Whole-Person, Urobiome-Centric Therapy for Uncomplicated Urinary Tract Infection

A healthy urinary tract contains a variety of microbes resulting in a diverse urobiome. Urobiome dysbiosis, defined as an imbalance in the microbial composition in the microenvironments along the urinary tract, is found in women with uncomplicated urinary tract infection (UTI). Historically, antibiotics have been used to address UTI. An alternative approach to uncomplicated UTI is warranted as the current paradigm fails to take urobiome dysbiosis into account and contributes to the communal problem of resistance. A whole-person, multi-modal approach that addresses vaginal and urinary tract dysbiosis may be more effective in reducing recurrent UTI. In this review, we discuss strategies that include reducing pathogenic bacteria while supporting commensal urogenital bacteria, encouraging diuresis, maintaining optimal pH levels, and reducing inflammation. Strategies for future research are suggested

Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts’ Opinions

Background: Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology. Methods: Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. Results: Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%). Conclusions: Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it

Reliability of self-reported constitutional questionnaires in Ayurveda diagnosis

Background: Ayurveda is one of the most ancient and widely practiced forms of medicine today, along with Traditional Chinese Medicine. It consists of determining an individual's constitution or Prakriti and current imbalance(s) through the use of multimodal approaches. Ayurveda practitioners may choose to include either a self-reported or structured interview constitutional questionnaire as part of the Prakriti assessment. Currently, there is no standardized or validated self-reported constitutional questionnaire tool employed by Ayurveda physicians or western Ayurveda educational institutions. Objectives: To examine test-retest reliability of three self-administered constitutional questionnaires at a one month interval and internal consistency of items pertaining to a single constitution. Materials and methods: Three constitutional questionnaires were administered online. 19 participants completed three questionnaires at two time points, one month apart. Age range was 21–62 years old with a mean age of 34. Of the 19, 5 were male and 14 female. Vata, Pitta, and Kapha scores obtained from each questionnaire were standardized to give a vector of three relative percentages, summing to 100. These percentages were further translated from numerical values to one of ten possible dosha diagnoses. Results: Analysis indicated that the three questionnaires had moderately good test-retest reliability according to numerical scores, but highly variable reliability according to discrete Ayurveda diagnosis. Internal consistency pertaining to individual constitutions within one questionnaire was poor for all three primary doshas, but especially for Kapha. Conclusion: Further research is necessary to develop a reliable and standardized constitutional questionnaire