Effectiveness of self-management programs for people with osteoarthritis of the knee

The effectiveness of a new disease-specific self-management program for people with osteoarthritis of the knee was evaluated in two randomised controlled trials. Compared to a no intervention control, the program was found to be effective resulting in improvements in pain, function and quality of life. Moreover, compared to a generic arthritis self-management program, the disease specific program resulted in superior improvements in pain, physical function and general health, particularly in the short term

Diabetes and eating disorders: an exploration of ‘Diabulimia'

Abstract: Background: ‘Diabulimia’ is the term given to the deliberate administration of insufficient insulin for the purpose of weight loss. Although Diabulimia can be life-threatening and prevalence rates in diabetes are high, there is a lack of research for how to effectively support people with the condition. This exploratory study aimed to provide much-needed information to healthcare professionals and guide the focus for future research. Methods: Forty-five individuals with Type 1 diabetes mellitus (T1DM) and a history of insulin misuse completed an online questionnaire. This included an assessment of their eating disorder psychopathology with the Eating Disorder Examination Questionnaire (EDE-Q) and 16 open-ended questions exploring their experience of Diabulimia. The responses to the open-ended questions were analysed using thematic analysis. Results: The average global EDE-Q score was 3.96 (1.21), which is consistent with eating disorder populations. Common themes identified were concerns about weight, difficulty coping with diabetes, past trauma, and the importance of relationships. Experiences with health professionals were overwhelmingly negative. Most participants had experienced serious medical intervention due to Diabulimia and were fully aware of the consequences of insulin restriction. Conclusions: Overall, individuals believed that a greater awareness of Diabulimia and more training for healthcare professionals is needed. While education on insulin misuse may be a necessary first step in treatment, psychological support is crucial. To deliver effective treatment, clinicians should be aware of the specific issues facing those with Diabulimia. The current study identified themes that clinicians may find useful to consider

Smoking in pregnancy: who makes quit attempts whilst pregnant and what types of cessation support do they prefer?

Background Smoking in pregnancy is strongly associated with adverse pregnancy and birth outcomes. In England, 26% of women smoke at some point during pregnancy, and 12% smoke throughout. Reducing smoking during pregnancy is therefore an NHS priority. Despite this, little is known about women who make a quit attempt during pregnancy. This study examined sociodemographic and psychological characteristics associated with making a quit attempt during pregnancy, and explored preferences for cessation support. Methods Cross-sectional, baseline data collected as part of the Pregnancy Lifestyle Survey cohort was analysed. Self-reported current or recent ex-smokers (smoked within 3 months of pregnancy) completed a questionnaire between 8-26 weeks gestation. Logistic regression analysis was used to examine characteristics associated with making a quit attempt. Descriptive statistics were used to investigate interest in accessing different forms of cessation support. Results Of the 850 participants, 57% were self-reported current smokers. Cigarettes smoked per day, smoking beliefs, previous pregnancy and a planned pregnancy were found to be significantly associated with whether women made a quit attempt whilst pregnant. Primiparous women were more than twice as likely (OR 2.20: 95% CI 1.33-3.66) to have made a quit attempt than multiparous women, and those who smoked ≥11 cigarettes per day were 72% less likely to have made a quit attempt than those who smoked ≤5 cigarettes per day (OR 0.28: 95% CI 0.16-0.48). Over 70% of women who had made a quit attempt were interested in accessing health professional led support and self-help materials. Conclusions Understanding the characteristics of women who make a quit attempt whilst pregnant and their cessation support preferences could inform future smoking cessation service design, and improve uptake of support services by allowing healthcare providers to target the women most likely to make a quit attempt, and provide support tailored specifically to meet their needs

Understanding career aspirations of Information Technology students at Deakin University

Students need to develop informed and realistic career aspirations to gain the most from their university studies towards their initial career development. However developing their aspirations, goals, and expectations is a complex process. In Information Technology (IT) no clear career development framework is evident in the literature. We present a pilot study which investigates the career aspirations of novice students studying IT at an Australian University. Through a series of career activities their aspirations were explored with the aim of improving support for career development. Results indicate that students have no clear short- or long- term aspirations, yet believe that programming skills are key to achieve a career in IT

Diabetes and eating disorders: an exploration of ‘Diabulimia’

From Springer Nature via Jisc Publications RouterHistory: received 2020-06-30, registration 2020-09-17, accepted 2020-09-17, pub-electronic 2020-09-23, online 2020-09-23, collection 2020-12Publication status: PublishedAbstract: Background: ‘Diabulimia’ is the term given to the deliberate administration of insufficient insulin for the purpose of weight loss. Although Diabulimia can be life-threatening and prevalence rates in diabetes are high, there is a lack of research for how to effectively support people with the condition. This exploratory study aimed to provide much-needed information to healthcare professionals and guide the focus for future research. Methods: Forty-five individuals with Type 1 diabetes mellitus (T1DM) and a history of insulin misuse completed an online questionnaire. This included an assessment of their eating disorder psychopathology with the Eating Disorder Examination Questionnaire (EDE-Q) and 16 open-ended questions exploring their experience of Diabulimia. The responses to the open-ended questions were analysed using thematic analysis. Results: The average global EDE-Q score was 3.96 (1.21), which is consistent with eating disorder populations. Common themes identified were concerns about weight, difficulty coping with diabetes, past trauma, and the importance of relationships. Experiences with health professionals were overwhelmingly negative. Most participants had experienced serious medical intervention due to Diabulimia and were fully aware of the consequences of insulin restriction. Conclusions: Overall, individuals believed that a greater awareness of Diabulimia and more training for healthcare professionals is needed. While education on insulin misuse may be a necessary first step in treatment, psychological support is crucial. To deliver effective treatment, clinicians should be aware of the specific issues facing those with Diabulimia. The current study identified themes that clinicians may find useful to consider

Undetectable mannose binding lectin is associated with HRCT proven bronchiectasis in rheumatoid arthritis (RA)

Aim: The aim of this study was to ascertain whether mannose binding lectin deficiency is implicated in coexistent rheumatoid arthritis and bronchiectasis and to determine whether undetectable mannose binding lectin confers poorer long-term survival in coexistent rheumatoid arthritis and bronchiectasis or in rheumatoid arthritis in general. Materials and methods: A retrospective audit was conducted in a rheumatoid arthritis cohort in which mannose binding lectin had been measured by enzyme linked immunosorbent assay from 2007–11. Rheumatoid arthritis patients with physician diagnosed HRCT proven bronchiectasis were recruited during this time and compared to those with uncomplicated rheumatoid arthritis. Survival from disease onset was recorded in October 2018. Kaplan-Meier survival estimates were performed to assess mortality over time in the two groups. Log rank tests were used for equality of survivor functions. Results: The two groups were demographically comparable. A higher frequency of undetectable mannose binding lectin was observed in coexistent rheumatoid arthritis and bronchiectasis (37.5%) compared to uncomplicated rheumatoid arthritis, (8.9%, P = 0.005). Undetectable mannose binding lectin correlated with a strong trend toward poor survival in rheumatoid arthritis overall (P = 0.057). Cox regression analysis however, showed no difference in the hazard ratio for survival between the two groups when corrected for age, gender, prednisolone use ever, rheumatoid factor status and the full range of MBL concentrations. Conclusion: In summary, undetectable mannose binding lectin is associated with coexistent rheumatoid arthritis and bronchiectasis and correlates with poor survival in rheumatoid arthritis overall. These findings further implicate immunodeficiency in the genesis of bronchiectasis in rheumatoid arthriti

The relationship between reported daily nicotine dose from NRT and daily cigarette consumption in pregnant women who smoke in an observational cohort study

Introduction: For nonpregnant people unable to quit smoking, the NHS recommends nicotine replacement therapy (NRT) for smoking reduction. This is not recommended during pregnancy due to concerns about higher nicotine intake than smoking alone. We investigated the relationship between daily nicotine dose from NRT and cigarette consumption reported by pregnant women receiving smoking cessation support. Methods: We conducted secondary analysis of data from currently smoking pregnant women, recruited from antenatal clinics (Nottingham University Hospitals, UK) or online between June 2019–September 2020. Participants set a quit date, received a prototype NRT adherence intervention, and reported cigarettes per day (CPD) and daily NRT dose (mg) via smartphone app for 28 days. Results: 388 women were screened, 32 (8%) were eligible and joined the study. 24 (75%) submitted 510 app reports in total. 17 (71%) reported smoking and using NRT concurrently on at least one day, with concurrent use reported on 109 (21%) of app reports. The relationship between daily NRT dose and CPD followed an exponential decay curve of approximately 7%. In multilevel repeated measures modelling using 4 linear splines (knots 17, 40, and 85 mg/NRT), significant fixed effects of daily NRT dose on CPD were observed for splines 1, 3, and 4. The strongest association was spline 1 (0–17 mg/NRT), where each 10 mg NRT increase was associated with a 0.6 CPD reduction (24% on average). Conclusions: Among women in a cessation study, many smoked and used NRT concurrently; within these women, daily nicotine dose and heaviness of smoking were inversely related. Implications: Findings have implications for the design of future interventions intended to reduce harm associated with smoking in pregnancy. They suggest using NRT alongside smoking in pregnancy could help some women reduce the number of cigarettes they smoke per day

Smoking and vaping patterns during pregnancy and the postpartum:a longitudinal UK cohort survey

Abstract:Introduction:There is limited information about longitudinal patterns of vaping during pregnancy and the postpartum. We describe the prevalence, frequency, and reasons for vaping throughout pregnancy and postpartum. We also describe temporal patterns in pregnant women’s vaping.Methods:A longitudinal cohort study across England and Scotland, with questionnaires in early pregnancy (8-24 weeks gestation), late pregnancy (34-38 weeks) and 3 months postpartum. A total of 750 women, aged 16 years or over, who were either current smokers, vapers or had smoked in the 3 months before pregnancy, were recruited between June and November 2017.<br/