Beliefs and practices of healthcare providers regarding obesity: a systematic review

Despite the implementation of various intervention measures, the number of obese individuals remain high; thus, it is important to consider what is contributing to this scenario. Authors have been striving to understand the role healthcare providers, especially in primary healthcare, seem to play in this context. The present review aims to synthesize the main investigation results regarding beliefs, attitudes, and practices of healthcare providers, as they seem to negatively influence the practitioner’s actions. The words “obesity”, “beliefs”, “healthcare professionals”, “general practitioners”, “attitudes”, “practices”, “health physicians”, and “family practitioners” were entered into databases, such as EBSCOHost, ScienceDirect, PsychInfo, PubMed, and SciELO. Thirteen studies from 1991 to 2011 were reviewed. The data indicate a lack of appropriate understanding and adequate competence regarding obesity, which likely contributes to ambivalent belief development and negative attitudes toward obese individuals, who are described as unmotivated, lazy, and lacking self-control. These professionals consider it hard to deal with obesity, manifesting low expectations of success regarding weight loss, thus considering themselves unsuccessful. Their practices are inconsistent, mirroring a certain skepticism towards the efficacy of available interventions. Either during graduation or as active practitioners, it is imperative to make healthcare providers aware of the impact their beliefs regarding obesity can exert on their practices, as these may impair appropriate and effective treatment delivery to obese individuals

Weighing In: The Public Problem of Obesity

The definition, significance and consequence of the disease of obesity have changed dramatically in the last few decades. Formerly regarded as a common comorbidity of other chronic diseases, obesity has become a discrete medical condition deserving public attention and resources. This dissertation studies the organizational and cultural process by which obesity came to recognized as a public problem through three interrelated papers critiquing claimsmaking via expert authority, the news media apparatus, and populist television. Chapter 1 analyzes the medical literature on obesity published between 1980-2000 in order to trace the social trajectory of obesity as a contemporary public problem through interrelated three stages of medical moral entrepreneurship: claimsmaking, consolidation, and institutionalization. It argues that the efforts of medical moral entrepreneurs moderated public scrutiny of individual health behavior but expanded the jurisdiction of biomedicine. Chapter 2 examines how the print news media reports on obesity as a predominantly biomedical and behavioral problem, specifically parsing who gets to say what about obesity. Based on a sample (n = 256) of news stories published in the New York Times and USA Today between 1995-2004, this paper analyzes how expert and lay statements are used to package obesity as a medicalized human interest story. Findings indicate media support of individualized blame during this period, which promoted clinical treatment to reform obese people and problematic health behavior. Chapter 3 considers how celebrity entrepreneurs leverage the makeover television genre as a popular media platform for demonstrating lifestyle and behavior interventions. Whenever celebrity entrepreneurs adopt new moral causes, their influence with audiences must be evaluated against personal brand promotion and misrepresentation of the original mission. In sum, this study shows how moral entrepreneurs are very much invested in promoting the obesity problem while also making claims to its imminent solvability. The obesity epidemic remains a serious health threat because expert authorities, methods, and stakeholders construct it as such

“But you still have the same insecurities”—Navigating Personal Trainer and Client Body Image through Emotional and Aesthetic Labor

While research on personal trainers’ emotional (controlling the portrayal of own emotions to produce an emotional response in another person) and aesthetic ( looking the part ) labor has been conducted, no research currently exists on personal trainer body image. Research demonstrates that body image concerns of athletes and exercising populations may differ from that of the general population. This is an important area to examine due to the personal trainer’s “quasi-professional” role as “cultural intermediaries” between healthcare and exercise science professionals and the average consumer and their provision of “expert service work” to clients, combining emotional labor through service work and provision of expert information. This position and rapport that personal trainers develop with clients creates the potential to be a major influencer on client body image. This project examines personal trainer body image in terms of the effects of emotional and aesthetic labor on perceived job performance and aspects of job satisfaction through individual interviews. Interviews were conducted in the summer and fall of 2017. Personal trainers were recruited through announcements by the primary researcher at personal trainer staff meetings from one upscale health club in Central Virginia. Interviews lasted between 45 and 100 minutes. A total of three male and three female personal trainers were interviewed. Interviews were transcribed and coded by the primary researcher using a Grounded Theory framework. Results suggest that personal trainers’ body image was shaped by previous experiences with their own behavior change process, particularly through their ability to identify distorted or disordered views or behaviors. Further, these experiences have influenced how personal trainers perceive and perform emotional and aesthetic labor in their jobs and how these factors have also shaped their client training philosophies, including a focus on health and body function as opposed to weight. Philosophies and training style were also influenced by unique factors of the personal trainers’ personality and qualities of their work environment. Personal trainers also shared experiences of job satisfaction although it does not appear from this research that there is a relational connection between personal trainer body image and job satisfaction. The results of this study reflect the narrative of six personal trainers from one upscale health club located in Central Virginia, so caution should be considered when generalizing results

Patients\u27 Perception of the Use of Motivational Interviewing for Childhood Obesity Treatment: A Qualitative Study

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and families, no study to date had looked at MI from the perspective of the child. Thorne’s (2008) framework for interpretive descriptive research was used for this study. Individual interviews with children ages 7 through 13 were conducted in an outpatient weight management clinic that utilizes MI as the primary communication style for facilitating behavior change. Qualitative data analysis was conducted utilizing Thorne’s recommendations for interpretive descriptive research. Five themes emerged from the data: 1) Empowerment, 2) Freedom to be Me, 3) Educating without “Educating”, 4) Unconditional Support, and 5) Blossoming. A conceptual model was developed from the research findings to help clinicians working with children in similar contexts glean a deeper understanding of the use of MI with children. Future research endeavors should focus on the implementation of this model in clinical practice to strengthen the conceptual links and determine applicability to practice

Dynamic Risk Models for Characterising Chronic Diseases' Behaviour Using Process Mining Techniques

[ES] Los modelos de riesgo en el ámbito de la salud son métodos estadísticos que brindan advertencias tempranas sobre el riesgo de una persona de sufrir un episodio adverso en el futuro. Por lo general, utilizan la información almacenada de forma rutinaria en los sistemas de información hospitalaria para ofrecer una probabilidad individual de desarrollar un resultado negativo futuro en un período determinado. Concretamente, en el campo de las enfermedades crónicas que comparten factores de riesgo comunes, los modelos de riesgo se basan en el análisis de esos factores de riesgo -tensión arterial elevada, glucemia elevada, lípidos sanguíneos anormales, sobrepeso y obesidad- y sus medidas biométricas asociadas. Estas medidas se recopilan durante la práctica clínica de manera periódica y, se incorporan a los modelos de riesgo para apoyar a los médicos en la toma de decisiones. Para crear modelos de riesgo que incluyan la variable temporal, se podrían utilizar técnicas basadas en datos (Data-Driven), de forma que se tuviera en cuenta el historial de los pacientes almacenado en los registros médicos electrónicos, extrayendo conocimiento de los datos en bruto. Sin embargo, en el ámbito de la salud, los resultados de la minería de datos suelen ser percibidos por los expertos en salud como cajas negras y, en consecuencia, no confían en sus decisiones. El paradigma Interactivo permite a los expertos comprender los resultados, para que los profesionales puedan corregir esos modelos de acuerdo con su conocimiento y experiencia, proporcionando modelos perceptivos y cognitivos. En este contexto, la minería de procesos es una técnica de minería de datos que permite la implementación del paradigma Interactivo, ofreciendo una comprensión clara del proceso de atención y proporcionando modelos comprensibles para el ser humano. Las condiciones crónicas generalmente se describen mediante imágenes estáticas de variables, como factores genéticos, fisiológicos, ambientales y de comportamiento. Sin embargo, la perspectiva dinámica, temporal y de comportamiento no se consideran comúnmente en los modelos de riesgo. Eso significa que el último estado de riesgo se convierte en el estado real del paciente. No obstante, la condición de los pacientes podría verse influenciada por sus condiciones dinámicas pasadas. El objetivo de esta tesis es proporcionar una visión novedosa del riesgo asociado a un paciente, basada en tecnologías Data-Driven que ofrezcan una visión dinámica de su evolución con respecto a su condición crónica. Técnicamente, supone abordar los modelos de riesgo incorporando la perspectiva dinámica y comportamental de los pacientes gracias a la información incluida en la Historia Clínica Electrónica. Los resultados obtenidos a lo largo de esta tesis muestran cómo las tecnologías de minería de procesos pueden aportar una visión dinámica e interactiva de los modelos de riesgo de enfermedades crónicas. Estos resultados pueden ayudar a los profesionales de la salud en la práctica diaria para una mejor comprensión del estado de salud de los pacientes y una mejor clasificación de su estado de riesgo.[CA] Els models de risc en l'àmbit de la salut són mètodes estadístics que brinden advertències primerenques sobre el risc d'una persona de patir un episodi advers en el futur. Generalment, utilitzen la informació emmagatzemada de forma rutinària en els sistemes d'informació hospitalària per a oferir una probabilitat individual de desenrotllar un resultat negatiu futur en un període determinat. Concretament, en el camp de les malalties cròniques que compartixen factors de risc comú, els models de risc es basen en l'anàlisi d'eixos factors de risc -tensió arterial elevada, glucèmia elevada, lípids sanguinis anormals, sobrecàrrega i obesitat- i les seues mesures biomètriques associades. Estes mesures es recopilen durant la pràctica clínica ben sovint de manera periòdica i, en conseqüència, s'incorporen als models de risc i recolzen la presa de decisions dels metges. Per a crear estos models de risc que incloguen la variable temporal es podrien utilitzar tècniques basades en dades (Data-Driven) , de manera que es tinguera en compte l'historial dels pacients disponible en els registres mèdics electrònics, extraient coneixement de les dades en brut. No obstant això, en l'àmbit de la salut, els resultats de la mineria de dades solen ser percebuts pels experts en salut com a caixes negres i, en conseqüència, no confien en les decisions dels algoritmes. El paradigma Interactiu permet als experts comprendre els resultats, perquè els professionals puguen corregir eixos models d'acord amb el seu coneixement i experiència, proporcionant models perceptius i cognitius. En este context, la mineria de processos és una tècnica de mineria de dades que permet la implementació del paradigma Interactiu, oferint una comprensió clara del procés d'atenció i proporcionant models comprensibles per al ser humà. Les condicions cròniques generalment es descriuen per mitjà d'imatges estàtiques de variables, com a factors genètics, fisiològics, ambientals i de comportament. No obstant això, la perspectiva dinàmica, temporal i de comportament no es consideren comunament en els models de risc. Això significa que l'últim estat de risc es convertix en l'estat real del pacient. No obstant això, la condició dels pacients podria veure's influenciada per les seues condicions dinàmiques passades. L'objectiu d'esta tesi és proporcionar una visió nova del risc, associat a un pacient, basada en tecnologies Data-Driven que oferisquen una visió dinàmica de l'evo\-lució dels pacients respecte a la seua condició crònica. Tècnicament, suposa abordar els models de risc incorporant la perspectiva dinàmica i el comportament dels pacients als models de risc gràcies a la informació inclosa en la Història Clínica Electrònica. Els resultats obtinguts al llarg d'esta tesi mostren com les tecnologies de mineria de processos poden aportar una visió dinàmica i interactiva dels models de risc de malalties cròniques. Estos resultats poden ajudar els professionals de la salut en la pràctica diària per a una millor comprensió de l'estat de salut dels pacients i una millor classificació del seu estat de risc.[EN] Risk models in the healthcare domain are statistical methods that provide early warnings about a person's risk for an adverse episode in the future. They usually use the information routinely stored in Hospital Information Systems to offer an individual probability for developing a future negative outcome in a given period. Concretely, in the field of chronic diseases that share common risk factors, risk models are based on the analysis of those risk factors -raised blood pressure, raised glucose levels, abnormal blood lipids, and overweight and obesity- and their associated biometric measures. These measures are collected during clinical practice frequently in a periodic manner, and accordingly, they are incorporated into the risk models to support clinicians' decision-making. Data-Driven techniques could be used to create these temporal-aware risk models, considering the patients' history included in Electronic Health Records, and extracting knowledge from raw data. However, in the healthcare domain, Data Mining results are usually perceived by the health experts as black-boxes, and in consequence, they do not trust in the algorithms' decisions. The Interactive paradigm allows experts to understand the results, in that sense, professionals can correct those models according to their knowledge and experience, providing perceptual and cognitive models. In this context, Process Mining is a Data Mining technique that enables the implementation of the Interactive paradigm, offering a clear care process understanding and providing human-understandable models. Chronic conditions are usually described by static pictures of variables, such as genetic, physiological, environmental, and behavioural factors. Nevertheless, the dynamic, temporal, and behavioural perspectives are not commonly considered in the risk models. That means the last status of the risk becomes the actual status of the patient. However, the patients' condition could be influenced by their past dynamic circumstances. The objective of this thesis is to provide a novel risk vision based on Data-Driven technologies offering a dynamic view of the patients' evolution regarding their chro\-nic condition. Technically, it supposes to approach risk models incorporating the dynamic and behavioural perspective of patients to the risk models thanks to the information included in the Electronic Health Records. The results obtained throughout this thesis show how Process Mining technologies can bring a dynamic and interactive view of chronic disease risk models. These results can support health professionals in daily practice for a better understanding of the patients' health condition and a better classification of their risk status.Valero Ramón, Z. (2022). Dynamic Risk Models for Characterising Chronic Diseases' Behaviour Using Process Mining Techniques [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/181652TESI

The Role of a Community-Driven, Structured Exercise Program on Children\u27s and Adolescent\u27s Quality of Life

Childhood obesity is a long-standing epidemic in the United States as of 2020, and the problem is continuing to worsen. Childhood obesity has been shown to have many unhealthy effects, such as increasing prevalence of cardiovascular disease, depression, and social anxiety, which all can contribute to a worsened quality of life. Research suggests that summer is the most critical time period to combat childhood obesity is because children’s lives are less structured over the summer, which can lead to increased unhealthy behaviors, obesity, and a decrease in quality of life. The current study, the Skybrook Swim Team Study, aimed to combat obesity, as well as increase quality of life for children and adolescents. In order to achieve this, swimmers from a nine-week community-centered, structured exercise program based on competitive swimming were surveyed at the beginning and end of the season. Differences between the survey scores were examined to gain insight into swimmers’ perceived changes associated with Physical Fitness, Sense of Community, Self-Confidence, Health, and Happiness. Children and adolescents were allocated to one of six groups (9-10 Males), (11-12 Males), (13-18 Males), (9-10 Females), (11-12 Females), and (13-18 Females) in order to gain knowledge on how age and gender affect the perceived benefits obtained by participating in a community-based, structured exercise program. All six groups significantly increased their overall quality of life score. Females tended to have a larger increase in the measure of Happiness, while males showed a larger increase in the measures of Physical Fitness and Health. On average, the 9-10-year olds obtained the most benefit from the program in terms of improved quality of life, while the 13-18-year-old males showed the least improvement. In conclusion, the results of this study suggest that children and adolescents can improve their quality of life through a community-oriented, structured exercise program; however, a child’s age and sex may predispose them to obtaining different perceived benefits within the various dimensions of quality of life

Scale-up and scale-out of a gender-sensitized weight management and healthy living program delivered to overweight men via professional sports clubs: the wider implementation of Football Fans in Training (FFIT)

Increasing prevalence of obesity poses challenges for public health. Men have been under-served by weight management programs, highlighting a need for gender-sensitized programs which can be embedded into routine practice or adapted for new settings/populations, to accelerate the process of implementing programs which are successful and cost-effective under research conditions. To address gaps in examples of how to bridge the research to practice gap, we describe the scale-up and scale-out of Football Fans in Training (FFIT), a weight management and healthy living program in relation to two implementation frameworks. The paper presents the development, evaluation and scale-up of FFIT, mapped onto the PRACTIS guide; outcomes in scale-up deliveries and the scale-out of FFIT through programs delivered in other contexts (other countries, professional sports, target groups, public health focus). FFIT has been scaled-up through a single-license franchise model in over 40 UK professional football clubs to 2019 (and 30 more from 2020) and scaled-out into football and other sporting contexts in Australia, Canada, New Zealand, England and other European countries. The successful scale-up and scale-out of FFIT demonstrates that, with attention to cultural constructions of masculinity, public health interventions can appeal to men and support them in sustainable lifestyle change

Recent Research Trends in Medical and Health Sciences

The present volume is based on the contributions made by various authors on different important topic of “Recent Research Trends in Medical and Health Sciences” and introduces the subject along the following topics: Methods in Improving Short Term Memory: A Brief Review; Are Children Falling into the Trench of Fast Food?; Biomedical Research Ethics: Past, Present and Future; Early (Short-Term) Side-Effects of Chemotherapy in Pediatric Solid Tumors; Health and Pollution in Banbishnupur village, Haldia, West Bengal; A Study to Evaluate the Morphometric measures of Gonial angle and Bi-gonial width for Healthy Individuals in Garden City university dental camp; Prevalence of Overweight and Obesity (overnutrition) among the Bengali Adolescent Girls: A Cross-Sectional Study from Darjeeling District, West Bengal (India). We must place on record our sincere gratitude to the authors not only for their effort in preparing the papers for the present volume, but also their patience in waiting to see their work in print