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Background Nocturnal enuresis (NE) is a multifactorial and complex condition. One less understood factor in its pathophysiology is the enuretic inability to wake up when the bladder is full (impaired arousal). Objective We aimed to investigate the relationship between sleep and NE in children and adolescents. Methods A systematic review was performed following the PRISMA guidelines, and the electronic databases MEDLINE (via PubMed) and SCOPUS were searched until March 2022. Eligibility criteria were studies that recruited patients aged five-17 years with a diagnosis of NE according to the International Child Continence Society (ICCS), Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), or International Classification Criteria of Sleep Disorders-Third edition (ICSD-3) who had their sleep assessed using validated questionnaires and/or polysomnography. The tool used to analyze the risk of bias in the included studies was the risk of bias in non-randomized studies of exposure. Results Of 1582 citations screened, nine were included, giving 1685 participants, 581 with NE. All studies were observational and half had a low risk of bias. Four studies evaluated sleep by questionnaires only; two used questionnaires and polysomnography; two used only polysomnography, and one used sleep logs and actigraphy. Sleep questionnaires showed that children with enuresis had more sleep problems than controls, especially parasomnias, breathing disorders, and daytime sleepiness. Among the polysomnography parameters, the sleep stage architecture and periodic limb movements during sleep had conflicting data between the two studies. Limitations The studies evaluated sleep through heterogeneous tools. They used different questionnaires; even those considered by polysomnography did not record the same channels. Conclusion It seems that enuretic children and adolescents sleep differently from those who are non-enuretic. More studies are needed to clarify the best way to assess sleep and better understand this relationship. The review protocol was registered with PROSPERO, CRD42021266338. There was no funding., Author(s): Ana Elisa Ribeiro Fernandes [sup.1] , José Reinaldo Corrêa Roveda [sup.1] , Carolina Rodrigues Fernandes [sup.1] , Diego Ferreira Silva [sup.1] , Isabela Cristina de Oliveira Guimarães [sup.1] , [...]

Grape seeds are rich in bioactive substances, including polyphenols, terpenoids, and phytosterols. Linseed (Linum usitatissimum L.) boasts a high concentration of polyunsaturated fatty acids (PUFAs), lignans, phytoestrogens, and soluble fibers, all contributing to its therapeutic potential. In this study, we pioneered the formulation of an oil blend (GL) combining grape seed oil (G) and golden linseed oil (GL) in equal volumes (1:1 (v/v)) and we evaluated in terms of the nutritional, physical, and chemical properties and their influence in an in vivo experimental model. We analyzed the oils by performing physical–chemical analyses, examining the oxidative stability using Rancimat; conducting thermal analyses via thermogravimetry/derivative thermogravimetry (TG/DTG) and differential scanning calorimetry (DSC), performing optical UV–vis absorption analyses; examining the fluorescence emission–excitation matrix, total carotenoids, and color, and conducting metabolic assessments in an in vivo experimental trial. The fatty acid profile presented a higher fraction of linoleic acid (C18:2) in G and GL and alpha-linolenic acid (C18:3) in L. The acidity and peroxide indices were within the recommended ranges. The TG/DTG, DSC, and Rancimat analyses revealed similar behaviors, and the optical analyses revealed color variations caused by carotenoid contents in L and GL. In the in vivo trial, G (G2: 2000 mg/kg/day) promoted lower total consumption, and the blend (GL: 2000 mg/kg/day) group exhibited less weight gain per gram of consumed food. The group with G supplementation (G2: 2000 mg/kg/day) and GL had the highest levels of HDL-c. The group with L supplementation (L2: 2000 mg/kg/day) had the lowest total cholesterol level. The L2, G1 (1000 mg/kg/day), and G2 groups exhibited the lowest MCP-1 and TNF-α values. Additionally, the lowest adipocyte areas occurred in G and GL. Our results suggest that this combination is of high quality for consumption and can influence lipid profiles, markers of inflammation, and antioxidant status. [ABSTRACT FROM AUTHOR]

Context: BETTER WISE is a comprehensive and structured approach for cancer and chronic disease prevention and screening (CCDPS) that addresses cancer survivorship and screens for lifestyle risks and poverty in patients aged 40 to 65. Objective: To describe the impact, barriers and facilitators of BETTER WISE. Study Design and Analysis: Qualitative study: 17 focus groups and 48 key informant interviews were conducted, transcribed and analyzed employing thematic analysis using a constant comparative method. Written feedback (585 feedback forms) from patients was also collected and analyzed. Setting: 13 primary care settings (urban, rural and remote) in Alberta, Ontario, and Newfoundland and Labrador, Canada. Participants: Primary care team members (N=132) including clinicians, managers and clerical staff participated in focus groups or one-on-one key informant telephone interviews. Additionally, patients submitted 585 written feedback forms. Intervention: 1,005 patients were invited for a one-hour visit with a 'prevention practitioner' (PP), a member of the primary care team with training in CCDPS and the BETTER WISE approach. PPs met with patients one-on-one to provide them with an overview of their individual risk for chronic diseases, eligibility for screening, and assistance with lifestyle counselling. Results: Four main themes were identified: 1) Impact on patients: Patients appreciated the BETTER WISE approach and found it empowering. They caught health concerns that were overlooked and reported improved lifestyle changes; 2) Impact on primary care providers (PCPs): PPs reported improved teamwork, increased knowledge of CCDPS, and better relationships with patients and physicians; 3) The main barrier to implementation of BETTER WISE was the onset of the COVID-19 pandemic, which: i) changed prevention visits to phone visits, ii) put screening tests on hold, and iii) added hardship on patients and PCPs as focus shifted to emergencies, acute care, and COVID-19 screening and vaccinations; 4) Facilitators of the implementation of BETTER WISE included: i) buy-in from PPs, physicians, and patients, ii) good relationship and team culture within primary care teams, and iii) alignment with CCDPS activities already happening at the clinics. Conclusion: Despite the interruption of the COVID-19 pandemic, the participating primary care clinics completed the BETTER WISE study and the BETTER WISE approach had a positive impact on patients and PCPs., Presenters Nicolette Sopcak, PhD, Carolina Fernandes, MA, MSc, Melanie Wong, BSc, Daniel Ofosu, Lelaf Khalil, Mary Ann O'Brien, PhD, Tracy Wong, PhD, Donna Manca, MD, [...]

Context: Cancer and chronic disease prevention and screening (CCDPS) guidelines are not consistently applied in primary care. Furthermore, while most patients have multiple risks and conditions, guidelines are focused on a specific disease or organ system. The BETTER program (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) involves an evidence-based intervention provided by an allied health professional within a primary care practice who acquires advanced skills in CCDPS and takes on the role of Prevention Practitioner (PP). Using the BETTER toolkit, created through a rigorous process of knowledge synthesis and harmonization of recommendations, the PP meets with patients for a personalized prevention visit. Objective: To describe the: 1) evidence review process used to identify high-quality clinical practice guidelines (CPGs), 2) harmonization of primary prevention and screening recommendations, and 3) identification, development, and refinement of resources and tools for inclusion in the BETTER toolkit. The BETTER toolkit will be used to inform CCDPS in rural, remote, and urban primary care settings across Canada. Methods: In 2017, the BETTER Program conducted a literature review of evidence-based CPGs published between 2010 and 2016. For this update, high-quality international, Canadian, and Provincial CPGs published between 2016 and 2021, focusing on primary prevention and screening of cancer and chronic disease, and applicable to patients 40-69 years of age were identified. A Clinical Working Group consisting of decision-makers, researchers, clinicians, and a patient representative across Canada was split up into 3 topic review teams. A total of 19 CCDPS topics within scope for BETTER were identified. Topic teams reviewed the literature and synthesized guidelines based on evidence for their topic and updated the toolkits to inform the PP role. Results: Development of an updated care map that considers family history and risk factor assessment that is tailored to the patient and adaptable to diverse practice settings. Conclusions: Synthesized and evidence-based integrated care plans can be used to assess patients' CCDPS risk and preferences in diverse populations in Canada. The updated toolkit will facilitate the application of recommendations for the primary prevention of cancer and chronic disease in patients 40-69 years of age., Presenters Donna Manca, MD, MCLSC, Denise Campbell-Scherer, MD, PhD, Carolina Fernandes, MA, MSc, Eva Grunfeld, MD, PhD, FCFP, Kris Aubrey-Bassler, MD, FCFP, MSc, Aisha Lofters, MD, Katherine Latko, CDE, RD, [...]