Proposed Health Curriculum

Students need to understand the role their behaviour plays in supporting their health and other peoples’ health; they need to know that getting sick happens to everyone and doesn’t always require a visit to the doctor; they need to know how to do simple nursing at home so that people in their care do not get sicker; they need to know what kinds of symptoms require a doctor’s care or even a visit to the hospital.  This is why I advocate teaching First Aid and basic nursing skills such as ways to reduce fevers without resorting to drugs,  appropriate foods to feed patients with stomach bugs or colds, how long a patient needs to rest, stay home, take it easy and what the signs are of severe problems which require help.

I am not advocating that students be trained to be medical professionals but they should be trained to have sufficient knowledge and skills to care for themselves and others and be able to ask reasonable questions about health issues.  Part of growing up should be about caring for other people as well as oneself.  An understanding of the differences in infants and the elderly from the regular population in their health needs is vital.  An educated population could reduce the burden on hospitals and medical professionals.

– WHAT IS WELL?

– HOW TO KEEP THE BODY IN GOOD TRIM FOR DEALING WITH BUGS AND ACCIDENTS:

Diet – what kind?

Exercise- what kind? How much?

Sleep – its importance and how much

Main health effects of sleep deprivation (See Wikipedia:Sleep deprivation). Model: Mikael Häggström. To discuss image, please see Template talk:Häggström diagrams (Photo credit: Wikipedia)

Dealing with stress

Hygiene – both mental and physical eg.

Person washing his hands (Photo credit: Wikipedia)

hand washing after using the toilet and before eating

The importance of friends

The social self. (Photo credit: Wikipedia)

Vaccinations

– how they work

– Dangerous myths about vaccinations

Helmets for cycling

– Proper use

– Rules of the road for cyclists & cars and pedestrians.

– Defensive cycling

Safety – risk appraisal and safe behaviour

– Alcohol

– Cigarettes

SEXUALITY:

Menstrual cycle

Relationships

Male & female genitalia

Well Baby Check up (Photo credit: BenSpark)

Conception

Pregnancy

Birth

Breastfeeding & alternatives

Contraception

STDs

Menopause

– WELL BABY CARE

Senior Strutters March Show (Photo credit: Old Shoe Woman)

– ISSUES IN AGING SUCH AS:

Age Wave (Photo credit: jurvetson)

Maintaining physical and mental health

Cardiovascular Disease (Photo credit: GEEKSTATS)

– Through exercise, diet, participation in the community

– Planning finances for retirement

– Keeping the person living independently as long as possible

Weakening immune system

Loss of bone and muscle strength and ways

Gym Free-weights Area Category:Gyms_and_Health_Clubs (Photo credit: Wikipedia)

to reduce it.

Sleeping problems

Elder abuse

MENTAL HEALTH

Dealing with stress

Preventing stress

Good stress

Kindness and compassion as elements in maintaining good health

– WHAT IS SICK?

– HOW THE BODY DEALS WITH ILLNESS – anti-bodies

– Fever

– Fatigue

– SYMPTOMS OF COMMON PLACE ILLNESSES:

Colds

Stomach bugs

Influenza (flu)

Cold/Flu/H1N1 symptom chart (Photo credit: Kevin Baird)

Viruses

Headaches

Infections

Differences in symptoms and appropriate treatment for the elderly and infants

– TREATMENT OF COMMON PLACE ILLNESSES:

Role of the caregiver in keeping a patient comfortable

Rest – what is it?

Fluid – what kind?

Diet – what kind?

Cold sweat… (Photo credit: squishband)

Observation – fever, rashes, behaviour, vomiting, diarrhoea symptoms

Over the counter medication such as acetylsalicylic acid, ibuprofen and acetaminophen, their use, minimum & maximum doses, cautions on use

Symptom suppressors such as over the counter cough and cold medication & how and when to use them

– HOW TO PREVENT INJURIES

Cycling Oxford (Photo credit: tejvanphotos)

Safety on the road

Cleaning up spills

Tidying floors

Understanding which chemicals are dangerous and how to find out if they don’t know.

Storing chemicals and medications appropriately

Fire and scalding prevention

Using and storing knives

Water safety

– SYMPTOMS OF COMMON PLACE INJURIES:

Scrapes

Sprains

Cuts

Bruises

Breaks

English: A typical examination room in a doctor’s office. (Photo credit: Wikipedia)

bites

Drowning

– FIRST AID FOR THE ABOVE

– WHEN TO CALL THE DOCTOR & HOW TO HANDLE A VISIT TO THE DOCTOR’S OFFICE

Bring information about medicines

A clear description of symptoms – the fine art of taking and using notes

Health card

Patience

A child and adolescent’s right to confidentiality – how much, under what circumstances and at what age

– WHEN TO GO TO THE EMERGENCY:

Bankstown Hospital Emergency Room (Photo credit: redwolfoz)

Bleeding

Breathing

Unconsciousness

High fever (what is a high fever?)

Pain – prolonged or fierce

– & WHAT TO EXPECT

Hospital expectations such as:

bringing health cards

washing hands

wearing a mask for cold symptoms or coughs to prevent spread

First contact

Triage

Waiting times

A child and adolescent’s right to confidentiality – how much, under what circumstances and at what age

– DISEASES FREQUENTLY CAUSED BY LIFESTYLE:

Diabetes 2

Heart and stroke

What scientists call “Overweight” changes with our knowledge of human health (Photo credit: Wikipedia)

Obesity

Addictions

Tooth decay and loss

Emphysema

COMMON CHRONIC DISEASES, PROGRESSION AND TREATMENTS:

Diabetes 1

Asthma

Acne

Emphysema

Cancer

Migraines

MENTAL ILLNESS, SYMPTOMS & COMMON TREATMENTS

Explanation of common terms used to describe mental illness such as:

psychotic,

paranoid,

1212mentalhealth-RW (Photo credit: Robbie Wroblewski)

phobia

MOOD DISORDERS

• Major Depressive Disorder
• Dysthymic Disorder
• Bipolar Disorder
• Suicide

SCHIZOPHRENIA

ANXIETY DISORDERS

• Panic Disorder
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Generalized Anxiety Disorder (GAD)
• Social Phobia
• Agoraphobia
• Specific Phobia

EATING DISORDERS

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

AUTISM

PERSONALITY DISORDERS

• Antisocial Personality Disorder
• Avoidant Personality Disorder
• Borderline Personality Disorder
• http://www.mind.org.uk/mental_health_a-z/8034_mental_health_problems
• WHERE TO GO FOR HELP:

Family doctor

Teacher

Support groups

ETCETERA

Explanation of terms bandied about the educational system such as ADD, ADHD, intelligence, autism, learning disability and how they affect a person’s learning and education.  Treatments.

English: Ritalin (Australian packaging) (Photo credit: Wikipedia)

Explanation of interaction of physical and mental illness, drugs and physical and mental illness.

Explanation of alternative treatments such as:

Massage on the RM Elegant (Photo credit: yachtfan)

Acupuncture

Chiropractic

Massage

Physiotherapy

Biofeedback

Discussion of drug use: over the counter, prescription, illegal and naturopathic and the role of the pharmacist in ensuring that the appropriate medications are prescribed.

Pharmacy Rx symbol (Photo credit: Wikipedia)

Discussion of commonly prescribed medications, how they work and how to use them effectively:

eg Antibiotics

Antidepressants

Antivirals

Analgesics

Antipyretics

Anti-inflammatories

Antihistamines

Examples of curriculum, including the health curriculum (from Ontario’s ministry of education) that could integrate with or already cover the proposed health curriculum. 

Health Curriculum Grades 1 to 8

Healthy Eating.

Personal Safety and Injury Prevention.

Substance Use, Addictions, and Related Behaviours.

Growth and Development

Integration of Mental Health

Grade nine and ten science

A1.4 apply knowledge and understanding of safe practices and procedures when planning investigations (e.g., appropriate techniques for handling, storing, and disposing of laboratory materials [following the Workplace Hazardous Materials Information System-WHMIS]; safe operation of optical equipment; safe handling and disposal of biological materials), with the aid of appropriate support materials (e.g., the Reference Manual on the WHMIS website; the Live Safe! Work Smart! website)

A1.8 analyse and interpret qualitative and/or quantitative data to determine whether the evidence supports or refutes the initial prediction or hypothesis, identifying possible sources of error, bias, or uncertainty

A1.9 analyse the information gathered from research sources for reliability and bias

A1.10  draw conclusions based on inquiry results and research findings, and justify their conclusions

B1.3 describe public health strategies related to systems biology (e.g., cancer screening and prevention programs; vaccines against the human papillomavirus [HPV] and measles, mumps, and rubella [MMR]; AIDS education), and assess their impact on society [AI, C]

Sample issue: Early-childhood vaccination programs have greatly reduced the incidence of certain diseases and the social and medical costs associated with them. Influenced by controversial studies arguing that there may be health risks associated with such vaccines, some parents have chosen not to vaccinate their children, which could lead to a resurgence of these potentially deadly diseases.

Sample questions: What strategies are included in public health initiatives aimed at reducing the incidence of smoking-related diseases? What impact have these initiatives had on smoking rates and associated medical costs? How have health authorities responded to the threat of West Nile virus? What effect does this response have on people’s lifestyles? How did various cultures attempt to prevent disease before vaccines were available? What impact have vaccines had on global health?

B 2. investigate cell division, cell specialization, organs, and systems in animals and plants, using research and inquiry skills, including various laboratory techniques;

B3.2 describe the interdependence of the components within a terrestrial and an aquatic ecosystem, and explain how the components of both systems work together to ensure the sustainability of a larger ecosystem

B3.3 describe the complementary processes of cellular respiration and photosynthesis with respect to the flow of energy and the cycling of matter within ecosystems (e.g., carbon dioxide is a by-product of cellular respiration and is used for photosynthesis, which produces oxygen needed for cellular respiration), and explain how human activities can disrupt the balance achieved by these processes (e.g., automobile use increases the amount of carbon dioxide in the atmosphere; planting trees reduces the amount of carbon dioxide in the atmosphere)

Sample issue: Scientists are researching changes in climate patterns as possible contributing factors to an increase in the number of smog days in Ontario and elsewhere in Canada. As the air quality worsens, people may curtail their outdoor activities, and those with respiratory problems may require medical attention, increasing health care costs.

C1.1 analyse, on the basis of research, various safety and environmental issues associated with chemical reactions and their reactants and/or product(s) (e.g., chemical reactions related to the use of cyanide in gold mining, the corrosion of metal supports on bridges, the use of different antibacterial agents such as chlorine and bromine in recreational pools) [IP, PR, AI, C]

Sample issue: Ammonia and chlorine bleach are two common household cleaning agents. How-ever, when these two substances are mixed, the chemical reaction produces chlorine gas, which is highly toxic.

Sample questions: Why is it important to understand the chemical composition of chlorinating agents used in swimming pools before using them? What chemical reactions result in acid precipitation? What impact does it have on the environment? What sources of information are available on the safety or environmental implications of chemicals and chemical reactions? Why is it important to ensure that these sources are up to date? Why is it important to understand WHMIS information, including Material Safety Data Sheets, before using any chemicals?

• recognize that communities consist of various physical features and community facilities that meet human needs;

• use a variety of resources and tools to gather, process, and communicate information about the distinguishing physical features and community facilities in their area;

• describe how people in the community interact with each other and the physical environment to meet human needs

C2.1 use appropriate terminology related to chemical reactions, including, but not limited to: compounds, product, and reactant [C]

C2.2 construct molecular models to illustrate the structure of molecules in simple chemical reactions (e.g., C + O2 ? CO2; 2H2 + O2 ? 2H2O), and produce diagrams of these models [PR, C]

C2.3 investigate simple chemical reactions, including synthesis, decomposition, and displacement reactions, and represent them using a variety of formats (e.g., molecular models, word equations, balanced chemical equations) [PR, AI, C]

C2.4 use an inquiry process to investigate the law of conservation of mass in a chemical reaction (e.g., compare the values before and after the reaction), and account for any discrepancies [PR, AI]

C2.5 plan and conduct an inquiry to identify the evidence of chemical change (e.g., the formation of a gas or precipitate, a change in colour or odour, a change in temperature) [IP, PR, AI]

C2.6 plan and conduct an inquiry to classify some common substances as acidic, basic, or neutral (e.g., use acid-base indicators or pH test strips to classify common household substances) [IP, PR, AI]P

Sample issue: Ultrasound is routinely used during pregnancy to monitor the development of the fetus. It is also used to perform amniocentesis, which screens for genetic disorders, and allows doctors to perform surgery on the fetus before birth to correct some abnormalities. However, there have been few studies on the long-term effects of the use of ultrasound.

Sample questions: How are medical imaging technologies used in the diagnosis and treatment of heart disease and stroke? What types of imaging technologies are used in ophthalmology? How have they benefited people who have eye disease? How have developments in biophotonics advanced a range of surgical procedures?analyse a technological device or procedure related to human perception of light (e.g., eyeglasses, contact lenses, infrared or low light vision sensors, laser surgery), and evaluate its effectiveness.

What strategies are included in public health initiatives aimed at reducing the incidence of smoking-related diseases? What impact have these initiatives had on smoking rates and associated medical costs? How have health authorities responded to the threat of West Nile virus? What effect does this response have on people’s lifestyles?

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A practical health curriculum

Injury – face plant into the concrete floor on our way home (Photo credit: Lee Turner)

While I am the last person to want to add to teachers’ work load, I do think it is time to teach a real health curriculum, starting in kindergarten.  We are facing difficulties with our health system and it is likely to get worse.  I have been surprised by how little people understand about dealing with minor illnesses and injuries; as our aging population increases, we will have more patients with increasing health needs.  We can’t avoid the need for medical professionals to treat serious illnesses but we can learn to recognise what is serious and what isn’t and how to reduce the load on doctors and hospitals.  People need to understand how their bodies function, especially to keep them well.  They need to know how to support their body’s effort to keep them well and how to recognise the seriousness of an illness or injury and how to respond.   And they need to know how infants and the elderly differ in their health needs.

I have done some research and discovered that much of the curriculum could be covered not only in health classes, but some science and even (economic) geography.  It would require some reshaping of the curriculum but, for example, cells are how human beings are constructed, sometimes repaired, attacked by bacteria and viruses and healed.  A biology curriculum would have to go further than just teaching cells, but the teaching of how cells operate in bodies may actually help improve retention of cell biology.

Ontario’s grade 1 to 8 curriculum is primarily concerned with making healthy choices:

Health Curriculum Grades 1 to 8

Healthy Eating.

Personal Safety and Injury Prevention.

Substance Use, Addictions, and Related Behaviours.

Growth and Development

Integration of Mental Health

This is good, but not enough.  A more thoroughly developed curriculum would empower our future citizens in taking responsibility for their own health.

I live in a city where a lot of people bicycle.  I have noticed that very few cyclists realise that they come under the same laws and regulations as cars.  There are some allowances made for parking bikes and occasionally they are allowed (the permission is posted clearly) to enter a road blocked to cars.  There are many bike lanes.

English: Graph of adult cyclist head injuries versus helmet use in New Zealand. (Photo credit: Wikipedia)

Driving a car without lights and using a cellphone while driving are both illegal here.  Recently a young woman was hit by a car as she cycled on the wrong side of the road at night without lights and while texting.  The local media did say the driver of the car was not charged but they did not make it clear how many violations this woman was guilty of.  In addition, she was not wearing a helmet.  Helmets are mandatory here for children (not adults) but many children and adults wear them sitting improperly on their heads, on top of caps or not firmly secured.  A great waste of money.

Carelessness causes accidents… Accidents slow up production. – NARA – 535274 (Photo credit: Wikipedia)

When I was a kid, the police used to come to the school to talk to us about road safety – as pedestrians and cyclists.  While many of us might have ignored the advice, at least we knew that what we were doing was either dangerous or illegal.  That program no longer exists.  Fire departments have trailers designed to teach fire safety and public health nurses used to come to school to teach personal hygiene and how to use a toothbrush.  These programs not only made an impression but it broadened students’ horizons to recognise what some of the resources in their community were.

I realise that changes need to be made to the way our health care is delivered and medical professionals are taking steps to streamline care without making it less effective.  That is not my field, however.  What I am proposing is that we educate our citizenry in how to care for themselves and when they need to seek professional help.

Including mental health is perhaps not more than a gesture as treatment is

Rethink Mental Illness (Photo credit: Wikipedia)

available only to those are seriously ill or who have enough money to pay for care.  Perhaps a country of people who understand mental illness, believe it can be treated and are aware of what mental illness costs in productivity are might decide that mental health also needs funding.

What I propose is a curriculum starting in grade one and largely delivered by the end of grade ten. My next post will give a detailed outline of the proposed health curriculum.

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A Salute to the Nurses at CHEO, the Children’s Hospital of Eastern Ontario

The little girl next door was in hospital.  For forty-eight hours we were very worried about her; then all that remained was for her to stay in hospital for an additional nine days while an antibiotic was delivered intravenously.  For the first few days, family and friends took turns being at her bedside 24 hours a day.  Once she was on the

Cholera Strikes Dessalines, Haiti (Photo credit: United Nations Photo)

mend, they no longer needed to stay all night or all day, but visited frequently enough that she never feels abandoned.

As I spent time with her at the hospital, it came home again to me that 90% of recovery is letting the body do its thing.  Once the doctors have consulted,

Portrait of Miss Georgina Pope, head nurse of First Canadian Contingent during the Boer war. Possibly in her nurse’s uniform from Bellevue Hospital, New York (Photo credit: Wikipedia)

examined the results of tests, made a diagnosis, prescribed a treatment and followed up, the rest is up to the nurses and the child’s body.

The nurses come in to check on the IV, add medications, observe the monitors but most importantly, they pay attention to the child.  They talk to her and listen to her.  They explain what is happening.  I have watched them patiently listen to morphine–fuddled child try to explain what she is worried about.  They look for ways to comfort a child in pain.  Sometimes it’s as simple as a warm facecloth washing a hand temporarily free of the IV.  They coax a child to use a hand that is still sore.  They brush her

Hospital (Photo credit: José Goulão)

teeth if she doesn’t feel she can cope.  They carry the train of IV pole and trailing lines so the child can use the toilet.  They persuade children to drink and eat.  These are all ways of allowing the body to get on with its share of healing.

English: Nurses on the Army Hospital Ship Relief in 1898 while serving off of Cuba, US Navy Historical Center Photograph NH 92846 (Photo credit: Wikipedia)

One day our patient asked someone “are you a nurse or a doctor?”  The nurse told her that you could tell the difference by how much time the person spent with her.  The doctors usually didn’t stay long or come more than once a day; patients saw more of the nurses, especially their own nurse.  Our patient thought a bit and added, “the nurses talk to me.  The cleaners are here a lot but they don’t talk to me.”  The nurse smiled at the astute observation, “yes, they don’t want to disturb you if you are resting and they have a lot of work to do cleaning the ward”.

Good nursing is a major factor in healing; it’s as true today as it was two

English: Navy nurses attending to a patient, 1960s. (Photo credit: Wikipedia)

hundred years ago.  So let’s salute nurses everywhere, their professionalism, their knowledge and their compassion.  They comfort the patients and their families and are often the first to observe subtle changes in their condition.  Especially let us salute the nurses at children’s hospitals and especially at CHEO.  For nearly 35 years I have watched them care for children in my family and now the neighbours’ children.  Thank you.

English: First District Nurses in Melbourne (Photo credit: Wikipedia)

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