Suchergebnisse

Population and Public Health (SPPH), School of ; Medicine, Faculty of ; Reviewed ; Faculty

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<i>Objective:</i> To document the role of physicians' family history of cancer in terms of personal use of cancer preventive services and in recommending that patients receive such services. <i>Methods:</i> We examined the Women Physicians' Health Study, a questionnaire-based study of a representative sample of 4,501 female physicians in the United States. <i>Results:</i> Among the physicians surveyed, 38.9% (95% confidence interval 37.1–40.7) reported a family history of cancer. A physician's self-reported family history of a specific cancer was positively associated with the physician having had a more recent screening exam for that cancer. Family history of any cancer was positively associated with older age, white race, recent sigmoidoscopy, recent mammogram, digital rectal exam, a blood stool test, history of cigarette smoking and history of recent alcohol use. Physicians' family histories did not significantly influence the reported frequency of recommendations of screening services for their patients. <i>Conclusions:</i> The observed association between a positive physician family history and personal cancer prevention practices suggests that physicians are receptive to the concept of a positive family history of cancer as a risk factor for cancer. This could present an educational opportunity for physicians to emphasize the importance of cancer family history in patients, particularly with respect to underutilized services such as screening for colorectal cancer.

Background: Trends in New Zealand (NZ) medical students' health and the influence of a wellbeing curricula are unknown. Methods: The author's collected self-report data from NZ medical students on 'Graduation Day' from 2014 to 2018, using a serial cross-sectional survey design with validated scales assessing psychological health, stigma, coping, and lifestyle. Comparisons were made with NZ general population same-age peers. Analyses examined trends, differences between 'cohorts' of students receiving different exposures to a wellbeing curriculum, and correlations between students' own lifestyle practices and their frequency of talking with patients about those topics. Results: Of 1,062 students, 886 participated. The authors found statistically significant self-reported increases from 2014 to 2018 for negative psychological indices, including scores for distress and burnout, suicidal thoughts in the preceding year, and the likelihood of being diagnosed with an anxiety disorder. There was a significant increase in numbers of students reporting having their own doctor as well as increased healthy coping strategies and a significant decrease in stigma scores. Academic cohorts of students who had completed a wellbeing curriculum were more likely to report high distress levels, having been diagnosed with a mood disorder, and being non-drinkers than students without wellbeing training. When compared to NZ peers, medical students smoked less, exercised more, and were less likely to have diagnosed mood and anxiety disorders, but reported more distress. The authors found a significant correlation between the amount of exercise students undertook and their likelihood to discuss exercise with patients. Conclusions: NZ medical students have better physical health than general population peers and are more likely to discuss exercise with patients if exercising themselves. However, cohorts of graduating students report increasing distress despite the implementation of a wellbeing curriculum. Research is needed into mechanisms between students' self-awareness, willingness to report distress, stigma, mind-set, coping, and psychological outcomes, to inform curriculum developers.

BackgroundMost U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California.MethodsRespondents were part of Stanford University's WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18-2/15/18) and 6-months (7/1/2018-7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others' cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization.ResultsThe sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others' cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization ...

Purpose– Delivery of sustainability-related curriculum to undergraduate students can be problematic due to the traditional "siloing" of curriculum by faculties along disciplinary lines. In addition, while there is often a ready availability of courses focused on sustainability issues in the later years of students' programs, few early entry-level courses focused on sustainability, broad enough to apply to all disciplines, are available to students in the first year of their program.Design/methodology/approach– In this paper, we describe the development, and preliminary implementation, of an entry-level, interdisciplinary sustainability course. To do so, the authors describe the development of a university-wide initiative designed to bridge units on campus working and teaching in sustainability areas, and to promote and support sustainability curriculum development.Findings– The authors describe the conceptual framework for organising course content and delivery. The authors conclude with an informal assessment of the successes and challenges, and offer learning activities, student assessments and course administration recommendations for consideration when developing courses with similar learning goals.Originality/value– The positive and negative experiences gained through developing and offering a course of this nature, in a large research-focused university, offers knew insights into potential barriers for implementing first-year cross-cutting sustainability curriculum.