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Aim: To identify factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. Methods: Semi‐structured qualitative interviews based on the theoretical domains framework (TDF) were conducted with a convenience sample (n = 15) of shift workers (32–59 years) diagnosed with T2D who worked night shifts as part of a mixed shift schedule. The TDF was applied to analyse transcripts using a combined deductive framework and inductive thematic analysis approach. Identified influences were mapped to the behaviour change technique taxonomy to identify potential strategies to change dietary behaviour in this context. Results: Key barriers to healthy dietary behaviours were access and cost of food available during night work (TDF domain: Environment Context and Resources). Factors identified as both enablers and barriers included: availability of staff facilities and time to take a break, (Environment Context and Resources), the physical impact of night work (Beliefs About Consequences), eating in response to stress or tiredness (Emotion), advance planning of meals/food and taking own food to work (Behavioural Regulation). Potential techniques to address these influences and improve dietary behaviour in this context include: meal planning templates, self‐monitoring and biofeedback, and increasing accessibility and availability of healthier food choices during night shifts. Conclusions: The dietary behaviour of shift workers with T2D is influenced by interacting individual, socio‐cultural and environmental factors. Intervention should focus on environmental restructuring and strategies that enable monitoring and meal planning. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to understand the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. Methods: A cross‐sectional study was conducted using data collected from an anonymous online survey. Participant agreement was measured using five‐point Likert scale (strongly disagree to strongly agree) against 38 belief statements informed by the Theoretical Domains Framework (TDF) of behaviour change. Results: From the complete responses (n = 119), 65% worked shifts without nights, 27% worked mixed shift rota including nights and 8% worked only night shifts. The statements ranked with the highest agreements were in the TDF domains: Environment Context/Resources (ECR) – mainly identified as a barrier to healthy eating, Behaviour Regulation (BR) and intention (IN) – identified as enablers to healthy eating. For the belief statement 'the available options for purchasing food are too expensive' (ECR), 80% of night workers and 75% non‐night workers agreed/strongly agreed. Taking their own food to work to prevent making unhealthy food choices (BR) had agreement/strong agreement in 73% of non‐night and 70% night workers; 74% non‐night workers and 80% of night workers agreed/strongly agreed with the statement 'I would like to eat healthily at work' (IN). Mixed shift workers agreed that following dietary advice was easier when working a non‐night compared to a night shift (p = 0.002). Conclusions: Access and affordability of food were identified as important determinants of dietary behaviour during shifts. The findings support interventions targeting the food environment for shift workers with T2D. Key points: The present study investigated the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings.The findings support previous findings from semi‐structured interviews, with the main domain influencing dietary behaviours being Environmental Context and Resources (i.e., physical and economic availability of food during shifts). The findings support interventions targeting the food environment across shift workers living with T2D. [ABSTRACT FROM AUTHOR]

Background: Blood glucose is higher in people working night shifts compared to day workers. Changes to eating behaviour, activity and sleep patterns in addition to circadian disruption are likely to impact glucose management in night-shift workers with type 2 diabetes. Aim: To investigate current dietary intake and glucose variability during night work, including barriers and facilitators to dietary behaviour in this context. Methods: A mixed-methods case study will be conducted. Shift workers with type 2 diabetes working in a hospital setting will be recruited to this two-part study. Part 1: 70 participants will complete a 10-day observational study collecting data on continuous glucose, diet (self-report diary), sleep and physical activity during a period covering night work, rest days and non-night workdays. Mean glucose concentration and variability, and the mean healthy diet index score, will be compared between days of night work, non-night work and rest, after adjusting for other individual factors (sleep/physical activity/demographics). Part 2: A sample (n~13) will complete semi-structured interviews based on behavioural science frameworks to explore barriers/enablers to dietary behaviour when working night shifts. This will inform a quantitative survey to explore the generalisability of interview findings. Discussion: Findings from Part 1 and 2 will be triangulated to identify potential intervention strategies to address key barriers and enablers to healthier eating, and in turn improved glucose control, in shift workers with type 2 diabetes. This will be facilitated through stakeholder consultation and application of behavioural science frameworks. Shift-Diabetes study registration: ISRCTN11764942. [ABSTRACT FROM AUTHOR]

Increasing 24‐h demand for products, services and health care is resulting in a substantial portion of the workforce engaging in shift work. Observational studies suggest an association between shift work exposure and increased incidence of cardiometabolic disease. Shift workers report less healthy diets compared to day workers. As diet is a modifiable behaviour, it is important to understand how it might mediate the relationship between shift work and health. We reviewed online dietary advice for shift workers by searching for existing guidelines for shift workers published by websites of credible sources, for example institutions or government agencies. Based on the 26 guidelines retrieved, the most common categories of advice were eating patterns (n = 25), general healthy eating and/or specific food groups (n = 22), control of caffeine intake (n = 23) and maintaining hydration/fluid intake (n = 17). Although the majority of publicly available advice for shift workers follows general healthy eating guidelines, there are inconsistencies in the recommendations around the frequency of eating and snacking. Few studies have investigated modification of diet quality in shift workers. With the goal of adding to the evidence base, the Shift‐eat study is a feasibility trial designed to test whether dietary intakes in line with UK healthy eating recommendations during night work improve markers of health (interstitial glucose and heart rate variability) in free‐living shift‐working employees. Shift work is unavoidable and necessary for many industries. With an increasing section of the population employed in jobs requiring shift work, consistent dietary guidance based on evidence from shift‐working populations is urgently needed to support maintenance of health and wellbeing in employees working outside standard daytime hours. [ABSTRACT FROM AUTHOR]

Background There is convincing evidence that daily whole almond consumption lowers blood LDL cholesterol concentrations, but effects on other cardiometabolic risk factors such as endothelial function and liver fat are still to be determined. Objectives We aimed to investigate whether isoenergetic substitution of whole almonds for control snacks with the macronutrient profile of average snack intakes, had any impact on markers of cardiometabolic health in adults aged 30–70 y at above-average risk of cardiovascular disease (CVD). Methods The study was a 6-wk randomized controlled, parallel-arm trial. Following a 2-wk run-in period consuming control snacks (mini-muffins), participants consumed either whole roasted almonds (n  = 51) or control snacks (n  = 56), providing 20% of daily estimated energy requirements. Endothelial function (flow-mediated dilation), liver fat (MRI/magnetic resonance spectroscopy), and secondary outcomes as markers of cardiometabolic disease risk were assessed at baseline and end point. Results Almonds, compared with control, increased endothelium-dependent vasodilation (mean difference 4.1%-units of measurement; 95% CI: 2.2, 5.9), but there were no differences in liver fat between groups. Plasma LDL cholesterol concentrations decreased in the almond group relative to control (mean difference −0.25 mmol/L; 95% CI: −0.45, −0.04), but there were no group differences in triglycerides, HDL cholesterol, glucose, insulin, insulin resistance, leptin, adiponectin, resistin, liver function enzymes, fetuin-A, body composition, pancreatic fat, intramyocellular lipids, fecal SCFAs, blood pressure, or 24-h heart rate variability. However, the long-phase heart rate variability parameter, very-low-frequency power, was increased during nighttime following the almond treatment compared with control (mean difference 337 ms2; 95% CI: 12, 661), indicating greater parasympathetic regulation. Conclusions Whole almonds consumed as snacks markedly improve endothelial function, in addition to lowering LDL cholesterol, in adults with above-average risk of CVD. This trial was registered at clinicaltrials.gov as NCT02907684. [ABSTRACT FROM AUTHOR]

We present the case of an asymptomatic Loa loa disease in a 28-year-old Nigerian man living in Italy for 5 years. The man was admitted to our clinic for an occasional identification of hypereosinophilia (white blood cell count 5440/mmc, eosinophil 42%) and the presence of microfilaria at an hemoscopic evaluation. The diagnosis was made by testing the diurnal peripheral blood that showed a parasitaemia of 7000 microfilia/mL. The patient was treated with ivermectin 12 mg on the first day followed by albendazole 400 mg every 12 hours for 21 days with a reduction but no negativization of the parasitaemia and no collateral effect. Filariasis should be considered in all patients who come from or have stayed in endemic areas or who present alterations in the leukocyte formula, including hypereosinophilia, or some unexplainable allergic disorders. The lab diagnosis can be conducted through a hemoscopic test or directly with the identification of the adult worm, whereas the parasitaemia can be evaluated only through a hemoscopic test. The therapy can be non-conclusive or carried out with difficulty as finding diethylcarbamazine may be a hard task or potentially fatal anaphylactic reactions may occur.

The Authors underline the importance to always and correctly investigate also for Campylobacters and related organisms (Clo's) in faeces of humans with enteritis, because prevalent like Salmonella and for surveillance antibiotic resistances; in fact for campylobacteriosis specific therapy is often necessary. Between 2001 and 2005 248 strains of Campylobacter and Clo's were isolated: 225 were C. jejuni (90.7%) and 16 C. coli (6.5%). The recommended antibiotics to use for therapy, for preventing secondary effects too, are erythromycin, ciprofloxacin and tetracycline. Among C. jejuni, resistances towards erithromycine were 6.8% during 2001-02, 6.8% during 2003 and 4.8% during 2004-05; the resistances towards ciprofloxacin were 52.9% during 2001-02, 53.8% during 2003 and 42.9% during 2004-05; the resistances towards tetracycline were 39.2% during 2001-02, 46.2% during 2003 and 50.0% during 2004-05. The strains of C. coli showed less resistances, also in respect of previous our data too. No relevant differences were observed in antibacterial resistances among strains isolated from children and strains isolated from adults.

The Authors relate clinical-microbiological criteria for a rational diagnosis of acute and prolonged enteritis, distinguishing between home and imported diarrheas. During 2005, 381 subjects (192 children and 189 adults) with acute diarrhea and 110 subjects (16 children and 94 adults) with prolonged diarrhea were examined. In the first group Salmonella prevailed in 11.1% of cases (10.9% among children and 11.1% among adults); Campylobacter in 9.2% (respectively 8.9% and 9.5%); other bacteria were identified in 3.2% of cases (1.0% and 3.8% respectively). Rotavirus were observed in 29.5% of children and Adenovirus in 6.2% of pediatric population. Pathogenic protozoa were observed in 1.6% of people (0.5% in children and 2.7% in adults). Among second group pathogenic protozoa prevailed in 6.4% (6.3% in children and 6.4% in adults); toxin A of C. difficile were detected in 8.5% of total cases. The Authors emphasize the importance to investigate always for Salmonella, Shigella and Campylobacter; in children with vomiting (with acute non invasive enteritis) is necessary to investigate for Rotavirus too; if the diarrhea is prolonged could be important investigate for toxin A/B of C. difficile and for protozoa with specific stains. Based on clinical and epidemiological findings other pathogens could be researched, if possible for own resources.

We studied 91 faecal specimens of 38 children and 53 adults in a five-day epidemiological survey between the end of February and the beginning of March, 2006. The subjects were in- or out-patients of Chacas Hospital, Ancash. The O&P were performed with macroscopic evaluation, microscopic (direct and after formalin-ether concentration, FEA) observations and Giemsa permanent stain of all faecal samples. 61 subjects (67.0%) were infected with parasites (25 children, 65.5%, and 36 adults, 67.9%). D. fragilis was prevalent in 30.8% of subjects (28.9% of children, 32.1% of adults); G. duodenalis was observed in 12.1% of cases (21.1% of children and 5.7% of adults); A. lumbricoides was observed in 15.4% of cases (18.4% and 19.9% respectively); other helminths were identified in 7.7% of cases (10.1% and 5.7% respectively); non-pathogenic protozoa alone were observed in 23.1% of cases (28.9% among children and 19.9% among adults). D. fragilis was more frequent among females (44.7% vs. 20.8%), while G. duodenalis and A. lumbricoides among males (13.2% vs. 10.5% and 17.0% vs. 13.2% respectively). We emphasize the usefulness of both FEA and Giemsa permanent stain for a good O&P.

Between 2002 and 2003 the Authors analyzed stool specimens of 1,989 subjects, 966 children (1-14 years old) and 1,023 adults, to investigate for intestinal protozoa too: 380 children and 656 adults with intestinal aspecific troubles, 546 children and 291 adults with acute diarrhoea, 40 children and 76 adults with prolonged diarrhoea. G. duodenalis prevailed in 1.8% of all cases (0.2% among children and 3.2% among adults), D. fragilis in 4.1% (0.6% and 7.3% respectively). Other pathogenic parasites were very rare. Only B. hominis (opportunistic/saprophytic protozoon) or other commensal protozoa were observed, also associated with D. fragilis and/or G. duodenalis. Among subjects suffering from intestinal aspecific troubles, G. duodenalis prevailed in 3.7% and D. fragilis in 8.7% of adults; both protozoa were observed in 0.5% of children each one. Among acute diarrhoeas G. duodenalis was observed in 1.7% of adults and never in children, D. fragilis in 4.5% and 0.4% respectively. Among prolonged diarrhoeas, G. duodenalis was observed in 5.3% of adults and never in children, D. fragilis in 6.6% of adults an in 5.0% of children. The Authors emphatyze the clinical importance of D. fragilis and the diagnostical importance of a permanent stain, like Giemsa, for a good and sure diagnosis.

During 2004, we identified 39 intestinal infections caused by Dientamoeba fragilis and 23 caused by Giardia duodenalis, on 1141 home subjects (3.4% and 2.0% respectively): D. fragilis was observed in 4.5% of O and P (29/644 subjects suffering from aspecific bowel disorders) and in 2.0% of diarrhoeas (10/497); G. duodenalis was observed in 3.1% (20/644) and in 0.6% (3/497) of cases respectively. No other pathogenic parasites were identified (only 1 case of enterobiasis in an asymptomatic child). Commensal protozoa were observed, among O and P, in 4.3% of cases (28/644). The non-pathogenic B. hominis, often associated with other protozoa, was observed in 4.1% of all 1141 cases. D. fragilis is undoubtedly more frequent in adults (36/39 cases, 92.3%) than in children (3/39, 7.7%), and is prevalent among females (24/39, 61.5%) in respect of males (15/39, 38.5%). G. duodenalis is more prevalent among adults (16/23, 69.5%) than children (7/23, 30.5%), but is more frequent among males (13/23, 56.5%) than females (10/23, 43.5%). Clinical correlations of dientamoebiasis and giardiasis are reported, seasonal and epidemiological features of these protozooses are outlined, and the authors emphasize the importance and need of Giemsa stain, among O and P and acute or prolonged diarrhoeas, on the basis of previous good direct microscopic observations of faecal specimens, for correct and complete diagnosis of intestinal infections.

The authors describe a human case of ophthalmomyiasis caused by the "sheep fly" Oestrus ovis larva. They emphasize the importance of collaboration between practitioner or specialist and parasitologist for a sound, definitive aetiological diagnosis of such uncommon pathologies.

We report data concerning our experience during three years (1998-2001) about isolation, identification and susceptibility towards antimicrobial agents of coryneform bacteria in infections of hospitalized/at risk patients. We isolated 54 Corynebacterium spp., with prevalence of C. striatum (8 strains) and C. amycolatum (7 strains), and 1 strain of Oerskovia spp. and 1 strain of Actinomyces neuii. 31 strains were isolated from the "exit-site" and 6 from peritoneal fluid of CAPD patients. Vancomycin and teicoplanin were always "in vitro" efficacious. Resistance rates towards other antibiotics were the following: 11% for minocycline, 12.5% for tetracycline, 20% for gentamicin and netilmicin, 61% for erythromycin and chloramphenicol, 66% for penicillin.

During 2001 we analyzed 1730 pharyngeal swabs for S. pyogenes (SGA): 1142 children (0-10 years old), 132 adolescent subjects (11-17 years old), and 456 adults (18 or more years old). 994 subjects (664 children, 85 adolescent ones, 245 adults) had acute pharyngotonsillitis. In this last group we observed 321 positivities (32.3 %) for SGA: 40.4 % among children, 24.7 % among adolescent people, 13.1 % among adults. The pharyngotonsillitis prevailed during winter and spring. The resistances (R) towards erythromycin were 27.7 % (89 cases), and among children 30.6 % (82 cases), towards clyndamicin 15.3 % (49 cases, and 17.2 %, 46 cases, among children), towards rokytamicin 11.8 % (38 cases, and 13.1 %, 35 cases, among children). These were the phenotypes of R to erythromycin: 25.8 % M-phenotype, 19.1 % inducible (iMLS), 55.1 % constitutive (cMLS); among children respectively 25.6 %, 18.3 % and 53.7 %. Increased resistances towards 16-C macrolides, increased resistances of cMLS to erythromycin, and the persistence of R to 14-C macrolides around 30 % are discussed.

During 2001 we analyzed 523 stool specimens (330 children, 193 adults) of patients with recent diarrhoea. We processed all specimens for protozoa, rotavirus, adenovirus, toxin A of C. difficile, and usual enteropathogen bacteria. Salmonella prevailed in 12.8% of cases (16.4% among children, 6.7% among adults), Campylobacter in 9.9% (11.5% and 7.3%), C. difficile toxin A producer in 11.3% (13.7% and 8.1%); other bacteria generally prevailed in 2.4%, protozoa in 2.7%. Among children rotavirus prevailed in 41.4%, adenovirus in 3.6%. Enteritis prevailed in children between 1 and 6 years of age. All pathogens were reported during all the seasons, but salmonellosis and campylobacteriosis were more frequent during spring and summer, rotavirus infections during the winter. Non particular and/or specific correlations could be observed between clinical manifestations and pathogen agents; anyway only bacteria were identified among invasive enterites. Vomitus was more frequent in rotavirus infections. Finally the Authors suggest a rational and efficacious methodology for diagnosis of presumptive infectious diarrhoeas.