Communication strategies and effectiveness of early childhood obesity-related prevention programs for linguistically diverse communities: A rapid review.

Children from culturally and linguistically diverse backgrounds experience higher rates of obesity and have poorer outcomes in obesity prevention studies. Interventions tailored to specific cultural groups may be limited within linguistically diverse, multicultural communities, and thus, alternative approaches to childhood obesity prevention in these communities are needed. This study aims to describe communication strategies used in interventions targeting prevention of obesity/obesity-related behaviors, among children 0-5 years, from linguistically diverse communities, and assess their effectiveness. A rapid review was conducted by systematically searching Medline, Embase, and CINAHL. The inclusion criteria are as follows: Studies reported an intervention tailored to linguistically diverse communities targeting at least one obesity-related behavior among children 0-5 years. The exclusion criteria are as follows: Interventions used simple language translations, targeted one language group, or treated obesity. A total of 4677 articles were identified with 14 studies meeting inclusion criteria. Key communication strategies included materials in multiple languages, English text written at a set readability level, and multimodal delivery. Six studies reported effectiveness data, of which five had effective primary or secondary outcomes. This is the first rapid review to identify communication strategies used in childhood obesity prevention interventions for linguistically diverse communities, highlighting a need for future research to incorporate and evaluate the communication strategies identified.

Inflammation and Endotyping in Chronic Rhinosinusitis-A Paradigm Shift.

Chronic rhinosinusitis (CRS) is a heterogeneous chronic inflammatory condition of the paranasal sinuses and nasal passage. It is characterized as inflammation of the sinonasal passage, presenting with two or more symptoms (nasal blockage, secretions, facial pain and headaches) for more than 12 weeks consecutively. The disease is phenotypically differentiated based on the presence of nasal polyps; CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Traditionally, CRSwNP has been associated with a type 2 inflammatory profile, while CRSsNP has been associated with a type 1 inflammatory profile. Extensive work in characterizing the inflammatory profiles of CRS patients has challenged this dichotomy, with great variation both between and within populations described. Recent efforts of endotyping CRS based on underlying pathophysiology have further highlighted the heterogeneity of the disease, revealing mixed inflammatory profiles coordinated by a number of inflammatory cell types. This review will highlight the current understanding of inflammation in CRS, and discuss the importance and impact of refining this understanding in the development of appropriate treatment options for CRS sufferers.

Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial.

BACKGROUND: Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder (AUD). AIMS: To perform a randomised rater-blinded trial to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD. METHODS: Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive twice daily supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months. Primary outcome measures were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD) in days at three months. TRIAL REGISTRATION: NCT0137868. RESULTS: There was a statistically significant difference in three month BDI-II scores between the intervention and control groups; 8.5 (SD=8.0) vs. 16.7 (SD=10.3) respectively after adjusting for the baseline scores, F (1, 49)=9.54, p=0.003, η(p)(2)=0.17. The mean difference in change BDI-II scores was -7.9 (95% CI -13.06 to -2.76, Cohen'sd=0.85). There was a trend for a greater CAD in the text message group than the control group: 88.3 (SD=6.2) vs. 79.3 (SD=24.1), t=1.78, df=48, p=0.08. LIMITATIONS: Limitations of the study include the small sample size, the potential for loss of rater blinding and the lack of long term follow-up to determine the longer term effects of the intervention. CONCLUSION: Supportive text messages have the potential to improve outcomes for patients with comorbid depression and alcohol dependency syndrome.

Eating problems in Irish children and adolescence - EPICA.

OBJECTIVES: To examine eating concerns in a cohort of Irish adolescents. METHODS: Students from a stratified random sample of post primary schools were screened using the EAT-26, the EDI-III and a study specific questionnaire. RESULTS: A total of 3,031 students (mean age 14.74, range 12-19) enrolled in the study. The majority of respondents felt popular (91%), happy (75.2%) and perceived themselves to have a good quality of life (86.8%). Despite this, 32% of females dieted, 29.4% were dissatisfied with their bodies, and 10.8% scored above 20 on the EAT-26. Adolescents always on a diet reported a lower quality of life (QoL) X2(16, N=2,961) =144.43, p <.000, perceived themselves to be less popular X2(15, N=2,963) =53.26, p <.000 and less academically able X2(16, N=2,297) =43.96, p<.000, than those who never dieted. Comparing EPICA values to published norms, Irish males had significantly lower EAT scores, females had comparable total EAT-26 scores but significantly lower levels of dieting and higher levels of bulimic features and oral control. Girls in mixed schools had higher rates of body dissatisfaction F (1,2855) = 16.61, p <.001 and drive for thinness F (1,2860) = 11.78, p <.005 than girls attending same sex schools. CONCLUSIONS: Weight and body image concerns were high among Irish adolescents, especially females, with higher than expected levels of bulimia and oral control scores on the EAT but lower scores on the dieting subscale. Females attending mixed sex schools appear most at risk of eating pathology.

Defining an anaesthetic curriculum for medical undergraduates. A Delphi study.

BACKGROUND AND OBJECTIVES: Anaesthesia is commonly taught to medical students. The duration and content of such teaching varies however and no consensus exists as to what constitutes an optimal curriculum. Anaesthetists possess the necessary knowledge and skills and operate in clinical settings suitable to provide training for medical undergraduates, especially in areas where deficiencies have been identified. This Delphi study was directed towards developing a consensus on an optimal anaesthesia, intensive care and pain medicine curriculum for medical undergraduates. METHODS: This Delphi survey consisted of three iterative rounds with feedback given at the start of each successive round in the form of the results of the previous round. The participants consisted of 27 consultant anaesthetists, chosen by the three Professors of anaesthesia in Ireland to be experts in undergraduate medical education. RESULTS: Thirty one consultant anaesthetists were chosen to participate in the study. Two consultants declined to participate. Two consultants were omitted from the first round in error and were not included in the remainder of the study. The response rate to the first round was 100%. Two hundred and nine individual items were included in the second questionnaire. 67% consultants responded to the second questionnaire and 59% to the third questionnaire. 74 Items achieved consensus level on completion of the study. CONCLUSION: This study demonstrated support amongst respondents for an expanded role for anaesthetists in teaching medical students. An expanded teaching role for anaesthetists would take advantage of the large number of anaesthetists in Irish teaching hospitals, their enthusiasm for teaching, the frequency of patient-consultant proximity and the likely value of their teaching to student learning outcomes. The consensus reached by this study does not recommend a comprehensive anaesthesia curriculum. Rather, more emphasis has been placed on anaesthetists teaching a broader range of knowledge, skills and attitudes relevant to every newly qualified doctor.

Group therapy for selective mutism - a parents' and children's treatment group.

OBJECTIVE: To evaluate the feasibility and effectiveness of group therapy for children with selective mutism and their parents. METHOD: Five children (mean age 6.1 years) with a diagnosis of selective mutism were administered group therapy over an 8-week period. Parents simultaneously attended a second group, aimed at providing education and advice on managing selective mutism in everyday situations, and in the school environment. RESULTS: At post-treatment, all children increased their level of confident speaking in school, clinic and community settings. Parents indicated a reduction in their own anxiety levels, from pre- to post-treatment on self-rating scales. CONCLUSIONS: Findings support the feasibility and effectiveness of group therapy for children with selective mutism and their parents.