PubMed · 15757998
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Mary Kinoulty. 2005. Monitor.. https://doi.org/10.1093/occmed%2Fkqi058
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Bimodal distributions of counts with one mode at zero are often seen in medical research. In a health survey parents were asked the number of days their children missed their activities (Y(1)) and the number of days their children spent in bed (Y(2)) due to illness in the past four weeks. Both variables exhibited zero inflation. We consider a bivariate Poisson-Poisson regression model, in which the two variables are regarded as indicators of an unobserved health status variable. Based on this, we further develop a bivariate Poisson-Poisson model that constrains Y(1)>or=Y(2). It is often claimed that there is a critical window of growth and nutrition in foetal life and infancy during which subsequent health status is affected. It is not clear whether the claim is true and whether childhood growth matters more. We analyse the bivariate data in relation to weight-for-age in infancy and weight gain from infancy to age 7 years. The findings do not support the existence of a critical window in infancy. There is some indication that childhood weight gain might affect health status.
The General Medical Council in the UK recommends that undergraduate medical students be exposed to a variety of learning opportunities and increasingly take responsibility for their own learning. This study presents quantitative and qualitative data relating to attendance at non-compulsory plenary lectures in order to understand factors affecting the value placed by students on this component of the first 2 years of a contemporary medical curriculum. Attendance data were available for 87% first year and 78% second year plenary lectures. There was no difference in attendance at lectures that were delivered telematically to a remote site when compared with those where the speaker was present. There were markedly more students attending lectures at the beginning of the first academic year, with numbers decreasing as the year progressed. More first year students attended lectures on biomedical science and clinically focussed topics than on human science and public health whereas second year student attendance was similar across topics. Reasons given for non-attendance at plenary sessions fell into "student-related" factors (e.g. dislike of lecture-based learning) and "teaching-related" factors (e.g. perceived variable quality of lectures). This study confirms that some students value lectures highly as a method to supplement other learning opportunities, whereas others find they learn better by other means.
African adolescents are at high risk of poor sexual health. School-based interventions could reach many adolescents in a sustainable and replicable way, if enrolment, funding and infrastructure are adequate. This study examined pupils', recent school leavers', parents' and teachers' views and experiences of rural Tanzanian primary schools, focusing on the implications for potential sexual health programmes. From 1999 to 2002, participant observation was conducted in nine villages for 158 person-weeks. Half of Year 7 pupils were 15-17 years old, and few went on to secondary school, suggesting that primary schools may be a good venue for such programmes. However, serious challenges include low enrolment and attendance rates, limited teacher training, little access to teaching resources and official and unofficial practices that may alienate pupils and their parents, e.g. corporal punishment, pupils being made to do unpaid work, forced pregnancy examinations, and some teachers' alcohol or sexual abuse. At a national level, improved teacher training and supervision are critical, as well as policies that better prevent, identify and correct undesired practices. At a programme level, intervention developers need to simplify the subject matter, introduce alternative teaching methods, help improve teacher-pupil and teacher-community relationships, and closely supervise and appropriately respond to undesired practices.