Assessment of health related quality of life among school children with cancer in Alexandria.

UNLABELLED: In recent years, the necessity of measuring health related quality of life (HRQOL) among children with cancer has been stressed. The aim of the present work was to assess the HRQOL in terms of physical, emotional and social functioning, to identify some predictors of QOL and to describe the scholastic achievement and nutritional status among school children with cancer in Alexandria. A cross-sectional study of 215 students with cancer who attended the oncology school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month (June 2005) was conducted. Every child was subjected to the Pediatric Oncology Quality Of Life scale to assess the quality of life with cancer. Anthropometric measurements including weight and height were measured for each child and BMI was calculated. Review of records of each child was done to take the last heamoglobin level. Lymphoma was the most common tumour (34.9%), followed by leukemia (24.2%), brain tumour (13.0%), osteosarcoma (7.9%), and Wilm's tumour (7%). About one third of the sample (36.7%) reported poor QOL which was more evident in the physical domain (54.4%), as compared to 34.4% in emotional domain and 26% in the social domain. Sex (p<0.05), age (p<0.05), complications (p<0.01), place of treatment (p<0.05), place of diagnosis (p<0.05) and treatment (p<0.05) were all significantly associated with QOL. However after adjustment for other variables, poor QOL was more likely among students of younger age, students with complications, and students whose diagnosis was done at the student hospital. About two thirds of the sample (68.5 %) reported poor scholastic achievement, 25.1% were underweight and 87.4% were anemic. CONCLUSION AND RECOMMENDATIONS: HRQOL measurement should be done as a routine for all children with cancer in order to identify specific therapies that require modifications in management. More efforts are needed to improve the health care in the student's hospital, especially for young children with cancer.

Nutritional factors affecting the menarcheal state of adolescent school girls in Alexandria.

The nutritional status of adolescents plays a dominant role in determining the maturation status. The aim of the present work was to assess the mean age of menarche and the main nutritional factors affecting it. A cross-sectional study of 1606 girls was conducted in primary and preparatory schools in Alexandria. Every girl was subjected to anthropometric assessment including weight, height, mid upper arm circumference (MUAC), waist circumference, hip circumference and triceps skin-fold thickness. BMI and body fat percentage were calculated. A 24 hours diet recall method was used to assess the dietary intake. The mean age of menarche was 11.98+/-0.96 years. The mean MUAC, triceps skin-fold thickness, waist circumference and hip circumference were significantly higher among menstruating girls as compared to non-menstruating. (p<0.01). Only 7.5% of the females less than the 5th percentile of BMI (thinness) were menstruating, while the corresponding figure for those at or more than 85th percentile (overweight) was 65.6% and this was statistically significant (X 2 (2) =102.8, P<0.001). Girls who attained menstruation demonstrated a higher significant mean percent of body fat (43.40+/-10.0) as compared to non menstruating ones (35.41+/-7.87), ( t=17.09, P<0.001). The oldest age at menarche was noted when the protein, iron and caloric intake was less than 80% of the RDAs. However after adjustment of other variables direct relation was detected between age of girls and their age of menarche and those in private school had earlier age of menarche than those in governmental one. The nutritional status of the adolescents had a significant association with the onset of menstruation and the age at menarche.

Psychosocial characteristics of diabetic students at Sporting Students Hospital in Alexandria.

Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. The aim of the present work was to study the psychosocial characteristics of diabetic students and to determine predictors of diabetes control. A cross-sectional study of 150 diabetic students who attended the diabetic school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month was conducted. A pre-designed interviewing questionnaire was used to collect--from the child and/or his/her parents--personal data, data about the child social relationships and school and disease characteristics. School adjustment index and stress symptom index were used to assess the school performance and the stress symptoms respectively. The result revealed that 34% of the diabetic students were maladjusted to school and 31.3% were symptomatic based on the stress index. Generally speaking, diabetic children reported good relationship to peers (65.3%), parents (57.3%) and siblings (51.3%), most of them have good friendship (82%) and those involved in one or more kind of hobby were about three fourth of all. Both age (P<0.05), sex (P<0.05), social class (P<0.05), disease duration (P<0.05) and stress symptoms (P<0.05) were all significantly associated with the disease control. However after adjustment for other variables, students of low social class families (OR=5.1, p<0.01) and those of longer disease duration (6-10 years) (OR=7.9, p<0.05) were significant predictors of diabetes control. In conclusion diabetes per se might have no significant association with academic performance or social relationship. Students with large diabetic duration-especially those of low social class families--are at increased risk of suboptimal glycaemic control and should be targeted for interventional strategies.

Predictors of personality disorders among Alexandria University students.

Personality disorders (PDs) represent a common and serious public health problem. The aim of the present work was to determine the prevalence of different PDs among first grade students of Alexandria University and to investigate some ecological factors of the problem. A cross-sectional study was carried out and included 1086 students. The Arabic Version of Personality Diagnostic Questionnaire-4+(PDQ-4+) was applied. Results revealed that more than one quarter of the studied sample had at least one PD (26.1%). Cluster C was the most frequently occurring (24.9%). The commonest subtypes recorded were avoidant PD (20.4%) and obsessive-compulsive PD (20.2%) followed by paranoid PD (15.0%). Significant predictors of PD delineated on the logistic regression analysis were mainly psychosocial factors including parental inconsistent discipline, intrafamilial conflicts, parental rejection and control, decreased familial and friends' social support, and sexual abuse. A positive history of conduct disorder, chronic medical illness or psychiatric problem also significantly predicted the occurrence of PD. Lack of freedom in college selection and smoking emerged as recent events that predicted the PD status of students.

Impact of health education program about reproductive health on knowledge and attitude of female Alexandria University students.

In Egypt, adolescents don't have enough and/or correct knowledge regarding reproductive health. Health education interventions are widely seen as the most appropriate strategy for promoting young people's sexual health. The aim of the present work was to assess the impact of a short-term health education program about reproductive health on knowledge and attitude of female Alexandria university students. Quasi-experimental study (pre-post testing control group) was carried out among 682 female university students living in the university hostels, 354 students represented the intervention group (Ezbet-Saad hostel) who received the program and 328 students constituted the control group (El-Shatby hostel). The study revealed that no one had satisfactory knowledge level while 61.7 % and 38.3% respectively had fair and poor levels. The low knowledge level was more evident regarding the questions about: the meaning of the term 'reproductive health' (only 5.1% gave correct complete answer), the benefits of premarital examination (only 37.9% reported complete answer), the investigations done for the pregnant woman (only 28.3% gave complete answer) the benefits of breast feeding (only 8.2% reported complete answer), methods of family planning (only 36.4% gave complete answer), side effects of female genital mutilation (only 4% reported complete answer), sexually transmitted diseases and methods of protection (only 11.9% and 3.9% reported complete answer). It was evident that 32.6% had an overall positive attitude level, 46.3% were in the neutral level and 21.1% had a negative level. It was also found that students of highly or moderately educated mothers and of high social class reported significantly higher knowledge score about premarital examination, age of marriage and breast-feeding than those of non-educated mothers and of low social class. After the intervention program there was a significant improvement in the majority of knowledge questions from pre to post test in the intervention group and no absolute changes were detected in the control group. The highest percentage of gain scores (33.3%) was detected for knowledge about the term 'reproductive health' and female genital mutilation. A significant gain score of 25% was observed for the knowledge about sexually transmitted diseases. Also there was a gain of 20% in the median score concerning the knowledge about breast feeding and family planning. A significant shift towards a positive attitude was found among the intervention group.