Health-related quality of life in children with food allergy and their parents: a systematic review of the literature.

BACKGROUND: Health-related quality of life (HRQoL) in food-allergic children and their parents can be assessed using generic and specific questionnaires. OBJECTIVES: We investigated whether HRQoL scores in food-allergic children and their parents were similar to normative data and whether they were correlated. METHODS: We searched PubMed, Scopus, and the New York Academy of Medicine Grey Literature Report site. Electronic searches were supplemented by perusal of the references of the papers retrieved. RESULTS: Seventeen studies were eligible. Two studies compared total HRQoL scores for children with food allergy and normative data and found no significant differences. Six studies compared HRQoL questionnaire subdomain scores for children with normative data, and 4 studies compared the same scores for parents with normative data. Children with food allergy scored worse in subdomains including bodily pain, physical functioning, mental health, general health, and emotional, social, and psychological quality of life. However, they performed better in physical health, and had fewer limitations in schoolwork due to behavioral problems. Parents performed better in subdomains such as physical and environmental health, social and psychological health, and family cohesion but scored worse on social health, overall quality of life, emotional health, impact on parental time, and limitations in usual family activities. Statistically significant results for these subdomains were not invariably corroborated by subsequent studies. No study provided data on the correlation between children's HRQoL and that of their parents. CONCLUSIONS: HRQoL of food-allergic children and their parents may differ from that of the normative population in certain subdomains. However, the evidence was not sufficient to draw robust conclusions.

The good student is more than a listener - The 12+1 roles of the medical student.

BACKGROUND: The process of medical education, particularly in the fast evolving new era of medical metaschools, is a broad and complex issue. Harden & Crosby claimed that a good teacher is more than a lecturer, and identified 12 roles that certify a good and capable teacher. However, this is only half the truth: the good student is more than a listener. Teaching-and-learning is not simply a one-way process, and, as medical students are not children, the relationship between teacher and students involves andragogy rather than pedagogy. We therefore propose the 12+1 roles of the student. SUMMARY OF WORK: The Harden & Crosby paper was distributed in a class of 90 third year Ioannina University medical students, who were asked to think about the student's roles. A small discussion group brainstormed ideas, which were then refined further by the authors. SUMMARY OF RESULTS: 12+1 roles of the good medical student were produced and grouped into six areas: information receiver, in lectures and clinical context; role model in learning, in class, with the added subarea of comparative choice of role models; teaching facilitator and teacher's mentor; teacher's assessor and curriculum evaluator; active participator and keeping-up with curriculum; resource consumer/co-creator and medical literature researcher. The ideal student should fulfil the majority if not all of these complementary roles. TAKE-HOME MESSAGE: These 12+1 student's roles are complementary to the 12 roles of the teacher and help reshaping our understanding of today's medical education process.

Students' perceptions of the educational environment in a Greek Dental School, as measured by DREEM.

AIM: The aim of this study was to estimate the dental students' perceptions of their educational environment and to identify any differences related both to their gender and semester of studies. MATERIALS AND METHODS: The translated and validated in Greek Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed to all 2nd- to 5th-year students of the Athens Dental School. The questionnaire consisted of 50 statements organised in five subscales (perceptions of learning, teachers, atmosphere, academic self-perceptions and social self-perceptions). Internal validity was checked with Cronbach alpha. Confirmatory factor analysis (CFA) was performed under the same conditions as the original inventory. Mean statement, subscale and overall scores were calculated and given as percentages. RESULTS: The response rate was 64%. Overall Cronbach alpha was 0.93 (excellent). CFA produced five meaningful subscales, not matching the original ones. The overall DREEM mean score was 56%. Gender did not influence the findings. The students' perceptions of the educational environment with the exception of the academic self-perceptions were more positive in the pre-clinical years. Statistically significant differences were revealed only for the 'learning' subscale between the 3rd- and the 4th-year students. Seventy-eight percent of the statements were in the positive side. The lowest scores were related to students' stress, tiredness and lack of appropriate feedback from the teachers, and the highest were related to accommodation, school friends and perceptions that they feel socially comfortable in class. CONCLUSIONS: Students' perceptions of the educational environment were reasonably positive, with no gender difference. However, some weaknesses were identified, particularly in the clinical years. Further research is needed to clarify appropriate interventions.

A validation study and psychometrical evaluation of the Maastricht Upper Extremity Questionnaire (MUEQ) for the Greek-speaking population.

OBJECTIVES: The Maastricht Upper Extremity Questionnaire (MUEQ) is a tool to examine the physical, psychological and environmental risk factors in the work place that may contribute to the prevalence of complaints of arm, neck and shoulder. The aim of this study was to develop a Greek language version of the MUEQ and to assess its psychosocial parameters. METHODS: The MUEQ was translated into the Greek language and culturally adapted. Exploratory factor analysis was used to analyze interrelations among the questionnaire items and for each of the seven domains two factors were given, thus resulting in the identification of a total of 14 factors. RESULTS: The tool was handed out to 455 computer office workers (179 males, 276 females) with a mean age of 37.4 (SD 9.2). Factor analysis and Cronbach's alpha coefficient indicate that the results are generalizable to the population and the total scale has high internal consistency. The results showed that in the last year, 35.8% of respondents experienced upper extremity pain, specifically in the neck or the shoulders. CONCLUSIONS: The Greek version of the MUEQ appears to be a valid tool for the assessment of risk factors related to pain in the upper extremity among Greek computer office workers.

Validation of the Greek translation of the Dundee Ready Education Environment Measure (DREEM).

CONTEXT: The educational environment makes an important contribution to student learning. The DREEM questionnaire is a validated tool assessing the environment. OBJECTIVES: To translate and validate the DREEM into Greek. METHODS: Forward translations from English were produced by three independent Greek translators and then back translations by five independent bilingual translators. The Greek DREEM.v0 that was produced was administered to 831 undergraduate students from six Greek medical schools. Cronbach's alpha and test-retest correlation were used to evaluate reliability and factor analysis was used to assess validity. Questions that increased alpha if deleted and/or sorted unexpectedly in factor analysis were further checked through two focus groups. FINDINGS: Questionnaires were returned by 487 respondents (59%), who were representative of all surveyed students by gender but not by year of study or medical school. The instrument's overall alpha was 0.90, and for the learning, teachers, academic, atmosphere and social subscales the alphas were 0.79 (expected 0.69), 0.78 (0.67), 0.69 (0.60), 0.68 (0.69), 0.48 (0.57), respectively. In a subset of the whole sample, test and retest alphas were both 0.90, and mean item scores highly correlated (p<0.001). Factor analysis produced meaningful subscales but not always matching the original ones. Focus group evaluation revealed possible misunderstanding for questions 17, 25, 29 and 38, which were revised in the DREEM.Gr.v1. The group mean overall scale score was 107.7 (SD 20.2), with significant differences across medical schools (p<0.001). CONCLUSION: Alphas and test-retest correlation suggest the Greek translated and validated DREEM scale is a reliable tool for assessing the medical education environment and for informing policy. Factor analysis and focus group input suggest it is a valid tool. Reasonable school differences suggest the instrument's sensitivity.

Early European attitudes towards "good death": Eugenios Voulgaris, Treatise on euthanasia, St Petersburg, 1804.

Eugenios Voulgaris (Corfu, Greece, 1716; St Petersburg, Russia, 1806) was an eminent theologian and scholar, and bishop of Kherson, Ukraine. He copiously wrote treatises in theology, philosophy and sciences, greatly influenced the development of modern Greek thought, and contributed to the perception of Western thought throughout the Eastern Christian world. In his Treatise on euthanasia (1804), Voulgaris tried to moderate the fear of death by exalting the power of faith and trust in the divine providence, and by presenting death as a universal necessity, a curative physician and a safe harbour. Voulgaris presented his views in the form of a consoling sermon, abundantly enriched with references to classical texts, the Bible and the Church Fathers, as well as to secular sources, including vital statistics from his contemporary England and France. Besides euthanasia, he introduced terms such as dysthanasia, etoimothanasia and prothanasia. The Treatise on euthanasia is one of the first books, if not the very first, devoted to euthanasia in modern European thought and a remarkable text for the study of the very early European attitudes towards "good death". In the Treatise, euthanasia is clearly meant as a spiritual preparation and reconciliation with dying rather than a physician-related mercy killing, as the term progressed to mean during the 19th and the 20th centuries. This early text is worthy of study not only for the historian of medical ethics or of religious ethics, but for everybody who is trying to courageously confront death, either in private or in professional settings.