Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population

<p>Abstract</p> <p>Background</p> <p>Animal experiments have shown a protective effect of vitamin C on the formation of gallstones. Few data in humans suggest an association between reduced vitamin C intake and increased prevalence of gallstone disease. The aim of this study was to assess the possible association of regular vitamin C supplementation with gallstone prevalence.</p> <p>Methods</p> <p>An observational, population-based study of 2129 subjects aged 18-65 years randomly selected from the general population in southern Germany was conducted. Abdominal ultrasound examination, completion of a standardized questionnaire, compilation of anthropometric data and blood tests were used. Data were collected in November and December 2002. Data analysis was conducted between December 2005 and January 2006.</p> <p>Results</p> <p>Prevalence of gallstones in the study population was 7.8% (167/2129). Subjects reporting vitamin C supplementation showed a prevalence of 4.7% (11/232), whereas in subjects not reporting regular vitamin C supplementation, the prevalence was 8.2% (156/1897). Female gender, hereditary predisposition, increasing age and body-mass index (BMI) were associated with increased prevalence of gallstones. Logistic regression with backward elimination adjusted for these factors showed reduced gallstone prevalence for vitamin C supplementation (odds ratio, OR 0.34; 95% confidence interval, CI 0.14 to 0.81; P = 0.01), increased physical activity (OR 0.62; 95% CI, 0.42 to 0.94; P = 0.02), and higher total cholesterol (OR 0.65; 95% CI, 0.52 to 0.79; P < 0.001).</p> <p>Conclusion</p> <p>Regular vitamin C supplementation and, to a lesser extent, increased physical activity and total cholesterol levels are associated with a reduced prevalence of gallstones. Regular vitamin C supplementation might exert a protective effect on the development of gallstones.</p

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

BACKGROUND: The implementation of the 58(th )World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. METHODS: The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. RESULTS: There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". CONCLUSION: In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision

Toward a Unified Framework of Perceived Negative Leader Behaviors Insights from French and British Educational Sectors

In this paper, we challenge the commonly held assumption that actors in the education sector are largely ethical, and that there is therefore little need to scrutinize leader behaviors in this sector. We also overcome past scholars’ tendencies to either focus selectively on positive leader behaviors, or to stay content with categorizing leader behaviors into effective and ineffective (if at all they do focus on negative leader behaviors). Using data (Critical Incidents) from three case studies previously conducted in eight British and French academic establishments, we show that not only do negative leader behaviors abound in the education sector, but they can also be differentiated into three types: (1) behaviors emanating from leaders’ lack of functional skills i.e., ineffective behaviors, (2) behaviors emanating from leaders’ insouciance toward harming the organization and its members i.e., dysfunctional behaviors, and (3) behaviors emanating from leaders’ lack of honesty, integrity, ethicality, and transparency i.e., unauthentic behaviors. We enrich current understanding on ineffective, dysfunctional, and unauthentic leader behaviors, and offer a unified (yet differentiated) framework of negative leader behaviors in the academic sector. Since each type of negative behavior emanates from different motivational drivers, different measures are required to curb them. These are also discussed. A comparison of our findings with those from leadership studies in other sectors reveals that negative leader behaviors in the education sector are quite similar to those in other sectors

Using OR to support the development of an integrated musculo-skeletal service

This paper discusses the question of how operational research in general, and discrete event simulation in particular, can help to meet management challenges in hospital-based orthopaedics medicine. It focuses on the reduction of waiting times for elective patients, both for a first outpatient appointment and for the subsequent commencement of in-patient treatment. The research is based on a series of projects carried out by students from the Department of Management Science, University Strathclyde in Stobhill Hospital and the Glasgow Royal Infirmary between 1999 and 2003. An increasingly detailed and complex simulation model was developed for the musculo-skeletal service provided by these hospitals. The paper discusses the application of a modelling methodology-based on the idea of requisite models evolving over time-that is participatory, iterative and focused on enhancing the clients' understanding of the main performance drivers of the service. It concludes that this methodology fits well with successful strategies to sustain reductions in waiting times

Report of a joint WHO/WFH meeting on the control of haemophilia: Carrier detection and prenatal diagnosis

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