A brief report of the epidemiology of obesity in the inflammatory bowel disease population of Tayside, Scotland

© 2009 The Authors. Published by Karger Publishers. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1159/000262276Aim: Obesity in inflammatory bowel disease (IBD), particularly Crohn’s disease (CD), has previously been considered unusual (3%). CD patients who are obese tend to have increased perianal complications and a higher level of disease activity on an annual basis. Obesity in Scotland has been documented to have increased over the last decade, and over half all men and women in Scotland are now considered to be overweight. This study aims to assess obesity prevalence in the IBD community in Tayside, Scotland. Methods: All IBD patients (n = 1,269) were considered for inclusion. Inclusion criteria required a weight measurement taken from the preceding 12 months and a height measurement within the last decade. 489 patients were included in the analysis. Results: 18% of the Tayside IBD population were obese in comparison to approximately 23% of the Scottish population on a whole. A further 38% of patients were over-weight, the same percentage as the general population. In the overweight and obese ulcerative colitis patients there were higher levels of surgery, but the converse was true in the CD group, where the normal-weight group had the highest levels of surgery. There were significantly more obese men and women with CD than with ulcerative colitis (P = 0.05). Conclusion: Obesity prevalence has increased in IBD patients. This is significant because of the known increased levels of postoperative complications, perianal disease and requirement for more aggressive medical therapy. Research needs to be done to look at the effects of obesity on the co-morbid associations of other diseases with IBD, in particular colorectal cancer, and to ascertain whether or not screening frequency should be altered depending on BMI.Published versio

The impact of severe haemophilia and the presence of target joints on health-related quality-of-life

Background: Joint damage remains a major complication associated with haemophilia and is widely accepted as one of the most debilitating symptoms for persons with severe haemophilia. The aim of this study is to describe how complications of haemophilia such as target joints influence health-related quality of life (HRQOL). Methods: Data on hemophilia patients without inhibitors were drawn from the ‘Cost of Haemophilia across Europe – a Socioeconomic Survey’ (CHESS) study, a cost-of-illness assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the UK). Physicians provided clinical and sociodemographic information for 1285 adult patients, 551 of whom completed corresponding questionnaires, including EQ-5D. A generalised linear model was developed to investigate the relationship between EQ-5D index score and target joint status (defined in the CHESS study as areas of chronic synovitis), adjusted for patient covariates including socio-demographic characteristics and comorbidities. Results: Five hundred and fifteen patients (42% of the sample) provided an EQ-5D response; a total of 692 target joints were recorded across the sample. Mean EQ-5D index score for patients with no target joints was 0.875 (standard deviation [SD] 0.179); for patients with one or more target joints, mean index score was 0.731 (SD 0.285). Compared to having no target joints, having one or more target joints was associated with lower index scores (average marginal effect (AME) -0.120; SD 0.0262; p < 0.000). Conclusions: This study found that the presence of chronic synovitis has a significant negative impact on HRQOL for adults with severe haemophilia. Prevention, early diagnosis and treatment of target joints should be an important consideration for clinicians and patients when managing haemophilia

Using the Community of Practice model to shape approaches to Education for Sustainable Development across disciplines in a Technological University context: A Roundtable Podcast

This roundtable discussion podcast comprises eight colleagues engaged in reflective discussion of their shared experiences of being members of SDG Literacy.ie, a Community of Practice (CoP) first established in TU Dublin in 2020. This CoP focuses on and promotes the enhancement of Sustainability Literacy among student cohorts as one measure to be employed in strengthening Education for Sustainable Development (ESD) in line with the broader strategic aims of the university. Harvey et al. (2021) in a case-based paper which includes examination of the CoP discussed here conclude that teaching and learning innovation took place as a consequence of the resource-sharing, idea-generation and overall peer support that CoP members experience. The voices you will hear in this podcast discussion represent the inter-disciplinary SDG Literacy academic community who all share an interest in the sustainability domain and are acutely aware of SDG4.7 which focuses on ensuring all learners acquire the knowledge and skills for sustainable development by 2030. Discussion themes include (i) our shared understanding of ESD, (ii) how membership of SDGLiteracy.ie shaped our Teaching, Learning and Assessment (TLA) approaches in relation to ESD, Sustainability Literacy and Authentic Assessment, (iii) how membership of SDGLiteracy.ie shaped our broader personal and professional development (research, collaboration, output etc.) and (iv) our future plans in relation to ESD and the CoP model. The podcast transcript has been annotated through footnotes to direct the listener/reader to further reading on the various topics that emerge in the discussion

Female sex but not oestrogen receptor expression predicts survival in advanced gastroesophageal adenocarcinoma—a post-hoc analysis of the go2 trial

Gastroesophageal adenocarcinoma is a disease of older adults that is associated with a very poor prognosis. It is less common and has better outcomes in females. The reason for this is unknown but may relate to signalling via the main oestrogen receptors (ER) α and β. In this study, we sought to investigate this using the GO2 clinical trial patient cohort. GO2 recruited older and/or frail patients with advanced gastroesophageal cancer. Immunohistochemistry was performed on tumour samples from 194 patients. The median age of the population was 76 years (range 52–90), and 25.3% were female. Only one (0.5%) tumour sample was positive for ERα, compared to 70.6% for ERβ expression. There was no survival impact according to ERβ expression level. Female sex and younger age were associated with lower ERβ expression. Female sex was also associated with improved overall survival. To our knowledge, this is the largest study worldwide of ER expression in a cohort of patients with advanced gastroesophageal adenocarcinoma. It is also unique, given the age of the population. We have demonstrated that female sex is associated with better survival outcomes with palliative chemotherapy but that this does not appear to be related to ER IHC expression. The differing ER expression according to age supports the concept of a different disease biology with age

Interactions between anti-EGFR therapies and cytotoxic chemotherapy in oesophageal squamous cell carcinoma: why clinical trials might have failed and how they could succeed

Acknowledgements We thank Alice Savage for technical laboratory assistance. Funding The work undertaken was funded by Ninewells Cancer Campaign (Dundee) and Scottish Government Chief Scientist Office (Grant reference TCS/19/18).Peer reviewedPublisher PD

Comparing the effectiveness of a short-term vertical jump vs. weightlifting program on athletic power development

Efficient training of neuromuscular power and the translation of this power to sport-specific tasks is a key objective in the preparation of athletes involved in team-based sports. The purpose of the current study was to compare changes in center of mass (COM) neuromuscular power and performance of sport-specific tasks following short-term (6-week) training adopting either Olympic Style Weightlifting (WL) exercises or vertical jump (VJ) exercises. Twenty six recreationally active males (18-30 years; height: 178.7±8.3 cm; mass: 78.6±12.2 kg) were randomly allocated to either a WL or VJ training group and performance during the countermovement jump (CMJ), squat jump (SJ), depth jump (DJ), 20m sprint and the 5-0-5 agility test assessed pre- and post-training. Despite the WL group demonstrating larger increases in peak power output during the CMJ (WL group: 10% increase, d=0.701; VJ group: 5.78% increase, d=0.328) and SJ (WL group: 12.73% increase, d=0.854; VJ group: 7.27% increase, d=0.382), no significant between-group differences were observed in any outcome measure studied. There was a significant main effect of time observed for the three vertical jumps (CMJ, SJ, DJ), 0-5m and 0-20m sprint times, and the 5-0-5 agility test time, which were all shown to improve following the training (all main effects of time p<0.01). Irrespective of the training approach adopted by coaches or athletes, addition of either WL or VJ training for development of power can improve performance in tasks associated with team-based sports, even in athletes with limited pre-season training periods

The STAR care pathway for patients with pain at 3 months after total knee replacement:a multicentre, pragmatic randomised controlled trial

BACKGROUND: Approximately 20% of people experience chronic pain after total knee replacement, but effective treatments are not available. We aimed to evaluate the clinical effectiveness and cost-effectiveness of a new care pathway for chronic pain after total knee replacement. METHODS: We did an unmasked, parallel group, pragmatic, superiority, randomised, controlled trial at eight UK National Health Service (NHS) hospitals. People with chronic pain at 3 months after total knee replacement surgery were randomly assigned (2:1) to the Support and Treatment After Replacement (STAR) care pathway plus usual care, or to usual care alone. The STAR intervention aimed to identify underlying causes of chronic pain and enable onward referrals for targeted treatment through a 3-month post-surgery assessment with an extended scope practitioner and telephone follow-up over 12 months. Co-primary outcomes were self-reported pain severity and pain interference in the replaced knee, assessed with the Brief Pain Inventory (BPI) pain severity and interference scales at 12 months (scored 0–10, best to worst) and analysed on an as-randomised basis. Resource use, collected from electronic hospital records and participants, was valued with UK reference costs. Quality-adjusted life-years (QALYs) were calculated from EQ-5D-5L responses. This trial is registered with ISRCTN, ISRCTN92545361. FINDINGS: Between Sept 6, 2016, and May 31, 2019, 363 participants were randomly assigned to receive the intervention plus usual care (n=242) or to receive usual care alone (n=121). Participants had a median age of 67 years (IQR 61 to 73), 217 (60%) of 363 were female, and 335 (92%) were White. 313 (86%) patients provided follow-up data at 12 months after randomisation (213 assigned to the intervention plus usual care and 100 assigned to usual care alone). At 12 months, the mean between-group difference in the BPI severity score was −0·65 (95% CI −1·17 to −0·13; p=0·014) and the mean between-group difference in the BPI interference score was −0·68 (−1·29 to −0·08; p=0·026), both favouring the intervention. From an NHS and personal social services perspective, the intervention was cost-effective (greater improvement with lower cost), with an incremental net monetary benefit of £1256 (95% CI 164 to 2348) at £20 000 per QALY threshold. One adverse reaction of participant distress was reported in the intervention group. INTERPRETATION: STAR is a clinically effective and cost-effective intervention to improve pain outcomes over 1 year for people with chronic pain at 3 months after total knee replacement surgery. FUNDING: National Institute for Health Research

Evaluating veld condition index: how many samples is enough?

Short Communication