Multidimensional health locus of control scales: applicability among Ghanaian adolescents.

BACKGROUND: Primary preventive approaches are likely to be more effective if the motivational factors of health behaviours are known. Beliefs about control over health outcomes are among the most important motivational factors, commonly assessed with the multidimensional health locus of control scale (MHLC). OBJECTIVES: To examine the validity, reliability and cross-cultural correspondence of the MHLC scales among Ghanaian adolescents. DESIGN: Cross-sectional questionnaire survey. SETTING: Secondary schools in the Awutu-Effutu-Senya district of Ghana, 1998. SUBJECTS: The analysis is based on 504 secondary school children constituting a response rate of 86%. INTERVENTION: Non-intervention study. MAIN OUTCOME MEASURES: The MHLC score comprising beliefs in own control over health, beliefs in provider control over health and beliefs in chance health outcomes. RESULTS: Fifty per cent urban and 48% rural pupils recorded health as an important issue. More than 90% of the participants were correctly informed regarding oral health consequences of tooth cleaning, tobacco smoking and sugar consumption. Exploratory factor analysis gave two sub-factors of the MHLC corresponding to internal and provider control over health and having internal consistency reliability of 0.72 and 0.76, respectively. CONCLUSION: The results lend support to the cultural correspondence of the MHLC instrument, several aspects of its validity and internal consistency reliability.

Oral hygiene and sugar consumption among urban and rural adolescents in Ghana.

OBJECTIVES: The purpose of this study was to compare categories of self-reported oral health behavior among adolescents raised in urban and rural areas of Ghana. METHODS: Second year students (n=583) aged 14-18 years were selected from the five secondary schools in the Awutu-Effutu Senya district, using a stratified random sampling procedure. A total of 504 (86%) students completed questionnaires under supervision at school. RESULTS: Cross-tabulation analyses revealed that most urban and rural residents (97% and 96%) reported daily tooth brushing, whereas small and moderate proportions reported use of toothpicks and intake of sugared snacks, respectively. Multiple logistic regression analyses, controlling for gender and parents' education, showed that the socio-regional context (urban/rural) was significantly related to intake of cakes/biscuits (odds ratio (OR)=2.6, 95% CI 1.7-4.4), chocolate/sweets (OR=3.5, 95% CI 2.0-6.0) and use of toothpicks (OR=2.6, 95% CI 1.3-5.5), indicating true differences between urban and rural residents. CONCLUSION: As predicted, urban residents were more likely than their rural counterparts to use toothpicks and to consume sugared snacks. Among both urban and rural residents, males and those having less educated parents reported oral hygiene and sugar intake less frequently than did females and the highly educated. Whereas the gender difference with respect to intake of sugared snacks was larger among urban than rural residents, the socio-economic disparity with respect to use of toothpicks was most pronounced among rural residents. The results appear to imply that in addition to targeting specific oral health behaviors, bath individual characteristics and the wider socio-regional context should be addressed when planning oral health intervention among Ghanaian adolescents.

Prone position may increase temperature around the head of the infant.

Recommendations to adopt the supine position were followed by a dramatic decrease of SIDS. But no explanation has been given for the association between SIDS and the prone position nor for its decrease in the supine position. We report data on an infant and a mannequin demonstrating an increase in temperature around the head in the prone position. A 4-month-old boy presented an acute life-threatening event related to temperature after febrile otitis despite treatment: 40.5 degrees C, heart rate 280 bpm with circulatory failure and cardiorespiratory arrest requiring resuscitation. There were no seizures. Blood and CSF cultures were negative. The course under antibiotics was favourable. On d 3, we measured temperature at several sites on and around the heat. Temperatures were higher in the prone than in the supine position in pericephalic areas: +1 degrees C (supracephalic), +2.5 degrees C (peritemporal), and +3.5 degrees C (submandibular). In a thermoregulated room, we used a mechanically ventilated mannequin of an infant. The prone position was also associated with an increase in temperature around the head: +3.3 degrees C (supracephalic), +1.8 degrees C (peritemporal), and +1.1 degrees C (submandibular). Changing from the supine to prone position thus increased temperature around the head (infant and mannequin). To our knowledge, this has not been reported before. SIDS is related to factors modifying temperature status and environment. Furthermore, evacuation of heat is mandatory for an infant. We think the increase in temperature around the head in the prone position is due to the absence of convective fluxes, and speculate it could impair thermolysis.

Convective heat transfer around an infant head.

Knowledge of heat and mass transfer between an infant and his environment is necessary to control hospital care conditions, or understand a pathology as Sudden Infant Death Syndrome (SIDS). This paper precises the particular importance of the heat transfer over the head and quantifies the influence of various parameters on natural convection heat transfer.