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Found 5 results

  1. Celiac.com 08/20/2018 - Following a gluten-free diet is critical for people with celiac disease. However, the factors that influence gluten-free diet success for people with celiac disease are not well understood on a population-wide scale. A team of researchers recently set out to assess the factors that influence gluten‐free diet adherence in patients with celiac disease. The research team included E. P. Halmos, M. Deng, S. R. Knowles, K. Sainsbury, B. Mullan, and J. A. Tye‐Din. The team asked celiac patients to complete an online survey that included the validated Celiac Dietary Adherence Test, along with questions on demographics, details of diagnosis and management and assessment of diet knowledge, quality of life and psychological distress. The team then reviewed the survey data for predictors of adherence and quality of life. There were a total of 7,393 survey responses, with 5,310 people completing the Celiac Dietary Adherence Test, and 3,230 of whom were following a gluten‐free diet. Multivariate regression showed that predictors of gluten-free dietary adherence included older age, being male, symptoms severity after gluten consumption, above average gluten-free food knowledge, and lower risk of psychological distress. People with celiac disease who followed a gluten-free diet also reported better quality of life. Respondents who reported having poor food knowledge were more likely to wrongly identify gluten‐free foods, though they could still recognize gluten‐containing foods. This indicates that poor overall food knowledge may lead people with celiac disease to over‐restrict their diet. Poor understanding of gluten‐free diet and stressful psychological well-being were the main modifiable risk factors for failure to follow a gluten‐free diet in patients with celiac disease. From these responses, the team concluded that access to a dietitian and mental health care professional, in cases of psychological stress, is likely necessary to improve gluten-free dietary observation, and thus to improve overall patient health and well-being. Read more at: Alimentary Pharmacology & Therapeuticsdoi.org/10.1111/apt.14791 The researchers in this study are variously affiliated with the Department of Gastroenterology, The Royal Melbourne Hospital in Parkville, Victoria, Australia, the Department of Gastroenterology, Central Clinical School, Monash University in Melbourne, Victoria, Australia, the Cartovera Pty. Ltd. in Adelaide, SA, Australia, the Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology in Hawthorn, Victoria, Australia, the Department of Mental Health, St Vincent's Hospital in Fitzroy, Victoria, Australia, the Department of Psychiatry, University of Melbourne in Parkville, Victoria, Australia, Institute of Health and Society, Faculty of Medical Sciences, Newcastle University in Newcastle Upon Tyne, UK, the Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University in Bentley, WA, Australia, the Immunology Division, The Walter and Eliza Hall Institute of Medical Research in Parkville, Victoria, Australia, and the Department of Medical Biology, University of Melbourne in Parkville, Victoria, Australia.
  2. Celiac.com 03/03/2017 - Previous studies have shown us that men are generally less troubled living with celiac disease than are women, but most studies of men with celiac disease have been mostly quantitative, and have a bio-medical emphasis. A team of researchers recently set out to explore the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis. The research team included Ethel Kautto, Cecilia Olsson, Anneli Ivarsson, Phil Lyon, Agneta Hörnell, and Lena Alex. They are variously affiliated with the Department of Food and Nutrition and Umeå Center for Gender Studies, Umeå University, Sweden, the Department of Food and Nutrition, Umeå University, Sweden, the Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden, the School of Arts, Social Sciences and Management at Queen Margaret University, UK, and the Department of Nursing at Umeå University in Sweden. Using a large Swedish school-based celiac screening-study, the team arranged to interview seven young men, all of whom were diagnosed with celiac disease at 13 years-old. The semi-structured interviews were analyzed from a gender perspective which resulted in three themes. Those themes were of young adult men being subjected to changes, striving for normality and emphasizing commitment. Many of young men reported dissociating themselves from being seen as a person with a life-long chronic disease. The analysis also showed that the young men’s daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively. In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease. If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations. So, basically, being relaxed and socially confident about eating gluten-free helps to ensure success with the diet. Source: International Journal of Celiac Disease Vol. 4, No. 4, 2016, pp 138-145. doi: 10.12691/ijcd-4-4-7
  3. Celiac.com 12/04/2013 - About 1 of of 100 Americans has celiac disease, but most cases remain undiagnosed, partly because of failure on the part of physicians to collect at least four specimens during duodenal biopsy, as per current recommendations. A team of researchers recently set out to determine whether physician and practice characteristics are associated with these failures. The research team included Benjamina Lebwohl, Robert M. Genta, Robert C. Kapel, Daniel Sheehan, Nina S. Lerner, Nina, Peter H. Green, Alfred I. Neugut, and Andrew Rundle. For their study, the team used a large national pathology database to identify all adult patients who underwent duodenal biopsy during 2006–2009. They used hierarchical modeling to determine whether procedure volume, the number of gastroenterologists per endoscopy suite, and the number of gastroenterologists per capita of the zip code of the practice were associated with adherence to recommendations. The team identified 92,580 patients who met their inclusion/exclusion criteria. Patient group was 67% female, averaging 53.5 years of age. The team received biopsy specimens from 669 gastroenterologists from 200 endoscopy suites, located in 191 zip codes, with a mean of 3.4 gastroenterologists per suite. Multivariate analysis showed that higher procedure volume was associated with decreased adherence to specimen recommendations [odds ratio (OR) for each additional 100 procedures, 0.92; 95% confidence interval (CI), 0.88–0.97; P=0.002]. Gastroenterologists employed in suites with higher numbers of gastroenterologists reported higher levels of adherence (OR for each additional gastroenterologist, 1.08; 95% CI, 1.04–1.13; P<0.001) However, that was not the case for a higher gastroenterologist density in the zip code of the practice (OR for each additional gastroenterologist per capita, 1.01; 95% CI, 0.99–1.03; P=0.21). This study suggests that high-volume physicians exhibit lower rates of adherence to biopsy guidelines, possibly because of the additional time required to submit the minimum of four specimens. In contrast, doctors working in endoscopy suites with high numbers of colleagues showed higher rates of adherence, possibly because of peer education. Basically, doctors who do large numbers of biopsies are more likely to submit too few samples for accurate analysis, whereas doctors working in close contact with large numbers of peers are more likely to follow current recommendations, and to produce better, more accurate results. Source: European Journal of Gastroenterology & Hepatology: November 2013 - Volume 25 - Issue 11 - p 1273-1278. doi: 10.1097/MEG.0b013e3283643542
  4. Celiac.com 06/15/2011 - A duodenal biopsy during endoscopy is the gold standard for diagnosing celiac disease. Because the histopathological features suggesting celiac disease , specifically villous atrophy, can vary in severity throughout the length of the small intestines, the American Gastroenterological Association Institute recommended in 2006 that at least 4 specimens be taken for examination. Yet the degree of adherence to this recommendation has not been assessed, and neither has its impact on diagnoses. A recent study by Benjamin Lebwohl at the Columbia University Celiac Disease Center concludes that most physicians are not following the guidelines, but they should be; doing so doubles the diagnosis of celiac disease. Dr. Lebwohl and colleagues collated the specimens sent to Caris Life Sciences, a specialized GI pathology laboratory that receives samples from endoscopy centers in forty-three states plus the District of Columbia and Puerto Rico. They looked at 132, 352 patients who had endoscopies for various indications between January 1, 2006 and December 31, 2009. From these endoscopies, only 35% followed the recommendation of submitting at least four specimens. There was a slight increase once the guidelines were proposed, in 2006; but by the end of 2009 adherence to the guidelines was still a low 37%. Interestingly, the number of specimens submitted could be directly correlated with the probability of a positive diagnosis of celiac disease. Adherence varied by indication, with the highest rates (43.9%) among patients undergoing endoscopies for diarrhea and the lowest rates (30.0%) among those having endoscopies because of heartburn. Among patients having endoscopies for malabsorption or suspected celiac disease adherence was only 38.5%. Adherence to the guidelines also decreased with the age of the patient. The researchers did not have access to socioeconomic or racial data regarding the patients, so could not determine if that factored into adhering to the guidelines. The proportion of patients diagnosed with celiac doubled when at least four biopsy specimens were submitted. This increase varied by indication; it was most apparent in those undergoing endoscopy because of malabsorption and suspected celiac disease, but was present for the other indications as well. This study validates those recommendations; hopefully the slight increase in adherence since they have been proposed will continue to grow. Source: Lebwohl B, Kapel RC, Neugut AI, Green PHR, and Genta RM. Adherence to biopsy guidelines increases celiac disease diagnosis. Gastrointest Endosc. 2011 May 19.
  5. Celiac.com 05/08/2013 - A team of researchers recently set out to test determine if an interactive online intervention might help to improve gluten free diet adherence in adults with celiac disease. The research team included Kirby Sainsbury BA/BEd, DCP (candidate), Barbara Mullan PhD and Louise Sharpe PhD. They are affiliated with the School of Psychology, and the Clinical Psychology Unit at the University of Sydney in Sydney, New South Wales, Australia For their controlled trial, the researchers recruited 189 adults with biopsy-confirmed celiac disease. They randomly assigned 101 adults to receive the intervention, and 88 adults to a wait-list control condition. They retrieved post-intervention data for 70 intervention subjects and 64 wait-list participants, along with three month follow-up data for 46 of 50 who completed the intervention period. The team first measured overall gluten-free diet adherence, then measured gluten-free diet knowledge, quality of life and psychological symptoms. The researchers based their results on intention-to-treat analysis, which bases their calculations on initial treatment assignment and not on the treatment eventually received. ITT analysis helps avoid various misleading factors that can color intervention research, such as non-random attrition of participants from the study or crossover. Overall, the intervention group showed strong improvement in gluten-free diet adherence, and gluten-free diet knowledge following the treatment period compared to the wait-list control group. However, changes in knowledge had no effect on adherence. These improvements continued through the 3-month’ follow-up period. The results show that the online intervention program helped improve adherence to a gluten-free diet for people with celiac disease. Such a program can be developed into a valuable resource for celiacs who are struggling with gluten-free diet adherence. Source: Am J Gastroenterol advance online publication 5 March 2013;
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