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Descriptors:
Student Characteristics; Prevention; Evidence; Testing; Hygiene; Preventive Medicine; Medical Schools; Medical Students; Positive Attitudes; Questionnaires; Correlation; Counseling; Intention; Primary Health Care; Health Behavior; Student Attitudes; Gender Differences; Patients

Abstract:
Little is known about the extent to which evidence-based prevention topics are taught in medical school. All class of 2003 medical students (n = 2316) at 16 US schools were eligible to complete three questionnaires: at the beginning of first and third years and in their senior year, with 80.3% responding. We queried these students about 21 preventive medicine topics, concerning the extent of their training and their patient counseling frequency at some of these time points. At the beginning of the third year, self-reported extensive training was low for all preventive medicine topics (range 7-26%). USPSTF-recommended topics received more curricular time (median for topics: 36% if recommended versus 24.5% if not, P = 0.025), as did topics addressed through testing rather than through discussion (median for topics: 37% for testing and 25% for discussion, P = 0.005). Extensive training was always associated with higher counseling frequency, and intention to go into primary care, female gender, a positive attitude toward prevention and positive personal health habits were associated with higher counseling frequency. Although some bemoan the overall low levels of US medical students' prevention-related training and practice, we demonstrate that at least they are preferentially evidence-based, a novel and encouraging finding for preventionists. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Physical Activities; Heart Disorders; Physical Education; Physical Fitness; Physical Education Teachers; Health Related Fitness; Health Promotion; Athletic Coaches; Disease Incidence; Etiology; Exercise Physiology; Sports Medicine; Preventive Medicine

Abstract:
A collapse and cardiac arrest from Commotio Cordis can occur instantaneously from a relatively modest and nonpenetrating blow to the chest in the absence of underlying cardiovascular disease or structural injury to the chest wall or heart itself (Maron, 1998). It is important to note that this collapse could be instantaneous or proceeded by brief periods of consciousness or even physical activity (Maron, Estes, & Link, 2005). Whatever can be done to decrease the incidence of or aid in the treatment of Commotio Cordis should be the focus of coaches and physical educators. Sudden cardiac death describes the unexpected natural death from a cardiac cause within a short time period (Zipes & Wellens, 1998). These events may be a more frequent cause of sudden death than previously believed, and also more common than many of the cardiovascular diseases that are often believed to cause such catastrophes (Maron, Estes, & Link, 2005). (Contains 1 table and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Medical Education; Medical Schools; Physicians; Public Health; High School Graduates; Surgery; Psychiatry; Preventive Medicine; Pathology; Family Practice (Medicine); Undergraduate Study; Higher Education; Medical Students; Intervention; Graduate Medical Education; Graduate Students; Labor Force; Medicine; Biomedicine; Microbiology; Genetics; Epidemiology; Health Services; Outcomes of Education

Abstract:
Undergraduate medical education is too long; it does not meet the needs for physicians' workforce; and its content is inconsistent with the job characteristics of some of its graduates. In this paper we attempt to respond to these problems by streamlining medical education along the following three reforms. First, high school graduates would be eligible for undergraduate medical education programs of 4 years duration. Second, medical school applicants would be required to commit themselves to a medical specialty and choose one of four undergraduate paths: (1) "Interventions/consultations" path that would prepare its graduates for residencies in secondary and tertiary specialties, such as cardiology and surgery, (2) "continuous patient care" path for primary care specialties, such as family medicine and psychiatry, (3) "diagnostic laboratory medicine and biomedical research" path that would prepare for either laboratory-based careers, such as pathology, biochemistry and bacteriology, or research in e.g., immunology and molecular genetics, and (4) "epidemiology and public health" path that would include population-based research, preventive medicine and health care administration. Third, the content of each of these paths would focus on relevant learning outcomes, and medical school graduates would be eligible for residency training only in specialties included in their path. Hopefully, an early commitment to a medical specialty will reduce the duration of medical education, improve the regulation of physicians' workforce and adapt the curricular content to the future job requirements from medical school graduates. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Welfare Services; Preventive Medicine; Parent Child Relationship; Adjustment (to Environment); Patients; Foreign Countries; Guidance; Clinics; Psychological Patterns; Psychiatry; Child Development; Theory Practice Relationship; Emotional Disturbances; Children

Abstract:
British child guidance was a form of psychiatric, preventive medicine for children and young people and centred, at least in principle, on specialist clinics led by psychiatrists. From small beginnings in the aftermath of the First World War, child guidance expanded steadily, in terms of both numbers of patients and numbers of clinics, and came to be legislatively embedded in the post-war welfare state. Among its underlying principles was the idea that any child, however apparently "normal", might experience disturbance in the course of their emotional and psychological development. The causes of such disturbance, manifested by maladjustment, were generally deep-rooted and multiple in nature and were for the most part seen as deriving from problems in the child-parent relationship. The stability of the child, its family and even the wider society were threatened by this maladjustment, which therefore had to be treated to prevent further or future problems. This article places British child guidance in its broader context and analyses both its theory and its practice. Its central concern, however, is with what was actually meant by terms such as maladjustment, stability and normalcy. Child guidance practitioners themselves were unclear on such issues and, ultimately, normalcy in particular came to be defined negatively, that is, by what it was not. (Contains 93 footnotes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Body Composition; Health Promotion; Mental Retardation; Prevention; Cancer; Risk; Questionnaires; Genealogy; Preventive Medicine; Foreign Countries; Residential Care; Residential Institutions; Surveys; Language Impairments; Life Style; Diagnostic Tests; Public Service

Abstract:
Background: As people with intellectual disabilities (ID) are living longer, their chances of developing cancer also increases. However, recognising the early signs and symptoms of cancer in a population with cognitive impairment and communication difficulties poses difficulties for both family carers and professional care staff. Engagement in health promotion and cancer prevention activities is also a challenge; yet, people with ID have an equal right to these important public services as other members of the population. Aims: The aim of this study was to examine how care staff engaged in cancer prevention and health promotion activities on behalf of people with ID. Methods: This was an exploratory descriptive study using a postal survey design employing a questionnaire. Fifteen residential facilities for adults with ID were targeted within one geographic region of the UK. In total, 40 residential staff completed a questionnaire about their knowledge of the risk and protective factors of stomach, breast, cervical and testicular cancer. Staff then completed questionnaires regarding 90 adults with ID, recording details about body mass index (BMI), lifestyle choices (i.e. smoking, dietary intake), "Helicobacter pylori" testing, family history of cancer and staff's health promotion and cancer prevention activities with these individuals. Findings: The women with ID were reported to have significantly higher BMIs than the men with ID and only two people with ID had been tested for the "H. pylori" infection: potential risk factors for developing breast and stomach cancer, respectively. The majority of the staff reported that they did not receive training in cancer prevention. Likewise, the majority of the staff reported that they were unaware of the family histories of the people with ID in their care. Reports varied with how staff engaged with people with ID regarding stomach, breast, cervical and testicular cancer health promotion activities and cancer screening opportunities. Discussion: Findings of this study show that health promotion and cancer prevention activities for people with ID may be less than optimal. The importance of staff training in order to raise knowledge and awareness is highlighted. Educating both staff and people with ID about the early signs and symptoms of cancer and the importance of a healthy lifestyle as a protective factor may help lead to more informed healthier lifestyle choices and lower cancer risk and morbidity. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Medical Education; Public Health; Asian Americans; Disproportionate Representation; Ethnic Groups; Health Personnel; Health Promotion; Communicable Diseases; Cancer; Diseases; Preventive Medicine; Disease Control; Epidemiology; Medicine; Screening Tests

Abstract:
For years, New York health-care providers have treated Asian-Americans afflicted by serious, even life-threatening illnesses with ever-increasing frequency. Many doctors in the nation's largest city agreed that Asians seemed particularly at risk for specific health problems, but there was neither research nor statistics supporting physician observations. In this article, the author describes a pioneering center at New York University that employs a community-based approach to addressing illnesses disproportionately affecting Asian-Americans. Established in 2003, the Center for the Study of Asian American Health (CSAAH) is the only center of its kind at a U.S. academic medical center dedicated solely to evaluating public health issues of this racial group. Soon after CSAAH's inception, which was financed by a National Institutes of Health grant, its scientific efforts began exploring the relationship between viral and bacterial infections and cancer, as well as the risk for cardiovascular disease, among different Asian ethnic groups. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Human Services; Strategic Planning; Health Promotion; Smoking; Public Health; Quality of Life; Dental Health; Preventive Medicine; Disease Control; Dental Evaluation; Program Effectiveness; Program Evaluation; Intervention; Foreign Countries; Young Children; Older Adults

Abstract:
Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects, quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of oral health promotion is integral to strategic planning for both oral and general health settings. Objective: The objective of this article is to report the key findings of a systematic review of the evidence for oral health promotion commissioned by the Victorian Department of Human Services in 2006. Methods: Evidence was collected and evaluated using a combined approach incorporating the Cochrane Public Health and Health Promotion Field Handbook and the Health Gains Notation in order to a develop a synthesis approach to reporting, framed around the Ottawa Charter. Findings: Findings included evidence supporting the continued fluoridation of water supplies, interventions aimed at early childhood and aged care settings, smoking cessation and capacity building with non-oral health care providers. Emerging evidence supporting multi-strategy community based approaches is also reported along with gaps in the evidence. General Conclusions: The authors conclude that, while there is good support for the incorporation of oral health into general health promotion, it will be important to monitor the outcomes in oral health terms. (Contains 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Education; Advisory Committees; Health Programs; Public Health; Preventive Medicine; Compliance (Legal); National Standards; Accreditation (Institutions); Community Programs; Higher Education; Quality Control

Abstract:
Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health, jointly formed the Council on Education for Public Health (CEPH or Council) to conduct accrediting activities. Initially, CEPH limited its focus to schools of public health embedded within colleges and universities. However, in the late 1970s, CEPH responded to requests from practitioners and educators to accredit community health/preventive medicine programs, and to a request from the APHA to accredit community health education programs. The CEPH accredits schools of public health and public health programs outside schools of public health. The agency currently accredits 40 schools of public health and 71 public health programs located in 41 states, plus the District of Columbia and Puerto Rico. This paper presents the recommendations of the staff of the National Advisory Committee on Institutional Quality and Integrity (NACIQI) concerning CEPH's petition for continued recognition. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Needs; Mental Health; Foreign Countries; Intervention; Health Promotion; Preventive Medicine; Administrator Role; Teacher Role; Special Education; Educational Policy; Public Policy

Abstract:
There has been recent attention paid to the mental health issues experienced by many children and youth in Canada and internationally. In particular, the role of the school and educational leaders in preventing mental health difficulties and intervening in the case of mental illnesses has been highlighted. This paper presents an overview of several policies, programs, and initiatives related to the prevention of and intervention for mental health difficulties in Canadian schools with a focus on the Ontario context. Following this, literature examining the role of educational leaders in meeting the mental health needs of students will be reviewed and recommendations put forward. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Test Validity; Efficiency; Factor Structure; Measures (Individuals); Factor Analysis; Psychometrics; Fear; Anxiety; Scores; Statistical Analysis; Symptoms (Individual Disorders); Goodness of Fit; Injuries; Preventive Medicine; Human Body; Medical Services

Abstract:
The present investigation examined the factor structure and psychometric properties of the Injection Phobia Scale-Anxiety (IPS-Anx). Principal components analysis of IPS-Anx items in Study 1 (n = 498) revealed a 2-factor structure consisting of Distal Fear and Contact Fear. However, CFA results in Study 2 (n = 567) suggest that a 1-factor structure may be more parsimonious. IPS-Anx scores demonstrated excellent reliability including test-retest over a 12-week period in Study 3 (n = 195). Supportive evidence for convergent and divergent validity of IPS-Anx scores was also found in Study 4 (n = 319), with strong associations with disgust propensity and sensitivity and weak associations with positive affect. Further evidence of validity was found in Study 5 (n = 1,674) because IPS-Anx scores discriminated those who have experienced fainting symptoms or avoided medical procedures from those without a history of such symptoms. In Study 6, data from Studies 2 through 5 were pooled, and the findings of Study 2 were replicated. The 1-factor model also fit the data well for men and women in Study 6. Lastly, IPS-Anx scores differentiated those with blood-injection-injury phobia (n = 39) from those without this phobia (n = 43) in Study 7. These findings suggest that the IPS-Anx has excellent psychometric properties, making it suitable for use in programmatic research on injection phobia. However, future research examining the validity of a short form of the scale with only the Contact Fear items may further improve the efficiency and utility of the IPS-Anx. (Contains 10 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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