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Jeffrey J.,University of California at Los Angeles | Dumont R.A.,University of California at Los Angeles | Kim G.Y.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Family Medicine | Year: 2011

BACKGROUND AND OBJECTIVES: The present study reviewed the published literature to examine the effects of international health electives (IHEs) on medical student learning and career choice. METHODS: A systematic literature review was conducted to identify key English-language articles on IHEs, using PubMed journal databases for the period 1990-2009. Article inclusion for this review was vetted by a rigorous evaluation of each article's study methods, content, and data quality. Pooled or aggregate information from 11 key articles, including information on type and duration of IHE, study and comparison group characteristics, and measured outcomes such as self-reported changes in cultural competency, clinical skills, and specialty choice, were extracted and summarized. RESULTS: Findings suggest that having IHE experiences contributed to a more well-rounded training for medical students; students reported being more culturally competent and were more likely to choose a primary care specialty and/or a public service career. CONCLUSIONS: Although IHE experiences appear to have educational benefits, the quality and availability of these electives vary by institution. Barriers to ensuring that students attain a safe and rich experience include the lack of consistent categorical funding, safety concerns when traveling, and limited faculty experience and resources to support and guide students during their rotations abroad. Source


Weber M.D.,Tobacco Control and Prevention Program | Messex M.,Tobacco Control and Prevention Program | Aragon L.,Tobacco Control and Prevention Program | Kuo T.,Office of Senior Health
American Journal of Public Health | Year: 2012

The Los Angeles County Tobacco Control and Prevention Program was significantly restructured in 2004 to improve capacity for local policy adoption. Restructuring included creating a fully staffed and trained policy unit; partnering with state-funded tobacco control organizations to provide high-quality, continuous technical assistance and training; implementing a highly structured policy adoption approach; expanding community capacity building; and establishing local coalitions to mobilize communities. Over the ensuing 6 years (2004-2010), 97 tobacco control policies were enacted in the county's 88 cities and unincorporated area, including 79 that were attributable to the program. By comparison, only 15 policies were enacted from 1998 to 2003. Expanding policy adoption capacity through program restructuring may be achievable in other local jurisdictions. Source


Piron J.,Surveillance | Smith L.V.,Surveillance | Smith L.V.,University of California at Los Angeles | Simon P.,University of California at Los Angeles | And 3 more authors.
Public Health Nutrition | Year: 2010

Objective The present study examines the receptivity to and potential effects of menu labelling on food choices of low-income and minority individuals - a group often at disproportionate risk for preventable, lifestyle-related health conditions (e.g. obesity, diabetes and CVD).Design We conducted a cross-sectional survey to examine the knowledge, attitudes and potential response to menu labelling in an urban public health clinic population. Setting United States.Subjects A total of 639 clinic patients were recruited in the waiting rooms of six, large public health centres in Los Angeles County (2007-2008). These centres provide services to a largely uninsured or under-insured, low-income, Latino and African-American population.Results Among those approached and who met eligibility criteria, 88% completed the survey. Of the 639 respondents, 55% were overweight or obese based on self-reported heights and weights; 74% reported visiting a fast food restaurant at least once in the past year, including 22% at least once a week; 93% thought that calorie information was important; and 86% thought that restaurants should be required to post calorie information on their menu boards. In multivariate analyses, respondents who were obese, female, Latino and supportive of calorie postings were more likely than others to report that they would choose food and beverages with lower calories as a result of menu labelling.Conclusions These findings suggest that clinic patients are receptive to this population-based strategy and that they would be inclined to change their food selections in response to menu labelling. © 2009 The Authors. Source


Cummings P.L.,Office of Senior Health | Sorvillo F.,Office of Health Assessment and Epidemiology | Sorvillo F.,University of California at Los Angeles | Kuo T.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Journal of the American Geriatrics Society | Year: 2012

Objectives To update and examine Alzheimer's disease-related mortality trends according to age, sex, race and ethnicity, geography, and other case characteristics for a 10-year period. Design Trend and comparative analyses of the U.S. multiple-cause-of-death records for 1999 to 2008. Setting United States. Participants Participants were decedents with Alzheimer's disease (AD) coded as underlying or associated cause of death; decedents with other forms of dementia or cognitive disorder were excluded. Measurements Case frequency, age-specific death rates, and crude and age-adjusted mortality rates were estimated for all AD decedents from the sampled period. Measures of AD mortality burden were compared with those of other leading causes of death (e.g., diabetes mellitus, stroke). Results From 1999 to 2008, 879,281 AD-related deaths were identified. The age-adjusted mortality rate for AD increased from 45.3 per 100,000 population (95% confidence interval (CI) = 45.0-45.7) in 1999 to 50.0 per 100,000 population (95% CI = 49.7-50.3) in 2008. The average age at death was 85.9. Differences in AD-related deaths varied according to sex, race and ethnicity, and geography. The number of AD-related deaths and age-specific mortality for persons aged 85 and older (n = 532,338, 1,096.6 per 100,000 population) were comparable with those from the same age group who died from diabetes mellitus (n = 488,593, 1,006.5 per 100,000 population). Conclusion The burden of AD-related mortality was substantial for the period 1999 to 2008. This burden is expected to grow rapidly as the baby boomer generation ages. Findings from this study may have important implications for present and future planning in medicine, social services, public policy, and public health. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society. Source


Redelings M.D.,Office of Health Assessment and Epidemiology | Piron J.,Office of Health Assessment and Epidemiology | Smith L.V.,Office of Health Assessment and Epidemiology | Chan A.,Office of Health Assessment and Epidemiology | And 3 more authors.
Vaccine | Year: 2012

Objective: The Public Health Center Vaccine Survey (PHCVS) examines the knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a largely low-income, urban, public health clinic population in Los Angeles County, USA. Design: A cross-sectional survey of vulnerable individuals at risk for severe influenza infection was conducted in one of the nation's largest local public health jurisdictions. Subjects: A total of 1541 clinic patients were recruited in the waiting rooms of five large public health centers in Los Angeles County from June to August, 2010. Results: Among prospective respondents who met eligibility criteria, 92% completed the survey. The majority was black or Latino and most were between the ages of 18 and 44 years. More than half were unemployed; two-thirds had no health insurance; and nearly one-half reported having a high school education or less. About one-fifth reported they had received the H1N1 vaccine during the previous flu season. In comparative analyses, negative beliefs about vaccine safety and efficacy were highly predictive of H1N1 vaccination. Blacks were less likely than non-black respondents to report receiving the H1N1 vaccine (OR=0.7, 95% CI=0.6-1.0). Blacks were also less likely than other respondents to agree that vaccines can prevent disease (OR=0.4, 95% CI=0.3-0.5), that vaccines are safe (OR=0.5, 95% CI=0.4-0.6), and that they trust doctors/clinicians who recommend vaccines (OR=0.5, 95% CI=0.4-0.7). Conclusions: Study findings provide a useful risk profile of vulnerable groups in Los Angeles County, which may be generalizable to other urban jurisdictions in the United States. They also describe real world situations that can be used to forecast potential challenges that vaccine beliefs may pose to national as well as local influenza pandemic planning and response, especially for communities with limited access to these preventive services. © 2011 Elsevier Ltd. Source

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