Age and Body Satisfaction Predict Diet Adherence in Adolescents with Inflammatory Bowel Disease

The aim of the current study was to determine whether age and body satisfaction predict dietary adherence in adolescents with Inflammatory Bowel Disease (IBD), and whether older females are less adherent than younger males and females. Forty-four participants aged 10-21 with IBD were recruited. Participants provided informed consent and demographics. Body satisfaction was measured by a questionnaire and a task in which participants selected their current and ideal body image out of silhouettes depicting bodies ranging from underweight to obese. Adherence was measured by marking a 100mm visual analog scale, the 1-week completion of a dietary log, and a questionnaire evaluating coping strategies used for overcoming obstacles to dietary adherence. Age was related to dietary adherence, with younger children being more likely to adhere. Participants more satisfied with their body reported better dietary adherence. Findings remained consistent across multiple measures of body satisfaction and adherence. Healthcare providers and parents should be informed of these findings in order to improve adherence

A novel research definition of bladder health in women and girls: Implications for research and public health promotion

BACKGROUND:Bladder health in women and girls is poorly understood, in part, due to absence of a definition for clinical or research purposes. This article describes the process used by a National Institutes of Health funded transdisciplinary research team (The Prevention of Lower Urinary Tract Symptoms [PLUS] Consortium) to develop a definition of bladder health. METHODS:The PLUS Consortium identified currently accepted lower urinary tract symptoms (LUTS) and outlined elements of storage and emptying functions of the bladder. Consistent with the World Health Organization's definition of health, PLUS concluded that absence of LUTS was insufficient and emphasizes the bladder's ability to adapt to short-term physical, psychosocial, and environmental challenges for the final definition. Definitions for subjective experiences and objective measures of bladder dysfunction and health were drafted. An additional bioregulatory function to protect against infection, neoplasia, chemical, or biologic threats was proposed. RESULTS:PLUS proposes that bladder health be defined as: "A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of LUTS. Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being (e.g., travel, exercise, social, occupational, or other activities)." Definitions for each element of bladder function are reported with suggested subjective and objective measures. CONCLUSIONS:PLUS used a comprehensive transdisciplinary process to develop a bladder health definition. This will inform instrument development for evaluation of bladder health promotion and prevention of LUTS in research and public health initiatives

Treatment decision-making among men with lower urinary tract symptoms:A qualitative study of men’s experiences with recommendations for patient-centred practice

Aims: To inform and guide patient-centred care for men with lower urinary tract symptoms (LUTS), by providing in-depth qualitative evidence regarding men’s perspectives on treatment decision-making for LUTS.Methods: Interview study of men recruited from 26 English urology departments. Purposive sampling captured, surgical/non-surgical treatment decisions, and diversity in demographics and symptom burden, in men who had urodynamics and those who did not. After diagnostic assessments, men were interviewed either pre-treatment, or after LUTS surgery. Thematic analysis was conducted. Participants’ descriptions of how LUTS treatment decisions were made were categorised as patient-led, doctor-led, or shared.Results: 41 men participated (25 pre-treatment, 16 post-surgery), ages 52-89. 20/41 described the treatment decision as shared with their consultant, 14 as doctor-led, and 7 as patient-led. There was no obvious association between treatment decision-making style and patients’ satisfaction with either clinicians’ role in their decision or their treatment decision. Incomplete or rushed discussions and misperceptions of LUTS and its treatment were reported, indicating a risk of suboptimal decision-making support by clinicians. As well as clinician opinion, men’s treatment decision-making was influenced by the results of urological assessments, comparing current symptoms with possible side-effects of surgery, and others’ experiences and opinions. Conclusions: Men with LUTS report and prefer different kinds of decision-making support from their clinicians, who must tailor their input to patients’ preferences and needs. Patients’ treatment decision-making involves multiple factors and can be challenging, and areas of inadequate clinician support were identified. Recommendations for patient-centred consultations about LUTS treatment are presented. <br/

Survival and Presenting Complaint of Canine and Feline Paediatric Emergencies Presenting to UK Emergency Clinics

Objective: To describe the presenting problems for paediatric dogs and cats presented to emergency clinics, and to determine what factors influence mortality.Background: There is a lack of published literature available on canine and feline paediatric emergencies, their survival rates and factors that contribute to mortality. Experience and opinion largely replace evidence-based medicine when treating this subset of the emergency population.Evidentiary value: Evidentiary value for primary and emergency care practitioners is strong as the data is based on a large primary emergency care database. The paediatric population analysed consisted of 3142 paediatric canine and feline patients.Methods: A retrospective review of canine and feline emergency admissions to emergency out-of-hours clinics (May 2012-January 2014) was conducted. Data recorded included age, nature of complaint, euthanasia/death during treatment, and survival to discharge. Survival to discharge included all patients who presented to the clinic for examination, received treatment and were subsequently discharged; this includes those patients who were discharged  home or to their primary vets care. Patients were divided into four groups: canine patients ≤ 3 months of age and 3-6 months and feline patients ≤ 3 months of age and 3-6 months.Results: Paediatric patients represented around 3% of the emergency cases identified in the database. Survival to discharge in patients ≤3 months of age was significantly reduced in comparison to patients between 3-6 months of age, in both species. Feline paediatric patients had reduced survival to discharge compared to their canine counterparts.Conclusion: Paediatric patients have a low survival rate, indiscriminate of species and reason for presentation, with lower survival in younger animals; with a significant difference in survival between canine and feline patients.Application: The results of this study are important to small animal veterinarians in both emergency and non-emergency practice. <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /

Association between plasma neutrophil gelatinase-associated lipocalin and cardiac disease hospitalizations and deaths in older women

Background Neutrophil gelatinase-associated lipocalin ( NGAL ) or lipocalin 2 may promote atherosclerosis and plaque instability leading to increased risk of cardiac events. We investigated the relationships between plasma NGAL , cardiovascular disease biomarkers, and long-term cardiac events. Methods and Results The study population consisted of 1131 ambulant older white women (mean age 75 years) without clinical coronary heart disease ( CHD ) and measures of plasma NGAL in the Perth Longitudinal Study of Ageing Women with 14.5-year CHD and heart failure hospitalizations or death (events) captured using linked records. Over 14.5 years, 256 women had CHD events, while 118 had heart failure events. Per SD increase in log-transformed NGAL there was a 35% to 37% increase in relative hazards for CHD and heart failure events in unadjusted analyses, which remained significant after adjustment for conventional risk factors for CHD events (hazard ratio 1.29, 95% CI 1.13-1.48, P0.05). Women in the highest 2 quartiles of NGAL had higher relative hazards for CHD events compared with women in the lowest quartile hazard ratio 1.61, 95% CI 1.08-2.39, P=0.019 and hazard ratio 1.97, 95% CI 1.33-3.93, P=0.001, respectively. These associations were independent of high-sensitivity cardiac troponin I, homocysteine, and estimated renal function. NGAL correctly reclassified 1 in 4 women who sustained a CHD event up in risk and 1 in 10 women without CHD events down in risk. Conclusions NGAL was associated with increased risk of long-term CHD events, independent of conventional risk factors and biomarkers. These findings provide mechanistic insight into the role of NGAL with cardiac events

Physical activity for antenatal and postnatal depression in women attempting to quit smoking: randomised controlled trial

Background: Antenatal depression is associated with harmful consequences for both the mother and child. One intervention that might be effective is participation in regular physical activity although data on this question in pregnant smokers is currently lacking. Methods: Women were randomised to six-weekly sessions of smoking cessation behavioural-support, or to the same support plus 14 sessions combining treadmill exercise and physical activity consultations. Results: Among 784 participants (mean gestation 16-weeks), EPDS was significantly higher in the physical activity group versus usual care at end-of-pregnancy (mean group difference (95% confidence intervals (CIs)): 0.95 (0.08 to 1.83). There was no significant difference at six-months postpartum. Conclusion: A pragmatic intervention to increase physical activity in pregnant smokers did not prevent depression at end-of-pregnancy or at six-months postpartum. More effective physical activity interventions are needed in this population

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146323/1/nau23787_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146323/2/nau23787.pd