Health Status and Lifestyle Habits of US Medical Students: A Longitudinal Study

Background: Evidence shows that physicians and medical students who engage in healthy lifestyle habits are more likely to counsel patients about such behaviors. Yet medical school is a challenging time that may bring about undesired changes to health and lifestyle habits.Aims: This study assessed changes in students’ health and lifestyle behaviors during medical school. Subjects and Methods: In a longitudinal study, students were assessed at both the beginning and end of medical school. Anthropometric, metabolic, and lifestyle variables were measured at a clinical research center. Data were collected from 2006 to 2011, and analyzed in 2013–2014 with SAS version 9.3. Pearson’s correlations were used to assess associations between variables and a generalized linear model was used to measure change over time.Results: Seventy‑eight percent (97/125) of participants completed both visits. At baseline, mean anthropometric and clinical measures were at or near healthy values and did not change over time, with the exception of increased diastolic blood pressure (P = 0.01), high‑density lipoprotein‑cholesterol (P < 0.001), and insulin (P < 0.001). Self‑reported diet and physical activity habits were congruent with national goals, except for Vitamin D and sodium. Dietary intake did not change over time, with the exceptions of decreased carbohydrate (percent of total energy) (P < 0.001) and sodium (P = 0.04) and increased fat (percent of total energy) and Vitamin D (both P < 0.01). Cardiovascular fitness showed a trend toward declining, while self‑reported physical activity increased (P < 0.001). Conclusions: Students’ clinical measures and lifestyle behaviors remain generally healthy throughout medical school; yet some students exhibit cardiometabolic risk and diet and activity habits not aligned with national recommendations. Curricula that include personal health and lifestyle assessment may motivate students to adopt healthier practices and serve as role models for patients.Keywords: Lifestyle, Medical school, Medical students, Nutrition, Preventio

Measuring need satisfaction and frustration in educational and work contexts: the Need Satisfaction and Frustration Scale (NSFS)

The satisfaction and frustration of the psychological needs for autonomy, relatedness and competence predict well-being and ill-being outcomes. However, research within educational and work contexts is stifled by the lack of an exhaustively validated measure. Following extensive preparatory and pilot work, the present three studies (total N = 762) aimed to develop such a measure and validate it against the Basic Need Satisfaction at Work Scale (Deci et al. in Personal Soc Psychol Bull 27(8):930–942, 2001) and an adapted version of the Balanced Measure of Psychological Needs (Sheldon and Hilpert in Motivation Emot 36(4):439–451, 2012). The Need Satisfaction and Frustration Scale demonstrated a better factor structure and internal reliability than its predecessors, and good criterion validity. This improvement was due to the exclusion of ambiguous items and items measuring antecedents of need satisfaction and frustration. The results also strengthen current evidence showing that need satisfaction and frustration are distinct but related constructs, and each better predicts well-being and psychological health problems, respectively

Cost savings associated with improving appropriate and reducing inappropriate preventive care: cost-consequences analysis

<p>Abstract</p> <p>Background</p> <p>Outreach facilitation has been proven successful in improving the adoption of clinical preventive care guidelines in primary care practice. The net costs and savings of delivering such an intensive intervention need to be understood. We wanted to estimate the proportion of a facilitation intervention cost that is offset and the potential for savings by reducing inappropriate screening tests and increasing appropriate screening tests in 22 intervention primary care practices affecting a population of 90,283 patients.</p> <p>Methods</p> <p>A cost-consequences analysis of one successful outreach facilitation intervention was done, taking into account the estimated cost savings to the health system of reducing five inappropriate tests and increasing seven appropriate tests. Multiple data sources were used to calculate costs and cost savings to the government. The cost of the intervention and costs of performing appropriate testing were calculated. Costs averted were calculated by multiplying the number of tests not performed as a result of the intervention. Further downstream cost savings were determined by calculating the direct costs associated with the number of false positive test follow-ups avoided. Treatment costs averted as a result of increasing appropriate testing were similarly calculated.</p> <p>Results</p> <p>The total cost of the intervention over 12 months was $238,388 and the cost of increasing the delivery of appropriate care was$192,912 for a total cost of $431,300. The savings from reduction in inappropriate testing were$148,568 and from avoiding treatment costs as a result of appropriate testing were $455,464 for a total savings of$604,032. On a yearly basis the net cost saving to the government is $191,733 per year (2003$Can) equating to $3,687 per physician or$63,911 per facilitator, an estimated return on intervention investment and delivery of appropriate preventive care of 40%.</p> <p>Conclusion</p> <p>Outreach facilitation is more expensive but more effective than other attempts to modify primary care practice and all of its costs can be offset through the reduction of inappropriate testing and increasing appropriate testing. Our calculations are based on conservative assumptions. The potential for savings is likely considerably higher.</p