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[Attitude of general practitioners to the importance of gender and diet in disease prevention]

https://arctichealth.org/en/permalink/ahliterature10741
Source
Ugeskr Laeger. 1999 Jan 4;161(1):40-3
Publication Type
Article
Date
Jan-4-1999
Author
U. Hølund
G. Boysen
P. Charles
E F Eriksen
O K Overvad
B H Petersson
B. Sandström
A R Thomassen
M A Vittrup
Author Affiliation
Mejeriernes Ernaeringscenter, Arhus.
Source
Ugeskr Laeger. 1999 Jan 4;161(1):40-3
Date
Jan-4-1999
Language
Danish
Publication Type
Article
Keywords
Attitude of Health Personnel
Denmark
Dietary Services
English Abstract
Female
Food Habits
Health Behavior
Humans
Life Style
Male
Physicians, Family - psychology
Preventive Health Services - economics - organization & administration - standards
Primary Prevention
Questionnaires
Sex Factors
Abstract
Three hundred and seventy-four general practitioners (GPs) in Denmark filled in a questionnaire on attitudes to include information on gender and diet in the strategy for prevention of coronary heart disease, cancer, osteoporosis, and overweight/underweight. Risk factors for disease in general were ranked as follows: smoking, alcohol, stress, diet, physical exercise, heredity and hygiene. The patients' lack of motivation, insufficient time for each patient, and inadequate knowledge about nutrition were stated as barriers to dietary counselling. The GPs stated that the gender of the patient was important only to the counselling on osteoporosis. Lack of time and insufficient knowledge were perceived as barriers for including gender specific issues in prevention. It is concluded that GPs consider dietary counselling important but lack time and knowledge. The results point at a need for better pre- and postgraduate training in nutrition, and for a better reimbursement system for time spent on prevention.
PubMed ID
9922687 View in PubMed
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Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited.

https://arctichealth.org/en/permalink/ahliterature61816
Source
J Intern Med. 2000 Feb;247(2):260-8
Publication Type
Article
Date
Feb-2000
Author
H. Glerup
K. Mikkelsen
L. Poulsen
E. Hass
S. Overbeck
J. Thomsen
P. Charles
E F Eriksen
Author Affiliation
Department of Endocrinology, Aarhus Amtssygehus, University Hospital of Aarhus, Aarhus, Denmark. h.glerup@dadlnet.dk
Source
J Intern Med. 2000 Feb;247(2):260-8
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Adult
Alkaline Phosphatase - blood
Arabs
Calcium - blood - urine
Case-Control Studies
Clothing - adverse effects
Creatinine - blood
Cross-Sectional Studies
Denmark - ethnology
Female
Food Habits
Humans
Hydroxyproline - urine
Hyperparathyroidism, Secondary - blood - diagnosis
Magnesium - blood
Nutrition Policy
Parathyroid Hormone - blood
Phosphates - blood
Sunlight
Ultraviolet Rays
Vitamin D - administration & dosage - analogs & derivatives - blood
Vitamin D Deficiency - blood - etiology
Abstract
OBJECTIVES: Sunlight exposure of the skin is known to be the most important source of vitamin D. The aims of this study were: (i) to estimate vitamin D status amongst sunlight-deprived individuals (veiled Arab women, veiled ethnic Danish Moslem women and Danish controls); and (ii) through food intake analysis to estimate the oral intake of vitamin D necessary to keep a normal vitamin D status in sunlight-deprived individuals. DESIGN: Cross-sectional study amongst randomly selected Moslem women of Arab origin living in Denmark. Age-matched Danish women were included as controls. To control for racial differences, a group of veiled ethnic Danish Moslem women (all Caucasians) was included. SETTING: Primary Health Care Centre, City Vest and Department of Endocrinology and Metabolism C, University Hospital of Aarhus, Aarhus Amtssygehus, Aarhus, Denmark. SUBJECTS: Sixty-nine Arab women (60 veiled, nine non-veiled) and 44 age-matched Danish controls were randomly selected amongst patients contacting the primary health care centre for reasons other than vitamin D deficiency. Ten ethnic Danish Moslem women were included through a direct contact with their community. MAIN OUTCOME MEASURES: Serum levels of 25-hydroxyvitamin D were used as estimates of vitamin D status. Intact parathyroid hormone (PTH) was used to control for secondary hyperparathyroidism. Alkaline phosphatase and bone-specific alkaline phosphatase were used as markers for osteomalacic bone involvement. Oral intake of vitamin D and calcium were estimated through a historical food intake interview performed by a trained clinical dietician. RESULTS: Veiled Arab women displayed extremely low values of 25-hydroxyvitamin D: 7.1 +/- 1.1 nmol L-1, compared with 17.5 +/- 2. 3 (P
PubMed ID
10692090 View in PubMed
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The Danish Osteoporosis Prevention Study (DOPS): project design and inclusion of 2000 normal perimenopausal women.

https://arctichealth.org/en/permalink/ahliterature202067
Source
Maturitas. 1999 Mar 15;31(3):207-19
Publication Type
Article
Date
Mar-15-1999
Author
L. Mosekilde
A P Hermann
H. Beck-Nielsen
P. Charles
S P Nielsen
O H Sørensen
Author Affiliation
University Department of Endocrinology and Metabolism, Aarhus Amtssygehus, Denmark.
Source
Maturitas. 1999 Mar 15;31(3):207-19
Date
Mar-15-1999
Language
English
Publication Type
Article
Keywords
Body Composition
Bone Density
Denmark - epidemiology
Female
Follow-Up Studies
Fractures, Spontaneous - epidemiology - prevention & control
Hormone Replacement Therapy
Humans
Middle Aged
Osteoporosis, Postmenopausal - complications - epidemiology - prevention & control
Premenopause
Research Design
Risk factors
Time Factors
Abstract
In 1990 we initiated a 20 year, partly randomised study (Danish Osteoporosis Prevention Study, DOPS) in order to (a) evaluate clinical, biochemical and osteodensitometric variables as predictors of low bone mass and future osteoporotic fractures, and (b) test the hypothesis, that hormone replacement therapy (HRT) initiated shortly after menopause reduces the risk of later osteoporotic fractures. This report describes study design and baseline characteristics of the DOPS-cohort.
The study design is pragmatic, attempting to mimic the normal clinical situation. Several HRT alternatives are available according to clinical need. It was considered futile, impractical and unethical to use placebo for 20 years. Instead the study focus on hard endpoints (fractures) confirmed by independent persons (peripheral fractures) or by methods which allow investigator blinding (spinal X-rays). Statistical evaluation will focus on intention to treat analyses evaluating the decision of HRT and it's feasibility. With a compliance of 60% we will have sufficient statistical power (88%) to detect a fracture reduction of 40% in the treatments group. Clinical risk factors, current daily intakes of macronutrients, vitamins and minerals, anthropometric variables, biochemical variables (including bone markers and 25-hydroxyvitamin D), regional bone mineral density (BMD) and total body composition were assessed in all participants at entry and at various follow up intervals.
2016 study participants were recruited by direct mailing to a random sample of 45-58 years old women. In the randomised arm 501 were allocated to HRT and 505 to no treatment. In the non-randomised arm 219 preferred HRT and 791 preferred no treatment. Post-randomisation analysis revealed a slight but significant difference in age (50.01 versus 50.44 years) but no difference in menopausal age, prevalence of hysterectomy, educational level, BMI, serum bone alkaline phosphatase, serum osteocalcin, urine hydroxyproline or serum 25-hydroxyvitamin D. In the non-randomised arm women preferring HRT were closer to menopause, had a higher prevalence of hysterectomy, were better educated, were leaner, and had lower bone turnover than the women, who refused HRT.
It is possible to include a sufficient number of perimenopausal women in a randomised 20 year study on the antifracture effect of HRT.
PubMed ID
10340280 View in PubMed
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A healing journey based on Yuuyaraq, the way of the human being through Ellum Iinga, the Eye of Awareness

https://arctichealth.org/en/permalink/ahliterature273799
Source
National Resource Center for American Indian, Alaska Native, and Native Hawaiian Elders
Date
Mar-2008
  1 document  
Author
Kanaqlak (George P. Charles)
Source
National Resource Center for American Indian, Alaska Native, and Native Hawaiian Elders
Date
Mar-2008
Language
English
Digital File Format
Text - PDF
Keywords
Eye of Awareness
Healing
Yup'ik values
Abstract
Mary Stachelrodt (younger sister of George P. Charles) developed the symbolic model of regaining Ellum Iinga (the Eye of Awareness) based on Yuuyaraq, The Way of the Human Being that is the central core for her work in alcohol and drug addiction in 1986. The central core of Yup'ik values are embedded within the circle with the four quadrants.
Documents

yr5_historical-trauma_3-08.pdf

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Hormone replacement therapy dissociates fat mass and bone mass, and tends to reduce weight gain in early postmenopausal women: a randomized controlled 5-year clinical trial of the Danish Osteoporosis Prevention Study.

https://arctichealth.org/en/permalink/ahliterature186795
Source
J Bone Miner Res. 2003 Feb;18(2):333-42
Publication Type
Article
Date
Feb-2003
Author
L B Jensen
P. Vestergaard
A P Hermann
J. Gram
P. Eiken
B. Abrahamsen
C. Brot
N. Kolthoff
O H Sørensen
H. Beck-Nielsen
S Pors Nielsen
P. Charles
L. Mosekilde
Author Affiliation
Department of Rheumatology, Amager Hospital, Copenhagen, Denmark.
Source
J Bone Miner Res. 2003 Feb;18(2):333-42
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Age Factors
Body Composition - drug effects
Body mass index
Body Weight - drug effects
Bone Density - drug effects
Bone and Bones - drug effects - pathology - physiology
Cohort Studies
Denmark
Estrogens - metabolism
Female
Hip - pathology
Hormone Replacement Therapy
Humans
Linear Models
Lumbar Vertebrae - pathology
Menopause
Middle Aged
Osteoporosis
Postmenopause
Time Factors
Abstract
The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design. A total of 2016 women ages 45-58 years from 3 months to 2 years past last menstrual bleeding were included. One thousand were randomly assigned to HRT or no HRT in an open trial, whereas the others were allocated according to their preferences. All were followed for 5 years for body weight, bone mass, and body composition measurements. Body weight increased less over the 5 years in women randomized to HRT (1.94 +/- 4.86 kg) than in women randomized to no HRT (2.57 +/- 4.63, p = 0.046). A similar pattern was seen in the group receiving HRT or not by their own choice. The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat. The main determinant of the weight gain was a decline in physical fitness. Women opting for HRT had a significantly lower body weight at inclusion than the other participants, but the results in the self-selected part of the study followed the pattern found in the randomized part. The change in fat mass was the strongest predictor of bone changes in untreated women, whereas the change in lean body mass was the strongest predictor when HRT was given. Body weight increases after the menopause. The gain in weight is related to a decrease in working capacity. HRT is associated with a smaller increase in fat mass after menopause. Fat gain protects against bone loss in untreated women but not in HRT-treated women. The data suggest that women's attitudes to HRT are more positive if they have low body weight, but there is no evidence that the conclusions in this study are skewed by selection bias.
PubMed ID
12568411 View in PubMed
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Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement.

https://arctichealth.org/en/permalink/ahliterature198521
Source
Calcif Tissue Int. 2000 Jun;66(6):419-24
Publication Type
Article
Date
Jun-2000
Author
H. Glerup
K. Mikkelsen
L. Poulsen
E. Hass
S. Overbeck
H. Andersen
P. Charles
E F Eriksen
Author Affiliation
Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, University Hospital of Aarhus, Tage Hansensgade 2, DK-8000 Aarhus C, Denmark.
Source
Calcif Tissue Int. 2000 Jun;66(6):419-24
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Alkaline Phosphatase - blood
Arabs
Cross-Sectional Studies
Denmark
Female
Humans
Male
Middle Aged
Muscle Contraction - drug effects
Muscle, Skeletal - drug effects - physiology
Muscular Diseases - blood - etiology
Osteomalacia - blood - complications - drug therapy
Time Factors
Vitamin D - blood - therapeutic use
Vitamin D Deficiency - blood - complications
Abstract
The aims of this study were to investigate myopathy in relation to vitamin D status, and to study the muscular effects of vitamin D treatment on vitamin D-deficient individuals. Further, hypovitaminosis D myopathy was investigated in relation to alkaline phosphatase (ALP), the most commonly used marker for hypovitaminosis D osteopathy. Eight patients with osteomalacia had an isokinetic dynamometer test of all major muscle groups before and after 3 months of vitamin D treatment. The most pronounced improvements in muscle power were seen in the weight-bearing antigravity muscles of the lower limbs. A cross-sectional study was performed among 55 vitamin D-deficient veiled Arab women living in Denmark and 22 Danish controls. An isometric dynamometer model was used for determination of quadriceps muscle power. Both maximal voluntary contraction (MVC) and electrically stimulated values (single twitch, maximal production rate (MPR), and maximal relaxation rate (MRR)) were determined. The women underwent high-dose vitamin D treatment and were retested after 3 and 6 months. Prior to vitamin D treatment all parameters of muscle function in the group of vitamin D-deficient Arab women were significantly reduced compared with Danish controls. MVC: 259.4 +/- 11.0 N (Newton) versus 392.6 +/- 11. 4 N (P
PubMed ID
10821877 View in PubMed
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Importance of diet and sex in prevention of coronary artery disease, cancer, osteoporosis, and overweight or underweight: a study of attitudes and practices of Danish primary care physicians.

https://arctichealth.org/en/permalink/ahliterature11048
Source
Am J Clin Nutr. 1997 Jun;65(6 Suppl):2004S-2006S
Publication Type
Article
Date
Jun-1997
Author
U. Hølund
A. Thomassen
G. Boysen
P. Charles
E F Eriksen
K. Overvad
B. Petersson
B. Sandström
M. Vittrup
Author Affiliation
Nutrition Department, Danish Dairy Board, Aarhus, Denmark.
Source
Am J Clin Nutr. 1997 Jun;65(6 Suppl):2004S-2006S
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Attitude of Health Personnel
Child
Child, Preschool
Comparative Study
Coronary Disease - prevention & control
Denmark
Diet
Family Practice
Female
Humans
Infant
Male
Middle Aged
Neoplasms - prevention & control
Obesity - prevention & control
Osteoporosis - prevention & control
Physician's Practice Patterns
Primary Health Care
Questionnaires
Risk factors
Sex Factors
Abstract
General practitioners (GPs) in Denmark (n = 374) answered a questionnaire on attitudes toward including information on diet and sex in the prevention of coronary artery disease, cancers, osteoporosis, and weight problems. Risk factors for disease were ranked as follows: smoking, alcohol, stress, diet, physical exercise, heredity, and hygiene. Patients' lack of motivation, insufficient time for each patient, and inadequate knowledge about nutrition were listed by GPs as barriers to dietary counseling. GPs stated that the sex of the patient was important only for counseling on osteoporosis. Lack of time and insufficient knowledge were perceived as barriers to including sex-specific issues in prevention. One-half of the GPs were questioned about the issue of prevention on the basis of female case stories and the other half on the basis of male case stories with identical wording. Responses to the case stories indicated that GPs would give dietary guidance and recommend loss of weight to slightly overweight male patients to a much greater degree than to overweight female patients for prevention of coronary artery disease, give dietary counseling and recommend loss of weight and exercise to female patients more than to male patients for prevention of cancers, recommend a supplement of calcium and vitamin D for prevention of osteoporosis to female patients, and recommend weight gain and discuss psychosocial issues more with underweight female patients than with underweight male patients. Female GPs included measures of prevention such as dietary counseling, exercise prescription, dietary supplement prescription, and discussion of psychosocial issues to a greater extent than did male GPs.
PubMed ID
9174510 View in PubMed
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Module based training improves and sustains surgical skills: a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature273399
Source
Hernia. 2015 Oct;19(5):755-63
Publication Type
Article
Date
Oct-2015
Author
C G Carlsen
K. Lindorff-Larsen
P. Funch-Jensen
L. Lund
L. Konge
P. Charles
Source
Hernia. 2015 Oct;19(5):755-63
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Curriculum
Denmark
Female
Hernia, Inguinal - surgery
Herniorrhaphy - education
Humans
Male
Models, Anatomic
Operative Time
Outcome Assessment (Health Care)
Abstract
Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills.
A randomised controlled trial concerning supervised hernia repair in eight training hospitals in Denmark was performed. The participants were 18 registrars [Post graduate year (PGY) 3 or more] in their first year of surgical specialist training. The intervention consisted of different modules with a skills-lab course followed by 20 supervised Lichtenstein hernia repairs. Operative performance was video recorded and blindly rated by two consultants using a previously validated skills rating scale (8-40 points). Outcome measures were change in the ratings of operative skills and operative time.
In the intervention group (n = 10) the average rating of operative skills before intervention was 22.5 (20.6-24.3) and after 26.2 (23.5-28.8), p = 0.044. At follow-up after 1 year, rating was 26.9 (23.4-30.4), p = 0.019. In the conventionally trained group average rating was 23.4 (19.4-27.3) at start and 21.7 (17.3-26.1) at end, p = 0.51. At start no difference was detected between the two groups, p = 0.59; by 1 year the difference was statistically significant favouring intervention, p = 0.044. Operative time showed similar results in favour of the intervention.
A module-based training model in Lichtenstein hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures.
PubMed ID
25731946 View in PubMed
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[Prevention in general practice. Are female and male patients treated the same way? A questionnaire study]

https://arctichealth.org/en/permalink/ahliterature21278
Source
Ugeskr Laeger. 1999 Jan 4;161(1):44-8
Publication Type
Article
Date
Jan-4-1999
Author
U. Hølund
G. Boysen
P. Charles
E F Eriksen
O K Overvad
B H Petersson
B. Sandström
A R Thomassen
M A Vittrup
Author Affiliation
Mejeriernes Ernaeringscenter, Arhus.
Source
Ugeskr Laeger. 1999 Jan 4;161(1):44-8
Date
Jan-4-1999
Language
Danish
Publication Type
Article
Keywords
Adult
Denmark
Dietary Services
English Abstract
Family Practice
Female
Health Behavior
Humans
Life Style
Male
Middle Aged
Physician's Practice Patterns
Preventive Health Services
Primary Prevention
Questionnaires
Sex Factors
Abstract
Three hundred and seventy-four general practitioners (GPs) in Denmark filled in a questionnaire on practices regarding prevention of coronary heart disease (CHD), cancer, osteoporosis, and overweight/underweight. Half of the GPs were questioned about the issue of prevention based upon female case stories and the other half on male case stories with identical wording. The GPs more often in relation to: Prevention of CHD gave dietary counselling and recommended weight loss to slightly overweight male than female patients. Prevention of cancers gave dietary counselling and recommended weight loss and increase of exercise to female than to male patients. Prevention of osteoporosis recommended a supplement of calcium and vitamin D to female than to male patients. Treatment of underweight recommended weight gain and discussion of psycho-social issues to underweight female than male patients. In conclusion, GPs distinguish between men and women in relation to prevention strategies in general practice. There is a need for well-described prevention and action strategies with relevant gender differentiation for use in general practice.
PubMed ID
9922688 View in PubMed
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13 records – page 1 of 2.