Mild Cognitive Impairment and modifiable risk factors among Lebanese older adults in primary care.

OBJECTIVE: Mild Cognitive Impairment (MCI) is an intermediate state between normal cognition and dementia. Identification of MCI and associated risk factors is important for early intervention. This study investigated the prevalence of MCI among Lebanese older adults and associated risk factors in primary care. METHODS: For this cross-sectional study, 337 adults aged 60 years and older met inclusion criteria and were recruited at a primary care clinic associated with a tertiary medical center in Beirut, Lebanon. The validated Arabic version of the Montreal Cognitive Assessment, the 5-item Geriatric Depression Scale, and the Lawton Instrumental Activities of Daily Living Scale were administered. Data about sociodemographic, behavioral, and clinical characteristics was obtained. RESULTS: There was no difference in the mean age between those with normal cognition and those with MCI (mean age 70.38 ± 7.4 and 72.12 ± 7.6 years, respectively). The prevalence of MCI was 14.8% (50 out of 337), 42% were males and 58% were women. Participants having more than 12 years of education (OR = 0.297; CI = 0.112-0.788; P = 0.015) were less likely to have MCI. Participants with history of smoking (OR = 2.599; CI = 1.266-5.339; P = 0.012) or at risk of depression (OR = 2.847; CI = 1.392-5.819; P = 0.004) were more likely to have MCI. CONCLUSION: Identification of patients with history of smoking and at risk of depression may serve as an opportunity to offer intensive counseling and targeted treatment to delay the onset or progression of MCI to Alzheimer's disease.

A Model of Academic, Personality, and Emotion-Related Predictors of University Academic Performance.

This paper investigates the relationships between personality (i.e., trait Emotional Intelligence - trait EI - and the Big Five) and academic performance (AP). Academic motivation, procrastination, and major satisfaction were also studied. The sample consisted of 201 Lebanese undergraduates. The model represented a good fit. There was a negative direct effect of procrastination on AP and positive direct effects of major satisfaction and absorption on AP. Trait EI showed a negative direct effect on procrastination and a positive direct effect on major satisfaction, which, in turn, significantly predicted AP. Also, conscientiousness indirectly predicted AP, via procrastination, major satisfaction, and absorption. Findings point at individual differences contributing to AP and can be helpful to students, educators, and counselors in higher education.

Medical students' knowledge, attitudes and behaviours related to substance use in Lebanon: a cross-sectional survey.

The study aims were to explore the knowledge, attitudes and behaviours of Lebanese medical students related to substance use and to determine prevalence and psychosocial predictors. A cross-sectional survey of 231 medical students (48.6% male; 53.1% preclinical, 46.9% clinical) was conducted during June 2012-July 2013. The questionnaire addressed knowledge and attitudes about substance use, religiosity, depression, anxiety and demographic characteristics. The knowledge score was 52.7% (standard deviation 14.4%), and was significantly lower in 2nd year students (48.53%) than in 3rd and 4th year students (57.5% and 57.4%) (P < 0.05). Students reported more training in drug abuse than alcohol abuse (38.2% vs. 34.4%). One-fourth reported smoking, 57.7% using alcohol and 46.8% using drugs. Significant predictors of lower substance use included intrinsic religiosity and interest in working in the field. The findings reveal inadequate knowledge and considerable substance use in Lebanese medical students. Therefore, training in substance use and counseling of students are necessary.

Association of environmental markers with childhood type 1 diabetes mellitus revealed by a long questionnaire on early life exposures and lifestyle in a case-control study.

BACKGROUND: The incidence of childhood type 1 diabetes (T1D) incidence is rising in many countries, supposedly because of changing environmental factors, which are yet largely unknown. The purpose of the study was to unravel environmental markers associated with T1D. METHODS: Cases were children with T1D from the French Isis-Diab cohort. Controls were schoolmates or friends of the patients. Parents were asked to fill a 845-item questionnaire investigating the child's environment before diagnosis. The analysis took into account the matching between cases and controls. A second analysis used propensity score methods. RESULTS: We found a negative association of several lifestyle variables, gastroenteritis episodes, dental hygiene, hazelnut cocoa spread consumption, wasp and bee stings with T1D, consumption of vegetables from a farm and death of a pet by old age. CONCLUSIONS: The found statistical association of new environmental markers with T1D calls for replication in other cohorts and investigation of new environmental areas. TRIAL REGISTRATION: Clinical-Trial.gov NCT02212522 . Registered August 6, 2014.

Management of adolescents with very poorly controlled type 1 diabetes by nurses: a parallel group randomized controlled trial.

BACKGROUNDS: Fluctuation in glycemia due to hormonal changes, growth periods, physical activity, and emotions make diabetes management difficult during adolescence. Our objective was to show that a close control of patients' self-management of diabetes by nurse-counseling could probably improve metabolic control in adolescents with type 1 diabetes. METHODS: We designed a multicenter, randomized controlled, parallel group, clinical trial. Seventy seven adolescents aged 12-17 years with A1C >8% were assigned to either an intervention group (pediatrician visit every 3 months + nurse visit and phone calls) or to the control group (pediatrician visit every 3 months). The primary outcome was the evolution of the rate of A1C during the 12 months of follow-up. Secondary outcomes include patient's acceptance of the disease (evaluated by visual analog scale), the number of hypoglycemic or ketoacidosis episodes requiring hospitalization, and evaluation of A1C rate over time in each group. RESULTS: Seventy-seven patients were enrolled by 10 clinical centers. Seventy (89.6%) completed the study, the evolution of A1C and participants satisfaction over the follow-up period was not significantly influenced by the nurse intervention. CONCLUSION: Nurse-led intervention to improve A1C did not show a significant benefit in adolescents with type 1 diabetes because of lack of power. Only psychological management and continuous glucose monitoring have shown, so far, a slight but significant benefit on A1C. We did not show improvements in A1C control in teenagers by nurse-led intervention. TRIAL REGISTRATION: Clinical Trials.gov registration number: NCT00308256, 28 March 2006.