that improvement is needed in significant areas in the veterinary school, including curriculum review, faculty development, provision of sports and cultural facilities, stress management, and academic support systems.


Asunto(s)
Educación de Pregrado en Medicina , Educación en Veterinaria , Estudiantes de Medicina , Animales , Región del Caribe , Estudios Transversales , Humanos , Percepción , Facultades de Medicina Veterinaria , Encuestas y Cuestionarios , Indias Occidentales
7.
J Bodyw Mov Ther ; 24(1): 56-62, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31987563

RESUMEN

INTRODUCTION: Tumors are generally considered as red flags to manual therapy. The purpose of this report is to describe the clinical course of a patient diagnosed with spinal Schwannoma at L2-L3 level, who was referred to physiotherapy (PT) for the treatment of low back pain radiating to the left lower limb. CASE DESCRIPTION: A 30-year old man previously diagnosed with L2-L3 Schwannoma was referred for physiotherapy for the treatment of radiating pain. The patient had not responded favorably to symptomatic management. As the patient's history and physical examination were consistent with a mechanical dysfunction, it was decided to manage the patient along similar lines. The patient was treated with McKenzie extension and central postero-anterior mobilization over T4-T6 vertebrae. This intervention was followed up with strengthening and aerobic exercises. RESULTS: The outcomes were measured by the numerical rating scale (NRS), Oswestry Disability Index (ODI) and the Global rate of Change (GRC) scale. The patient responded well to McKenzie extension exercises and Thoracic mobilization. The NRS (7 at rest; 10 on activity) at the time of referral reduced to (2 on activity) at the time of discharge. The outcomes were maintained after 7 months. CONCLUSION: This case suggests that there is a need to undertake a detailed musculoskeletal examination and mobilization may be safely performed in patients diagnosed with spinal schwannomas. An individualized tailored approach may be beneficial in these patients.


Asunto(s)
Dolor de Espalda/terapia , Manipulación Espinal/métodos , Músculo Esquelético/fisiopatología , Neurilemoma/terapia , Adulto , Dolor de Espalda/etiología , Humanos , Masculino , Neurilemoma/complicaciones , Dolor , Examen Físico , Vértebras Torácicas/fisiopatología
8.
J Educ Health Promot ; 8: 57, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31008124

RESUMEN

Globally, health is regarded as a booming industry with greater stress being laid on high quality, accountability, and transparency. Traditional medical curricula rely primarily on clerkships during the clinical period of study to train clinical skills, while the preclinical period is mainly used to teach the basic sciences. In recent years, the early introduction of clinical skills training has received increased attention. This review aims to identify and summarize teaching approaches of clinical skills for medical students during preclinical years, namely, (1) framing objectives (2) learning activities, and (3) evaluation strategies. Although the clinical tutor's role is to ensure that students receive effective preclinical skills through different modes of learning (lectures, presentations, and problem-based learning), the role of advanced technologies, namely, simulation-based learning platforms and gamification are found to be very successful. To improve the communication skills, there is strong evidence in support of role plays, and similarly, for enhancing observation skills, an introduction of fine arts in clinical skills training was found to be very useful. Medical schools worldwide should give high priority to conduct faculty development programs on various aspects of training and teaching modalities, evaluation strategies, and improving the evaluation of various clinical skills. Students should be provided with sufficient learning opportunities including a well-equipped clinical skills laboratory and individual attention, and constructive feedback should be given to students for building their confidence level during their learning process.

9.
Physiother Res Int ; 24(1): e1747, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30226651

RESUMEN

OBJECTIVES: The evidence for the effectiveness of interventions targeting acute low back pain (LBP) is suboptimal. It is difficult to identify those patients who are more likely to develop chronic pain and disability after an acute episode of LBP. These shortcomings may be attributed to considering LBP as one homogenous condition. METHODS: In this quasi-experimental study, we examined and analysed a prospective cohort of 267 patients with first-onset LBP and classified them into one of the groups based on treatment-based classification: direction-specified exercises (Group 2), manipulation (Group 3), stabilization exercises (Group 4), traction (Group 5), and a physician care group (Group 1). Disability and pain were assessed at baseline, after treatment, and at 6 months using the Oswestry Disability Index and the Numerical Rating Scale, respectively. Comparisons were made between the groups, and we predicted measures of disability and pain intensity at 6 months with age, gender, fear avoidance behaviour, centralization phenomenon (CP), expectations about recovery, CP, group classification, baseline pain, and disability. RESULTS: Analysis showed that all the heterogeneous groups of LBP improved their outcomes with the respective treatment provided. However, when the entire sample was considered as one homogenous group of LBP, the results showed improvement with time (p < 0.05) only and no difference was found between groups (p > 0.05). None of the studied factors, except baseline pain (R = 0.227, R2  = 0.051, p < 0.05), were able to accurately predict the development of chronic pain in our study sample. CONCLUSION: Though our results showed no differences between the subgroups in the reduction of pain and disability, we conclude that classifying and treating patients with LBP into subgroups based on signs and symptoms produce better outcomes. Baseline pain alone may predict a small percentage of people who may develop chronic pain.


Asunto(s)
Reacción de Prevención , Evaluación de la Discapacidad , Miedo , Dolor de la Región Lumbar/clasificación , Dimensión del Dolor/métodos , Enfermedad Aguda , Adulto , Personas con Discapacidad/clasificación , Ejercicio Físico , Terapia por Ejercicio , Femenino , Humanos , Dolor de la Región Lumbar/rehabilitación , Masculino , Persona de Mediana Edad , Estudios Prospectivos
10.
J Educ Health Promot ; 7: 30, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29629391

RESUMEN

OBJECTIVES: The objective of this study was designed to investigate medical students' perceptions of small group teaching effectiveness in a hybrid curriculum. MATERIALS AND METHODS: A cross-sectional, descriptive survey was conducted at the School of Medicine, The University of the West Indies, St. Augustine where we collected the data from 195 undergraduate students. A self-administered questionnaire consisting of 25 items was used to measure students' perception on the effectiveness of problem-based learning (PBL) with regard to learning experience, teamwork, confidence, communication skills, and role of the tutor. Statistical analyses included mean and standard deviation for the description of each item; t-test to compare the mean scores for gender and class year, and one-way analysis of variance between groups for age group comparisons. RESULTS: The students overall perceptions of small group teaching effectiveness showed that the PBL sessions were beneficial to their learning process (mean: 3.63 ± 0.46). Students have positive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.98 ± 0.63) and teamwork (mean: 3.67 ± 0.58). The mean scores, measuring teamwork, for 2nd year students was significantly higher than that for 1st year students (3.76 ± 0.55 and 3.55 ± 0.60 respectively, P = 013). A similar significant trend was observed between 2nd year and 1st year students on communication skills (3.48 ± 0.67 and 3.29 ± 0.55, respectively, P = 0.046). CONCLUSIONS: PBL is an effective small group teaching method for medical students. Faculty development and students' training programs are required before implementing PBL.

11.
N Am J Med Sci ; 2(8): 392-4, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22737679

RESUMEN

CONTEXT: Superior mesenteric artery syndrome is a life- threatening upper gastrointestinal disorder due to compression of duodenum as it poses a difficult diagnostic dilemma. Third part of duodenum is in fixed compartment bounded anteriorly by the root of mesentery and superior mesentery artery and posteriorly by the aorta and lumbar spine. On barium contrast study and abdominal computerized tomography (CT) showed the dilatation of second part of duodenum and compression of the third part of duodenum between aorta and superior mesentery artery. CASE REPORT: A 22 year young asthenic man admitted with the complaint of recurrent abdominal pain, epigastric fullness, and vomiting and weight loss. Abdominal examination revealed epigastric fullness and hyper peristaltic bowel sounds. Upper gastrointestinal barium study showed a dilated stomach with dilated second part of the duodenum and cut off at the third part of duodenum with no intrinsic mucosal abnormalities. There was no relief of obstruction in the left lateral decubitus or prone position. Conservative treatment was tried for one month but failed. Intra-operative findings confirmed the extrinsic obstruction of third part of duodenum with distension of 2(nd) part. A retrocolic duodenojejunostomy, side to side anastomosis done. In post-operative follow up, patient was symptom free. CONCLUSION: Superior mesentery artery syndrome is a life threatening disease. It should be treated as soon as possible. Conservative trial can be given but Surgery is the treatment of the choice.

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