7,363 research outputs found

    The ethical implications of intervening in bodyweight

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    This chapter is about the ethical implications of health sector actions intended to change individuals\u27 or communities\u27 weight. We consider these implications using two hypothetical cases. The first is Megan, a 15-year-old girl whose BMI is in the range defined as obese. She has been unable to lose weight and her parents are considering seeking clinical help. The second case is the population of the state where Megan lives, in which 35% of adults and 15% of children are reportedly overweight, and 17% of adults and 5% of children obese. The minister for health, prompted by these statistics, is determined to take action. What ethical issues are relevant for Megan, her parents, and the health professionals they may consult? What ethical issues are relevant for the citizens of the state, their minister for health and their bureaucrats? How does a focus on the care of individuals impact on public health, and how might community-level interventions affect people like Megan? Interventions designed to treat and prevent obesity in individuals and in communities raise important ethical issues. These issues are both distinct and overlapping; because the interventions have different goals, risks and benefits, moral compromise is always necessary. The central task is to think through the ethical and philosophical issues before action is taken: whether in clinical medicine or in public health. We present ethical approaches that can assist in such reasoning

    The ethical implications of intervening in bodyweight

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    Contains fulltext : mmubn000001_027888673.pdf (publisher's version ) (Open Access)Promotores : H. van der Velden, A. van ’t Laar en W. Wijnen295 p

    Hormone replacement treatment choices in complete androgen insensitivity syndrome: an audit of an adult clinic

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    OBJECTIVE: To review the treatment choices of women with complete androgen insensitivity syndrome (CAIS) at a single tertiary centre. DESIGN: Retrospective review. PATIENTS: Women with CAIS identified from our database. RESULTS: The study group comprised 141 women with CAIS. Eleven percent (16/141) of women had gonads in situ, 3 of whom were under workup for gonadectomy. The age of gonadectomy in the remainder 125 women was 17 (0.1-53) years. The most common form of HRT was oral oestrogen or transdermal oestrogen in 80% (113/141). 13/141 (9%) women used vaginal oestrogens alone or together with other forms of HRT. Testosterone preparations had been used by 17% (24/141) of women and were currently used in 10% (14/141). Of those who had used testosterone, 42% (10/24) had chosen not to continue after a therapeutic trial. CONCLUSIONS: In a clinic offering individualised multidisciplinary care for women with CAIS, we found that the majority of women chose oestrogen-based treatment while a significant minority used testosterone

    Risk factors of developmental defects of enamel - A prospective cohort study

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    BACKGROUND AND OBJECTIVE: Current studies on the aetiology of developmental defects of enamel (DDE) are subject to recall bias because of the retrospective collection of information. Our objective was to investigate potential risk factors associated with the occurrence of DDE through a prospective cohort study. METHODS: Using a random community sample of Hong Kong children born in 1997, we performed a cohort study in which the subjects' background information, medical and dental records were prospectively collected. A clinical examination to identify DDE was conducted in 2010 when the subjects were 12 years old. The central incisor, lateral incisor and first molar in each quadrant were chosen as the index teeth and were examined 'wet' by two trained and calibrated examiners using the modified FDI (DDE) Index. RESULTS: With a response rate of 74.9%, the 514 examined subjects had matched data for background information. Diffuse opacites were the most common type of DDE. Of the various possible aetiological factors considered, only experience of severe diseases during the period 0-3 years was associated with the occurrence of 'any defect' (p = 0.017) and diffuse opacities (p = 0.044). The children with experience of severe diseases before 3 years of age were 7.89 times more likely to be affected by 'any defect' compared with those who did not have the experience (OR 7.89; 95% CI 1.07, 58.14; p = 0.043). However, after adjusting for confounding factors, the association no longer existed. CONCLUSION: No variables could be identified as risk factors of DDE in this Hong Kong birth cohort.published_or_final_versio

    Tooth eruption and obesity in 12-year-old children

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    An ultrastructural study of bonding of a self-etching primer to sclerotic dentin

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    Abstract no. 1538published_or_final_versio
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