What do children know about fat,fiber, and cholesterol? A survey of 5,116 primary and secondary school students

Knowledge and attitude regarding fat, fiber, and cholesterol were assessed by questionnaire in a multiracial sample of 5,116 school children ages 5 to 18, from five states. Across grades 1 through 12, the students were generally aware of the health effects of dietary fat, fiber, and cholesterol. However, students appear to have only limited knowledge of the cholesterol and fiber content of specific foods. For example, while most students were aware that butter contains cholesterol, they were generally unaware that whole milk contains cholesterol. The foods thought most likely to contain fiber were whole wheat bread and bran cereal although, with the exception of the high school sample, most students were unaware that beans contain fiber. These data suggest that American children are lacking essential information required to make positive nutritional choices. Additional research is needed to develop and test age-appropriate methodologies to inform children of the fat and fiber content of individual foods.     

What do medical students know about cause and epidemiology of the Creutzfeldt-Jakob disease in Germany?

Due to the increase of patients with the variant Creutzfeldt-Jakob disease (vCJD) in Great Britain and the first cases of autochthonous BSE cases in Germany, the study tried to investigate the knowledge of medical students about the epidemiology of CJD in Germany and how they assess the influence of different factors on the etiology of CJD. Altogether 63 first year medical students, 96 third year medical students and 50 nurses were included in an anonymous questionnaire survey. They were asked to estimate the annually incidence of CJD in Germany and to assess, by using analogue-scales, the influence of different factors on the risk of contracting CJD. For the medical students the median was 100 and for the nurses the median was 10 annual CJD cases. All participants, and especially the males, emphasised the influence of "risk behaviour" and "environmental factors" on the risk of contracting CJD, the factor "stress/ emotional strain" was seen as most unimportant. No significant differences between female and male participants in the knowledge about the incidence of CJD in Germany were found. It becomes obvious, that epidemiological knowledge about CJD in medical staff is associated with different and gender-specific views on the etiology. Medical education should consider this to avoid endangering medical staff and patients due to overprotection or insufficient precautions.     

What do students want? The types of learning activities preferred by final year medical students

CONTEXT: A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment. OBJECTIVES: To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship. SUBJECTS: Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors. METHOD: A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations. RESULTS: The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care. CONCLUSION: Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment.     

Do diseases have a prestige hierarchy? A survey among physicians and medical students

Surveys have shown that the prestige of medical specialities is ordered hierarchically. We investigate whether similar tacit agreement in the medical community also applies to diseases, since such rankings can affect priority settings in medical practice. A cross-sectional survey was performed in three samples of physicians and medical students in Norway in 2002. A questionnaire was sent to 305 senior doctors (response rate, 79%), 500 general practitioners (response rate, 65%) and 490 final-year medical students (response rate, 64%). Outcome measures were ratings on a 1-9 scale of the prestige these respondents believed most health personnel would accord to a sample set of 38 different diseases as well as 23 medical specialities. Both diseases and specialities were clearly and consistently ranked according to prestige. Myocardial infarction, leukaemia and brain tumour were among the highest ranked, and fibromyalgia and anxiety neurosis were among the lowest. Among specialities, neurosurgery and thoracic surgery were accorded the highest rank, and geriatrics and dermatovenerology the lowest. Our interpretation of the data is that diseases and specialities associated with technologically sophisticated, immediate and invasive procedures in vital organs located in the upper parts of the body are given high prestige scores, especially where the typical patient is young or middle-aged. At the other end, low prestige scores are given to diseases and specialities associated with chronic conditions located in the lower parts of the body or having no specific bodily location, with less visible treatment procedures, and with elderly patients.     

What do Swedish occupational therapists feel about research? A survey of perceptions, attitudes, intentions, and engagement

The aim of this study was to identify Swedish occupational therapists' perceptions and attitudes to research-related activities as well as the therapists' present engagement in future plans for research. A follow up design was used, and the study was undertaken between 1997 and 2003. A total of 425 and 442 Swedish occupational therapists responded to a postal questionnaire (response rate 74.4% and 70.4%). Questions regarding research-related activities were measured on a Likert-type scale, whereas questions referring to attitudes towards research used a semantic differential scale. There were small differences between the two surveys. The result showed that occupational therapists considered research-related activities to be an important part of their development of the professional role and status. Reading research literature to update knowledge was the most important research activity and the second most important activity was applying research findings to improve occupational therapy practice. High workload and lack of time were the most commonly mentioned barriers to participation in research- related activities. Occupational therapists read a large variety of journals, preferably in Swedish. The barriers to participation in research-related activities did not change from 1997 to 2003. The fact that occupational therapists reported reading research as rating highly gives hope for the future development of the occupational therapy profession and practice.     

What do mothers feed their children and why?

Health education interventions aimed at changing children's diets often target their mothers. However, little is known about what factors influence mothers' food choice for themselves and how this is related to their choice of food for their children. The present study aimed to examine the types of foods mothers eat themselves and their motivations for doing so in comparison with their choices for their primary school age children. In addition, the study aimed to assess whether the mother's dieting behaviour affected these differences. A questionnaire was completed by 218 (response rate 52%) mothers of children aged between 5 and 11 asking them about their behaviour and motivations for themselves and on behalf of their children. The results showed that mothers tend to feed their children in a less healthy way than they feed themselves. Specifically, they feed their children more sweet products, and more unhealthy breads and dairy products. However, whereas they are motivated more by practicality (e.g. availability, cost) and calories when choosing food for themselves, they state that health (e.g. nutritional value, long-term health) is more important when choosing for their children. In terms of the role of the mothers' dieting behaviour, dieters appeared to be more self-prioritizing than non-dieters in their differentiation between themselves and their children. The results are discussed in terms of the role of knowledge and cognitions in explaining the gaps between motivations and behaviour and the mothers' decisions for themselves and for their children. In addition, the implications for interventions are considered. In particular, it is suggested that changing a mother's own motivations and behaviour may not necessarily result in an improvement in their child's diet. Further, encouraging mothers to diet may be detrimental to their children's long-term health.     

What is dialogical research, and why should we do it?

Social scientists have explored the writing of Russian literary philosopher Bakhtin from a variety of perspectives, but little attempt has been made to apply Bakhtin's conception of dialogue to the conduct of research and the production of research reports. The author's questions relate to what dialogical research would look like and the ethical imperative of dialogical research.     

Becoming professional: when and how does it start? A comparative study of first‐year medical and law students in the UK

AIM: The purpose of this study is to investigate whether differences identified between first-year law and medical students in North America in the 1950s apply in the UK in the 1990s. First-year law and medical students are compared in terms of commitment to career, alternative career choices and length of time the student has wished to study for his/her chosen profession. METHOD: Questionnaires were administered to first-year law students at the University of East Anglia and Essex University and to first-year medical students at Liverpool University Medical School and St George's Hospital Medical School. A total of 162 questionnaires were completed by law students and 195 questionnaires from medical students. ANALYSIS: The questionnaire responses provided by law and medical students were analysed using a series of two-sample comparisons. Differences between the two groups were examined using t and chi-squared tests. In each of the seven questions answered by students, the differences between the law and medical students were found to be significant. This suggests a difference in career aspirations and perceptions between the two groups. RESULTS AND CONCLUSIONS: The study shows a greater commitment of medical students than law students to their chosen career. This is demonstrated by medical students' greater desire to pursue their career, their greater satisfaction with their choice of career and finding that more medical students would persist with reapplying for medicine than law students would in reapplying for law. It is also shown that medical students are twice as likely as law students to have a family member within the profession.     

What role do Death Doulas play in end‐of‐life care? A systematic review

Current health and social care systems do not always meet the needs of the dying in our communities. As a result, patients and families are choosing to place their trust in those who can advocate for them or fill the gaps in care. Birth Doulas have been working with women during pregnancy and after birth for many years, and we are now seeing a new role, that of a Death Doula emerging in the end‐of‐life care space. How Death Doulas work within health and social care systems is not understood and we conducted a systematic review to explore the published literature to explore the role and potential implications for models of care delivery. Following the PRISMA recommendations, we searched the literature in January 2018 via bibliographic databases and the grey literature without search date parameters to capture all published literature. We looked for articles that describe the role/work of a death doula or a death midwife in the context of end‐of‐life care, or death and dying. Our search retrieved 162 unique records of which five papers were included. We analysed the papers in relation to relationship to health service, funding source, number and demand for services, training, licensing and ongoing support, and tasks undertaken. Death Doulas are working with people at the end of life in varied roles that are still little understood, and can be described as similar to that of “an eldest daughter” or to a role that has similarities to specialist palliative care nurses. Death doulas may represent a new direction for personalised care directly controlled by the dying person, an adjunct to existing services, or an unregulated form of care provision without governing oversight.     

What has influenced patient health‐care expenditures in Japan?: variables of age,death, length of stay,and medical care

This study considers variables related to health-care expenditures associated with aging and long-term hospitalization in Japan. We focused on daily per capita inpatient health-care expenditures, and examined the impact of inpatient characteristics such as sex, age, survived or deceased, length of stay, adult disease, and type of medical care received during the duration of each stay. We analyzed data from the Survey of Medical-Care Activities in Public Health Insurance by multinomial logistic regression analyses. Age of patient had little impact on per capita inpatient health-care expenditures per day. As regards length of stay, inpatient stays of 8-14 days had a little impact on health-care expenditures. This study suggested that these results might be due to the kind of medical care received. More research is needed to determine the appropriate medical services to reduce long-term hospitalization. In the last month of care for patients who died, medical examinations had a great influence on health-care expenditures. This study showed that increasing medical examinations in the end-of-life care needs further investigation.     

How acceptable are innovative health-care technologies? A survey of public beliefs and attitudes in England and Wales

There has been a continuing debate about the extent to which the public finds health-care technological innovation acceptable. The public's ambivalence about scientific medicine may have been exacerbated, more recently, by developments such as the introduction of the 'new genetics' with their associated ethical and social implications and the claims that public trust in health care and practitioners and, more widely, in society has been eroded. The aim of this paper is to examine public attitudes to a range of innovative health-care technologies to see whether (i) certain technologies are perceived as particularly problematic, and (ii) attitudes to new health-care technologies are associated more broadly with beliefs about science, trust in health care and social trust, and perceptions of the benefits and risks of complementary and alternative medicine versus orthodox (technological) medicine. These questions are examined through a statistical analysis of data collected in a national, postal survey of the adult population (n = 1187) in England and Wales. The results showed public ambivalence about new health-care technologies, although genetic technologies, as a whole, were not seen to be problematic and their acceptability depended on their ability to control serious diseases. However, there was a level of consistency in attitude across the different technologies. Those consistently against new health-care technologies were also more likely to be suspicious of science, and doubtful about the benefits of other established, orthodox technologies (screening; medications) and to have less trust in health and health-care practitioners.     

What is the educational impact of standards‐based assessment in a medical degree?

CONTEXT: Many medical courses use standards-based assessment, usually reported by a restricted range of categories, but there is little evidence of its educational impact. This study aimed to evaluate the impact on medical student learning of changing to standards-based assessments reported by distinction, pass or fail. METHODS: We carried out a prospectively planned before-and-after study within an undergraduate medical course using a questionnaire to compare motivation and approaches to the study, and a diary to compare the number of hours spent studying. RESULTS: Questionnaire response rates were 607/752 (81%) before the change and 651/780 (83%) afterwards. Daily diary response rates were 1074/1478 (73%) before, and 1304/1844 (71%) after the change. Deep motive declined with class year during norm-referenced assessments but not with standards-based assessment (r = - 0.11 versus 0.01; P < 0.02). Deep strategy increased significantly under standards-based assessments in students in Years 2 and 3 (mean difference 0.64 [0.08-1.2]; P < 0.05) and Year 6 (mean difference 2.0 [0.03-3.9]; P < 0.05). Competitiveness scores declined as students progressed through the course in both cohorts. Students identified themselves as feeling more like a doctor after the change to standards-based assessments. Time spent studying was largely unchanged but the proportions of wanted discretionary study increased from 64% to 71% for students in Years 2 and 3, and from 65% to 70% for students in Years 4 and 5. CONCLUSIONS: The changes were associated with beneficial effects on deep motive, deep strategy, professional identify and intrinsically motivated study. There were no changes in competitiveness and minimal changes in amount of time spent studying.     

Does medical school cause health anxiety and worry in medical students?

OBJECTIVES: The aim of this study was to investigate the self-reported experience of health anxiety and worry in medical students compared with control subjects. It was hypothesised that medical students would experience more health anxiety as a consequence of being exposed to medical education, compared to students who are not routinely exposed to such knowledge. DESIGN: The design was cross-sectional. SETTING: Participants were recruited from London University (Guy's, King's & St Thomas' School of Medicine and King's College). PARTICIPANTS: Medical students (n = 449) and non-medical students (n = 485) were recruited across Years 1-4. Questionnaires relating to health anxiety and worry were completed at the end of their lectures. MAIN OUTCOME MEASURES: Health anxiety was measured using a questionnaire known as the Health Anxiety Questionnaire (HAQ). Worry was assessed using the Anxious Thoughts Inventory (ANTI). RESULTS: Health anxiety was significantly lower in medical students in Years 1 and 4 than in controls (P = 0.017 and P < 0.001, respectively). Worry was significantly lower in the medical students in all years of study. CONCLUSIONS: Medical students are not a cohort of preselected health-anxious people, nor are they 'worriers'. Medical education at a clinical level was shown to mitigate health anxiety in the medical student population.