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Drinking habits and pain in chronic pancreatitis.

To study the role that continuous drinking plays in the pain of chronic pancreatitis, we have examined 67 patients with alcoholic chronic pancreatitis with pain and 29 patients without pain, and we report on their alcoholic habits. Drinking habits played a part 92 (67.6%) of 136 times in patients with pain; in 185 without pain, 86 (46.5%) had continued their drinking habit (p < 0.001). Advanced pancreatic exocrine insufficiency was seen in 27 patients; 11 of them had pain during follow-up, whereas 16 did not. The nondrinker rate was similar in patients with and without pain, whereas among 69 patients with better pancreatic exocrine function, 56 had pain episodes and 13 did not. Alcoholic consumers were significantly more in number in the pain group: 70.4% versus 35% of the no pain group (p < 0.002). Our study shows that drinking alcohol in patients with chronic pancreatitis increased the frequency of painful episodes when there was relatively good pancreatic function, whereas in severe pancreatic insufficiency drinking had less influence on the development of pain.

Abdominal Pain↗

African American girls' smoking habits and day-to-day experiences with racial discrimination.

BACKGROUND: Although it is recognized that African Americans experience racial discrimination, relatively little research has explored the health implications of this experience. Few studies have examined the relationship between racial discrimination and specific health risks. OBJECTIVES: To examine the relationship between smoking habits and perceptions of racial discrimination among African American adolescent girls and to identify and test potential psychological mechanisms through which racial discrimination may operate to increase smoking among this group. METHODS: A sample of 105 African American adolescent girls (mean age 15.45 years) derived from a larger cross-sectional research project comprised the sample. Univariate analyses were conducted to provide descriptive data on the participants of the study, including information about their use of licit and illicit substances. Bivariate correlational analyses were conducted to evaluate the relationship between perceptions of discrimination and smoking habits. The ability of stress to mediate the relationship between discrimination and smoking was examined by using standard analytical procedures for testing mediation models as outlined by Baron and Kenny (1986). RESULTS: The sample (93%) reported experiencing discrimination and racial discrimination was highly correlated with cigarette smoking (r =.35, p >.001). Removing the effects of stress significantly reduced the relationship between racial discrimination and smoking (r =.17, p <.05), indicating that racial discrimination is related to smoking because of its stressful nature. CONCLUSION: Perceptions of racial discrimination are related to the smoking habits of African American adolescent girls.

Adolescent↗

Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype.

BACKGROUND: Disturbed bowel habit, diarrhoea or constipation is a key manifestation of irritable bowel syndrome (IBS). In some patients, diarrhoea and constipation alternate, giving rise to the so-called alternating subtype. AIMS: To assess IBS subtype breakdown (constipation (C-IBS), diarrhoea (D-IBS) or alternating (A-IBS)) according to the Rome II criteria and patients' self-assessment, the predominance in the alternating subtype (i.e. constipation, diarrhoea or neither), and the medical and personal impact, including health-related quality of life (HRQoL), of the different IBS subtypes. SUBJECTS AND METHODS: Two thousand individuals selected randomly to represent the general population were classified as potential IBS subjects (n = 281) or as non-potential IBS subjects (n = 1719) according to a validated questionnaire. Bowel habit classification was determined using the Rome II IBS supportive symptoms. RESULTS: Among 201 subjects meeting the Rome I criteria, 15% presented with D-IBS, 44% presented with C-IBS, 19% presented with A-IBS, and 22% presented with normal bowel habit. Among the 63 subjects meeting the Rome II criteria, 23% presented with A-IBS. According to the subjects' self-assessment, of those meeting the Rome I criteria, 16% considered themselves to have D-IBS, 66% to have C-IBS and 18% to have A-IBS. In subjects meeting the Rome II criteria, 24% considered themselves to have A-IBS. Among those classified with A-IBS by the Rome II criteria, most considered themselves to be constipated. Regardless of the subtype self-classification, most subjects reported a normal frequency of bowel movements. Clinical manifestations in A-IBS were very similar to those of C-IBS but with the added presence of defecatory urgency. Abdominal discomfort/pain and frequency of visits to physicians were greater in the A-IBS subtype than in the other two IBS subtypes. HRQoL was affected similarly in all IBS subtypes. CONCLUSIONS: Approximately one-quarter of subjects with IBS belong to the A-IBS subtype by the Rome II criteria, although the majority consider themselves to be constipated; indeed, clinical manifestations are more akin to the C-IBS subtype than to the D-IBS subtype. Abdominal discomfort/pain and frequency of visits to physicians are greater in the A-IBS subtype than in the other two IBS subtypes, while HRQoL is impaired similarly.

Adolescent↗

The reading habits of medicine clerks at one medical school: frequency, usefulness, and difficulties.

PURPOSE: To describe the reading habits of medicine clerks, which previously have not been well described. Understanding issues related to student reading habits may provide insights and opportunities for medical educators to develop methods to improve clerks' clinical clerkship experiences and their information literacy skills. METHOD: The authors administered an 18-item survey tool to 120 students on their first inpatient internal medicine clerkships at the Johns Hopkins University School of Medicine in 2002-03. The questionnaire focused on issues related to what and how often they read during their basic medicine clerkship. Data were explored mainly with descriptive statistics. RESULTS: One hundred twelve of 120 (93%) medicine clerks completed the survey. Clerks reported reading for an average of 10.8 (SD 5.6) hours per week (median ten hours per week, range one to 30 hours per week). The most commonly used and useful reading sources were UpToDate and test preparation textbooks. Approximately 30% of students reported substantial problems in reading about their patients. Limited data suggest that reading habits and learning methods vary by year of medical school. Clerks are given disparate advice on appropriate reading sources to consult by attending physicians, resident physicians, and fellow students. CONCLUSIONS: Students spend significant amounts of time reading online sources during their medicine clerkship, especially UpToDate. Medical educators should become familiar with these sources and contribute to maximizing their effectiveness for students. Additional research focused on understanding how students build skills in information literacy and how educational programs can facilitate the development of those skills is needed.

Baltimore↗

Physical activity, leisure habits and obesity in first-grade children.

BACKGROUND: Overweight and obesity are already on the rise in early childhood years. The relationships between genetic factors, malnutrition and physical inactivity are the underlying mechanisms. In this study, we examine the association between body indices, motor abilities and active (sport) and passive (television/computer) leisure time activities in a cohort of first-grade pupils. METHODS: The study group consisted of 344 children (51.5% male, 48.5% female). They were 6.8+/-0.4 years old, height was 123.9+/-4.9 cm, weight 24.8+/-5.0 kg, body mass index (BMI) 16.1+/-2.3 kg/m. After determination of the anthropometric data, a fitness test was performed in order to determine motor abilities. Parents were questioned about their children's leisure time activities, using a standardized questionnaire. Differences between BMI groups were evaluated using multivariate ANCOVA, adjusted for gender and age. RESULTS: Based on German BMI references, overweight and obesity were found in 12% of the children. They had poorer results with respect to endurance (P<0.001), leg strength (P=0.002), co-ordination and balance (P=0.045) and spent more leisure time in watching television and at the computer (each P<0.001). No differences were found between their active leisure habits such as club sports. DISCUSSION: Our examinations with first-grade children show no differences in active leisure habits between obese children and their counterparts, although the former had poorer results in motor abilities, but they spend more time on sedentary leisure habits like audiovisual media. A possible explanation is their fewer regular daily activities.

Analysis of Variance↗

Sexual habits and human papillomavirus infection among females in three New Independent States of the former Soviet Union.

BACKGROUND: On a global scale, the New Independent States (NIS) of the former Soviet Union have an intermediate incidence of cervical cancer, the main etiologic factor of which is human papillomavirus (HPV), a major sexually transmitted disease (STD). Recently, the prevalence of all STDs has exploded in these countries. GOAL: The goal of this study was to examine the sexual habits and HPV prevalence among females in three NIS countries. STUDY DESIGN: In this multinational (European Community-funded) trial, a series of 3,175 consecutive female patients were examined for HPV status (by Hybrid Capture II) at six clinics in Russia, Belarus, and Latvia. A meticulous survey of their sexual habits and other potential risk factors of HPV infections was made by structured questionnaire. RESULTS: Three categories of patients were examined: those attending STD clinics (n=722), gynecological patients (n=761), and those who participated in cervical cancer screening (n=1,692). These three categories were significantly differentiated by a large number of key variables, including the HPV detection rate (44.9% of STD patients, 39.8% of gynecological patients, and 24.5% of those who were screened). A wide variety sexual habits of these subjects were predictors of the HPV status in univariate analysis. Binary logistic regression analysis found that six different variables remained as independent predictors of HPV status. Patient category (STD) and (young) age were two highly significant predictors of increased risk (P<0.0001), whereas having a nonsmoking partner and having zero or one partner during the past 2 years were significant protective factors (P=0.004 and P=0.007, respectively). CONCLUSION: The results of this study indicate that women and girls in these NIS countries are conservative in many key characteristics of "high-risk" sexual behavior, such as age at onset of sexual activity, number of partners, and casual sex partners. HPV-positive and HPV-negative groups are clearly distinguished by the same variables identified as the key risk factors of HPV infection and cervical intraepithelial neoplasia in Western countries.

Adolescent↗

Brain-behavior relations during motor processing in chronic tic and habit disorder.

OBJECTIVE: This study examined electrophysiological indices of preparation (readiness potential, RP) and execution (movement-associated potential, MAP) during automated and controlled reaction time (RT) in 13 chronic tic disorder, 17 habit disorder, and 14 control participants. BACKGROUND: Both tic and habit disorders are hypothesized to involve states of heightened activation, which could impede initiation and the control of complex motor actions. METHOD: The electrophysiological signal was recorded from 4 electrodes (Fz, C3, C4, Pz) during a fixed 4-second foreperiod reaction time task. RESULTS: During automated responses, controls showed a shorter RP peak onset, and during controlled responses a longer MAP peak onset, compared with both clinical groups. The controls were the only group who showed a consistent linear relationship between RP and RT. CONCLUSIONS: Patients with chronic tic as well as habit disorder may not modulate cortical activation optimally in planning and executing both automated and controlled responses.

Adult↗

Smoking habits and carcinoma of the stomach: a case-control study.

Over a period of 8 years, a case-control study was carried out on smoking habits in 117 patients with carcinoma of the stomach and 234 controls, and a significant association of a particular method of smoking with the site of gastric carcinoma was found in the cancer patients. Furthermore, there was a highly significant difference in method of smoking between the cancer patients and the control group. The prevalence of smoking habit in the latter was 37%, of which 26% had swallowed the smoke regularly. In contrast, the incidence of smoking habit in the cancer patients was over 56%, of which 64% had swallowed the tobacco smoke. The difference is highly significant (P less than 0.001). The study also suggests that the distal part, in particular, the antrum of the stomach was affected more frequently among the smokers of the cancer patients who had swallowed the smoke regularly but the cardiac end seemed to be involved more often in the other groups of the cancer patients. These included 'never-smokers,' ex-smokers and those smokers who did not swallow the smoke (P less than 0.01). It is therefore concluded that the swallowing of tobacco smoke seems to influence the site of gastric carcinoma. The relative risk was six-fold higher among the smokers who did swallow the smoke compared with the 'never-smokers' of the control group.

Adult↗

Effect of dietary antioxidants and risk of oral, pharyngeal and laryngeal squamous cell carcinoma according to smoking and drinking habits.

Several intervention trials and prospective studies have reported that beta-carotene supplementation is not associated with a decreased risk of several cancers among smokers and drinkers, and that it may even have adverse effects in these groups. The relationship between dietary antioxidant intake and the risk of head and neck squamous cell carcinoma (HNSCC) has been examined intensively, but little is known about the effects of antioxidants on HNSCC with respect to smoking and drinking habits. Here, we conducted a case-control study of 385 histologically confirmed cases of HNSCC (193 oral, 132 pharyngeal and 60 laryngeal), excluding nasal and paranasal cancer, and 1925 age-matched and sex-matched cancer-free outpatient controls using data from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center, Japan. The intake of nutrients and food groups was assessed with a food frequency questionnaire, and multivariate-adjusted odds ratios for cancer were estimated for smoking and drinking habits using logistic models. The results showed an overall inverse association between the intake of dietary antioxidants, including carotene, and vitamins C and E, and risk of HNSCC. The protective effect of these antioxidants was seen in both men and women. High consumption of antioxidants was associated with a decreased risk of HNSCC among smokers, drinkers and those with both smoking and drinking habits. These findings suggest that dietary antioxidant intake prevents HNSCC in smokers and drinkers.

Adult↗

Unemployment and change of tobacco habits: a study of young people from 16 to 21 years of age.

In a cohort study of 1080 pupils who were followed for 5 years from when they left compulsory school (from age 16 to age 21 years), smoking habits were found to correlate with unemployment among both boys and girls. Pupils who were smokers in school had a higher risk of becoming unemployed than non-smokers. Irrespective of early smoking, smoking habits developed more unfavourably among unemployed young people than among those with no unemployment during the period studied. The odds ratio of being a smoker at the age of 21 years when unemployed more than 20 weeks during the observation period, compared with those without or with short unemployment, was 2.44 for men and 3.45 for women. When adjusted for the influence of socio-economic background, education, economy and smoking habits at the start of the period, the odds ratio was 1.7 (95% CI 1.01-2.86) for men and 2.0 (1.13-3.53) for women. The adjusted odds ratio for increasing or starting smoking during the period was 1.5 (95% CI 0.89-2.56) for men and 2.0 (1.18-3.35) for women. No significant correlation was found between snuffing and unemployment. Thus, it seems that unemployment is a risk factor for development of tobacco smoking in young people, especially among women.

Adolescent↗

The effect of combined topical steroids and habit-reversal treatment in patients with atopic dermatitis.

A modified behavioural method called habit-reversal, in combination with potent and weak corticosteroid cream, was compared with the use of the creams alone in the treatment of 45 patients with atopic dermatitis. The patients were randomly assigned to four groups, which received two different cream regimes in combination with the habit-reversal treatment. The patients' skin was assessed before, during and after treatment, and they recorded the amount of scratching during the study. The skin condition improved in all groups, but to a significantly greater degree in the habit-reversal groups. A strong correlation was found between the reduction in scratching and the improvement in skin status.

Administration, Topical↗

Risk of colorectal cancer in general practice patients presenting with rectal bleeding, change in bowel habit or anaemia.

The aim was to use data routinely collected in general practice to assess the absolute risk of colorectal cancer in patients newly presenting to their general practitioner (GP) with relevant symptoms. Three cohorts were identified from patients attending a sample of UK general practices. Patients with new symptoms of rectal bleeding, changes in bowel habit or anaemia were identified, and their incident rate for colorectal cancer and the positive predictive value (PPV) of each symptom in the following 12 months were calculated by age and gender. The total population over the age of 40 years was 2.8 million, and 9143 incident cases of colorectal cancer were identified. A total of 67,164 patients (28% men) were identified with anaemia, 27,524 (40% men) with changes in bowel habit and 44,741 (48% men) with rectal bleeding. For each cohort, the absolute risk rose with increasing age, and men were twice as likely to develop colorectal cancer. The PPV for developing colorectal cancer in the subsequent 12 months in those aged 60-69 years with anaemia was 3.02% for men, 1.38% for women; with changes in bowel habit 6.89% for men, 2.42% for women; and with rectal bleeding was 5.99% for men, 3.50% for women. A combination of any two signs and symptoms doubled the risk of an underlying cancer. In UK general practice, men are less likely to present with symptoms and signs of colorectal cancer compared with women, but after investigation are much more likely to have a colorectal cancer diagnosed. This should be taken into account in guidelines for referral.

Adult↗

Dietary habits of the Somali population in Liverpool, with respect to foods containing calcium and vitamin D: a cause for concern?

BACKGROUND: A large percentage of Liverpool Somalis have vitamin D deficiency and low calcium excretion. The dietary habits of Liverpool Somalis were investigated with respect to food items containing calcium and vitamin D. METHODS: A questionnaire, administered by a Somali field worker, assessed the intake of food of 60 adult (45 females and 15 males; mean age 42 years) and 10 child (seven females and three males; mean age 10 years) Somali volunteers. Questions concerned personal details, health (bone and muscle problems) and dietary habits including the frequency of consumption of food items containing substantial amounts of calcium and vitamin D. Results Most subjects reported bone and muscle pain. Eating habits reflected traditional customs. Foods containing substantial amounts of calcium and vitamin D were consumed infrequently. Milk was only consumed in tea. Those self-reporting bone pain consumed eggs, cheese and beans rarely. CONCLUSION: The food choices of these individuals with regard to bone health is a cause for concern and indicates a likelihood of low calcium and vitamin D intake.

Adult↗

The relationship of occlusion, parafunctional habits and recent life events to mandibular dysfunction in a non-patient population.

This study investigated the association between occlusion, oral habits and stress relative to the level of mandibular dysfunction in the total population and in specific diagnostic subgroups (normal, joint disorder, muscle disorder and joint/muscle disorder). A total of 269 nursing students were given a questionnaire and examination. The questionnaire included items to calculate an oral habit index and a social readjustment rating scale. The examination included items to calculate an occlusal index, two craniomandibular indices and a diagnostic criteria for specific subgroups. In the total population there was a positive association between mandibular dysfunction and three postulated risk factors. The total population was then divided into diagnostic subgroups. There was a positive association between the degree of mandibular dysfunction and parafunctional habits for normals, muscle disorders and joint/muscle disorders. There was a positive association between mandibular dysfunction and occlusion for normals only. Finally there was a positive association between mandibular dysfunction and stress for muscle disorders only. The results suggest that associations between postulated aetiologic factors and mandibular dysfunction vary depending on whether the subjects have a muscle and/or joint disorder. Since all associations were weak, other possible risk factors need to be investigated.

Adult↗

The study of risk habits in reproductive and perinatal epidemiologic research: the use of a donor inseminated population of women.

In this study we assess whether a population of donor inseminated women (ADI) provides an efficient alternative to an open population of women of reproductive age to study the effects of risk habits (cigarette smoking and alcohol consumption) on reproductive and perinatal health. An ADI population can be prospectively monitored before and after pregnancy; women enter the programme because of their husband's infertility. In the pilot clinic every couple asking for first insemination was requested to fill in a self-administered questionnaire on risk habits and the use of medicine. Medical histories of both the man and woman were taken. In 1986 and 1987, 519 women entered the programme. The response rate was 95%. Distribution of the exposure variables of the women currently smoking (52%) and currently drinking (68%) compared well with a general population survey from the town of Rotterdam. With regard to their risk habits and reproductive health, the population of women married to totally infertile men seems representative of women of reproductive age from an open population.

Adolescent↗

Premedication administered to anesthesiologists as patients: their evaluations of its effect and its influence on premedication prescribing habits.

Inquiries were sent to practising Austrian anesthesiologists to ascertain their premedication-prescribing habits and their assessment of premedicants that they received as patients. The 143 replies received showed meperidine/promethazine (M/P) as most used n = 83 and received (n = 54) drug (combination), followed by fentanyl/droperidol (F/D) n = 33 (n = 21), benzodiazepines (BZ) n = 17 (n = 10) and several other drugs (combinations) n = 10 (n = 14). There was no significant difference in the premedication habits of the 82 anesthesiologists who had received premedication and those (61) who had no personal experience with premedicants. The former judged M/P to be significantly superior to F/D and other schemes; however there was no significant difference from the judgement of the BZ. Unpleasant side effects have been described in 9% of M/P, 10% of BZ, 24% of F/D and 21% of other premedicants. On future occasions 10% of BZ-, 13% of the M/P-, 24% F/D- and 21%-receivers of other combinations would reject the same drug. Seven F/D and five M/P users converted their prescription schemes after they had received the same drug for their own premedication. The prescription habits were not influenced by dependency on departmental or hospital orders. Of those who had received it 75% desired premedication and 25% accepted premedication, suggesting that anesthesiologists believe in the positive effects of premedication. However, the overall incidence of 10% unpleasant side effects, even in the better ranked drugs, shows that the available premedicants do not yet seem to be satisfactory.

Anesthesiology↗

Dietary habits in renal stone patients compared with healthy subjects.

The dietary habits of renal calcium stone patients were investigated both by dietary history and by 4-day food records and compared with the dietary habits of control subjects, matched on the basis of age, sex, social and professional status. The method using 4-day records seemed to be more precise, judged by the correlation to the urinary output of nutrients. There was no difference in the daily intake of major nutrients between stone formers and controls, but a higher ingestion of vitamin C in controls and a larger consumption of alcohol among stone formers. In contrast to some epidemiological evidence, there were no significant differences in consumption of animal protein when stone formers were matched for social class. Despite a similar total intake of calcium, the stone formers excreted more calcium in the urine, probably reflecting a higher intestinal absorption of calcium. There seem to be only marginally different dietary habits between stone formers and carefully matched control subjects. Differences in the urinary output of minerals and electrolytes are mainly due to variations in gastrointestinal uptake.

Adult↗

A methodology to select a wire insulation for use in habitable spacecraft.

This paper investigates electrical overheating events aboard a habitable spacecraft. The wire insulation involved in these failures plays a major role in the entire event scenario from threat development to detection and damage assessment. Ideally, if models of wire overheating events in microgravity existed, the various wire insulations under consideration could be quantitatively compared. However, these models do not exist. In this paper, a methodology is developed that can be used to select a wire insulation that is best suited for use in a habitable spacecraft. The results of this study show that, based upon the Analytic Hierarchy Process and simplifying assumptions, the criteria selected, and data used in the analysis, Tefzel is better than Teflon for use in a habitable spacecraft.

Chemical Phenomena↗