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BACKGROUND: Brown marmorated stink bug (BMSB), Halyomorpha halys (Hemiptera: Pentatomidae) is native to East Asia but has invaded many countries in the world. BMSB is a polyphagous insect pest and causes significant economic losses to agriculture worldwide. Knowledge on the genetic diversity among BMSB populations is scarce but is essential to understand the patterns of colonization and invasion history of local populations. Efforts have been made to assess the genetic diversity of BMSB using partial mitochondrial DNA sequences but genetic divergence on mitochondria is not high enough to precisely accurately identify and distinguish various BMSB populations. Therefore, in this study, we applied a ddRAD (double digest restriction-site associated DNA) sequencing approach to ascertain the genetic diversity of BMSB populations collected from 12 countries (2 native and 10 invaded) across four continents with the ultimate aim to trace the origin of BMSBs intercepted during border inspections and post-border surveillance. RESULT: A total of 1775 high confidence single nucleotide polymorphisms (SNPs) were identified from ddRAD sequencing data collected from 389 adult BMSB individuals. Principal component analysis (PCA) of the identified SNPs indicated the existence of two main distinct genetic clusters representing individuals sampled from regions where BMSB is native to, China and Japan, respectively, and one broad cluster comprised individuals sampled from countries which have been invaded by BMSB. The population genetic structure analysis further discriminated the genetic diversity among the BMSB populations at a higher resolution and distinguished them into five potential genetic clusters. CONCLUSION: The study revealed hidden genetic diversity among the studied BMSB populations across the continents. The BMSB populations from Japan were genetically distant from the other studied populations. Similarly, the BMSB populations from China were also genetically differentiated from the Japanese and other populations. Further genetic structure analysis revealed the presence of at least three genetic clusters of BMSB in the invaded countries, possibly originating via multiple invasions. Furthermore, this study has produced novel set of SNP markers to enhance the knowledge of genetic diversity among BMSB populations and demonstrates the potential to trace the origin of BMSB individuals for future invasion events.
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Heterópteros , Animales , China , Heterópteros/genética , Humanos , Japón , TecnologíaRESUMEN
BACKGROUND: We examined preterm infants' weight gain velocity (WGV) to determine how much calculation methods influences actual WGV during the first 28 days of life. METHODS: WGV methods (Average 2-point, Exponential 2-point, Early 1-point, and Daily) were calculated weekly and for various start times (birth, nadir, regain, day 3 and day 7) to 28 days of age for 103 preterm < 1500 gram infants, with daily weights. RESULTS: Range of WGV estimates decreased 10-22 g/kg/day to 15.5-15.8 g/kg/day when the Early 1-point method and the postnatal weight loss phase were excluded. WGV were lower when the postnatal weight loss was included and higher using the early method. WGV calculations beginning at day 7 did not differ from calculations beginning at the nadir. CONCLUSIONS: Variations in WGV calculations were large enough to create difficulties for comparing results between studies and translating research to practice. We recommend that the postnatal weight loss phase be excluded from WGV calculations and clinical studies report weight nadir and weights at day 7 and 28 to allow adequate comparison and translation of findings in clinical practice. The Average2pt method may be easier to calculate at bedside, so we recommend it be used in clinical settings and research summaries. The Early1pt method should not be used to summarize WGV for research.
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Antropometría/métodos , Peso Corporal , Recien Nacido Prematuro/fisiología , Aumento de Peso , Recolección de Datos , Femenino , Humanos , Recién Nacido , Enfermedades del Recién Nacido , Masculino , Valores de Referencia , Reproducibilidad de los Resultados , Pérdida de PesoRESUMEN
OBJECTIVE: To examine how well growth velocity recommendations for preterm infants fit with current growth references: Fenton 2013, Olsen 2010, INTERGROWTH 2015, and the World Health Organization Growth Standard 2006. STUDY DESIGN: The Average (2-point), Exponential (2-point), Early (1-point) method weight-gains were calculated for 1,4,8,12, and 16-week time-periods. Growth references' weekly velocities (g/kg/d, gram/day and cm/week) were illustrated graphically with frequently-quoted 15 g/kg/d, 10-30 grams/day and 1 cm/week rates superimposed. The 15 g/kg/d and 1 cm/week growth velocity rates were calculated from 24-50 weeks, superimposed on the Fenton and Olsen preterm growth charts. RESULTS: The Average and Exponential g/kg/d estimates showed close agreement for all ages (range 5.0-18.9 g/kg/d), while the Early method yielded values as high as 41 g/kg/d. All 3 preterm growth references were similar to 15 g/kg/d rate at 34 weeks, but rates were higher prior and lower at older ages. For gram/day, the growth references changed from 10 to 30 grams/day for 24-33 weeks. Head growth rates generally fit the 1 cm/week velocity for 23-30 weeks, and length growth rates fit for 37-40 weeks. The calculated g/kg/d curves deviated from the growth charts, first downward, then steeply crossed the median curves near term. CONCLUSIONS: Human growth is not constant through gestation and early infancy. The frequently-quoted 15 g/kg/d, 10-30 gram/day and 1 cm/week only fit current growth references for limited time periods. Rates of 15-20 g/kg/d (calculated using average or exponential methods) are a reasonable goal for infants 23-36 weeks, but not beyond.
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Gráficos de Crecimiento , Recien Nacido Prematuro/crecimiento & desarrollo , Pediatría/métodos , Pediatría/normas , Estatura , Peso Corporal , Femenino , Edad Gestacional , Cabeza/fisiología , Humanos , Lactante , Recién Nacido , Masculino , Estándares de Referencia , Aumento de PesoRESUMEN
OBJECTIVE: Women exposed to diethylstilbestrol (DES) in utero are at increased risk for the development of vaginal and cervical clear cell adenocarcinoma (CCA) at younger age. It is unknown if a second peak will occur in later life, the ages when CCA developed spontaneously in the pre-DES era. The complete epidemiologic curve of CCA has not been reported, yet. METHODS: We reviewed 720 cases of CCA from the CCA registry at the University of Chicago through 2014. Incidence rates and cumulative risks for CCA were calculated based on white women born in the U.S. from 1948 through 1971. RESULTS: In 420 CCA cases there was documented evidence of prenatal DES exposure. 80% were among those between ages 15 and 31 but some occurred as late as age 55. A small second peak occurred around age 42. The risk of DES-related CCA was highest in the 1951-1956 birth cohort and this birth cohort effect closely correlated with DES prescriptions over time in the U.S. (r=0.98, P=0.005). By age 50, the cumulative risk of CCA was 1 per 750 exposed women. CCA cases without evidence of DES exposure had similar ages, year of diagnosis, and birth cohort patterns as the documented DES-exposed cases, suggesting that some negative cases were exposed. Their inclusion raises the cumulative risk of CCA to 1 per 520. CONCLUSION: With the largest data available, our results confirmed the association between prenatal DES exposure and clear cell adenocarcinoma. The study also refines the risks of DES-related CCA.
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Adenocarcinoma de Células Claras/epidemiología , Dietilestilbestrol/efectos adversos , Efectos Tardíos de la Exposición Prenatal/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias Vaginales/epidemiología , Adolescente , Adulto , Anciano , Niño , Estudios de Cohortes , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Embarazo , Medición de Riesgo , Factores de Tiempo , Estados Unidos/epidemiología , Adulto JovenAsunto(s)
Adenocarcinoma de Células Claras/mortalidad , Dietilestilbestrol/efectos adversos , Efectos Tardíos de la Exposición Prenatal , Neoplasias del Cuello Uterino/mortalidad , Neoplasias Vaginales/mortalidad , Adenocarcinoma de Células Claras/inducido químicamente , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Embarazo , Análisis de Supervivencia , Neoplasias del Cuello Uterino/inducido químicamente , Neoplasias Vaginales/inducido químicamente , Adulto JovenRESUMEN
Requirements for optimal nutrition, especially for micronutrients, are not well defined for premature infants. The "reference fetus," developed by Ziegler et al,(1) has served as a model to define nutritional needs and studies designed to determine nutrient requirements. Revision of nutrient requirements and provision of optimal nutrition may lead to improved outcomes in preterm infants. Appropriate provision of nutrients also may help prevent nutritional disorders, such as metabolic bone disease and anemia. In this review, we discuss calcium, phosphorus, magnesium, vitamin D, iron, and copper, and define optimal intakes based on the available published data.
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Fenómenos Fisiológicos Nutricionales del Lactante , Recien Nacido Prematuro/fisiología , Micronutrientes/fisiología , Necesidades Nutricionales/fisiología , Calcio de la Dieta/administración & dosificación , Calcio de la Dieta/metabolismo , Cobre/administración & dosificación , Cobre/fisiología , Dieta , Suplementos Dietéticos , Humanos , Recién Nacido , Hierro de la Dieta/administración & dosificación , Hierro de la Dieta/metabolismo , Magnesio/administración & dosificación , Magnesio/fisiología , Micronutrientes/administración & dosificación , Fósforo Dietético/administración & dosificación , Fósforo Dietético/metabolismo , Vitamina D/administración & dosificación , Vitamina D/fisiologíaRESUMEN
BACKGROUND: Halyomorpha halys, (brown marmorated stink bug, BMSB), is a high-concern invasive species causing severe damage to orchards in many countries outside its native Asian range. Management methods other than frequent sprays of broad-spectrum insecticides are needed to restore integrated pest management (IPM) practices in orchards. Chitin synthesis inhibitors are usually regarded as desirable options in IPM programs because of lower toxicity to beneficial insects and non-target organisms compared to neurotoxic insecticides. In this study, the activity of three chitin synthesis inhibitors (namely buprofezin, novaluron and triflumuron) was investigated on BMSB egg masses, third instars and adults by means of laboratory bioassays. RESULTS: Novaluron and to a lesser extent triflumuron were detrimental to BMSB nymphs exposed to residues on potted peach plants. Novaluron caused high mortality among early instars that emerged from sprayed egg masses. No significant differences were found between buprofezin and water control on eggs or third instars. When sprayed on BMSB adults, none of the chitin synthesis inhibitors affected survival, fecundity, or egg hatching. CONCLUSION: Given the activity on nymphs, but the lack of effects on adults, novaluron and triflumuron might be considered for field applications only as a tool in a wider management strategy along with other methods aimed at preventing the invasion of crops by BMSB adults. © 2023 Society of Chemical Industry.
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Heterópteros , Insecticidas , Animales , Insecticidas/farmacología , Ninfa , QuitinaRESUMEN
BACKGROUND: In the past decade, the brown marmorated stink bug (BMSB), Halyomorpha halys (Hemiptera: Pentatomidae) has caused extensive damage to global agriculture. As a high-risk pest for many countries, including New Zealand, it is important to explore its genetic diversity to enhance our knowledge and devise management strategies for BMSB populations. In this study, two mitochondrial genes, Cytochrome c oxidase I (COI) and Cytochrome c oxidase II (COII) were used to explore the genetic diversity among 463 BMSB individuals collected from 12 countries. RESULT: In total, 51 COI and 29 COII haplotypes of BMSB were found, which formed 59 combined haplotypes (5 reported and 54 novel). Of these, H1h1 was the predominant haplotype. The haplotype diversity (Hd) and nucleotide diversity (π) were high while the neutrality (Fu's Fs) values were negative for the BMSB populations in the native countries, China, and Japan. For the BMSB populations from the invaded countries, the Fu's Fs values were negative for populations from Chile, Georgia, Hungary, Italy, Romania, Turkey, and USA, indicating that those populations are under demographic expansion. In comparison, the Fu's Fs values were positive for the populations from Austria, Serbia, and Slovenia, revealing a potential population bottleneck. Analysis of molecular variance (AMOVA) suggested that significant genetic difference exists among the BMSB populations from China, Japan, and the invasive countries. CONCLUSION: This study revealed that the haplotype diversity of the BMSB populations was high in those two studied countries where BMSB is native to (China and Japan) but low in those countries which have been invaded by the species. The analysis indicated that multiple invasions of BMSB occurred in Europe and the USA. The study also revealed three ancestral lines and most of the novel haplotypes were evolved from them. Moreover, we observed two genetic clusters in the invasive populations that are formed during different invasion events. Our study provided a comprehensive overview on the global haplotypes distribution thus expanding the existing knowledge on BMSB genetic diversity that potentially could play an important role in formulating feasible pest management strategies.
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Complejo IV de Transporte de Electrones/genética , Variación Genética , Haplotipos , Heterópteros/genética , Animales , Heterópteros/enzimologíaRESUMEN
Human milk is the most optimal source of nutrition for preterm and term infants. However, in most preterm infants, breast milk fails to meet the energy needs of the newborn infant. Overwhelming evidence supports the fortification of breast milk in preterm infants to facilitate better short-term outcomes. Several single-nutrient and multinutrient breast milk supplements and fortifiers are used to improve the macronutrient and micronutrient content of breast milk. An individualized fortification strategy has the potential to offer better results compared with standard fortification strategies. Human milk-derived fortification is promising, but the benefits in exclusively human milk-fed preterm infants are unclear.
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Fórmulas Infantiles , Leche Humana , Suplementos Dietéticos , Ingestión de Energía , Alimentos Fortificados , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Micronutrientes , NutrientesRESUMEN
Preterm infants are increasingly diagnosed as having "extrauterine growth restriction" (EUGR) or "postnatal growth failure" (PGF). Usually EUGR/PGF is diagnosed when weight is <10th percentile at either discharge or 36-40 weeks postmenstrual age. The reasons why the phrases EUGR/PGF are unhelpful include, they: (i) are not predictive of adverse outcome; (ii) are based only on weight without any consideration of head or length growth, proportionality, body composition, or genetic potential; (iii) ignore normal postnatal weight loss; (iv) are usually assessed prior to growth slowing of the reference fetus, around 36-40 weeks, and (v) are usually based on an arbitrary statistical growth percentile cut-off. Focus on EUGR/PGF prevalence may benefit with better attention to nutrition but may also harm with nutrition delivery above infants' actual needs. In this paper, we highlight challenges associated with such arbitrary cut-offs and opportunities for further refinement of understanding growth and nutritional needs of preterm neonates.
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Retardo del Crecimiento Fetal , Recien Nacido Prematuro , Retardo del Crecimiento Fetal/diagnóstico , Edad Gestacional , Humanos , Lactante , Recién Nacido , Estado Nutricional , Alta del PacienteRESUMEN
OBJECTIVE: We sought to describe how the sensory processing of adults with obsessive-compulsive disorder (OCD) differs from that of the general population within the context of Dunn's (1997) model of sensory processing and to evaluate the discriminant validity of the Adolescent/Adult Sensory Profile (AASP). METHOD: Using unequal variance ttests, the AASP results of 51 adults with OCD were compared with the means of the AASP standardization study's adult age group. RESULTS: Adults with OCD scored higher than the means of the AASP standardization study's adult age group on sensory sensitivity and sensation avoiding, consistent with predictions based on the OCD literature. Adults with OCD also scored higher on low registration and lower on sensation seeking. CONCLUSIONS: The results provide a preliminary description of how the sensory processing of adults with OCD differs from that of the general population and preliminary support for the AASP's discriminant validity.
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Trastorno Obsesivo Compulsivo/psicología , Sensación , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/complicaciones , Reproducibilidad de los Resultados , Umbral Sensorial , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Menopause onset, on average, occurs earlier among women who smoke cigarettes than among women who do not smoke. Prenatal smoke exposure may also influence age at menopause through possible effects on follicle production in utero. Smoking information was obtained from the mothers of 4,025 participants in the National Cooperative Diethylstilbestrol Adenosis (DESAD) Project, a US study begun in 1975 to examine the health effects of prenatal diethylstilbestrol exposure. Between 1994 and 2001, participants provided information on menopausal status. Cox proportional hazards modeling compared the probability of menopause among participants who were and were not prenatally exposed to maternal cigarette smoke. Participants prenatally exposed to maternal cigarette smoke were more likely than those unexposed to be postmenopause (hazard ratio = 1.21, 95% confidence interval: 1.02, 1.43). The association was present among only those participants who themselves had never smoked cigarettes (hazard ratio = 1.38, 95% confidence interval: 1.10, 1.74) and was absent among active smokers (hazard ratio = 1.03, 95% confidence interval: 0.81, 1.31). In this cohort of participants predominantly exposed to diethylstilbestrol, results suggest that prenatal exposure to maternal cigarette smoke may play a role in programming age at menopause. The possibility that active cigarette smoking modifies this effect is also suggested.
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Actitud Frente a la Salud , Dietilestilbestrol/toxicidad , Exposición a Riesgos Ambientales/efectos adversos , Exposición Materna , Bienestar Materno , Menopausia , Fumar/efectos adversos , Contaminación por Humo de Tabaco/efectos adversos , Adolescente , Adulto , Factores de Edad , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Efectos Tardíos de la Exposición Prenatal , Medición de Riesgo , Asunción de RiesgosRESUMEN
BACKGROUND: Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available. OBJECTIVES: To establish content validity, analyze interrater reliability, and determine sensitivity and specificity of an evidence-based postextubation dysphagia screening tool developed by a multidisciplinary team. METHODS: A prospective nonexperimental study was conducted in 4 medical-surgical intensive care units in 4 hospitals. The study was conducted in 3 phases: (1) establishing content validity with clinical experts who participated in a Delphi survey, (2) establishing inter-rater reliability by agreement with nurses who simultaneously and independently completed the tool, and (3) establishing sensitivity and specificity with speech language pathologists and nurses who independently and blindly completed the tool for eligible patients. RESULTS: Individual item scores were > 0.82 and the overall content validity index was 0.93, indicating content validity. Interrater reliability was established (Cohen κ = 0.92). In 66 eligible patients, the prevalence of postextubation dysphagia was 56%, sensitivity of the postextubation dysphagia screening tool was 81%, and specificity was 69%. CONCLUSION: The reliability and validity of a postextubation dysphagia screening tool that can help nurses determine an extubated patient's ability to swallow after prolonged endotracheal intubation were established.
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Extubación Traqueal/enfermería , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Intubación Intratraqueal/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Trastornos de Deglución/enfermería , Técnica Delphi , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Estudios Prospectivos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factores de TiempoAsunto(s)
Neoplasias de los Genitales Femeninos/fisiopatología , Neoplasias de los Genitales Femeninos/psicología , Disfunciones Sexuales Fisiológicas/etiología , Sexualidad/psicología , Sobrevivientes/psicología , Neoplasias del Cuello Uterino/complicaciones , Neoplasias del Cuello Uterino/psicología , Neoplasias Vaginales/complicaciones , Neoplasias Vaginales/psicología , Femenino , Humanos , MasculinoRESUMEN
CONTEXT: Clinicians assess the growth of preterm infants and compare growth velocity using a variety of methods. OBJECTIVE: We determined the numerical methods used to describe weight, length, and head circumference growth velocity in preterm infants; these methods include grams/kilogram/day (g/kg/d), grams/day (g/d), centimeters/week (cm/week), and change in z scores. DATA SOURCES: A search was conducted in April 2015 of the Medline database by using PubMed for studies that measured growth as a main outcome in preterm neonates between birth and hospital discharge and/or 40 weeks' postmenstrual age. English, French, German, and Spanish articles were included. The systematic review was conducted by using Preferred Reporting Items for Systematic Reviews and Meta-analyses methods. STUDY SELECTION: Of 1543 located studies, 373 (24%) calculated growth velocity. DATA EXTRACTION: We conducted detailed extraction of the 151 studies that reported g/kg/d weight gain velocity. RESULTS: A variety of methods were used. The most frequently used method to calculate weight gain velocity reported in the 1543 studies was g/kg/d (40%), followed by g/d (32%); 29% reported change in z score relative to an intrauterine or growth chart. In the g/kg/d studies, 39% began g/kg/d calculations at birth/admission, 20% at the start of the study, 10% at full feedings, and 7% after birth weight regained. The kilogram denominator was not reported for 62%. Of the studies that did report the denominators, the majority used an average of the start and end weights as the denominator (36%) followed by exponential methods (23%); less frequently used denominators included birth weight (10%) and an early weight that was not birth weight (16%). Nineteen percent (67 of 355 studies) made conclusions regarding extrauterine growth restriction or postnatal growth failure. Temporal trends in head circumference growth and length gain changed from predominantly cm/wk to predominantly z scores. LIMITATIONS AND CONCLUSIONS: The lack of standardization of methods used to calculate preterm infant growth velocity makes comparisons between studies difficult and presents an obstacle to using research results to guide clinical practice.
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Recien Nacido Prematuro/crecimiento & desarrollo , Modelos Biológicos , Estatura , Cefalometría , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Aumento de PesoRESUMEN
The brown marmorated stink bug, Halyomorpha halys (Hemiptera: Pentatomidae), is a gregarious crop pest that has rapidly spread across the world in the last two decades. It is an excellent hitchhiker species, especially as an over-wintering adult. During this period it is often associated with non-biological commodities such as shipping containers and machinery that travel long distances. Inadequate identification keys and similarity to common species has assisted its spread across Europe, while accurate identification from immature stages or eggs is not possible. We developed a real-time TaqMan PCR assay for the accurate and sensitive detection of the brown marmorated stink bug from all life stages. The assay performance against required diagnostic criterion and within a quarantine framework are described.
RESUMEN
The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm and high-risk newborn infants. The future systematic reviews that will ultimately provide the underpinning for guideline development will be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL). To accomplish the objectives of this first phase, the Pre-B Project organizers established 4 working groups (WGs) to address the following themes: 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. Each WG was asked to 1) develop a series of topics relevant to their respective themes, 2) identify questions for which there is sufficient evidence to support a systematic review process conducted by the EAL, and 3) develop a research agenda to address priority gaps in our understanding of the role of nutrition in health and development of preterm/neonatal intensive care unit infants. This article is a summary of the reports from the 4 Pre-B WGs.
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Nutrición Enteral , Medicina Basada en la Evidencia , Trastornos del Crecimiento/prevención & control , Fenómenos Fisiológicos Nutricionales del Lactante , Nutrición Parenteral , Medicina de Precisión , Nacimiento Prematuro/terapia , Investigación Biomédica/métodos , Investigación Biomédica/tendencias , Ciencias de la Nutrición del Niño/educación , Ciencias de la Nutrición del Niño/métodos , Ciencias de la Nutrición del Niño/tendencias , Terapia Combinada/efectos adversos , Terapia Combinada/tendencias , Congresos como Asunto , Nutrición Enteral/tendencias , Trastornos del Crecimiento/etiología , Prioridades en Salud , Humanos , Recién Nacido , Necesidades Nutricionales , Nutrición Parenteral/efectos adversos , Nutrición Parenteral/tendencias , Guías de Práctica Clínica como Asunto , Nacimiento Prematuro/dietoterapia , Nacimiento Prematuro/fisiopatologíaRESUMEN
OBJECTIVES: To identify the reasons why some people do not participate in bowel cancer screening so that steps can be taken to improve informed decision-making. DESIGN: Qualitative study, using focus groups with thematic analysis of data to identify, analyse and report patterns. Transcripts were repeatedly read and inductively coded using a phenomenological perspective, and organised into key themes. SETTING: Belfast and Armagh, two areas of Northern Ireland with relatively low uptake of bowel cancer screening. PARTICIPANTS: Ten women and 18 men in three single-gender focus groups (two male and one female), each with 9-10 participants. Study participants were recruited by convenience sampling from the general public and were eligible for, but had not taken part in, the Northern Ireland Bowel Cancer Screening Programme. RESULTS: Key themes identified were fear of cancer; the test procedure; social norms; past experience of cancer and screening; lack of knowledge or understanding about bowel cancer screening; and resulting behaviour towards the test. Fear about receiving bad news and reluctance to conduct the test themselves were reactions that participants seemed willing to overcome after taking part in open discussion about the test. CONCLUSIONS: We identified barriers to participation in bowel cancer screening and used these insights to develop new materials to support delivery of the programme. Some of the issues raised have been identified in other UK settings, suggesting that knowledge about barriers, and strategies to improve uptake, may be generalisable.
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Neoplasias Colorrectales/psicología , Detección Precoz del Cáncer/psicología , Aceptación de la Atención de Salud/psicología , Participación del Paciente/psicología , Anciano , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Tamizaje Masivo , Motivación , Irlanda del Norte/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Investigación Cualitativa , Factores SocioeconómicosRESUMEN
All components of assessment contribute to the final decision regarding nutritional status of the infant and the nutritional therapy indicated. One parameter by itself such as nutrient intake, weight change, or a laboratory value cannot clearly determine the total nutritional state of the infant. Achieving appropriate intakes and weight gains are two excellent parameters. Laboratory values can determine if nutrition is tolerated and manipulations are indicated.