ABSTRACT
Background: Fatigue, pain and faecal incontinence are common in people with IBD. However, little is known about co-existence of these multiple symptoms, how they inter-relate and whether people want help for these symptoms. In qualitative interviews, patients have reported that these symptoms are often ignored in clinical consultations where the focus is on inflammation, but that they are very bothered by these symptoms, even when disease is apparently in remission The aim of this study was to determine the presence and relationship between fatigue, pain and incontinence in people with inflammatory bowel disease, and desire for intervention for these symptoms Methods: A purpose-designed survey (online or postal), incorporating validated tools and demographic details, was sent to unselected UK clinic and UK IBD-BioResource adult patients. When the covid-19 pandemic halted clinic recruitment, additional self-selected UK recruits were solicited via social media. Using the validated PROMIS tools the following definitions were used for presence of symptoms: Fatigue: PROMIS fatigue T-score of 60 or more;pain: PROMIS pain intensity T-score of 60 or more;PROMIS bowel incontinence: Raw score of 50 or more. Participants also reported disease activity using the relevant PRO-2 score, IBD-Control, anxiety (GAD-7), depression (PHQ-9) and quality of life (EQ-5D-5L) which will all be reported elsewhere Results: A total of 8486 useable responses were received (7716 online 770 postal). 4176 reported Crohn's disease, 4255 had ulcerative colitis or other form of IBD. There were 3281 men and 4883 women. Median age was 51 years (range 18 - 92). 2550 (30%) reported fatigue 1766 (21%) pain and 4565 (54%) faecal incontinence according to the above definitions;925 (10.9%) reported having all three symptoms Demographics by symptom are shown in Table 1. Table 2 reports those participants indicating the presence of each symptom and each combination of symptoms. Table 3 shows a summary of self-defined severity and impact of symptoms (scoring scale 0-10 for both severity and impact of each symptom). Participants scored severity and impact a mean between 3.3 and 4.8, with a wide variation. 56% of all respondents (not just those with symptoms) "definitely" wanted help for fatigue;42% wanted help for pain;53% wanted help for incontinence. 29% reported "definitely" wanting help for all three symptoms (Table 4) Conclusion(s): This study confirms that fatigue, pain and urgency are common in IBD and for the first time reports the co-existence and unmet need for help with these symptoms.
ABSTRACT
This study surveys members of an Illinois state-wide consortium to chart changes to the instructional practices of academic librarians in response to the conditions brought on by the COVID-19 pandemic. The survey findings and analysis provide insights into changes made to multiple aspects of participants' teaching, such as modality, technology use, instructional design, and adjustments to students' socioemotional needs at a time of rapid change, disruption, and stress. In addition to exploring instructional adaptations of librarians, the study identifies gaps in institutional support that might be addressed at the consortial level. While librarians initially altered their teaching and instructional services in "emergency mode,” their reflections reveal that many changes could be beneficial and long-lasting, given adequate and sustained support. © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.
ABSTRACT
OBJECTIVES: The objective of this study was to inform public health practitioners who are designing, adapting and implementing testing and tracing strategies for Coronavirus disease (COVID-19) control. STUDY DESIGN: The study design is monitoring and evaluation of a national public health protection programme. METHODS: All close contacts of laboratory-confirmed cases of COVID-19 identified between the 19th May and 2nd August were included; secondary attack rates and numbers needed to test were estimated. RESULTS: Four thousand five hundred eighty six of 7272 (63%) close contacts of cases were tested with at least one test. The secondary attack rate in close contacts who were tested was 7% (95% Confidence Interval [CI]: 6.3 - 7.8%). At the 'day 0' test, 14.6% (95% CI: 11.6-17.6%) of symptomatic close contacts tested positive compared with 5.2% (95% CI: 4.4-5.9%) of asymptomatic close contacts. CONCLUSIONS: The application of additional symptom-based criteria for testing in this high-incidence population (close contacts) is of limited utility because of the low negative predictive value of absence of symptoms.