In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation

Introduction: Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection. Stool donors are essential, but difficult to recruit and retain. We identified factors influencing willingness to donate stool.Methods: A 32-item questionnaire targeted young adults and health care workers via social media and university email lists in Edmonton and Kingston, Canada; London and Nottingham, England; and Indianapolis and Boston, USA. Items included baseline demographics and FMT knowledge and perception. Investigated motivators and deterrents included economic compensation, screening process, time commitment, and stool donation logistics. Logistic regression and linear regression models estimated associations of study variables with self-assessed willingness to donate stool.Results: 802 respondents completed our questionnaire: 387 (48.3%) age 21–30 years, 573 (71.4%) female, 323 (40%) health care workers. Country of residence, age and occupation were not associated with willingness to donate stool. Factors increasing willingness to donate were: already a blood donor (OR 1.64), male, altruism, economic benefit, knowledge of how FMT can help patients (OR 1.32), and positive attitudes towards FMT (OR 1.39). Factors decreasing willingness to donate were: stool collection unpleasant (OR 0.92), screening process invasive (OR 0.92), higher donation frequency, negative social perceptions of stool, and logistics of collecting/transporting feces.Discussion: Blood donors and males are more willing to consider stool donation. Altruism, economic compensation, and positive feedback are motivators. Screening process, high donation frequency, logistics of collecting/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention

Use of medium chain triglyceride (MCT) oil in subjects with Alzheimer's disease: A randomized, double‐blind, placebo‐controlled, crossover study, with an open‐label extension

Abstract Introduction Cerebral glucose and insulin metabolism is impaired in Alzheimer's disease (AD). Ketones provide alternative energy. Will medium chain triglyceride (MCT) oil, a nutritional source of ketones, impact cognition in AD? Methods This was a 6‐month randomized, double‐blind, placebo‐controlled, crossover study, with 6‐month open‐label extension in probable AD subjects, on stable medications. MCT dose was 42 g/day, or maximum tolerated. Cognition was assessed with Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Cognigram®. Results Twenty subjects, average age 72.6 years, 45% women, 70% university educated had baseline MMSE 22.6/30 (10–29); MoCA 15.6/30 (4–27); baseline Cognigram® Part 1: 65–106, Part 2: 48–107. Average MCT oil consumption was 1.8 tablespoons/day (25.2 g, 234 kcal). Eighty percent remained stable or improved. Longer MCT exposure and age > 73, resulted in higher final MMSE (P < .001) and Cognigram® 1 scores. Discussion This is the longest duration MCT AD study to date. Eighty percent had stabilization or improvement in cognition, and better response with 9‐month continual MCT oil

sj-docx-3-jpx-10.1177_23743735231151537 - Supplemental material for Cultural Knowledge in Context – People Aged 50 Years and Over Make Sense of a First Fracture and Osteoporosis

Supplemental material, sj-docx-3-jpx-10.1177_23743735231151537 for Cultural Knowledge in Context – People Aged 50 Years and Over Make Sense of a First Fracture and Osteoporosis by Patricia Harasym, Lauren A Beaupre, Angela G Juby, Paul Kivi, Sumit R Majumdar and Heather M Hanson in Journal of Patient Experience</p

Cultural Knowledge in Context – People Aged 50 Years and Over Make Sense of a First Fracture and Osteoporosis

Catch a Break (CaB) is a secondary fracture prevention program that uses medical understandings of osteoporosis to assess first fractures and determine appropriateness for secondary fracture prevention. In this study, we interviewed CaB program participants to identify the understandings that patients themselves used to make sense of first fractures and the osteoporosis suggestion as cause. Semi-structured interviews were conducted with female and male participants of the CaB program in Canada. An interpretive practice approach was used to analyze the data. A random sample of 20 individuals, 12 women, and eight men all aged 50 years and over participated. First fractures were produced as meaningful in the context of osteoporosis only for seniors of very advanced age, and for people of any age with poor nutrition. The trauma events that led to a first fracture were produced as meaningful only if perceived as accidents, and having an active lifestyle was produced as beneficial only for mental health and well-being unrelated to osteoporosis. Cultural knowledge shapes, but does not determine, how individuals make sense of their health and illness experiences. Risk prevention program designers should include patients on the design team and be more aware of the presumptive knowledge used to identify individuals at risk of disease