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PubMed1984

Status of nutrition education in Canadian dental and medical schools.

To investigate the present status of nutrition education for dentists and physicians in Canada, we conducted a survey of the nutrition education programs in 10 Canadian dental and 16 medical schools in the academic year 1982-83. Seven of the dental schools and seven of the medical schools had a separate course in nutrition. The average duration of these courses was 22 hours for the dental schools and 26 hours for the medical schools. Nutrition education was integrated with another discipline in 4 of the dental schools and 11 of the medical schools. The average duration of this type of instruction was 14 hours for the dental schools and 18 hours for the medical schools. Six of the dental schools and eight of the medical schools employed a nutritionist/dietitian to provide instruction in nutrition. We recommend that courses in basic and applied clinical nutrition be incorporated throughout the curricula of Canadian dental and medical schools, and that personnel trained in clinical nutrition be employed to provide instruction in this area.

Canada↗

PubMed1994

Differences between men and women undergoing major orthopedic surgery for degenerative arthritis.

OBJECTIVE: To determine whether women have worse functional status than men at the time of laminectomy for degenerative spinal stenosis or total joint arthroplasty for degenerative arthritis of the hip and knee. METHODS: Consecutive patients undergoing laminectomy for degenerative lumbar spinal stenosis or unilateral, primary hip or knee arthroplasty for advanced degenerative arthritis were recruited. Functional status was measured with self-administered questionnaires. We compared preoperative functional status scores of men and women, using linear regression models that adjusted for age, comorbid conditions, work status, education, living arrangement, and body mass index. We also compared the rates of in-hospital complications and 6-month followup functional status scores for men and women. RESULTS: Women had much worse functional status than men prior to laminectomy for spinal stenosis (P < 0.01) and prior to total hip arthroplasty (P < 0.001) and total knee arthroplasty (P < 0.0001). These differences persisted after statistical adjustment for demographic and clinical characteristics. Women had comparable or greater functional improvement following surgery and experienced a similar number of complications compared with men. CONCLUSIONS: The observed gender differences in functional status prior to major orthopedic surgery indicate that women are operated on at a more advanced stage in the course of their disease. These results are not due to gender differences in demographic or clinical characteristics of the patients, and cannot be justified by differences between men and women in the outcome of surgery. The role of patient preferences and differential access to these procedures should be explored in future studies.

Aged↗

PubMed2004

Symptoms of depression and anxiety in post-myocardial infarction patients.

OBJECTIVE: To assess the frequency of symptoms of depression and/or anxiety following acute myocardial infarction (AMI) and to analyse their association with demographic variables. DESIGN: A cross-sectional analytical, non-interventional hospital based study. PLACE AND DURATION OF STUDY: The study was carried out at Punjab Institute of Cardiology (PIC), Lahore, from January 2000 to January 2001. PATIENTS AND METHODS: A total number of 100 inpatients suffering from AMI were studied. After a careful selection of the subjects the Urdu version of Hospital Anxiety and Depression Scale (HADS) was administered to each patient during the period of 5-7 days following AMI to assess symptoms of depression and anxiety. A semi-structured clinical interview was also conducted which included demographic information, psychiatric history and other variables. Results were analyzed by using Statistical Package for Social Sciences (SPSS version 8.0). RESULTS: Out of 100 subjects, 80 (80%) were males and 20 (20%) were females. Their ages ranged from 30-60 years (mean age, 50.92+/-8.53). Overall, symptoms of anxiety and/or depression were found in 50 (50%) patients. More specifically, symptoms of depression were found in 14%, anxiety symptoms in 18% and mixed symptoms (anxiety and depression) in 18% of the patients. Results revealed that patients above 45 years of age (i.e. 46-60 years) were more likely to experience symptoms of depression and/ or anxiety following AMI. A significant association was also found between female sex (p <0.02), lower socioeconomic status (p <0.05) and symptoms of depression and/ or anxiety in these patients. However, no significant association was found in relation to educational status, marital status and origin (urban/rural). CONCLUSION: The high proportion of patients with AMI found to be suffering from symptoms of depression and/ or anxiety one week after AMI highlights the essential need to assess these symptoms in all such patients during the post-MI period as they merit appropriate treatment along with the other complications of AMI.

Adult↗

PubMed2004

Health and psychosocial status of patients with turner syndrome after transition to adulthood: the Belgian experience.

BACKGROUND: Most girls with Turner syndrome (TS) are intensively followed by paediatricians, but are lost to follow-up when they reach adulthood. To gain insight into the adult medical and psychosocial situation, we performed a survey in young adult TS patients. PATIENTS AND METHODS: A questionnaire concerning current health status, education, occupation and living situation was sent to 160 young adult TS women, all treated during childhood with GH and oestrogen if needed. RESULTS: We received 102 completed questionnaires. Mean +/- SD age at reception of the questionnaire was 23.4 +/- 3.3 years, height 153.3 +/- 5.2 cm, body mass index 23.7 +/- 4.9 kg/m(2). Age and auxological parameters were comparable between responders and non-responders. Thirteen (12.7%) responders were not under regular medical care; 15 (14.7%) were seen by a general practitioner, while 28 (27.4%) needed several specialists. Forty-one (40.2%) patients reported health problems. The most frequently reported problem was hypertension (10.7%), followed by hypothyroidism (5.8%) and back problems (4.9%). Twenty-four (23.5%) of the 41 patients were taking medication for the indicated health problems. Twenty-six (25.5%) women had undergone spontaneous puberty; 16 of them reported spontaneous menstruations while 10 received oestrogen replacement therapy. Of the 76 women with induced puberty, 11 (14.5%) were not taking any oestrogen anymore. Compared with the general population, more TS women attended university and more obtained higher education. Forty-six women (45.1%) were working full-time, 7 (6.9%) were unemployed, and 4 (3.9%) received an allocation. Seventy (68.6%) patients were still living with their parents, while 18 (17.6%) were living together or married, and 14 (13.7%) were living alone. CONCLUSIONS: The transition of adolescents with TS to adult medical care is not optimal in Belgium. Although 40.2% of these young women reported health problems, 12.7% did not consult any physician. Many TS women did not take oestrogen replacement therapy. A specialized multidisciplinary approach for adults with TS is needed in order to optimize health and psychosocial status in these women.

Adolescent↗

PubMedDate not supplied

Nutrition education in schools of nursing in the United States. Part 2: The status of nutrition education in schools of nursing.

To explore whether nurses in academic institutions are being adequately educated to care for patients' nutritional needs, we conducted a survey of National League for Nursing accredited baccalaureate programs in the United States and their associated graduate programs. Data indicate that nutrition content is an integral part of baccalaureate nursing programs. Less emphasis is reported on nutrition content at the graduate level. Recommendations include revision of the substantive nutritive content and increased clinical experience in nutrition in both undergraduate and graduate nursing education.

Curriculum↗

PubMed1999

Trajectories of fetal loss in the Czech Republic.

Using data for 555,038 pregnancies conceived in the Czech Republic in 1987-1990, we show that pronounced differences in fetal survival in the middle trimester of pregnancy by marital status, educational level, and labor force attachment become much smaller at full term; survival differences by age at conception and number of previous deliveries show relatively constant proportional hazards throughout gestation. Social inequalities in postpartum life chances have been documented previously, but we show that similar inequalities exist before birth.

Abortion, Induced↗

PubMed2006

Perception of health state and the use of vignettes to calibrate for socioeconomic status: results of the World Health Survey in Brazil, 2003.

As part of the World Health Organization (WHO) project focused on assessing the performance of national health systems, the World Health Survey (WHS) was carried out in many member countries. In order to enable comparison of self-rated health between different cultures of the same country or between different nations, the WHS questionnaire included vignettes of sample cases, that is, hypothetical stories that describe the health problems of third parties. The objective of the present study is to evaluate the possibility of using vignette ratings to implement a socioeconomic calibration scale for self-rated health in Brazil. Using Brazilian WHS data, perceptions of state of health, measured through two different strategies (self-rating and vignette-rating), were compared. The effects of socioeconomic status (educational level and number of household assets) on health domain ratings were estimated via multiple regression models, controlled for age and sex. The effects of socioeconomic status were significant for the majority of health domains in the case of self-perception, but statistically null in the case of third party ratings. It is concluded that the WHO vignettes are not appropriate for calibrating self-rated health measures in Brazil.

Adult↗

PubMedDate not supplied

[Dental health practices of 506 Greek adults attending a dental clinic].

A recording of dental education and oral hygiene practices of 506 adults attending the clinics of Preventive Dentistry and Periodontics of the University of Thessaloniki, by answering a questionnaire, has been attempted. The answers were treated statistically using the chi 2 test according to sex, age and educational status. It appears that 49% of men and 27% of women do not brush their teeth daily (7% of men never do), while age, sex and education are significant parameters of most dental practices examined. Only 24% have been shown brushing technique by a dentist, whilst toothbrush selection is mainly based on advertisement or non-professional advice. Although about 84% of the dentifrices sold in Thessaloniki contain fluoride, only 20% of this sample were aware of its usefulness. The results call for urging the public to higher dental education and motivation to practicing oral hygiene procedures.

Adult↗

PubMed2004

Base rates for panic and depression according to the Brief Patient Health Questionnaire: a population-based study.

BACKGROUND: Recently published studies analyzing sensitivity and specificity scores have demonstrated that the brief version of the Patient Health Questionnaire (PHQ [J. Am. Med. Assoc. 282 (1999) 1734]) is a useful tool for the detection of panic disorder and depression. METHODS: We aimed to get normative data for the brief PHQ in a representative population-based sample. Sociodemographic data and PHQ data from 2066 subjects were included. RESULTS: Base rates for PHQ criteria of major depression were 3.8% with the typical 1:2 ratio between males and females (frequency of minor depressive forms: 9.2%). Normative data for the depression total scores were reported. Marital status, education and family income were significantly associated with depression, even after controlling for age and sex. For panic disorder, base rates were 1.8%; age, gender, and marital status were significant predictors. Frequency for panic attacks as a less restrictively defined version were 4.5%. CONCLUSIONS: The normative data provide a framework for the interpretation of depression and panic scores of the PHQ.

Adolescent↗

PubMed2002

Seroepidemiology of Helicobacter pylori infection in children living in eastern Turkey.

BACKGROUND: The prevalence of Helicobacter pylori is higher in developing countries, with most infections occurring in childhood. Because the prevalence in eastern Turkey has not been previously reported, we carried out an investigation to detect the prevalence of H. pylori infection in a large city center in this region. METHODS: Serum samples of 466 randomly selected healthy schoolchildren aged 6-17 years were tested for the presence of anti-H. pylori IgG antibodies. RESULTS: Overall 300 (64.4%) samples were seropositive. The frequency of H. pylori infection was similar in males and females (P = 0.47), was correlated with age (P < 0.0001) and was inversely correlated with economic status (P < 0.0001). Those who had a larger sibship size had a higher seroprevalence (P < 0.0001). There was no significant difference between children whose parents of different educational status (P = 0.56 for fathers and P = 0.86 for mothers). CONCLUSIONS: This very high prevalence of H. pylori in eastern Turkey seems to depend on environmental factors.

Adolescent↗

PubMed1990

Group process effect on caregiver burden.

This ex-post facto study examined the burden experience of people caring for a stroke survivor. It was hypothesized there would be less caregiver burden in those caregivers who participated in a stroke club (experimental) than those who did not (control). The CADET was used to evaluate functional status of the stroke survivor. The Physical Caregiving Responsibility Inventory measured the degree of difficulty performing caregiving experiences, and the Geriatric Depression Scale determined caregiver depression. Advanced educational status, high income and moderate physical disabilities are related to reduced feelings of burden in the thirty-eight caregiver-survivor dyads studied.

Adult↗

PubMed1997

A study of the attitudes of a rural Indian community toward people with physical disabilities.

OBJECTIVE: To examine the attitudes of a rural community in southern India toward its disabled members. DESIGN: Prospective cross-sectional study. METHOD: One hundred and twenty randomly selected villagers around the town of Vellore in southern India were invited to take part in the study. The attitudes towards individuals with physical disabilities were examined using a modified version of the Scale of Attitudes Toward Disabled Persons (SADP). The questionnaire was administered in its original English format with simultaneous translation into Tamil. RESULTS: Data were complete in 111 cases, 82% of whom showed a positive attitude toward people with disability. Gender and employment status did not appear to have an influence on whether the respondent regarded disabled people in a positive or negative way but most older individuals expressed prejudice and/or challenged the rights of disabled people to equal opportunities in education, employment and social integration. Further data analysis demonstrated that more subjects with than without a disabled family member supported the rights of disabled individuals to education, employment and social integration. By contrast, the items of SADP which described the personal attributes of disabled people did not discriminate between the two groups. CONCLUSION: The attitudes of the rural community studied toward people with disabilities were unrelated to the sex or educational status of the respondents but was influenced by their age. This suggests that older subjects in rural communities in developing countries should be the main target for educational programmes which promote positive images of disability.

Adolescent↗

PubMed1992

Risk factors for breast cancer by age and menopausal status: a case-control study in Singapore.

A case-control study was conducted among Singapore Chinese women, comprised of 200 histologically confirmed cases of breast cancer and 420 hospital controls. Subjects were interviewed on family history of breast cancer, social and demographic characteristics, reproductive history, and diet one year prior to interview. Differences in risk factors were observed according to menopausal status. In the premenopausal group, the most consistently significant nondietary effect was an increased risk with late age at first birth. In postmenopausal women, the most consistent nondietary effects were increased risks with nulliparity, tall stature, high educational status, and a family history of breast cancer. In premenopausal women, the strongest dietary effects were low risks with high intakes of polyunsaturated fatty acids (PUFA), beta-carotene, soya protein as a proportion of all protein, and a high risk with high red-meat intake. No dietary effects were observed in postmenopausal women. Examination of effects by 10-year age groups suggested that the differences in the effects of age at first birth, nulliparity, height, education, beta-carotene intake, and PUFA intake between premenopausal and postmenopausal women were at least partly attributable to age-related differences in the baseline distributions of these variables. The variation in the effects of red meat and soya protein appeared to be attributable mainly to menopausal status itself, which is consistent with the hypothesis that these factors operate on risk by way of hormonal mechanisms.

Adult↗

PubMed1986

Factors affecting attrition in the Baltimore Longitudinal Study of Aging.

In a longitudinal study of aging, the influence on attrition of age, marital status, education, occupation, distance between a subject's residence and study center, self-health and financial assessment, and method of recruitment was examined. Prospective, follow-up information on the subsequent active/dropout and alive/dead status on the 1088 subjects, who joined the Baltimore Longitudinal Study of Aging during the first twenty years (1958-1977), were studied using a proportional hazards model. Three analyses, each controlling for death in a different manner, produced similar results. The analysis indicates that age, education and distance have the strongest association with attrition (p less than 0.001), while self-health assessment has a lesser association (p less than 0.05). The lowest risk in age, for example, occurs in 40-49.9 year olds with subjects less than 30 having an increased risk of 91% and subjects 70 or older having an increased risk of 189%. Examination of attrition probabilities show that subjects living 500 or more miles from study center, ages 70 and older, with less than bachelors degree, and perceiving their health as average or below have the greatest probability of dropping out-approximately 3-fold greater than the average subject's probability.

Adolescent↗

PubMed1996

Direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in normal geriatric persons: a structural equation model.

The direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in elderly individuals were examined using a LISREL structural equation model. One-hundred fifty-six geriatric subjects were individually administered a comprehensive neuropsychological battery, an extensive medical history and demographics questionnaire, and the Neuropsychology Behavior and Affect Profile (a psychological assessment instrument). The model assessed the effects of five independent latent variables (medical history, psychological functioning, global mental status, education, and gender-related functioning) on two dependent latent variables (nonverbal and verbal neuropsychological functioning). The best fitting model revealed that three latent variables (medical history, global mental status, and gender-related functioning) had direct effects on neuropsychological functioning and that all five independent variables exhibited indirect effects. These findings suggest that the influence of demographic variables on neuropsychological functioning for geriatric persons is complex and that certain variables should not be interpreted independently of each other due to their significant moderating influences.

Aged↗

PubMed2000

A study of prevalence of protein energy malnutrition among 0-5 years in rural Benue State, Nigeria.

Three hundred and seventy pre-school children (181 males and 189 females) were studied in order to document the prevalence of protein energy malnutrition and factors that militate it. The prevalence of protein energy malnutrition among the children was revealed to be 41.6% (154). One hundred and fiftyone (40.8%) of them were found to have weight-for-height below -2SD indicating level of stunting among the children. Most malnourished children belonged to mothers who were illiterate 97 (54.8%) when viewed from the mothers' educational perspective. This study also showed the following factors that were statistically significant with PEM: educational status of mothers (p<0.05), marital status (p<0.05) of mothers, occupational status of mothers (p=0.000), parental income per annum (p=0.000), length of breastfeeding (p=0.000), water supply and regularity, type of housing and toilet facilities. Intensification of health education aimed at encouraging beneficial childhood feeding practices in the community is needed together with further study on the subject, which will be directed at actual analysis of the nutritive values of available local foodstuffs as a prerequisite for an effective intervention programme.

Anemia, Iron-Deficiency↗

PubMed1992

Social, educational and vocational status of 48 young adult females with gonadal dysgenesis.

OBJECTIVE: The purpose of this study was to evaluate the educational, vocational and social function of young adults with gonadal dysgenesis. DESIGN: Forty-eight female patients with gonadal dysgenesis (17, 45XO; 26, 45XO/46XX or other mosaics; and five pure gonadal dysgenesis) followed by our multidisciplinary team from childhood, were re-evaluated in adult age. RESULTS: Mean age +/- SD at diagnosis was 11.4 +/- 5.0 years and mean age at the time of survey was 29.6 +/- 6.3 years. The mean final height for the patients was 145.5 +/- 8.3 cm (range 134-170 cm). Mean verbal IQ (WISC-R) for the 39 subjects tested was 101.4 +/- 20.7 and mean performance IQ was 86.8 +/- 17.7. No difference in verbal IQ levels was found between the various karyotype groups. Twenty-five had an academic education. All were employed except for one housewife; 37 work in white collar professions. A significant correlation was found between verbal IQ and education (P = 0.005) and between verbal IQ and profession (P = 0.005). Twenty-three served in the army. Fourteen are married: three have an adopted child and two a child born after in vitro fertilization (IVF); others are waiting for IVF or adoption. Five patients had some form of psychiatric problem that required psychiatric or psychological treatment in the past (two had transitory anorexia nervosa and three behavioural problems). Sixty-three per cent reported having wide and satisfactory social relations but limited to female friends. CONCLUSION: Positive adjustment in the professional area and fair adjustment in the social area were not related to physical stigmata or to any other independent variable tested, but rather to intellectual ability and a high degree of achievement motivation.

Adult↗

PubMed2002

["Multimedia symposium wares". An enrichment of medical and graduate education?].

The continual development of the internet has supported the spread of surgical knowledge by electronic means. High quality products have to be offered from a software as well as a contents point of view. The question as to whether these new media and their contents have a real value for efficient and motivating use in medical education needed to be answered by first assessing a quality profile for the development of surgical educational modules which were then evaluated on the basis of so-called "symposia ware". First, the reactions and opinions of physicians at 47 universities were assessed by a standardized questionnaire concerning their demands on multimedia teaching/learning modules. Several different aspects of technique, content, presentation, didactics and background knowledge were analyzed. In a second step, their opinions were evaluated concerning two applications (symposia implemented on CD-ROM as a slideshow with original slides and audio) with surgical and gastroenterological contents by standardized questionnaire. Questions concerning personal background such as educational status and experience with computers, e-mail and the internet on one hand and the CD-ROM itself concerning content, relevance for daily clinical work and continuing medical education as well as the quality of the application on the other hand, were evaluated using marks (1 = best, 6 = worst). A total of 320 physicians participated in the first part of the interview. Of these, 93% were equipped with computers in hospital as well as privately. The Internet was used by 90% of them. The majority declined a full text presentation as well as the application of scroll fields. The participants rather favored the integration of text, pictures, animations and videos. Furthermore, 95% demanded the provision on the internet. Thirty-seven colleagues in their 5th (1-11) year of training were interviewed, and of those, 27 were working in a surgical department and 10 in a medical department. Individual computer knowledge was rated with a median of 3. This revealed that 60% were equipped with computers in hospital as well as at home, the remaining 40% had computers either in hospital or at home. All participants used the internet. In total, 57% had experience with "Symposia ware". The rating of the "Symposia ware" itself was positive. Relevance and applicability of a slideshow for imparting knowledge were rated with a median of 2. This showed that 81% would buy the CD-ROM in principle, and 89% would spent up to 50 EUR. Quality, language, content and user-friendliness were all rated 2. Physicians frequently use computers and the internet. All this indicates a high degree of acceptance of electronic teaching/learning modules in medical education. A uniform structure of contents as well as a platform-independent, web-based presentation is appreciated. To enhance illustration, a picture and video-oriented visualization should be chosen. Overall, "symposia ware" is rated positively. It should cost no more than 50 EUR and it represents a valuable source of information for physicians.

CD-ROM↗