Objective
Breakfast skipping is reported to be associated with obesity in children and younger populations; however, few studies report the association among elderly. The purpose of this study was to ...investigate the relationships between breakfast skipping and obesity prevalence among elderly.
Design
Cross-sectional study.
Setting
Community-dwelling elderly in Nara, Japan.
Participants
1052 elderly participants (mean age: 71.6 years).
Measurements
Obesity and breakfast skipping were defined as body mass index of ≥25 kg/m
2
and skipping breakfast one or more times per week, respectively.
Results
Two hundred and seventy-two participants (25.9%) were classified as obese and forty-one (3.9%) were as breakfast skippers. Obesity prevalence was significantly higher in breakfast skippers than in breakfast eaters (43.9% vs. 25.1%, P = 0.007). In multivariable logistic regression analysis adjusted for potential confounders (age, sex and alcohol consumption), breakfast skippers showed significantly higher odds ratio (OR) for obesity than breakfast eaters (OR, 2.23; 95% confidence interval, 1.17–4.27; P = 0.015), which continued to be significant after further adjustment for socioeconomic status. In addition, breakfast skippers showed significantly lower daily potassium (P <0.001) and dietary fibre intakes (P = 0.001) and lower subjective physical activity (P = 0.035) than breakfast eaters.
Conclusions
Breakfast skipping was significantly associated with obesity among elderly. Poor diet quality and physical inactivity may be potential intermediators underlying the association between breakfast skipping and obesity.
Higher morning blood pressure (BP) surge is a risk factor for cardiovascular disease independent of 24-h mean BP. Although low outdoor temperatures are associated with higher morning BP surges ...(MBPSs), the influence of indoor temperature and ambient temperatures (temperature while indoors or temperature while outdoors) on MBPS remains unclear. Such information may help prevent excess winter mortality. We simultaneously measured indoor temperatures (living room and bedroom), ambulatory BP and physical activity using wrist actigraphy for 768 person-days during winter and spring/fall in 192 participants (mean age, 69.9 years). Although the indoor and outdoor temperatures showed a strong correlation during periods of moderate temperature (range: 9.8 to 27.7 °C, rp=0.84), the correlation decreased during periods of lower outdoor temperatures (range: -3.37 to 9.73 °C, rp=0.28). In univariate and multivariate analyses, models with ambient temperatures showed the best goodness of fit (lowest Akaike's information criterion (AIC)) followed by models with indoor temperatures and those with outdoor temperatures (AIC: ambient<indoor<outdoor temperature). A multivariate linear mixed-effect regression model showed that a 1 °C decrease in the ambient temperature was significantly associated with a 0.44 mm Hg increase in the sleep-trough MBPS and a 0.52 mm Hg increase in the prewaking BP surge. This was independent of potential confounders, including physical activity.
Background. Researchers have emphasized a need to identify predictors that can explain the variability in weight management after bariatric surgery. Eating self-efficacy has demonstrated predictive ...impact on patients' adherence to recommended eating habits following multidisciplinary treatment programs, but has to a limited extent been subject for research after bariatric surgery. Recently an American short form version (WEL-SF) of the commonly used Weight Efficacy Lifestyle Questionnaire (WEL) was available for research and clinical purposes. Objectives. We intended to translate and culturally adapt the WEL-SF to Norwegian conditions, and to evaluate the new versions' psychometrical properties in a Norwegian population of morbidly obese patients eligible for bariatric surgery. Design. Cross-sectional Methods. A total of 225 outpatients selected for Laparoscopic sleeve gastrectomy (LSG) were recruited; 114 non-operated and 111 operated patients, respectively. The questionnaire was translated through forward and backward procedures. Structural properties were assessed performing principal component analysis (PCA), correlation and regression analysis were conducted to evaluate convergent validity and sensitivity, respectively. Data was assessed by mean, median, item response, missing values, floor- and ceiling effect, Cronbach's alpha and alpha if item deleted. Results. The PCA resulted in one factor with eigenvalue > 1, explaining 63.0% of the variability. The WEL-SF sum scores were positively correlated with the Self-efficacy and quality of life instruments (p < 0.001). The WEL-SF was associated with body mass index (BMI) (p < 0.001) and changes in BMI (p = 0.026). A very high item response was obtained with only one missing value (0.4%). The ceiling effect was in average 0.9 and 17.1% in the non-operated and operated sample, respectively. Strong internal consistency (r = 0.92) was obtained, and Cronbach's alpha remained high (0.86-0.92) if single items were deleted. Conclusion. The Norwegian version of WEL-SF appears to be a valid questionnaire on eating self-efficacy, with acceptable psychometrical properties in a population of morbidly obese patients.
A new, fast and efficient multiple reaction monitoring (MRM) high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS) method for the determination of cyclopiazonic acid (CPA) in ...mixed feed, wheat, peanuts and rice is presented. The analytical methodology involves sample extraction with an alkaline methanol–water mixture, defatting with hexane and quantification using HPLC–MS/MS without further treatment of sample extracts. Reversed-phase liquid chromatography using a C18 stationary phase coupled to negative mode electrospray triple quadrupole tandem mass spectrometry was applied. The limit of detection was 5
μg/kg while the limit of quantification was 20
μg/kg in the matrices investigated. The detector response was found to be linear over the range 25–250
μg/kg in feed and 25–500
μg/kg in wheat, peanuts and rice. The mean overall recoveries (
n
=
18) of CPA varied from 79% to 114% in the range of concentrations studied over a period of 4 months. Mean recoveries (
n
=
3 or 6) of CPA in wheat, peanuts and rice varied from 70% to 111%, 77% to 116% and 69% to 92%, respectively. The method was successfully applied to the analysis of feed and rice samples artificially infected with the fungal strain
Penicillium commune, where the toxin was found at different levels.
Introduction Blue light information plays an important role in synchronising internal biological rhythm within the external environment. Circadian misalignment is associated with the increased risk ...of sleep disturbance, obesity, diabetes mellitus, depression, ischaemic heart disease, stroke and cancer. Meanwhile, blue light causes photochemical damage to the retina, and may be associated with age-related macular degeneration (AMD). At present, clear intraocular lenses (IOLs) and blue-blocking IOLs are both widely used for cataract surgery; there is currently a lack of randomised controlled trials to determine whether clear or blue-blocking IOLs should be used. Methods and analysis This randomised controlled trial will recruit 1000 cataract patients and randomly allocate them to receive clear IOLs or blue-blocking IOLs in a ratio of 1:1. The primary outcomes are mortality and the incidence of cardiovascular disease, cancer and AMD. Secondary outcomes are fasting plasma glucose, triglycerides, cholesterol, glycated haemoglobin, sleep quality, daytime sleepiness depressive symptoms, light sensitivity, the circadian rhythm of physical activity, wrist skin temperature and urinary melatonin metabolite. Primary outcomes will be followed until 20 years after surgery, and secondary outcomes will be assessed at baseline and 1 year after surgery. Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board of Nara Medical University (No. 13-032). The findings of this study will be communicated to healthcare professionals, participants and the public through peer-reviewed publications, scientific conferences and the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) home page. Trial registration number UMIN000014680.
Purpose: The current study investigates relative and absolute motor speech timing errors in children with typically developing speech production (TD), Childhood Apraxia of Speech (CAS) and ...Phonological Disorder (PD). The study’s overarching goal is to examine these speech timing errors as a potential objective measure for differential diagnosis of Speech Sound Disorders (SSDs). Timing is a critical aspect of motor planning, and it is assumed that CAS is a speech motor planning impairment. However, it is not clear whether the errors of children with other SSDs, such as PD, are a result of additional influence by imprecise speech-motor control, and therefore whether these children would also show greater timing errors. We predicted three outcomes: (1) Adults will show smaller timing errors than children for both absolute timing and relative timing, (2) the SSD group will have larger timing errors than the TD group, and (3) children with CAS are the only children who will show differences from the control (TD) group on these timing error measures. Method: This retrospective study examined timing accuracy based on speech samples obtained at the phrase level from 10 adults, 21 typically developing (TD) children, and 12 children with SSD. Samples (brief phrases containing novel words) were elicited via a repetition task following prerecorded models. Data was abstracted from the acoustic record and analyzed to determine the accuracy of relative timing (PROP) and absolute timing (E). Each timing error measure was averaged for each speaker across sessions and blocks by fricative and vowel. The results of each of these measurements quantified the extent in which a generalized motor program (GMP) and its manipulations (parameters) deviate from the target production (represented by the prerecorded model). Results: Children with SSDs demonstrated significantly higher values of absolute and relative timing error than typically-developing children, suggesting either delayed or disordered speech-motor timing control. As a group, children with CAS (but not children with non-CAS SSD) had larger timing errors than the TD children, suggesting that the group effect (SSD > TD) was driven largely by the children with CAS. However, individual analyses revealed high variability in groups. Conclusions: Measures of relative and absolute timing error at the phrase level during a repetition task may capture aspects of speech motor control in adults, typically developing children, and children with SSDs. Future research with larger sample sizes and longitudinal designs is needed to determine: (1) how relative and absolute timing control develop as children stabilize speech motor control, (2) the degree in which children with SSD deviate from the typical development of these measures, and (3) whether or not these measures are sensitive enough to be a potential objective measure of children with CAS.
Abstract Context Limited information is available about lung cancer patients' symptoms in the pre- and postoperative periods. Objectives Study purposes were to evaluate for changes in symptom ...occurrence and severity from the preoperative period to five months after surgery and to evaluate for predictors of the occurrence and trajectories of these symptoms. Methods Patients completed the Memorial Symptom Assessment Scale before and at one and five months after surgery. Changes in the six most common physical symptoms and the most common psychological symptom were evaluated using multilevel growth mixture modeling. Age, gender, comorbidity, and receipt of adjuvant chemotherapy were included as covariates in the conditional models for symptom occurrence and severity. Results The total number of symptoms increased significantly from the preoperative to the one month assessment. At five months, the number of symptoms was lower than at one month but significantly higher than at the preoperative assessment. The occurrence of five of the symptoms (i.e., pain, lack of energy, shortness of breath, feeling drowsy, and worrying) increased significantly from before through the first month after surgery and then decreased over time. Cough and difficulty sleeping persisted over the five months of the study. In general, the effect of the four covariates was to increase patients' overall symptom burden. Conclusion Changes in the occurrence and severity of these seven symptoms were variable. All seven symptoms occurred at relatively high rates and were of moderate severity. Findings can be used to identify patients who are at higher risk for more severe symptoms.
Abstract Context. Colorectal cancer (CRC) is one of the most common cancers worldwide. Patients with CRC may have multiple co-occurring symptoms as a result of their disease or its treatment. Little ...is known about potential differences in symptom burden in CRC patients scheduled to receive curative versus palliative chemotherapy (CTX). Objectives The purposes of this study were to investigate the overall symptom burden of patients with CRC prior to their first CTX treatment or prior to the initiation of a new CTX regimen, and to evaluate for differences in symptom occurrence, severity, and distress between patients with CRC who were scheduled to receive curative versus palliative CTX. Methods Consecutive patients with CRC were recruited ( n =120) and symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS) prior to the initiation of the CTX. The most common symptoms that occurred in ≥ 30% of the patients were evaluated. Differences in occurrence rates and severity and distress scores between the curative ( n =68) and palliative ( n =52) patient groups were evaluated using binary logistic regression and ordinal logistic regression analyses, respectively. Results In both groups, patients reported an average of 10 co-occurring symptoms. Worrying (65%), lack of energy (59%), feeling drowsy (54%), feeling bloated (53%), pain (51%), and difficulty sleeping (50%) were the most prevalent symptoms. Problems with sexual interest had the highest severity and distress scores in both groups. For the 13 most common symptoms, no significant differences were found between the two patient groups on any of the MSAS dimensions (i.e., occurrence, severity, distress). Conclusion Regardless of the reason for CTX, CRC patients experience a large number of co-occurring symptoms.
Postoperative delirium (PD) after transcatheter aortic valve implantation (TAVI) remains to be explored. We sought to (1) determine the incidence of PD in octogenarians who underwent TAVI or surgical ...aortic valve replacement (SAVR), (2) identify its risk factors, and (3) describe possible differences in the onset and course of PD between treatment groups. A prospective cohort study of consecutive patients aged ≥80 years with severe aortic stenosis who underwent elective TAVI or SAVR (N = 143) was conducted. The incidence of PD was assessed for 5 days using the Confusion Assessment Method (CAM). Risk factors for PD were studied with logistic regression. Patients treated with TAVI were older (p ≤0.001), had lower cognitive scores (p = 0.007), and more co-morbidities (p = 0.003). Despite this, significantly fewer (p = 0.013) patients treated with TAVI (44%) experienced PD compared to patients treated with SAVR (66%). Undergoing SAVR (p = 0.02) and having lower cognitive function (p = 0.03) emerged as risk factors for PD, whereas gender, activities of daily living, frailty, atrial fibrillation, and postoperative use of opioids and anxiolytics did not. Patients treated with TAVI and without PD during the first 2 postoperative days were unlikely to experience PD on subsequent days. The onset of PD after SAVR could occur at any time during the postoperative evaluation. In conclusion, SAVR in octogenarian patients with aortic stenosis might be considered as a predisposing factor for PD. Our data also suggest that the onset of PD was more unpredictable after SAVR.
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