Health promotion services for lifestyle development within a UK hospital – Patients' experiences and views

<p>Abstract</p> <p>Background</p> <p>UK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education. This study investigated hospitalised patients' experiences of health education for smoking, alcohol use, diet, physical activity, and weight, and their views concerning the appropriateness of hospitals as a setting for the delivery of health education services.</p> <p>Methods</p> <p>Recently discharged adult hospital patients (n = 322) were sent a questionnaire asking about their smoking, alcohol use, diet, physical activity, and weight. For each of these risk factors, participants were asked whether they agreed with screening for the risk factor, whether they received health education, whether it was "helpful", and if they wanted to change their behaviour. Participants were also asked a set of general questions concerning health education within hospitals.</p> <p>Results</p> <p>190 patients responded (59%). Over 80% agreed with screening for all risk factors. 80% of smokers, 52% consuming alcohol above recommended limits, 86% of obese, 66% consuming less than five fruit and vegetables a day, and 61% of physically inactive participants wanted to change their respective behaviour. However only a third reported receiving health education. While over 60% of patients wanted health education around discharge, the majority of those receiving health education did so at admission. The majority agreed that "hospital is a good place for patients to receive" health education (87%) and that "the hospital should provide patients with details of community organisations that provide" health education (83%). Only a minority (31%) reported a preference for health education from their GP instead of hospital.</p> <p>Conclusion</p> <p>While the delivery of health education to patients within hospital was poor, hospitals are viewed by patients as an appropriate, and in some cases preferred setting for the screening of risk factors and delivery of health education.</p

Multi-Modal Proteomic Analysis of Retinal Protein Expression Alterations in a Rat Model of Diabetic Retinopathy

As a leading cause of adult blindness, diabetic retinopathy is a prevalent and profound complication of diabetes. We have previously reported duration-dependent changes in retinal vascular permeability, apoptosis, and mRNA expression with diabetes in a rat model system. The aim of this study was to identify retinal proteomic alterations associated with functional dysregulation of the diabetic retina to better understand diabetic retinopathy pathogenesis and that could be used as surrogate endpoints in preclinical drug testing studies.A multi-modal proteomic approach of antibody (Luminex)-, electrophoresis (DIGE)-, and LC-MS (iTRAQ)-based quantitation methods was used to maximize coverage of the retinal proteome. Transcriptomic profiling through microarray analysis was included to identify additional targets and assess potential regulation of protein expression changes at the mRNA level. The proteomic approaches proved complementary, with limited overlap in proteomic coverage. Alterations in pro-inflammatory, signaling and crystallin family proteins were confirmed by orthogonal methods in multiple independent animal cohorts. In an independent experiment, insulin replacement therapy normalized the expression of some proteins (Dbi, Anxa5) while other proteins (Cp, Cryba3, Lgals3, Stat3) were only partially normalized and Fgf2 and Crybb2 expression remained elevated.These results expand the understanding of the changes in retinal protein expression occurring with diabetes and their responsiveness to normalization of blood glucose through insulin therapy. These proteins, especially those not normalized by insulin therapy, may also be useful in preclinical drug development studies

Cough in the Elderly Population: Relationships with Multiple Comorbidity

BACKGROUND: The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. METHODS: A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough) were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. RESULTS: The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8%) were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. CONCLUSIONS: Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly