University students’ awareness of causes and risk factors of miscarriage: a cross-sectional study

Background

Spontaneous miscarriage is the most common complication of pregnancy, occurring in up to 20% of pregnancies. Despite the prevalence of miscarriage, little is known regarding peoples’ awareness and understanding of causes of pregnancy loss. The aim of this study was to explore university students’ understanding of rates, causes and risk factors of miscarriage.

Methods

A cross-sectional study including university students. An online questionnaire was circulated to all students at the University College Cork using their university email accounts in April and May 2016. Main outcomes included identification of prevalence, weeks of gestation at which miscarriage occurs and causative risk factors for miscarriage.

Results

A sample of 746 students were included in the analysis. Only 20% (n?=?149) of students correctly identified the prevalence of miscarriage, and almost 30% (n?=?207) incorrectly believed that miscarriage occurs in less than 10% of pregnancies. Female were more likely to correctly identify the rate of miscarriage than men (21.8% versus 14.5%). However, men tended to underestimate the rate and females overestimate it. Students who did not know someone who had a miscarriage underestimated the rate of miscarriage, and those who were aware of some celebrities who had a miscarriage overestimated the rate. Almost 43% (n?=?316) of students correctly identified fetal chromosomal abnormalities as the main cause of miscarriage. Females, older students, those from Medical and Health disciplines and those who were aware of a celebrity who had a miscarriage were more likely to identify chromosomal abnormalities as a main cause. However, more than 90% of the students believed that having a fall, consuming drugs or the medical condition of the mother was a causative risk factor for miscarriage. Finally, stress was identified as a risk factor more frequently than advanced maternal age or smoking.

Conclusion

Although almost half of the participants identified chromosomal abnormalities as the main cause of miscarriage, there is still a lack of understanding about the prevalence and most important risk factors among university students. University represents an ideal opportunity for health promotion strategies to increase awareness of potential adverse outcomes in pregnancy.

     

Atrial fibrillation in the Malmö diet and cancer study: a study of occurrence,risk factors and diagnostic validity

The validity of atrial fibrillation (AF) diagnoses in national registers for use as endpoints in prospective studies has not been evaluated. We studied the validity of AF diagnoses in Swedish national hospital discharge and cause of death registers and the occurrence of and risk factors for AF in a middle-aged Swedish population using these registers. Our study included the 30,447 individuals (age 44–73) who attended baseline visits in 1991–1996 of the Malmö Diet and Cancer study. Individuals with a first AF diagnosis were identified by record linkage with national registers. A subset of cases was randomly selected for validation by examination of electrocardiograms and patient records. Electrocardiograms were available in 98% of the validation sample (95% definitive AF, 3% no AF). The 2% with ECGs unavailable had probable AF. Baseline AF prevalence was 1.3%, higher in men and increased with age. During 11.2 years of follow-up 1430 first AF diagnoses occurred. Risk factors were age, hypertension, BMI, diabetes, history of heart failure, history of myocardial infarction and, in men but not women, current smoking. The strongest risk factors were history of heart failure (hazard ratio men 4.5, women 8.7) and myocardial infarction (hazard ratio men 2.0, women 1.8). The largest population attributable risks were observed for hypertension (men 38%, women 34%) and obesity (men 11%, women 10%). In conclusion, case misclassification of AF in national registers is small, indicating feasibility of use in prospective studies. Hypertension and obesity account for large portions of population risk in middle-aged individuals with low prevalence of manifest cardiac disease.     

A prospective study of adiposity and all-cause mortality: the Malmö Diet and Cancer Study

OBJECTIVE: This study aims to examine the association between various measures of adiposity and all-cause mortality in Swedish middle-aged and older men and women and, additionally, to describe the influences of age and sex on these associations. RESEARCH METHODS AND PROCEDURES: A prospective analysis was performed in a cohort of 10,902 men and 16,814 women ages 45 to 73 years who participated in the Malm? Diet and Cancer Study in Sweden. Baseline examinations took place between 1991 and 1996, and 982 deaths were documented during an average follow-up of 5.7 years. All-cause mortality was related to the following variables measured at baseline: body mass index (BMI), percentage of body fat, lean body mass (LBM), and waist-to-hip ratio (WHR), with adjustment for age and selected covariates. Body composition data were derived from bioelectrical impedance analysis. RESULTS: The association between percentage of body fat and mortality was modified by age, particularly in women. For instance, fatness was associated with excess mortality in the younger women but with reduced mortality in the older women. Weaker associations were seen for BMI than for percentage of body fat in both sexes. Placement in the top quintiles of waist-to-hip ratio, independent of overall body fat, was a stronger predictor of mortality in women than in men. The observed associations could not be explained by bias from early death or antecedent disease. DISCUSSION: The findings reveal sex and age differences for the effects of adiposity and WHR on mortality and indicate the importance of considering direct measures of adiposity, as opposed to BMI, when describing obesity-related mortality risks.     

Stroke survivors’ and relatives’ negotiation of relational and activity changes: A qualitative study

Objective: This study explores stroke survivors’ and relatives’ negotiation of relational and activity change in their interrelated long-term meaning-making processes of everyday life and what it means for the experience of progress and well-being. Material and methods: Repeated retrospective in-depth interviews were conducted with both the stroke survivor and relatives. A Critical Psychological Perspective gives the frame of reference to study more closely what is going on in and across particular contexts in family members’ ongoing social practices. Results: An asymmetric problematic relationship can develop among the participants in the context of family life. However, the analysis identifies six beneficial relational and activity changes, which contribute to a reciprocal, balanced repositioning, and help the family move in a more positive direction. The repositioning processes facilitate a new transformation of family we-ness, which is important for the participants’ experience of process and well-being. The comprehensive family work that has to be done is about managing the imbalance of everyday life, upholding separate activities outside the family sphere and dealing with the fact that peripheral others become more peripheral. Conclusion: The study addresses some arguments for taking a family-centred perspective in occupational therapy practice, as well as in a stroke rehabilitation service in general.     

Guys and dolls: a qualitative study of teachers’ views of gendered play in kindergarten

Drawing on data collected for a larger study investigating kindergarten teachers’ online discussions of play, the present qualitative study examines teachers’ discussions of gender. Findings suggest that teachers’ project onto their kindergarten students many of their own gender prejudices about play. These teachers reinforced gendered attitudes by encouraging the children, especially the boys, to play only with toys and in activities traditionally associated with their gender. Email interviews were then conducted with seven kindergarten teachers to further explore the main theme from the netnographic research. Findings support the contention that further research is needed to examine gendered play in kindergartens, and that kindergarten teachers could benefit from becoming aware of their unintentional teachings and in learning how better to encourage gender equity in play-based class activities.     

Cigarette smoking and risk of cancers of the colon and rectum: A case–control study from Italy

The relationship between smoking habit and risk of colon and rectal cancers was considered in a case–control study conducted between 1991 and 1996 in six Italian centers. Cases were 1225 patients below age 75 with histologically confirmed cancer of the colon and 728 with cancer of the rectum.Controls were 4154 patients admitted to hospital for a wide spectrum of acute, non-neoplastic diseases. Compared to neversmokers, the odds ratios (OR) for current smokers of 25 or more cigarettes/day was 0.90 for patients with colon and 0.86 for those with rectal cancer and those for ex-smokers were 1.02 and 1.09 for colon and rectal cancer, respectively. No increase in risk was found with duration of the habit, the OR for 40 or more years being 0.79 for colon and 0.87 for rectal cancer. Furthermore, no relationship was apparent with time since starting (the OR for 40 or more years were 0.94 for colon and 1.01 for rectal cancer), or age at starting (the OR for < 18 years were 1.02 for colon and 1.00 for rectal cancer), or for pack-years smoked (the OR for 40 or more pack-years were 0.93 for colon and 0.91 for rectal cancer) or time since stopping among ex-smokers. No increase in risk was found in smokers of 15 cigarettes/day for 40 years or longer (OR: 0.93). No significant heterogeneity was found across strata of age at diagnosis, sex, education, physical activity at work, intake of alcohol, coffee, vegetables, total energy, and number of meals/day. Likewise, no significant association was apparent for various intestinal subsites. Thus, this study did not find cigarette smokers at higher risk for cancer of the bowel even after a long duration and a long period since starting.     

Surgical trauma and postoperative nutrition:A longitudinal study of muscle protein metabolism

A catabolic state develops following surgical trau-ma.including weight loss and muscle wasting,whichleads to an increased loss of nitrogen in the urineThere is a decrease in muscle protein synthesis and anincreased translocation of amino acids from muscle tothe splanchnic area.This results in an impoverish-ment of muscle free amino acids.mainly GLN,andeventually impairment of muscle function which can-not be counteracted by conventional TPN.However,TPN supplemented with GLN improves nitrogen bal-     

Quantitative and qualitative approaches in the study of poverty and adolescent development: separation or integration?

This paper examines the use of quantitative and qualitative approaches to study the impact of economic disadvantage on family processes and adolescent development. Quantitative research has the merits of objectivity, good predictive and explanatory power, parsimony, precision and sophistication of analysis. Qualitative research, in contrast, provides a detailed, holistic, in-depth understanding of social reality and allows illumination of new insights. With the pragmatic considerations of methodological appropriateness, design flexibility, and situational responsiveness in responding to the research inquiry, a mixed methods approach could be a possibility of integrating quantitative and qualitative approaches and offers an alternative strategy to study the impact of economic disadvantage on family processes and adolescent development.     

Validity of self-reported weight and height: the Goiânia study, Brazil

OBJECTIVE: To assess the validity of self-reported weight and height at the time of diagnosing obesity, and to identify the sociodemographic and individual characteristics that might be a source of information bias. METHODS: This was a cross-sectional population-based study carried out in the city of Goiania in 2001. Interviews were conducted with 1,023 individuals aged 20-64 years, in their homes, to collect sociodemographic and self-reported weight and height information. On the same occasion, weight and height measurements were made on these individuals. The mean differences and correlation coefficients between self-reported and measured data were calculated according to age, body mass index (BMI), schooling, income and height. RESULTS: Both the men and women overestimated their heights (p<0.05), by 0.9 cm and 2.2 cm, respectively. There was no difference between self-reported and measured weights, either for the men (-0.44 kg; p=0.06) or for the women (-0.03 kg; p>0.05). The behavior of overestimating height was influenced by age, schooling, height and body mass index. Although this index obtained from the self-reported data was underestimated (p<0.05), by 0.27 kg/m(2) and 0.67 kg/m(2) for men and women respectively, the measured and self-reported data presented a high degree of agreement. Both the sensitivity and specificity of the self-reported body mass index were high, in relation to identifying the measured index. CONCLUSIONS: In epidemiological studies for monitoring the prevalence of excess weight in populations, self-reported weights and heights constitute reliable data, which gives validity to the methodology utilized.     

Coffee consumption and decreased serum γ-glutamyltransferase: a study of middle-aged Japanese men

The potential inverse association between coffee intake and serum -glutamyltransferase (GGT) was examined in a cross-sectional study involving 1353 Japanese male office workers aged 35–59 years in Osaka, Japan. Those who had serum aminotransferases exceeding the normal range and/or who had been administered medical care for, or had a past history of, liver disease were excluded. Multiple linear regression analysis and analysis of covariance were used to control for confounding variables (age, body mass index, alcohol use, and cigarette smoking) and to examine possible interactions. From the linear regression analysis, coffee intake was inversely related to serum GGT levels independently of age, body mass index, alcohol intake, and cigarette smoking. All of the latter variables were also independently and positively associated with serum GGT levels. When the interactions between coffee and each of four covariates on serum GGT were evaluated by adding each interaction term to the above regression model, significant negative interactions were observed for age and cigarette smoking. From the analysis of covariance, lower levels of serum GGT associated with coffee consumption were more evident in the older age group and at the higher levels of cigarette smoking. These findings suggest that coffee consumption is inversely related to serum GGT and that coffee may inhibit the inducing effects of aging and possibly of smoking on serum GGT in the liver.     

Physical exercise and food habits: a study of adolescents in Cádiz

BACKGROUND: A increased number of eating disorders among teen-agers are currently being reported. Physical exercise, especially when done individually, is one of the methods chosen for losing weight. We are basing this study on the hypothesis of a larger number of eating habit disorders (EHD's) in subjects who do physical exercise alone. This study describes and compares eating habits among teen-agers that do individual exercise as opposed to athletes who work out in groups or on teams. METHOD: Cross-section study of 532 teen-agers ages 14-18 who are enrolled in school and who do physical exercise, having been selected at random by means of a two-stage, stratified sampling process. The subjects were divided into two groups according whether they did individual physical exercise alone (Number: 216) or in groups (Number: 316). The eating habits of both groups were analyzed based on a questionnaire filled out by the subjects themselves. RESULTS: In the group preferring individual sports, females were predominant (degree of males 0.44). Of these females, their being on diets in order to lose weight was 3.12 times more frequent, compulsive eating episodes being 3.73 times more frequent. As regards behaviors which might be considered to be compensatory, there is a clear concentration thereof among those who do sports individually, hence 43% stated to voluntarily undergo periods of fasting (4.96 times more than those who exercise in groups), 46% stating to have brought on vomiting at one time or another for "dieting" purposes (3.76 more) and up to 26% have used laxatives with the intention of losing weight (2.56 times more than among athletes who play on teams). CONCLUSION: The existence of EHD's seems to be associated with teen-agers who play individual sports as opposed to those who play on teams.     

Validity of self-reported diabetes and its determinants: evidences from the Bambuí study

OBJECTIVE: To assess the validity of self-reported diabetes and its determinants in the elderly. METHODS: Cross-sectional study including 1,492 subjects aged >or= 60 years, which corresponds to 86% of all residents in this age group living in the municipality of Bambuí, Southeastern Brazil, in 1997. The validity of self-reported diabetes was assessed comparing to diabetes mellitus defined by medical criteria (fasting glucose > 126 mg/dl or current treatment). Multivariate analysis was carried out to assess factors independently associated with sensitivity and specificity. RESULTS: The prevalence of diabetes mellitus and self-reported diabetes were 14.5% and 11.7%, respectively. Sensitivity and specificity of self-reported diabetes were 57.1% (95% CI: 50.3;63.8) and 96.9% (95% CI: 94.7;97.0), respectively. Medical visits in the previous two years (PR=3.78), as well as 1-3 (PR=1.90) and > 4 years (PR=1.55) of schooling were positively and independently associated with sensitivity. Medical visits in the previous two years (PR= 0.96) and female sex (PR = 0.97) were negatively and independently associated with specificity. CONCLUSIONS: The study results indicated that self-reported diabetes should not be either used to estimate the prevalence of diabetes mellitus or to identify individuals with the disease in the study population. Schooling and medical visits were determinants of the elderly awareness of being diabetics, indicating that these modifiable characteristics may play a role in secondary and tertiary prevention.     

Desktop study of occupational exposure judgments: do education and experience influence accuracy?

This study examines the impact of several experience and education determinants on exposure judgment accuracy. The study used desktop assessments performed on several different tasks with different exposure profiles to identify correlations between determinants and judgment accuracy using logistic regression models. The exposure judgments were elicited from industrial hygienists with varying levels of experience, education, and training. Videos and written and oral information about the exposure tasks were presented to all participants as they documented a series of qualitative and quantitative exposure judgment probabilities in four exposure categories. Participants (n = 77) first documented their qualitative and then their quantitative exposure assessments after receiving the series of sampling data points. Data interpretation tests and training in simple rules-of-thumb for data interpretation were also given to each participant to investigate the impact of data interpretation skills on exposure judgment accuracy. Logistic regression analysis indicated "years of exposure assessment experience" (p < 0.05), "highest EHS degree" (p < 0.05), and a participant's "data interpretation test score" (p < 0.05) directly impacted qualitative exposure judgment accuracy. Logistic regression models of quantitative judgment accuracy showed positive correlation with "greater than 10 years of exposure assessment experience" (p < 0.05), "highest EHS degree" (p < 0.05), a participant's "data interpretation test score" (p < 0.001), rules-of-thumb data interpretation training (p < 0.001), and the number of sample data points available for a judgment (p < 0.005). Analyzing judgments in subsets for participants with less or more than 10 years' experience indicated additional correlations with Certified Industrial Hygienist and Certified Safety Professional certifications, total number of task exposure assessments, and career number of air surveys. The correlation of qualitative and quantitative exposure judgment accuracy with "greater than 10 years experience" supports similar research findings from other fields. The results of this study indicate that several determinants of experience, education, and training, in addition to the availability of sampling data, significantly impact the accuracy of exposure assessments. The findings also suggest methods for enhancing exposure judgment accuracy through statistical tools, mathematical exposure modeling, and specific training.     

Evaluation of the quality of life of children with celiac disease and their parents: a case–control study

Purpose  

The purpose of the present study was to evaluate the quality of life (QoL) of children with CD and of their parents and to compare it with that of children without CD and of their parents.     

Are our investments paying off?: a study of reading level and bereavement materials

The purpose of this article is to discuss the findings of a study that examined bereavement materials for reading level. The main research question for the study was: are printed hospice bereavement materials written at an eighth grade level or below? Readability was determined for approximately 90 individual pieces of hospice bereavement literature. The literature came from materials that were collected in a larger study and included bereavement letters to families and other educational and resource materials available to the bereaved families, the caregivers, and the public. The method used to perform readability on the materials was the Simplified Measure of Gobbledygook. This process has been used to determine readability for more than 35 years and is widely accepted by the literacy community. Results of the study revealed that the materials analyzed were written at just above a 10th grade reading level.     

Adolescents,parents and teachers’ perceptions of risk and protective factors of substance use in Moroccan adolescents: a qualitative study

Background

Substance use in adolescents is a global public health concern that continues to draw attention from academics, policy experts, and government officials. In Morocco, few studies have investigated the influencing factors of substance use in adolescents. Here, we aimed to fill this gap and to better understand factors that protect or influence substance use in adolescents.

Methods

We conducted a qualitative study using focus group discussions. The semi-structured interview guides were based on the socio-ecological model as a theoretical framework to explore perceptions of students, parents, and teachers regarding substance use risks and protective factors in adolescents. Data from each group were audio-recorded, transcribed, and analyzed using thematic analysis.

Results

From May to July 2016, 17 focus group discussions were conducted at two middle schools in Taza city, Morocco, which included 8 groups of 7 adolescents (28 boys and 28 girls) aged 14 to 16 years, 5 groups of parents (5 females and 21 males), and 4 groups of teachers (13 males and 5 females). Thematic analysis resulted in six common themes that represented the most salient perceived risk and protective factors regarding substance use among adolescents: perceived benefits of substance use, awareness and beliefs, family influence, peer influence, easy accessibility of substances, and social norms.

Conclusions

Our results demonstrate that multilevel prevention programs in adolescents should address influencing factors from the individual to the societal level, including social norms and the government’s policy toward substance use. Health education programs included as part of the school curriculum can contribute to promoting awareness and reducing risky behaviors of Moroccan adolescents.