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Cockerell K.M.,King's College London | Watkins A.S.M.,King's College London | Reeves L.B.,East Oxford Health Center | Goddard L.,Imperial College London | And 2 more authors.
Journal of Human Nutrition and Dietetics | Year: 2012

Background: Manipulation of dietary fibre intake represents a longstanding treatment for patients with irritable bowel syndrome (IBS), particularly for those with constipation. Linseeds are often recommended by both clinicians and dietitians as a source of dietary fibre to alleviate symptoms. Recent guidance on the management of irritable bowel syndrome (IBS) advises that linseeds may reduce wind and bloating, although there is limited clinical evidence to support this recommendation. The present pilot study aimed to compare the clinical effectiveness of: (i) whole linseeds versus ground linseeds; (ii) whole linseeds versus no linseeds; and (iii) ground linseeds versus no linseeds in the management of IBS symptoms. Methods: In an open randomised controlled trial, subjects with IBS (n=40) were allocated to one of three intervention groups: two tablespoons of whole linseeds per day (n=14), two tablespoons of ground linseeds per day (n=13) and no linseeds as controls (n=13). Symptom severity (primary outcome) and bowel habit were assessed before and after a 4-week intervention and statistical differences between the groups were compared. Results: Thirty-one subjects completed the present study. Between-group analysis comparing the improvement in symptom severity did not reach statistical significance for whole linseeds (n=11) versus ground linseeds (n=11; P=0.62), whole linseeds versus controls (n=9; P=0.12) and ground linseeds versus controls (P=0.10). There were no significant changes in stool frequency or stool consistency for any of the groups. Conclusions: Linseeds may be useful in relief of IBS symptoms. Further research is needed to detect clear differences between the effects of whole and ground linseeds. © 2012 The British Dietetic Association Ltd.

Reeves L.,East Oxford Health Center | Reeves L.,University of Southampton | Meyer R.,Hospital for Sick Children | Holloway J.,University of Southampton | And 3 more authors.
Clinical and Translational Allergy | Year: 2015

Background: Many food allergy guidelines have been published worldwide over recent years. The United Kingdom National Institute of Health and Clinical Excellence guidelines and The Royal College of Paediatrics and Child Health food allergy care pathways require dietitians to assist with the diagnosis and management of food allergies, which highlighted the need for further education of dietitians to meet these competencies. The aim of this study was to design a competence based one day education course for dietitians on the diagnosis and management of cow's milk protein allergy in infants and children. Methods: A one day training course was developed. Dietitians' knowledge was assessed via multiple choice questions before and on the day of the course and retention of knowledge was assessed one month after the course. Pre course reading was given once the first assessment was completed. Results: Thirty seven dietitians attended the course and 32 completed all three assessments. A significant improvement in assessment scores was seen between the pre course and on the day assessments of 7.2% (p < 0.001) and between pre course and post course assessments of 8.9% (p < 0.001). In delegates who rated their perceived level of knowledge as high, a significant increase was seen between pre course and on the day and between pre course and post course (both p < 0.001). Actual increase in knowledge was seen alongside a significant increase in high rating of perceived level of confidence between pre course and on the day and between pre course and post course (both p < 0.001). Conclusions: Educating dietitians using the format of one day teaching with pre and post course assessment has improved both knowledge and competencies in the diagnosis and management of cow's milk protein allergy. Further courses in other areas of food allergy could be developed using this approach within the UK and worldwide. © 2015 Reeves et al.; licensee BioMed Central.

Moscrop A.,University of Oxford | Siskind D.,University of Queensland | Stevens R.,East Oxford Health Center
Family Practice | Year: 2012

Objective: The objective is to examine the relation between young adults' non-attendance at primary care appointments and mental health problems, using a retrospective cohort study, in a urban primary health care facility in a relatively deprived and ethnically diverse area of Oxford, England. Methods: Two hundred and nine patients aged between 15 and 35 years who failed to attend a doctor's appointment in primary care during 2008 each matched with two control patients of the same age and gender who had attended appointments during the same period. Main outcome measure is the presentation with a mental health problem within 12 months following the missed appointment. Results: Non-attendance in primary care among 15-35 year olds was strongly associated with presentation of mental health problems. Those who did not attend an appointment were more likely to have presented mental health problems in the past [31.0% versus 8.9%, odds ratio (OR) 4.72, 95% confidence interval (CI) 3.00-7.42] and to present mental health problems within the ensuing 12 months (32.0% versus 7.4%, OR 5.91, 95% CI 3.69-9.46) when compared with those who attended appointments. Patients with no known past history of mental health problems were more likely to make their first recorded mental health presentation in the 12 months following a non-attendance when compared with those who attended (10.3% versus 3.1%, OR 3.60, 95% CI 1.76-7.35). Conclusions: Non-attendance of a young adult for a doctor's appointment in primary care may signal a mental health problem. This applies whether or not the patient is known to have presented mental health problems in the past. © The Author 2011. Published by Oxford University Press. All rights reserved.

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