A pilot study of the relationship between diet and mental health in female university students enrolled in a training course for registered dietitians

Objective

The purpose of the present pilot study was to investigate the link between diet and mental health in female university students enrolled in a training course for registered dietitians.

Subjects and methods

A total of 62 female university students, with a mean age of 18.79 ± 0.45 years, participated in this cross-sectional study. Diet surveys were performed using the brief-type self-administered diet history questionnaire (BDHQ). Mental health was also evaluated using the general health questionnaire-12 (GHQ-12), which was the shortest form and clinically available. Lifestyles such as physical activity levels were also evaluated.

Results

The mean energy intake was 1379 ± 575 kcal and the mean GHQ score was 3.11 ± 2.41. Among nutrients, vegetable fat and sucrose showed a weak positive correlation with the GHQ scores. Among food groups, potatoes, fats and oils, and confectioneries also showed a weak positive correlation with the GHQ scores. A multiple regression analysis showed that the confectioneries were the determining factor for the GHQ scores.

Conclusion

Proper education concerning their diets and reducing confectioneries in their daily lives might be beneficial for the mental health of female university students.

     

Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a meta-analysis

BACKGROUND: Intracytoplasmic sperm injection (ICSI) is a method of assisted reproductive technology that involves the selection of a single sperm cell and the manual injection of this cell into the egg. The lack of relevant experimental studies, the nature of the technology involving non-natural selection of the fertilizing sperm, and possible damage to the egg have caused concern that ICSI could increase the risk of birth defects. Data from available cohort studies comparing ICSI with standard in vitro fertilization (IVF) should be combined to evaluate the risks involved with ICSI. METHODS: We reviewed more than 2500 titles and abstracts containing keywords related to ICSI and identified 22 scientific articles with data on birth defects among ICSI-births. A total of four peer-reviewed, non-overlapping prospective cohort studies provided reliable and comparable data on birth defects both for children conceived by ICSI and children conceived by standard IVF. These studies included a total of 5395 children born after ICSI. RESULTS: The pooled estimate of the risk of a major birth defect was a 1.12-fold increase after ICSI when compared with standard IVF (risk ratio = 1.12, 95% confidence interval (CI): 0.97-1.28, P = 0.12). There was no marked heterogeneity of risk ratios between these studies (P = 0.10). We found no significantly increased risks after ICSI for any of the categories cardiovascular defects, musculoskeletal defects, hypospadias, neural tube defects, or oral clefts. CONCLUSIONS: Our analysis does not indicate that the ICSI-procedure represents significant additional risks of major birth defects in addition to the risk involved in standard IVF. The data was limited, particularly on risks of specific categories of defects.     

Citizenship, community participation, and health as seen by health care professionals: a case study in public health services

This paper deals with the subject of citizenship and people's participation in the health area through an analysis of ideas pertaining to a specific group: health care professionals working in Basic Health Care Clinics in the 3.1 Programmatic Area of the City of Rio de Janeiro (Brazil). The article analyzes their views on the subject and presents them in light of health-related legislation in the Brazilian constitution. It also analyzes the professionals' role vis-à-vis users in raising community awareness that health care is one of their basic rights. Field data from qualitative social research methodology showed a significant heterogeneity in the professionals' conceptions, dividing them into two groups: those belonging to teaching institutions and those working in institutions providing health care. This analysis shows the strategic role that day-to-day relationships between professionals and the community can play in the social change process and the establishment of social rights. It also discusses the viability of this process in view of the discovery of the subjective involvement of the health professionals who promote this process.     

Perceptions of primary health care among users and health professionals: a comparison of units with and without family health care in Central-West Brazil

This study analyzes perceptions of performance by primary health care facilities with and without the Family Health Program in municipalities with more than 100,000 inhabitants. Questionnaires from the Primary Care Assessment Tool developed by John Hopkins University and adapted to Brazil, contemplating eight dimensions of primary health care, were applied to users and professionals from a sample of 36 family health care facilities and 28 traditional primary care facilities. Thirty health professionals with university education, 207 with secondary education, 490 adult users, and 133 family members answered the questionnaires. The overall result did not show significant differences between perceptions of family health care facilities as compared to traditional primary health care facilities, but perceptions of health professionals were consistently more favorable than those of users. Comparing the scores for each dimension, family health care facilities always scored better (with the exception of level of access), but the difference in scores between facilities with and without the Family Health Strategy was only statistically significant for all three categories of respondents in relation to the items "family focus" and "community orientation".     

A review of the nutritional challenges experienced by people living with severe mental illness: a role for dietitians in addressing physical health gaps

People experiencing a severe mental illness (SMI), such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic features, have a 20‐year mortality gap compared to the general population. This ‘scandal of premature mortality’ is primarily driven by preventable cardiometabolic disease, and recent research suggests that the mortality gap is widening. Multidisciplinary mental health teams often include psychiatrists, clinical psychologists, specialist mental health nurses, social workers and occupational therapists, offering a range of pharmacological and nonpharmacological treatments to enhance the recovery of clients who have experienced, or are experiencing a SMI. Until recently, lifestyle and life skills interventions targeting the poor physical health experienced by people living with SMI have not been offered in most routine clinical settings. Furthermore, there are calls to include dietary intervention as mainstream in psychiatry to enhance mental health recovery. With the integration of dietitians being a relatively new approach, it is important to review and assess the literature to inform practice. This review assesses the dietary challenges experienced by people with a SMI and discusses potential strategies for improving mental and physical health.     

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

Background

HIV voluntary counselling and testing was a key HIV prevention strategy brought to scale by India's National AIDS Control Organization. Condom uptake is an essential metric of intervention impact given the expansion of the epidemic into an increasingly diverse population. With only 20% of first-time counselling and testing clients at the largest HIV treatment hospital in south India reporting previous condom use, the question of intervention impact on condom use deserves investigation. In this study, we track intervention impact across various demographic groups and identify the added value of more thorough counselling.

Methods

Data were collected from 8,865 individuals who attended counselling multiple times at the Tamil Nadu Government Hospital of Thoracic Medicine over the years 2004-2009. Counsellors recorded client demographic characteristics, HIV risk behaviours reported, and counselling services provided after each counselling session. Matching and regression methods were used to determine the probability of condom uptake by serostatus, gender, and receipt of personalized risk reduction counselling while controlling for other characteristics.

Results

HIV counselling and testing was associated with condom uptake among 29.2% of HIV positive women (CI 24.5-34.4%), 31.7% of HIV positive men (CI 27.8-35.4%), 15.5% of HIV negative women (CI 11.2-20.8%), and only 3.6% of HIV negative men (CI 1.9-5.9%) who had previously never used condoms. Personalized risk reduction counselling increased impact in some groups; for example an additional 18% of HIV negative women (CI 11.3-24.4%) and 17% of HIV positive men (CI 10.9-23.4%) started using condoms. The number of sexual partners was not associated with the impact of counselling completeness.

Conclusions

Because the components of testing and counselling impact the condom use habits of men and women differently, understanding the dynamics of condom use negotiation between partners is essential to optimizing impact on Indian couples. Clients' predicted condom uptake ranged between 4% and 47% depending on factors like gender, serostatus, and services provided. Personalized risk reduction counselling is associated with increased chance of condom use, with larger gains in HIV negative women and HIV positive men. HIV negative men are least likely to start using condoms and least impacted by additional counselling.     

Putting the community back in community health assessment: a process and outcome approach with a review of some major issues for public health professionals

Community health assessment is a tool for allocating resources in a manner responsive to the community needs and conducive to maximizing community input in decision-making. A process-focused, team approach that draws upon social and behavioral sciences, as well as public health and medical disciplines, is presented--in the context of definitions of community and health and models of community health determinants--as a means of maximizing community involvement in local health issues. Such an approach requires that professionals function less as "experts" than as resources to community members, who are engaged in every step of the process.     

Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia

This paper compares the sensitivity to change of a multi-item, multi-dimensional health status measure with a single global health status question, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered postally at baseline and follow up. General practices in Berkshire, Buckinghamshire, Northamptonshire and Oxford-shire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two admini-strations of the questionnaires. A single global question was given to patients asking them to rate their overall health status as excellent, very good, good, fair or poor. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels of improvement for patients who received drug treatment. However, on many dimensions of the SF-36, a moderate to large improvement was detected for the surgical group. However, small changes were reported in overall health status, as indicated by the single global question, for both groups. Single item measures of health status may not provide a sufficiently accurate indication of health status to be appropriate for use in longitudinal studies.     

Perceptions of the quality of life for the adolescent with a chronic illness by teachers,parents and health professionals: a Delphi study

AIMS: The perceptions that teachers, parents and health professionals have on the relative importance of different aspects of quality of life (QOL) for the adolescent with a chronic illness were explored using a three-round Delphi study. METHODS: The first round questionnaire identified the level of importance each panel attached to 16 aspects relating to QOL. Panellists were also encouraged to provide additional comments on why they felt a particular item was important. In round two, panellists were asked to prioritize the items in order of importance, whereas round three attempted to achieve consensus among each of the three panels. RESULTS: Differences between and within panels in the prioritization of items in round one and round two were evident. However, consensus was achieved in round three, except for the prioritization of very important items by the panel of teachers. Items identified by all three panels as extremely important included the adolescent's attitude, family relationships and friendships with the same age group. Themes to emerge from the qualitative responses to the open-ended questions included the perception of the chronically ill adolescent 'not wanting to be different' and the importance of a 'positive attitude'. The majority of participants also perceived adolescents with a chronic illness as having worse QOL than their healthy counterparts. CONCLUSIONS: By increasing the awareness among the different groups of the impact of chronic illness on various aspects of adolescent QOL, the overall care and support of those adolescents could be improved. Further studies should also be undertaken to explore the views of the chronically ill adolescents themselves.     

Diet in a group of 18-month-old children in South West England, and comparison with the results of a national survey

Objective To investigate the normal range of nutrient intakes and food consumption patterns in 18-month-old children.
Subjects 1026 children resident in South West England, forming part of the Children in Focus (CIF) research cohort.
Methods Diet was assessed using a 3-day unweighed dietary record. Nutrient and food intakes were compared with the dietary reference values and with the results of a British survey of preschool children – the National Diet and Nutrition Survey (NDNS).
Results Intakes of energy and nearly all nutrients were significantly higher in boys than in girls. Intakes of energy were slightly above the estimated average requirements. For most nutrients the mean and median intakes were well above the Reference Nutrient Intakes (RNI). The exceptions were vitamin D, iron and zinc. Nutrient intakes in CIF were very similar to those in the NDNS except for carotene, calcium, vitamin D and iodine, where intakes were considerably higher in CIF, and sugar intake which was lower in CIF. Intakes of most foods were similar in the two surveys. However, consumption of milk, yoghurt and fromage frais and baby foods was higher in CIF, intakes of most fruit and vegetables was somewhat higher, and intakes of savoury snacks and sugar confectionery were lower. In addition, there were differences between the two groups in the types of meat and meat products consumed.
Conclusions These children are unlikely to be deficient in any nutrients, with the possible exceptions of iron, zinc and vitamin D. The use of vitamin D supplements and the inclusion of iron- and zinc-rich foods in the diets of preschool children should be encouraged. These data will be important in assessing the influence of early diet on subsequent health and development.     

Diet in a group of 18-month-old children in South West England, and comparison with the results of a national survey

OBJECTIVE: To investigate the normal range of nutrient intakes and food consumption patterns in 18 month old children. SUBJECTS: 1,026 children resident in South West England, forming part of the Children in Focus (CIF) research cohort. METHODS: Diet was assessed using a 3 day unweighed dietary record. Nutrient and food intakes were compared with the dietary reference values and with the results of a British survey of preschool children -- the National Diet and Nutrition Survey (NDNS). RESULTS: Intakes of energy and nearly all nutrients were significantly higher in boys than in girls. Intakes of energy were slightly above the estimated average requirements. For most nutrients the mean and median intakes were well above the Reference Nutrient Intakes (RNI). The exceptions were vitamin D, iron and zinc. Nutrient intakes in CIF were very similar to those in the NDNS except for carotene, calcium, vitamin D and iodine, where intakes were considerably higher in CIF, and sugar intake which was lower in CIF. Intakes of most foods were similar in the two surveys. However, consumption of milk, yoghurt and fromage frais and baby foods was higher in CIF, intakes of most fruit and vegetables was somewhat higher, and intakes of savoury snacks and sugar confectionery were lower. In addition, there were differences between the two groups in the types of meat and meat products consumed. CONCLUSIONS: These children are unlikely to be deficient in any nutrients, with the possible exceptions of iron, zinc, and vitamin D. The use of vitamin D supplements and the inclusion of iron- and zinc-rich foods in the diets of preschool children should be encouraged. These data will be important in assessing the influence of early diet on subsequent health and development.     

Development and validation of a three-item questionnaire for dietitians to screen for poor oral health in people living with human immunodeficiency virus and facilitate dental referral

Aim: The aim of the present study was to develop and validate a three-item oral health questionnaire for use by dietitians in an ambulatory care setting to screen human immunodeficiency virus-1-infected patients at risk of oral diseases to facilitate dental referral. Methods: The study was a questionnaire-based survey of 273 participants attending a human immunodeficiency virus clinic in Sydney, Australia. Subjects completed the oral health questionnaire and the Oral Health Impact Profile-14 contemporaneously. Results: A statistically significant correlation (rho = 0.617 (95% CI 0.54, 0.69), P < 0.0001) was found between the oral health questionnaire and the Oral Health Impact Profile-14 indicating adequate validity. Sensitivity for the three-question oral health questionnaire was found to be 84% (95% CI 76, 89) with a specificity of 55% (95% CI 46, 63). The negative predictive value was 77 % (95% CI 68, 85). A single screening question performed less well compared with overall sensitivity of the three-item oral health questionnaire. Conclusion: The present study found the three-item oral health questionnaire to be a valid and sensitive screening tool to ‘trigger’ for further oral health assessment and referral to dental professionals. This is a useful tool for dietitians and other health-care workers involved in the multidisciplinary preventative care of people living with human immunodeficiency virus.     

Area deprivation and its association with health in a cross-sectional study: are the results biased by recent migration?

Background  

The association between area deprivation and health has mostly been examined in cross-sectional studies or prospective studies with short follow-up. These studies have rarely taken migration into account. This is a possible source of misclassification of exposure, i.e. an unknown number of study participants are attributed an exposure of area deprivation that they may have experienced too short for it to have any influence. The aim of this article was to examine to what extent associations between area deprivation and health outcomes were biased by recent migration.     

Anticoagulant treatment of patients with chronic atrial fibrillation in primary health care in Sweden--a retrospective study of incidence and quality in a registered population

BACKGROUND: The number of patients receiving anticoagulant treatment is increasing. Chronic atrial fibrillation is the most common treatment diagnosis. The literature indicates a variable level of treatment control. Estimates of time within the therapeutic range have been recommended as a measurement of quality. Electronic patient records are providing clinical data that are useful for audits concerning anticoagulant treatment in real-life practice. OBJECTIVE: Our aim was to assess warfarin treatment for chronic atrial fibrillation in primary health care with regard to prevalence, incidence and quality. METHODS: A 2 year retrospective study was carried out of electronic patient records up to April 2002 in primary health care in Stockholm, including 12 primary health care centres with a registered population of 203 407. Main outcome measures were the number of new patients on wafarin treatment for chronic atrial fibrillation, and time within the therapeutic prothrombin range in the first 90 days of treatment using a linear interpolation method. RESULTS: In total, 827 patients were on warfarin treatment for chronic atrial fibrillation, giving a prevalence of 0.41%. Of these, 144 patients (study group) started treatment with warfarin for chronic atrial fibrillation during the study period, giving a yearly incidence of 0.07%. Their mean age was 73.1 years and 61.1% were men. There were 1721 prothrombin monitoring episodes registered in the first 90 days of treatment, on average once a week per patient. The average proportion of time within the therapeutic range was 54.1% (95% confidence interval (CI) 50.1-58.1), and the proportion of therapeutic tests was 50.2% (95% CI 47.8-52.6). CONCLUSIONS: During the first, second and third months of warfarin treatment for chronic atrial fibrillation, patients were outside the therapeutic range time nearly half the time. There was a gender difference favouring men regarding initiation of treatment.