Changes in medical student attendance at in-person teaching sessions: a systematic review

Introduction
The COVID-19 pandemic has had a significant impact on medical education, with many institutions shifting to online learning to ensure the safety of students and staff. However, there appears to be a decline in in-person attendance at medical schools across the UK and worldwide following the relaxation of social distancing rules and the reinstatement of in-person teaching. Importantly, this trend was also observed before the pandemic. While reflected within the literature, there is currently no systematic review describing these changes. We aim to find out how medical students’ attendance is changing as documented within the literature and its impact on their educational outcomes.

Methods
This systematic review followed the guidelines of the Centre of Research and Dissemination, Moose and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched the major databases of Medline via Ovid, Embase via Ovid, Scopus, Web of Science, British Education Index via EBSCOhost and ERIC via EBSCOhost in September 2023. Two reviewers independently screened each paper and extracted the data, with a third reviewer for dispute resolution. All studies reporting on medical students from various universities, both graduate and undergraduate, and describing changes in attendance and/or students’ educational outcomes were included. Risk of bias in individual studies was assessed using the Agency for Healthcare Research and Quality tool. A narrative synthesis of the findings from all included studies was done.

Results
12 papers were included in the analysis. Primary aim: Of the eight papers that measured attendance data over more than one academic year, only one paper demonstrated a statistically significant decrease while one paper demonstrated a statistically significant increase in attendance over the observational period. Other papers either did not perform statistical tests or did not demonstrate statistical significance. Secondary aims: Most papers showed a general positive correlation between attendance and educational outcomes. No studies explicitly explored reasons for changes in attendance seen. Only one paper outlined a possible strategy to address changes in attendance, a mandatory attendance policy, which has mixed outcomes.

Discussion
Despite widespread anecdotally reported attendance decline post-COVID-19, overall, there was no consistent change in attendance noted. However, there was a large heterogeneity in the studies included. Further research is required to elucidate trends in attendance and its impact on medical education.

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Progress towards prevention of suicide in India by improving print media reporting of suicide news: a repeat content analysis study in Tamil Nadu

Objectives
Suicide rates in India are among the highest in the world, with the most recent suicide death rate estimates ranging between 18 and 21 deaths per 100 000 population (compared with the global average of 11/100 000). Responsible media reporting of suicide is one of the few evidence-based population-level suicide prevention interventions. Reports of recent suicides are a routine daily feature in major newspapers in India, and the reporting style carries many concerning features. In 2019, the Press Council of India adopted the WHO media guidelines, yet there has been no investigation as to whether this guidance is being followed. The aim of this paper was to systematically investigate whether the quality of print media reports of suicides has changed since the adoption of media guidelines for suicide reporting in India.

Design
We used content analysis to assess the quality of suicide reporting against WHO guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016 and June and December 2023. Our analyses of changes in reporting were based on a sample of 1681 print newspaper articles from 2016 and 512 print newspaper articles from 2023. Two-tailed t-tests and proportion tests on aggregate means and frequencies assessed whether the reporting characteristics had changed between 2016 and 2023.

Results
There were small yet statistically discernible reductions in the proportion of articles containing various potentially harmful reporting characteristics, such as articles placed on the front page (4.9–1.8%, p=0.002) and articles mentioning the suicide method (92.7–86.5%, p

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Response to: correspondence on 'Revisiting the role of sphincterotomy in sphincter of Oddi disorder: a critical appraisal of the RESPOnD study by Zeng

Thanks to Dr Zeng for his insightful comments1 about our recent publication on 12-month outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for sphincterotomy for sphincter of Oddi disorders (SOD).2 Many of the comments were addressed in the discussion of the paper, especially the significance of the unmeasured placebo response and greater importance of patient characteristics such as somatisation and opioid exposure compared with physician-defined factors like a dilated duct. We disagree that RESPOnD’s heterogeneous patient population reduces the study’s generalisability. RESPOnD subjects represent the full spectrum of SOD subtypes and thus have lower selection bias compared with more stringent enrolment criteria. For example, restricting subjects to those with a dilated bile duct would have precluded our observation that duct size correlated poorly with response to sphincterotomy. As noted by Dr Zeng, sphincterotomy does not seem to be a promising intervention for idiopathic acute recurrent pancreatitis because…

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Omics Approach for Personalised Prevention of Type 2 Diabetes Mellitus for African and European Populations (OPTIMA): a protocol paper

Introduction
The prevalence of type 2 diabetes (T2D) within sub-Saharan Africa (SSA) is increasing. Despite the pathophysiology of T2D differing by ethnicity and sex, risk stratification and guidelines for the prevention of T2D are generic, relying on evidence from studies including predominantly Europeans. Accordingly, this study aims to develop ethnic-specific and sex-specific risk prediction models for the early detection of dysglycaemia (impaired glucose tolerance and T2D) to inform clinically feasible, culturally acceptable and cost-effective risk management and prevention strategies using dietary modification in SSA and European populations.

Methods and analysis
This multinational collaboration will include the prospective cohort data from two African cohorts, the Middle-Aged Soweto Cohort from South Africa and the Research on Obesity and Diabetes among African Migrants Prospective cohort from Ghana and migrants living in Europe, and a Swedish cohort, the Pre-Swedish CArdioPulmonary bioImage Study. Targeted proteomics, as well as targeted and untargeted metabolomics, will be performed at baseline to discover known and novel ethnic-specific and sex-specific biomarkers that predict incident dysglycaemia in the different longitudinal cohorts. Dietary patterns that explain maximum variation in the biomarker profiles and that associate with dysglycaemia will be identified in the SSA and European cohorts and used to build the prototypes for dietary interventions to prevent T2D. A comparative cost-effectiveness analysis of the dietary interventions will be estimated in the different populations. Finally, the perceptions of at-risk participants and healthcare providers regarding ethnic-specific and sex-specific dietary recommendations for the prevention of T2D will be assessed using focus group discussions and in-depth interviews in South Africa, Ghana, Germany (Ghanaian migrants) and Sweden.

Ethics and dissemination
Ethical clearance has been obtained from all participating sites. The study results will be disseminated at scientific conferences and in journal publications, and through community engagement events and diabetes organisations in the respective countries.

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Sustainability of fall prevention exercise programmes for community-dwelling older adults: a scoping review protocol

Introduction
Falls have financial, emotional and physical implications for ageing individuals and the healthcare system. Evidence-based exercise programmes have been one of the most effective ways of preventing falls in community dwellings for older adults. However, more research is needed to understand how to sustain these programmes. This scoping review protocol describes our plan to investigate the factors influencing the sustainability of community-based fall prevention exercise programmes.

Methods and analysis
Our scoping review will use the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. The studies will have no restrictions, including publication date, language or geographic location. Key search terms concerning programme sustainability and exercise falls prevention will be conducted in Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, APA PsycINFO and SPORTDiscus in consultation with an experienced librarian. Once duplicates have been removed, two independent reviewers will conduct title and abstract screening, full-text screening and data extraction. Data from eligible articles will be collated and charted to summarise data into three categories: (1) study description, including publication date, author(s), study location, paper’s aim/purpose, study participants, study design and conclusion; (2) data regarding the type of exercise programme will be used using the 16-point checklist Consensus on Exercise Reporting Template; and (3) data regarding sustainability will be organised using domains from the Program Sustainability Assessment Tool. Our results will be charted through the use of Covidence to identify patterns across the studies. Additionally, narrative synthesis will be employed to articulate the study findings.

Ethics and dissemination
As this is a scoping review, we do not require ethics approval. We intend to share our report findings with scientists, healthcare professionals and decision-makers. We will publish our results in reputable scientific journals and present them at relevant conferences.

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