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PubMed2026

Prevalence and risk factors of nutritional anaemia among adolescents in India: a systematic review with meta-analysis of prevalence.

BACKGROUND: Nutritional anaemia is a major public health concern among adolescents in India, threatening physical growth, cognitive development, and future maternal health. This systematic review with meta-analysis of prevalence aimed to estimate the pooled prevalence of nutritional anaemia among Indian adolescents aged 10-19 years and identify key associated risk factors. METHODS: A systematic search was conducted across PubMed, Embase, Web of Science, and Scopus up to February 2025. Data were extracted on study design, setting, diagnostic methods, prevalence, and risk factors. Quality was assessed with a modified Newcastle-Ottawa Scale. A random-effects meta-analysis estimated pooled prevalence, with subgroup analyses by state and gender, and pooled odds ratios for risk factors. RESULTS: Forty-five studies encompassing diverse Indian regions and 159,979 adolescents were included. The pooled prevalence of nutritional anaemia was 56% (95% CI: 49%-63%), with higher rates among girls (62%) than boys (39%). Iron deficiency (OR 2.38-4.68), other micronutrient deficiencies, low socioeconomic status, poor dietary diversity, female gender, and inadequate supplementation were consistently associated with higher anaemia risk. CONCLUSION: Nutritional anaemia impacts more than half of Indian adolescents, with notable regional and gender differences. Its complex nutritional, socioeconomic, and behavioural causes demand targeted, context-specific interventions to enhance adolescent health nationwide.

Humans↗
PubMed2003

Experiences of a community-based dietary intervention to enhance micronutrient adequacy of diets low in animal source foods and high in phytate: a case study in rural Malawian children.

A community-based dietary diversification/modification intervention, employing a quasiexperimental design with a nonequivalent control group, was conducted in two intervention and two control villages in rural Southern Malawi. The aim was to enhance the content and bioavailability of micronutrients in maize-based diets of stunted children ages 30-90 mo. Efficacy was evaluated through a comparison of the changes in knowledge and practices, anthropometry, malaria screening, hemoglobin and hair zinc after 12 mo, common infections monthly postintervention and nutrient adequacy postintervention via 24-h recalls. Intervention diets were more diverse and of higher quality than the control diets, supplying significantly more animal source foods, especially soft-boned fish, but less phytic acid (p < 0.01). Median intakes of energy, protein, calcium, available zinc, heme iron and vitamin B-12 were greater (p < 0.05) in intervention compared to the control groups; some spread of knowledge and practices to the control groups occurred. Intervention enhanced Z-scores for mid-upper-arm circumference and arm muscle area (p < 0.001), but had no impact on weight or height gain. After controlling for baseline variables, mean hemoglobin was higher (107 vs. 102 g/L; p < 0.01) postintervention, whereas incidence of anemia and common infections were lower in the intervention groups compared to the control groups, with no change in malaria or hair zinc status. Dietary strategies reduced the prevalence of inadequate intakes of protein, calcium, zinc and vitamin B-12, but not iron, because fish was the major source of animal food consumed. More efforts to raise small animals and promote their consumption are needed to enhance dietary quality and ensure optimal growth, health and cognitive development in young Malawian children.

Animals↗
PubMed1991

Reexamination of relationships between students' undergraduate majors, medical school performances, and career plans at Jefferson Medical College.

A reexamination of the possible relationships between medical students' undergraduate academic majors and their medical school performances and career plans seems appropriate, given the continuing changes in the characteristics of the medical school applicant pool in the last several years. This study investigated these relationships by comparing cognitive and noncognitive characteristics of medical students who had had different undergraduate majors. The study sample consisted of 812 students who entered Jefferson Medical College between 1985 and 1988. They were classified into six categories based on their undergraduate majors: biological, chemical and physical, social and behavioral, other sciences, humanities and arts, and indeterminate majors. Results indicated that performances in the basic science component of medical education were about the same for students with different undergraduate majors. The groups had similar rates of delayed graduation, but the attrition rate was highest for students who had majored in humanities and arts. The students in undergraduate disciplines traditionally oriented toward medicine (biological, physical, and chemical sciences) were younger and had made the decision to become a physician at earlier ages than had their counterparts with undergraduate majors in social sciences and humanities. Also, the groups differed with regard to their estimates of their future incomes and plans for professional activities after graduation. Similarities concerning the students' preferred professional activities were also noticed among the groups.

Career Choice↗
PubMed1995

What makes a tutor effective? A structural-equations modeling approach to learning in problem-based curricula.

PURPOSE: To test and further develop a causal model of the influence of tutor behaviors on student achievement and interest in the context of problem-based learning. METHOD: Data from 524 tutorial groups involving students participating in the four-year undergraduate health sciences curriculum at the University of Limburg in 1992-93 were analyzed. The tutorial groups were guided by 261 tutors. Overall, 3,792 data records were studied, with each student participating in an average of 2.3 groups. Correlations among tutors' social-congruence, expertise-use, and cognitive-congruence behaviors, small-group functioning, and student' self-study time, intrinsic interest in subject matter, and level of achievement were analyzed using structural-equations modeling. This statistical technique allows the investigator to test causal hypotheses on correlational data by comparing the structure of data with a theoretical model. RESULTS: After minor adaptations, the hypothesized causal model of the effective tutor fitted the data extremely will. Each tutor's level of expertise use and social congruence not only directly affected his or her level of cognitive congruence but also affected other elements of the model. Level of social congruence influenced group functioning in a direct fashion, while expertise use had a slightly negative effect on the students' level of self-study time and a slightly positive effect on level of achievement. As hypothesized, the level of cognitive congruence influenced tutorial-group functioning. Level of group functioning affected self-study time and intrinsic interest. Finally, time spent on self-study influenced level of achievement. CONCLUSION: The results suggest that subject-matter expertise; a commitment to students' learning and their lives in a personal, authentic way; and the ability to express oneself in the language used by the student are all determinants of learning in problem-based curricula. The theory of the effective tutor, presented in this article, merges two different perspectives prevalent in the literature. One perspective emphasizes the personal qualities of the tutor: his or her ability to communicate with students in an informal way, coupled with an empathic attitude that enables the tutor to encourage student learning by creating an atmosphere in which open exchange of ideas is facilitated. The other stresses the tutor's subject-matter knowledge as a determinant of learning. The data presented in this article suggest that what is needed, really, is much of both.

Achievement↗
PubMed2004

Taking the social origins of human nature seriously: toward a more imperialist social psychology.

To recognize that human beings are adapted for social living is fundamental to the science of human psychology. I argue that the development of broad social psychological theory would benefit from taking this basic premise more seriously. We need to pay more attention to the implications for personality and social psychology of recognizing that all of the building blocks of human psychology--cognition, emotion, motivation--have been shaped by the demands of social interdependence. In this article I illustrate the generative potential of this basic premise for development of more expansive social theory.

Adaptation, Psychological↗
PubMed1990

The prognosis of depression in the elderly.

Controversy prompted a systematic and critical review of original research articles to determine the prognosis of depression in the elderly. A search of three computer databases for articles published from January 1980 to May 1989 and of the bibliographies of articles located revealed 10 reports, involving 990 subjects, that met the following inclusion criteria: original research, published in English or French since 1950, sample of at least 25 patients, inclusion of only patients over 60 years, mean follow-up period of 1 year or more and description of the patients' mental state during follow-up. The methods and study designs were then assessed with the use of the criteria for prognostic studies established by McMaster University Health Sciences Centre, Hamilton, Ont. All of the studies had serious, multiple flaws. Nevertheless, when the results were combined it appeared that at least 60% of the patients remained well or had relapses with recovery (mean follow-up 31.9 months); up to 25% remained continuously ill. Physical illness, cognitive impairment and severe depressive symptoms were frequently related to poor prognosis; most of the social factors studied were not related to prognosis. Future studies must pay attention to methods and design, particularly the composition of study populations, the assessment of outcomes and the control of extraneous prognostic factors.

Aged↗
PubMed2006

Implementation science: a role for parallel dual processing models of reasoning?

BACKGROUND: A better theoretical base for understanding professional behaviour change is needed to support evidence-based changes in medical practice. Traditionally strategies to encourage changes in clinical practices have been guided empirically, without explicit consideration of underlying theoretical rationales for such strategies. This paper considers a theoretical framework for reasoning from within psychology for identifying individual differences in cognitive processing between doctors that could moderate the decision to incorporate new evidence into their clinical decision-making. DISCUSSION: Parallel dual processing models of reasoning posit two cognitive modes of information processing that are in constant operation as humans reason. One mode has been described as experiential, fast and heuristic; the other as rational, conscious and rule based. Within such models, the uptake of new research evidence can be represented by the latter mode; it is reflective, explicit and intentional. On the other hand, well practiced clinical judgments can be positioned in the experiential mode, being automatic, reflexive and swift. Research suggests that individual differences between people in both cognitive capacity (e.g., intelligence) and cognitive processing (e.g., thinking styles) influence how both reasoning modes interact. This being so, it is proposed that these same differences between doctors may moderate the uptake of new research evidence. Such dispositional characteristics have largely been ignored in research investigating effective strategies in implementing research evidence. Whilst medical decision-making occurs in a complex social environment with multiple influences and decision makers, it remains true that an individual doctor's judgment still retains a key position in terms of diagnostic and treatment decisions for individual patients. This paper argues therefore, that individual differences between doctors in terms of reasoning are important considerations in any discussion relating to changing clinical practice. SUMMARY: It is imperative that change strategies in healthcare consider relevant theoretical frameworks from other disciplines such as psychology. Generic dual processing models of reasoning are proposed as potentially useful in identifying factors within doctors that may moderate their individual uptake of evidence into clinical decision-making. Such factors can then inform strategies to change practice.

Journal Article↗
PubMed2006

Translational and developmental perspective on N-methyl-D-aspartate synaptic deficits in schizophrenia.

Schizophrenia has long been approached from a translational perspective; however, new findings from the past decade have radically affected the dominant accounts of this illness. It is now possible to derive a consistent account of one contributing cause of schizophrenia across multiple levels of analysis, from genes to receptors, functional neuroanatomy, cognition, and symptoms. To this end, we summarize the data attributing the disorganization symptoms of schizophrenia to a failure of executive, prefrontal cortical processes. We describe the hypothesis that this failure reflects an impairment in N-methyl-D-aspartate (NMDA) glutamatergic neurotransmission, that is likely to involve both the dysregulated function of NMDA synapses, as well as the physical loss of NMDA synapses, particularly in prefrontal cortex. Dysregulation in NMDA synaptic function can be in turn attributed to polymorphisms in a variety of genes (regulator of G-protein signaling 4, dystrobrevin binding protein I, neuregulin-1, D-amino acid oxidase activator, and others) that have been linked to schizophrenia and are likely to impact NMDA-mediated synaptic neuroplasticity. Although the science of schizophrenia is not yet at a point where any domain or set of findings provides strong constraints across other levels of analysis, the further development of evidence for this chain of causation can provide increasingly strong tests of the NMDA synapse deficit theory.

Carrier Proteins↗
PubMed1998

Handedness and sex differences in intelligence: evidence from the medical college admission test.

Our analysis of Medical College Admission Test subtest scores by writing hand preference and sex suggests that (a) right hemispheric dominance is associated with intellectual giftedness in verbal reasoning (left-handers obtained higher scores on the verbal reasoning test and were overrepresented in the upper tail of the distribution), (b) different patterns of brain lateralization are associated with different subcomponents of cognition (right-handers scored higher, on average, on the writing test and were overrepresented in the upper tail of the distribution), and (c) men generally score higher than women on tests of scientific knowledge (the most striking differences between men and women were on the biological and physical science tests).

Adult↗
PubMed2003

Common method biases in behavioral research: a critical review of the literature and recommended remedies.

Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.

Behavior↗
PubMed2003

Causal inference in lead research: introduction to the special section on the neurobehavioral effects of environmental lead.

This Special Section on the Neurobehavioral Effects of Environmental Lead includes empirical reports from three major longitudinal prospective studies and a review of animal research modeling effects of lead on human cognition. This Introductory article addresses a fundamental controversy in lead and other epidemiologic research. It is argued that, contrary to conventional wisdom, valid causal inferences can be made from correlational research. Justification for this is to be found in contemporary frameworks drawn from the field of the philosophy of science; an essential, but often neglected perspective for such metatheoretical issues as causal inference. It is concluded that the nonexperimental methods described in the articles comprising this Special Section can, indeed, contribute to causal formulations of lead effects on human development, and that such inferences are not exclusive to experimental evidence.

Causality↗
PubMed2006

Diagnosis and treatment of Parkinson disease: molecules to medicine.

Parkinson disease (PD) is a relatively common disorder of the nervous system that afflicts patients later in life with tremor, slowness of movement, gait instability, and rigidity. Treatment of these cardinal features of the disease is a success story of modern science and medicine, as a great deal of disability can be alleviated through the pharmacological correction of brain dopamine deficiency. Unfortunately these therapies only provide temporary, though significant, relief from early symptoms and do not halt disease progression. In addition, pathological changes outside of the motor system leading to cognitive, autonomic, and psychiatric symptoms are not sufficiently treated by current therapies. Much as the discovery of dopamine deficiency led to powerful treatments for motor symptoms, recent discoveries concerning the role of specific genes in PD pathology will lead to the next revolution in disease therapy. Understanding why and how susceptible cells in motor and nonmotor regions of the brain die in PD is the first step toward preventing this cell death and curing or slowing the disease. In this review we discuss recent discoveries in the fields of diagnosis and treatment of PD and focus on how a better understanding of disease mechanisms gained through the study of monogenetic forms of PD has provided novel therapeutic targets.

Disease Progression↗
PubMed1994

Neurologic health outcomes and Agent Orange: Institute of Medicine report.

The National Academy of Sciences' Institute of Medicine conducted an independent scientific investigation to evaluate the strength of evidence for human health effects among veterans exposed to herbicides used in Vietnam and to suggest future research recommendations. Neurologic domains where multiple studies had been performed in military, occupational, or environmental situations were (1) cognitive and neuropsychiatric effects, (2) motor/coordination dysfunction and other central nervous system disorders, and (3) peripheral neuropathy. In all categories, no strong evidence established an association between herbicides used in Vietnam and clinical neurologic disorders. Methodologic weaknesses, long durations between exposure and assessments, and poor exposure measures limited many studies. The committee concluded that the available evidence was insufficient to determine an association between neurologic disorders and exposure to herbicides used in Vietnam. Neurotoxicologic studies available did not suggest strong biological plausibility for neurologic alterations related to herbicide exposure. Furthermore, given the large uncertainties in the epidemiologic studies reviewed and inadequate control for important confounders, the committee could not quantify a degree of risk for neurologic disorders from herbicide exposure likely to be experienced by Vietnam veterans. Although not part of the neurologic report, the risk of brain tumors was considered in the cancer analysis, and the committee concluded that there is limited/suggestive evidence of no association between exposure to herbicides and brain tumors.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMedDate not supplied

The treatment of eating disorders as addiction among adolescent females.

As science and medicine enter the new millennium, the influences of genetics and neurochemistry as high-risk determinants in the etiology and development of eating disorders are increasingly manifest in professional literature. Eating disorders are now recognized as major medical and psychiatric problems affecting millions throughout the world. Psychoeducational, cognitive, behavioral, and psychopharmacologic treatments form the basis of most interventions which, for the most part, tend to view the eating disorder as a symptom of underlying psychopathology. The Israel Counseling and Treatment Center of the North has been treating eating disorders as addictive disease by applying the twelve step program of the Anonymous Fellowships as an adjunct to counseling and treatment for those who suffer from compulsive overeating and bulimia. Following the ongoing program of interventions with adults, a counseling group for adolescent females was co-facilitated under the supervision of the author. A co-therapist, in recovery from bulimia and comulsive overeating, uses the twelve step philosophy and served as a role model in this group intervention. Another sample of adolescent females was offered individual counseling adhering to the same addiction treatment approach. Success rates were operationally defined and measured by weight loss in the obese population and the cessation of purging behaviors among bulimic subjects for a six-month period. The two adolescent treatment samples had success rates of 62% and 33% respectively. A higher success rate of 71% was observed with adult bulimic females who participated in group counseling. A mean weight loss of 3.9 kg for the small sample of adolescents and a 9.7 kg. mean weight loss for obese adults in treatment was reported. The theoretical basis of the addiction treatment paradigm for eating disorders is presented. Results and problems encountered specific to treating the adolescent population are discussed.

Adolescent↗
PubMedDate not supplied

Evidence and mechanisms of retrogenesis in Alzheimer's and other dementias: management and treatment import.

Retrogenesis is the process by which degenerative mechanisms reverse the order of acquisition in normal development. Alzheimer's disease (AD) and related conditions in the senium have long been noted to resemble "a return to childhood" Previously, we noted that the functional stages of AD precisely and remarkably recapitulated the acquisition of the same functional landmarks in normal human development. Subsequent work indicated that this developmental recapitulation also applied to the cognitive and related symptoms in AD. Remarkably, further investigations revealed that the same neurologic "infantile" reflexes, which mark the emergence from infancy in normal development, are equally robust indicators of corresponding stages in AD. Neuropathologic and biomolecular mechanisms for these retrogenic processes are now evident. For example, the pattern of myelin loss in AD appears to mirror the pattern of myelin acquisition in normal development. Also, recent findings indicate that mitogenic factors become reactivated in AD, and, consequently, the most actively "growing" brain regions are the most vulnerable. Because of this robust retrogenic process, the stages of AD can be translated into corresponding developmental ages (DAs). These DAs can account for the overall management and care needs of AD patients. A science of AD management can be formulated on the basis of the DA of the Alzheimer's patient, taking into consideration differences of AD from normal development as well as homologies.

Adolescent↗
PubMed2006

Emotion in short-term psychotherapy: an introduction.

Our understanding of the importance of emotion in psychopathology, personality, and psychotherapy has been rapidly advancing. New findings from neuroscience support the centrality of emotion as a convergent force in shaping individuals and relationships. Emotion-focused short-term psychotherapy capitalizes on the power of emotion to accelerate the course of treatment. This article provides a brief historical background on the development of affective science, offers some ways in which emotion can enhance clinical utility, and introduces the Journal of Clinical Psychology: In Session issue devoted to emotion-focused, short-term psychotherapy.

Cognition↗
PubMed1990

The role of advanced technology in inpatient child psychiatry: leading edge or useful aid?

New technology has played a catalytic role in advancing understanding of etiology, diagnosis, and treatment in virtually all fields of medicine. Child psychiatry, a relatively new medical specialty, has begun to employ such advanced technology in diagnosis and treatment monitoring. This current study demonstrates that, in an inpatient child psychiatric setting, such advanced technology has a positive diagnostic yield of 5% for new medical diagnoses and a cost of about 0.5% of the hospital bed cost. Other tests, such as psychotropic blood level monitoring and psychometric evaluation of cognitive functioning, have a much higher yield.

Adolescent↗
PubMed2000

Cognitive behaviour therapy for adults with chronic fatigue syndrome.

OBJECTIVES: 1. To systematically review all randomised controlled trials of cognitive-behaviour therapy (CBT) for adults with chronic fatigue syndrome (CFS); 2. To test the hypothesis that CBT is more effective than orthodox medical management or other interventions in adults with CFS. SEARCH STRATEGY: 1. Electronic searching of bibliographic databases, including Medline, PsycLIT, Biological Abstracts, Embase, SIGLE, Index to Theses, Index to Scientific and Technical Proceedings, and Science Citation Index, using multiple search terms in order to perform a highly sensitive search. 2. Electronic searching of the Trials Register of the Depression, Anxiety and Neurosis group. 3. Citation lists of relevant studies and reviews were perused for other relevant trials. 4. Contact with the principal authors of relevant studies, and with researchers in the field. SELECTION CRITERIA: All randomised controlled trials were included in which - adult patients with CFS; - received CBT or a control intervention, being either orthodox medical management or another intervention; - and whose outcomes were assessed in an appropriate way. CBT could be either type 'A' (encouraging return to 'normal' levels of rest and activity) or type 'B' (encouraging rest and activity which were within levels imposed by the disorder). DATA COLLECTION AND ANALYSIS: The two reviewers worked independently throughout the selection of trials and data extraction, comparing findings only when there was disagreement. Relevant trials were allocated to one of three quality categories. Full data extraction, using a standardised data extraction sheet, was performed on studies which were of high or moderate quality. Trials of low quality were excluded from the review. The comparisons made to test the review hypothesis were of type 'A' CBT versus other intervention(s), and of type 'B' CBT versus other intervention(s). Functional outcome was used as the main outcome for comparison, but other appropriate outcomes were compared where possible. Results were synthesised using the Review Manager software. For dichotomous data, the odds ratio was calculated for each study. For continuous data, effect sizes were obtained and the standardised mean difference, with 95% confidence intervals, was calculated. MAIN RESULTS: Only three relevant trials of adequate quality were found. These trials demonstrated that CBT significantly benefits physical functioning in adult out-patients with CFS when compared to orthodox medical management or relaxation. It is necessary to treat about two patients to prevent one additional unsatisfactory physical outcome about six months after treatment end. CBT appeared highly acceptable to the patients in these trials. There is no satisfactory evidence for the effectiveness of CBT in patients with the milder forms of CFS found in primary care or in patients who are so disabled that they are unable to attend out-patients. Additionally, there is no satisfactory evidence for the effectiveness of group CBT. REVIEWER'S CONCLUSIONS: Cognitive behaviour therapy appears to be an effective and acceptable treatment for adult out-patients with chronic fatigue syndrome. CFS is a common and disabling disorder. Its sufferers deserve the medical profession to be more aware of the potential of this therapy to bring lasting functional benefit, and health service managers to increase its availability. Further research is needed in this important area. Trials should conform to accepted standards of reporting and methodology. The effectiveness of CBT in more and less severely disabled patients than those usually seen in out-patient clinics needs to be assessed. Trials of group CBT and in-patient CBT compared to orthodox medical management, and of CBT compared to graded activity alone, also need to be conducted.

Adult↗