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Item Open Access Healthy Lifestyles and Attitudes Towards Preventive Counseling: a Survey of Chinese and US Medical Students(2013) Sebranek, Matthew PaulBACKGROUND: Non-communicable diseases are currently the leading cause of death worldwide. Leading healthy lifestyles as a means of prevention is one of the most important aspects of preventing the occurrence of non-communicable diseases. Working from the premise that physicians globally serve as role models for patients and their health beliefs can influence how they interact and counsel patients, this international study ("MedLife") seeks to examine the self-report of health behaviors and clinical practice attitudes towards preventive counseling of medical students at institutions in China and the US, and identify any associations between these behaviors and students' clinical practice attitudes towards preventive counseling of future patients.
METHODS: From 2012-2013, a total of 860/1,216 (response rate = 71%) medical students from Duke University in the US and Peking University Health Science Center and Xi'an Jiaotong University in China completed culturally-adapted web versions of the 33-item "MedLife" questionnaire. Items from the survey were pulled from previously validated survey tools and included questions on diet, exercise, smoking, and alcohol consumption. Alcohol consumption was divided into heavy drinking and binge drinking. Prevalence estimates of health behaviors and attitudes towards preventive counseling in the domains of diet, exercise, smoking, and alcohol consumption were obtained in addition to measures of association between health behaviors and clinical practice attitudes towards counseling future patients on these issues. Finally, multivariate logistic regression analyses were performed to assess the associations between personal habits and clinical practice attitudes towards preventive counseling while adjusting for gender.
RESULTS: The median ages of students at Duke University in years 1, 2, 3, and 4 were 23 years, 24 years, 25 years, and 26 years, respectively. The median ages of students at both schools in China among second, fourth, and seventh year students were 19 years, 22 years, and 24 years, respectively. In addition, the percentage of total females at Duke University and in China who completed the survey was 51% and 54%, respectively. Prevalence estimates of a healthy lifestyle, defined as complying with widely recognized recommendations at Duke University in the domains of diet, exercise, smoking, non-binge drinking, and non-heavy drinking were 30%, 42%, 99%, 41%, and 97%, respectively. Prevalence estimates in China of a healthy lifestyle in diet, exercise, smoking, non-binge drinking, and non-heavy drinking were 17%, 33%, 97%, 94%, and 99%, respectively. Overall, approximately 30% of medical students at Duke and 25% of medical students in China had positive clinical practice attitudes towards preventive counseling in terms of diet, exercise, smoking, and alcohol consumption combined. No statistically significant associations between the self-report of health behaviors and clinical practice towards preventive counseling were found among Duke medical students. Second, fourth, and seventh year medical students in China together who complied with all lifestyle recommendations were two times more likely to have a positive clinical practice attitude towards preventive counseling on all healthy lifestyle domains (diet, exercise, smoking, and alcohol) combined (OR=2.03 95% CI=1.06-3.92; p=0.03). When adjusted for gender, this positive association among Chinese medical students was still statistically significant (OR=1.98 95% CI=1.02-3.83; p=0.04).
CONCLUSION: Medical students self-reported that they led unhealthy lifestyles in the domains of diet, exercise, and alcohol binge drinking at Duke and in the domains of diet and exercise in China. However, there was little evidence of an association between self-report of health behaviors and clinical practice towards preventive counseling for Duke medical students. But there was evidence among Chinese medical students to support an association between an overall self-reported healthy lifestyle and positive clinical practice attitudes towards preventive counseling on diet, exercise, smoking, and alcohol consumption combined, even after adjusting for gender. If clinicians are going to serve as role models and have their behaviors and lifestyle choices influence patients, medical schools need to ensure students lead healthy lifestyles in these areas and improve positive clinical practice attitudes towards preventive counseling on diet, exercise, smoking, and alcohol consumption to help curb the global cardiovascular disease epidemic. Student health and positive clinical practice attitudes towards preventive counseling should be a top priority for all medical schools, and it seems that policies aimed at improving student health in China are likely to be associated with positive clinical practice attitudes towards preventive counseling.
Item Open Access Killing Iraq: A look at agency and power in relation to the U.S. mainstream media(2009-05-01T15:15:25Z) Ighile, OsagieItem Open Access THE FUTURE OF BIG OIL IN THE HYDROGEN ECONOMY(2021-04-30) Koutsogeorgas, Panayiotis; Ripecky, ZoëGlobally, oil and gas companies have approached hydrogen fuel with varying levels of interest and investment. In Europe, where policymakers have earmarked large sums of investment in the future of hydrogen, oil majors have been generally more proactive about incorporating hydrogen into their corporate strategies. US policymakers and oil majors have overall been less focused on hydrogen, but the US has some unique conditions that may be favorable to an expanded hydrogen industry. This project outlines the current positions of oil majors when it comes to hydrogen. It explores the unique challenges and opportunities that exist for traditional oil and gas companies, and how oil majors might adapt their infrastructure and workforce to embrace a hydrogen future.Item Open Access Transnational Blogospheres: Virtual Politics, Death, and Lurking in France and the U.S.(2009) Kushner, ScottWhat are the meanings of "here" and "there" in a digital age? This dissertation explores how blogs reveal new meanings of being "here" in a political space, how blogs reveal new meanings of being (or not being) "here" in a textually-mediated universe, and how blogs reveal new ways of being seen to be "here" when most internet users are just looking and log on and off without saying a word. Beginning with a reflection on the possibilities of democracy in a world where the interface is drawn to the forefront, I argue that the internet presents a new (and imperfect) way for citizens to operate the machinery of government. Next, I consider the consequences of this interface being available to people regardless of their geographic locations or national origins. I argue that citizenship in a digital moment is more closely bound to participation than it is to blood or territory and construct a notion of virtual transnational citizenship.
Such a notion of transnational citizenship does not signal the end of place and the irrelevance of presence and absence. Instead, it reveals that these concepts must be rethought and refigured. Bloggers flicker between absence and presence: in the blogosphere, every post may be a blogger's last, but there may just be another one waiting for us if we'll click reload. With this ambiguity in mind, I outline a digital ethics of reading that is attentive to both of these possibilities. Finally, I turn to the vast majority of blog users: the "lurkers" who read silently but do not write. I untangle reading, writing, and inscription in order to produce an understanding of how reading works in the blogosphere and argue that the lurker is not so much the reader who does not write as the reader who has not yet written.
By tracing the meanings of "here" and "there" through the blogosphere, this dissertation contributes to our understanding of what it means to be -politically and metaphysically -in the age of the internet.