A multidisciplinary health care team's efforts to improve educational attainment in children with sickle-cell anemia and cerebral infarcts

The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically before and after the intervention. A baseline evaluation was completed assessing the presence of an Individualized Education Plan (IEP), grade retention in school, and days absent from school in the year preceding the intervention. A postintervention assessment occurred 2 years later for these same measurements. At baseline, 74% (17 of 23) of the students were receiving IEPs. Two years later, 87% (20 of 23) students received IEPs (p = .34). Despite the intervention, the rate of children retained in their school grade increased from 0.6 per 100 years in school at baseline to 1.7 per 100 years, 95% CI (-3.86, 1.49). The school absenteeism rate did not significantly change after the intervention; the average days absent per student rose from 15.5 to 22.5, (p = .05). The multidisciplinary team effort alone was insufficient to decrease grade retention and absenteeism rate. Further support, from either the parents or school administration, is needed to increase education attainment of students with cerebral infarcts.     

学校预防艾滋病教育对中学生知识态度和技能的影响

目的 通过学校预防AIDS教育，促进学生预防AIDS知识、态度和技能，为在我国中学开展预防AIDS教育提供重要的实践经验。方法 对学校健康教育教师进行了为期两天的培训。为评价教育前后学生预防AIDS知识、态度和技能的变化，对约8000名参与此项研究的初一、高一学生进行了教育前和教育后的问卷调查。结果 教育后学生预防AIDS基本知识平均得分由教育前的7．3提高到11．2(满分为15分)；知道如何避免感染AIDS的比例由教育前的47．9％上升到83．8％；与家长及朋友谈论HIV／AIDS的比例分别由教育前的31．1％、39．6％上升到44．2％和59．2％；表示愿意与HIV感染者／AIDS病人同班上课的比例由教育前的7．4％上升到26．1％；反对男青年及女青年婚前性行为的比例分别由教育前的45．3％、50．6％上升到54．9％和61．2％。结论学校预防AIDS健康教育对增加学生预防艾滋病知识、培养正确的性道德观念、不歧视HIV感染者以及促进学生谈论和宣传预防HIV／AIDS知识等方面均产生了积极的影响。     

Targeting school tobacco policy: lessons from the Acadiana Coalition of Teens Against Tobacco (ACTT)

This case study examines the comparative effect of no-use school tobacco policies and restricted-use tobacco policies on teacher and student smoking behaviors and attitudes. Data from teachers (n = 1,041) and ninth-grade students (n = 4,763) at 20 schools in five districts in southern Louisiana were available. No significant difference was observed between teacher smoking (11% vs. 13%, p = .42) or student smoking (24.6% vs. 25.2%, p = .75) at no-use versus restricted-use policy schools. The proportion of teachers smoking on campus at no-use or restricted-use schools was not significantly different. Teachers at restricted-use schools were however less concerned about students seeing teachers smoke and less supportive of a no-use policy than teachers at no-use schools. Tobacco use policies are often not promoted, and enforcement of policies impacting teachers is complex. Changing social norms for smoking at high schools through policy promotion and enforcement is understudied.     

Enhanced surveillance for adverse events following immunization: Two years of dTap catch-up among high school students in Yukon, Canada (2004, 2005)

BACKGROUND: To address the increasing age of pertussis cases, Yukon replaced the Grade 9 tetanus/diphtheria/inactivated polio booster with diphtheria/tetanus/acellular pertussis (dTap) and implemented a dTap catch-up program for Grade 12 students. The program began in June 2004, making Yukon one of the first Canadian jurisdictions to introduce dTap within five years of a tetanus booster. We implemented enhanced surveillance to monitor adverse events following immunization (AEFI) to determine whether students receiving dTap > or =3 to <5 years after their last tetanus booster were at increased risk of severe AEFI. METHODS: Students completed a self-administered AEFI questionnaire one week post-dTap vaccination. Public health professionals contacted students reporting severe AEFI. Health care providers were requested to report AEFI. Symptom rate, severity and duration were compared between students receiving dTap > or =3 to <5 years after their last tetanus booster and those receiving it >5 years later. RESULTS: The > or =3 to <5 years group was more likely than the > or =5 years group to report pain at the injection site (70.6% vs. 61.5%, p=0.038) and less likely to report injection site redness (10.0% vs. 17.3%, p=0.022), injection site swelling (8.9% vs. 16.4%, p=0.013), decreased energy (10.0% vs. 17.1%, p=0.023), body aches (2.2% vs. 7.2%, p=0.014) and sore joints (3.3% vs. 10.1%, p=0.004). Severe AEFI did not differ between the groups (3.3% vs. 5.6%, p=0.232). Health care professionals reported no AEFI. CONCLUSIONS: Results suggest no increased risk of severe AEFI among students receiving dTap > or =3 to <5 years after their last tetanus booster.     

A comparison of nutrition knowledge of freshmen and senior medical students: a collaborative study of southeastern medical schools.

It has been documented previously that nutrition knowledge of senior medial students at ten southeastern medical schools varies and is positively correlated with student assessment of the quantity and quality of nutrition education. To determine whether the differences in knowledge are related to the medical educational experience or are simply a reflection of differences in the students' knowledge on entry to medical school, the same examination was administered to entering freshmen at eight of the medical schools. The knowledge scores of freshmen were remarkably homogeneous from school to school (53 +/? 1%, range 51-55%), and nutrition knowledge was significantly higher for seniors than for the freshmen at all schools (mean 69 vs 53%, p less than 0.0001). On the basis of responses to survey items on the examination, the freshman medical students were more inclined than senior students to take a nutrition elective (62 vs 34%, p less than 0.0001), and more freshman rated nutrition as being important to their careers (74 vs 59%, p less than 0.05). These data indicate that 1) entering freshman medical students at the different schools studied have comparable levels of nutrition knowledge and are receptive to nutrition education, and 2) differences in medical training programs most likely explain the previously documented variability in nutrition knowledge of graduating medical students. These findings have important implications for professionals planning curricula for medical-nutrition education.     

A comparison of nutrition knowledge of freshmen and senior medical students: a collaborative study of southeastern medical schools

It has been documented previously that nutrition knowledge of senior medial students at ten southeastern medical schools varies and is positively correlated with student assessment of the quantity and quality of nutrition education. To determine whether the differences in knowledge are related to the medical educational experience or are simply a reflection of differences in the students' knowledge on entry to medical school, the same examination was administered to entering freshmen at eight of the medical schools. The knowledge scores of freshmen were remarkably homogeneous from school to school (53 +/- 1%, range 51-55%), and nutrition knowledge was significantly higher for seniors than for the freshmen at all schools (mean 69 vs 53%, p less than 0.0001). On the basis of responses to survey items on the examination, the freshman medical students were more inclined than senior students to take a nutrition elective (62 vs 34%, p less than 0.0001), and more freshman rated nutrition as being important to their careers (74 vs 59%, p less than 0.05). These data indicate that 1) entering freshman medical students at the different schools studied have comparable levels of nutrition knowledge and are receptive to nutrition education, and 2) differences in medical training programs most likely explain the previously documented variability in nutrition knowledge of graduating medical students. These findings have important implications for professionals planning curricula for medical-nutrition education.     

Schoolteachers’ Nutrition Knowledge,Beliefs, and Attitudes Before and After an E-Learning Program

ObjectiveΤο explore teachers’ nutrition knowledge, beliefs, and attitudes and to examine the effectiveness of an electronic learning (e-learning) program in teachers’ nutrition knowledge.DesignCross-sectional and experimental design.SettingThe study took place in Greece, while schoolteachers were invited by e-mail.ParticipantsTeachers of primary and secondary education, with no exclusion criteria, were enrolled in the study between March, 2015 and 2016.Main Outcome MeasuresSchoolteachers' nutrition knowledge, beliefs, and attitudes.InterventionTeachers completed a 36-item nutrition questionnaire and then a subgroup participated in an e-learning program. After the intervention, teachers completed the same questionnaire.AnalysisPrincipal component analysis and multivariate logistic regression were used for data analysis.ResultsA total of 1,094 teachers completed the questionnaire; 619 participated in the e-learning program. Teachers showed moderate nutrition knowledge scores (ie, 65% correct answers) before the intervention, whereas their attitudes regarding acting as role models and their belief in the importance of the role of nutrition were associated with 74% (odds ratio, 1.28; 95% confidence interval, 1.13–1.45) and 79% (odds ratio, 1.21; 95% confidence interval, 1.07–1.37) increased possibility of having good nutrition knowledge, respectively. The e-learning program was effective in strengthening teachers’ nutrition knowledge (P < .001) and improving their beliefs and attitudes (P < .05).Conclusions and ImplicationsFuture research is needed to validate the current results, which can be used to design and implement similar educational programs to teachers as a means of creating health-promoting schools.     

Prioritization of intervention domains to prevent cardiovascular disease: a country-level case study using global burden of disease and local data

AMI and stroke are the leading causes of premature mortality and hospitalizations in China. Incidence data at the population level for the two diseases is limited and the reliability and completeness of the existing incidence registry have not been investigated. We aim to assess if the completeness of case ascertainment of AMI and stroke incidence has improved since the implementation of electronic reporting and to estimate the incidence of AMI and stroke in Tianjin, China. We applied the DisMod II program to model the incidence of AMI and stroke from other epidemiological indicators. Inputs include mortality rates from Tianjin’s mortality surveillance system, and the point prevalence, remission rates and relative risks taken from IHME’s Global Burden of Disease studies. The completeness of AMI and stroke incidence reporting was assessed by comparing the sex and age-specific incidence rates derived from the incidence surveillance system with the modeled incidence rates. The age and sex standardized modeled incidence per 100,000 person-year decreased (p?相似文献   

Knowledge of stroke risk,signs of stroke,and the need for stroke education among children with sickle cell disease and their caregivers

Objectives : This study assessed stroke knowledge and the need for stroke education among children with sickle cell disease (SCD) and their caregivers. Methods : A cross-sectional study was conducted and includes: (1) structured interviews of 44 children with SCD and their 50 caregivers, and (2) a self-administered survey completed by medical directors of 22 SCD centers. The participants were interviewed regarding stroke knowledge and stroke educational materials. Results : Among the caregivers, only 34% named stroke as a complication associated with SCD, 36% were aware that their children were at higher risk, and 46% were not able to identify any warning signs of stroke. Only 11% of the children could accurately describe a stroke. Although 82% of the medical directors provided stroke information to caregivers, only 50% provided stroke educational materials to children. Caregivers and children were interested in receiving information about stroke. The preferred format for the educational material was a pamphlet for adults and a video for the children. Conclusions : Children with SCD, caregivers, and healthcare providers need and desire educational materials about stroke. Educational materials to improve knowledge about stroke may be an important strategy to increase completion of stroke screening tests.     

Plasma leptin association with body composition and energy expenditure in sickle cell disease

OBJECTIVE: To examine the association between fasting plasma leptin concentrations and the hypercatabolic state observed in sickle cell disease (SCD). METHODS: Plasma leptin concentration and resting energy expenditure (REE) were measured in 37 SCD patients (10 men, 12 boys 14 to 18 years-old, seven women, and eight girls 14 to 18 year-old) and in 37 age, gender and fat mass (FM) matched controls. Body composition was measured hydrostatically, REE by whole room-indirect calorimeter, and plasma leptin using an RIA kit. RESULTS: Plasma leptin concentration and leptin normalized for body fat (ng/dL*kg FM(-1)) were significantly lower in SCD patients than in non-SCD controls (4.00+/-3.23 vs. 9.94+/-14.69, p=0.021 and 0.406+/-0.260 vs. 0.643+/-0.561, p=0.024, respectively). A positive linear association between log plasma leptin and FM was observed in both males and females, adjusting for age and SCD status. The strength of this association was greater in females compared with males (slope=0.699 and 0.382 log ng/mL per 10 kg FM, respectively; p=0.013). SCD patients on average demonstrated a higher REE, adjusting for FFM (p<0.0001). Log plasma leptin and FM were not statistically significant predictors of REE after adjustment for FFM and SCD. CONCLUSIONS: Once corrected for body composition, mean plasma leptin concentration was significantly lower among female SCD patients than among non-SCD matched controls. Although REE was higher in SCD patients, there is no simple association between leptin and REE in SCD.     

Use of a computerized kiosk in an assessment of food safety knowledge of high school students and science teachers

A multimedia touch-screen kiosk was used to assess food safety knowledge and convey food safety principles to 93 high school science teachers and 165 students. The kiosk program based on the FightBAC messages informed users of correct responses and reasons for the response. Teachers correctly answered more questions than students; however, for the areas of hand washing, sources of foodborne illness, and handling of leftover foods, at least 40% of both students and teachers provided incorrect answers.     

Implementation of a school-based Fitbit program for youth with Autism Spectrum Disorder: A feasibility study

BackgroundSchool settings may be optimal for physical activity interventions for youth with Autism Spectrum Disorder (ASD). Additionally, consumer-based fitness trackers may encourage youth with ASD to increase their physical activity levels, however, no studies have examined whether a fitness tracker program would be feasible in youth with ASD.ObjectiveTo examine the feasibility of a 12-week school-based Fitbit© program for youth with ASD.MethodsSix classroom teachers and their students (n = 45) were provided with Fitbit fitness trackers to wear over 12-weeks. Classroom teachers monitored student tracker use and completed open-ended surveys to describe both their experience and their students’ experience with the fitness trackers.ResultsOut of the 45 eligible students, 42 (94%) opted to participate in the study. All six teachers and 32 (76%) of the 42 students wore the fitness tracker daily over 12 weeks. Teachers reported that students were most interested in tracking their daily steps, and the short batter life, and account set-up were the biggest challenges to students. All six teachers felt that this program could have long-term sustainability, especially if tracker use could be incorporated into school curriculum and classroom activities.ConclusionsA school-based Fitbit program appears to be both feasible, and well-accepted by students with ASD. Future work should evaluate the preliminary efficacy of this type of program.     

Gender differences in health-related practices among university students in northeast Thailand

The study aims at appraising gender differences in health-related practices, and health behaviour among university students of the Khon Kaen University, northeast Thailand, using a self-administered questionnaire. Of 539 university students, there were 155 males, 384 females, with mean ages 19.7 (+/- 1.2) and 19.6 (+/- 1.1) years, respectively. Persistent health problems were not significantly different between male and female students (12.9% vs. 15.4%). An average body mass index (BMI) was significantly different between male and female students (20.2 +/- 2.1 vs. 19.8 +/- 2.1). Female students reported positive health habits, in terms of drinking, smoking, sun protection, tooth brushing, fruit consumption, conscious efforts to avoid fat and cholesterol, over men, while regular exercise and safety belt use were more likely practised among male students. Using ANOVA and pairwise multiple comparisons, female students demonstrated better health eating habits than men (p = 0.0001). Coronary heart disease preventive habits between the medical and nonmedical faculty was greater for female students than for male students (p = 0.0006 for gender; p = 0.0001 for faculty). Health behaviour (combination of health eating habits, deliberate nutritional practices and coronary heart diseases preventive behaviour) was found to be better practised among women than men (p = 0.0001). These findings, therefore, should focus attention on university students as a target group for health education.     

苏州市高校师生器官捐献的认知状况调查

目的 了解苏州市高校师生对器官捐献的认知、态度及主要的影响因素,为开展人体器官捐献试点工作提供参考.方法 以问卷调查形式,对苏州市部分高校师生进行器官(或遗体)捐献的认知度现状调查.结果 所调查的475名对象中器官捐献愿意率为52.2％,其中汉族高于其他少数民族(P=0.033);大学师生对器官捐献相关知识知晓率较低,其中医学相关专业师生略高于非医学类专业;高校师生获取相关知识主要途径中,广播电视59.4％、网络57.1％、学校教育22.7％、医护人员宣传8.6％;60.4％的调查对象认为捐献器官可以赐予他人生存条件,延续自己生命;传统文化和观念的束缚、不了解捐献程序和法规、担心医学不合理应用等是目前导致师生不愿意捐献的主要原因.结论 苏州市高校师生总体愿意捐献率较高,但相关捐献知识仍有待于进一步提高,今后在高校素质教育中,可以聘请工作在器官捐献一线的医疗护理人员深入校园对师生进行系统全面的知识宣教.     

沈阳市中学生预防艾滋病教育影响评价

目的 探讨学校预防AIDS教育对学生知识、态度的影响。方法 以沈阳市9所中学初一、高一学生为研究对象,由受过培训的健康教育教师在学校对学生进行教育,于教育前后对学生进行有关预防AIDS知识和态度方面的不记名问卷调查。结果 教育后学生预防AIDS基本知识平均得分由教育前的6．67提高到10．98（满分为15分）;反对男青年及女青年婚前性行为的比例分别由教育前的47．8％、52．0％上升到57．3％和63．0％;表示愿意与AIDS患同班上课的比例由教育前的5．1％上升到22．6％。结论 学校预防AIDS教育使学生预防AIDS基本知识得到提高,拥有正确态度的学生比例增加。但学生中拥有正确态度的比例仍有待进一步提高,因此,在今后的教育中除了应重视基本知识的传授外,还应重视发展学生与预防AIDS有关的正确态度。     

Pre-test and post-test in a medicine clerkship

Offered the opportunity to take the previous quarter's post-test as a pre-test at the beginning of their 3-month medicine clerkship with the understanding it would have no effect on their final grades, 132 of 148 students (89%) took this opportunity. Post-test means for each quarter's group were significantly greater than pre-test means ( P = 0.0001). Pre-test means did not increase over the four quarters of the year of this study despite increasing student experience in other clinical disciplines. For this entire year correlations were as follows: Pre-test vs post-test r =0.591 ( P =0.0001), pre-test vs clinical r =0.306 ( P =0.0004), and post-test vs clinical r =0.329 ( P =0.0001). By quarter these correlations were generally consistent. An interesting and unexpected finding was that students in the autumn quarter had significantly lower pre-test and clinical scores than students in the winter quarter. This may indicate that students highly motivated to medicine take this as their first clinical clerkship and those least motivated as their last first clinical-year clerkship.     

Evaluation of the Impact of a Diabetes Education Curriculum for School Personnel on Disease Knowledge and Confidence in Caring for Students

BACKGROUND: School personnel may lack knowledge of diabetes and be unprepared to address the needs of students with type 1 diabetes. This project evaluated the effectiveness of a type 1 diabetes education program for school personnel on increasing knowledge of diabetes and confidence in caring for students with diabetes. METHODS: Two types of diabetes education programs were created for school personnel. The basic program provided a 60-minute overview of diabetes. The expanded program, intended for volunteer health aides, provided participants with a more in-depth overview of diabetes during a 180-minute session, including demonstrations of how to assist students with insulin injections. Instruments were created to assess changes in diabetes-related knowledge and confidence in caring for students. Separate knowledge instruments were created for the basic and expanded programs. Knowledge instruments were administered before and after delivery of the education programs to both groups. Confidence instruments were administered before and after for persons completing the expanded program. RESULTS: A total of 81 school personnel participated in the basic (N = 44) or expanded programs (N = 37). Overall knowledge regarding diabetes significantly increased in both the basic and expanded programs from baseline (p < .001). Confidence in caring for students with diabetes also increased from pretest to posttest, both for overall confidence and each individual item (p < .001). CONCLUSIONS: Educational programs offered for school personnel can lead to increased knowledge and increased confidence in caring for students with diabetes, which may assist school personnel in addressing the needs of students with diabetes.     

The effect of endorsement by local opinion leaders and testimonials from teachers on the dissemination of a web-based smoking prevention program

The effect of endorsement by local opinion leaders and teacher testimonials on dissemination of a web-based program to prevent smoking was tested in a group-randomized 2 x 2 factorial post-test-only design with 394 junior and senior high schools. Schools were assigned to condition by region served by local tobacco control coalitions. Visits to the 'Consider This' (CT) website were recorded. Teachers at 226 schools completed a post-test. More schools receiving the opinion leader letter had visits to the website by teachers (12%) than schools not receiving it (4%, P = 0.015). More teachers at schools receiving the testimonials reported reading the materials (29%) than those not receiving them (22%, P = 0.059). Testimonials created more intentions to use CT (49% testimonials, 35% no testimonials, P = 0.047). Testimonials may be effective at increasing teachers' exposure to the promotional materials but recommendations from opinion leaders appear to convince some teachers to visit and assign students to use it.     

Outcomes from a school-based nutrition education program alternating special resource teachers and classroom teachers

This study modified a successful nutrition program to improve its transferability and potential for institutionalization. Specific aims were to determine: 1) if 16 nutrition lessons taught alternately by special resource teachers (SRT) and classroom teachers, could produce outcomes equivalent to 24 SRT lessons; and 2) teachers' reactions to the program. The quasi-experimental design used classrooms (19 treatment and 19 comparison) in matched schools. Surveys and plate waste measured children's outcomes, and classroom teachers were observed and interviewed. Treatment students showed greater knowledge and self-efficacy scores and consumed 0.36 more servings of fruits and vegetables at lunch. Behavioral differences between groups were greater when SRTs provided all instruction. Teachers supported the program and anticipated teaching more nutrition on their own, but noted serious structural barriers. Findings support the need for long-term contact to induce behavior change and the advantage of using teachers specifically trained in nutrition and experiential education.