Victor Mogre

Lifestyle risk factors of general and abdominal obesity in students of the school of medicine and health science of the university of development studies, tamale, ghana.

This study evaluated the prevalence of general and abdominal obesity among students of the University for Development Studies, School of Medicine and Health Sciences (UDS-SMHS), Tamale, Ghana. Also, lifestyle risk factors for the two obesity indices were investigated. This study was conducted among a sample of 646 students. Anthropometric measures of weight, height, and waist circumference were appropriately assessed. The prevalence of general and abdominal obesity was 1.9% and 4.2%, respectively. Risk factors of general obesity were being female (crude OR = 6.9, 95% CI = 1.85–25.80, P = 0.0021), engaging in light PA (OR = 12.45, 95% CI = 2.96–52.41, P = 0.0006), being aged 28–37 years (OR = 5.37, 95% CI = 1.39–20.68, P = 0.0329), nonintake of coffee (OR = 4.1, 95% CI = 1.10–15.28, P = 0.0357), being married (OR = 5.7, 95% CI = 1.48–22.02, P = 0.0286), and being abdominally obese (OR = 02.7, 95% CI = 25.61–11.60, P < 0.0001). Risk factors for abdominal obesity were being female, being married, having general obesity, and nonintake of coffee. Abdominal obesity was more prevalent than general obesity. Risk factors included being female, married, and generally obese and nonintake of coffee.

Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus

BackgroundAdults with the metabolic syndrome (MetS) are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. About 70-80% of type 2 diabetes mellitus (type 2 DM) patients are diagnosed with the MetS. Investigating the occurrence of the MetS in type 2 DM patients is critical for cardiovascular disease prevention. We evaluated the prevalence and components of the MetS and its associated clinical and demographic factors in a Ghanaian adult population with DM 2.MethodsThis cross-sectional study was conducted among 200 previously diagnosed type 2 DM patients receiving care from an outpatient clinic of the Tamale Teaching Hospital, Ghana. Anthropometric measurements of waist circumference (cm), weight (Kg) and height (m) were measured appropriately. Clinical data were obtained from the personal health record files of the participants. MetS was defined according to the International Diabetes Federation criteria.ResultsThe prevalence of MetS was 24.0% (n=48). The prevalence was higher in women (27.3%, n= 42) compared to men (13.0%, n=6). The commonest occurring components of the MetS included abdominal obesity (77.0%) and elevated FPG (77.0%) denoting uncontrolled diabetes. The prevalence of elevated BP was found to be 44.0%(n=88) and was higher in men (56.5%) than in women (40.3%). Factors that were found to be associated to the MetS were being overweight/obese (Crude OR = 2.9, 95% CI = 1.43 – 5.90, p=0.004), ever tried to lose weight (Crude OR = 2.5, 95% CI = 1.24 – 4.94, p=0.015) and having diabetes for over 5 years (Crude OR = 11.3, 95% CI = 5.26 – 24.08, p<0.001). Other factors that were associated to the MetS were current smokers (Crude OR = 6.8, 95% CI = 1.21- 38.49, p=0.030) and alcohol drinkers (Crude OR = 3.1, 95% CI = 1.23 – 7.65, p=0.018).ConclusionA comparatively low prevalence of the MetS was found. More females than males had the MetS. Uncontrolled diabetes and abdominal obesity were prevalent. The factors identified by our univariate logistic regression model were not significant predictors of the MetS in our multivariate model.

Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

Medical students' achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery Final Part I and II licensing examination: a comparison of students in problem-based learning, community-based education and service, and conventional curricula in Ghana.

Purpose: Problem-based learning is an established method of teaching and learning in medical education. However, its impact on students’ achievement on examinations is varied and inconsistent. We compared the levels of achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery (MB ChB) Part I and II licensing examination of students in problem-based learning, community-based education and service (PBL/COBES), and conventional curricula. Methods: In 2014, we analyzed the MB ChB Final Part I and II licensing examination results of students in three classes (2004, 2005, and 2006) of the School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana. Ninety-three students in the 2004 and 2005 cohorts followed a conventional curriculum, and 82 students in the 2006 cohort followed a PBL/COBES curriculum. Using appropriate statistical tools, the analysis compared individual discipline scores and the proportions of students who received distinction/credit/pass grades among the classes. Results: The PBL students had significantly higher mean and median scores than the conventional students in Obstetrics and Gynecology, Internal Medicine, Community Health and Family Medicine, Surgery, and Psychiatry, but not in Child Health and Pediatrics. Also, a significantly (P=0.0010) higher percentage, 95.1% (n=78), of the PBL students passed all the disciplines, compared to 79.6% (n=74) of the conventional students. Conclusion: The PBL students significantly performed better in all the disciplines except child health and pediatrics, where the conventional students scored higher. These findings demonstrate that the benefits of the PBL/COBES curriculum are tangible and should be fostered.

A realist review of educational interventions to improve the delivery of nutrition care by doctors and future doctors

BackgroundDietary interventions are considered an important aspect of clinical practice, more so in the face of the rising prevalence of obesity, diabetes and cardiovascular diseases globally. Routinely, most doctors do not provide such intervention to their patients, and several barriers, present during both training and clinical practice, have been identified. Educational interventions to improve nutrition care competencies and delivery have been implemented but with variable success, probably, due to the complex nature of such interventions. Using traditional methods only to investigate whether interventions are effective or not could not provide appropriate lessons. It is therefore pertinent to conduct a realist review that investigates how the interventions work. This realist review aims at determining what sort of educational interventions work, how, for whom, and in what circumstances, to improve the delivery of nutrition care by doctors and future doctors.Methods/designThis realist review will be conducted according to Pawson’s five practical steps for conducting a realist review: (1) clarifying the scope of the review, (2) determining the search strategy, including adopting broad inclusion/exclusion criteria and purposive snowballing techniques, (3) ensuring proper article selection and study quality assessment using multiple methods, (4) extracting and organising data through the process of note taking, annotation and conceptualization and (5) synthesising the evidence and drawing conclusions through a process of reasoning. This realist review protocol has not been registered in any database before now.DiscussionFindings will be reported according to the publication criteria outlined by the realist and meta-narrative evidence synthesis (RAMESES) group.

Prevalence of obesity and systemic hypertension among diabetes mellitus patients attending an out-patient diabetes clinic in a Ghanaian Teaching Hospital

AIMS Diabetes Mellitus is now a prevalent disease in both developed and developing countries. Overweight/obesity and hypertension are potential modifiable risk factors for diabetes mellitus and persist during the course of the disease. This study was aimed at reporting the prevalence of overweight/obesity and systemic hypertension and their association to blood glucose levels in persons with diabetes mellitus attending a diabetic clinic in Ghanaian Teaching Hospital. MATERIALS AND METHODS This cross-sectional study was conducted among 100 previously diagnosed diabetes mellitus patients attending a diabetic clinic at the Tamale Teaching Hospital, Ghana. Anthropometric variables of age, weight and height were measured with appropriate instruments, computed into BMI and classified according to WHO classifications. Systolic and diastolic blood pressures were measured by an appropriate instrument and classified by WHO standards. Fasting plasma glucose levels of the study participants were recorded from their personal health folder. All data was analysed by GraphPad prism version 5. RESULTS In general, 7.0% of the participants were underweight and 32.0% were overweight or obese. The mean±SD weight, height and BMI of the participants were 67.53±13.32, 1.68±0.12 and 24.18±5.32. Twenty-one percent of the studied participants were hypertensive. Mean±SD fasting plasma glucose of 7.94±2.82 was observed among the diabetic patients. As the prevalence of hyperglycaemia was higher among patients aged ≤40 years (88.9% vs. 75.8%), normoglycaemia (11.1% vs. 24.2%) was higher among those over 40 years. The differences were not significant. The prevalence of hyperglycaemia was significantly higher in participants with overweight/obese (0.0% vs. 41.6%, p<0.0001) than those with underweight (26.1% vs. 1.3%, p=0.0005) and normal weight (73.9% vs. 57.1%, p=0.2228). CONCLUSION A high prevalence of overweight/obesity and systemic hypertension was found. Hyperglycaemia was more prevalent among overweight/obese participants.

Awareness, use and associated factors of emergency contraceptive pills among women of reproductive age (15-49 years) in Tamale, Ghana

BackgroundEmergency contraceptive pills (ECPs) are one of the means by which women can use after intercourse to prevent pregnancy. ECPs can be used to reduce the prevalence of unwanted pregnancies and unsafe abortions. This study investigated awareness and use of ECPs among reproductive age (15-49 years) women in Tamale, Ghana. Factors associated with the use of ECPs were also investigated.MethodsThis cross sectional study was conducted among 200 women of reproductive age (15-49 years) in Tamale, Ghana. Data on socio-demographic variables, awareness and usage of ECPs were assessed by means of a previously validated questionnaire. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the use of ECPs.ResultsAwareness level of ECPs were found to be 69.0% (n = 138); 42.8% (n = 59) got the awareness from a health worker, 31.8% (n = 44) from the radio/TV and 25.4% (n = 35) from family members/friends. Eighty-five percent (n = 117) knew the correct time-frame for an effective use of ECP to prevent pregnancy. Forty percent (39.9%, n = 55) of the participants who had awareness have ever used ECPs. Factors that were found to be associated with the use of ECPs were; participants who said ECPs were affordable (AOR = 6.1, 95% CI = 2.51 – 10.40, p = 0.001), available (AOR 2.1, 95% CI = 0.61 – 6.01, p = 0.001), cultural (AOR = 3.5, 95% CI = 1.01 – 10.15, p = 0.011) and religious unacceptable (AOR = 4.0, 95% CI = 1.02 – 10.0, p = 0.005).ConclusionA relatively high level of awareness and usage of ECPs was found. Factors that were associated with the use of ECPs were availability and affordability. Cultural and religious unacceptability did not hinder the use of ECPs. Health authorities should continue to make ECPs available to women of reproductive age.

Assessing the reliability and validity of the Revised Two Factor Study Process Questionnaire (R-SPQ2F) in Ghanaian medical students.

Purpose: We investigated the validity and reliability of the Revised Two Factor Study Process Questionnaire (R-SPQ2F) in preclinical students in Ghana. Methods: The R-SPQ2F was administered to 189 preclinical students of the University for Development Studies, School of Medicine and Health Sciences. Both descriptive and inferential statistics with Cronbach’s alpha test and factor analysis were done. Results: The mean age of the students was 22.69± 0.18years, 60.8% (n=115) were males and 42.3% (n=80) were in their second year of medical training. The students had higher mean deep approach scores (31.23±7.19) than that of surface approach scores (22.62±6.48). Findings of the R-SPQ2F gave credence to a solution of two-factors indicating deep and surface approaches accounting for 49.80% and 33.57%, respectively, of the variance. The scales of deep approach (Cronbach’s alpha, 0.80) and surface approach (Cronbach’s alpha, 0.76) and their subscales demonstrated an internal consistency that was good. The factorial validity was comparable to other studies. Conclusion: Our study confirms the construct validity and internal consistency of the R-SPQ2F for measuring approaches to learning in Ghanaian preclinical students. Deep approach was the most dominant learning approach among the students. The questionnaire can be used to measure students’ approaches to learning in Ghana and in other African countries.

Factors associated with central overweight and obesity in students attending the University for Development Studies in Tamale, Ghana: a cross-sectional study

Abstract Objectives: This study assessed the prevalence of central overweight and obesity in students of the University for Development Studies in Tamale, Ghana. Lifestyle factors associated with central overweight and obesity were also investigated in this study population. Design: A cross-sectional study design was employed. Setting: School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana. Subjects: A sample of 552 students was randomly selected to participate. Method: Waist and hip circumference was measured with appropriate tools and computed into a waist-to-hip ratio (WHR). Demographic and socio-cultural factors, such as age, sex, smoking status and coffee and alcohol consumption, were recorded. Physical activity was assessed using the World Health Organization Global Physical Activity Questionnaire. Results: Generally, 29.3% of the participants had a normal WHR (44.1% males, 3.0% females). 60.9% (55.9% males, 69.7% females) were centrally overweight and 9.8% (0.0% males, 27.3% females) centrally obese. Age and smoking status were not associated with central overweight and obesity. Being female was significantly associated with a higher prevalence of central obesity. The prevalence of central obesity was 13.9% in non-coffee drinkers, 6.7% in coffee drinkers, 11% in non-alcohol drinkers and 0% in alcohol drinkers. Almost 95% of centrally obese participants engaged in light or moderate physical activity, and 5.6% in vigorous physical activity (p-value < 0.0001). Conversely, 55% of normal weight participants engaged in light or moderate physical activity and 44% in vigorous physical activity (p-value 0.0008). Conclusion: Physical activity, female gender, alcohol and coffee consumption were associated with central obesity.

Psychometric properties of the dundee ready educational environment measure in a sample of Ghanaian Medical Students

Background: The Dundee Ready Educational Environment Measure (DREEM) has been widely accepted and recognized for the assessment of the educational environment in a variety of health professions education programs. Concerns regarding the psychometric properties of the DREEM have been raised. This study evaluated the psychometric properties of the DREEM in a sample of Ghanaian medical students following a problem-based learning curriculum. Methods: A sample of 234 second to fourth year medical students of the University for Development Studies, School of Medicine and Health Sciences were invited to complete the DREEM questionnaire. Psychometric measures employed included Cronbachs alpha analysis, confirmatory factor analysis and principal component analysis with varimax rotation. Results: The internal consistency for the overall DREEM was 0.92. Apart from two subscales that had Cronbachs alpha values < 0.70, the remainder had values ranging from 0.73 – 0.78. Confirmatory factor analysis did not support the original five factor structure of the DREEM. Large significant correlation coefficients were found between the five factors raising concerns about the independency of the individual subscales. Exploratory factor analysis suggested various factor solutions ranging from 4 to 14 factors. The four factor structure was interpretable and was maintained. All of the four factors achieved eigenvalues > 1, and in total they accounted for 37.6% of the variance. Alpha values for the subscales of the new four factor structure ranged from 0.618 – 0.915. Discussion: The overall internal consistency of the DREEM was found to be excellent. The internal consistency of the individual subscales was variable, as two subscales had alpha values < 0.70 and the remainder exceeding 0.70. The original five factor structure of the DREEM was not supported. Exploratory factor analysis suggested a four factor solution as a possible alternative to the five factor structure of the DREEM.