Prevalence of vitamin D deficiency during the summer and its relationship with sun exposure and skin phototype in elderly men living in the tropics

Marcelo Azevedo Cabral,1 Carla Núbia Borges,1 Juliana Maria Coelho Maia,1 Caio Augusto Martins Aires,2 Francisco Bandeira3 1Department of Clinical Medicine, University of Pernambuco Medical School, 2Department of Biomedicine, University of Pernambuco Medical School, 3Division of Endocrinology, University of Pernambuco Medical School, Recife, Brazil Objective: The aim of the study reported here was to determine the prevalence of vitamin D deficiency among elderly men and its association with sun exposure and skin phototypes. Subjects and methods: This was an analytical cross-sectional study, which involved 284 men aged 60 years or over, randomly recruited from a basic care unit in the city of Recife (Brazil). Measurements: Serum levels of 25 hydroxyvitamin D (25(OH)D), sun index, and skin phototypes were evaluated. Results: The prevalence of vitamin D deficiency was 31.5% and 66.7% when cut points of less than 20 and 30 ng/mL, respectively, were used. Mean serum 25(OH)D was 27.86 ± 13.52 standard deviation (SD) ng/mL. There was no difference (P = 0.113) in 25(OH)D (23.98 ± 14.66 SD vs 29.88 ± 13.78 SD) between individuals in the lowest quartile (Q) of the sun index (Q1: 1.96) compared with those in the highest (Q4: 7.86). When considering a cutoff of 20 ng/mL, the sun index was different in the two groups (P = 0.006), but there was no difference when cutoffs of 25 and 30 ng/mL were used. After adjustment, sun index and body mass index were associated positively and negatively, respectively with serum 25(OH)D independently. Most subjects (66.7%) had Fitzpatrick’s skin phototypes IV, V, and VI. Low calcium intake was observed in 72%. There was no difference in serum 25(OH)D levels between patients with low intake and those with intermediate and high intakes. Only 2.5% were taking a vitamin supplement. Conclusion: We found a high prevalence of vitamin D deficiency among elderly men despite their high sun exposure during the summer months. Keywords: sun index, serum 25(OH)D levels, body mass index, Brazi

The Patient Teacher in General Practice Training: Perspectives of Residents

[Article first published online]International audienceBackground: Patient teachers were involved in training general practice residents (GPRs) to strengthen the patient-centered approach. They teach a course on health democracy by themselves and teach in tandem with a physician teacher during reflective practice-based classes (named GEPRIs). We present the GPRs' representations of patient teacher characteristics and capacities and their perception of how useful patient teachers are to their professional development. Methods: We administered a questionnaire based on a preliminary qualitative study to 124 GPRs. It explored (a) changes in the GPRs' representations about patient teacher characteristics and capacities with regard to teaching over the first year of the experiment; (b) GPRs' perception of patient teacher utility to their training and their contribution to developing patient perspective-related competencies. Results: The response rate was 89.5% (111/124). The majority of GPRs agreed with 17 (before) and 21 (after) of the 23 patient teacher characteristics and with 17 (before) and 19 (after) of the 20 capacities. The agreement rate increased, overall, after patient teacher participation. The GPRs found patient teacher useful to their training in 9 of 11 topics (agreement rate 65%-92%). They felt they had developed the 14 patient knowledge-related competencies (agreement rate 62%-93%), and 52% to 75% of the GPRs rated the patient teachers' contribution to those competencies "high or very high," depending on the competency. Conclusion: This study demonstrates the specific contribution of patient teachers to university-level medical training in France. The GPRs recognized that patient teachers helped them develop competencies by providing patient-specific content

Luminosity Determination in pp Collisions at 1a(s)=7 TeV Using the ATLAS Detector at the LHC

Measurements of luminosity obtained using the ATLAS detector during early running of the Large Hadron Collider (LHC) at √s = 7 TeV are presented. The luminosity is independently determined using several detectors and multiple algorithms, each having different acceptances, systematic uncertainties and sensitivity to background. The ratios of the luminosities obtained from these methods are monitored as a function of time and of μ, the average number of inelastic interactions per bunch crossing. Residual time- and μ-dependence between the methods is less than 2% for 0 < μ < 2.5. Absolute luminosity calibrations, performed using beam separation scans, have a common systematic uncertainty of ±11%, dominated by the measurement of the LHC beam currents. After calibration, the luminosities obtained from the different methods differ by at most ±2%. The visible cross sections measured using the beam scans are compared to predictions obtained with the PYTHIA and PHOJET event generators and the ATLAS detector simulation. © CERN for the benefit of the ATLAS collaboration 2011