Result of school-based intervention on cardiovascular risk factors

Abstract

Objective. To assess the effectiveness of a two-year school-based intervention, consisting of integrated and replicable physical activity and nutritional education on weight, fat percentage, cardiovascular risk factors, and blood pressure. Design and setting. Six elementary schools in Reykjavik were randomly assigned to be either intervention (n = 3) or control (n = 3) schools. Seven-year-old children in the second grade in these schools were invited to participate (n = 321); 268 (83%) underwent some or all of the measurements. These 286 children were followed up for two years. Intervention. Children in intervention schools participated in an integrated and replicable physical activity programme, increasing to approximately 60 minutes of physical activity during school in the second year of intervention. Furthermore, they received special information about nutrition, and parents, teachers, and school food service staff were all involved in the intervention. Subjects. 321seven-year-old schoolchildren. Main outcome measures. Blood pressure, obesity, percentage of body fat, lipid profile, fasting insulin. Results. Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure (SBP) and a 2.9 mmHg increase in diastolic blood pressure (DBP) over the two-year intervention period, while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg. These changes were not statistically significant. Furthermore there were no significant changes in percentage body fat, lipid profile, or fasting insulin between the intervention and control schools. Conclusion. A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors.     

Sifting,sorting and saturating data in a grounded theory study of information use by practice nurses: A worked example

The terminology used to analyse data in a grounded theory study can be confusing. Different grounded theorists use a variety of terms which all have similar meanings. In the following study, we use terms adopted by Charmaz including: initial, focused and axial coding. Initial codes are used to analyse data with an emphasis on identifying gerunds, a verb acting as a noun. If initial codes are relevant to the developing theory, they are grouped with similar codes into categories. Categories become saturated when there are no new codes identified in the data. Axial codes are used to link categories together into a grounded theory process. Memo writing accompanies this data sifting and sorting. The following article explains how one initial code became a category providing a worked example of the grounded theory method of constant comparative analysis. The interplay between coding and categorization is facilitated by the constant comparative method.     

Prevalence of Subjectively Experienced Symptoms in a Population Sample of Women with Special Reference to Women with Arterial Hypertension

The patients' reasons for encounter were recorded in 10278 personal doctor—patient contacts in nine Norwegian municipalities over a two-month period, and were classified according to a simplified version of the WHO “Reason for Encounter Classification”. A two-dimensional classification system was used where each reason was classified according to the location and type of problem. Symptoms and complaints made up 64.9% of all encounters. Most of the encounters were related to the musculo-skeletal, circulatory and female genital systems. The most frequent single reason for encounter was pain in the musculo-skeletal system (15.5% of all encounters). Psychological and social reasons were rather infrequent 3.1% and 0.3%. Compared with the frequencies of psychiatric and social diagnoses recorded in general practice, this indicates a discrepancy between the patient's own opinion of problems and the doctor's interpretations. Females had a significantly higher contact rate than males, mainly due to problems related to the genital system, inclusive of the breast.     

General paresis presenting with lens dislocation

A 62-year-old woman is described in whom the occurrence of bilateral lens dislocation into the vitreous led to the diagnosis of general paresis. In this patient the dislocated lenses were discovered on a computed tomographic scan of the brain. The literature concerning the association of syphilis and lens dislocation is reviewed.     

新农村基层综合医院设计初探

农村基层医院建设是新农村城镇一体化发展进程中的重要一环,根据医院自身发展的特有规律,立足于现有条件,将医院建设规模与用地矛盾一次性统一解决是一个新课题。同时,如何突破医院建筑设计固有模式,真正体现医院建筑便捷、高效等共性,山东省金乡县人民医院在这方面进行了一些探索。     

Flemish general dental practitioners' knowledge of dental radiology

The aim of this study was to assess general dental practitioners'' knowledge of dental radiography and radiation protection in order to alert the Belgian authorities and dental professional societies. Prior to attending a postgraduate course on intraoral radiology, general dental practitioners in Flanders, Belgium, were asked to fill in a questionnaire regarding the radiological equipment and the techniques they used for intraoral radiography. The availability and type of dental panoramic equipment were also assessed. A total of 374 questionnaires were available for this study. 15% of the attendants used radiographic equipment that was more than 27 years old and 43% reported equipment that operated with a clockwork timer. 32% and 75% respectively had no idea what the kV or mA settings were on their intraoral equipment. 5% were unaware which cone geometry or geometric technique (paralleling or bisecting angle technique) they were using. 81% claimed to be using a short cone technique. 47% did not know what collimation meant, whereas 40% stated that they were using circular collimation. 38% used digital intraoral image detectors (63% were photostimulable storage phosphorplate (PSPP)), but 16% were not sure about the type of sensor they were using (PSPP or solid-state sensors). 61% also had dental panoramic equipment available, 25% of which was digital (10% charge coupled device (CCD) and 15% PSPP). These results clearly indicate the need for continued education on this subject. The latter is an important signal to Belgian authorities and dental professional societies.     

Practice development: ambiguity in research and practice

Practice development activity occupies an ambiguous position in relation to both clinical practice and research. In practice, it is seen at times as an added extra to normal work despite arguably being an inherent part of professional practice. In research, it fails to demonstrate the rigour of being generalisable because of its explicit location in a specific care environment. The study reported in this paper explored the implications of this ambiguity for practitioners who seek to develop health care practice. Ten focus groups were held with health care researchers and practitioners concerning the processes of developing practice in the North East of England. The results demonstrate how people manage themselves and the uncertainty that surrounds the use of research in clinical practice. The paper argues for an appreciation of reflexive forms of research, such as action and practitioner research, which do not disassociate research and practice and in which practitioners have a role in knowledge creation as well as knowledge implementation.