A Preliminary Qualitative Evaluation of an In-home Geriatric Care Elective Experience for Third-year Medical Students.

INTRODUCTION: The aging population is growing quickly and has a higher prevalence of comorbid and chronic diseases. A majority of this group resides in the home setting. The purpose of this study was to examine the attitudes of third-year medical students following a pilot component of an internal medicine clerkship, consisting of four in-home visits with geriatric patients. METHODS: A qualitative study design, utilizing focus groups, was used to assess general themes in students' responses regarding their attitudes to geriatrics, the field of geriatrics and the in-home care pilot program. RESULTS: Twelve students participated in three focus group sessions. Six themes were identified across all focus group sessions. These included 1) distinct advantages to the home setting, 2) more time for relationship building, 3) increased insight to the aging process, 4) increased compassion, 5) suggestions for program improvement, and 6) future quality of care. CONCLUSION: The results demonstrate that students found the program to be of value to their medical education. Students developed positive attitudes and compassion for the elderly community. The insight they gained during this program may allow them to understand their role in caring for increasing numbers of aging patients in future populations. Suggestions made by the students showed their perceived value of the program and desire for it to continue for future students. Future studies should utilize validated tools and more longitudinal study designs to assess temporal changes in attitudes.

School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

BACKGROUND: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. METHODS: We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. RESULTS: Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. CONCLUSIONS: We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region.

United States medical students' knowledge of Alzheimer disease.

PURPOSE: A knowledge gap exists between general physicians and specialists in diagnosing and managing Alzheimer disease (AD). This gap is concerning due to the estimated rise in prevalence of AD and cost to the health care system. Medical school is a viable avenue to decrease the gap, educating future physicians before they specialize. The purpose of this study was to assess the knowledge level of students in their first and final years of medical school. METHODS: Fourteen participating United States medical schools used e-mail student rosters to distribute an online survey of a quantitative cross-sectional assessment of knowledge about AD; 343 students participated. Knowledge was measured using the 12-item University of Alabama at Birmingham AD Knowledge Test for Health Professionals. General linear models were used to examine the effect of demographic variables and previous experience with AD on knowledge scores. RESULTS: Only 2.5% of first year and 68.0% of final year students correctly scored ten or more items on the knowledge scale. Personal experience with AD predicted higher knowledge scores in final year students (P= 0.027). CONCLUSION: Knowledge deficiencies were common in final year medical students. Future studies to identify and evaluate the efficacy of AD education programs in medical schools are warranted. Identifying and disseminating effective programs may help close the knowledge gap.

Interventions for the treatment of obesity among children and adolescents in Latin America: a systematic review.

OBJECTIVE: The objective of this systematic literature review was to identify evidence-based strategies associated with effective healthcare interventions for prevention or treatment of childhood obesity in Latin America. MATERIALS AND METHODS: A systematic review of peer-reviewed, obesity-related interventions implemented in the healthcare setting was conducted. Inclusion criteria included: implementation in Latin America, aimed at overweight or obese children and evaluation of at least one obesity-related outcome (e.g., body mass index (BMI), z-score, weight, and waist circumference, and body fat). RESULTS: Five interventions in the healthcare setting targeting obese children in Latin America were identified. All five studies showed significant changes in BMI, and the majority produced sufficient to large effect sizes through emphasizing physical activity and health eating. CONCLUSION: Despite the limited number of intervention studies that treat obesity in the healthcare setting, there is evidence that interventions in this setting can be effective in creating positive anthropometric changes in overweight and obese children.

Interventions for the treatment of obesity among children and adolescents in Latin America: a systematic review / Intervenciones para el tratamiento de la obesidad en niños y adolescentes en Latinoamérica: una revisión sistemática

Objective. The objective of this systematic literature review was to identify evidence-based strategies associated with effective healthcare interventions for prevention or treatment of childhood obesity in Latin America. Materials and methods. A systematic review of peer-reviewed, obesity-related interventions implemented in the healthcare setting was conducted. Inclusion criteria included: implementation in Latin America, aimed at overweight or obese children and evaluation of at least one obesity-related outcome (e.g., body mass index (BMI), z-score, weight, and waist circumference, and body fat). Results. Five interventions in the healthcare setting targeting obese children in Latin America were identified. All five studies showed significant changes in BMI, and the majority produced sufficient to large effect sizes through emphasizing physical activity and health eating. Conclusion. Despite the limited number of intervention studies that treat obesity in the healthcare setting, there is evidence that interventions in this setting can be effective in creating positive anthropometric changes in overweight and obese children.

Objetivo. El objetivo de esta revisión sistemática de la literatura fue identificar estrategias basadas en evidencia asociadas con intervenciones en salud efectivas para la prevención y el tratamiento de la obesidad infantil en Latinoamérica. Material y métodos. Se realizó una revisión sistemática por pares de intervenciones relacionadas con la obesidad, que fueron llevadas a cabo en clínicas de atención para la salud. Criterios de inclusión: implementadas en Latinoamérica, dirigidas a niños con obesidad y sobrepeso y evaluación de por lo menos un resultado relacionado con obesidad (ej. índice de masa corporal (IMC), puntaje Z, peso, circunferencia de cintura o grasa corporal). Resultados. Se identificaron cinco intervenciones dirigidas a niños obesos en clínicas de salud en Latinoamérica. Todas las intervenciones mostraron cambios significativos en IMC y la mayoría obtuvo un tamaño del efecto grande a través de la promoción de actividad física y alimentación saludable. Conclusión. A pesar del número limitado de estudios de intervención para tratar la obesidad en clínicas de salud, existe evidencia que las intervenciones en estos lugares pueden ser efectivas en alcanzar cambios antropométricos positivos en los niños con obesidad y sobrepeso.