Jim Medder

A comparison of learning outcomes and attitudes in student‐ versus faculty‐led problem‐based learning: an experimental study

To compare learning outcomes and perceptions of facilitator behaviours and small‐group process in problem‐based learning (PBL) groups led by students and those led by faculty.

Mental health problems due to community violence exposure in a small urban setting

Objective Studies conducted in large metropolitan inner-city communities with high violent crime rates have demonstrated an association between exposure to violence and mental health problems; therefore the purpose of this study was to determine if similar trends exist in smaller inner-city communities with substantially lower violent crime rates. Methods One hundred twenty-six children and young adults living in inner-city Omaha, Nebraska, were screened for posttraumatic stress disorder (PTSD), depression, and anxiety symptoms and assessed for community violence exposure (CVE). Pearson’s correlation and analysis of variance were used to determine the relationship between PTSD, depression, and anxiety symptoms and CVE. Results A statistically significant relationship was found between CVE and PTSD and anxiety symptoms among participants despite their having lower rates of exposure to violent events in comparison with other studies. No association was found between violence and depression symptoms. Additionally, the presence of anxiety and depression, as well as increased age of participants, was associated with higher rates of PTSD symptoms. Conclusion We recommend that health care providers in smaller cities, where the effects of violent crime may be underestimated or overlooked, be informed of the existence of this public health problem within their community and that they screen at-risk patients for mental health problems.

Caring for Men Who Have Sex with Men

Men who have sex with men (MSM) account for about 3.6 % of adult men in the United States (US) (2.2 % gay men and 1.4 % bisexual men for an estimated total of about four million men). Social and medical stigmatization of this sexual minority leads to stress, high-risk health behaviors, and avoidance of medical care and preventive services; these combined factors result in a higher prevalence of several health problems for gay and bisexual men compared to heterosexual men. To overcome these issues, clinicians should become culturally competent and knowledgeable of minority sexual health problems and develop communication skills and clinical environments that welcome and identify MSM. Clinicians should also be familiar with the “coming-out” process and assess the level of support provided by family and friends. Specific MSM health disparities compared to heterosexual men include tobacco use, dietary habits (e.g., eating/body image disorders and weight), alcohol/drug use, mental health (e.g., depression, suicide, and anxiety), injuries/violence, sexually transmitted infections (e.g., gonorrhea, chlamydia, syphilis, viral hepatitis, human papillomavirus, and herpes simplex), human immunodeficiency virus, anal cancer, and cardiovascular disease. Clinicians should also be cognizant of legal inequalities that affect the health of MSM and the health concerns of special MSM populations (youth, families and children, older MSM, bisexual men, racial/ethnic minorities, and transgender men).