@article { author = {}, title = {Assessment of Medical Students’ Readiness for Self-directed Learning}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {1-12}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6866}, abstract = {Background:Importance of self-directed learning (SDL) has been discussed over a long time. More recently, SDL has been described as the most effective mode of learning for individuals in the information age as it is the way for coping with the constant changes in knowledge.Objective: This study aimed at exploring the SDL readiness of the students of the second year undergraduate medical students.Methods:The study was a descriptive cross-sectional one conducted at IbnSina National College for Medical Studies (ISNC) on all the second year medical students during the academic year 2014-2015. We used the self-directed learning readiness scale (SDLRS) developed by Fisher et al (2001) which contained 40 items grouped under 3 sub-scales: Self-management, Desire for Learning, and Self-control. Descriptive statistics together with regression analysis were applied using SPSS v.20.Results:The mean score for students in SDL readiness was 159.25(range: 117 to 193), with 76.2% of students who got scores ≥ 150 and 23.8% of them who got scores < 150. Among three subscales, “Self-control” got the highest mean score (4.15) followed by “Desire for Learning” (4.07), while “Self-management” got the lowest mean score (3.69) on a 5-point scale. Females got higher SDLRS scores than males. There was a positive linear relationship between GPA and SDLRS score.Conclusion:Studentsin ISNC showed a satisfactory degree of readiness for self-directed learning, which was positively related to the academic achievement represented by GPA. Females showed significantly more readiness than males.}, keywords = {Self-Directed Learning,IbnSina National College in Jeddah,SDLRS}, url = {https://ejcm.journals.ekb.eg/article_6866.html}, eprint = {https://ejcm.journals.ekb.eg/article_6866_4db901eb52e1d407a8be5bd8479b20c6.pdf} } @article { author = {}, title = {Accuracy of blood pressure-to-height ratio for screening elevated blood pressure in Egyptian adolescents aged 11-15 years}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {13-29}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6867}, abstract = {Objective: This study aims to validate measures of blood pressure-to-height ratios (BPHR) inscreening for elevated blood pressure (EBP) in a sample of the Egyptian adolescence aged 11-15 years.Methods: A cross sectional study was conducted on a sample of 1707 students aged11-15 years. Elevated blood pressure was defined according to the international gold standarddefinition. Systolic and diastolic BPHR (SBPHR and DBPHR) were calculated for boys andgirls, and their ability to identify EBP has been determined by the area under the curve of thereceiver operator characteristic curves. Sex-specific optimal cut-off points were determinedalong the curve, and their sensitivity, specificity, positive and negative predictive values(PPVs, and NPVs), and positive and negative likelihood ratios (LR+, and LR-) wereestimated. Results: The accuracy of SBPHR and DBPHR in diagnosing EBP in both sexesranged from 0.906 to 0.981. For diagnosing systolic and diastolic pre-hypertension (pre-HTN), the optimal cut-off points were: 0.69, 0.44 in boys, and 0.71, 0.46 in girls respectively.For diagnosing systolic and diastolic hypertension (HTN), the corresponding values were0.75, 0.49, and 0.75, 0.50 respectively. These determined cut-off points revealed highsensitivity (0.88-1.00), moderate to high specificity (0.77-0.95), high NPVs (0.99-1.00), lowPPVs (0.15-0.38), and variable likelihood ratio values (LR+: 3.8-20.0, and LR-: 0.0-.36.0).Conclusion: Blood pressure-to-height ratios are considered of high accuracy inidentifying pre-HTN and HTN in the Egyptian adolescents aged 11-15 years. Further researchis needed for examining the performance of the BPHR in other age groups, in high riskadolescents, and for examining the performance of modified ratios.}, keywords = {Adolescents,blood pressure-to-height ratios,elevated blood pressure,Prehypertension,Hypertension}, url = {https://ejcm.journals.ekb.eg/article_6867.html}, eprint = {https://ejcm.journals.ekb.eg/article_6867_75d356300dcbeb432c1705bb1a28cbfc.pdf} } @article { author = {}, title = {Hypertension and Dyslipidemia among Type II Diabetic Patients and Related Risk Factors and Complications}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {31-43}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6868}, abstract = {Background:Diabetics are likely to develop hypertension. Hypertension occurs in about 70%of type II diabetics moreover, it clusters with other cardiovascular risk factors such as obesity,insulin resistance and dyslipidemia.Objective:To estimate the prevalence of hypertension anddyslipidemia amongtype II diabetic patients and to identify common risk factors andcomplications of type II diabetes with hypertension.Methods:A Cross sectional study wasconducted on type II diabetics attending outpatient clinics at Zagazig University and El-AhrarHospitals.Participants were selected by systematic random sampling. Data were collectedabout participants’ socio-demographic characteristics, life style risk factors, andexistentdiabetic complications.Blood pressure, Body Mass Index,serum fasting glucose, totalcholesterol, and triglyceride levels were measured.Results:Prevalence of hypertension,hypercholesterolemia and hypertriglyceridemia were 68%, 57.3%, and 47% respectively.Hypertension significantly occurred among female, elderly,and low social patientsandassociated with family history of DM, physical inactivity or not following diabetic diet.Diabetic hypertensive patients were significantly obese and havinghigh cholesterol andfasting blood sugar (FBS). They were significantly complicated with FBS >300 mg/dl, ocularand cardiovascular diseases.Conclusion:There was increased prevalence of hypertension anddyslipidemia among type II diabetics. Hypertension was common in low social old agedobese diabetic patients not following diabetic diet and regular exercise and those with highcholesterol and fasting blood sugar. Hypertensive diabetics were prone to many complicationsas hyperglycemia, ocular problems and CVD.Recommendations:Further studies are neededto explore related risk factors of hypertension and dyslipidemia among type II diabetics,Health education programs are recommended for both clinicians and diabetic patients forearly detection and management of hypertension and dyslipidemia.}, keywords = {Hypertension,dyslipidemia,prevalence,Type II diabetes,risk factors,Complications}, url = {https://ejcm.journals.ekb.eg/article_6868.html}, eprint = {https://ejcm.journals.ekb.eg/article_6868_e84462eebf38bd5d7c4f0915248dc93c.pdf} } @article { author = {}, title = {Predictors of Stunting among Children Attending the National Nutrition Institute in Egypt}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {45-60}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6869}, abstract = {Back ground: Child malnutrition is a major public health problem in low income and middleincome countries especially among marginalized populations. Stunting contributes to 14.5%of annual deaths and 12.6% of disability adjusted life years (DALYS) in under-5 yearschildren. Objective: To identify factors contributing to stunting among a sample of children.Methods: A case control study was conducted at the National Nutrition Institute, Egypt. Thestudy recruited 300 children aged 2-8 years, 148 stunted children as cases and 152 nonstuntedas control. Anthropometric measurements were assessed, socio economic status wasevaluated, dietary assessment was done using 24 hours recall and food frequencyquestionnaire, previous feeding practices, and morbidities in the last two weeks wereassessed. Results: Four logistic regression models were developed to predict stunting basedon the framework developed by the WHO. Mothers’ education was the only socioeconomicpredictor of stunting where low maternal education attainment was associated with stunting.Formula feeding during first six moth of life was associated with reduced stunting. Childrenwith history of delayed milestones were 2.4 times more likely to be stunted (p=0.002) whilechildren with history of rickets were four times more likely to be stunted (p=0.007). Bothanemia and chest infection increased the risk of being stunting by two folds. Dietarypredictors included milk, meat and calcium consumption where meeting milk and meatgroups recommendation reduced risk of being stunted by 80% and 40% while reducedcalcium intake by 1 mg increase risk of being stunting by 1%. Conclusion: maternaleducation, previous formula feeding, previous morbidities and decrease intake of milk andmeat groups are significant predictors for stunting.}, keywords = {}, url = {https://ejcm.journals.ekb.eg/article_6869.html}, eprint = {https://ejcm.journals.ekb.eg/article_6869_0c33918e0b7effc856a60d8efcb9517c.pdf} } @article { author = {}, title = {Burnout Syndrome: Determinants and Predictors among Medical Students of Tanta University, Egypt}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {61-73}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6870}, abstract = {Objective: to study the magnitude of burnout syndrome, its determinants and predictorsamong medical students of Tanta University.Methods:A cross-sectional study wasconducted using The Copenhagen Burnout Inventory (CBI) and a structured sociodemographicquestionnaire.Results:Burnout syndrome was diagnosed in 79.9% of thestudied students. 56.8 % and 60% of them suffered personal and work-related burnoutrespectively, whereas 38.2% and 28.9% suffered teacher and colleague burnoutcorrespondingly.A significant association was found between all subscales of burnout andthoughts of quitting the course.Significant association was also evident between personal,work and colleagues related burnout and difficulties in achieving academic goals.The oddsof having burnout were2.4 significantly greater for thoughts of quitting the medicinestudy. It was 1.9 times significantly higher with difficulty to achieve academic goals andwas1.7 higher among students at the clinical stage. Burnout was higher among studentswho were dissatisfied with studying medicine.Conclusion:Burnout and/or its subscaleswere quite obvious amongst Medical Students of Tanta University especiallyat the clinicallevel of study.Disappointment with coursework and difficulties in achieving academicgoalslead somestudents totake medication because of studying or thinkquitting theprogram}, keywords = {Burnout syndrome,Medical students,determinants,predictors}, url = {https://ejcm.journals.ekb.eg/article_6870.html}, eprint = {https://ejcm.journals.ekb.eg/article_6870_fe8e389836429d59a375e8a0efc6570b.pdf} } @article { author = {}, title = {Fruit and Vegetable Consumption among Medical Students in an Egyptian University: Knowledge, Practice, and Attitude towards Accessible Healthy Food}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {75-93}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6871}, abstract = {Background: Diet rich in fruits and vegetables is associated with a decreased risk for many chronic diseases. Several studies have shown low fruit and vegetable consumption among university students. The burden of disease associated with inadequate nutrition negatively affects their health. Objectives: Assessment of fruit and vegetable (F&V) consumption among medical students, knowledge of daily requirements, perceptions of benefits, barriers and motives for (F&V) consumption and identify their acceptance of accessible healthy food.Methods: A self-administered questionnaire adapted from Food Attitudes and Behaviors Survey (FAB) was completed by 473 students. Scores were calculated for knowledge, benefits, barriers and motives. Food events were done in between teaching sessions and in the faculty campus where healthy stuffs were provided. Students' acceptance of healthy food was assessed by those who got food items during events and those who expressed willingness to try food stuffs in future events. Results: Knowledge of the recommended five daily servings for F&V was recalled by 8.2% of students, 110 (23.26%) consumed 5 servings of F&V daily. Mean knowledge score percent was 28.11±26.69 and higher among males (P < 0.01). Mean benefit score percent was 83.9±11.7, for barriers 61.75±16.55 and for motivation 59.79±19.83. Males as well as smokers had higher mean barrier score (P < 0.01). Healthy food items were tried by 35.7% of students. Fresh orange juice, green salad and banana were the most requested items. Almost 44% expressed willingness to try healthy food in future events. Conclusion and recommendation: Medical students have infrequent F&V consumption; however, they have motives to consume them. A high frequency of students accepts presence of healthy food environment. Wider access is recommended.}, keywords = {fruits and vegetables,Consumption,Knowledge,motives,barriers,healthy food}, url = {https://ejcm.journals.ekb.eg/article_6871.html}, eprint = {https://ejcm.journals.ekb.eg/article_6871_9f171acd6dacc61b37cf103e9e180d17.pdf} } @article { author = {}, title = {Diagnosis of Occupational Asthma in Flour Mills at South Cairo}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {95-103}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6872}, abstract = {Introduction: Occupational asthma is an international problem affecting largenumber ofworkers. Few studies were done on occupational asthma in Egypt focusing mainly on asthmasymptoms and not on spirometric tests.Objective: The present study investigated the presenceof occupational asthma (BA) among workers at flour mills of south Cairo as there was a lackof data. Methods: The participants (n=120) were recruited from flour mills at South Cairo. Aquestionnaire, clinical examination, chest x-ray,spirometry, bronchodilator test andpeak flowrate variabilitytest were done. Occupational asthma was diagnosed according to GINAguidelines. Results: This study showed that 25% of mills workers had asthma related towork.The asthma symptoms appearduring work which showed improvement after leavingworkplace. It showed also reversibility in FEV1,PEFR as well as diurnal PEFR variabilitycharacteristics of occupational asthma. It revealed also that asthmatic workers had lower levelof spirometric parameters in relation to non-asthmatic. Conclusion: Asthma questionnairefollowed by ventilatory function test assessing reversibility and variability can be used forearly diagnosis of occupational asthma in Egypt.}, keywords = {bronchialreversibility andvariability,Flour dusts,Bronchodilator test,occupational asthma}, url = {https://ejcm.journals.ekb.eg/article_6872.html}, eprint = {https://ejcm.journals.ekb.eg/article_6872_8b0c3ecebec84093f2800e928a50487d.pdf} } @article { author = {}, title = {Optimizing Clinical Diagnosis and Antibiotic Prescribing for Common Respiratory Tract Infections, Fanara Family Health Center- Rural Egypt}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {105-115}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6873}, abstract = {Background: Antibiotic prescribing for respiratory tract infections (RTI) by primary caredoctors has received renewed interest due to the continuing emergence of antibioticresistance, increased incidence of adverse effects and the attendant cost to healthcareespecially in developing countries like Egypt. Despite the majority of these infectionsbeing viral it seems that many determinants other than the etiology are the main factorsthat influence a high rate of prescribing antibiotic for these self-limiting infections.Objective: We aimed to assess the impact of a physician- based educational interventionto improve clinical diagnosis of bacterial causes of RTIs and reduce unnecessary antibioticprescription for these infections. Methods: This is a clinical trial, where 11 familymedicine residents working at a rural family health center in Egypt participated in aneducational program to improve their antibiotic prescribing skills when treating commonRTI. Their patterns of prescribing antibiotic have been studied among all patients 3months old or above who attended the family center with RTI, for 2 months before andafter the educational intervention (1st of December 2015 to 10th of March 2016). Theeducational intervention comprised 4 hours, 2 lectures and another 4 hours, 2 small groupdiscussions in updated management of RTI and health education principles based mainlyon NICE guidelines and Health Belief Model (HBM) respectively. The primary outcomewas measuring the impact of the educational intervention on rates of prescribing antibioticfor 4 RTI [Acute otitis media (AOM), tonsillopharyngitis, rhino sinusitis and acutebronchitis], the appropriateness of using clinical diagnostic criteria of bacterial causes ofthese infections and the appropriate selection of antibiotic when its use was justified.Results: The overall antibiotic prescription was significantly reduced (8.3%) from baseline ( 80.3%( to post intervention (72%) period, (P=0.007). This reduction was significantfor both tonsillopharyngitis (12.2%, P=0.019) and otitis media (14.2%, P= 0.033). Therewere also significant improvement in using clinical diagnostic criteria for bacterial causesof the four studied RTI with 12.5% overall improvement (P=0.001). There was alsoimprovement in the overall appropriateness of selecting first line antibiotic when its usewas justified this improvement was achieved for both tonsillopharyngitis (17.8%, P=0.004) and AOM (P= <0.001). Conclusion: Clinical diagnosis of bacterial causes ofcommon RTIs and appropriate antibiotic use for these infections can be improvedin primary health care settings using a physician based educational program.}, keywords = {antibiotic,acute respiratory tract infections,health education,health belief model,proper prescribing}, url = {https://ejcm.journals.ekb.eg/article_6873.html}, eprint = {https://ejcm.journals.ekb.eg/article_6873_635d7bea2db302a2317d8a4277328186.pdf} } @article { author = {}, title = {Role of School Teachers in Pupils’ Mental Health Promotion}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {117-129}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6874}, abstract = {Background: Mental health is an integral and essential component of health.Schoolteachers should have an effective role in promoting mental health of their students.Objective: To investigate teachers` attitude towards their role in pupils’ mental healthpromotion, and identify barriers they may encounter.Methods:Multistage randomsampling was undertaken, where Misr El Gededa and El Nozha Educational Zones wereselected randomly from education zones in Cairo governorate. Twenty two (22)schoolswere selected from different strata of governmental, experimental and private schools inthe preparatory stage for boys and girls. All available school teachers were invited tocomplete a self-administered questionnaire including questions aboutpersonalcharacteristics, work related qualifications andteachers’ cognitive, affective and behaviorattitude towards pupils mental health promotion. Results:382 teachers (95.5%) agreedthat teachers play an influential role in recognizing pupils with mental health problems,389 teacher (97.25%) agreed that referring pupils with mental health problems forappropriate early support reduces their risk of developing mental health problems, 374(93.5%) agreed that schools hold a unique position in positively affecting the mentalhealth of pupils and nearly 350 teachers(88%) reported inadequatetrainingto recognize theearlysigns of pupils’mental healthproblems, concerns over workload and lack of servicesthat promote teachers mental health to mitigate the workload before expecting from them topromote pupils' mental health as barriers to pupils mental health promotion. Total scores ofthe three dimensions of attitude (cognitive, affective and behavioral) were as regard thefollowing variables the two educational zones, different school types, educational stages,graduation college, and taking educational diploma among those graduated from collegeother than graduation college, attending activities about pupils` mental health,teaching forspecial needs pupils and teaching for pupils with mentalhealth problems.Conclusion:Mostof teachers had positive attitude toward their role in pupils` mental health promotion.Recommendation:Implementation of a training program for teachers on a screening toolto pick up cases that need specialized help and activation of the role of teachers inparticipation in health promoting activities with their pupils.}, keywords = {mental health promotion,teachers'role,Attitude}, url = {https://ejcm.journals.ekb.eg/article_6874.html}, eprint = {https://ejcm.journals.ekb.eg/article_6874_9f516ec7af9726cd350c30fcc6221040.pdf} } @article { author = {}, title = {Knowledge of Radiology Technicians Regarding Radiation Health Hazards and Radiation Safety Measures in Ain-Shams University Hospitals}, journal = {The Egyptian Journal of Community Medicine}, volume = {36}, number = {1}, pages = {131-140}, year = {2018}, publisher = {Egyptian Community Medicine Association}, issn = {1110-1865}, eissn = {2090-2611}, doi = {10.21608/ejcm.2018.6875}, abstract = {Background: Radiation exposure in hospitals accounts for the largest number of workersoccupationally exposed to radiation, hence radiation safety practice in medicine ismandatory. Objective:The study aim was to measure the knowledge of radiologytechnicians regarding radiation health hazards and radiation safety in Ain-Shamsuniversity hospitals in Egypt. Methodology:61 radiology technicians participated in thestudy, technicians were recruited from Ain-Shams universityhospitals.Results:Technicians’ radiation knowledge score was10.53 ± 3.8. No associationwas found between technicians’ age, gender, duration of experience in radiology,attending radiation safety courses or workplace and the radiation knowledge score.Conclusion and Recommendations: It is recommended to provide radiation safetycourses.}, keywords = {Radiation Safety,Knowledge,Radiation health hazards}, url = {https://ejcm.journals.ekb.eg/article_6875.html}, eprint = {https://ejcm.journals.ekb.eg/article_6875_d6b93351080ff4b8c29baeaf9ebed6e0.pdf} }