Highlights of the BMC series: April 2018

Interview with Professor Gabriel Richet • Review of systems medicine in cardiovascular disease • Correlation between poor diet and smoking • Comparing doctor performances based on gender and country • The role of psychological distress on poverty among older Australians • Digit sucking and dental anxiety

BMC Nephrology: The Pioneers of Nephrology – Professor Gabriel Richet: “I will maintain”

Gabriel Richet in his home in Paris in 2010. Photos by Gilberto Richiero

This highlights blog opens with an interview introduced by Piccoli, Richiero and Jaar, recently published in BMC Nephrology. Professor Gabriel Richet (1916-2014) is considered to be one of the pioneers of European Nephrology.

In this interview, recorded in Paris in 2010, Professor Richet gives an account of the early days of European Nephrology, describing himself as a “lucky man” and stating his view on what he considered the moral stature that every physician should have.

BMC Systems BiologySystems medicine in cardiovascular disease

This review has been published as part of an ongoing “Systems Medicine” thematic series in BMC Systems Biology and gives us an overview of the systems biology tools currently being used to further our understanding of cardiovascular disease (CVD). Here, Zeller and colleagues state that applying innovative methodologies to increase our understanding of the causes of CVD may result in better assessment of the risk facts involved and pave the way for tailored therapies.

They describe the current tools available, including various cardiac disease models, epidemiological cohort studies (such as the Framingham Heart Study) and publically available data sources. Various proposed methods for integrated data analyses are then discussed, all with general aim of classifying the data available in order to help guide diagnosis, treatment decisions and patient prognosis.  Finally, the authors acknowledge the various challenges and limitations that exist in systems medicine.

BMC Public HealthMore to gain: dietary energy density is related to smoking status in US adults

Smoking is the leading cause of preventable death and is associated with a number of chronic diseases, such as CVD, cancer and stroke. Poor diet is also one of the top three preventable risk factors for CVD as well as being linked to obesity. Due to the pharmacological effects of nicotine, cigarette smoking is negatively associated with obesity.

In this study, published in BMC Public Health, MacLean and colleagues investigated the correlation between smoking and poor diet. They analyzed data from the 2013-2014 National Health and Nutrition Examination Surveys (NHANES) and found that there was a strong linear relationship between smoking and dietary energy density(ED), indicating high levels of consumption of high fat foods such as potato chips, cookies and processed cheese rather than low-ED foods such as leafy vegetables, fruit and pasta.

The authors conclude by stating that this demonstrates that that smoking is associated with poor diet and also that former smokers, although consuming a lower-ED diet than smokers, have a poorer diet compared to people who have not smoked at all.

BMC Medical EducationPassing MRCP (UK) PACES: a cross-sectional study examining the performance of doctors by sex and country

In general, female doctors earn less and are less likely to be senior authors on academic paper but are also less likely to be sanctioned and have been found to perform better academically and clinically. International medical students also tend to perform less well academically that those from the UK, USA or Canada. What is not known, however, is to what extent gender influences performance.

Here, in an article recently published in BMC Medical Education, Unwin et al looked at the association between gender and performance via the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES) examination. Taking the results of 7671 PACES, sex differences in first time pass rates were analyzed for three groups: (1) UK Medical graduates (2) non-UK medical graduates registered with the General Medical Council (GMC) and (3) non-UK medical graduates without GMC registration.

It was found that, for all groups, female doctors were more likely to pass at their first attempt, with the differences between genders particularly significant for non-UK medical graduates that were not registered with GMC. The authors conclude that further investigation is required in order to explain these results and also how examination performance may relate to performance in practice.

BMC Psychology:Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness

In this article, recently published in BMC Psychology, Callander and Schofield describe their research into whether high psychological distress is associated with poverty among older adults living in Australia. Using data from the Household Income and Labour Dynamics in Australian (HILDA) survey, they performed a longitudinal analysis using tailored Poisson regression models to estimate the risk of a person falling into poverty with adjustments made for age, employment status, place of residence, marital status and housing tenure.

Population Attributable Risk methodology was then applied to estimate the proportion of poverty  directly attributable to psychological distress, as measured by the Kessler 10 scale.

The researchers found that men, being psychological distressed increased their risk of falling into income poverty by 1.68 and multidimensional poverty (taking into account income, health status and education attainment) by 3.40. For women, having high psychological distress increased the risk of multidimensional poverty by 2.15. Based on this Is evidence, they conclude that falling into poverty has been an overlooked cost of poor mental health.

BMC Oral Health: General anxiety, dental anxiety, digit sucking, caries and oral hygiene status of children resident in a semi-urban population in Nigeria

It is thought that some people will suck their fingers or thumbs (digit sucking) when they are suffering from anxiety or another emotional problem. In this study, published in BMC Oral Health, a team of researchers investigated whether digit sucking is an indicator not only of general anxiety but also anxiety associated with dental issues, for example caries in a group of children in Nigeria.

Is digit sucking  an indicator of both general anxiety and anxiety associated with dental issues?

The study used data of children aged between 6 and 12 taken as part of a larger household survey. General anxiety levels were measured using the Revised Child Manifest Anxiety Scale and dental anxiety was measured using the Dental Subscale of the Child Fear Survey Schedule. Logistic regression was used to determine whether general anxiety or dental anxiety could be predicted according to whether someone was sucking their fingers and/or thumbs. The researchers used the same analysis to see whether general anxiety and dental anxiety could predict whether a child had caries and the general state of their oral health.

Results showed that, although digit sucking is not a significant predictor of dental anxiety and general anxiety, children with high general anxiety and high dental anxiety are more likely to have caries and good oral hygiene respectively.

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