A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff.

UNLABELLED: There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.

Effect of antiretroviral treatment and counselling on disclosure of HIV-serostatus in Johannesburg, South Africa.

This prospective non-randomized study of clinic attendees, compares self-reported HIV disclosure patterns in relation to access to antiretroviral access and counselling. It was carried out in public sector hospital HIV clinics in Johannesburg, South Africa, and 144 HIV-positive men and women attending the HIV clinics participated in the study.The results showed that there was no correlation between being on antiretroviral therapy and disclosure of HIV status. There was also no correlation between disclosure of HIV status and with different levels of counselling and access to support groups. Disclosure levels were high (92% told at least one person), however, there was a high level of delayed (15% greater than a year) or non-disclosure (21%) to partners. Family members and partners provided most moral support after disclosure. Having access to antiretroviral therapy and support groups and available counselling did not seem to affect disclosure patterns. It is possible that a patients beliefs about their treatment plays a more important role for disclosure than the actual treatment itself. Other factors are also likely important for disclosure, such as the patient's social network especially with their families, and knowledge of the disease.

Medical Student Summer Externship Program: Increasing the Number Matching in Family Practice.

BACKGROUND AND OBJECTIVES: The number of US allopathic medical school graduates choosing a residency in family medicine has fallen from 13.4% in 1999 to 10.5% in 2002. Concern about declining numbers has led to the development of programs to provide medical students exposure to family medicine outside the clerkship. This paper reports on the development and longitudinal achievements of a clinical summer externship program 1993 to 1999. METHODS: The program description, practice settings, students' experiences, and department commitment are described. The purpose of this prospective study is to determine the percentage of family medicine summer externship participants (n=115) who match into family medicine. RESULTS: During the six years studied, 49 (43.4%) of the participants matched into family medicine. Program participants viewed the program favorably, mean = 5.82 out of 6. CONCLUSIONS: The Ohio State University Department of Family Medicine Medical Student Summer Externship Program demonstrates an effective educational experience that can increase and/or attain the proportion of students going into family medicine at the time of graduation.

Methods for teaching physical examination skills to medical students.

BACKGROUND AND OBJECTIVES: Teaching physical examination (PE) skills is a fundamental component of medical education. However, there is little information available about how medical school faculty teach PE skills. This study surveyed PE course directors to determine how they presently teach PE skills, the methods that are perceived to be the best, and how standardized patients (SPs) are recruited and paid. METHODS: A written survey was mailed to PE course directors at US allopathic and osteopathic medical schools. RESULTS: PE course directors at 83 (58%) schools responded. Results indicate that the top three methods presently used for teaching (demonstration on an SP, practice on an SP, and practice on patients) and those perceived to be the best methods are the same but in different rank order. A significant difference was observed in the overall mean scores of the present methods versus the best methods in 8 of the 10 teaching methods; thus, instructors are not always using the best methods to teach PE. There were also differences in methods used to teach "sensitive areas" (ie, genital or breast exam). CONCLUSIONS: The highest-ranked methods for teaching PE are demonstrations and practice with SPs and practice on real patients. However, PE instructors are not always using the teaching methods they deem best.