Experiences of patients with chronic gastrointestinal conditions: in their own words

<p>Abstract</p> <p>Background</p> <p>Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are chronic conditions affecting millions of individuals in the United States. The symptoms are well-documented and can be debilitating. How these chronic gastrointestinal (GI) conditions impact the daily lives of those afflicted is not well documented, especially from a patient's perspective.</p> <p>Methods</p> <p>Here we describe data from a series of 22 focus groups held at three different academic medical centers with individuals suffering from chronic GI conditions. All focus groups were audio recorded and transcribed. Two research team members independently analyzed transcripts from each focus group following an agreed upon coding scheme.</p> <p>Results</p> <p>One-hundred-thirty-six individuals participated in our study, all with a chronic GI related condition. They candidly discussed three broad themes that characterize their daily lives: identification of disease and personal identity, medications and therapeutics, and daily adaptations. These all tie to our participants trying to deal with symptoms on a daily basis. We find that a recurrent topic underlying these themes is the dichotomy of experiencing uncertainty and striving for control.</p> <p>Conclusions</p> <p>Study participants' open dialogue and exchange of experiences living with a chronic GI condition provide insight into how these conditions shape day-to-day activities. Our findings provide fertile ground for discussions about how clinicians might best facilitate, acknowledge, and elicit patients' stories in routine care to better address their experience of illness.</p

Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study

In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk

Influence of experimental set-up and methodology for measurements of metabolic rates and critical swimming speed in Atlantic salmon Salmo salar

In this study, swim‐tunnel respirometry was performed on Atlantic salmon Salmo salar post‐smolts in a 90 l respirometer on individuals and compared with groups or individuals of similar sizes tested in a 1905 l respirometer, to determine if differences between set‐ups and protocols exist. Standard metabolic rate (SMR) derived from the lowest oxygen uptake rate cycles over a 20 h period was statistically similar to SMR derived from back extrapolating to zero swim speed. However, maximum metabolic rate (MMR) estimates varied significantly between swimming at maximum speed, following an exhaustive chase protocol and during confinement stress. Most notably, the mean (±SE) MMR was 511 ± 15 mg O2 kg−1 h−1 in the swim test which was 52% higher compared with 337 ± 9 mg O2 kg−1 in the chase protocol, showing that the latter approach causes a substantial underestimation. Performing group respirometry in the larger swim tunnel provided statistically similar estimates of SMR and MMR as for individual fish tested in the smaller tunnel. While we hypothesised a larger swim section and swimming in groups would improve swimming performance, Ucrit was statistically similar between both set‐ups and statistically similar between swimming alone v. swimming in groups in the larger set‐up, suggesting that this species does not benefit hydrodynamically from swimming in a school in these conditions. Different methods and set‐ups have their own respective limitations and advantages depending on the questions being addressed, the time available, the number of replicates required and if supplementary samplings such as blood or gill tissues are needed. Hence, method choice should be carefully considered when planning experiments and when comparing previous studies.publishedVersio

Ann Work Expo Health

Introduction: Job coding into a standard occupation or industry classification is commonly performed in occupational epidemiology and occupational health. Sometimes, it is necessary to code jobs into multiple classifications or to convert job codes from one classification to another. We developed a generic tool, called CAPS-Canada (http://www.caps-canada.ca/), that combines a computer-assisted coding tool covering seven International, Canadian and US occupation and industry classifications and an assistant facilitating crosswalks from one classification to another. The objectives of this paper are to present the different functions of the CAPS-Canada tool and to assess their contribution through an inter-rater reliability study. Method: The crosswalk assistant was built based on a database of >30,000 jobs coded during a previous project. We evaluated to what extent it would allow automatic translation between pairs of classifications. The influence of CAPS-Canada on agreement between coders was assessed through an inter-rater reliability study comparing three approaches: manual coding, coding with CAPS-Canada without the crosswalk assistant, and coding with the complete tool. The material for this trial consisted of a random sample of 1000 jobs extracted from a case-control study and divided into three subgroups of equivalent size. Results: Across the classification systems, the crosswalk assistant would provide useful information for 83-99% of jobs (median 95%) in a population similar to ours. Eighteen to eighty-one percent of jobs (median 56%) could be entirely automatically recoded. Based on our sample of 1000 jobs, inter-rater reliability in occupation coding ranged from 35.7 to 66.5% (median 53.7%) depending on the combination of classification/resolution. Compared with manual coding, the use of CAPS-Canada substantially improved inter-rater reliability. Conclusion: CAPS-Canada is an attractive alternative to manual coding and is particularly relevant for coding a job into multiple classifications or for recoding jobs into other classifications

Pontiac fever among retirement home nurses associated with airborne legionella.

International audienceThe aim of this study was to ascertain incidence of symptoms compatible with Pontiac fever (PF) and to assess their association with exposure to legionella bacteria among retirement home nurses who help residents take their shower. Within a non-epidemic framework, 104 nurses of 19 retirement homes were followed up during an average period of four months. Data on symptoms, number and location of showers they attended were recorded daily by each participant. Water and aerosol bacterial quality was characterised at the end of follow-up using the culturable and the in-situ hybridisation techniques. Among 11 Pontiac-like episodes, eight cases complied with the study definition of PF. Water concentrations >10(3) cfu legionella per litre were associated with an increased risk of PF, with dose-response patterns. No association was established between the aerosol legionella concentrations and PF events. A threshold value of 103 cfu legionella per litre of water might be used with a view to protection from legionella-associated occupational conditions