Self-management goal setting: identifying the practice patterns of community-based physical therapists.

PURPOSE: To describe the collaborative goal-setting practices of community-based physical therapists trained in a self-management (SM) approach who work with clients with chronic conditions and to describe clients' goal-achievement rates. Methods : A retrospective chart review was conducted for 296 randomly selected home-care clients from July 2009 through July 2010 using a chart-abstraction form created to capture demographic data and information related to goal setting and achievement. Data were analyzed using frequencies, percentages, and Pearson's chi-square tests. RESULTS: There was no significant relationship between sex, age, or number of chronic conditions and setting SM or non-self-management (NSM) goals or the type of SM goal set. The majority of goals set were "action" as opposed to "verbal" goals. A high proportion (89-100%) of both SM and NSM goals were met. CONCLUSIONS: Clinicians should be aware that it is possible to set SM goals regardless of the client's sex, age, or number of chronic conditions. Other possible influences on goal setting, such as severity of chronic conditions and challenges of the health care system, should be further investigated.

Objectif : Décrire les méthodes d'établissement d'objectifs en collaboration des physiothérapeutes communautaires qui ont reçu une formation en autogestion et qui travaillent avec des clients vivant avec un problème chronique et décrire les taux d'atteinte des objectifs chez les clients. Méthodes : On a procédé à un examen rétrospectif des dossiers de 296 clients de services de soins à domicile choisis au hasard entre juillet 2009 et juillet 2010 en utilisant un résumé de dossier créé pour saisir des données démographiques et des renseignements portant sur l'établissement et l'atteinte d'objectifs. On a analysé les données en utilisant les fréquences, les pourcentages et des tests chi-carré de Pearson. Résultats : Il n'y avait pas de lien significatif entre le sexe, l'âge ou le nombre de problèmes chroniques et l'établissement d'objectifs liés ou non à l'autogestion, ou les types d'objectifs liés à l'autogestion établis. La majorité des objectifs établis portaient sur « l'action ¼ plutôt que sur le « verbe ¼. Un pourcentage élevé (89 à 100 %) des deux types d'objectifs a été atteint. Conclusions : Les cliniciens devraient savoir qu'il est possible d'établir des objectifs liés à l'autogestion sans égard au sexe, à l'âge ou au nombre de problèmes chroniques du client. Il convient d'étudier plus à fond d'autres facteurs qui peuvent avoir une influence sur l'établissement d'objectifs comme la gravité des problèmes chroniques et les défis posés au système de santé.

High serum level of retinol and α-tocopherol affords protection against oral cancer in a multiethnic population.

BACKGROUND: A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, α-tocopherol and ß-carotene with the risk of oral cancer. MATERIALS AND METHODS: This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, α-tocopherol and ß-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively. RESULTS: It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and α-tocopherol among cases (0.177±0.081, 1.649±1.670µg/ml) were significantly lower than in controls (0.264±0.137, 3.225±2.054µg/ml) (p<0.005). Although serum level of ß-carotene among cases (0.106±0.159 µg/ml) were lower compared to controls (0.134±0.131µg/ml), statistical significance was not observed. Logistic regression analysis showed that high serum level of retinol (OR=0.501, 95% CI=0.254-0.992, p<0.05) and α-tocopherol (OR=0.184, 95% CI=0.091-0.370, p<0.05) was significantly related to lower risk of oral cancer, whereas no relationship was observed between ß-carotene and oral cancer risk. CONCLUSIONS: High serum levels of retinol and α-tocopherol confer protection against oral cancer risk.

MDM2 SNP309 does not confer an increased risk to oral squamous cell carcinoma but may modulate the age of disease onset.

The MDM2 SNP309 has been associated with increased expression of the protein which could suppress p53 function, and has been shown to modulate risk to cancer. We have previously shown that overexpression of MDM2 is a common event in oral cancers. In the present study, we determined the association between the MDM2 SNP309 polymorphism and oral cancer in 207 oral cancer patients and 116 normal subjects. We genotyped the MDM2 SNP309 by PCR-RFLP. Logistic regression was adapted to calculate odds ratios for MDM2 SNP309 polymorphism from univariate and multivariable adjusted models. Our results suggest that MDM2 SNP309 does not confer increased risk to oral cancer (OR=1.55, 95% CI=0.77-3.11). However, the GG/TG genotype was associated with later disease onset in women above 55 years of age. Collectively, our data suggests that MDM2 SNP309 may modulate the risk to oral cancer and is a modifier of the age at oral cancer onset in women above the age of 55 years.