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Biomedical subjects

J M Chan

Publications and source records attributed to J M Chan.

25 records · Page 2Linked to original sources
PubMed1998

Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer (Sweden)

OBJECTIVES: Dairy products consistently have been associated with an increased risk of prostate cancer, yet the mechanism of this relationship remains unknown. Recent hypotheses propose that 1,25 dihydroxyvitamin D (1,25 D) is protective for prostate cancer. One study in the United States found that calcium consumption, which can lower circulating 1,25 D, was associated with higher risk of advanced prostate cancer, and we sought to address this hypothesis in a distinct population. METHODS: We analyzed data from a population-based case-control study of prostate cancer conducted in Orebro, Sweden, with 526 cases and 536 controls. Using unconditional logistic regression models, we examined the relationship of dairy products, dietary calcium, phosphorous, and vitamin D with risk of total, extraprostatic, and metastatic prostate cancer. RESULTS: Calcium intake was an independent predictor of prostate cancer (relative risk (RR) = 1.91, 95 percent confidence interval (CI) 1.23-2.97 for intake > or = 1183 vs. < 825 mg/day), especially for metastatic tumors (RR = 2.64, 95 percent CI 1.24-5.61), controlling for age, family history of prostate cancer, smoking, and total energy and phosphorous intakes. High consumption of dairy products was associated with a 50 percent increased risk of prostate cancer. CONCLUSIONS: Our results support the hypothesis that high calcium intake may increase risk of prostate cancer, and this relation may underlie previously observed associations between dairy products and prostate cancer.

Adult↗
PubMed1994

Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men.

OBJECTIVE: To investigate the relation between obesity, fat distribution, and weight gain through adulthood and the risk of non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: We analyzed data from a cohort of 51,529 U.S. male health professionals, 40-75 years of age in 1986, who completed biennial questionnaires sent out in 1986, 1988, 1990, and 1992. During 5 years of follow-up (1987-1992), 272 cases of NIDDM were diagnosed among men without a history of diabetes, heart disease, and cancer in 1986 and who provided complete health information. Relative risks (RRs) associated with different anthropometric measures were calculated controlling for age, and multivariate RRs were calculated controlling for smoking, family history of diabetes, and age. RESULTS: We found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of diabetes. Men with a BMI of > or = 35 kg/m2 had a multivariate RR of 42.1 (95% confidence interval [CI] 22.0-80.6) compared with men with a BMI < 23.0 kg/m2. BMI at age 21 and absolute weight gain throughout adulthood were also significant independent risk factors for diabetes. Fat distribution, measured by waist-to-hip ratio (WHR), was a good predictor of diabetes only among the top 5%, while waist circumference was positively associated with the risk of diabetes among the top 20% of the cohort. CONCLUSIONS: These data suggest that waist circumference may be a better indicator than WHR of the relationship between abdominal adiposity and risk of diabetes. Although early obesity, absolute weight gain throughout adulthood, and waist circumference were good predictors of diabetes, attained BMI was the dominant risk factor for NIDDM; even men of average relative weight had significantly elevated RRs.

Adult↗
PubMed1991

Self-understanding and reaching out to sick children and their families: an ongoing professional challenge.

Health care professionals face a series of taxing, emotionally wrenching, painful experiences as they begin to care for frightened, ill children and their families. Loss, grief, overidentification with patients, and overwhelming anxiety are among their "occupational hazards." Open, frank discussion of intense feelings and reactions and mutual support are essential elements in helping caregivers to cope in ways that do not result in withdrawal from children and families. By developing strategies that reach out to patients and their families, professionals enhance their own personal professional gratification and self-esteem. The insights of parents are used extensively both to illustrate concepts and to emphasize the critical role parents can play as "resources" for professionals and "partners in care."

Adaptation, Psychological↗
PubMed1988

Play and the abused child: implications for acute pediatric care.

Child maltreatment is a major pediatric health care concern. A large number of children will be admitted to inpatient pediatric settings for treatment of injuries that have resulted from child abuse and/or neglect. This article focuses on the role of play during the abused child's acute inpatient admission. Sensitive crisis management and careful assessment and treatment of the child through play are significant contributions to the comprehensive care of such children.

Child↗
PubMed1982

Parenting the chronically ill child in the hospital: issues and concerns.

Chronic childhood illness and hospitalization are stressful events within the family unit. Parental response to the crisis of hospitalization profoundly affects the child's recovery process. This article discusses a team approach toward assessing and understanding parental reactions, methods of offering assistance and guidance, and basic issues and problems concerning staff-parent relationships. The focus is on the pediatric health care "team" as an agent for aiding families.

Child↗
PubMed1980

Preparation for procedures and surgery through play.

The child life therapist utilizes play techniques with hospitalized children for preparation and integration before and after medical procedures and surgery. Unstructured and structured play sessions enable children to anticipate threatening events and mobilize their coping behaviors. Through manipulating appropriate play materials including miniature-size medical equipment, children communicate if facts of preparation have been understood, misinterpreted or denied. Concrete play experiences (e.g., doctor puppet play), enable children to understand hospital routines and sequences of events. Sensory experiences (e.g., needle play), help them dramatize situations and to adopt changes of role from passive to active ones. Opportunities for play after procedures (particularly intrusive ones) and surgery must be made available to clarify any misconceptions and to emphasize the nurturing and healing aspects of treatment. Psychological preparation for necessary procedures and surgery through play results in children enduring and cooperating more readily and have more trust in all medical personnel.

Adolescent↗