A systematic review of measurement methods used to estimate fluid and beverage intake in free-living, working-age adults.

BACKGROUND: Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduced work performance. This systematic review aimed to (1) characterise existing fluid intake measurement tools used in the workplace setting or among free-living, healthy adults of working age and (2) report the current validation status of available assessment tools for use in a UK setting. METHODS: Three electronic databases were searched for publications measuring beverage intake using a defined tool or method. Additional studies were identified by hand from trial registers, grey literature and reference lists. Eligibility was determined using predefined inclusion/exclusion criteria. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology framework. Narrative synthesis was performed. RESULTS: The review identified 105 studies. The most frequently reported beverage assessment methods were total diet diaries/records (n = 22), fluid specific diaries/records (n = 18), food and fluid frequency questionnaires (n = 17), beverage-specific frequency questionnaires (n = 23) and diet recalls (n = 11). General dietary measurement tools (measuring beverages as part of total diet) were used in 60 studies, and 45 studies used a beverage-specific tool. This review identified 18 distinct dietary assessment tools, of which 6 were fluid/beverage specific. Twelve tools published relative validity for a beverage-related variable and seven tools for total daily fluid intake (from whole diet or from beverages only). CONCLUSIONS: Several fluid intake assessment tools were identified; however, few have been fully evaluated for total beverage intake, and none in a UK working population.

Development and assessment of relative validity and reliability of the Workplace Beverage Intake Questionnaire in UK office workers.

BACKGROUND: There are no beverage measurement tools evaluated for use in UK working-age adults. This study aimed to develop and evaluate a novel beverage intake questionnaire. METHODS: A 57-item online tool (Workplace Beverage Intake Questionnaire [WBIQ]) was developed through stakeholder consensus. Relative validity was measured against 7-day food records, and reliability was tested across three time points. Evaluation outcomes of interest were total beverage intake and beverage intake during working hours, intake from seven beverage categories (plain water, sugar sweetened, low/zero calorie, tea, coffee, milk based and 100% fruit based) and energy, caffeine and free sugar intake from beverages. Reliability was determined by intraclass correlation coefficients (ICC) and validity via correlation analyses and visual assessment of Bland-Altman plots. RESULTS: The evaluation study population comprised office workers (n = 71, 74.6% women, mean age: 32, standard deviation: 8.5 years). The WBIQ had moderate reliability (ICC: 0.50-0.75) across total fluid intake and all beverage categories except milk-based drinks and 100% fruit-based drinks where it was rated poor. Caffeine, free sugar and energy from beverages had poor-to-moderate reliability. Correlation coefficients were large (r > 0.50, p < 0.001) comparing diet records and WBIQ across all categories of beverage except low-/zero-calorie soft drinks (r = 0.34, p < 0.01). Bland-Altman plots showed a similar trend across all variables, with better agreements at lower intake and the absolute difference increasing proportionally at higher intakes. Over 90% of respondents agreed/strongly agreed that the tool was easy to navigate and understand. CONCLUSIONS: The WBIQ is the first stage in the development of a tool for UK-specific beverage intake measurement in working-age adults. Further refinement and testing are required to improve reliability.

A Review of the Effect of Dietary Composition on Fasting Substrate Oxidation in Healthy and Overweight Subjects.

AIM: The purpose of this review was to assess existing evidence on the effects of chronic dietary macronutrient composition on substrate oxidation during a fasted state in healthy and overweight subjects. METHODS: A systematic review of studies was conducted across five databases. Studies were included if they were English language studies of human adults, ≥19 years, used indirect calorimetry (ventilated hood technique), specified dietary macronutrient composition, and measured substrate oxidation. RESULTS: There was no evidence that variations of a typical, non-experimental diet influenced rate or ratio of substrate utilization, however there may be an upper and lower threshold for when macronutrient composition may directly alter preferences for fuel oxidation rates during a fasted state. CONCLUSION: This review indicates that macronutrient composition of a wide range of typical, non-experimental dietary fat and carbohydrate intakes has no effect on fasting substrate oxidation. This suggests that strict control of dietary intake prior to fasting indirect calorimetry measurements may be an unnecessary burden for study participants. Further research into the effects of long-term changes in isocaloric macronutrient shift is required.

Dynamic upper airway obstruction secondary to severe feline asthma.

A 2 yr old castrated male cat presented to an emergency referral facility for several episodes of gagging, nonproductive coughing, and increased respiratory effort. He was diagnosed with inspiratory stridor and referred to another emergency referral practice for further diagnostics. Three separate, sedated oral examinations, nasal computed tomography (CT), rhinoscopic biopsies, and tracheoscopy showed no structural causes for the cat's stridor. An endotracheal wash was consistent with feline asthma. Blood work showed a peripheral eosinophilia and exposure to Dirofilaria immitis (D. immitis). The feline asthma was treated with albuterol, fluticasone, dexamethasone sodium phosphate, and terbutaline. Despite aggressive therapy for feline asthma, the cat had several episodes of severe inspiratory respiratory distress and stridor secondary to an upper airway obstruction. After 3 days of hospitalization, a temporary tracheostomy was performed and no further episodes of respiratory distress were noted. The tracheostomy tube was removed 3 days later, and the cat was discharged on the fourth day. At a 14 mo follow-up examination, the client reported no further episodes of respiratory distress, coughing, or gagging. To the authors' knowledge, this is the first report of dynamic upper airway obstruction secondary to feline asthma.

Acute Anaplasma phagocytophilum infection in a pediatric domestic cat.

Case summary: A domestic shorthair cat estimated to be 4-6 weeks old was presented to a referral center for evaluation of lethargy, anorexia and diarrhea for a duration of 24 h. A feline vector-borne PCR panel, as well as a blood smear, examined by a board-certified pathologist, confirmed an Anaplasma phagocytophilum infection. Morulae were identified in both feline neutrophils and eosinophils. Treatment consisted of a 21-day course of liquid doxycycline. Clinical signs rapidly resolved and were not noted to recur. Relevance and novel information: This case demonstrates that A phagocytophilum can infect cats as young as 4-6 weeks old. Doxycycline, as the antibiotic of choice for the treatment of A phagocytophilum infections, was used. Consistent with the literature, a rapid clinical improvement was detected. Anaplasmosis should be listed as a differential diagnosis in pediatric cats suffering from acute febrile illness with potential previous tick exposure (history of living outdoors) in order to provide proper treatment.

Retrospective evaluation of elevator-related injuries in dogs (2015-2020): 13 cases.

OBJECTIVE: To describe elevator-related injuries in dogs. DESIGN: Retrospective study, August 2015 to October 2020. SETTING: Four urban referral and emergency veterinary facilities. ANIMALS: Thirteen client-owned dogs presenting with injuries sustained while using an elevator. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Thirteen dogs were treated for elevator-related injuries. The mean age of this population was 4.9 ± 4.1 years. Median body weight was 4.3 kg (range = 1.5-32 kg). Dogs in this study were significantly smaller than dogs presenting for all types of trauma during the same study period found in the Veterinary Committee on Trauma registry (VetCOT) (median = 14.5 kg, range = 0.1-141; P = 0.038). There was no difference in age between this study population and dogs presenting for trauma in the VetCOT registry (median = 4.2 years, range = 0.1-26.4, P = 0.7358). Nine dogs sustained a crush injury (69%), and 7 of these dogs received surgical intervention. Four dogs experienced leash entrapment in the elevator doors (31%), and none required surgical intervention. Two of these 4 dogs required inpatient hospital care. No deaths occurred in either group. CONCLUSIONS: Injuries that can be sustained by dogs in an elevator include crush injuries from doors closing on limbs or tails and injury due to leash entrapment in an elevator door. Many elevator-related injuries required surgical intervention, and recovery was often protracted. All dogs survived to hospital discharge in the present study, and none of the injuries in these dogs had serious long-term consequences.

Preoperative physiotherapy education for patients undergoing colorectal cancer resection.

BACKGROUND: Surgical resection is a common treatment for patients with colorectal cancer. Patients undergoing surgery are at risk of functional deterioration as a response to surgical stress. Furthermore, patients with cancer often present with systemic problems as well as a functional decline. The study aimed to create a framework for preoperative education for patients undergoing colorectal cancer resection. METHODS: Five databases were utilised to find intervention-based studies describing the content, mode, setting and timing of delivery of preoperative education for patients undergoing abdominal surgery. Physiotherapists were purposively sampled to participate in a focus group session using a seven-step nominal group technique (NGT) with the goal to reach consensus on the proposed content of a preoperative patient education programme. RESULTS: Seventeen studies were reviewed. Results indicate that the mode and timing of the education provided are heterogenous. Content included in the education programs described were breathing exercises, coughing techniques, verbal advice, physical exercises, surgical information, postoperative pain management, nutritional support, relaxation techniques and information about postoperative complications. Six physiotherapists participated in the focus group discussion. Ideas generated in the focus group were similar to those described in the literature. CONCLUSION: Results from both the narrative review and the focus group session assisted the authors to develop a framework for the content, timing, setting and mode of delivery of physiotherapy preoperative education for patients undergoing surgical resection for colorectal cancer.Contribution: The framework can be used to inform a physiotherapy preoperative education programme for patients undergoing surgery for colorectal cancer.

The use of IV lipid emulsion for lipophilic drug toxicities.

IV lipid emulsion (ILE) therapy is emerging as a potential antidote for lipophilic drug toxicities in both human and veterinary medicine. ILE has already gained acceptance in human medicine as a treatment of local anesthetic systemic toxicity, but its mechanism of action, safety margins, and standardized dosing information remains undetermined at this time. Experimental and anecdotal use of ILE in the human and veterinary literature, theorized mechanisms of action, current dosing recommendations, potential adverse effects, and indications for use in human and veterinary emergency medicine are reviewed herein.

Presumed zonisamide-induced blood dyscrasias in four dogs.

OBJECTIVE: To describe 4 canine cases of presumed zonisamide-induced blood dyscrasias. CASE SUMMARY: From 2007 to 2018 at Angell Animal Medical Center and from 2014 to 2019 at the Cummings School of Veterinary Medicine at Tufts University, 4 dogs presented with febrile neutropenia while being administered zonisamide. No septic focus was found on workup for any of the dogs, and the clinical signs were attributed to an idiosyncratic drug reaction. All WBC counts returned to normal with drug withdrawal, and all dogs survived. NEW OR UNIQUE INFORMATION PROVIDED: Presumptive zonisamide-induced blood dyscrasias are a rare complication that has not previously been reported in the veterinary literature.

Retrospective analysis of the use of tranexamic acid in critically ill dogs and cats (2018-2019): 266 dogs and 28 cats.

OBJECTIVE: To describe the signalment, dosing, adverse events, and patient diagnosis for dogs and cats admitted to the critical care unit (CCU) receiving tranexamic acid (TXA). DESIGN: Case series from 2018 to 2019. SETTING: Private referral and primary care veterinary hospital. ANIMALS: Two hundred and sixty-six dogs and 28 cats. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Records of dogs and cats admitted to the CCU that received TXA were evaluated. A diagnosis was assigned to each patient based on the International Statistical Classification of Diseases system. "Neoplasia" ([most frequently] hemangiosarcoma) (89/226 [39%]) and "diseases of the blood and blood forming organs" (idiopathic hemoabdomen, pericardial effusion) (78/226 [34%]) were the most common disease processes for which dogs received TXA. In cats, "diseases of the blood and blood forming organs" (idiopathic hemoabdomen) (9/28 [32%]), "neoplasia" (hemangiosarcoma, mast cell tumor, carcinoma) (7/28 [25%]), and "injury, poisoning, or certain other consequences of external causes" (high-rise syndrome) (5/28 [17%]) were most common. One hundred and forty-eight dogs (65%) and 13 cats (46%) underwent an invasive procedure during hospitalization. Thirty percent (70/226) of dogs received a packed RBC (pRBC) transfusion. Administration of TXA before or after pRBC transfusion did not significantly affect median dose of pRBC administered (P = 0.808). The median IV dose of TXA was similar for dogs and cats at 10 mg/kg. One cat received a 10 times overdose of TXA and did not suffer any appreciable adverse effects. Adverse events were reported in 1.7% (4/226) of dogs including hypersalivation (3/226) and seizure (1/226) in a dog that received a cumulative dose of 280 mg/kg of TXA. Hypersalivation was the only adverse event reported in 3% (1/28) of cats. CONCLUSION: TXA is primarily utilized in critically ill dogs and cats diagnosed with neoplasia, bleeding disorders, and trauma at this institution. Adverse events were infrequent and largely mild.

The association between lifestyle-related risk factors and survival in patients with colorectal cancer in an urban South African cohort.

Background: Lifestyle-related factors have been linked with risk for colorectal cancer. Data describing the relationship between lifestyle factors of South African patients who present with colorectal cancer and their survival is sparse. Objectives: The objectives were to describe the profile of patients with colorectal cancer; to determine the association between lifestyle-related factors and survival, and to compare results of patients in the private and public sectors. Methods: A retrospective review and secondary analysis of information of patients with colorectal cancer were conducted. The independent samples t-test and Mann Whitney U test were administered to determine differences in the clinical presentation. Pearson's Chi-Squared and Eta (η) tests were used to determine the association between survival and lifestyle-related factors. Results: Data of 441 patients were included. When compared to the public sector cohort, patients in the private sector cohort were older (p=0.0110), had earlier stages of cancer at the time of diagnosis (p<0.001), had a higher percentage of current alcohol consumption (p<0.001) and had higher survival rates (p<0.001). Waist circumference was shown to have a large-strength effect on survival (η2=0.266). Conclusion: Emphasis should be placed on anthropometric screening and education to effect long-term behaviour change. Physiotherapists are well placed to provide screening and non-pharmacological interventions for patients with colorectal cancer.

Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism.

OBJECTIVES: The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). METHODS: Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher's exact, Student's t- and Mann-Whitney-Wilcoxon tests. RESULTS: Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [P = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups (P <0.001). Limb score at 48 h was 1 point lower (better) in the TPA group (P = 0.19). Thrombolysis had no statistically significant effect on 48 h survival (P = 0.22). Lower affected limb lactate was associated with better 48 h survival (odds ratio 1.53, 95% confidence interval 1.08-2.17; P = 0.02). The survival to discharge rates were 45% (TPA) and 30% (placebo; P = 0.51). Complications in the TPA and placebo groups included acute kidney injury (22% and 19%, respectively; P = 1.00) and/or reperfusion injuries (33% and 19%, respectively; P = 0.45). CONCLUSIONS AND RELEVANCE: Survival and complication rates of acute FATE were not different with or without thrombolysis. High in-hospital mortality decreased the statistical power to detect a statistically significant difference between treatments with regard to our primary outcome.

Preoperative physical activity and functional performance levels are predictors of acute postoperative outcomes in a private South African colorectal cancer cohort.

BACKGROUND: For patients with colorectal cancer, surgical resection of the primary tumour remains the best treatment option. Surgery for colorectal cancer is being performed on patients who would previously not have been considered as suitable candidates. It remains to be seen which factors influence hospital length of stay (LOS) and the development of acute postoperative complications in South African patients. OBJECTIVES: The objectives of our study were to determine the modifiable factors that influence patients' development of postoperative complications and hospital LOS and, to identify the types of postoperative complications that develop. METHOD: A retrospective review and secondary analysis of information in an existing database of patients with colorectal cancer were conducted. Regression analysis statistics were used to determine the predictors of postoperative outcomes. The level of significance at which testing was performed was set at 5% (p ≤ 0.05). RESULTS: Data of 125 patients were included. Surgical site infections and postoperative paralytic ileus were the most frequently reported postoperative complications. Preoperative vigorous-intensity physical activity (p = 0.048, ß = -0.000) and functional performance status (p = 0.05, ß = 0.926) significantly predicted hospital LOS and the incidence of postoperative complications, respectively. CONCLUSION: Preoperative physical activity and functional performance levels are predictors of acute postoperative outcomes in a private South African cohort of patients with colorectal cancer. Future research which includes other modifiable factors is required to make informed suggestions for changes in clinical practice. CLINICAL IMPLICATIONS: Patients requiring surgery for colorectal cancer should be screened for signs of physical deconditioning and referred for physiotherapy intervention before elective surgery to optimise their recovery.

Experimental studies of blowfly (Calliphora stygia) longevity: A little dietary fat is beneficial but too much is detrimental.

This paper is one in a series of experimental studies on the effects of food composition on aging and longevity, using the golden-haired blowfly Calliphora stygia as the animal model. Here we examine how diet fat content affects blowfly life history traits such as longevity, reproduction, feeding rate, body mass, total fat content and membrane fatty acid composition. The highest median and maximum longevity was observed in blowflies fed on low fat diets, while high-fat diets caused more rapid death of the blowflies. A major result was that blowflies feeding on the lowest fat diet had the highest maximal lifespan demonstrating that low levels of diet fat enhanced blowfly lifespan. Diet also influenced gender-specific mortality rates; females lived longer on a high-fat diet, while males lived longer on a low fat diet. Furthermore, we provide data for and explain how blowfly feeding rates, egg production and male harassment affected blowfly longevity. Our results highlight the need for further studies to understand how dietary fats are metabolised and utilised in the golden-haired blowfly.

Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study.

BACKGROUND: Critically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU. OBJECTIVES: To determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans. METHOD: A single-centred pre-post quasi-experimental study was conducted. The population was a consecutive sample of surgical and trauma ICU patients. Participants' functional ability was assessed with the CPAx tool on alternative days during their ICU stay, and rehabilitation goals were modified according to their CPAx score. Intensive care unit and hospital LOS data were collected and compared to data of a matched historical control group. Descriptive and inferential statistics were used. RESULTS: A total of 26 ICU patients were included in the intervention group (n = 26). They received CPAx-guided therapy, and outcomes were matched with ICU patients in the historical control group (n = 26). The median sequential organ failure assessment (SOFA) score was significantly higher in the control group (p = 0.005) (3.5 [IQR 2-6.3]) versus (2 [IQR 1.8-2.5]) for the intervention group. The median admission CPAx score for the intervention group was 33.5 (IQR 16.1-44), and the median ICU discharge score was 38 (IQR 28.5-43.8). No significant differences were found in ICU days (control 2.7 [IQR 1.1-5.2]; intervention 3.7 [IQR 2.3-5.4]; p = 0.27) or hospital LOS (control 13.5 [IQR 9.3-18.3]; intervention 11.4 [IQR 8.4-20.3], p = 0.42). Chelsea critical care physical assessment scores on ICU admission had a moderate negative correlation with hospital LOS (r = -0.58, p = 0.00, n = 23). Chelsea critical care physical assessment scores at ICU discharge had strong positive correlation with discharge SOFA scores (r = 0.7; p = 0.025; n = 10). CONCLUSION: Problem-oriented patient rehabilitation informed by the CPAx tool resulted in improvement of physical function but did not reduce ICU or hospital LOS. CLINICAL IMPLICATIONS: A higher level of physical function at ICU admission, measured with CPAx, was associated with shorter hospital LOS.

Escalator-related injuries in 30 dogs (2007-2014).

OBJECTIVE: To describe a population of dogs affected by escalator-related injuries, and to characterize the types of injuries sustained and describe treatment administered. DESIGN: Retrospective study from March 2007 to November 2014. SETTING: Large urban referral and emergency facility. ANIMALS: Thirty client-owned dogs presenting with injuries acquired while riding an escalator. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All injuries in this study occurred secondary to entrapment of 1 or more paws in the moving parts of an escalator; 39 paws were injured in total. The median body weight of the patients in this study was 4.25 kg, with 73.3% of the patients weighing less than 10 kg. Fifteen patients (50.0%) were treated surgically, the remainder were managed conservatively. Eight patients (26.7%) underwent digit or partial-digit amputation. Of the conservatively managed patients, 10 were treated with bandaging of the wounds. Antimicrobials, opiate analgesics, and nonsteroidal anti-inflammatory drugs were administered in both surgically and conservatively managed patients. CONCLUSIONS: While uncommon, escalator accidents can result in significant injury to dogs. Measures can be taken to prevent these injuries from occurring, whether through client education, dog training, structural modifications in the escalators themselves, or avoidance of escalators. In the present study, the survival rate of dogs injured on escalators was 100%.

Relative validity of a brief Fat and Fibre Behaviour Questionnaire in a population of overweight and obese breast cancer survivors: A note of caution.

AIM: Dietary intake assessment is often difficult in research contexts because of time and resource constraints and participant burden. Valid, reliable and brief assessments of dietary behaviour are needed. Additionally, examination of instrument performance in a variety of populations is needed. This study assessed relative validity and responsiveness to change of the Fat and Fibre Behaviour Questionnaire (FFBQ) in a population of breast cancer survivors compared with dietary intake measured by 24-hour recalls. METHODS: Data were collected at baseline and six months after baseline of a six-month, randomised controlled trial that evaluated a telephone-based behavioural weight loss intervention (n = 45) compared to usual care (n = 45) among overweight and obese breast cancer survivors. The FFBQ's total index, fat index and fibre index were assessed for relative validity against two 24-hour recalls (Pearson's correlations). Responsiveness to change was assessed as intervention group change divided by standard deviation of usual care group change. RESULTS: Pearson's correlations of the fat index with fat intake measures ranged from -0.09 to -0.30 (P < 0.05) at baseline and from -0.19 to -0.28 (P < 0.05) for dietary change. Correlations of the fibre index with unadjusted and energy-adjusted fibre intake measures (0.25-0.32, P < 0.05) were significant at baseline only. Both the FFBQ and 24-hour recall were responsive to fat-related dietary changes and not responsive to fibre-related changes. CONCLUSIONS: The FFBQ showed small to medium relative validity against 24-hour dietary recall for assessing fat and fibre dietary behaviours and changes in dietary fat, and was responsive to fat-related dietary changes in this population.

Telephone-delivered weight management services in the hospital outpatient setting: Decision-makers' perceptions of their use in routine practice.

AIM: Providing effective weight management services to the growing number of overweight or obese hospital patients necessitates long-term service provision; however, it is arguably not within the acute-care hospital remit to provide such extended services. Referral to community-based programs is required to provide continuing weight management services. The Get Healthy Service is a free six-month, telephone-delivered lifestyle program, now offered in several states of Australia with potential for wide population reach. However, health practitioner referral into the service has been low. The study aimed to examine awareness and suitability of the Get Healthy Service for referral of hospital outpatients for weight management, among key health-care decision-makers. METHODS: Nine key decision-makers from metropolitan and rural Queensland Health hospitals took part in semi-structured telephone interviews that were audio-recorded (January-July 2014), transcribed verbatim and thematically analysed. RESULTS: Interviews revealed that most decision-makers had limited awareness of the Get Healthy Service but perceived the telephone service to be suitable for patient referrals. Incorporating Get Healthy Service referrals into patient care was seen to be potentially valuable and relatively easy to implement, with most interviewees suggesting that they would provide a Get Healthy Service brochure to patients who could then self-refer into the service. CONCLUSIONS: The Get Healthy Service provides a referral model for weight management service provision that appears feasible for use in Queensland hospital settings. Increased awareness and a more integrated approach to referrals would likely result in improved enrolment to the service, with future research needed to demonstrate this.

Intensive family exposure-based cognitive-behavioral treatment for adolescents with anorexia nervosa.

BACKGROUND: Anorexia nervosa exhibits high comorbidity rates and shared features with anxiety disorders and obsessive-compulsive disorder. Anxiety-based etiological models have proposed that fear of eating-related stimuli is the central mechanism around which avoidance of food and food-related rituals are performed. Building on this approach, exposure-based interventions have demonstrated promising results. Limited evidence in adolescents encourages the evaluation of exposure approaches in this population. METHOD: The current study presents a preliminary evaluation, in eight adolescents with anorexia nervosa, of an exposure-based CBT featuring an intensive format and parental involvement. RESULTS: significant improvements in physical and psychological outcomes were observed. CONCLUSIONS: this case series provides preliminary support for the efficacy of intensive family exposure-based CBT for treating adolescents with severe anorexia nervosa.