'Eating is like experiencing a gamble': A qualitative study exploring the dietary decision-making process in adults with inflammatory bowel disease.

BACKGROUND: For adults with inflammatory bowel disease (IBD), they experience many challenges in dietary decision-making. Thus, this study examined the perspective and experiences of adults with IBD in dietary decision-making. OBJECTIVE: This study aimed to explore the perception and consideration of people with IBD in their daily dietary decisions through monitoring, interpretation and action during the decision-making process. DESIGN: A qualitative study of individuals affected by IBD was conducted through semistructured interviews. RESULTS: Twenty patients were recruited from four tertiary hospitals in Nanjing, China, and each participant completed a semistructured interview. The majority of participants reported on the process and experience of dietary decision-making. Key themes were categorised into three stages: (1) assessing needs, preferences and food cues (monitor); (2) moving from experience to expertise (interpret) and (3) balancing expectations amidst limitations (act). The majority of participants reported that their decisions were shaped by assessing current disease status and food cues. Those interviewed with IBD were willing to make tradeoffs for bowel stability, but their decisions were also influenced by past dietary experiences and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a significant barrier to healthy eating decisions. Positive or negative feelings accompanied dietary decisions. CONCLUSION: Although most people with IBD change their diet after diagnosis, the changes made are often inconsistent with existing dietary recommendations. Several factors can influence the dietary decision-making process. This study will help assess the experiences of people with IBD in dietary decision-making to encourage the formation of targeted dietary health and well-being interventions. Knowledge of nutrition and diet should be provided in education and training programmes for IBD management. PATIENT OR PUBLIC CONTRIBUTION: The first three authors of this paper were the lead researchers in this study's design. These authors were mentored by patient researchers who also contributed to the manuscript, and the research process was co-lead and directed by other patient participants and consultants. The results of this paper were directly obtained from patient participants.

[Approaches used for assessment of the burden of advanced schistosomiasis japonica: a comparative study].

OBJECTIVE: To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica. METHODS: The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method. RESULTS: The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia. CONCLUSIONS: The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.

[Disease burden of patients with advanced schistosomiasis in Jiangsu Province].

OBJECTIVE: To understand the disease burden of patients with advanced schistosomiasis in Jiangsu Province. METHODS: Totally 450 patients with advanced schistosomiasis from southern, northern and central Jiangsu were chosen by the stratified sampling method, and surveyed by the self-designed economic burden questionnaire in 2015. The economic burden of the patients was analyzed by the descriptive analysis method, and its determinants were explored by the multiple linear regression analysis. RESULTS: A total of 450 subjects were surveyed and 434 valid questionnaires were recovered with the recovery rate of 96.44%. The per capita economic burden of advanced schistosomiasis patients was 10 217 Yuan in Jiangsu Province in 2015, including 7 221 Yuan in direct economic burden and 2 996 Yuan in indirect economic burden. The average lost labor force time was 140 days for the patients, and was 23 days for the family. The multiple linear regression analysis showed that the marital status, hospitalization health service utilization, and self-reported health score impacted on the disease economic burden. CONCLUSIONS: The disease burden of patients with advanced schistosomiasis in Jiangsu Province is heavy.

[Global burden and challenges of parasitic diseases in Africa].

Parasitic diseases are common infectious diseases closely related to poverty, which are mainly endemic in the tropical and subtropical regions. Africa is the major epidemic area of parasitic diseases, and the global burden of malaria and schistosomiasis is over 85% in Africa. This paper reviews the disease burden, regional distribution and control strategies of the main parasitic diseases in Africa, in order to promote the prevention and control of parasitic diseases in this area.