Search PubMed⌕ Search

Biomedical subjects

T Ostbye

Publications and source records attributed to T Ostbye.

At least 91 records · Page 5Linked to original sources
PubMed1989

Type 2 (non-insulin-dependent) diabetes mellitus, migration and westernisation: the Tokelau Island Migrant Study.

The migration of Tokelauans from a traditional atoll in the Pacific to urban New Zealand is associated with an increased prevalence and incidence of Type 2 (non-insulin-dependent) diabetes mellitus over the period 1968-1982. During the same period, a lesser but definite increase is seen among non-migrants in Tokelau. The age standardised prevalence rates rose from 7.5 and 11.7 to 10.8 and 19.9 per 100 respectively in the male and female migrants compared with an increase from 3.0 and 8.7 to 7.0 and 14.3 per 100 in the non-migrant males and females respectively. The incidence of diabetes is shown to be consistently higher in the migrants compared to the non-migrants giving relative risks of 1.5 in males and 1.9 in females. The factors most likely contributing to this difference, are changes to a higher calorie, high protein diet, higher alcohol consumption, a greater weight gain and altered levels of physical activity in the migrants. A number of populations in the Pacific have been shown to have a low rate of diabetes in their traditional setting, but may have a genetic predisposition for diabetes which responds to factors in the urban industrialised environment and life-style. The social and economic changes taking place in Tokelau are also clearly increasing the risk of diabetes. To reverse these trends and prevent the development of complications of Type 2 diabetes, it will be important to institute preventive programmes and to follow up the population in both environments for long-term outcomes, including mortality.

Adult↗
PubMed1989

An 'electronic' extramural course in epidemiology and medical statistics.

This article describes an extramural university course in epidemiology and medical statistics taught using a computer conferencing system, microcomputers and data communications. Computer conferencing was shown to be a powerful, yet quite easily mastered, vehicle for distance education. It allows health personnel unable to attend regular classes due to geographical or time constraints, to take part in an interactive learning environment at low cost. This overcomes part of the intellectual and social isolation associated with traditional correspondence courses. Teaching of epidemiology and medical statistics is well suited to computer conferencing, even if the asynchronicity of the medium makes discussion of the most complex statistical concepts a little cumbersome. Computer conferencing may also prove to be a useful tool for teaching other medical and health related subjects.

Computer Communication Networks↗
PubMed1989

A follow-up study of three hepatitis B virus markers in personnel from the Canadian Armed Forces.

Prevalence rates for three hepatitis B virus (HBV) markers in two groups of personnel within the Canadian Armed forces (1848 incoming recruits and 210 crew members from a destroyer) were determined. Blood specimens for analysis were provided twice. The initial prevalence rates fell at the lower end of the spectrum when compared with those found in United States military personnel, Canadian military health personnel, and certain Canadian civilian populations. Eleven recruits and one destroyer crew member seroconverted for at least one of the markers between the first and the second testing. Their serological profiles are discussed in detail. No transmission of HBV between individuals in the group of recruits studied was established. However, evidence was found for a probable limited transmission of HBV between two crew members of HMCS Margaree. These findings combined with the high cost of the hepatitis B vaccine indicate that mass immunization for HBV in the Canadian Forces population cannot be justified on the basis of this study.

Adolescent↗
PubMed1987

Migration and gout: the Tokelau Island migrant study.

The prevalence and 14 year incidence of clinical gout and its precursors were investigated in the Polynesian population of Tokelauans living in the Pacific basin, non-migrant Tokelauans living in their isolated atoll homeland being compared with migrant Tokelauans living in urban New Zealand. The age standardised prevalence of gout in Tokelauan men in New Zealand was higher than that in non-migrant Tokelauan men, being 21.0 and 19.5/1000 subjects at the beginning of the study and 51.0 and 14.6/1000 at the end of study, respectively. Migrant men in New Zealand aged under 55 had higher mean serum uric acid concentrations than non-migrant men of the same age. The prevalence of gout was low in women in both environments. The age standardised relative risk of developing gout between 1968 and 1982 was 9.0 times higher in the migrant men than in the non-migrant men. Age, serum uric acid concentration, serum cholesterol concentration, and self reported alcohol consumption at entry to the study were the best set of predictors of gout in men. Preventive strategies to change body mass, diet, and patterns of alcohol use need to be developed in this population.

Adolescent↗
PubMedDate not supplied

The electronic house call. Consequences of telemedicine consultations for physicians, patients, and society.

Within the next 10 years, telemedicine technology is likely to become widely available in physicians' offices and patients' homes. Rather than describing the technology of telemedicine, we discuss the implications of its widespread use among physicians, patients, and society as a whole, focusing on that mainstay of communication between physician and patient, the "electronic house call." After exploring the new relationship that is likely to develop between patients and physicians as a consequence of the use of telemedicine, we discuss the broader economic, legal, and political consequences of the widespread use of this technology.

Communication↗
PubMedDate not supplied

Place of birth and dietary intake in Ontario. I. Energy, fat, cholesterol, carbohydrate, fiber, and alcohol.

BACKGROUND: The importance of dietary intake in the prevention of major health problems is acknowledged. Because of the impact of culture on food intake, this study investigated the relationship between place of birth and nutrient intake in Ontario, using data from the 1990 Ontario Health Survey. METHODS: Adults (age = 18) were categorized as non-immigrants (born in Canada; n = 29,458) or immigrants (born outside of Canada, classified by countries of birth; n = 7,158). Energy, fat, cholesterol, carbohydrate, and fiber intakes were examined, as well as alcohol consumption during the previous week. A companion article describes results for protein and selected micronutrients. Multiple linear and logistic regression analyses investigated the association of place of birth with nutrient intakes, adjusting for sociodemographic factors and ethnicity. RESULTS: Fat and carbohydrate intakes were strongly associated with place of birth, but cholesterol and fiber intakes were not. Immigrants, overall, were less likely than nonimmigrants to consume more fat (OR = 0.45, P < 0.0001), less carbohydrate (OR = 0.55, P < 0.0001), or more alcohol (OR = 0.64, P = 0.0004) than recommended. However, variations existed by country of birth. CONCLUSIONS: Immigrants were generally more likely to meet recommendation for fat and carbohydrate intakes than were nonimmigrants. These healthy eating behaviors need to be reinforced as part of health promotion.

Adult↗
PubMedDate not supplied

Place of birth and dietary intake in Ontario. II. Protein and selected micronutrients.

BACKGROUND: Because of the importance of dietary intake on health, this study investigated the relationship between place of birth and nutrient intake in Ontario, using cross-sectional data from the 1990 Ontario Health Survey. METHODS: Adults (age = 18) were categorized as nonimmigrants (born in Canada; n = 29,458) or immigrants (born outside of Canada, classified by countries of birth; n = 7,158). Protein, calcium, iron, vitamin C, thiamin, riboflavin, and niacin intakes were studied (a companion article describes energy and other nutrient intakes). Multiple linear and logistic regression analyses investigated the association of place of birth with nutrient intakes, adjusting for sociodemographic factors and ethnicity. RESULTS: The proportions of subjects at an increased risk of "inadequate" nutrient intakes were relatively low. However, immigrants (particularly from Asian countries) were at a higher risk of inadequate intakes of protein (OR = 1.51, P = 0.001), calcium (OR = 1.41, P < 0.0001), and iron (OR = 1.44, P = 0.002) compared with nonimmigrants. Immigrants from various Asian countries were more likely to report inadequate thiamin, riboflavin, and niacin intakes. CONCLUSION: Some immigrants groups in Ontario display higher risks of inadequate protein and micronutrient intakes compared with nonimmigrants. More research on the nutritional status of these subgroups is needed to develop culturally sensitive health and nutrition promotion programs.

Adult↗
PubMedDate not supplied

Patient satisfaction as an indicator of quality care in independent health facilities: developing and assessing a tool to enhance public accountability.

The objective of this research was to examine the performance of a brief patient survey about quality of care received in community-based diagnostic and therapeutic facilities. The survey was administered to patients in 44 facilities that were also scheduled for a formal external assessment. The response rate was 53%. Patients generally rated their care positively; 18.5% of patients rated at least 1 item as fair or poor. The amount of information received about risks and complications was rated least favorably; concern and caring shown by staff was rated most favorably. The 10 items which patients rated regarding aspects of quality formed an internally consistent scale (alpha = .93). Patients' ratings were not useful predictors of assessor ratings. Although patients' ratings cannot substitute for expert on-site assessments, they are an important part of a quality management program. The patient survey provides additional, complementary information about components of quality care that are important to them.

Analysis of Variance↗
PubMedDate not supplied

Time since immigration and excess body weight.

OBJECTIVES: To examine the relationship between time since immigration and excess body weight. METHODS: Secondary data analysis of a cross-sectional survey of 19,600 Canadians. RESULTS: The prevalence of excess weight (BMI > 25) increases with time since immigration for both men and women. After controlling for birthplace, socio-demographic, lifestyle and health correlates, only female immigrants (less than five years) are significantly less likely to have BMI scores greater than 25 kg/m2 compared to those born in Canada. Stratified analyses, however, revealed similar findings for Asian men who had immigrated less than five years prior to the survey. DISCUSSION: Our results suggest that length of time since immigration is an important risk factor for excess weight. Further research with longitudinal data, more reliable measures of ethnicity and anthropometric measures of weight are required to confirm these initial findings.

Adult↗
PubMedDate not supplied

Do nutrition indicators predict death in elderly Canadians with cognitive impairment?

This study describes the independent association between nutritional risk and death in older adults diagnosed with cognitive impairment. Canadian Study of Health and Aging participants who completed a clinical exam and were diagnosed with cognitive impairment and had complete data for regression analyses were included (n = 735). Nutritional risk was defined as the presence of at least one abnormal nutrition indicator identified during the clinical exam (history of weight loss, abnormal serum albumin, poor appetite, body mass index < 20). Other covariates believed to influence mortality were modelled with nutritional risk using logistic regression. There were 373 deaths during the five-year follow-up period in this sample. Nutritional risk was found to independently increase the likelihood of death (OR = 1.6, 95% CI 1.1, 2.2) in these older adults suffering from cognitive impairment. Further work is required to determine if interventions can improve nutritional status and quality of life of these older adults.

Aged↗
PubMedDate not supplied

Correlates of dysphoria in Canadian seniors: the Canadian Study of Health and Aging.

OBJECTIVE: To examine the correlates of dysphoria in elderly Canadians. METHOD: Randomly sampled elderly underwent screening in 1992 (CSHA-1) and in 1997 (CSHA-2). Community-living subjects without dementia at CSHA-1 were re-interviewed at CSHA-2 (n = 5234). A score < 53 on the mental health component of the Medical Outcomes Study Questionnaire (SF-36) was used to measure dysphoria. Sociodemographic, functional, social support, disease and lifestyle correlates of dysphoria were examined. RESULTS: 4.76% of men, and 8.59% of women were classified as dysphoric. The occurrence declined with age. In multivariate analyses, chronic pain, poor self-rated health, functional dependency and, in men only, being married, were significantly related to dysphoria. Perceived social support remained significant after controlling for sociodemographic, functional and disease variables. CONCLUSION: Dysphoria is common among the elderly, especially elderly women. Given the interrelationships and number of correlates of dysphoria, elderly Canadians require broad programs promoting health and social support as well as functional and economic independence.

Age Factors↗