Health Education Of Population Research Articles

Modern Trends in Development of Educational and Scientific Discipline ‘Public Health and Healthcare’: Its Methodological Role and Integrative Function

INTRODUCTION: In modern conditions of social development, there is a change of emphasis in definitions concerning not only public, but also individual health. Preserving and strengthening the health of the population is a complex task that implies the interaction of various specialists. This integration, the complexity of interaction in issues concerning preserving and strengthening the health of the population, should undoubtedly be reflected in the training of specialists, and, first of all, in higher medical education. AIM: To determine the role of the discipline ‘Public Health and Healthcare’ (PHH) in teaching population health issues and in the integration of departments of various profiles in the study of individual, group and population health in modern conditions. The article presents a discussion about modern trends in the development of the educational and scientific PHH discipline based on the opinions of students, teachers and the experience of Sechenovskiy University. Thus, students of profiles ‘General Medicine’, ‘Pediatrics’, ‘Medical and Preventive Care’ think that studying public health issues is the task of doctors of all clinical specialties (69.4%–76.7%), of hygienists ( 60.0%), of epidemiologists ( 30.0%). Integration in the teaching of PHH issues, according to teachers of PHH departments, in such types of activities as academic work, educational work, general scientific projects, joint printed works, textbooks and teaching aids, joint innovative projects, is mainly carried out with teachers of preventive educational disciplines, to a much lesser extent with teachers of clinical and fundamental disciplines. CONCLUSION: An integrative approach to definitions, terms, and concepts is needed in the study of the health of individuals, population groups and population with a significant variety of disciplines and departments teaching them. The methodological role in teaching these issues is the prerogative of the PHH discipline.

Teaching Population Panel Management: A Patient Outreach Activity in a Family Medicine Clerkship.

The delivery of population health education in medical school can be challenging. We developed a patient outreach activity for third-year students to teach them the role of population panel management in primary care. The family medicine undergraduate medical education and population health teams collaborated to develop an educational patient outreach toolkit. After an orientation, family medicine clerkship students were assigned to call patients on their faculty adviser's patient panel to discuss care gaps and identify barriers and potential strategies to improve care. After the experience, students completed reflection questions, which we analyzed. From February to August 2022, 82 third-year medical students participated in the patient outreach activity during their 6-week clerkship. Of the 1,235 total attempted calls, 24% of the patients scheduled their appointments afterward. After analyzing the reflective student feedback, we identified six main takeaways, which focused on the importance of population health, the identification of barriers to care, positive and negative feelings that students experienced when making calls, student self-identified areas of growth, and the fragmentation/inefficiency of the health care system. An opportunity exists to continue to teach students about how to communicate with patients about their health and how to address and improve social determinants of health. This curricular activity can be a step toward efforts to align population health and clinical practice and a way for medical students to add value by educating patients.

Health in All Education: A Transdisciplinary Learning Outcomes Framework

Historical and recent population health issues necessitate the goal of educating and preparing a transdisciplinary workforce with population health knowledge and competence to be able to develop, implement, and evaluate innovative and feasible solutions that not only address multifaceted community health problems downstream but also to be able to predict and prevent those factors that contribute to an inequitable health burden upstream. To identify where population health education is already shared among multiple disciplines, the Centers for Disease Control and Prevention's Academic Partnerships to Improve Health program conceptualized the Health In All Education initiative that was implemented in partnership with the Association for Prevention Teaching and Research. The purpose of the initiative was to (1) show the importance of integrating population health principles into higher-education transdisciplinary practices; (2) discuss examples of Centers for Disease Control and Prevention collaboration with disciplines related to public health (i.e., economics, environmental engineering, health informatics, health law and policy, social work, liberal education in general education); and (3) explore opportunities to promote transdisciplinary learning to prepare for collaborative, interprofessional practice in population health. This article introduces the Health in All Education Learning Outcomes Framework, a set of shared population health concepts identified on the basis of discipline-representative consensus. The following domains were identified as having transdisciplinary applicability on the basis of established public health curricula, competency, and learning outcome models: determinants of health, evidence-based approaches, population health focus, interprofessional practice, community collaboration, environmental health, occupational health, global health, diversity/cultural competence, health systems, finance and budgeting, and health law and policy.

Integrating Quality Improvement and Community Engagement Education: Curricular Evaluation of Resident Population Health Training

The Accreditation Council for Graduate Medical Education requires all residents be trained in population health, but the most effective training strategies to impact care of patients and populations are not well established. The purpose of this study is to assess resident self-efficacy and expected application of population management skills through iterative experiential, longitudinal, team-based training in the office and community settings. Using a prospective longitudinal curricular evaluation, we surveyed residents at a single institution from 2014-2020, evaluating self-efficacy in population health skills as well as perceived impact on patient care and future practice. We collected surveys before and after participating in a 3-year, longitudinal, team-based, experiential population health curriculum that integrates clinic-based quality improvement and community engagement projects. Fifty-nine of 68 residents (87%) responded to the presurvey, and 42/56 (75%) responded to the postsurvey. We observed significant increases in resident self-efficacy in all population health skills. All respondents reported finding common population health skills that were applicable in both office and community settings; 81% reported care of their continuity clinic patients changed because of taking part in the curriculum. Finally, 94% of respondents reported the intention to use population health skills and incorporate quality improvement (75%) and community engagement (100%) in future practice. Teaching population health management skills in both office and community settings allows residents to integrate and apply these skills across settings and may enhance their use in patient care and future practice.

No Quick Fixes: Integrating Population Health Education and Quality Improvement in a Large Residency Program.

The intersection of population health (PH), quality improvement (QI), and health disparities is increasingly a focus in graduate medical education. However, it remains unclear how trainees may best improve disparities within clinical training environments. We integrated PH education for residents participating in a practical QI experience in a continuity clinic serving an underserved population. We analyzed whether PH education increased confidence in creating care plans and implementing team-based care strategies after selection of one of three QI metrics with known health disparities led to improvement. Posteducational session, attendees had odds of confidence in creating care plans 10.0 (95% confidence interval [CI] 4.6-21.7) times the presession period, whereas nonattendees' confidence was unchanged (OR 1.63, 95% CI 0.78-3.4). Residents participating in the QI project did not have higher confidence in creating a care plan at baseline (20% vs. 9.6%, p = .09) nor any additional shift in confidence versus other residents (p = .57). There were no differences in QI metric performance rate trends for residents choosing a specific QI metric versus those that did not (p > .33 for all comparisons). PH didactics can increase resident confidence around PH topics. However, translating such learning into outcomes and improved health equity may require dedicated efforts across residency training.

Disorders caused by contaminated fish meat consumption: Literature review / Doenças causadas por consume de carne de peixe contaminada: Revisão de literatura

Between 2007 and 2017, Brazil registered 99,826 outbreaks of foodborne diseases and 0.84% of those were associated with fish meat intake. It is estimated that approximately 56 million infection cases occur worldwide due to raw or undercooked fish meat containing several disease-causing parasites. Hence, this study aimed to review the literature concerning diseases caused by ingestion of contaminated fish meat. Reviews, case reports and epidemiologic studies were searched in Portuguese, Spanish and English in the databases LILACS, Pubmed, Science Direct, SciElo and Scholar Google using as keywords: transmissive diseases, contaminated fish and human infections were used to retrieve papers from 2014 to 2020. Nine papers, including seven reviews, one case report and one case-control study fulfilled inclusion criteria and presented several consequences of contaminated raw or undercooked fish meat ingestion, which ranged from nemathode, bacterial and toxin diseases that may cause gastrointestinal problems to allergic reactions, lung infection, endemic acute myalgia, bacteremia, meningitis and death. Growing fish meat intake in several dishes presents significant health risk due to the pathogenic potential of toxins and parasites that remain when food is consumed raw or undercooked. Tighter sanitary surveillance, population health education, training and sensitization of health professionals in recognizing and notifying cases might contribute to minimize risk.

Information and Scientific Impact of Advanced Therapies in the Age of Mass Media: Altmetrics-Based Analysis of Tissue Engineering.

BackgroundTissue engineering (TE) constitutes a multidisciplinary field aiming to construct artificial tissues to regenerate end-stage organs. Its development has taken place since the last decade of the 20th century, entailing a clinical revolution. TE research groups have worked and shared relevant information in the mass media era. Thus, it would be interesting to study the online dimension of TE research and to compare it with traditional measures of scientific impact.ObjectiveThe objective of this study was to evaluate the online dimension of TE documents from 2012 to 2018 using metadata obtained from the Web of Science (WoS) and Altmetric and to develop a prediction equation for the impact of TE documents from altmetric scores.MethodsWe analyzed 10,112 TE documents through descriptive and statistical methods. First, the TE temporal evolution was exposed for WoS and 15 online platforms (news, blogs, policy, Twitter, patents, peer review, Weibo, Facebook, Wikipedia, Google, Reddit, F1000, Q&A, video, and Mendeley Readers). The 10 most cited TE original articles were ranked according to the normalized WoS citations and the normalized Altmetric Attention Score. Second, to better comprehend the TE online framework, correlation and factor analyses were performed based on the suitable results previously obtained for the Bartlett sphericity and Kaiser–Meyer–Olkin tests. Finally, the linear regression model was applied to elucidate the relation between academics and online media and to construct a prediction equation for TE from altmetrics data.ResultsTE dynamic shows an upward trend in WoS citations, Twitter, Mendeley Readers, and Altmetric Scores. However, WoS and Altmetric rankings for the most cited documents clearly differ. When compared, the best correlation results were obtained for Mendeley Readers and WoS (ρ=0.71). In addition, the factor analysis identified 6 factors that could explain the previously observed differences between academic institutions and the online platforms evaluated. At this point, the mathematical model constructed is able to predict and explain more than 40% of TE WoS citations from Altmetric scores.ConclusionsScientific information related to the construction of bioartificial tissues increasingly reaches society through different online media. Because the focus of TE research importantly differs when the academic institutions and online platforms are compared, basic and clinical research groups, academic institutions, and health politicians should make a coordinated effort toward the design and implementation of adequate strategies for information diffusion and population health education.

Embedding Population Health in Physical Therapist Professional Education.

The future of health care professional education is moving from a focus on the individual to embrace the health of the larger society. The COVID pandemic has further highlighted the connection between social determinants and the health of populations. There are frameworks and competencies to support the delivery of population health content in the entry-level DPT curriculum. Three options for integrating population health content into the DPT curriculum are presented: (1) threading the content throughout the curriculum, (2) concentrating the content in 1 or 2 identified courses, and (3) offering elective courses. Each of these strategies has benefits and challenges but threading the content throughout the curriculum provides the best opportunity to reinforce population health competencies across populations and practice settings. Experiential learning using authentic scenarios provides an ideal opportunity for students to understand population health concepts in a real-world context. Activities that incorporate interaction with other health professions broadens students’ perspectives of the role of different professions for achieving population health goals. Examples of learning activities are included in three competency areas, Foundations of Population Health, Prevention and Health Promotion, and Health Policy. Current societal issues provide an opportunity to enhance population health education from a meaningful perspective for students. The topic of health equity presents an opportunity to tie social and political factors of population health to social justice and health outcomes. Similarly, the COVID-19 pandemic puts issues of mental health, health disparities, and health systems front and center in our understanding of population health.ImpactHealthcare practitioners are looking at health through the lens of health equity and acknowledging the impact of social and political determinants on health to address health disparities, decrease healthcare expenditures, and respond to changes necessitated by pandemics such as COVID-19. As healthcare systems and practices are rethought and reconstructed, the intentional integration of population health principles woven into the fabric of professional education is a critical component of preparing future providers. This paper describes how population health concepts can be meaningfully embedded into Doctor of Physical Therapy curriculum along with providing realistic examples and activities.

The Behavior of Consumers and Producers of Food of Animal Origin and Their Impacts in One Health.

Most people consume animal foods, for example meats, but few are concerned with the quality and origin of these products. Many studies point out hygiene problems of these foods after production; however, the lack of knowledge of the consumers of animal products about the importance of hygienic-sanitary control during the production process can lead them to a bad choice when buying these products and, consequently, expose themselves to the risk of acquiring many diseases, such as zoonosis. In this perspective, the objective of this work is to reflect about the consumers' role in the production of safe food of animal origin and to show that the population's health education is necessary and urgent. Only by helping the consumers to obtain knowledge about the production of animal products origin will there be a change in consumption habits, preventing the ingestion of contaminated foods that can cause damage to human health and to the environment, consequently, promoting one's health.

Covid-19: As a Fear Factor in Response to Stroke Code and Other Interventional Radiology Emergencies?

The COVID-19 coronavirus crisis has posed an international challenge for all health systems. The first patient registered in Spain with the COVID-19 coronavirus was known on January 31, and the state of alarm was declared on March 14, 2020. The advance of the infection worldwide has caused a modification of the usual pattern in hospital emergency responses. This study describes the incidence of emergencies in the interventional radiology section of the Marqués de Valdecilla University Hospital and analyzes whether the presence of COVID-19 caused a decrease in the number of patients treated especially for ischemic strokes. A descriptive cross-sectional study was carried out on a sample of 236 patients treated at the interventional radiology on call between June 1, 2019 and May 10, 2020, at the Marqués de Valdecilla University Hospital. No specific results were found that indicate a decrease in the incidence of urgent procedures, especially mechanical thrombectomies in patients with ischemic strokes performed by the interventional radiology team since the establishment of the alarm state by COVID-19 in Cantabria. Patients' fear of contracting COVID-19 infection in the hospital environment has not led to a decrease in urgent procedures, especially for ischemic strokes.

ENT emergencies during the first wave of COVID-19 pandemic in Spain: Our experience

ObjectivesTo analyze the characteristics of the visits attended to in an ENT Emergency Department (ENT-ED) during the first wave of COVID-19, comparing them with the emergencies attended to during the same period of time in 2019. MethodsDescriptive and analytical observational retrospective study of all emergency consultations between March 1, 2020, and May 21, 2020, carried out by the Otorhinolaryngology–Head and Neck Surgery Department of a tertiary university hospital. The adequacy of consultations was assessed with the Hospital Emergency Suitability Protocol (HESP). The correlation between the emergencies and the SARS-CoV-2 confirmed cases was assessed with a generalized linear model. ResultsAlthough there was a decrease of almost 50% in ENT-ED visits during the first wave of COVID-19, the pattern of most cases remained similar to the pre-COVID-19 era: non-urgent consultations, not previously assessed by Primary Care (PC), being considered inadequate by the HESP. The three main reasons for consultation were otalgia, odynophagia, and epistaxis. The number of ENT-ED visits and the total number of confirmed cases of SARS-CoV-2 in the health area were correlated. ConclusionsSARS-CoV-2 pandemic was a challenge for the Spanish health system. The critical epidemiological situation experienced during March, April, and May explains the reduction in the number of visits to the ENT-ED. However, this condition did not affect the predominant pattern of visits with respect to the pre-COVID-19 era, which were mostly inadequate. A strengthening of PC and an improvement in the population's health education is essential.

Assessment of Health and Health Related Problems in the Community of Mettu Town, South Western, Ethiopia, 2021: A Community Based Descriptive Cross Sectional Study

Background: Community Based Education is an educational philosophy aims at developing professionals with problem identification and solving skills and positive attitudes to serve the society. The communities’ health need is mostly rounded on either communicable or non-communicable diseases in which communicable diseases remain the most vital health problems in the developing countries. Objective: The intent of this survey was to ascertain the apprehensive of health and health related problems in the community of Mettu town, south western, Ethiopia. Methods and materials: A community based descriptive cross sectional survey was employed in Mettu town, from January 17/2021-May 25/2021. A stratified random sampling technique was applied, and data was gathered by using an interviewer-administered semi structured questionnaire. Data was analyzed by statistical packages of social sciences 23.0 version statistical software. Findings: The overall prevalence of health related problems was 66.23%. The survey revealed that hypertension 36.94% and diabetes mellitus 27.8% were the most common cause of morbidity and mortality.55.9% participants had a roof that was made of tin and floor made of cement and 54.79% of population use pipe water.68.47% user of family planning were majorly used 47.13% injection and 27.39% of them used implant.51.59% women gave birth in health institution and 59.87% attained ANC services at least one times reguraly. 27.27% of infants under 6 months are exclusively breastfed and 55.84% of children start complementary feeding at 6 months. Conclusion and Recommendation: The present survey indicated that the prevalence of health related problems in individuals was escalated dramatically. Majority of Mettu town population was use open field for their waste disposal. Rodent, household flee and bed bug are common insects & rodents that threaten population health. Health professionals should have to give the population health education about substance, waste disposal, family planning, sanitation condition, and immunization.

Population Health in the Medical School Curriculum: a Look Across the Country.

Population health (PH) is an important component of medical school education and is required for physicians to practice effectively. Identifying the number of medical schools teaching population health and the individual curricular components could lead to a better understanding of the current status of population health implementation into medical education. Between February and March 2019, medical schools in the USA were surveyed about the structure and content of their population health curriculum. Differences were analyzed by school funding and class size. Respondents were gathered from 28 (68%) public and 13 (32%) private schools; 27 (66%) schools having fewer than 150 students and 14 (34%) having greater than or equal to 150. Thirty-two schools (78%) had a structured PH curriculum. Seven (22%) only had a dedicated preclinical module and 33 (83%) had a longitudinal curriculum throughout multiple years of school. Many programs utilized flipped classroom models (n = 19, 46%); however, only 8 (20%) utilized standardized patients. Health disparities (100%), community health initiatives (88%), and preventative health guidelines (88%) are among the most commonly taught subjects. Quality improvement was taught by 34 of 41 programs (83%), but only sixteen (39%) schools required students to complete a quality improvement project. Differences in population health curricula were found between school size and funding. As evidenced by this study, most medical schools recognize the importance of population health by including it in their curriculum and a majority are incorporating the subject longitudinally into multiple years of school.

What Are DPT Program Practices and Attitudes Related to Population Health, Prevention, Health Promotion, and Wellness? Results of a National Survey.

Noncommunicable diseases have increased in prevalence and are now responsible for the majority of the burden of disease. Aligning entry-level (professional) physical therapist education with these changing societal needs may position physical therapists to best address them. However, no comprehensive understanding of the practices and attitudes related to population health, prevention, health promotion, and wellness (PHPW) content among accredited US professional doctor of physical therapy (DPT) programs has been established. This study aims to identify practices and attitudes related to PHPW content among accredited US DPT programs. A mixed-methods cross-sectional design using an electronic survey was utilized. Program directors of each accredited DPT program were identified using an official Commission on Accreditation in Physical Therapy Education list and invited to ascertain the perceived importance of PHPW, describe the delivery of PHPW content, and identify factors that influence inclusion of PHPW content in US DPT programs. Individuals from 49% of 208 invited programs responded. Nearly all programs reported teaching prevention (96.1%), health promotion (95.1%), and wellness content (98.0%), while fewer reported teaching population health (78.4%). However, only 15% of PHPW topics were covered in depth. Facilitators and barriers to the delivery of PHPW content were reciprocal and included faculty with PHPW expertise, logistical flexibility and support, and the perceived importance of PHPW content. The majority of US DPT programs are teaching PHPW content. Lack of trained faculty and lack of professional competencies hinder further integration of PHPW content into curricula. The findings of this study highlight avenues for additional research to determine professional PHPW competencies and additional educational needs for faculty members.

Strategies for embedding population health concepts into nursing education.

Advances in community and public health are needed to address contemporary health needs, particularly poor health outcomes related to the social determinants of health and inequity. Nurses are ideally placed to promote meaningful advances in community and public health, collectively referred to as population health. Nurse educators can promote a deeper understanding of core population health concepts by threading these concepts throughout the academic nursing curricula in addition to standalone population or public health courses. Strategies for incorporating population health concepts in a variety of courses can be conceptualized through the themes emphasizing context, honoring community voices, cultivating community connection, and fostering leadership in social responsibility. Nurse educators with expertise in population health can serve as a resource for faculty as these strategies are implemented. Teaching population health provides exciting opportunities for innovative approaches to facilitate students to link their practice to wider social contexts. Further steps to strengthen the public and community health workforce will still be needed to meet population health needs.

Population Health Beyond the Classroom: An Innovative Approach to Educating Baccalaureate Nursing Students.

An increasingly diverse population warrants an innovative and transformational educational approach to prepare the baccalaureate nurse to practice and lead. This article describes an innovation for teaching population health to meet complex community health needs and provide interprofessional collaborative opportunities and diverse leadership experiences. Course revision for clinical and didactic courses included the incorporation of cross-sector and interdisciplinary collaboration in the community, along with a strong emphasis on social determinants of health.

Abstract 224: Implementation of an Actionable EHR-based Population Health Dashboard and Curriculum in a Cardiovascular Disease Fellowship

Background: The advent of learning healthcare systems requires physicians to not only manage individual patients, but also use data to manage their patient population as a whole. Improving care using data has been facilitated via the adoption of the EHR and its ability to collate data for populations of patients. While incorporation of population health into residency curricula has become more common, there have been few educational initiatives for fellows despite the requirements of the ACGME that fellowship programs provide trainees with practice habit data relevant to their patient population. We aimed to create and evaluate an ambulatory cardiovascular disease fellowship population health dashboard and curriculum incorporating actionable, relevant metrics. Methods: In 2018 we developed a curriculum that taught principles of population health through didactics and videos that CVM fellows in our program could access asynchronously. In parallel, we developed a novel fellow-specific population health dashboard embedded in our EHR. The dashboard included demographic information relating to the fellow’s clinic patient population such as race/ethnicity, healthcare utilization information like percentage of no-show visits, and specialty specific quality metrics such as beta-blocker use in patients with CHF. CVM fellows (PGY4-7) participated in the effort. Fellows were encouraged to review their practices then coached by a CVM faculty member in one-to-one sessions to develop strategies to improve one or more quality metrics of their choice. Pre and post surveys were administered to determine baseline and post-curriculum knowledge, attitudes, and experience with the topic of population health. We tracked fellow engagement through measured dashboard utilization. Results: Pre and post survey response rate was 81% and 46% respectively. At baseline, 23.5% (8) of fellows reported never receiving any education in population health and 67.6% (23) of fellows reported previous experience with population health tools such as EHR dashboards. Only 14.7% (5) of fellows had baseline knowledge of how quality metrics affect health care reimbursement. After the initial year of the curriculum and dashboard implementation, 100% (11) of fellows responding believed that it was important to learn about population health management and planned to utilize the skills they learned in practice. Further, 72% (8) of fellows changed one or more aspects of their practice after utilizing the dashboard coupled with one-on-one coaching. Since EHR dashboard implementation, fellows have accessed the dashboard 560 times. Discussion: Integrating population health education utilizing a fellow-specific EHR dashboard in a CVM fellowship is both feasible and highly rated. This method of population health education is scalable across other cardiovascular disease fellowship programs and other subspecialties.

Myanmar health professionals' educational needs: a pilot study.

Background and aim of the work:The main factor hindering the development of the Myanmar health system lies in the scarcity of financial and human resources attributed to the health system. This paper presents the preliminary results of a pilot study on the educational needs of Myanmar health professionals, addressing the empowerment of human resources as a strategic pillar for delivering the essential packages of health services.Methods:An explorative study following a qualitative approach has been conducted through semi-structured interviews to a convenience sample of 15 persons, selected as authoritative key-informants.Results:In addition to the lack of infrastructures, medicines, ambulances and health instruments, and the health disparities between the urban and rural areas, some widespread problems are reported as requiring health professionals’ training empowerment: traumas due to road accidents, management of childbirth, non-communicable diseases’ management and poor health education of the population.Discussion:Some areas can be evidenced for an improvement of professionals, training: maternal, neonatal and child health; communication between professionals and laypeople; Myanmar population’s health education; inter-professional training between doctors and nurses, but also between health personnel and non-health personnel.Conclusions:The educational needs of Myanmar health professionals emerge as closely related to the social and health needs of the Myanmar population, to the available resources and missing resources of the country’s health system and to the role of professionals within professionals/patients’ relationship. (www.actabiomedica.it)

The prevalence of anemia among children infected with Entamoeba histolytica in Baghdad

The relation between Entamoeba histolytica and anemia has lately had much attention. The aim of this study was to determine the possible correlation between anemia and parasitic intestinal infection with E.histolytica in children from Baghdad-Iraq. This study was conducted from October 2018 to April 2019 in different hospitals, primary health care centers, and primary schools. Eighty-one children participated in this study and their ages were between 1 and 12 years. The participants were divided into two groups based on their general microscopic stool examination. The first group was diagnosed as E.histolytica infected group (n=47), while no pathogens were detected in the stool samples of the second group which was considered as a healthy control (n=34). Blood samples were taken from all subjects and tested for haemoglobin level, serum ferritin, serum iron, total binding iron capacity (TBIC) and mean corpuscular volume (MCV). Nutritional status was also evaluated for all children aged ≥5 years old. Results showed that the prevalence of anemia was higher in children infected with E.histolytica compared with the control subjects. Anemia was largely reported among children aged 1-3 years for both E.histolytica infected children and control subjects. The results also illustrated that both haemoglobin and iron levels were significantly (p˂0.05) lower in E.histolytica infected children compared with control subjects, while non-significant differences (p˃0.05) were observed in the level of ferritin between E.histolytica infected children and control subjects, although the ferritin was lower in E.hisolytica infected group. The results showed that both gender and age are significantly related to low serum iron levels in both infected and control groups. Significant relationshipswere also noticed between each of the anemia types and the nutritional status with the E.histolytca infection. Microcytic anemia as well as high records of severe malnutrition were observed in the majority of E. histolytica infected children
 These findings indicate that anemia is more expected to be present in children infected with E.histolytica. Therefore, efforts should be focused on health education of populations at high risk of both anemia and E.histolytica.

Street Medicine: Creating a "Classroom Without Walls" for Teaching Population Health.

"Street Medicine" programs provide medical care to homeless populations outside of traditional healthcare institutions, literally on the street and in transitional settings where unsheltered homeless people live. Such programs are emerging around the world often based at medical schools and primary care residency programs, and can provide ideal frameworks for twenty-first century "Classrooms Without Walls" aimed at improving Population Health. We provide a 12-step blueprint for creating a Street Medicine program in the context of a medical teaching institution.