Bowel cancer knowledge gaps evident among Irish residents: results of a national questionnaire survey.

BACKGROUND: The extent of knowledge of bowel cancer, its symptoms and risk factors are unknown in Irish residents. An understanding of bowel cancer awareness may be useful in aiding healthcare professionals, and policy makers develop improved bowel cancer awareness programmes and public health initiatives in Ireland. AIMS AND METHODS: A 22-question online questionnaire survey was designed to gather data to assess residents' awareness of bowel cancer, its symptoms, and risk factors and to determine reasons for not participating in BowelScreen Ireland. RESULTS: There were 449 participants (329 women, 119 men and 1 'prefer not to say'). The majority of participants were aged 35-49 years (42.8%), and 82.6% had completed a third level qualification. Irish residents (non-healthcare professionals/scientists (NHCP/S)) recalled on average less than three warning signs/symptoms. Among NHCP/S the most well-recalled protective diet and lifestyle choices were active lifestyle/exercise (62.1%), a fibre rich diet (45.4%) and no/low alcohol consumption (32.1%). Many were unable to recall red and processed meat as risk factors with only 10.7% and 4.9%, respectively, citing these foods. However, prompted awareness was superior with 71.1% agreeing or strongly agreeing that consumption of red and processed meat is a risk factor. 43.4% said they would be 'fairly confident' in recognising a sign/symptom, but more than a third (38.7%) reported they were 'not very confident'. CONCLUSION: This survey emphasises the need to improve the awareness of bowel cancer as gaps in this specific cancer knowledge were evident among Irish residents.

Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore.

BACKGROUND: Excess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population. METHODS AND FINDINGS: This is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21-74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC. CONCLUSIONS: BAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.

Identifying similar and different factors effecting long-term cardiac exercise rehabilitation behavior modification between New Zealand and the United Kingdom.

BACKGROUND: Cardiac Rehabilitation (CR) programs are the most cost-effective measure for reducing morbidity associated with Coronary Vascular Disease (CVD). To be more effective there is a need to understand what influences the maintenance of healthy behaviors. This study identifies similar and different influences in CR of the United Kingdom (UK) and New Zealand (NZ). METHODS: A retrospective study. Participants had previously been discharged from CR for 6 to 12+ months within the UK (n = 22) and NZ (n = 21). Participant's attended a focus group. Discussions were digitally recorded, transcribed then thematically analyzed. The CR programs were observed over 2 months to enable comment on findings relating to 'theory in practice.' RESULTS: Similar positive patient experiences influencing behavior between groups and countries were; support, education, positive attitude, and motivation. Companionship and exercising alongside people with similar health problems was the major determinant for positive exercise behavior. Barriers to maintaining exercise included; physical disabilities, time constraints, and weather conditions. NZ participants were more affected by external factors (eg, opportunity, access, and time). CONCLUSION: Both CR programs were successful in facilitating the maintenance of healthy lifestyles. Exercising with other cardiac patients for support in a structured environment was the strongest influence in maintaining healthy lifestyles beyond CR programs.

Difference between continuous positive airway pressure via mask therapy and incentive spirometry to treat or prevent post-surgical atelectasis.

OBJECTIVE: To assess the effect of early use of continuous positive airway pressure (CPAP) therapy to treat or prevent acute atelectasis in post-operative cardiac patients particularly smokers and elderly patients. METHODS: A pilot study suggested enrolling at least 32 participants in each group to be significant. One hundred and eight patients from King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia who met the inclusion criteria participated in this study conducted between March 2010 and March 2011. The participants were divided randomly into 3 groups, incentive spirometry (IS) therapy, and CPAP therapy every 2 (CPAP 2 hrs), or 4 hours (CPAP 4 hrs). Inspiratory capacity (IC) was used to compare the 3 therapy regimes. Simultaneously, respiratory rate (RR), heart rate (HR) and oxygen saturation (SpO2) were measured for all groups. Failure was defined as requiring intubation, bi-level positive airway pressure, or added chest physiotherapy. RESULTS: Thirty-six patients participated in each group (98 male and 10 female, with a mean age of 62+/-9.3 years). The IC increased significantly in the CPAP 2 hrs group when compared with the control group or the CPAP 4hrs group. The SpO2 decreased significantly in the control group and the CPAP 4 hrs groups when compared with the CPAP 2 hrs group. Also, there were no significant differences in RR and HR between all groups. CONCLUSION: Early use of CPAP via mask therapy for half an hour every 2 hours had better outcomes to re-open collapsed alveoli after cardiac surgery.

Physiologic responses and energy expenditure of kinect active video game play in schoolchildren.

OBJECTIVE: To evaluate the physiologic responses and energy expenditure of active video gaming using Kinect for the Xbox 360. DESIGN: Comparison study. SETTING: Kirkby Sports College Centre for Learning, Liverpool, England. PARTICIPANTS: Eighteen schoolchildren (10 boys and 8 girls) aged 11 to 15 years. MAIN EXPOSURE: A comparison of a traditional sedentary video game and 2 Kinect activity-promoting video games, Dance Central and Kinect Sports Boxing, each played for 15 minutes. Physiologic responses and energy expenditure were measured using a metabolic analyzer. MAIN OUTCOME MEASURES: Heart rate, oxygen uptake, and energy expenditure. RESULTS: Heart rate, oxygen uptake, and energy expenditure were considerably higher (P < .05) during activity-promoting video game play compared with rest and sedentary video game play. The mean (SD) corresponding oxygen uptake values for the sedentary, dance, and boxing video games were 6.1 (1.3), 12.8 (3.3), and 17.7 (5.1) mL · min-1 · kg-1, respectively. Energy expenditures were 1.5 (0.3), 3.0 (1.0), and 4.4 (1.6) kcal · min-1, respectively. CONCLUSIONS: Dance Central and Kinect Sports Boxing increased energy expenditure by 150% and 263%, respectively, above resting values and were 103% and 194% higher than traditional video gaming. This equates to an increased energy expenditure of up to 172 kcal · h-1 compared with traditional sedentary video game play. Played regularly, active gaming using Kinect for the Xbox 360 could prove to be an effective means for increasing physical activity and energy expenditure in children.

Randomized controlled evaluation shows the effectiveness of a home-based cardiac rehabilitation program.

OBJECTIVE: To evaluate the effectiveness of a home-based cardiac rehabilitation (CR) program on post-coronary arteries bypass graft patients. METHODS: This is a randomized study conducted in King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia between June 2008 and January 2010. Forty-nine participants were randomized to either a control group (standard hospital treatment, n=21) or an intervention group (home-based CR, n=28). Data were collected before hospital discharge (baseline test) and repeated 6 months after hospital discharge (follow-up test). RESULTS: There were no significant differences between the groups in the body mass index, hemodynamics, serum fasting lipid profile, and Quality of Life questionnaire (QoL) (p>0.05), with differences in physical function and Hospital Anxiety and Depression Scales (HADS) (p<0.05) at the baseline test. At the follow-up test, the intervention group showed greater improvement in health-related QoL and risk factors compared to the control group, with significant differences in fasting blood glucose, triglycerides, high density lipoprotein cholesterol, physical function, and both QoL and HADS questionnaires (p<0.05). The intervention group also demonstrated significant improvements in QoL, HADS, body mass index, heart rate, high density lipoprotein cholesterol and physical function (p<0.05), while significant differences were observed in the control group in heart rate, QoL and physical function (p<0.05). CONCLUSION: The home-based CR program improves health-related QoL and risk factor profiles for patients following coronary arteries bypass graft to greater extent than the standard hospital care.

The efficacy of frequency specific microcurrent therapy on delayed onset muscle soreness.

This study compared the effects of frequency specific microcurrent (FSM) therapy versus sham therapy in delayed onset muscle soreness (DOMS) in order to determine whether specific frequencies on two channels would produce better results than single channel single frequency microcurrent therapy which has been shown to be ineffective as compared to sham treatment in DOMS. 18 male and 17 female healthy participants (mean age 32+/-4.2 years) were recruited. Following a 15-min treadmill warm-up and 5 sub-maximal eccentric muscle contractions, participants performed 5 sets of 15 maximal voluntary eccentric muscle contractions, with a 1-min rest between sets, on a seated leg curl machine. Post-exercise, participants had one of their legs assigned to a treatment (T) regime (20 min of frequency specific microcurrent stimulation), while the participant's other leg acted as control (NT). Soreness was rated for each leg at baseline and at 24, 48 and 72 h post-exercise on a visual analogue scale (VAS), which ranged from 0 (no pain) to 10 (worst pain ever). No significant difference was noted at baseline p=1.00. Post-exercise there was a significant difference at 24h (T=1.3+/-1.0, NT=5.2+/-1.3, p=0.0005), at 48 h (T=1.2+/-1.1, NT=7.0+/-1.1, p=0.0005) and at 72 h (T=0.7+/-0.6, NT=4.0+/-1.6, p=0.0005). FSM therapy provided significant protection from DOMS at all time points tested.

"First-hit" heart attack risk calculators on the world wide web: implications for laypersons and healthcare practitioners.

BACKGROUND: Heart attack risk calculators are readily accessible on the world wide web, offering potentially powerful means of health education and risk awareness. Laypersons may be unaware of differences in applicability, risk calculation algorithms and output formats among such calculators. This study assesses the impact of basic web searching terms on type of calculator accessed and on the resulting risk score. DESIGN: Observational study. METHODS: Seventy-two notional individual risk factor profiles were constructed, based on six combinations of presence or absence of smoking habit, hypercholesterolaemia, mixed hyperlipidaemia, hypertension and family history of premature coronary disease among males and females in age groups 30, 40, 50, 60, 70 and 80 years. The term heart attack risk calculator was entered into the Google, Yahoo, MSN, AltaVista and Excite search engines. RESULTS: The first five web pages purporting to contain heart attack risk calculators were included. Subpages of URLs leading to duplicate calculators were excluded. All search engines provided similar "hits" for the same search term. Framingham or PROCAM risk prediction models were the templates for all calculators. Different calculators often gave different absolute percentage risk scores for the same notional risk factor profiles. Differences were clinically insignificant in most cases when comparisons were made between bracketed risk scores within 5% of one another. One calculator gave disproportionately high risk estimates for women compared to men with the same risk factor profile and compared to other calculators into which identical risk profiles were entered. CONCLUSIONS: Simple search terms resulted in appropriate "hits". All calculators were based on reputable risk assessment models. There was broad agreement across different calculators for the range of risk factor profiles entered, but one calculator gave inconsistent risk scores.