Misreporting of Energy Intake From Food Records Completed by Adolescents: Associations With Sex, Body Image, Nutrient, and Food Group Intake

Background and Objectives: A healthy diet during adolescence is important for growth and pubertal development. Assessing the diet of adolescents may be challenging as the behavioural factors and food habits which impact on what they eat may also affect how they report dietary intake. This study assesses factors associated with the misreporting of dietary intake. Methods: Adolescents (n = 4,844; average age 13.8 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC) completed a 3-day diet record. Misreporting was estimated using an individualised method, and adolescents were categorised by reporting status. Foods were categorised as core and noncore foods to evaluate diet quality. Body composition measurements were recorded at a research clinic. Information on dieting, weight concern, family socioeconomic status, and parental BMI were collected via questionnaires. Binary logistic regression was performed, in boys and girls separately, to investigate factors associated with underreporting of dietary intake. Results: Girls were much more likely than boys to be dissatisfied with their weight and to diet, but showed similar levels of underreporting (~67%). In adjusted regression analysis underreporters (UR) were more likely to be overweight or obese: OR in boys 2.8 (95% CI 1.7–4.8) and in girls 2.2 (95% CI 1.5–3.2). Dissatisfaction with weight and dieting were positively associated, and perception of being underweight negatively associated with underreporting in boys. Perception of being overweight, dieting, and exact age were positively associated with underreporting in girls. UR obtained a greater percentage of energy from protein and a smaller percentage of energy from fat; they reported greater intake of core foods and lower intakes of non-core foods than plausible reporters. Conclusion: A large proportion of adolescents underreported their dietary energy intake. This was associated with their body weight status and body image and had a differential effect on their estimated food and macronutrient intakes. Assessment of misreporting status is essential when collecting and interpreting dietary information from adolescents

Planning for tomorrow whilst living for today: the views of people with dementia and their families on Advance Care Planning

Background: Advance care planning (ACP) is increasingly prominent in many countries; however, the evidence base for its acceptability and effectiveness is limited especially in conditions where cognition is impaired, as in dementia. Method: This qualitative study used semi-structured interviews with people with mild to moderate dementia (n = 17) and family carers (n = 29) to investigate their views about planning for their future generally and ACP specifically. Results: People with dementia and their families make a number of plans for the future. Most people undertook practical, personal, financial, and legal planning. However participants did not make formal advance care plans with the exception of appointing someone to manage their financial affairs. Five barriers to undertaking ACP were identified: lack of knowledge and awareness, difficulty in finding the right time, a preference for informal plans over written documentation, constraints on choice around future care, and lack of support to make choices about future healthcare. Conclusions: Health and social care professionals can build on people's preferences for informal planning by exploring the assumptions underlying them, providing information about the possible illness trajectory and discussing the options of care available. Health and social care professionals also have a role to play in highlighting the aspects of ACP which seem to be most relevant to the wishes and aspirations of people with dementia

Virtual Prostate Biopsy with Prostate-specific Membrane Antigen and Magnetic Resonance Imaging: Closer to Reality in a Subgroup of Prostate Cancer Patients?

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Association of nutrition in early childhood with body composition and leptin in later childhood and early adulthood

Objectives: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), this study aimed to replicate the finding of the Etude Longitudinale Alimentation Nutrition Croissance des Enfants (ELANCE) that low fat intake in early childhood was associated with increased adiposity in adulthood. Methods: Diet was assessed at 8 and 18 months using 3-day food records. Body composition variables were measured at 9 and 17 years, and serum leptin at 9 years. Associations were modelled using adjusted linear regression. Results: In replication analyses, in contrast to ELANCE, there was a positive association between fat intake (% energy) at 18 months and fat mass (FM) at 9 years (B coefficient 0.10 (95% CI 0.03, 0.20) kg, p = 0.005). There was no association with serum leptin. In extended analyses fat intake at 18 months was positively associated with FM in boys (0.2 (0.00, 0.30), p = 0.008) at 9 years but not in girls. Fat intake was positively associated with serum leptin concentration in boys (0.2 (0.1, 0.4) ng/mL, p = 0.011) but not in girls. Conclusions: Our results did not corroborate the findings from the ELANCE study. A high fat diet in early life may have implications for later childhood and adolescent obesity

Prospective, multisite, international comparison of \u3csup\u3e18\u3c/sup\u3eF-fluoromethylcholine PET/CT, multiparametric MRI, and \u3csup\u3e68\u3c/sup\u3eGa-HBED-CC PSMA-11 PET/CT in men with high-risk features and biochemical failure after radical prostatectomy: Clinical performance and patient outcomes

A significant proportion of men with rising prostate-specific antigen (PSA) levels after radical prostatectomy (RP) fail prostate fossa (PF) salvage radiation treatment (SRT). This study was done to assess the ability of F-fluoromethylcholine ( F-FCH) PET/CT (hereafter referred to as F-FCH), Ga-HBED-CC PSMA-11 PET/CT (hereafter referred to as PSMA), and pelvic multiparametric MRI (hereafter referred to as pelvic MRI) to identify men who will best benefit from SRT. Methods: Prospective, multisite imaging studies were carried out in men who had rising PSA levels after RP, high-risk features, and negative/equivocal conventional imaging results and who were being considered for SRT. F-FCH (91/91), pelvic MRI (88/91), and PSMA (31/91) (Australia) were all performed within 2 wk. Imaging was interpreted by experienced local/central interpreters who were masked with regard to other imaging results, with consensus being reached for discordant interpretations. Expected management was documented before and after imaging, and data about all treatments and PSA levels were collected for 3 y. The treatment response to SRT was defined as a reduction in PSA levels of .50% without androgen deprivation therapy. Results: The median Gleason score, PSA level at imaging, and PSA doubling time were 8, 0.42 (interquartile range, 0.29–0.93) ng/mL, and 5.0 (interquartile range, 3.3–7.6) months. Recurrent prostate cancer was detected in 28% (25/88) by pelvic MRI, 32% (29/91) by F-FCH, and 42% (13/31) by PSMA. This recurrence was found within the PF in 21.5% (19/88), 13% (12/91), and 19% (6/31) and at sites outside the PF (extra-PF) in 8% (7/88), 19% (17/91), and 32% (10/31) by MRI, F-FCH, and PSMA, respectively (P, 0.004). A total of 94% (16/17) of extra-PF sites on F-FCH were within the pelvic MRI field. Intra-pelvic extra-PF disease was detected in 90% (9/10) by PSMA and in 31% (5/16) by MRI. F-FCH changed management in 46% (42/91), and MRI changed management in 24% (21/88). PSMA provided additional management changes over F-FCH in 23% (7/31). The treatment response to SRT was higher in men with negative results or disease confined to the PF than in men with extra-PF disease ( F-FCH 73% [32/44] versus 33% [3/9] [P, 0.02], pelvic MRI 70% [32/46] versus 50% [2/4] [P was not significant], and PSMA 88% [7/ 8] versus 14% [1/7] [P, 0.005]). Men with negative imaging results (MRI, F-FCH, or PSMA) had high (78%) SRT response rates. Conclusion: F-FCH and PSMA had high detection rates for extra-PF disease in men with negative/equivocal conventional imaging results and rising PSA levels after RP. These findings affected management and treatment responses, suggesting an important role for PET in triaging men being considered for curative SRT. 18 18 18 68 18 18 18 18 18 18 18 18 1

Planning for tomorrow whilst living for today: the views of people with dementia and their families on advance care planning

Background: Advance care planning (ACP) is increasingly prominent in many countries; however, the evidence base for its acceptability and effectiveness is limited especially in conditions where cognition is impaired, as in dementia. Method: This qualitative study used semi-structured interviews with people with mild to moderate dementia (n = 17) and family carers (n = 29) to investigate their views about planning for their future generally and ACP specifically. Results: People with dementia and their families make a number of plans for the future. Most people undertook practical, personal, financial, and legal planning. However participants did not make formal advance care plans with the exception of appointing someone to manage their financial affairs. Five barriers to undertaking ACP were identified: lack of knowledge and awareness, difficulty in finding the right time, a preference for informal plans over written documentation, constraints on choice around future care, and lack of support to make choices about future healthcare. Conclusions: Health and social care professionals can build on people's preferences for informal planning by exploring the assumptions underlying them, providing information about the possible illness trajectory and discussing the options of care available. Health and social care professionals also have a role to play in highlighting the aspects of ACP which seem to be most relevant to the wishes and aspirations of people with dementia

EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

Funding support and role of sponsor: The EAU/EANM PSMA-based imaging and therapy consensus meeting was supported by an unrestricted educational grant from Novartis; Novartis had no influence over the content of the meeting or the publication. Medical writing support was funded by the European Association of Urology Research Foundation. Acknowledgements: The authors acknowledge Emily Spieker (Management Assistant, European Association of Urology) for project management. Medical writing support was provided by Angela Corstorphine of Kstorfin Medical Communications (KMC) limited.Peer reviewedPublisher PD

The Impact of Surveillance Imaging Frequency on the Detection of Distant Disease for Patients with Resected Stage III Melanoma

Background It is not known whether there is a survival benefit associated with more frequent surveillance imaging in patients with resected American Joint Committee on Cancer stage III melanoma. Objective The aim of this study was to investigate distant disease-free survival (DDFS), melanoma-specific survival (MSS), post distant recurrence MSS (dMSS), and overall survival for patients with resected stage III melanoma undergoing regular computed tomography (CT) or positron emission tomography (PET)/CT surveillance imaging at different intervals. Patients and Methods A closely followed longitudinal cohort of patients with resected stage IIIA–D disease treated at a tertiary referral center underwent 3- to 4-monthly, 6-monthly, or 12-monthly surveillance imaging between 2000 and 2017. Survival outcomes were estimated using the Kaplan–Meier method, and log-rank tests assessed the significance of survival differences between imaging frequency groups. Results Of 473 patients (IIIA, 19%; IIIB, 31%; IIIC, 49%; IIID, 1%) 30% underwent 3- to 4-monthly imaging, 10% underwent 6-monthly imaging, and 60% underwent 12-monthly imaging. After a median follow-up of 6.2 years, distant recurrence was recorded in 252 patients (53%), with 40% detected by surveillance CT or PET/CT, 43% detected clinically, and 17% with another imaging modality. Median DDFS was 5.1 years (95% confidence interval 3.9–6.6). Among 139 IIIC patients who developed distant disease, the median dMSS was 4.4 months shorter in those who underwent 3- to 4-monthly imaging than those who underwent 12-monthly imaging. Conclusion Selecting patients at higher risk of distant recurrence for more frequent surveillance imaging yields a higher proportion of imaging-detected distant recurrences but is not associated with improved survival. A randomized comparison of low versus high frequency imaging is needed