Preventive Medicine Students Research Articles

Prevalence of stress and related factors among healthcare students: a cross - sectional study in Can Tho City, Vietnam.

Stress is a major public health issue that can impact both physical and mental well-being. It is prevalent in many areas of modern life, including education. Healthcare students are at a high risk of experiencing stress due to the unique demands of their fields of study. An online survey was conducted on 2,515 undergraduate students pursuing degrees in medicine, preventive medicine, pharmacy, and nursing at Can Tho University of Medicine and Pharmacy in Can Tho City, Vietnam. Using the Perceived Stress Scale-10 (PSS-10), it was found that 35.2% of students reported mild stress, 62.7% had moderate stress, and only 2.1% experienced severe stress. Multivariable logistic regression analysis revealed nine significant factors associated with students' stress levels (p ≤ 0.05). Particularly, medicine students exhibited a significantly higher level of moderate and severe stress (95% CI = 1.22-2.01), 1.57 times higher than preventive medicine students. Sixth-year students had a stress level 1.58 times higher (95% CI = 1.11-2.26) than first-year students. Students achieving excellent and very good academic performances in the last semester had a stress level 1.60 times higher (95% CI = 1.16-2.22) than students with average and lower academic performance. Students living at home had a stress level 1.73 times higher (95% CI = 1.05-2.84) than students living in their relatives' houses. Students who rarely or never had a part-time job during academic years had a stress level 1.70 times higher (95% CI = 1.31-2.20) than those who often or sometimes had a part-time job. Students with a family history of smoking addiction had a stress level 1.69 times higher (95% CI = 1.28-2.22) than students without such a family history. Students who rarely or never received concern and sharing from family had a stress level 7.41 times higher (95% CI = 5.07-10.84) than students who often or sometimes received concern and sharing from family. Students who were often or sometimes cursed by family had a stress level 2.04 times higher (95% CI = 1.09-3.81) than students who were rarely or never cursed by family. Students without close friends had a stress level 1.46 times higher (95% CI = 1.11-1.91) than students with close friends. The rates of mild and moderate stress levels were significantly higher than severe stress level among healthcare students. Research has provided scientific findings as the basis for determining risk factors and imposing solutions that aim to reduce the rate of stress in students. Therefore, it helps students overcome difficulties and enhance their physical and mental health.

Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China

BackgroundPublic health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students’ preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute.MethodsBased on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students’ stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job’s attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute.ResultsA total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students’ WTP for a job located in the county or city is much lower than that of urban students.ConclusionsThe heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.

Stress and influencing factors of public health and preventive medicine students in the post-pandemic period: a cross-sectional study in Changsha, China.

Little is known about the stress levels and associated factors of public health and preventive medicine students in the post-pandemic period. This study aims to investigate the stress levels of these students in the post-COVID-19 era and to determine the association of personal background, employment attitude, and psychological state with stress. A cross-sectional survey was conducted in March 2023 among 620 public health and preventive medicine students from two universities in Changsha, China. The survey included demographic characteristics, employment attitudes, perceived stress scale 10, general anxiety disorder 7, the University of California at Los Angeles loneliness scale 20, and the PTSD checklist-civilian version. Two-sided t-tests and ANOVA tests were used to compare the differences in PSS scores among variables, and multiple hierarchical regression analysis was used to evaluate the associated factors with stress. The survey was completed by 504 students (mean age: 21.5 ± 2.6 years, 69.2% female). 24.8% of the students were screened for a high level of stress. 69.0% thought the epidemic positively impacted employment while 18.5% believed it had a negative impact. The results of regression analysis showed that older age (B = 0.42, p = 0.001), higher grade (3.59, p < 0.001, 4.57, p < 0.001), having internship experiences (B = 1.16, p = 0.006), having anti-epidemic experiences (B = 1.77, p < 0.001), believing that COVID-19 has a negative impact on employment (B = 2.56, p < 0.001), and having higher GAD scores (B = 0.64, p < 0.001) and UCLA scores (B = 0.07, p = 0.002) were significantly associated with high-stress levels. Conversely, being female (B = -1.64, p < 0.001) and believing that the pandemic had a positive impact on employment (B = -1.98, p = 0.001) were associated with low-stress levels. Public health and preventive medicine students in Changsha, China, experienced a high-stress level in the post-pandemic period, which was influenced by age, gender, grade, employment attitude, internship experience, anxiety, and loneliness. As one of the main guardians of the epidemic, these students should be given more attention and psychological interventions in the future.

Knowledge about monkeypox disease of students of Preventive Medicine and Public Health of Hanoi Medical University in 2022 and some related factors

Background: To describe the knowledge of monkeypox among students majoring in Preventive Medicine and Public Health at Hanoi Medical University in 2022 and several associated factors. Methods: A cross-sectional study, using self-administered questionnaire was conducted with 551 students. Multivariate logistic regression was performed to describe associated factors. Results: The proportion of students with good knowledge about monkeypox is 88.9%. In which the knowledge of female students is 2 times higher than that of male students (OR:2.0; 95% CI: 1.1 – 3.7). Students in subsequent years have higher knowledge than first-year students, except for fourth year. Conclusion: The proportion of preventive medicine and public health students with a good knowledge of monkeypox is relatively high. However, there has been no assessment on the sustainability. Therefore, providing appropriate and updated materials and training course for students on epidemics and responses is essential

Status of medication literacy and its related factors among undergraduate students in Shanxi Province, China: A cross-sectional study.

Medication safety problem has always been the focus of healthcare providers and public health community scholars. As the backbone of the future society, the mastery of college students' knowledge to use medicine will directly affect the level of medication literacy (ML) of the public in the future. The purpose of this study was to investigate the current ML of college students in Shanxi Province and to identify its related factors. A cluster random sampling method was utilized to select 800 college students from 10 universities in Shanxi province as participants from 21March to 10 April 2020. After quality control, 763valid questionnaires were collected (effective rate 95.4%). This study applied the ML scale adapted from the 14-item health literacy scale (HLS-14) to estimate ML, which contains functional ML, communicative ML and critical ML dimensions to estimate the ML situation. Then, we used structural equation modelling (SEM) to test the hypothesized relationship among three dimensions of ML, self-evaluated health status and safety medication science popularization activities on campus. The results showed that the reliability and validity of the ML scale were good. The average score of ML level of college students in Shanxi Province was 44 points, and the interquartile range was 40-48 points (full score is 65 points). The proportion of high ML level was estimated at as low as 26.7%. 73.1% participants had an average level, and only 1 participant (0.1%) had a low level of ML. Univariate analysis showed that the ML level was significantly influenced by gender, universities, field of study, academic performance and ethnic group (p<0.05). SEM showed that functional ML (λ=0.01) and communicative ML (λ=0.75) had a direct positive association with critical ML. Meanwhile, the model also had a mediating effect. Functional ML had an indirect positive association with critical ML through the mediating effect of communicative ML (λ=0.11). In addition, both self-evaluated health status and safety medication science popularization activities on campus had an indirect positive association with critical ML through the mediating effect of functional ML and communicative ML. The study revealed that the ML of most college students in Shanxi Province was at the average level. Among them, medical college student (including pharmacy, nursing, public health, preventive medicine, basic medicine and clinical medicine students), the Han nationality students (the students of China's majority ethnic group), students of good self-evaluated health status, and students who were more exposed to safety medication science popularization activities had a relatively higher ML level. Moreover, it highlighted the importance of self-evaluated health status and safety medication science popularization activities on campus to ML.

Perceived Stress and Coping Strategies During the COVID-19 Pandemic Among Public Health and Preventive Medicine Students in Vietnam.

PurposeLittle is known about the effect of COVID-19 pandemic on public health and preventive medicine students, particularly in resource-limited countries. This study evaluated stress level in this population in Vietnam and their coping strategies during the COVID-19 pandemic.Patients and MethodsA cross-sectional study was conducted in April 2020 among 563 public health and preventive medicine students. A structured questionnaire included background information, the level of stress measured by the Perceived Stress Scale (PSS) and coping strategies evaluated by the Brief COPE. To compare the PSS score and Brief COPE score among participants with different characteristics, two-sided t tests or ANOVA tests were used when appropriate.ResultsMost participants were females (71.4%), and the mean age was 21.6 years old (SD = 2.1). Almost all had moderate to high levels of knowledge, attitude and skill toward COVID-19 prevention and protection. The mean PSS score was 17.02 (SD 4.06), and more than 80% had a certain level of stress. The mean score of approach coping strategies was higher than avoidant coping strategies (2.74 and 1.84). Students with a high level of stress had a higher preference for avoidance coping strategies.ConclusionAlthough students reported relatively good knowledge, attitude and skill as well as the preference for adaptive coping strategies, they experienced a high level of stress during the COVID-19 pandemic.

Reform of Practical Teaching of Preventive Medicine Undergraduates

&lt;p&gt;Professional practice, as an important link of comprehensive talent training for preventive medicine students, is of great significance to cultivate innovative and practical talents. However, there are some problems in the current teaching system, such as insufficient attention to practical teaching, lack of overall planning and defects in practical teaching foundation.&lt;/p&gt;

E-Health Literacy of Medical Students at a University in Central Vietnam

Background: The study is to measure eHealth literacy of medical students at a university in central Vietnam and to examine factors influencing their skills. Material and Method: This is a cross-sectional study. Data were collected through the self-administered structured questionnaire of 410 students who were randomly selected among general medical students and preventive medicine students in the fifth year at Hue University. The eHealth literacy scale was developed on the basis of eHEALS to measure skills for seeking and utilizing sources of eHealth information. Multiple linear regression model was used to identify factors influencing their eHealth literacy. Results: The study found that the general mean score for eHealth literacy among participants is 27.03 (SD = 3.54). Factors influencing eHealth literacy are genders (p=0.001), training program (p=0.013), computer skills (p=0.031) and purpose of seeking and using medical information (p<0.001). Conclusions: The findings showed that eHealth literacy of medical students in the study setting is still limited. In order to improve these skills of students, the educators should have relevant teaching strategies that promote the interest and skills of students to locate and evaluate eHealth resources

Exploration on the curriculum reform for developing competency in health emergency response of students of preventive medicine

In order to meet the needs of social development for public health talents and optimize the curriculum system and teaching content of preventive medicine, the course of Health Emergency should be set up. It integrates the related content in many courses, and there are 20 hours for theory and 18 hours for experiment or practice. The course takes the emergency response as the cutting point focuses on the projects with high demand of the industry improves the platform and expands the content of emergency skill training through the extracurricular activities and special lectures. Combining theory with practice, this paper explores teaching reform measures that are conducive to improving students' core competence in public health. Key words: Preventive medicine; Curriculum reform; Talent cultivation; Health emergency; Public health

Preparing the next generation of health professionals to tackle climate change: Are China's medical students ready?

BackgroundClimate change is the biggest global health threat of the 21st century. Medical students will lead the health sector responses and adaptation efforts in the near future, yet little is known in China about their knowledge, perceptions and preparedness to meet these challenges. MethodsA nationwide study was conducted at five medical universities across different regions of China using a two-stage stratified cluster sampling design. A self-administered questionnaire was applied to collect the information including perception, preparedness and educational needs in response to climate change. The data were first analyzed descriptively, then chi-square tests and kruskal wallis tests were applied to determined differences among subgroups, and logistic regression analysis were deployed to detect the socio-demographic factors influencing student's perception. ResultsA total of 1436 medical students were approached and 1387 participated in the study (96.6% response rate). Most students were aware of the health impacts because of climate change, with over 90% perceived air quality-related and heat-related illness, while only a small part identified undernutrition and mental health. Approximately 90% embraced their role in tackling climate change, but 50% reported themselves and the health sectors were not adequately prepared. Compared to clinical students, preventive medicine students were more likely to perceive their responsibility to address climate change (OR:1.36, 95% CI: 1.04, 1.78). Also, 80% students admitted insufficient information and knowledge on climate change and health. Most students agreed that climate change and its health impacts should be included into their current curriculum. ConclusionsMedical students in China were aware of climate change and felt responsible, but were not ready to make responses to its health impacts. Educational efforts should reinforce eco-medical literacy development and capacity building in the era of climate change.

The investigation and analysis of college students' awareness, cognition and usage of shared courses on the internet

Objective To investigate college students' awareness and cognition of 84 shared courses on the Internet and analyze the discrepancies between different ethnicity and majors in Xinjiang Medical Uni-versity. Methods Purposive sampling was adopted with questionnaire of 1 448 students of 26 classes in Xin-jiang Medical University. The survey aimed to investigate students' awareness and cognition of these In-ternet courses. Obtained data were statistically analyzed using SPSS 13.0, and the test level α=0.05. Result The hits of preventative medicine, Chinese medicine, clinical medicine and pharmacy were 19.0%, 33.3%, 35.7% and 11.9% respectively. Among the courses whose hits exceeded 50,000, clinical medicine accounted for 50%, preventive medicine for 21.4%, Chinese medicine and pharmacy for 14.3% respectively, there being no significant difference in overall hits (P>0.05). 90.1% of the surveyed students knew shared courses on the In-ternet, there being no difference between gender, ethnicity and profession (P>0.05). 89.8% had an accurate understanding of the concept of shared courses on the Internet, there being differences between gender and major (χ2gender=11.013, P=0.026; χ2major=136.08, P=0.000) without significant differences in ethnicity (χ2=11.378, P=0.497). 71.9% of the students used shared courses on the Internet as reference resources for the course study, 46.6% for the learning content, 35.5%for the understanding of other resources related to the course, 30.1% for lab-class and exercises, 10% for discussion on online course forum. The Han and Kazak students used the courses as a study, experiment and exercise tool, while the Uyghur and Kazak mainly used these for learning and discussion on the forum, there being differences in ethnicity (χ2=26.889, P=0.001); the usage rate of the courses of preventive medicine students is higher, whereas pharmacy students rela-tively low, there being significant differences in major (χ2=38.01, P=0.004). The Kazakh and Uygur students mainly used the courses to formulate learning plans, and the Han students to learn the current curriculum. 44.7% of preventive medicine students used the courses to improve their abilities, which was significantly higher than those of other majors. Only 18.4% and 1% of pharmacy students used the courses to formulate learning plans and to improve their abilities, which were both lower than those of other majors, showing ethnic and professional differences (χ2ethnic=37.654, P=0.001; χ2major=73.68, P=0.000). Conclusion Students' aware-ness of shared courses on the Internet is high and their cognition is accurate. However, there are differences in the ways and purposes of the employment of the courses between different ethnicity and majors. The main reason may be related to major, the quality of the courses, as well as the lack of effec-tive supervision and evaluation system, suggesting that the management department in our university should strengthen the super-vision and evaluation of the courses and give full play to the important role of shared courses on the Internet. Key words: Shared courses on the Internet; Cognition; Awareness rate; Prevalence survey

Preventive medicine as a first- or second-choice course: a cross-sectional survey into students\u2019 motivational differences and implications for information provision

BackgroundChallenges in recruiting and retaining medical staff in preventive medical specialties have recently been the subject of numerous studies. To improve selection procedures, it is important to understand the career preferences and incentives of students in preventive medicine (PM), who initially marked the program as either their first choice or second choice. 1386 PM students in four Vietnamese medical schools participated in a survey using a structured, written questionnaire. Students were asked about their reasons for entering medical school and studying PM, their perceptions of PM during the academic course, and their expected career path following graduation.ResultsFirst-choice PM students (group 1) more often had siblings working as a preventive doctor, while second-choice PM students’ siblings (group 2) were more often medical students or clinical doctors. Group 1 had gathered more information about PM by consulting their high-school teachers and the national career guide. They were mainly drawn to the PM program by the newness of the profession, the prospect of a high-income job, its low entry criteria and low study burden compared to general medicine, their desire to uphold their family tradition, and to fulfill their family’s wish of having a doctor in the family. Group 2 chose to study PM because they wanted to pursue their dream of becoming a doctor. Compared to the first group, their perception of PM more frequently changed during the later years of the curriculum and they more frequently envisioned becoming a clinical doctor following graduation.ConclusionsInterest in and motivation for PM may be cultivated among prospective or current students by improving information provision, diffusing knowledge, and otherwise acquainting students better with the PM specialty before and during the program.

Qualitative and quantitative research of preventive medicine’s clinical internship

Objective To provide improvement measures and recommendations to improve preven-tive medicine's clinical internship. Methods 88 third-year students and 82 fifth-year students of preventive medicine in Sichuan University were surveyed. Then 81 valid questionnaires of the third grade and 79 valid questionnaires of the fifth grade were input into EpiData, and SPSS 17.0 was used to analyze the data. Then, in-depth interviews were conducted among 6 employees and 2 professional teachers of the employing units, and the interview records were organized to form an interview summary. Results The third-year preventive medicine students who are preparing to take part in the clinical internship know little about the clinical in-ternship, which accounts for only 0% and 92.59% (75) think that the internship content should be different with the clinical medicine, in the meantime 44.44% (36) think chief resident should be the internship teacher. For the fifth-year preventive medicine students who have finished the clinical internship, only 3.80% (3) is very satisfied with clinical internship; 84.81% (67) are considered to take into account the pro-fessional characteristics of the clinical practice; meanwhile, the satisfaction of the knowledge or the ability learned from the clinical internship as well as the help in the post-graduation job is only 8.86% (7); the employer's and professional teachers consider that the related clinical internship program of the preventive medicine stu-dent should be suitable for prevention medical students, and at the same time, preventive medicine students should focus on learning clinical knowledge related to disease prevention. Conclusion The clinical internship of preventive medicine needs further improvements, such as adjusting practice con-tents, learning teacher, management methods to form a clinical practice system characterized by preventive medicine so as to meet the needs of employers and students. Key words: Preventive medicine; Clinical internship; Questionnaire; In-depth interview

Comparative study on effects of tobacco control curriculum in different major students

Objective To compare the impact of tobacco control curriculum on self-efficacy of tobacco control in different major of public health students, and offer theoretical foundation for improving tobacco control curriculum. Methods We offered tobacco control curriculum for 150 public health students (including students of preventive medicine and public service administration research direction) in medical university of Harbin, and investigated twice general self-efficacy, smoking self-efficacy and tobacco control self-efficacy before and after tobacco control curriculum, then compared intervention effects between two major students by t test. Results There were no differences of tobacco control self-efficacy, smoking self-efficacy and general self-efficacy between two major students, tvalues were -0.832 (P=0.407), 0.190 (P=0.849) and -0.492 (P=0.624). The tobacco control self-efficacy (t=-3.566,P=0.001) and general self-efficacy (t=-2.237,P=0.028) increased remarkably but smoking self-efficacy (t=-1.102,P=0.273) in preventive medicine students after intervention. And all of three kinds of self-efficacy were not gotten better by intervention in public service administration students. There was no obvious difference of intervention effects between tobacco control self-efficacy and general self-efficacy among preventive medicine students (t=1.541,P=0.125). Conclusions The improvement of preventive medicine students by tobacco control curriculum is better than that of public service administration students. We should further perfect the tobacco control course, and on the one hand, improve the intervention effect of students majoring in course of public health management; on the other hand, strengthen the target effects of the tobacco control curriculum to students' tobacco control self-efficacy and smoking self-efficacy. Key words: Tobacco control curriculum; Preventive medicine specialty; Public service administration specialty; Tobacco control self-efficacy

Investigation on identification of practice teaching by the students of preventive medicine in Jiangsu

Objectives To learn the identification status for the practice teaching among the students majoring in preventive medicine in Jiangsu. Methods 832 students majoring in preventive medicine were randomly selected from 5 universities of Jiangsu province in clustering（Nanjing Medical University, South-East University, Suzhou University, Nantong University, Xuzhou Medical College）. They were investigated by the self-designed questionnaire about the recognition of significance and effect as well as the absent reasons for the discussion in class, research work and social practice. The data were calibrated and input into the database with Epidata 3.1, then were analyzed with SPSS 16.0. The identification status was described with constituent ratio, and the proportion of the students were analyzed with Chi-square test, in which it was recognize as of significant difference if the P value was less than 0.05. Results It was thought by the students that the ways to increase the interest were research work（757students, 91.0%）, discussion in class（507, 60.9%） and social practice（360, 43.3%）, the ways to increase the ability were social practice（494, 59.4%）, research work（122, 14.7%） and discussion in class（109, 13.1%） successively. But the actual effective ways to increase their interest were social practice（360, 43.3%）, discussion in class（128, 15.4%） and research work（100,13.2%）, the effective ways to increase the ability were social practice（615, 73.9%）, research work（97,11.7%） and discussion in class（92, 11.1%） successively. Only 50.0%of the students agreed with the effect of social practice because they were unable to play a major role, while the recognition of the effect of class discussion and research was also low（less than 20.0%） among some students who were unwilling to participate in class discussion and research work because of their lack of confidence, actual interest or time. Conclusions The identification rate is low among the students. It is suggested that the social practice should be based on the knowledge of the students and the class discussion or research work be designed or arranged carefully so that predicted goal can be achieved. Key words: Students; Study interest; Social practice; Discussion in class; Research work; Preventive medicine

Survey on satisfaction degree of preventive medicine undergraduates on tutorial system

Objective To survey on satisfaction degree of preventive medicine undergraduates on tutorial system and to improve the effects of tutorial system.Methods Totally 73 students of preventive medicine,who would graduate in 2012,were asked to fill the questionnaires by themselves.Main contents of questionnaires include effects,satisfaction score,expectations and reality benefits,requirements for the tutors and problems of the tutorial system.Chi-square was used to test the differences between expectations and reality benefits and the significance level was set as P ＜ 0.05.Results More than half of the students thought that the effect of tutorial system was general while 43.8％students thought good and excellent.Percentages of satisfaction score over 50,over 80 and over 90 were 75.3％,41.1％ and 12.3％,respectively.Statistical analysis shown that the real benefits from research activities were more than expectation (P ＜ 0.001),while the real benefits from tutor's academic encouragement,job guidance and life values were lower than expectation (P =0.026,P =0.003,P =0.010).Students expected to have more opportunities with the professors in the future.However,there were 17.8％ students hardly attended the activities of tutorial system,in which lack of understanding of tutorial system was the main reason and without enough time was another reason.Conclusions Students basically satisfies with tutorial system and the satisfaction degree needs to be improved.Roles of tutorial system should be fully strengthened by the management department,tutors and students. Key words: Preventive medicine; Undergraduate; Tutorial system; Satisfaction; Survey

Evaluation on problem-based social practice improving preventive medicine students' tobacco control capacity

Problem-based social practice is organically combined with health education lessons,to improve tobacco control capacity of preventive medicine students,through study in class and social practice after class.The students' awareness rate of tobacco regulations,support rate of smoke-free school,rejecting smoking rate,and lifetime non-smokers rate have significantly increased ( 40％～90％ ) after intervention.The teaching method is adult learning model,and it has effectively enhanced preventive medical students' tobacco control capacity. Key words: Preventive medical students; Tobacco control capacity; Social practice; Problem-based learning

Epidemiology training needs assessment in Vietnam

Vietnam is facing numerous health threats, including those imposed by HIV/AIDS, acute diarrhoea, H5N1 and H1N1, and has a shortage of trained preventive medicine staff (PMS). Only 15% of the health workers currently working in the preventive medicine system are trained in this specialty. The system is estimated to require a further 320 and 1400 PMS at national and provincial levels, respectively, in the course of this year. Thus, developing an updated and practical preventive medicine curriculum (PMC) to help to deal with these health threats is a top priority. Epidemiology is an essential component in the PMC. Unfortunately, the epidemiology competencies developed in the traditional PMC are no longer appropriate in training PMS to deal with health threats in the current global context. An epidemiological training needs assessment (ETNA) is a crucial first step for clarifying the competencies needed by PMS. Three stages of ETNA were carried out. Stage 1 used focus group discussion and in-depth interviews with PMS, faculty members and community representatives to identify the competencies needed at different levels of the preventive medicine system. In Stage 2, workshops with key preventive medicine and public health informants and faculty clarified the overlapping and inconsistent competencies identified in Stage 1 and grouped them into 15 main competencies. In Stage 3, 426 PMS were asked to rate these 15 competencies on three dimensions: ‘frequency of use’; ‘importance’, and ‘self-confidence in doing’. In addition, 220 faculty staff were asked to rate these 15 competencies on three dimensions: ‘need’; ‘required skill level’, and ‘self-confidence in teaching’. Different points of view emerged among the different stakeholder groups. Across the 15 competencies, the faculty ratings for ‘need’ and PMS ratings for ‘frequency of use’ differed. Only four competencies were rated similarly; four other competencies were rated one scale higher or lower and the other seven competencies were rated significantly differently by the rater groups. A comparison of faculty ratings for ‘required skill level’ and PMS ratings for ‘frequency of use’ showed that six of the 15 competencies were rated significantly differently. A similar outcome emerged in a comparison between faculty ratings for ‘required skill level’ and PMS ratings for ‘self-confidence in doing’, except for the vector control competency. Although faculty members seem more aware of the need for these 15 competencies than PMS, they were less self-confident using these competencies: 25.84% (± 4.86%) of faculty members felt confident with 15 competencies versus 61.72% (± 9.82%) of PMS. Notably, an average of 27% of PMS did not feel confident in practising the five most frequently used competencies. That there are different points of view among different stakeholders regarding the epidemiology competencies required for PMS is a key point which must be kept in mind when developing the epidemiology component in the PMC. Competencies that PMS frequently use but lack confidence in should be prioritised. Competencies for which the ratings by faculty members and PMS differed should be considered in terms of their content and the time allocated to them. Trainer training for faculty staff in the 15 identified competencies is necessary to prepare faculty members to teach preventive medicine students.

Training the veterinary public health workforce: a review of educational opportunities in US veterinary schools.

This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.

Taenia Solium Cysticercosis: From Basic to Clinical Science

our thousand years. Remarkably, the life cycle of the tapeworm was not understood until scarcely more than a century ago, and well into the 20th century the very clinical entity ofhuman cysticercosis was controversial, frankly disregarded by many prominent authorities. Even now, with praziquantel and albendazole, effective cysticidal drugs, there remain controversies about treatment. With only 25 years ofgradual success in immunologic investigations, laboratory diagnosis still has only limited utility, and in many parts ofthe world, the prevalence ofasymptomatic inf ection is unknown. For a disease affecting millions of patients in all continents except Antarctica (and possibly Australia) this is the first comprehensive reference monograph. As the editors and several contributors point out, in a world with ever-increasing immigration and international travel, the distribution and epidemiology will continue to be more prevalent and complicated. At various times, Osler said that to understand medicine one need only to know syphilis, tuberculosis, or typhoid. Taenia solium would probably be an even better subject. Although there is only one chapter exclusively devoted to history, throughout most ofthe chapters, especially the epidemiologic ones, the history ofthe disease and pertinent research is a constant and compelling subplot. Although this is a multi-authored definitive reference, it is in fact also a very interesting book to read. Particularly strong chapters deal with molecular determinants ofhost-parasite interactions, mitochondrial DNA ofthe organism, and five chapters dealing with immunology and spectroscopic studies. The epidemiology section has 10 chapters starting with an overview ofglobal distribution of T. solium cysticercosis, then specific chapters about Africa, Mexico, Central America, Brazil, Peru, Asia, the United States, and the disease in pigs. I suspect the 15 chapters about clinical aspects will attract more readers and periodic reference use. Although the past decade has seen more attention to cysticercosis than the previous century, there is no similar work that is as comprehensive or accessible. For public policy decisions, and planning off uture investigations, clearly the final section of the book, “TaeniasisCysticercosis−Therapy and Prevention,” is most important. This disease should be preventable, and should be eradicable. However, a chapter by Gonzalez on control ofporcine cysticercosis, which demonstrates several effective chemotherapeutic solutions to the infection, also explains the challenges involved. C. A. W. Evans’ chapter on human and porcine vaccination argues that eradication through vaccination is theoretically possible, and summarizes a number oftrials. Although he concludes the trials are promising, the efficacy of vaccines in both people and pigs have not yet demonstrated any effect on numbers of cysts in exposed persons or animals. This is a useful and authoritative reference, and it is easily read. It will be required for workers in tropical medicine, parasitic disease, and especially those who deal with tapeworm. I strongly recommend it for all students of preventive medicine, infectious disease, veterinary medicine, epidemiology, neurology, and history ofmedicine. The chapters are well organized, the editing maintains consistency ofstyle and focus, and the illustrations and graphs are well displayed and always appropriate.