Reference period analysis of vaginal bleeding with triphasic oral contraceptive agents containing norethindrone or levonorgestrel: a comparison study.

The World Health Organization recommends the use of fixed reference periods for quantification of the incidence and severity of vaginal bleeding when patients use various forms of contraception. Ninety- and 110-day reference periods were used in the analysis of data from daily menstrual diaries kept by 72 healthy women in a one-year study of oral contraceptive agents containing ethinyl estradiol and either norethindrone or levonorgestrel. Analysis of bleeding patterns reported during both 90-day and 110-day periods revealed fewer days of bleeding and/or spotting overall with norethindrone than with levonorgestrel (e.g., a mean of 16.06 vs. 19.55 days, respectively, over the first 90-day period; P = .013) and significantly shorter bleeding and/or spotting episodes with the norethindrone preparation. This trend persisted when data were adjusted for a day-1 pill start. Using either method of analysis, duration of bleeding episodes was shorter among subjects taking norethindrone than levonorgestrel. Pills were missed in both study groups, but more women in the LNG/EE group missed from 1 to 3 pills in at least one cycle (31 vs. 21 in the NET/EE group). The between-group difference in bleeding events may be due to intrinsic hormonal differences in regimens or to the greater number of pills missed among levonorgestrel users.     

The ‘Tasty School’ model is feasible for food education in primary schools

Background

The ‘Tasty School’ is a tailored teacher-delivered food education model for primary schools in Finland. The aim of the current study was to investigate the feasibility of the Tasty School model in primary schools. Furthermore, the aim was to assess changes during the intervention in the class teachers' perspectives and experiences related to food education and school dining.

Methods

The method involved a quasi-experimental study with intervention and control groups. A total of 130 class teachers from 15 intervention and 10 control schools from five municipalities in Finland participated in the study during one school year. The theoretical framework of acceptability was utilised to evaluate feasibility using frequencies. The comparison data were analysed using a mixed-effects model for repeated measures to account for the intervention effects and selected standardising effects.

Results

Teachers reported that the model was highly acceptable and easily integrated into the school environment. Support from principals and colleagues was the most important facilitator of food education, and lack of time was the barrier. Teachers in the intervention schools were more likely to consider school meals healthy after the intervention, and they reported having sufficient materials and supplies for food education.

Conclusions

The Tasty School was shown to be a feasible model for food education in primary schools. The current study especially found that the commitment of the whole school and principals' role are crucial in the implementation of food education. The factors that support the implementation must be strengthened, and efforts must be made to reduce the barriers.     

Wie Stadtarchitektur die Gesundheit beeinflusst: das PAKARA-Modell

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Der Mensch steht in ständiger Wechselwirkung mit seiner Umwelt. Führt diese Interaktion zur individuellen...     

Visuospatial declarative learning despite profound verbal declarative amnesia in Korsakoff’s syndrome

Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterised by severe amnesia. Although the presence of impairments in memory has long been acknowledged, there is a lack of knowledge about the precise characteristics of declarative memory capacities in order to implement memory rehabilitation. In this study, we investigated the extent to which patients diagnosed with KS have preserved declarative memory capacities in working memory, long-term memory encoding or long-term memory recall operations, and whether these capacities are most preserved for verbal or visuospatial content. The results of this study demonstrate that patients with KS have compromised declarative memory functioning on all memory indices. Performance was lowest for the encoding operation compared to the working memory and delayed recall operation. With respect to the content, visuospatial memory was relatively better preserved than verbal memory. All memory operations functioned suboptimally, although the most pronounced disturbance was found in verbal memory encoding. Based on the preserved declarative memory capacities in patients, visuospatial memory can form a more promising target for compensatory memory rehabilitation than verbal memory. It is therefore relevant to increase the number of spatial cues in memory rehabilitation for KS patients.