The need for a new model of the physician–patient relationship: a challenge for modern medical practice

A revolution in the field of medicine, enhancing knowledge and techniques, has been affecting, for the last fifty years, all aspects of healthcare, bioethics and finance. It is in this new context that we should relocate the physician–patient relationship and identify the different form that it is currently taking. The aim of this review paper is to evaluate the different models of the physician– –patient relationship, described in medical literature, and to emphasize the need for an innovative interaction that fits the new dimensions of modern medical practice. During the last decade, the debate has grown around the opposition between several patterns of the physician–patient relationship. The model of mutual participation of Szasz and Hollender (involving a relationship set between equals and built on helpfulness) and the deliberative model of Emanuel and Emanuel (encouraging the patient’s independence in decisionmaking, which occurs after the physician’s helpful advice) were considered appropriate models of the physician–patient relationship, with several limitations. In modern medi.cine, patients have an increasing number of needs that have to be satisfied: personal and familial, psychological and social, material and spiritual. The physician is rarely adequately prepared for the new needs and the new dimensions of the current physician–patient interaction

Clinical Nutrition 2017: Association between lifestyle, dietary factors and body composition among Notre Dame University students: A cross-sectional study- Jessy El Hayek- Notre Dame University

International audienc

Vitamin D status and body composition: a cross-sectional study among employees at a private university in Lebanon

Abstract Background The prevalence of low vitamin D status is increasing globally, and Lebanon is not spared. The objectives of this study are to determine the prevalence and correlates of low vitamin D status, and to assess the association between percent body fat and vitamin D status, independently of obesity. Methods A cross-sectional study was performed on NDU employees. Data on dietary intake, physical activity, lifestyle, health status, and demographic variables were collected during a face-to-face interview. Anthropometric measures (weight, height and waist circumference) were measured and body composition was assessed using the bioelectrical impedance analysis (BIA) machine InBody 720 (Biospace, Seoul, Korea). The Nutritionist Pro diet analysis software version 31.0 was used to estimate dietary intake of vitamin D. Serum 25 hydroxyvitamin D (25(OH)D) was measured using enzyme linked immunosorbent assay kit (ELISA) (Calbiotech, Spring Valley, California, USA). Vitamin D status was assessed according to the National Osteoporosis Foundation (sufficiency: ≥ 75 nmol/L / ≥30 ng/mL) and the Institute of Medicine cut-offs (adequacy: ≥50 nmol/L / ≥20 ng/mL). Statistical analyses were performed by SPSS version 22. Results A total of 344 employees (50% Male) aged between 20 and 74 years participated in the study. More than half of the participants were overweight and obese. Mean serum vitamin D concentrations were 28.2 ± 13.9 ng/mL. Among participants, 37.5% of our study population had 25(OH)D ≥ 30 ng/mL, and 68.3% had 25(OH)D ≥ 20 ng/mL. Individuals with low vitamin D status had significantly higher percent body fat (PBF) (p < 0.005), and higher waist circumference (WC) (p = 0.012) than in the sufficient group, however BMI did not differ by vitamin D status. Logistic regression analysis indicated that a 1% increase in body fat increases the odds of having 25(OH)D ≤ 30 ng/mL by 8% while controlling for BMI and other confounders (p = 0.019). Conclusion This study reinforces the need for regular screening for low vitamin D status in Lebanese adults, particularly individuals at risk, including those with high risk WC, high PBF, who work indoors and have low vitamin D intake, and recommending vitamin D supplementation if needed

The relationship between hypovitaminosis D and metabolic syndrome: a cross sectional study among employees of a private university in Lebanon

Abstract Background The prevalence of low vitamin D status and metabolic syndrome is increasing globally and in Lebanon. The objectives of this study are to assess the prevalence of metabolic syndrome (MetS) and its components (elevated triglycerides, low HDL, abdominal obesity defined by high waist circumference, hypertension, impaired fasting blood glucose) and investigate the association between serum 25-hydroxyvitamin D (25(OH)D) concentrations and MetS and its components among a sample of Lebanese adults. Methods A cross-sectional study was carried out on Notre Dame University employees. A background questionnaire, a short-form of the International Physical Activity Questionnaire and a food frequency questionnaire were administered. Participants were invited to the nutrition laboratory to gather data on anthropometric (height, waist circumference, weight, body composition and body mass index) and biochemical measurements (serum vitamin D, triglycerides, HDL and fasting blood glucose). Vitamin D status was assessed according to the Institute of Medicine cut-offs (inadequate or adequate: 25(OH)D < or ≥ 50 nmol/L).The definition of the Third Report of the National Cholesterol Education Program was used to identify individuals who had MetS. The data were analyzed using the SPSS version 22. P < 0.05 was considered statistically significant. Results A total of 344 participants (age range of 20 to 74 years) were included in the study. The prevalence of MetS was 23.5%. Among MetS components, central obesity was the most prevalent condition (50.6%), while the least prevalent was impaired fasting blood glucose (20.3%). The odds of having MetS were found to be 2.5 (95% CI 1.3–4.7) higher among those with inadequate vitamin D status, than among those with adequate vitamin D status while controlling for important confounders (age, marital status, education level, income, medical morbidity, smoking and percent body fat and gender). Among the components of MetS, only hypertriglyceridemia (OR: 2.4, 95%CI: 1.3–4.2) and low HDL (OR: 1.8, 95% CI: 1.0–3.0) were associated with inadequate vitamin D status while controlling for important confounders. Conclusions Early identification and control of risk factors for cardiovascular diseases in the primary care level is needed, particularly among adults who have low vitamin D status, are obese, and have low income level