Physiologists at US medical schools: education, current status, and trends in diversity.
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Education, Medical↗
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[Continuing education: current status].
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Curriculum↗
Knowledge and perception of obstetric analgesia among prospective parturients at the Lagos University Teaching Hospital.
BACKGROUND: Natural labour is painful. Such pain has little value and is potentially harmful to the parturient and foetus. OBJECTIVE: To assess knowledge, perceptions and acceptance of obstetric analgesia among prospective parturients. The effect of age, educational status and parity on the above variables was evaluated. DESIGN AND SETTING: Prospective cross-sectional study between October 2002 and April 2003 at the Lagos University Teaching Hospital (LUTH). PATIENTS AND METHODS: Patients attending ante-natal clinics voluntarily responded to a structured questionnaire which enquired patient's age, educational status and parity; knowledge, perceptions and acceptance of obstetric analgesia. The association between the variables was determined with the Pearson's Chi square test. RESULT: Four hundred and fifty patients of varying educational levels were studied. Only 175 (38.9%) knew of obstetric analgesia. There was a significant association between educational status and knowledge of obstetric analgesia (p = 0.000). Two hundred and ninety four patients (65.3%) would accept analgesia during labour of which 179 (60.9%) would leave the choice to the doctor to give them the "best available". There was no association between age, educational status and parity with acceptance (p > 0.05). Reasons for rejection included labour being a 'natural process' in 15.1%, faith in divine intervention 6.0% and concerns about side effects 3.1%. CONCLUSION: This study has revealed a dearth of knowledge and gross misconception about obstetric analgesia. With proper education, many patients will accept some form of analgesia during labour. There is an urgent need to commence standard obstetric analgesia services in our tertiary hospitals.
Adolescent↗
Relationship of non-organic factors with malnutrition among children under three years of age.
OBJECTIVE: To study the association of socioeconomic and physical environmental factors with malnutrition among children under 3 years of age in four districts of Pakistan. DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Selected MCH, Centres of Lahore, Jhang, Gilgit and Pallandri (AJK) providing preventive, promotive and curative services during the month of January 2004. PATIENTS AND METHODS: A total of 448 children under 3-years of age coming to selected MCH centers, during the study period, were examined for malnutrition. The children were divided into two groups (normal/malnourished) on the basis of standard WHO weight for age growth chart. The compared variables were weaning and breast feeding practices, gender, vaccination status, living conditions and parents' educational status. RESULTS: There were 238 (53%) male and 210 (47%) female children examined for malnutrition. The difference in weaning age, gender and vaccination status among normal and malnourished children were found to be statistically significant (p<0.001). A higher proportion of malnourished children (62.6%) was also found in families living in one room houses as compared to 2 or more room houses (p=0.01). There was an inverse association of educational status of both parents with malnutrition of children (p<0.001). CONCLUSION: This series showed a higher proportion of malnutrition among children, who were unvaccinated, weaned after seven months of age, not exclusively breast-fed for first six months, and lived in poor environmental conditions.
Child, Preschool↗
Reading deficiencies in older patients.
To participate effectively in their health care, older patients often are expected to read a wide variety of materials, including written instructions, brochures, and consent forms. This study quantitates the reading ability of older patients and compares it to that of younger patients. Two hundred seventy-two patients 30 and older were selected from five outpatient clinics at a public teaching hospital and tested for objective reading ability using the Peabody Individual Achievement Test--Revised. The 76 patients 60 and older read significantly worse (grade level 2.9) than the 196 patients younger than 60 (grade level 5.8) (P < 0.0001). Older patients also completed significantly fewer years of school than younger patients (7.3 years versus 10.6 years). Analysis of variance for age categories 30-44, 45-59, 60-74, and 75 and older confirmed declining reading ability and educational status with advancing age. Multiple regression analysis helped show that an equation could be derived to predict reading ability from age, educational status, race, and sex, but the coefficient of determination was so low (r2 = 0.39) that it cannot be considered clinically useful for individual patients. In this study, older patients read significantly worse than younger patients, and a formula that combines age, race, sex, and educational status cannot reliably predict reading ability for individual patients. Most older patients read on a level so low that they cannot be expected to read most commonly used written materials. Routine testing of reading ability may allow more appropriate design and use of written materials.
Adult↗
Inter-generational educational advancement and body height.
This study investigates the association between body height and inter-generational social advancement through education. Questionnaire data were collected from 2800 students (1023 men and 1777 women) from the universities of Wroclaw, Poland. The questions referred to three generations: the students and their parents and grandparents. Information was collected on the age, body height and weight of the students and their parents, and on the parents' and grandparents' education. The lowest body heights were typically found for individuals from families with the lowest educational levels, whereas the greatest body heights were found for those brought up in families with a high educational status or in families who had upgraded their status. The size of the change in the educational level of parents is only associated with fathers' and female students' body height. Individuals who had advanced from a middle educational level or who came from families with this type of advancement were found to be significantly taller, on average, than those upgrading their educational level from the lowest position. The results show that, for men, educational advancement during the course of their lives or in the earlier generation is more favourable to achieving higher stature, whereas for women, the multi-generational tradition of a high educational status is of greater significance.
Adolescent↗
[A study of the prevalence of alcohol consumption in the Baix Ebre region (Tarragona)].
A cross-sectional study was carried out in the Baix Ebre region about the prevalence of alcohol use, within a wider study of hypertension and other risk factors. The following characteristics were considered for the elaboration of the present study: non drinker, moderate drinker and heavy drinker, as well as the amount of alcohol intake related with demographic, socioeconomical and cultural variables such as: age, sex, urban or rural medium, marital status, place of origin, working status, social and professional level, and educational status. 64.2% of the whole population greater than or equal to 20 years were usual alcohol users, and so were 79.4% of males and 48.2% of females. According to the definition of heavy or excessive drinker, such were 21.8% of males and 2.6% of females. Males drank a higher alcohol amount, with a mean and standard deviation of 47.1 +/- 35.5. In females, these figures were 19.4 +/- 12.4 g per day. The rate of alcohol drinkers was higher in young individuals, in those with active working status, in those with medium social and professional level, and in those with medium and high educational status.
Adult↗
Epilepsy and employment, marital, education and social status.
Employment, marital, educational and social status in epileptic patients attending a seizure clinic were assessed. A total of 343 patients were evaluated. The social group, employment and marital status did not compare favourably with the overall population. Forty per cent of patients belonged to social group five and six compared with 14% of the population. Thirty three per cent of male patients aged 20 years or more were married, compared with 65% in the community. The corresponding statistics for females were 46% and 73% respectively. The male unemployment rate of 34% compared poorly with the unemployment rate of 13% for the period during which the study data was collected. Patients with lower educational attainments were significantly more likely to have poor seizure control (P less than 0.001), or required polypharmacy. A similar situation was found between seizure control and social status, with poor seizure control occurring in patients in social group six.
Adolescent↗
Awareness of osteoporotic patients.
Osteoporosis has recently been recognized as a major public health problem by some governments and health care providers. Despite significant progress in knowledge about osteoporosis, public awareness is required for effective management if precautions are to be taken. The aim of this study was to evaluate the educational status of osteoporotic individuals, and their awareness about the disease and sources of information. We also aimed to compare the variables between the geographical regions of the country, since significant differences exist in socioeconomic status and lifestyle within the same cultural context. This multicenter study was carried out in eight cities located in six different geographical regions between September 2001 and January 2002. To our knowledge, this is the first multicenter study in Turkey evaluating the relationship between awareness of osteoporotic patients and other variables such as educational level and economic factors. Ten centers took part in this study and consecutive patients with either femoral or lumbar T-scores below -2.5 SD were enrolled into the study group. Bone mineral density was measured using dual energy X-ray absorptiometry (DXA). Patients were interviewed using a questionnaire on past medical history, education, awareness about their disease and risk factors for osteoporosis. A total of 540 women (93.8%) and 36 men (6.3%) were included in the study. Fifty-four percent of patients declared that they were aware of osteoporosis. With regard to sources of information, 56.8% of patients reported physicians as the main source of information. Awareness of the patients was negatively correlated with age (P=0.025, r=-0,94) but positively correlated with education (P=0.0001, r=0.327), level of physical activity (P=0.001, r=143), calcium intake (P=0.005, r=119) and modern clothing style (P=0.0001, r=309). Educational status of the patients was negatively correlated with BMI (P=0.0001, r=-283) and positively correlated with physical activity (P=0.0001, r=268), modern clothing style (P=0.0001, r=600) and smoking (P=0.0001, r=273). Regional comparison of female patients demonstrated that significant differences exist in terms of educational status, clothing style, smoking, level of physical activity, calcium intake, and knowledge about osteoporosis. As a result, education has profound effects on awareness about osteoporosis and many aspects of human behavior, such as calcium intake, physical activity, clothing style and smoking. Significant disparities may be observed between the geographical regions of the same country.
Adolescent↗
Social status of the rural girl child in Tamil Nadu.
OBJECTIVE: The social status of the girl child in school age was assessed in a village in Tamil Nadu applying both qualitative and quantitative methods. METHODS: The home milieu was taken as the social context for the study purpose since home is the first societal unit a child comes into contact with. The various issues considered to study the social status were (1) Gender preference in having children (2) Nutrition and health care given to them (3) Importance given to their education (4) Activity pattern in daily life (5) Attitude of the community towards (a) girl child after menarche and (b) marriage. RESULT: In the study village, although there was desire to have sons, a girl child is not ignored. The value of having a girl in the family was appreciated. There was no gender discrimination in giving nutrition and health care. However the workload in girls was found to be marginally higher than in boys. The educational status of girls was lower than that of boys in terms of school enrollment and attendance. But menarche, was not an important cause of the lower educational status of girls. In the sociocultural context of the study village the priority in a girl's life during school going age was marriage. Soon after attaining puberty in a girl's life during school going age was marriage, not education and this perhaps reveals the lesser importance given to a girl's education by the community. CONCLUSION: The need of the hour is to improve her educational status by changing the attitude of the community so that a girl child's priority in her school age is not marriage but education.
Child↗
Determinants of body mass index in Greek children and adolescents.
The aim of this study was to investigate the determinants of body mass index (BMI) among Greek children and adolescents, such as parental age and BMI, number of family members in the household, parents' educational status and occupation, physical activity and hours of television viewing and playing computer games by children per day. This cross-sectional study included 2,495 children aged 6-17 years from primary and high schools of Thessaloniki, capital of Northern Greece. Data were collected by questionnaires concerning age, height and weight of the parents, number of family members, and socioeconomic status as determined by occupation and educational status of the parents. Our results revealed that overweight in Greek children and adolescents is influenced positively by several determinant factors, such as parental age and obesity, hours of television viewing, and negatively by a high parental educational level. No significant association was found between children's BMI and physical activity. Intervention and prevention measures should be targeted at the reduction of sedentary activities, especially television viewing, and promotion of physical activity. These measures should be directed at families that are affected and/or concerned with obesity.
Adolescent↗
Is education a determinant of knowledge about malaria among Indian tribal population?
Malaria is a major public health problem in tribal villages of India, where 8% of the country's population lives. Literacy level among tribal population is very low. This study aims to examine the relation between education status and knowledge about malaria among Indian tribal communities. 125 randomly selected tribal respondents from one tribal village each of 17 states were administered a close ended questionnaire by trained interviewers to assess their knowledge about various aspects of malaria. Effect of educational status on the level of knowledge was analyzed using chi square test. Stratified analysis was performed using Mantel Haenszel chi square test to eliminate gender bias. 2125 respondents', randomly selected from 17 tribal villages in as many states, findings were analyzed. Fifty seven percent male and 72% female respondents were illiterate. Only 2% respondents had college level education. Educated females were more knowledgeable than their male counterparts. Mantel Haenszel chi square analysis showed that educated respondents were more knowledgeable than the illiterates, after adjusting for sex of respondents. However, there was gross lack of knowledge regarding diagnosis and treatment of malaria and use of insecticides irrespective of gender and educational status. Improvement in literacy status of tribal population will help in increasing awareness about malaria. Opportunities for disseminating information about various aspects of malaria should be utilized during treatment of malaria cases by health workers.
Adolescent↗
The three-year persistence of depressive symptoms in men and women.
Little is known about sex differences in the course of depression. The results of the few surveys of the general population are inconsistent. Furthermore, the generalizability of most of these findings is limited. First, only a handful of studies of the general population use a prospective design to estimate the persistence of depression in women and men. Second, in some studies only particular subgroups of the general population are sampled, and finally, depression persistence is often measured using unconventional short time-intervals. Using data from five waves of the Flemish subsample of the Panel Study of Belgian Households (PSBH)--a probability sample of 1168 (52.5%) women and 1055 (47.5%) men--we tried to go beyond these shortcomings. Depression persistence is estimated using a self-report inventory on four occasions separated by intervals of one year (1993, 1994, 1995, 1996). Results show a significant influence of sex, other sociodemographic characteristics, and depression severity at baseline on three-year depression persistence. Women experience more chronicity, a difference that can be partially ascribed to sex differences in employment status, education and marital status. Persistence in linked to marital status in women. In men persistence is associated with level of education and with employment status. Depression severity at baseline, however, largely explains the influence of these social conditions on depression persistence.
Adolescent↗
Medical education forum: status quo.
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Education, Medical↗
Education, socioeconomic status and risk of cancer of the colon and rectum.
BACKGROUND: Socioeconomic correlates of cancer of the large bowel differ in various countries and calendar periods and may differ for the colon and rectum. Thus, the relationship between education and social class and risk of cancers of the colon and rectum was considered. METHODS: Combination of two hospital-based case-control studies conducted in six Italian centres between 1985 and 1996. Cases were 3533 patients aged < 79, with histologically confirmed cancer of the colon (n = 2180) or rectum (n = 1353), and controls were 7062 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases. RESULTS: Compared to individuals with < 7 years of education the multivariate odds ratios (OR) of colon cancer for those with > or = 16 years were 2.45 (95% confidence interval [CI]: 1.87-3.23) in men and 1.29 (95% CI: 0.88-1.90) in women, with significant trends in risk. No significant association emerged between education and risk of rectal cancer, with OR of 1.18 (95% CI: 0.83-1.70) and 1.01 (95% CI: 0.61-1.67) respectively for men and women in the highest educational category compared to the lowest. Social class was also related to colon cancer risk: the OR were 2.30 (95% CI: 1.82-2.90) in men and 1.33 (95% CI: 1.03-1.73) in women in the highest versus the lowest social class. No association was found between social class and rectal cancer risk, with OR of 1.18 for either men or women in the highest as compared to the lowest social class. No significant heterogeneity was found for the association between education and colon cancer risk in either sex across strata of age at diagnosis, coffee, alcohol and vegetable intake, family history of the disease, and in anatomical subsites within the colon. CONCLUSION: This study, based on a uniquely large dataset, indicates that there are different social class correlates for colon and rectal cancer. Consequently the two sites should not be combined in studies considering lifestyle factors in the aetiology of these neoplasms.
Adult↗
Risk factors for poor glycemic control in diabetic children in France.
OBJECTIVE: To test whether immigrant versus nonimmigrant origin, among other factors, is associated with differences in glycemic control in diabetic children. RESEARCH DESIGN AND METHODS: A cross-sectional multicenter survey was performed in 165 French diabetic children aged 7-13 years and their parents. HbA1c was measured by high-performance liquid chromatography in a single laboratory (reference value: 5.1 +/- 0.6%). Standardized questionnaires were used to evaluate cognitive, familial, and socioeconomic factors and adherence to diabetes regimen. RESULTS: The mother's place of birth was found to account for 6.6% of the HbA1c variance. Two groups of children were identified with French-speaking immigrant (n = 27) and native French mothers (n = 138) who had significantly different HbA1c values of 9.1 +/- 8% vs. 8.1 +/- 1.4%, respectively (P < 0.001). Adherence to diabetes treatment was significantly lower in immigrant mothers for diet and insulin changes (P < 0.01), as well as their level of diabetes knowledge (P < 0.01). This immigrant group had no significant differences in parents' socioeconomic status, educational background, family status, family functioning, diabetes education background, and social support compared with the native French mothers' group. CONCLUSIONS: Despite no differences in socioeconomic status, a group of children with less well-controlled diabetes was identified by the mother's place of birth. Cultural factors have a crucial importance in glycemic control in diabetic children and in parents' adherence to treatment and must be taken into account in the development of educational programs.
Adolescent↗
The relationship between socio-economic status and physical activity patterns in South African children.
AIM: To examine: (1) the associations between socio-economic status, physical activity, anthropometric and body composition variables in South African children; (2) the influence maternal characteristics have on children's physical activity levels; and (3) associations between television watching, activity level and body composition. METHODS: In 381 South African children, physical activity and socio-economic status were assessed via structured retrospective interview using validated questionnaires. An asset indicator score was calculated as a proxy measure of socio-economic status and used to divide children into quartiles. RESULTS: Children falling into the highest socio-economic status quartile had mothers with the highest educational levels, generally came from dual parent homes, were highly physically active, watched less television, weighed more and had greater lean tissue than children in lower quartiles. A greater percentage of children living in dual parent homes and with mothers of a higher educational status were highly active compared with children living in single parent homes and with mothers of a lower educational status. We found greater levels of lean mass with increased activity level after controlling for television watching time and fat mass. There were high levels of low activity and high television watching time among lower socio-economic status groups. There were significant racial differences in patterns of activity. White children were found to be more active than black children, more likely to participate in physical education classes at school and watched less television than black children. CONCLUSION: Physical activity levels and socio-economic variables are closely related in this population of South African children.
Child↗
Knowledge of breast cancer and its risk and protective factors among women in Riyadh.
BACKGROUND: We conducted this study to assess knowledge of breast cancer and sources of information about breast cancer among women in Riyadh. We also analyzed whether associations existed between demographic variables, knowledge of breast cancer, and the practice of breast self-examination and use of mammography screening. METHODS: Women interested in participating in this community-based descriptive study provided data by completing a pre-tested structured RESULTS: Of 864 participating women, 84% were Saudi, 45% were married and 67.8% had a university level education. Eighty percent were between the ages of 20 to 50 years. Knowledge of breast self examination (BSE) was high; 82% (95% confidence intervals [CI], 79.2%-84.4%) knew about BSE, while 61% (95% CI: 57.9%-64.5%) knew about mammography, but only 41.2% (95% CI, 37.9%-44.5%) had performed BSE and 18.2% (95%CI, 15.5%-20.8%) had had mammography screening. Knowledge of breast cancer, risk factors and protective factors for breast cancer was moderate. There was a statistically significant association between the demographic characteristics (marital status, educational status and family history of breast cancer) and knowledge and practice of BSE and CONCLUSION: Though it has limitations, this study revealed an imbalance between the knowledge and practice of BSE among women. It also showed that there is only moderate knowledge of risk and protective factors for breast cancer and that knowledge and practice of BSE and mammograms vary according to marital and educational status. Hence, frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to prevent breast cancer.
Adult↗