Objective: To examine how physically active Danish old medical patients are during hospitalization and to achieve knowledge of motivation and barriers to physical activity. Background: Functional decline in frail old patients during hospitalization is an important clinical problem with potential long-lasting undesirable outcomes and complications. Design: A mixed methods study including qualitative and quantitative methods. Methods: Patients >60 years of age were recruited at two medical departments during one week. Three SenseWear armband monitors were used for quantitative monitoring of physical activity. Semi Structured interviews were used for qualitative data. Results: The study comprised 13 patients, five female and eight male, mean age 73 (SD 9); BMI 19.4-32.1, mean 25.2 (SD 3.7). Only 11 patients completed 24-hours of SenseWear armband monitoring. Half of the participants walked less than 50 steps a day. The majority were bedridden 9 to 15 hours a day. Five of 11 patients had very low activity score. Four patients were moderately active for 19-38 minutes. Five patients sleep less than 6,3 hours, mean 9 (SD 3.3). Lying down was recorded for a mean of 11 hours (SD 4). Factors motivating to physical activity were: Praise and recognition from the staff, experienced boredom, continued ability to perform Activities of Daily Living. Barriers: Symptoms of illness, fear of falling, lack of meaningful activities, inadequate facilities and staff’s lack of focus. Organisational routines such as waiting for physical examinations and rounds, were barriers for patients to get out of bed. Conclusion: Old medical patients were very inactive during hospitalization. Motivation for physical activity was continued ADL abilities, boredom and staff interest, however often hindered by organizational barriers, lack of meaningful activities and focus from staff.

Expert consensus papers recommend differentiating enuresis using questionnaires and voiding diaries into non- (NMNE) and monosymptomatic enuresis (MNE) is crucial at intake to decide the most appropriate workout and treatment. This national, Belgian, prospective study investigates the correlation, consistency, and added value of the two methods, the new against the old International Children’s Continence Society (ICCS) definitions, and documents the prevalence of the two enuresis subtypes in our population. Ninety treatment-naïve enuretic children were evaluated with the questionnaire, and the voiding diary and the two clinical management tools were compared. Almost 30% of the children had a different diagnosis with each method, and we observed inconsistencies between them in registering Lower Tract Symptoms (κ = –0.057–0.432 depending on the symptom). Both methods had a high correlation in identifying MNE (rs = 0.612, p = 0.001) but not for NMNE (rs = 0.127, p = 0.248). According to the latest ICCS definitions, the incidence of MNE was significantly lower (7 vs. 48%) with the old standardization.ConclusionThe voiding diary and the questionnaire, as recommended by the ICCS at the screening of treatment-naïve enuretic patients, are considerably inconsistent and have significantly different sensitivities in identifying LUTS and thus differentiating MNE from NMNE. However, the high incidence of LUTS and very low prevalence of MNE suggest that differentiating MNE from NMNE to the maximum might not always correlate with different therapy responses.

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