Studies in the West have shown lower cardiovascular disease (CVD) risk among people taking a vegetarian diet, but these findings may be confounded and only a minority selects these diets. We ...evaluated the association between vegetarian diets (chosen by 35%) and CVD risk factors across four regions of India.
Study participants included urban migrants, their rural siblings and urban residents, of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore (n = 6555, mean age-40.9 yrs). Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical history, medical history, as well as blood pressure, fasting blood and anthropometric measurements were collected. Vegetarians ate no eggs, fish, poultry or meat. Using robust standard error multivariate linear regression models, we investigated the association of vegetarian diets with blood cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, fasting blood glucose (FBG), systolic (SBP) and diastolic blood pressure (DBP).
Vegetarians (32.8% of the study population) did not differ from non-vegetarians with respect to age, use of smokeless tobacco, body mass index, and prevalence of diabetes or hypertension. Vegetarians had a higher standard of living and were less likely to smoke, drink alcohol (p<0.0001) and were less physically active (p = 0.04). In multivariate analysis, vegetarians had lower levels of total cholesterol (β = -0.1 mmol/L (95% CI: -0.03 to -0.2), p = 0.006), triglycerides (β = -0.05 mmol/L (95% CI: -0.007 to -0.01), p = 0.02), LDL (β = -0.06 mmol/L (95% CI: -0.005 to -0.1), p = 0.03) and lower DBP (β = -0.7 mmHg (95% CI: -1.2 to -0.07), p = 0.02). Vegetarians also had decreases in SBP (β = -0.9 mmHg (95% CI: -1.9 to 0.08), p = 0.07) and FBG level (β = -0.07 mmol/L (95% CI: -0.2 to 0.01), p = 0.09) when compared to non-vegetarians.
We found beneficial association of vegetarian diet with cardiovascular risk factors compared to non-vegetarian diet.
Background: Local grants programs are important since funding for medical education research is limited. Understanding which factors predict successful outcomes is highly relevant to administrators. ...The purpose of this project was to identify factors that contribute to the publication of local medical education grants in a Canadian context.
Methods: Surveys were distributed to previous Department of Innovation in Medical Education (DIME) and Department of Medicine (DOM) grant recipients (n = 115) to gather information pertaining to PI demographics and research outcomes. A backward logistic regression was used to determine the effects several variables on publication success.
Results: The overall publication rate was 64/115 (56%). Due to missing data, 91 grants were included in the logistic regression. Variables associated with a higher rate of publication; cross departmental compared to single department OR = 2.82 (p = 0.04), being presented OR = 3.30 (p = 0.01), and multiple grant acquisition OR = 3.85 (p = 0.005)
Conclusion: Although preliminary, our data suggest that increasing research publications from local grants may be facilitated by pooling funds across departments, making research presentations mandatory, and allowing successful researchers to re-apply.
Evidence from India, a country with unique and distinct food intake patterns often characterized by lifelong adherence, may offer important insight into the role of diet in breast cancer etiology. We ...evaluated the association between Indian dietary patterns and breast cancer risk in a multi-centre case-control study conducted in the North Indian states of Punjab and Haryana. Eligible cases were women 30⁻69 years of age, with newly diagnosed, biopsy-confirmed breast cancer recruited from hospitals or population-based cancer registries. Controls (hospital- or population-based) were frequency matched to the cases on age and region (Punjab or Haryana). Information about diet, lifestyle, reproductive and socio-demographic factors was collected using a structured interviewer-administered questionnaire. All participants were characterized as non-vegetarians, lacto-vegetarians (those who consumed no animal products except dairy) or lacto-ovo-vegetarians (persons whose diet also included eggs). The study population included 400 breast cancer cases and 354 controls. Most (62%) were lacto-ovo-vegetarians. Breast cancer risk was lower in lacto-ovo-vegetarians compared to both non-vegetarians and lacto-vegetarians with odds ratios (95% confidence intervals) of 0.6 (0.3⁻0.9) and 0.4 (0.3⁻0.7), respectively. The unexpected difference between lacto-ovo-vegetarian and lacto-vegetarian dietary patterns could be due to egg-consumption patterns which requires confirmation and further investigation.
Studies in the West have shown lower cardiovascular disease (CVD) risk among people taking a vegetarian diet, but these findings may be confounded and only a minority selects these diets. We ...evaluated the association between vegetarian diets (chosen by 35%) and CVD risk factors across four regions of India. Study participants included urban migrants, their rural siblings and urban residents, of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore (n = 6555, mean age-40.9 yrs). Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical history, medical history, as well as blood pressure, fasting blood and anthropometric measurements were collected. Vegetarians ate no eggs, fish, poultry or meat. Using robust standard error multivariate linear regression models, we investigated the association of vegetarian diets with blood cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, fasting blood glucose (FBG), systolic (SBP) and diastolic blood pressure (DBP). Vegetarians (32.8% of the study population) did not differ from non-vegetarians with respect to age, use of smokeless tobacco, body mass index, and prevalence of diabetes or hypertension. Vegetarians had a higher standard of living and were less likely to smoke, drink alcohol (p<0.0001) and were less physically active (p = 0.04). In multivariate analysis, vegetarians had lower levels of total cholesterol (beta = -0.1 mmol/L (95% CI: -0.03 to -0.2), p = 0.006), triglycerides (beta = -0.05 mmol/L (95% CI: -0.007 to -0.01), p = 0.02), LDL (beta = -0.06 mmol/L (95% CI: -0.005 to -0.1), p = 0.03) and lower DBP (beta = -0.7 mmHg (95% CI: -1.2 to -0.07), p = 0.02). Vegetarians also had decreases in SBP (beta = -0.9 mmHg (95% CI: -1.9 to 0.08), p = 0.07) and FBG level (beta = -0.07 mmol/L (95% CI: -0.2 to 0.01), p = 0.09) when compared to non-vegetarians. We found beneficial association of vegetarian diet with cardiovascular risk factors compared to non-vegetarian diet.
The purpose of this qualitative single case study was to explore preservice teachers' experiences, uses, and applications of videotaped lesson reflections during their practicum in the teacher ...preparation program (TPP) at one university in West Virginia. The theoretical framework encompassed Dewey's definition of reflection and Schon's concept of reflection-on-action. Homogeneous purposeful sampling was used. Data sources included participating preservice teachers' first written reflective narratives based on their videotaped lessons, face-to-face interviews, and second written reflective narratives. Data were analyzed with the four-step method for thematic analysis set forth by Harding. Five themes emerged from the data including: function, realization, reaction, lesson components, and logistics. Findings revealed that the participants viewed the videotaped lesson reflections as a tool that allowed them to remember their lessons and see themselves from a new perspective; as their students or an observer do. Through their reflections, participants uncovered several realizations about their students and themselves, both mental and physical. Several lesson components were considered: lesson planning, lesson delivery, classroom management, and assessment. The videotaped lesson reflections allowed participants to gauge the effectiveness of their teaching. Participants thought the videotaped lesson reflections helped them learn about their teaching, improve upon their practice, and grow as educators by making changes informed by their reflections. Theoretical implications, practical implications, and future implications have been included, as well as recommendations for future research and future practice. The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.
We conducted a case-control study to evaluate the association between PSA screening and prostate cancer mortality among 594 male members of Kaiser Permanente of Northern California. Cases were ...comprised of 297 men aged 50–84 years who died as a result of prostate cancer between 1995–1997 and controls included 297 men who were alive and free of prostate cancer at the time of the matched case's diagnosis. Controls were individually matched on year of birth, facility and length of membership. Medical charts were abstracted to collect information on screening and follow-up testing over the 10-year reference period leading up to the case's diagnosis (and the corresponding time period in matched controls). To distinguish between screening tests and diagnostic tests, an algorithm was developed, and all tests were classified as probable, possible, unlikely and non-screens. Our results revealed a higher proportion of PSA “screening” in cases relative to controls. This anomalous result—which would suggest that screening could increase mortality from prostate cancer—could be the result of bias to the concurrent use of a more widely used screening test, the DRE. This can result in misclassification of PSA's that were ordered in response to a suspicious DRE but mislabeled as “screens” because information on suspicious signs or symptoms was not recorded by the clinician. Nonetheless, using the most stringent criteria possible for screening, we still obtained an adjusted odds ratio greater than one associated with PSA. Another explanation is the rise in the occurrence of PSA testing over time in the population, which differentially increases screening in cases relative to controls. This serves to artificially inflate the odds ratio and underestimate the potential benefit associated with screening. Simulation models were used to assess the possible distortion due to increasing screening rates. The methodological considerations discussed in this paper are relevant for case-control studies of screening efficacy, especially those evaluating screening tests newly introduced into a population.
Previous efforts to report estimates of cancer incidence and mortality in India and its different parts include the National Cancer Registry Programme Reports, Sample Registration System cause of ...death findings, Cancer Incidence in Five Continents Series, and GLOBOCAN. We present a comprehensive picture of the patterns and time trends of the burden of total cancer and specific cancer types in each state of India estimated as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 because such a systematic compilation is not readily available.
We used all accessible data from multiple sources, including 42 population-based cancer registries and the nationwide Sample Registration System of India, to estimate the incidence of 28 types of cancer in every state of India from 1990 to 2016 and the deaths and disability-adjusted life-years (DALYs) caused by them, as part of GBD 2016. We present incidence, DALYs, and death rates for all cancers together, and the trends of all types of cancers, highlighting the heterogeneity in the burden of specific types of cancers across the states of India. We also present the contribution of major risk factors to cancer DALYs in India.
8·3% (95% uncertainty interval UI 7·9–8·6) of the total deaths and 5·0% (4·6–5·5) of the total DALYs in India in 2016 were due to cancer, which was double the contribution of cancer in 1990. However, the age-standardised incidence rate of cancer did not change substantially during this period. The age-standardised cancer DALY rate had a 2·6 times variation across the states of India in 2016. The ten cancers responsible for the highest proportion of cancer DALYs in India in 2016 were stomach (9·0% of the total cancer DALYs), breast (8·2%), lung (7·5%), lip and oral cavity (7·2%), pharynx other than nasopharynx (6·8%), colon and rectum (5·8%), leukaemia (5·2%), cervical (5·2%), oesophageal (4·3%), and brain and nervous system (3·5%) cancer. Among these cancers, the age-standardised incidence rate of breast cancer increased significantly by 40·7% (95% UI 7·0–85·6) from 1990 to 2016, whereas it decreased for stomach (39·7%; 34·3–44·0), lip and oral cavity (6·4%; 0·4–18·6), cervical (39·7%; 26·5–57·3), and oesophageal cancer (31·2%; 27·9–34·9), and leukaemia (16·1%; 4·3–24·2). We found substantial inter-state heterogeneity in the age-standardised incidence rate of the different types of cancers in 2016, with a 3·3 times to 11·6 times variation for the four most frequent cancers (lip and oral, breast, lung, and stomach). Tobacco use was the leading risk factor for cancers in India to which the highest proportion (10·9%) of cancer DALYs could be attributed in 2016.
The substantial heterogeneity in the state-level incidence rate and health loss trends of the different types of cancer in India over this 26-year period should be taken into account to strengthen infrastructure and human resources for cancer prevention and control at both the national and state levels. These efforts should focus on the ten cancers contributing the highest DALYs in India, including cancers of the stomach, lung, pharynx other than nasopharynx, colon and rectum, leukaemia, oesophageal, and brain and nervous system, in addition to breast, lip and oral cavity, and cervical cancer, which are currently the focus of screening and early detection programmes.
Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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