Quality of Life Following Massive Weight Loss and Body Contouring Surgery: an Exploratory Study.

Reconstructive surgery is a major growth intervention for body improvement, enhancing appearance and psychological well-being following massive weight loss. The psychosocial benefits include greater capacity for social networking, lower scores of body uneasiness, body image satisfaction, improved mental well-being and physical function. However little collective evidence exists regarding the impact of body contouring on patients Quality of Life (QoL) and there is a lack of systematic review and randomised controlled trials (RCTs) with a scarcity of high level evidence. The purpose of this exploratory study was to explore the QoL perceptions, experiences and outcomes of patients who have undergone body contouring following significant weight loss and to explore the relevance and potential utility of the Obesity Psychosocial State Questionnaire (OPSQ) as a valuable QoL outcomes measuring tool for use in clinical research. Data were collected in a community setting in the south of England via digitally recorded semi-structured interviews with twenty participants (18 women and 2 men), who also self-completed the Obesity Psychosocial State Questionnaire (OBSQ). Medical notes were reviewed retrospectively to gather data about body mass index (BMI), co-morbidities, eating profiles/lifestyle, uptake of bariatric surgery and type/number of body contouring procedures undergone. A thematic approach was adopted to analyse the interviews and medical record data, supported by Nvivo7 qualitative software, and a statistical approach to analyse the questionnaire data, supported by Statistical Analysis Software. The results provide unique glimpses of the body contouring interventions for empowering and facilitating a ‘transformation’, a ‘new identity’, a ‘new start’ in life, improved physical function, greater body image satisfaction, a stronger sense of well-being and an improved quality of life. A few of the participants who reported that their weight gain was powered by childhood traumas (abuse, neglect, abandonment) continued to struggle for ‘normality’, with fragile eating control and addictive traits. Eating disordered trauma survivors mentioned post traumatic flashbacks and underlying conflicts that triggered powerlessness and emotional eating. The emotional flooding with psychological and body related memories did not appear to be fully processed or released, despite counselling and binge eating programmes. The participants also confirmed the value of the OBSQ, whilst highlighting its limited set of three questions on feelings of self-efficacy towards eating habits. The study findings show that body contouring optimises quality of life with significant improvement in physical function, body image, mental health and psychosocial function. Further research is warranted to extent the scope of the findings within a sample drawn from multiple treatment centres. This would valuably: • Explore gender, ethnic and cultural variables, important to optimising quality of life. • Clarify distinguishing features between short and long-term QoL outcomes. • Lead to the development of national policy and guidelines on reconstructive ‘body contouring’ surgery following massive weight loss, in line with the call from the British Association for Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) A future multi-centre collaborative study could employ the OBSQ, supplemented by an additional tool to explore factors that influence eating habits such as the three factor eating questionnaire (such as the TFEQ-R1 21 Scale). Such research could enhance understanding of quality of life and long-term weight management

An Analytical Understanding Of Administrative Practices Minimizing Vicarious Traumatization In Domestic Violence Organizations I

Working within the field of domestic violence can result in the occurrence of vicarious traumatization. The literature supports that collegial support and supervision are effective tools organizations can implement to assist in minimizing vicarious trauma. This study, guided by constructive self development theory and feminist theory, examines whether the level of vicarious trauma is impacted by knowledge base, collegial support, and supervision. Staff within certified shelters in the state of Florida were surveyed using a research designed instrument and the Trauma and Attachment Belief Scale. A total of 112 participants were recruited using the Tailor Design Method of surveying. Findings indicate that uniquely none of the independent variables significantly impacted vicarious trauma symptoms. However, collectively knowledge base, collegial support and supervision did impact minimizing vicarious trauma. Further, five of the ten subscales of vicarious trauma showed a statistically significant relationship with the independent variables. Implications for domestic violence agencies, practitioners, and future research are drawn

Master of Science

thesisThe concept of modern hospice care was conceived by Dame Cicely Saunders, a British nurse who later trained as a social worker and doctor. Her mandate was to offer holistic care consisting of physical, emotional, spiritual and psychological support to dying people enabling them to live fully to the end of life. Hospice care has developed differently in the UK and the USA. This qualitative study, undertaken by a British nurse who has worked in end of life care in both countries, set out to discover how hospice care was perceived and delivered by seven hospice nurses in Utah. Emergent themes were consistent with early ideas of hospice care, and included supportive and comfort care that was directed by the patient and their family; unlike acute care, hospice care was accepting of death. Nurses felt that dealing constantly with dying was hard, but not necessarily stressful; they discussed coping mechanisms. The merits of the interdisciplinary team were praised as both a support to the family and the nurses. The reasons underpinning the routine taking of vital signs was investigated, with the conclusion being that it is done mainly to meet the perceived needs of the family of the patient. Documentation was seen as unwanted necessity, performed mainly for legal reasons. All nurses reported that hospice nursing was extremely rewarding, despite the inherent repeated loss and grief

A Case Study on the Key Habits of Long-Tenured Pastors in the Southern Baptist Convention

Pastors face a unique set of challenges as well as fierce spiritual warfare. Statistics reveal many pastors in the Southern Baptist Convention change churches every few years. In contrast, a minority of pastors withstand the difficulties and challenges, enjoying a long tenure in their churches. Studies also show a positive correlation between the long tenure of pastors and church health, which should necessarily encourage pastors to weather the storms and remain in their churches for the long haul. This project will focus on senior or lead pastors of Southern Baptist churches who have served at the same church for more than ten years or retired from a church in which they served for more than ten years. Besides, the pastors in focus will be currently serving or retired from a church considered healthy based on industry standards. Through interviews and surveys, this project will identify the key habits and attitudes of the long-tenured pastors. Of particular interest are the spiritual discipline and holy habits of these pastors and their typical pattern of response to challenges and difficulties common in ministry. Many pastors need encouragement and guidance, and this project is intended to offer insight into the lives of the men who have remained at their post faithfully for many years, not giving in to the temptation to pursue greener pastures, and allowing their example to serve as instructive for others

Exploring the relationships between personality disorder, sexual preoccupation, and adverse childhood experiences among individuals who have previously sexually offended

Sexual offending creates a significant public health issue (Mann, Hanson & Thornton, 2010), whereby having a better understanding of the underlying factors related to sexual offending will result in more effective prevention, assessment, and intervention (Seto, 2019). Various factors are identified as aetiological factors for sexual offending, or risk factors for recidivism, including adverse childhood experiences (ACEs), problematic personality traits, intimacy deficits, deviant sexual preferences, and sexual preoccupation (Hanson & Morton-Bourgon, 2005; Mann et al., 2010). Personality disorders (PDs) are highly prevalent among Individuals Who Have Previously Sexually Offended (IPSO; Chen, Chen & Hung, 2016; Craissati & Blundell, 2013), with this relationship being recognised in the UK by the development of the Offender Personality Disorder (OPD) pathway in 2011. However, there are issues regarding the current screening procedure in that it predominantly screens for antisocial and borderline PDs, meaning that a proportion of IPSO with a range of other PDs may be being missed. Furthermore, the prevalence of PDs among IPSO housed in UK prison establishments has not yet been explored. Another factor which is thought to contribute to the aetiology of sexual offending is Sexual Preoccupation (SP; Seto, 2019; Ward & Beech, 2017), which is one of the most strongly present treatment needs among IPSO in the UK (Hocken, 2014). Nonetheless, it is the only risk factor that is not currently addressed by psychological treatment programs for IPSO in the UK (Lievesley, 2019). A tentative link has been reported between PD and SP among IPSO, with sexually preoccupied IPSO presenting with a different personality profile compared to those without SP (Berman-Roberts, 2015). Given that these individuals have acted upon their sexual thoughts and engaged in illegal sexual behaviour, it is imperative to learn more about the underlying mechanisms of SP in order to inform and enhance assessment and treatment (Jardin et al., 2017), which is the main aim of this thesis. Additionally, ACEs are an integral part of understanding sexual offending (Hanson & Morton-Bourgon, 2005; Levenson, 2014), and are also implicated in the aetiology of PD and SP (Courtois & Weiss, 2018; Zanarini, 2000), whereby PD symptomology and SP may be better understood as functional responses deployed as ways of coping with these experiences. ACEs are now considered to be a public health ‘'crisis' (Anda, Butchart, Felitti & Brown, 2010), and studies have recently explored the prevalence of ACEs among prisoners in Scotland and Wales (Carnie, Broderick, Cameron, Downie & Williams, 2017; Ford et al., 2019). Yet, the prevalence of ACEs among IPSO housed in UK prison establishments has not yet been explored, nor the relationships between PD and ACEs, and SP and ACEs among this population. Therefore, ACEs were also included for exploration within this thesis in order to fully understand the relationship between PD and SP among IPSO. Through utilising a mixed-methods approach, this thesis offers the first in-depth exploration of the relationships between PD, SP, and ACEs among a sample of IPSO housed in two UK prison establishments. Study one (n = 203) explores the psychometric properties of two PD scales in a UK general population sample, before they were employed for use with a prison population. The second (n = 155) and third (n = 45) studies explore the prevalence of PD, SP, and ACEs among IPSO, as well as the relationships between PD and SP, PD and ACEs, and SP and ACEs. Finally, the fourth study (n = 5) explores the life trajectories and narrative identities of IPSO that experienced adverse environments during childhood and developed a preoccupation with sex and problematic personality traits. The findings reveal that attempting to understand the underlying mechanisms of SP is a complicated process, as SP manifests differently for each individual. SP may be used as a way to regulate emotions and manage stress, and/or as a way of managing identity and self-worth. Although this thesis provides support for the impulsivity and compulsivity models of SP, as well as it being used as a coping mechanism for anxiety and depression, it also highlights the relationships between SP and emotion dysregulation, and SP and impaired identity. Furthermore, the results bolster Montaldi's (2002) claim that some presentations of SP may be better understood through the use of PDs, whereby this thesis highlights the possibility of two pathways for IPSO with SP (in relation to borderline and narcissistic PDs). Multiple kinds of SP presentation suggest the need for multiple treatment approaches, and it is important for clinicians to tailor treatment according to the individual’s motivation for SP. In regard to the prevalence of PD among IPSO in the UK, a range of PDs (predominantly dependent, depressive, borderline, and avoidant PDs) were reported among IPSO housed in UK category C prison establishments. This has important implications for the current OPD pathway screening procedures, in that these may need amending to be more inclusive of the range of PDs present among IPSO, or specific services for IPSO with PD may need to be developed and implemented. Moreover, a large proportion of IPSO met the criteria for PD, and among these individuals, all of them experienced at least one ACE, with over half reporting four or more ACEs. Thus, this demonstrates the need for all services to adopt a trauma-informed and relational approach, whilst also highlighting how preventative measures are crucial in order to try and prevent the cyclical nature of ACEs, and to prevent individuals from coming into contact with the criminal justice system in the first place. This thesis concludes that PD and SP symptomology may be better understood as effective survival strategies to abnormal circumstances, and it is important that clinicians address this aspect of an individual's sense-making during treatment. Furthermore, a common thread throughout all studies is regarding impairments in identity. Therefore, a useful treatment target among IPSO is in relation to incoherence in the self-narrative, as having a coherent, pro-social identity is thought to be crucial to rehabilitation and desistance (Maruna, 2001). Clinicians should work from a Good Lives Model (GLM; Ward, Mann & Gannon, 2007) perspective in order to help individuals identify appropriate values and goals, and work towards a more appropriate narrative identity (Ward & Marshall, 2007). An individual’s protective factors should also be taken into account, in which peer-support roles and religiosity may play an important part in protecting individuals from future offending. Implications and limitations of all studies are discussed extensively throughout, as are opportunities for further research

Charismatic Christianity in Finland, Norway, and Sweden: Case Studies in Historical and Contemporary Developments

The history of Charismatic Christianity in the Nordic countries reaches as far back as Pentecostalism itself. The bounds of these categories remain a topic of discussion, but Nordic countries have played a vital role in developing this rapidly spreading form of world-wide Christianity. Until now, research on global Charismatic Christianity has largely overlooked the region. This book addresses and analyzes its historical and contemporary trajectories in Finland, Norway, and Sweden. Through a selection of cases written by Nordic scholars from various disciplines, it demonstrates historical and contemporary diversity as well as interconnections between local, national, and global currents. Highlighting change and continuity, the anthology reveals new aspects of Charismatic Christianity.publishedVersio

Psychological Well-Being in College: The Role of Parental Meta-Emotion Philosophy and Romantic Relationships

According to recent research, numerous components of psychological well-being have indicated Americans are struggling psychologically. Given that psychological well-being has a bidirectional and, in some cases, a predictive relationship with various environmental factors, this study sought to discover the “missing link” of psychological well-being. In doing so, this study organized parental meta-emotion philosophy, emotion expression, romantic relationship satisfaction, and psychological well-being into unique measurement and structural models. Correlations, t-tests and structural equation modeling conducted on a sample of 167 indicated emotion-coaching and psychological well-being were significantly related to romantic relationship satisfaction. Further, emotionally-dismissive parenting was significantly related to emotion expression in relationships. No significant, predictive relationships were found between variables. These results served as a foundation for future research seeking to understand how parental characteristics during childhood and current day relationship satisfaction help to support and influence psychological well-being

Using theory to inform capacity-building: Bootstrapping communities of practice in computer science education research

In this paper, we describe our efforts in the deliberate creation of a community of practice of researchers in computer science education (CSEd). We understand community of practice in the sense in which Wenger describes it, whereby the community is characterized by mutual engagement in a joint enterprise that gives rise to a shared repertoire of knowledge, artefacts, and practices. We first identify CSEd as a research field in which no shared paradigm exists, and then we describe the Bootstrapping project, its metaphor, structure, rationale, and delivery, as designed to create a community of practice of CSEd researchers. Features of other projects are also outlined that have similar aims of capacity building in disciplinary-specific pedagogic enquiry. A theoretically derived framework for evaluating the success of endeavours of this type is then presented, and we report the results from an empirical study. We conclude with four open questions for our project and others like it: Where is the locus of a community of practice? Who are the core members? Do capacity-building models transfer to other disciplines? Can our theoretically motivated measures of success apply to other projects of the same nature

Using Mixed Methodology to Assess High Risk Sexual Behavior and Adult Stage among Bolivian Truck Drivers

Bolivia has a high STI rate and an accelerating HIV/AIDS rate. The majority of the country\u27s newly diagnosed HIV/AIDS cases come from the province of Santa Cruz in eastern Bolivia, where this study took place. In this study, the investigator assessed the notion that Bolivian truck drivers are a bridge population of HIV transmission within heterosexual networks. This investigation determined risks of HIV/STI transmission through interviews, surveys, and workshops given to the truck drivers. Special attention was given to self reports of sexual behavior, cognitions and ego maturation stages, in order to assess risk. Mixed methodology was the research paradigm of choice, utilizing qualitative and quantitative phases. Workshops were designed, implemented, and evaluated. Analysis was completed on survey results from 246 male truckers (aged 18 to 67). More than half (56%) of these truckers admitted to having sex with casual partners. In addition, from 30% (quantitative inquiry) to 52% (qualitative inquiry) of these truck drivers have had sexually transmitted infections. Three factors predicted condom use: Age, Outcome expectancies, and Perceived social norms. Only one factor predicted STI history: Number of sex partners. Adult stage theory did not directly impact sexual behavior. A high risk of HIV/STI transmission has been detected in Bolivian truck drivers. This notion supports other studies involving truck drivers, and calls attention to the need for tailored health education programs for this population. Furthermore, younger truck drivers are at greater risk of HIV transmission than older truck drivers, in spite of their increased condom use. Sexual health workshops for Bolivian truck drivers are worthwhile and can be most effective when co-managed with truck companies or unions. Counseling, testing, and follow up research programs can best be implemented through these already-existing management structures. Future programs need to emphasize other behaviors besides condom use. Workshops should also include truckers\u27 spouses as participants. Lastly, since casual sex partners of truck drivers rarely fit the mold of a commercial sex worker, effort should be made to describe these casual partners and design subsequent workshops for them