A comparative study of community medicine and public health curriculum at medical schools in Iran and North America

2021 ◽  
Vol 10 (1) ◽  
pp. 19-19
Author(s):  
Tahereh Changiz ◽  
Mahasti Alizadeh
Keyword(s):  
Public Health ◽  
North America ◽  
Comparative Study ◽  
General Medicine ◽  
Medical Schools ◽  
The United States ◽  
Community Medicine ◽  
Center Staff ◽  
Health Curriculum ◽  
Spiral Curriculum

Background: Community medicine and public health are the core subjects in medical education. One of the main competencies of general physicians in the national curriculum is having knowledge and skills in health promotion and disease prevention in the health system. Any curriculum revision in community medicine departments needs to incorporate the evidence and use pioneer countries’ experiences in this issue. This study aims to compare community medicine and public health courses in medical schools between Iran and selected universities in North America. Methods: The elements of a community medicine curriculum for medical students were compared in a descriptive-comparative study using the Bereday model. These elements included objectives and competencies, educational strategies, teaching and learning methods, assessment, and educational fields in a community medicine curriculum in Iran and in selected universities in North America. A literature search was conducted in CINAHL, SCOPUS, MEDLINE, Web of Science, EBSCO, and on university websites. Results: Essential aspects of community-based strategies among community medicine and public health curriculum of general medicine in universities in Canada and the United States included a longitudinal approach, training in urban and rural primary care centers, teaching by family physicians and health center staff, a spiral curriculum, focus on social determinants of health, taking of social and cultural histories and social prescriptions, learning teamwork, and using LIC (Longitudinal Integrated Curriculum). Conclusion: The objective of community medicine and public health curriculum in selected North American universities was to prepare general practitioners who work in Level 2 and 3 hospitals and to improve their skills to provide high-quality services to the community. Some of the successful points in the selected universities that could be replicated in Iranian faculties of medicine included using integration strategy, a spiral curriculum, and an LIC approach.

scholarly journals Statements issued by academic medical institutions after George Floyd’s killing by police and subsequent unrest in the United States: cross-sectional study

2020 ◽  
Author(s):  
Mathew V. Kiang ◽  
Alexander C. Tsai
Keyword(s):  
Public Health ◽  
Black People ◽  
White Supremacy ◽  
Police Department ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional ◽  
Black Lives Matter ◽  
Medical Institutions ◽  
Academic Medical

AbstractBackgroundThe horrific nature of George Floyd’s killing by a Minneapolis Police Department officer on May 25, 2020 has sparked more than a month of nationwide protests against police brutality and in support of the Black Lives Matter movement. At critical junctures of the nation’s public health such as these, academic medical institutions may exert leadership by issuing public statements to communicate institutional values.MethodsWe obtained statements issued by 56 leading U.S. medical schools relevant to George Floyd’s killing and subsequent protests. We tokenized statements into words, n-grams of sizes 2 and 3, and sentences; removed non-informative stop words and words that would compromise de-identification; and stemmed the remaining words using the Porter algorithm. We followed a predefined set of rules for identifying important elements of these statements related to leadership in antiracism and public health.ResultsNearly all named George Floyd (50 [89%]), a majority noted the role of racism (43 [77%]) and acknowledged the Black community specifically (41 [73%]). Fewer ╌ slightly more than half ╌ referenced the act resulting in Floyd’s death (31 [55%]) or made explicit reference to the police (29 [52%]). Only 7 (13%) explicitly used terms denoting active support, like “antiracism” or “Black Lives Matter.” Most (45 [80%]) included references to negative sequelae resulting from racism like “disparities” or “inequality”. All included hopeful language.ConclusionOnly a minority of institutions made reference to the killing of George Floyd by the police, and most failed to address this country’s targeted, historically engrained, and sustained oppression of Black people through white supremacy. Thus, our study identifies significant opportunities for U.S. medical schools to exert meaningful leadership in health.

scholarly journals The emergence of SARS-CoV-2 in Europe and North America

Science ◽  
2020 ◽  
Vol 370 (6516) ◽  
pp. 564-570 ◽  
Author(s):  
Michael Worobey ◽  
Jonathan Pekar ◽  
Brendan B. Larsen ◽  
Martha I. Nelson ◽  
Verity Hill ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
North America ◽  
The United States ◽  
Washington State ◽  
Contact Tracing ◽  
Emerging Viruses ◽  
Transmission Networks ◽  
Health Measures ◽  
Global Spread

Accurate understanding of the global spread of emerging viruses is critical for public health responses and for anticipating and preventing future outbreaks. Here we elucidate when, where, and how the earliest sustained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission networks became established in Europe and North America. Our results suggest that rapid early interventions successfully prevented early introductions of the virus from taking hold in Germany and the United States. Other, later introductions of the virus from China to both Italy and Washington state, United States, founded the earliest sustained European and North America transmission networks. Our analyses demonstrate the effectiveness of public health measures in preventing onward transmission and show that intensive testing and contact tracing could have prevented SARS-CoV-2 outbreaks from becoming established in these regions.

scholarly journals Evolutionary Aspects of Emerging Lyme Disease in Canada

2015 ◽  
Vol 81 (21) ◽  
pp. 7350-7359 ◽  
Author(s):  
N. H. Ogden ◽  
E. J. Feil ◽  
P. A. Leighton ◽  
L. R. Lindsay ◽  
G. Margos ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
At Risk ◽  
North America ◽  
Lyme Disease ◽  
Severe Disease ◽  
The United States ◽  
Sensu Stricto ◽  
Content Type ◽  
Evolutionary Aspects

ABSTRACTIn North America, Lyme disease (LD) is a tick-borne zoonosis caused by the spirochete bacteriumBorrelia burgdorferisensu stricto, which is maintained by wildlife. Tick vectors and bacteria are currently spreading into Canada and causing increasing numbers of cases of LD in humans and raising a pressing need for public health responses. There is no vaccine, and LD prevention depends on knowing who is at risk and informing them how to protect themselves from infection. Recently, it was found in the United States that some strains ofB. burgdorferisensu strictocause severe disease, whereas others cause mild, self-limiting disease. While many strains occurring in the United States also occur in Canada, strains in some parts of Canada are different from those in the United States. We therefore recognize a need to identify which strains specific to Canada can cause severe disease and to characterize their geographic distribution to determine which Canadians are particularly at risk. In this review, we summarize the history of emergence of LD in North America, our current knowledge ofB. burgdorferisensu strictodiversity, its intriguing origins in the ecology and evolution of the bacterium, and its importance for the epidemiology and clinical and laboratory diagnosis of LD. We propose methods for investigating associations betweenB. burgdorferisensu strictodiversity, ecology, and pathogenicity and for developing predictive tools to guide public health interventions. We also highlight the emergence ofB. burgdorferisensu strictoin Canada as a unique opportunity for exploring the evolutionary aspects of tick-borne pathogen emergence.

scholarly journals ‘Resurgent’, ‘twin’ or ‘silent’ epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Benedikt Fischer ◽  
Caroline O’Keefe-Markman ◽  
Angelica (Min-Hye) Lee ◽  
Dimitri Daldegan-Bueno
Keyword(s):  
Public Health ◽  
North America ◽  
Illicit Drugs ◽  
Crack Cocaine ◽  
The United States ◽  
Opioid Use ◽  
Drug Problem ◽  
Public Health Burden ◽  
Stimulant Use ◽  
Prevention And Treatment

AbstractIn the early 2000s, increasing prevalence of psycho-stimulant (e.g., crack/cocaine, methamphetamine) use and related harms, including severe adverse health outcomes, was observed among - mostly marginalized - populations of persons using illicit drugs in North America, underscoring an urgent need for interventions options towards improved prevention and treatment. By about 2010, however, the ‘opioid crisis’, featuring unprecedented use and public health burden, had accelerated into full force in North America, largely muting attention to the psycho-stimulant issue until recently. Recent surveillance data on drug use and related mortality/morbidity from the present decade has documented a marked resurgence of psycho-stimulant use and harms especially in at-risk populations, commonly in direct combination with opioids, across North America, resulting in a ‘twin epidemic’ comprised of opioids and psycho-stimulants We briefly review select epidemiological data indicators for these developments from the United States and Canada; in the latter jurisdiction, related evidence has been less prevalent and systematic but corroborating the same trends. Evidently, the (widely ongoing) focus on the ‘opioid epidemic’ as a ‘mono-type’ drug problem has become an anachronism that requires urgent and appropriate correction. We then briefly consider existing, evidence-based options for – prevention and treatment – interventions targeting psycho-stimulant use and harms, which are substantially more limited and/or less efficacious than those available for problematic opioid use, while presenting major gaps and challenges. The observed resurgence of psycho-stimulants may, indirectly, relate to recent efforts towards curtailing (medical) opioid availability, thereby accelerating demand and supply for both illicit opioids and psycho-stimulants. The presently unfolding ‘twin epidemic’ of opioids and psycho-stimulants, combined with limited intervention resources, presents an acute challenge for public health and may crucially undermine actively extensive efforts to reduce opioid-related health harms in North America.

scholarly journals A comparison of Species Distribution Modeling approaches for an under-sampled parasite of public health importance, Echinococcus multilocularis

2016 ◽  
Author(s):  
Heather M. Williams ◽  
Brian Egan ◽  
Katharina Dittmar
Keyword(s):  
Public Health ◽  
High Resolution ◽  
North America ◽  
Species Distribution ◽  
Echinococcus Multilocularis ◽  
Research Effort ◽  
The United States ◽  
Distribution Models ◽  
Public Health Importance ◽  
Occurrence Data

AbstractBackgroundSpecies distribution models (SDMs) have an important role in predicting the range of emerging and understudied pathogens and parasites. Their use, however, is often limited by the lack of high-resolution unbiased occurrence records. Echinococcus multilocularis is a parasitic cestode of public health importance which is widely distributed throughout Eu rasia and is considered an emerging threat in North America. In common with many parasite species, available data for E. multilocularis occurrence are spatially biased and often poorly geo-referenced.ResultsHere we produce three separate SDMs using MaxEnt for E. multilocularis using varying complexities of sampling schemes and environmental predictors, designed to make the best possible use of non-ideal occurrence data. The most realistic model utilized both derived and basic climatic predictors; an occurrence sampling scheme which relied primarily on high resolution occurrences from the literature and a bias grid to compensate for an apparently uneven research effort. All models predicted extensive regions of high suitability for E. multilocularis in North America, where the parasite is poorly studied and not currently under coordinated surveillance.ConclusionsThrough a pragmatic approach to non-ideal occurrence data we were able to produce a statistically well supported SDM for an under-studied species of public health importance. Although the final model was only trained on data from Eurasia, the global model projection encompassed all known occurrences in the United States. The approach defined here may be applicable to many other such species and could provide useful information to direct resources for future field based surveillance programs for E. multilocularis in North America.

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