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Highlights of this issue
Disordered eating attitudes and behaviours
Jennifer Jones and colleagues evaluate the prevalence of disordered eating attitudes and behaviours among teenaged girls aged 12–18 years from schools in Toronto, Ottawa and Hamilton. Of the 1739 girls who completed a standardized questionnaire on eating disorders, 23% reported current dieting in order to lose weight, 15% reported binge eating associated with loss of control, 8.2% reported self-induced vomiting and 2.4% reported using diet pills. Overall, 27% of the sample indicated that they had significant symptoms of eating disorders and binge eating or purging, or both. The authors reinforce the importance of screening for disordered eating attitudes and behaviours among girls in their early teenaged years.
Preventing falls
Falls can be devastating for elderly people. David Hogan and colleagues conducted a 12-month randomized controlled trial to test the effectiveness of a multifaceted program to prevent falls, enrolling 163 community-dwelling elderly people who had fallen in the 3 months before the study. The intervention group received an in-home assessment as well as an individualized treatment plan and possible exercise program. The control group received usual care. The groups did not differ significantly in the cumulative number of falls (311 v. 241, p = 0.34), the proportion of subjects reporting 1 or more falls (79.2% v. 72.0%, p = 0.30) or the mean number of falls per person (4.0 v. 3.2, p = 0.43). Post hoc subgroup analysis showed that subjects with more than 2 falls in the 3 months preceding study entry who had been assigned to the intervention group were less likely to fall (p = 0.046) and had a significantly longer time between falls (p < 0.001) than those in the group who received usual care. In a related commentary, Pekka Kannus and Karim Khan point out that the authors had difficulty assessing adherence and argue that improving adherence to such interventions may be critical to their success.
Smoking cessation counselling 
Michèle Tremblay and colleagues describe the effectiveness of a 5-year intervention program targeted at GPs in Montreal to improve their smoking cessation counselling practices. Program activities during the first 3 years included cessation counselling workshops and conferences, publication of articles and guidelines in professional interest journals, and the provision of educational materials for both physicians and smokers. A comparison of responses to cross-sectional surveys completed by 337 (76.6%) randomly selected GPs in 1998 and 316 (69.6%) in 2000 demonstrated some improvements over time in several counselling practices, including offering counselling to more patients and discussing setting a quit date. More improvements were seen among the female GPs than among their male counterparts.
Clostridium myonecrosis and injection drug use A series of unexplained deaths associated with soft-tissue inflammation and severe systemic sepsis was reported among injection drug users in the United Kingdom and the Republic of Ireland in 2000. Nancy Williamson and colleagues report a case of probable Clostridium myonecrosis found in an injection drug user in Canada and remind physicians about this rare, but important, cause of soft-tissue infection.
Copyright 2001 Canadian Medical Association or its licensors |
