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Objective:To investigate the assessment and management of paediatric snoring and obstructive sleep apnoea in UK otolaryngology departments.Method:A telephone questionnaire survey of UK otolaryngology departments was conducted over a 16-week period.Results:The response rate was 61 per cent (85 out of 139 trusts). Use of pre-operative pulse oximetry was reported by 84 per cent of respondents, mainly to diagnose obstructive sleep apnoea (73 per cent) or stratify post-operative risk (46 per cent). Thirty-one per cent of respondents reported using post-operative pulse oximetry. Twenty-five per cent of respondents have a dedicated management protocol for paediatric obstructive sleep apnoea and snoring. Thirty-four per cent require prior clinical commissioning group approval before performing surgery. Fifty-eight per cent of respondents reported following up their obstructive sleep apnoea patients after surgery. The mean follow-up period (±standard deviation) was 6.8 ± 1.2 weeks.Conclusion:There is variation in the assessment and management of paediatric snoring and obstructive sleep apnoea across the UK, particularly in the use of pre- and post-operative pulse oximetry monitoring, and further guidelines regarding this are necessary. [ABSTRACT FROM AUTHOR]

Objectives:To assess the benefits of frenotomy on breastfeeding in infants, and determine the influence of age.Methods:A telephone questionnaire of all patients diagnosed with tongue-tie over 12 months was conducted pre-intervention and 1-month post-intervention. The Infant Breastfeeding Assessment Tool was used to assess breastfeeding.Results:Of 54 infants diagnosed with tongue-tie, 78 per cent of mothers participated in the survey. Eighty-six per cent of patients underwent frenotomy, with no surgical complications. In the frenotomy group, 81 per cent of mothers reported improvement in breastfeeding, versus 17 per cent in the non-surgical group (p = 0.0074). In the frenotomy group, the mean (±standard deviation) Infant Breastfeeding Assessment Tool score was 3.33 ± 1.51 pre-intervention, versus 9.19 ± 2.44 post-intervention (p = 0.0001). In the non-surgical intervention group, the mean score (±standard deviation) was 4.17 ± 0.75 pre-intervention, versus 6.00 ± 1.73 post-intervention (p = 0.16). For infants who underwent frenotomy, there was a reported improvement in 94 per cent of those aged less than 30 days, versus 68 per cent in infants aged over 30 days (p = 0.092).Conclusion:Frenotomy is a safe, short procedure that improves breastfeeding outcomes, and is best performed at an early age. [ABSTRACT FROM PUBLISHER]

Objectives:This study assessed the use of pulse oximetry testing in children with suspected obstructive sleep apnoea in a hospital setting.Methods:A retrospective review of patients who underwent pulse oximetry testing between April 2013 and October 2013 was performed. Primary outcome measures included positive pulse oximetry results, defined as a McGill oximetry score of 2–4.Results:Thirty-seven test results were usable for analysis: from 21 pre- and 16 post-operative tests. Only four patients had positive test results. There was a significant difference between pre- and post-operative quality of life outcome scores in the surgical group (p < 0.0001).Conclusion:Pre-operative pulse oximetry should be used as a guide to help triage patients who require specialist paediatric services, such as a paediatric intensive care unit. The use of pulse oximetry, particularly in the post-operative setting, is unlikely to change patient management and can incur unnecessary financial costs to UK National Health Service Hospital Trusts. [ABSTRACT FROM PUBLISHER]

Background We aimed to develop tools that could be reliably used to evaluate self-efficacy for consuming vegetables and low-sugar foods and beverages for African American and Latino children living in inner-city communities. Methods A total of 112 children, aged 8-11 years, identified by a parent as being either African-American or Latino, were recruited and administered questionnaires. Internal consistency, a measure of reliability, was assessed by calculating the Cronbach's alpha of test scores. Results Cronbach's alpha exceeded the threshold of acceptability of 0.70 for the Authors' Vegetables Self-Efficacy Index, and all three Low-Sugar Self-Efficacy Indices, including the Reference Index, the Authors' Low-Sugar Food and Beverage Index, and the Low-Sugar Beverages Index. Conclusions We present internally consistent tools that could be reliably used to evaluate self-efficacy for consuming vegetables and low-sugar foods and beverages in 8-11-year-old African-American and Latino children from low socio-economic communities. [ABSTRACT FROM AUTHOR]

Background Inuit in Nunavut, Canada, are currently undergoing a nutritional transition that may contribute to an increased prevalence of chronic disease. Information is lacking about the extent to which contemporary Inuit diets are meeting current dietary recommendations. Methods A culturally appropriate quantitative food frequency questionnaire ( QFFQ) developed and validated for Inuit in Nunavut, Canada, was used to assess food and nutrient intake in a cross-sectional sample of adults. Results Participants included 175 women and 36 men with mean (SD) ages of 42.4 (13.2) and 42.1 (15.0) years, respectively. The response rate for those who completed the study was 79% with 208 QFFQs included for analysis. Reported mean daily energy intakes were: men 15 171 kJ (3626 kcal); women 11 593 kJ (2771 kcal). Dietary inadequacy was expressed as the percentage of participants reporting intakes below the sex- and age-specific estimated average requirements ( EARs). For nutrients without EARs, adequate intakes were used. Energy and sodium intakes exceeded the recommendations. Less than 10% of participants met recommendations for dietary fibre intake. Vitamin E intakes were below EARs for ≥97% of participants, whereas >20% reported inadequate vitamin A, folate and magnesium intakes. Among women, >50% reported inadequate calcium and vitamin D intakes. Non-nutrient-dense foods contributed 30% of energy, 73% of sugars and 22% of fat. Traditional foods contributed 56% of protein and 49% of iron. Conclusions The present study demonstrates a relatively high prevalence of inadequate nutrient intakes among Inuit. The results may be used to monitor the nutrition transition among Inuit, evaluate nutritional interventions, and inform public health policy decision-making. [ABSTRACT FROM AUTHOR]

Background To describe the sources of meat and their contributions to vitamin B12, iron and zinc in five ethnic groups in the USA. Methods Dietary data for the Multiethnic Cohort, established in Hawaii and Los Angeles, were collected using a quantitative food frequency questionnaire from more than 215 000 subjects, aged 45-75 years at baseline (1993-1996). Participants included African American, Latino, Japanese American, Native Hawaiian and Caucasian men and women. Servings of meat items were calculated based on the US Department of Agriculture recommendations and their contributions to intakes of total meat, red meat, vitamin B12, iron and zinc were determined. Results Of all types of meat, poultry contributed the most to meat consumption, followed by red meat and fish among all ethnicities, except for Latino (born in Mexico and Central/ South America) men who consumed more beef. Lean beef was the most commonly consumed red meat for all ethnic-sex groups (9.3-14.3%), except for Native Hawaiian and Japanese American men, and Japanese American women whose top contributor was stew/curry with beef/lamb and stir-fried beef/pork with vegetables, respectively. The contribution of meat was most substantial for zinc (11.1-29.3%) and vitamin B12 (19.7-40%) and, to a lesser extent, for iron (4.3-14.2%). Conclusions This is the first large multiethnic cohort study to describe meat sources and their contributions to selected nutrients among ethnic minorities in the USA. These findings may be used to develop ethnic-specific recommendations for meat consumption aiming to improve dietary quality among these groups. [ABSTRACT FROM AUTHOR]

Inuit in Nunavut (NU) and Inuvialuit in the Northwest Territories (NWT), Canada, were traditionally nomadic peoples whose culture and lifestyle were founded on hunting and gathering foods from the local environment, primarily land and marine mammals. Lifestyle changes within the last century have brought about a rapid nutrition transition, characterised by decreasing consumption of traditional foods and an associated increase in the consumption of processed, shop-bought foods. This transition may be attributed to a multitude of factors, such as acculturation, overall food access and availability, food insecurity and climate change. Obesity and risk for chronic disease are higher in the Canadian Arctic population compared with the Canadian national average. This present review describes the study population and methodologies used to collect data in order to study the nutrition transition amongst Aboriginal Arctic populations and develop Healthy Foods North (HFN), a novel, multi-institutional and culturally appropriate programme that aims to improve dietary adequacy and reduce risk of chronic disease. Included in this special issue of the Journal of Human Nutrition and Dietetics are papers describing dietary intake patterns, physical activity levels, dietary behaviours, chronic disease prevalence and psychosocial factors that potentially mediate behaviour. A further paper describes how these data were utilised to inform and develop Healthy Foods North. [ABSTRACT FROM AUTHOR]

Background: Validation of a quantitative food frequency questionnaire (QFFQ) developed specifically for Inuit is necessary to determine its usefulness in assessing dietary intake and adequacy and in identifying dietary risk factors for chronic disease in this population. Methods: Seventy-five randomly selected Inuit adults in Nunavut, Canada, were recruited. Mean daily intake of nutrients from one to three 24-h recalls was used as the reference to measure QFFQ validity. Crude and energy-adjusted Spearman rank correlations (ρ), cross classification and weighted kappa were computed as measures of concordance. Bland–Altman plotting was used for additional assessment. Results: Excluding four participants with daily energy intake of >25.1 MJ, 71 participants were included in the analysis. For all nutrients, mean daily intake from the QFFQ was higher than the recall. ρ’s for macronutrients were in the range 0.71 for carbohydrate to 0.25 for protein. The best ρ amongst micronutrients was observed for vitamin C (0.66). Overall correlation between the two dietary tools improved after correction for within-person variance (from 0.46 to 0.49), although adjusting for energy did not improve the overall coefficient. When nutrient intakes were categorised into quartiles, the QFFQ and 24-h recalls indicated relative agreement proportion (same or adjacent quartiles) of 83% for energy, 94% for total sugar, 83% for macronutrients and 77% for micronutrients. Bland–Altman plots showed a tendency for increased scatter of the differences in nutrients at higher intakes. Conclusions: The QFFQ developed is valid and can be used to assess usual dietary intake and dietary adequacy, determine the contribution of foods to specific nutrient intakes, and identify dietary risk factors for chronic disease amongst this population. [ABSTRACT FROM AUTHOR]

Background: The estimation of dietary intake in population-based studies is often assessed by a food frequency questionnaire (FFQ). This present study aimed to establish the validity of a 142-item quantitative FFQ (QFFQ) developed to assess dietary intake in a population living in the Northwest Territories, Canada, and undergoing rapid nutrition transition. Methods: Sixty-four randomly selected Inuvialuit adults were recruited. The mean of one to three 24-h recalls was used as the reference to measure the validity of the QFFQ. Spearman rank correlations (ρ), cross-classification and weighted kappa were computed as measures of concordance, adjusting for the daily dietary intake variations in the recalls. Bland – Altman plots were used for additional assessment. Results: Four participants with daily energy intake of >25.1 MJ were not included in the analysis. For all nutrients, mean daily intake estimations were higher from the QFFQ than from the recalls. De-attenuated ρ’s for macronutrients ranged from 0.33 (protein) to 0.45 (carbohydrate). The best de-attenuated ρ amongst micronutrients was observed for vitamin C (0.53). Overall correlation between the two dietary tools improved after correction for within-person variance (from 0.32 to 0.35). When nutrient intakes were categorised into quartiles, the QFFQ and 24-h recalls indicated relative agreement (same or adjacent quartiles) for 77% for energy and macronutrients, 86% for total sugar and 72% for micronutrients. Bland–Altman plots showed a tendency for increased scatter of the differences at higher intakes. Conclusions: The QFFQ developed is valid and can be used to assess usual dietary intake and dietary adequacy, determine the contribution of foods to specific nutrient intakes, and identify dietary risk factors for chronic disease amongst Inuvialuit. [ABSTRACT FROM AUTHOR]

Objectives: To characterise the diet of First Nations in north-western Ontario, highlight foods for a lifestyle intervention and develop a quantitative food-frequency questionnaire (QFFQ).Design: Cross-sectional survey using single 24 h dietary recalls.Setting: Eight remote and semi-remote First Nations reserves in north-western Ontario.Subjects: 129 First Nations (Oji-Cree and Ojibway) men and women aged between 18 and 80 years.Results: The greatest contributors to energy were breads, pasta dishes and chips (contributing over 20 % to total energy intake). 'Added fats' such as butter and margarine added to breads and vegetables made up the single largest source of total fat intake (8.4 %). The largest contributors to sugar were sugar itself, soda and other sweetened beverages (contributing over 45 % combined). The mean number of servings consumed of fruits, vegetables and dairy products were much lower than recommended. The mean daily meat intake was more than twice that recommended. A 119-item QFFQ was developed including seven bread items, five soups or stews, 24 meat- or fish-based dishes, eight rice or pasta dishes, nine fruits and 14 vegetables. Frequency of consumption was assessed by eight categories ranging from 'Never or less than one time in one month' to 'two or more times a day'.Conclusion: We were able to highlight foods for intervention to improve dietary intake based on the major sources of energy, fat and sugar and the low consumption of fruit and vegetable items. The QFFQ is being used to evaluate a diet and lifestyle intervention in First Nations in north-western Ontario. [ABSTRACT FROM AUTHOR]

Background: Hairdressers undergo extensive and prolonged exposure to a variety of chemical substances present in the air in their salons. Although in low concentrations, the various products used for hair care are harmful as most of these products generate chemical aerosols during different procedures. These aerosols which have irritant or sensitizing effects on respiratory mucosa have been found to enter into the airways. Aim: The aim of this study is to assess the impairment of lung function in hairdressers in Gangtok. Method: This is a cross-sectional, comparative study conducted on 50 hairdressers and 50 age- and sex-matched non-hairdresser comparison group. The sampling technique used was simple random sampling. Permission from Institutional Ethical Committee was obtained before beginning the study. A standard questionnaire was used to record the respiratory symptoms. The pulmonary function parameters of the subjects were measured using portable spirometer HELIOS 720. Results: All the parameters were decreased in hairdressers and almost all the differences were statistically significant. FEV1 (P = 0.023) and FEV1/FVC ratio (P < 0.05) were reduced significantly. FEF25-75% and PEFR were also significantly reduced (P < 0.05 in both parameters). FVC was also reduced in hairdressers, but it was not statistically significant (P = 0.342). Conclusion: Hairdressers undergo exposure to different chemicals in their workplace and carry the risk of decreased pulmonary function. [ABSTRACT FROM AUTHOR]

Objective: Recurrent acute otitis media is common in children. The preferred treatment measures for recurrent acute otitis media have a mixed evidence base. This study sought to assess baseline practice across ENT departments in England. Methods: A national telephone survey of healthcare staff was conducted. Every ENT centre in England was contacted. A telephone script was used to ask about antibiotic and grommet use and duration in recurrent acute otitis media cases. Results: Ninety-six centres (74 per cent) provided complete information. Recurrent acute otitis media treatment across England by ENT departments varied. The antibiotic first- and second-line prophylaxis offered varies, with trimethoprim used in 33 centres and 29 centres not offering any antibiotics. The timing or choice about when to use grommets also varies, but 87 centres (91 per cent) offer grommet surgery at one stage. Conclusion: The treatments received by children in England for recurrent acute otitis media vary by centre; collaborative research in this area is advised. [ABSTRACT FROM AUTHOR]

Background: Bell's palsy is a lower motor neurone facial weakness of unknown aetiology, although reactivation of a virus within the facial nerve has been proposed. Methods: A prospective study was conducted of Bell's palsy cases presenting to our paediatric ENT unit over a 19-week period, from February to June 2020. Patients were invited for severe acute respiratory syndrome coronavirus-2 antibody testing. A text-message questionnaire was sent to other ENT centres to determine their observational experience. Results: During the study period, 17 children presented with Bell's palsy, compared with only 3 children in the same time period in the previous year (p < 0.0001). Five patients underwent severe acute respiratory syndrome coronavirus-2 antibody testing, the results of which were all negative. Four out of 15 centres questioned perceived an increased incidence in paediatric Bell's palsy. Conclusion: Clinicians are encouraged to be vigilant to the increase in paediatric Bell's palsy seen during the coronavirus disease 2019 pandemic, which may represent a post-viral sequela of coronavirus disease 2019. [ABSTRACT FROM AUTHOR]

Abstract: Background: Dietary habits formed during youth may result in the development of obesity and chronic diseases in adulthood. We aimed to determine the frequency of the consumption of foods and beverages and the degree of adherence to Canada's Food Guide recommendations among multi‐ethnic youths. Methods: Participants were recruited from 12 schools in the Edmonton, Alberta area by use of posters, school newsletters and advertisements. A 30‐item food frequency questionnaire was administered by a trained interviewer to assess dietary intake in a convenience sample of 557 (328 females and 229 males) youths aged 11–23 years; for the purpose of the present study, only the 14–18 years age group was considered in the analysis. Participants were divided by sex and self‐identified ethnicity into four groups [Indigenous, African & Middle Eastern (AME), Asian, and European]. Statistical analysis of the data was undertaken using t‐tests, Welch's analysis of variance and Games‐Howell tests. P < 0.05 was considered statistically significant. Results: Vegetables and Fruit recommendations were the least likely to be followed, with 90.7–96.8% of participants in all groups not consuming the recommended number of servings day–1. The mean frequency of fruit consumption was lower among Indigenous youths compared to Asian youths (0.90 versus 1.37 times day–1). A greater proportion of males than females (55.9% versus 44.3%) did not meet the minimum recommendations for Meat and Alternatives (P = 0.016). The percentage of youths not adhering to recommendations for Milk and Alternatives was 81.7% for Indigenous, 73.3% for AME, 78.6% for Asian and 63.5% for European youths. Indigenous youths more frequently consumed potato chips and soft drinks compared to other ethnic youths. The most frequently consumed beverage was milk (1.25 times day–1). Conclusions: The majority of youths did not consume minimum daily recommended servings of Vegetables and Fruit, Milk and Alternatives, and/or Meat and Alternatives food groups. Evidence‐based dietary interventions and public health strategies are needed. [ABSTRACT FROM AUTHOR]

Context: To evaluate the quality of life (QOL) outcome measures in disease-free survivors of pathological T1/T2 tongue cancers and to compare QOL in patients treated with only surgery and with adjuvant treatment.Settings and Design: Cross-sectional survey.Patients and Methods: All pathological T1/T2 anterior tongue cancer cases with follow-up from January 2011 till December 2015, who had locoregionally controlled disease with a minimum disease-free survival period of 1 year, were included in the study.Results: A total of 36 patients, 28 are males and 8 are females with an age range of 24-66 years (median age of 43) were enrolled in the study. The patients were divided into two groups with (n = 26) and without adjuvant postoperative radiotherapy (RT) (n = 10) and the University of Washington-QOL questionnaire version 4 for physical and social domains, global questions and three important domains were analyzed. On the physical and social domain scores, the surgery-alone group outscored the combined modality group on all scales and the differences were statistically significant for specific physical domains such as saliva (0.0001), taste (P = 0.0001), chewing (P = 0.0004), swallowing (P = 0.0026), and social domains such as mood (0.0001), pain (P = 0.0001), and shoulder function (P = 0.0061). The overall global QOL scores were also better for the surgical group compared with group which received adjuvant RT but was not statistically significant. All patients chose saliva as their top priority domain in the group which received radiation, and 60% chose "swallowing ability" as the preferred top priority domain in the only surgical group.Conclusions: Although locoregional control and disease-free survival are the major treatment-related endpoints for cancer management, QOL outcome measures have to assess to determine the impact of a treatment modality on patients well-being and for better rehabilitation of cancer-free patients. [ABSTRACT FROM AUTHOR]

Background: Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.Methods: We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.Results: Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P<0.001 for all comparisons). At the last spirometric measurement (mean [±SD] age, 26.0±1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001).Conclusions: Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; ClinicalTrials.gov number, NCT00000575.). [ABSTRACT FROM AUTHOR]

Background Traditionally, the Arctic diet has been derived entirely from locally harvested animal and plant species; however, in recent decades, imported foods purchased from grocery stores have become widely available. The present study aimed to examine Inuvialuit, traditional or nontraditional dietary patterns; nutrient density of the diet; dietary adequacy; and main food sources of energy and selected nutrient intakes. Methods This cross-sectional study used a culturally appropriate quantitative food frequency questionnaire to assess diet. Traditional and nontraditional eaters were classified as those consuming more or less than 300 g of traditional food daily. Nutrient densities per 4184 kJ (1000 kcal) were determined. Dietary adequacy was determined by comparing participants' nutrient intakes with the Dietary Reference Intakes. Results The diet of nontraditional eaters contained, on average, a lower density of protein, niacin, vitamin B12, iron, selenium, zinc, omega-3 fatty acids ( P ≤ 0.0001), vitamin B6, potassium, thiamin, pantothenic acid ( P ≤ 0.001), riboflavin and magnesium ( P ≤ 0.05). Inadequate nutrient intake was more common among nontraditional eaters for calcium, folate, vitamin C, zinc, thiamin, pantothenic acid, vitamin K, magnesium, potassium and sodium. Non-nutrient-dense foods (i.e. high fat and high sugar foods) contributed to energy intake in both groups, more so among nontraditional eaters (45% versus 33%). Traditional foods accounted for 3.3% and 20.7% of total energy intake among nontraditional and traditional eaters, respectively. Conclusions Diet quality and dietary adequacy were better among Inuvialuit who consumed more traditional foods. The promotion of traditional foods should be incorporated in dietary interventions for this population. [ABSTRACT FROM AUTHOR]

Background South Africa is experiencing a dietary and lifestyle transition as well as increased rates of noncommunicable chronic diseases. Limited information is available on the diets of rural populations. The present study aimed to characterise the diets of men and women from rural Kwa Zulu- Natal ( KZN) and develop a quantitative food-frequency questionnaire ( QFFQ) specific for this population. Methods A cross-sectional study was carried out by collecting single 24-h dietary recalls from 81 adults and developing a QFFQ in Empangeni, KZN, South Africa. Results The diet of this population was limited in variety, high in plant-based foods (especially cereals and beans), and low in animal products, vegetables and fruits. Amaize meal staple ( Phutu) was consumed by over 80% of subjects and accounted for almost 45% of energy intake, as well as making an important contribution to fat and protein intake. Most of the protein consumed by the study population was plant-based protein, with almost 40% being obtained from the consumption of phutu and beans. A culturally appropriate QFFQ was developed that includes 71 food and drink items, of which 16 are composite dishes unique to this population. Conclusions Once validated, this QFFQ can be used to monitor diet-disease associations, evaluate nutritional interventions and investigate dietary changes in this population. [ABSTRACT FROM AUTHOR]

Background Healthy Foods North ( HFN) is a community-based intervention designed to promote a healthy diet and lifestyle of Inuit and Inuvialuit populations in Arctic Canada. The objective of the present study was to determine the effects of HFN on the nutrient intake of women of childbearing age. Methods Six communities in Nunavut ( n = 3) and the Northwest Territories ( n = 3) were selected for programme implementation; four received a 12-month intervention and two served as controls. Quantitative food frequency questionnaires were used to assess dietary intake at baseline and 1 year post-intervention. Among women participants aged 19-44 years ( n = 136), 79 were exposed to the intervention and 57 were not. Mean daily energy and nutrient intake and density were determined. Dietary adequacy was assessed by comparing the women's daily nutrient intakes with dietary reference intakes ( DRI). Results Main outcomes were the pre- to post-intervention changes between intervention and control groups for energy and selected nutrient intakes, nutrient density and dietary adequacy. Among the participants, the intervention had a beneficial effect on vitamin A and D intake. The percentage of individuals with nutrient intakes below the DRI increased from pre- to post-intervention for vitamin A and D in the control group but only for vitamin A in the intervention group. The programme did not have a significant impact on calorie, sugar, or fat consumption. Conclusions The HFN programme is effective in mitigating some of the negative impacts of the nutrition transition on dietary adequacy among Inuit and Inuvialuit women of childbearing age. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective A cognitive interpersonal maintenance model of anorexia nervosa (AN) was first proposed in 2006 and updated in 2013 (Schmidt and Treasure, J Br J Clin Psychol, 45, 343-366, 2006; Treasure and Schmidt, J Eat Disorders, in press.). The aim of this study was to test the interpersonal component of this model in people with AN requiring intensive hospital treatment (inpatient/daypatient). Method On admission to hospital women with AN or eating disorder not otherwise specified (AN subtype; n = 152; P) and their primary carers ( n = 152; C) completed questionnaires on eating symptoms (P), depression and anxiety (P, C), accommodation and enabling (C), and psychological control (C). Structural equation modeling was used to examine relationships among these components. Results Carers' expressed emotion and level of psychological control were significantly related to carers' distress, which in turn, was related to patients' distress. This pathway significantly predicted eating symptoms in patients. Discussion The cognitive interpersonal maintenance model of eating disorders (EDs) was confirmed in part and suggests that interventions targeting interpersonal maintaining factors such as carer distress might impact on patient outcomes. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:867-874) [ABSTRACT FROM AUTHOR]

Background Previous studies highlight a possible association between alcohol-drinking patterns and dietary inadequacies, which may have negative implications, particularly for women of child-bearing age. The present study aimed to compare dietary adequacy among alcohol drinkers versus nondrinkers in Inuvialuit women of child-bearing age. Methods A cross-sectional survey of 92 randomly selected women of childbearing age (19-44 years) was conducted in three communities in the Northwest Territories of Arctic Canada, using a validated quantitative food frequency questionnaire. Data were analysed to compare mean daily energy and nutrient intakes, dietary adequacy and nutrient densities (per 4184 kJ) between alcohol drinkers and nondrinkers, as well as heavy drinkers and nonheavy drinkers, using the nonparametric Wilcoxen rank sum test. Results The response rate was between 65% and 85% depending on the community sampled. Of the study participants, 54% ( n = 49) were drinkers and 46% ( n = 42) were nondrinkers. Of the drinkers, 45% ( n = 22) were heavy drinkers. Mean energy intakes were high among all women, although they were significantly higher among drinkers [17 179 kJ (4106 kcal)] compared to nondrinkers [13 317 kJ (3183 kcal)]. There were no significant differences in nutrient intake between the two groups; however, drinkers had a lower nutrient density for most nutrients. Heavy drinkers had a significantly lower nutrient density for all nutrients, except protein, iron, and vitamins B6, C and D, compared to nonheavy drinkers. Conclusions The findings of the present study provide evidence of inadequate dietary intake among Inuvialuit of child-bearing age, regardless of alcohol-drinking behaviour. [ABSTRACT FROM AUTHOR]

Background Inuvialuit of Arctic Canada are at high risk for inadequate vitamin D status as a result of rapid dietary transitions and a lack of solar ultraviolet B exposure. This may have implications for the development of adverse skeletal diseases, cardiovascular diseases and cancers. Data are limited regarding supplement use in Arctic Aboriginal populations. The present study aimed to describe the type and extent of supplement use, emphasising vitamin D, and to identify differences between supplement users and non-users. Methods Supplement information was collected from a population-specific quantitative food frequency questionnaire in three communities in the Northwest Territories, Canada, as part of a cross-sectional study. Data were analysed for frequency of supplementation and types of supplements. Users and non-users were compared in terms of age, sex, body mass index, education, marital status, income support, employment and chronic disease diagnosis using nonparametric tests and the chi-squared test. Results Response rates ranged from 65% to 85%. Included in the analysis were 192 Inuvialuit (45 males, 147 females) with a mean (SD) age of 43.6 (13.9) years. Twenty-three percent reported using a supplement, with multivitamins being the most common. Three percent indicated taking a vitamin D-containing supplement. No significant differences between supplement users and non-users were found. Conclusions Despite limited sun exposure for many months of the year, a small proportion of Inuvialuit adults were using supplements, and specifically vitamin D-containing supplements. Future population-based intervention strategies should promote consumption of vitamin D rich foods and encourage the use of vitamin D supplements if diet alone is unable to meet recommendations. [ABSTRACT FROM AUTHOR]

Dietary transition in the Arctic is associated with decreased quality of diet, which is of particular concern for women of childbearing age due to the potential impact of maternal nutrition status on the next generation. The study assessed dietary intake and adequacy among Inuit women of childbearing age living in three communities in Nunavut, Canada. A culturally-appropriate quantitative food-frequency questionnaire was administered to 106 Inuit women aged 19-44 years. Sources of key foods, energy and nutrient intakes were determined; dietary adequacy was determined by comparing nutrient intakes with recommendations. The prevalence of overweight/obesity was >70%, and many consumed inadequate dietary fibre, folate, calcium, potassium, magnesium, and vitamin A, D, E, and K. Non-nutrient-dense foods were primary sources of fat, carbohydrate and sugar intakes and contributed >30% of energy. Traditional foods accounted for 21% of energy and >50% of protein and iron intakes. Strategies to improve weight status and nutrient intake are needed among Inuit women in this important life stage. [ABSTRACT FROM AUTHOR]

Background: Existing evidence indicates that Inuit in Arctic Canada are undergoing a lifestyle transition leading to decreased physical activity (PA) and increased body mass index (BMI). Data specific to PA and BMI amongst Inuit in Nunavut, Canada, are currently limited. The present study aimed to characterise current PA and BMI levels in a sample of Inuit adults. Methods: Inuit adults randomly selected from a cross-sectional survey of three communities in Nunavut, Canada, completed an adapted International Physical Activity Questionnaire (IPAQ) and an anthropometric survey. Data were analysed by gender and age group using standardised IPAQ protocol. Results: Response rates ranged from 69–93%. Two hundred and eighteen Inuit adults [180 women, 38 men; mean (standard deviation (SD)) ages 42.3 (13.0) and 42.4 (14.8) years respectively; age range 19–89 years] completed the IPAQ. All men and 97% of women allowed height and weight measurements; the remainder were self-reported. Mean (SD) BMI was 27.7 (6.3) kg/m2 for males and 30.3 (8.0) kg/m2 for females. The largest proportion of women and participants in both age groups had a BMI in the obese category; males were evenly split between the normal and obese categories. Self-reported PA was high, with most men, women and participants ≤50 years in the high category of PA. Participants >50 years were evenly split across the medium and high categories. Most participants (72%) were classified as being overweight or obese, yet reported medium or high levels of PA (89%). Conclusions: The findings obtained in the present study indicate the co-existence of high BMI and high self-reported PA amongst Inuit adults. [ABSTRACT FROM AUTHOR]

Background: Chronic disease prevalence amongst Canadian Arctic populations is increasing, but the literature amongst Inuvialuit is limited. The present study aimed to provide baseline data that could be used to monitor changes in chronic disease risk factors and long-term health in the Arctic by determining prevalence and risk factors of self-reported chronic disease amongst adult Inuvialuit in remote communities. Methods: Self-reported demographics and history of chronic disease (hypertension, heart disease, diabetes and cancer) were collected in three communities between July 2007 and July 2008 in the Northwest Territories. Food frequency questionnaires recorded dietary intake, International Physical Activity Questionnaires recorded physical activity and anthropometric measures of height and weight were obtained. Results: Response rates ranged from 65–85%. More than 20% of the 228 participants aged 19–84 years reported having a chronic disease. Age-adjusted prevalence was 28, 9, 9 and 6 per 100 for hypertension, heart disease, diabetes and cancer, respectively. Compared with non-cases, participants reporting hypertension were more likely to have a higher body mass index and a lower level of education. Hypertension was more common amongst participants reporting heart disease and diabetes than Inuvialuit not reporting these morbidities. Conclusions: Inuvialuit participants in this study were most affected by hypertension and diabetes compared with heart disease or any cancer. Female participants had a higher prevalence of heart disease compared with the Canadian average. Primary preventive strategies are necessary to mitigate the increasing rates of chronic disease risk factors in this population. Further studies with a larger sample size and measured chronic disease are necessary to confirm the findings obtained in the present study. [ABSTRACT FROM AUTHOR]

Background: Inuvialuit in the Canadian Arctic have been experiencing a nutrition transition resulting in a decrease in nutrient-dense food consumption, which may, in part, explain this population’s increasing chronic disease rates. Because the available literature is limited, the present study aimed to document the extent of this transition by examining current dietary patterns and socioeconomic factors affecting food group consumption. Methods: This cross-sectional study was conducted in three Inuvialuit communities in the Northwest Territories between 2007 and 2008. A validated food frequency questionnaire determined intake frequency of fruit and vegetables (FV), traditional foods (TF) and non-nutrient-dense foods (NNDF). Socioeconomic status (SES) was assessed by questions on education, ownership of items in working condition used to create a Material Style of Life (MSL) scale and residents in household employed/on income support. Daily intake frequencies were compared by gender and age group using Wilcoxon rank sum test. SES association with food group intake was determined using logistic regression. Results: The response rate was 65–85%. One hundred and seventy-five participants were female and 55 were male, aged 19–84 years [mean (SD) 44 (14)]. Mean frequencies of FV and TF consumption were 1.6 (1.5) and 1.6 (1.7) times per day, respectively. NNDF were reported 9.2 (3.0) times per day. The highest MSL score (>12) was significantly associated with higher fruit (≥0.7 times per day) and higher TF intake (≥1.1 times per day) compared with the lowest score (≤7). An intermediate MSL score (8–12) was related to higher vegetable consumption (≥0.4 times per day). Conclusions: NNDF were consumed approximately seven times more frequently than TF in the present study, indicating that the dietary transition is well underway amongst Inuvialuit. Participants with higher SES were more likely to consume nutrient-dense foods, suggesting possible cost barriers. [ABSTRACT FROM AUTHOR]

Background: Changing food behaviours amongst Canadian Inuit may contribute to rising chronic disease prevalence, and research is needed to develop nutritional behaviour change programmes. The present study examined patterns of food acquisition and preparation behaviours amongst Inuit adults in Nunavut and associations with psychosocial and socioeconomic factors. Methods: Developed from behavioural theories and community workshops, Adult Impact Questionnaires were conducted with adult Inuit (≥19 years) from randomly selected households in three remote communities in Nunavut, Canada, to determine patterns of healthy food knowledge, self-efficacy and intentions, frequencies of healthy and unhealthy food acquisition and healthiness of preparation methods. Associations between these constructs with demographic and socioeconomic factors were analysed using multivariate linear regressions. Results: Amongst 266 participants [mean (SD) age 41.2 (13.6) years; response rates 69–93%], non-nutrient-dense foods were acquired a mean (SD) of 2.9 (2.3) times more frequently than nutrient-dense, and/or low sugar/fat foods. Participants tended to use preparation methods that add fat. Intentions to perform healthy dietary behaviours was inversely correlated with unhealthy food acquisition (β = −0.25, P < 0.001), and positively associated with healthy food acquisition (β = 0.22, P < 0.001) and healthiness of preparation methods (β = 0.15, P = 0.012). Greater healthy food knowledge and self-efficacy were associated with intentions (β = 0.21, P = 0.003 and β = 0.55, P < 0.001, respectively). Self-efficacy was associated with healthier preparation (β = 0.14, P = 0.025) and less unhealthy food acquisition (β = −0.27, P < 0.001), whilst knowledge was associated with acquiring healthy foods (β = 0.13, P = 0.035). Socioeconomic status was positively associated with healthy preparation and food acquisition behaviours. Conclusions: Interventions to improve diet in Nunavut Inuit should target healthy food intentions, knowledge and self-efficacy. Behaviour change strategies emphasising economic benefits of a healthy diet should be employed to target individuals of low socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: The extent to which awareness of chronic disease (CD) diagnosis affects one’s healthy food knowledge, self-efficacy and intentions or healthy dietary and physical activity (PA) behaviours remains unexplored among Inuit in Canada. Methods: A food frequency questionnaire and an adult impact questionnaire were used in a cross-sectional study to collect self-reported data on daily energy and nutrient intake, PA and the diagnosis of hypertension, diabetes, heart disease and cancer amongst adult Inuit and their family members. Associations between awareness of personal and family CD status and healthy food knowledge, self-efficacy and intentions, percentage of energy consumed from non-nutrient-dense foods and PA were assessed via ordinal logistic regression. Results: Of the 266 participants, those who self-reported CD for both themselves and their relative(s) were more likely to have high healthy food knowledge [odds ratio (OR) = 2.45] than those who did not. Reporting hypertension and heart disease amongst only relatives increased the likelihood of high knowledge (OR = 5.20) and intentions (OR = 5.10) for healthy eating. Heart disease in both participants and their relatives was associated with high levels of PA (OR = 12.24). However, there were no associations when only participants (but not their relatives) reported having CD. A joint effect between a high level of education and awareness of CD was positively related to high food knowledge (OR = 38.93). An inverse association between awareness of CD and unhealthy eating was not observed. Conclusions: Awareness of a relative having a CD was a more important factor in increasing knowledge and, to a lesser degree, self-efficacy or intentions to eat healthy than participants’ awareness of personal CD. However, awareness was not associated with lower non-nutrient-dense food intake. [ABSTRACT FROM AUTHOR]

Background: Increasing consumption of non-nutrient-dense foods (NNDF), decreasing consumption of traditional foods (TF) and low consumption of fruit and vegetables (FV) may contribute to increasing chronic disease rates amongst Inuit. The present study aimed to assess the daily frequency and socioeconomic and demographic factors influencing consumption of TF, FV and NNDF amongst Inuit adults in Nunavut, Canada. Methods: Using a cross-sectional study design and random household sampling in three communities in Nunavut, a food frequency questionnaire developed for the population was used to assess frequency of NNDF, TF and FV consumption amongst Inuit adults. Socioeconomic status (SES) was assessed by education level, ownership of items in working condition, and whether or not people in the household were employed or on income support. Mean frequencies of daily consumption were compared across gender and age groups, and associations with socioeconomic indicators were analysed using logistic regression. Results: Two hundred and eleven participants (36 men, 175 women; mean (standard deviation) ages 42.1 (15.0) and 42.2 (13.2) years, respectively; response rate 69–93%) completed the study. Mean frequencies of consumption for NNDF, TF and FV were 6.3, 1.9 and 1.6 times per day, respectively. On average, participants ≤50 years consumed NNDF ( P = 0.003) and FV ( P = 0.01) more frequently and TF ( P = 0.01) less frequently than participants >50 years. Education was positively associated with FV consumption and negatively associated with TF consumption. Households on income support were more likely to consume TF and NNDF. Conclusions: These results support the hypothesis that the nutrition transition taking place amongst Inuit in Nunavut results in elevated consumption of NNDF compared with TF and FV. [ABSTRACT FROM AUTHOR]

Background: With increasing chronic disease amongst Inuvialuit in the Canadian Arctic, research on dietary behaviours and their determinants in this population is needed to develop nutritional behaviour change intervention strategies. The present study aimed to assess the knowledge, self-efficacy and intentions towards healthy eating and healthy eating behaviours of Inuvialuit adults in the Northwest Territories (NWT), Canada. Methods: The Adult Impact Questionnaire was developed from behavioural theories and workshops held in the communities. It was conducted with adult Inuvialuit (≥19 years) from randomly selected households in three NWT communities to collect data on the psychosocial constructs of healthy food knowledge, self-efficacy and intentions, and the dietary behaviours of healthy and unhealthy food acquisition and preparation. Associations between demographic, socioeconomic, psychosocial constructs and behaviours were analysed using multivariate linear regression. Results: The 228 participants [mean (SD) age 43.4 (13.6) years; response rates 65–85%] acquired non-nutrient-dense foods a mean (SD) of 2.7 (3.0) times more frequently than nutrient-dense, low sugar and low fat foods. Increased intention was associated with a greater frequency of acquiring healthy foods (β = 0.17, P = 0.012) and a lower frequency of acquiring unhealthy foods (β = −0.18, P = 0.008). Overall, participants reported using food preparation methods that reduce fat content slightly more than methods that add fat [mean (SD) score 0.3 (1.9)]. Use of healthier food preparation methods was associated with higher levels of healthy food knowledge (β = 0.26, P < 0.001), self-efficacy (β = 0.29, P < 0.001) and intentions (β = 0.22, P = 0.001). Conclusions: Healthy food intention was the construct most significantly associated with all three healthier dietary behaviours. Interventions that target intentions to change food choice and preparation may be effective strategies to improve dietary intake in Inuvialuit populations. [ABSTRACT FROM AUTHOR]

Background: Inuvialuit in Arctic Canada are undergoing nutrition and lifestyle transitions that encourage decreased physical activity (PA) and increased body mass index (BMI), although data specific to PA and BMI within this unique population are not currently available. The present study aimed to characterise current PA and BMI levels in a sample of Inuvialuit adults. Methods: Inuvialuit adults randomly selected from a cross-sectional survey of three communities in the Northwest Territories, Canada, completed an adapted International Physical Activity Questionnaire (IPAQ) and an anthropometric questionnaire to obtain height and weight. Data were analysed using the standardised IPAQ protocol, and the results are presented by gender and age group (≤50 and >50 years). Results: One hundred and ninety-six Inuvialuit adults [148 women, 48 men; mean (standard deviation (SD)) ages 45 (14) and 41 (14) years, respectively; age range 19–84 years] completed the IPAQ (response rates 65–85%). Seventy-one percent of men and 74% of women allowed height measurements, whilst 81% and 84% allowed weight measurements, respectively; the remainder provided self-reported anthropometrics. Mean (SD) BMIs were 28.6 (7.7) kg/m2 for males and 30.5 (8.8) kg/m2 for females. The greatest percentage of participants in both gender and age groups fell into the obese BMI category. Self-reported PA was high, with means for men and participants ≤50 years in the high category of PA and means for women and participants >50 years in the medium category. Almost two-thirds (65%) of participants were classified as being overweight or obese, although 89% reported medium or high levels of PA. Conclusions: The results obtained in the present study indicate widespread overweight/obesity accompanying high levels of self-reported PA. [ABSTRACT FROM AUTHOR]

Aims: This study sought to confirm the efficacy of using resting 12-lead ECG alongside personal symptom and family history questionnaires and physical examination when screening for diseases with the potential to cause sudden cardiac death in the young. Methods and results: 1374 national and international junior athletes (mean age 15.8 (SD 0.7) years, range 10 to 27) and 1646 physically active schoolchildren (16.1 (SD 2.1) years, range 14 to 20) were screened using personal and family history questionnaires, physical examination and resting 12-lead ECG. Nine participants with a positive diagnosis of a disease associated with sudden cardiac death were identified. None of the participants diagnosed with a disease associated with sudden cardiac death were symptomatic or had a family history of note. Conclusion Family history and personal symptom questionnaires alone are inadequate to identify people with diseases associated with sudden cardiac death. Use of the 12-lead ECG is essential when screening for cardiac pathology in the young. [ABSTRACT FROM AUTHOR]

Background: Radical cystectomy remains the standard of care for muscle-invasive transitional cell carcinoma of the bladder. A combination of maximum transurethral resection of the bladder tumour, radiation, and concurrent chemotherapy is the hallmark of modern bladder function preserving strategies. Our aim is to describe bladder, rectal, and sexual dysfunctions in survivors after radical radiotherapy for urinary bladder cancer. Methods: Twenty patients were treated with 3-D conformal radiotherapy (60–66Gy in 2Gy fractions, five fractions per week) on a linear accelerator machine. Median follow-up time was 30 months. For comparison, 20 controls were selected from our annual cancer register. Information was collected anonymously to avoid investigator-related bias using a questionnaire about changes in daily life after radiotherapy. Findings: Of the irradiated patients, 80% reported little or no distress from urinary symptoms. Twenty per cent of patients reported that radiotherapy had a moderate to severe impact on their present bladder function, causing dysuria, incontinence, or stenosis that required the use of a bladder catheter. Thirty per cent of irradiated patients reported moderate to severe impact on their present sexual function. Impotence and lack of sexual desire were significantly higher among the male patients who received radiotherapy. Forty per cent of the male patients had regular sexual intercourse (half of whom used aids like sildenafil to sustain erection) and 70% of the male patients reported they had ejaculation. Moderate distress from symptoms of the gastrointestinal tract was reported by 30% of irradiated patients. Diarrhoea was most common, followed by faecal urgency and faecal incontinence. Interpretation: After radical radiotherapy, most patients had a well functioning bladder. Radiotherapy is associated with considerable long-term intestinal side-effects because the treatment field includes the bowel. Moreover, radiotherapy can result in sexual dysfunction. Although we do not suggest that selective bladder-sparing treatment should replace radical cystectomy, sufficient data now exists to indicate that it is a valid alternative. The authors declared no conflicts of interest. [Copyright &y& Elsevier]