Smokeless tobacco (Swedish moist 'snus') users are often strongly addicted to nicotine. Compared to the large number of smoking-cessation studies, there have been few evaluated clinical cessation programs in conjunction with nicotine replacement therapy (NRT). The aim of this study was to evaluate a cessation program for snus users with a weekly use of >2 cans/week for >10 years.
A prospective, open, non-randomized intervention trial was undertaken including baseline oral examination and soft tissue biopsy, minor physical examination, brief cessation advice, NRT recommendations and five prospective follow-up visits within 12 months. Individual cessation counseling was given, together with oral examination in the dental office. Fifty snus users with a minimum consumption of 100 g/week who were actively seeking cessation treatment were recruited through advertising. Self-reported abstaining, including random-sample biochemical verification, and NRT use were evaluated at 6 weeks and 3, 6 and 12 months.
At the 3-, 6- and 12-month visits, 58%, 46% and 30% of subjects, respectively were tobacco-abstinent. All nicotine abstinence was randomly controlled during the study except at 12 months, where all subjects claiming abstinence were confirmed biochemically and clinically.
Smokeless tobacco cessation achieved together with suitable NRT seems a promising way to improve a persistent tobacco-free condition.
The compressed curriculum in modern knowledge-intensive medicine demands useful tools to achieve approved learning aims in a limited space of time. Web-based learning can be used in different ways to enhance learning. Little is however known regarding its optimal utilisation. Our aim was to investigate if the individual learning styles of medical students influence the choice to use a web-based ECG learning programme in a blended learning setting.
The programme, with three types of modules (learning content, self-assessment questions and interactive ECG interpretation training), was offered on a voluntary basis during a face to face ECG learning course for undergraduate medical students. The Index of Learning Styles (ILS) and a general questionnaire including questions about computer and Internet usage, preferred future speciality and prior experience of E-learning were used to explore different factors related to the choice of using the programme or not.
93 (76%) out of 123 students answered the ILS instrument and 91 the general questionnaire. 55 students (59%) were defined as users of the web-based ECG-interpretation programme. Cronbach's alpha was analysed with coefficients above 0.7 in all of the four dimensions of ILS. There were no significant differences with regard to learning styles, as assessed by ILS, between the user and non-user groups; Active/Reflective; Visual/Verbal; Sensing/Intuitive; and Sequential/Global (p = 0.56-0.96). Neither did gender, prior experience of E-learning or preference for future speciality differ between groups.
Among medical students, neither learning styles according to ILS, nor a number of other characteristics seem to influence the choice to use a web-based ECG programme. This finding was consistent also when the usage of the different modules in the programme were considered. Thus, the findings suggest that web-based learning may attract a broad variety of medical students.
Cites: Ann Intern Med. 2003 May 6;138(9):747-5012729430
Interprofessional education (IPE) for teams of undergraduate students has since 1999 been carried out at the orthopedic emergency department at the Karolinska University Hospital. During a 2-week period, teams of medical, nursing and physiotherapy students practice together. With the aim of training professional and collaboration skills, the teams take care of patients with varying acute complaints, under the guidance of supervisors from each profession. This study describes the educational model and compares the attitudes of the different student categories participating in this unique IPE model. All students who participated in this experience during the period 2008-2010 were asked to fill in a questionnaire on completion of their training period. Results showed that all three categories, with no significant difference, highly appreciated the setting and the team training. Results also showed that the training significantly increased the students' knowledge of their own professional role as well as their knowledge of the other professions. We conclude that training at an emergency department can provide excellent opportunities for interprofessional team training for undergraduate students. The teamwork enhances the students' understanding of the professional roles and can contribute to a more holistic approach to patient care.
Since 1969, studies of Swedish doctors' tobacco habits and attitudes have been carried out regularly every fifth year. The present investigation was made in 2001 in the form of a questionnaire distributed to a random sample of 5% of Swedish doctors (n = 1,367). The response rate was 80%. The proportion of daily smokers was 6%, a figure that had not changed since 1996. More doctors had never smoked (44% compared with 38% in 1996). Most smokers were found among psychiatrists and surgeons (10%). The use of oral snuff had increased to 16% among male and 5% among female doctors (compared with 9% and 3% in 1996). About 50% of the doctors believed that the use of snuff increased the risk of hypertension, angina pectoris, myocardial infarction and oral cancer. Protection of health was the main reason for not smoking (98%). An overall majority (92%) of doctors advise patients with lung diseases and pregnant women not to smoke, and only a few (16%) never give advice about smoking cessation to smokers with non-smoking related diseases. Many doctors do not allow smoking in their homes (69%) and ask for smoke free hotel rooms (82%). The doctor as a role model for patients was regarded as important by 71%. The number of smokers in the general Swedish population was as low as 19% in 2001, achieving the WHO goal for the year 2000. The low, unchanged level of 6% of doctors who smoke daily indicates that it might be possible to achieve a target level of 5-10% among the general population. The slowly increasing use of snuff requires further studies.