Premedication with N-acetylcysteine and simethicone markedly improves mucosal visibility during gastroscopy. It also reduces the time taken for the procedure. This low-cost and well-tolerated intervention may improve detection of early neoplasia.

The follow-up of infl ammatory bowel disease (IBD) patients is challenging due to the relapsing remitting nature of the diseases, the wide spectrum of severity and complexity as well as the need for monitoring of longterm complications and drug treatments. Conventional outpatient follow-up lacks fl exibility for patients and there are competing pressures for clinic time. Alternative followup pathways include telephone clinics, selfmanagement programmes or discharging patients. The IBD virtual clinic (VC) is a further option. Patients with an established diagnosis for >2 years, who have been stable for >1 year, do not have primary sclerosing cholangitis and who give their consent, are entered into the VC system. Two months before their annual followup is due patients are sent blood test forms and a simple questionnaire with an information sheet. If they meet any of the criteria on the questionnaire, they are asked to contact the IBD specialist nursing team to discuss their situation. The blood test results and the patient's database entry are reviewed to ensure that they are not due surveillance investigations. The patients and their GPs then receive a letter informing them of their management plan. We currently follow-up 20% of the Southampton IBD cohort using the VC. The VC system is an innovative, effi cient and patient-responsive method for following up mild to moderate IBD. It is well liked by patients but is dependent on a well-maintained database with good integration of IT systems and requires both clerical and IBD nurse specialist support.

Introduction: Consumption of sugar sweetened beverages (SSB)s has been linked with adult and childhood obesity, an increasing health burden in the United States. The aim of this study was to examine factors associated with the consumption of SSBs among Oklahoma adults with children in the home.Methods: A random sample of 1,118 Oklahoma adults with children in the home participated in a survey about their SSB consumption between August and October, 2015. We calculated weighted prevalence estimates and examined the relationship between types of SSBs consumed and covariates of interest using logistic regression techniques appropriate for survey data. Outcome variables included three categories of SSB consumption: consuming ≥1 sugar-sweetened sodas daily, consuming ≥1 other SSBs daily, and total daily SSB consumption, defined as ≥1 SSB of any kind. Heavy consumers were those who drank ≥3 SSBs per day.Results: Almost half (44%) of adults with children in the home consumed ≥1 total SSBs daily; 29% consumed ≥1 sugar-sweetened sodas and 28% consumed ≥1 other SSBs not including soda daily. The odds of consuming ≥1 SSBs daily was four times higher among those with a high school education or less (AOR = 4.06, 95% CI = 2.34, 7.04); almost three times higher for those who perceived their diet as somewhat healthy, or not very healthy (AOR = 2.72, 95% CI = 1.27, 5.82), more than double among those aged 18–34 years (AOR = 2.41, 95% CI = 1.08, 5.40), and almost double among those who consume <8 cups of water daily (AOR = 1.78, 95% CI = 1.06, 2.99).Conclusion: Because SSBs have been linked with obesity, understanding factors associated with consumption is important, especially among parents and caregivers of children. These findings have implications for developing and targeting messages to prevent SSB consumption among those most at risk.

Background: In 2016, Oklahoma launched "Shape Your Future-Rethink Your Drink" (SYF/RYD), an obesity prevention health communication program targeting parents and caregivers of children. The aims of this study are to compare sugar-sweetened beverage (SSB) consumption before and after the program and to report factors associated with SSB consumption, knowledge, and attitudes. Methods: This repeated cross-sectional study involved 2656 Oklahoma adults with ≥ one child under 18 years in the home. Weighted prevalence estimates were calculated and the relationship between SSB consumption and covariates of interest were examined using logistic regression techniques appropriate for survey data. Results: Following the SYF/RYD program, SSB consumption decreased 18.6% (p = 0.0232) and heavy SSB consumption, ≥ three SSB per day, decreased 42.9% (p = 0.0083). Factors associated with SSB consumption, 1 year after the launch of SYF/RYD included high school education or less (AOR = 1.33 with 95% CI = 1.02, 1.73), fair or poor health status (AOR = 2.02 with 95% CI = 1.47, 2.78), drinking less than eight cups of water daily (AOR = 1.77 with 95% CI = 1.39, 2.25), inability to afford healthy foods (AOR = 1.33 with 95% CI = 1.06, 1.67), and self-identifying as American Indian/Alaska Native (AOR = 1.59 with 95% CI = 1.10, 2.29). Conclusions: Health communication campaigns, such as SYF/RYD, are an evidence-based strategy for health behavior change and likely contributed to the declines observed in SSB consumption. Important differences in SSB consumption by population subgroups persist and have implications for future message development.

People with diabetic peripheral neuropathy (DPN) experience lower quality of life caused by associated balance, posture, and gait impairments. While focal muscle vibration (FMV) has been associated with improvements in gait performance in individuals with neurological disorders, little is known about its effectiveness in patients with DPN. The purpose of this study was to investigate the effect of FMV on gait outcomes in patients with DPN. The authors randomized 23 participants into three FMV intervention groups depending upon the delivery of vibration. Participants applied wearable FMV to the bilateral quadriceps, gastrocnemius, and tibialis anterior, 10 min per muscle, three times per week over a four-week period. Spatiotemporal, kinematic, and kinetic gait parameters at baseline and post-intervention were calculated and analyzed. Gait speed, cadence, stride time, left and right stance time, duration of double limb support, and left and right knee flexor moments significantly improved after four weeks of FMV. Trends toward significant improvements were noted in maximum left and right knee flexion. Results indicate that FMV therapy was associated with improvements in gait parameters in individuals with DPN, warranting expanded study of FMV therapy for long-term gait performance improvement in these individuals.