Primary Objective: Review the operational definitions of health and wellness coaching as published in the peer-reviewed medical literature. Background: As global rates of preventable chronic diseases have reached epidemic proportions, there has been an increased focus on strategies to improve health behaviors and associated outcomes. One such strategy, health and wellness coaching, has been inconsistently defined and shown mixed results. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review of the medical literature on health and wellness coaching allowed for compilation of data on specific features of the coaching interventions and background and training of coaches. Results: Eight hundred abstracts were initially identified through PubMed, with 284 full-text articles ultimately included. The majority (76%) were empirical articles. The literature operationalized health and wellness coaching as a process that is fully or partially patient-centered (86% of articles), included patientdetermined goals (71%), incorporated self-discovery and active learning processes (63%) (vs more passive receipt of advice), encouraged accountability for behaviors (86%), and provided some type of education to patients along with using coaching processes (91%). Additionally, 78% of articles indicated that the coaching occurs in the context of a consistent, ongoing relationship with a human coach who is trained in specific behavior change, communication, and motivational skills. Conclusions: Despite disparities in how health and wellness coaching have been operationalized previously, this systematic review observes an emerging consensus in what is referred to as health and wellness coaching; namely, a patient-centered process that is based upon behavior change theory and is delivered by health professionals with diverse backgrounds. The actual coaching process entails goalsetting determined by the patient, encourages self-discovery in addition to content education, and incorporates mechanisms for developing accountability in health behaviors. With a clear definition for health and wellness coaching, robust research can more accurately assess the effectiveness of the approach in bringing about changes in health behaviors, health outcomes and associated costs that are targeted to reduce the global burden of chronic disease. 摘要

Primary Objective:Review the operational definitions of health and wellness coaching as published in the peer-reviewed medical literature.Background:As global rates of preventable chronic diseases have reached epidemic proportions, there has been an increased focus on strategies to improve health behaviors and associated outcomes. One such strategy, health and wellness coaching, has been inconsistently defined and shown mixed results.Methods:A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)—guided systematic review of the medical literature on health and wellness coaching allowed for compilation of data on specific features of the coaching interventions and background and training of coaches.Results:Eight hundred abstracts were initially identified through PubMed, with 284 full-text articles ultimately included. The majority (76%) were empirical articles. The literature operationalized health and wellness coaching as a process that is fully or partially patient-centered (86% of articles), included patient-determined goals (71%), incorporated self-discovery and active learning processes (63%) (vs more passive receipt of advice), encouraged accountability for behaviors (86%), and provided some type of education to patients along with using coaching processes (91%). Additionally, 78% of articles indicated that the coaching occurs in the context of a consistent, ongoing relationship with a human coach who is trained in specific behavior change, communication, and motivational skills.Conclusions:Despite disparities in how health and wellness coaching have been operationalized previously, this systematic review observes an emerging consensus in what is referred to as health and wellness coaching; namely, a patient-centered process that is based upon behavior change theory and is delivered by health professionals with diverse backgrounds. The actual coaching process entails goal-setting determined by the patient, encourages self-discovery in addition to content education, and incorporates mechanisms for developing accountability in health behaviors. With a clear definition for health and wellness coaching, robust research can more accurately assess the effectiveness of the approach in bringing about changes in health behaviors, health outcomes and associated costs that are targeted to reduce the global burden of chronic disease.

The purpose of the study was to investigate the world of the high school music classroom. Motivation to join music ensembles and to remain, perception of the musical groups by their members and by the school community as a whole, the meaning and value that music ensembles engender for their participants, and the social climate of the music classroom were explored. Structured interviews were conducted with 60 students—20 each from band, choir, and orchestra. Students joined ensembles for musical, social, academic, and family reasons. Insider views highlighted the importance of labels and identifiers and changing perceptions throughout one's school career, whereas outsider views included the opinion that musicians are talented, intelligent, and underappreciated. Ensemble participation yielded musical, academic, psychological, and social benefits. The social climate emerged as a pervasive element in the study as students noted the importance of relationships for their well-being and growth.

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BackgroundDespite a large evidence base to demonstrate the health benefits of regular physical activity (PA), few physicians incorporate PA counseling into office visits. Inadequate medical training has been cited as a cause for this. This review describes curricular components and assesses the effectiveness of programs that have reported outcomes of PA counseling education in medical schools.MethodsThe authors systematically searched MEDLINE, EMBASE, PsychINFO, and ERIC databases for articles published in English from 2000 through 2012 that met PICOS inclusion criteria of medical school programs with PA counseling skill development and evaluation of outcomes. An initial search yielded 1944 citations, and 11 studies representing 10 unique programs met criteria for this review. These studies were described and analyzed for study quality. Strength of evidence for six measured outcomes shared by multiple studies was also evaluated, that is, students’ awareness of benefits of PA, change in students’ attitudes toward PA, change in personal PA behaviors, improvements in PA counseling knowledge and skills, self-efficacy to conduct PA counseling, and change in attitude toward PA counseling.ResultsConsiderable heterogeneity of teaching methods, duration, and placement within the curriculum was noted. Weak research designs limited an optimal evaluation of effectiveness, that is, few provided pre-/post-intervention assessments, and/or included control comparisons, or met criteria for intervention transparency and control for risk of bias. The programs with the most evidence of improvement indicated positive changes in students’ attitudes toward PA, their PA counseling knowledge and skills, and their self-efficacy to conduct PA counseling. These programs were most likely to follow previous recommendations to include experiential learning, theoretically based frameworks, and students’ personal PA behaviors.ConclusionsCurrent results provide some support for previous recommendations, and current initiatives are underway that build upon these. However, evidence of improvements in physician practices and patient outcomes is lacking. Recommendations include future directions for curriculum development and more rigorous research designs.

This study examines the participation of junior high school boys in choral music. Informants were eleven males, three females, and the teacher of a twenty-seven member grade 8/9 class at a suburban school. Data collection techniques included interview, observation, participant observation, and the examination of material culture. Data analysis involved the preparation of field notes and interview transcripts, document analysis, and study of the field note/interview text. Triangulation was achieved through the cross-referencing of informant statements and researcher observations. Four major themes emerged: motivation to join and remain in the choir; acquisition of musical skills, knowledge, and attitudes; repertoire preferences; and perception of the choral experience. Factors motivating boys' membership in choir were love of singing, teacher influence, and peer influence. Boy choristers were musically skilled, knowledgeable and articulate. They had clear though varied repertoire preferences. Perceived benefits from choir membership are discussed according to musical, non-musical, social, and teacher aspects.hilip sits in the front row of the choir, hugging his 'Linus-blanket' jacket around his knees. He watches the dance rehearsal intently and then comes alive when directed, along with his classmates, to sing and perform the actions for the rock music medley. On another occasion, Robert, Bruce, and Ron, the inseparable trio, stand close together in the second row as they sing their part, totally absorbed in the music. Their faces betray a concentration not often seen in junior high school music classrooms. A third example finds eighth grader Matt sporting an oversized blazer, his 'costume' for the up-coming concert, as he 'grooves' to the music. Three ninth grade boys look on with smiling faces. It's an instance of fraternal friendship between students of different ages.The reader will identify the foregoing examples as emanating from a music classroom-a junior high school choral classroom to be exact. Although the class is fairly equally-divided between girls and boys, it is the boys who provide the focus for this study. Such an investigation is timely, as recruiting and retaining males in choral ensembles is becoming an increasing challenge for teachers (Adler

Objective Eating whole grains (WG) is recommended for health, but multiple conflicting definitions exist for identifying whole grain (WG) products, limiting the ability of consumers and organizations to select such products. We investigated how five recommended WG criteria relate to healthfulness and price of grain products. Design We categorized grain products by different WG criteria including: the industry-sponsored Whole Grain stamp (WG-Stamp); WG as the first ingredient (WG-first); WG as the first ingredient without added sugars (WG-first-no-added-sugars); the word ‘whole’ before any grain in the ingredients (‘whole’-anywhere); and a content of total carbohydrate to fibre of ≤10:1 (10:1-ratio). We investigated associations of each criterion with health-related characteristics including fibre, sugars, sodium, energy, trans-fats and price. Setting Two major grocery store chains. Subjects Five hundred and forty-five grain products. Results Each WG criterion identified products with higher fibre than products considered non-WG; the 10:1-ratio exhibited the largest differences (+3.15 g/serving, P<0.0001). Products achieving the 10:1-ratio also contained lower sugar (−1.28 g/serving, P=0.01), sodium (−15.4 mg/serving, P=0.04) and likelihood of trans-fats (OR=0.14, P<0.0001), without energy differences. WG-first-no-added-sugars performed similarly, but identified many fewer products as WG and also not a lower likelihood of containing trans-fats. The WG-Stamp, WG-first and ‘whole’-anywhere criteria identified products with a lower likelihood of trans-fats, but also significantly more sugars and energy (P<0.05 each). Products meeting the WG-Stamp or 10:1-ratio criterion were more expensive than products that did not (+$US 0.04/serving, P=0.009 and +$US 0.05/serving, P=0.003, respectively). Conclusions Among proposed WG criteria, the 10:1-ratio identified the most healthful WG products. Other criteria performed less well, including the industry-supported WG-Stamp which identified products with higher fibre and lower trans-fats, but also higher sugars and energy. These findings inform efforts by consumers, organizations and policy makers to identify healthful WG products.

Live CME programs can be effective in educating healthcare providers about topics within the rapidly expanding field of lifestyle medicine.