Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators

International audienceBackground: Relapse is high in lifestyle obesity interventions involving behavior and weight change. Identifying mediators of successful outcomes in these interventions is critical to improve effectiveness and to guide approaches to obesity treatment, including resource allocation. This article reviews the most consistent self-regulation mediators of medium-and long-term weight control, physical activity, and dietary intake in clinical and community behavior change interventions targeting overweight/obese adults. Methods: A comprehensive search of peer-reviewed articles, published since 2000, was conducted on electronic databases (for example, MEDLINE) and journal reference lists. Experimental studies were eligible if they reported intervention effects on hypothesized mediators (self-regulatory and psychological mechanisms) and the association between these and the outcomes of interest (weight change, physical activity, and dietary intake). Quality and content of selected studies were analyzed and findings summarized. Studies with formal mediation analyses were reported separately. Results: Thirty-five studies were included testing 42 putative mediators. Ten studies used formal mediation analyses. Twenty-eight studies were randomized controlled trials, mainly aiming at weight loss or maintenance (n = 21). Targeted participants were obese (n = 26) or overweight individuals, aged between 25 to 44 years (n = 23), and 13 studies targeted women only. In terms of study quality, 13 trials were rated as " strong " , 15 as " moderate " , and 7 studies as " weak ". In addition, methodological quality of formal mediation analyses was " medium ". Identified mediators for medium-/long-term weight control were higher levels of autonomous motivation, self-efficacy/barriers, self-regulation skills (such as self-monitoring), flexible eating restraint, and positive body image. For physical activity, significant putative mediators were high autonomous motivation, self-efficacy, and use of self-regulation skills. For dietary intake, the evidence was much less clear, and no consistent mediators were identified. Conclusions: This is the first systematic review of mediational psychological mechanisms of successful outcomes in obesity-related lifestyle change interventions. Despite limited evidence, higher autonomous motivation, self-efficacy, and self-regulation skills emerged as the best predictors of beneficial weight and physical activity outcomes; for weight control, positive body image and flexible eating restraint may additionally improve outcomes. These variables represent possible targets for future lifestyle interventions in overweight/obese populations

Mesenchymal Stem Cells Modulate the Immune System in Developing Therapeutic Interventions

Mesenchymal stem cells (MSCs) are emerging as key players in regenerative medicine for the treatment of various diseases associated with the inflammation and degeneration, thereby aiding in therapeutic advancements. Several tissues have been identified as potential sources of MSCs including the bone marrow, cord blood, dental pulp, umbilical cord, adipose tissue, peripheral blood, and fetal liver, of which some are clinically recognized. MSCs are capable of differentiating into cells of multiple lineages and therefore established as suitable candidates for transplantation in damaged organs. They have added advantage of higher proliferation, easy expansion, and, more importantly, the absence of HLA class II receptors, with potential applications extending toward allogenic settings. MSCs are actively involved in different mechanisms related to repair and regeneration of tissues via immunomodulation, transdifferentiation, paracrine factors, etc. They are known to exhibit profound immunomodulatory effect on T and B cells and natural killer (NK) cells mediated via soluble factors and direct cell-cell contact. The MSCs activate the immune responses and inhibit proliferation, maturation, and differentiation of T and B cells. The MSC-activated immune responses induce the expression of regulatory T cells (Tregs). A plethora of studies have established that MSCs suppress immune responses via immunomodulation that makes them a preferred cell source for the use in clinical trials

Through the Looking Glass: Mediator Conceptions of Philosophy, Process and Power

While a number of civil reforms using mediation have emerged across Canada in recent years, of particular interest is the Ontario Mandatory Mediation Program that was first piloted in 1999, deemed successful and then made a permanent feature of the Rules of Civil Procedure in 2001. This article suggests that before we can evaluate the outcomes of mandatory mediation, we must first look more closely at the process being implemented by the mediators in this context. With that in mind, this article considers the ways in which the mediators themselves perceive of the mediation process. It reports on a qualitative study that examined the nature of mediator views on the topics of inter alia, settlement orientation and mediator power. This article advances the claim that mediator power is, in fact, far greater than that held by the disputants or their advocates. This article suggests that this power, in the context of a mandatory mediation scheme, creates mediator self interest in achieving high rates of settlement, regardless of whether or not settlement is in the best interests of the disputants in every situation

Emotional adaptation to relationship dissolution in parents and non-parents: A new conceptual model and measure

Relationship dissolution can cause declines in emotional well-being, particularly if there are children involved. Individuals’ capacity to cope with the pragmatics of the situation, such as agreeing childcare arrangements, can be impaired. Before now, there has been no psychometric test to evaluate individuals’ emotional readiness to cope with these demands. This paper presents a model of emotional adaptation in the context of relationship dissolution and its key assumptions, and validates the Emotional Adaptation to Relationship Dissolution Assessment (EARDA). In Study 1 (Sample 1, n = 573 separated parents, Sample 2, n = 199 mix of parents and non-parents), factor analyses support the EARDA as a unidimensional scale with good reliability. In Study 2 (using Sample 1, and Sample 3, n = 156 separated parents) the convergent, discriminant, concurrent criterion-related, and incremental validity of the EARDA were supported by tests of association with stress, distress, attachment style, and co-parenting communication and conflict. In Study 3, the nomological network of emotional adaptation to relationship dissolution was explored in Sample 2 using cluster analysis and multi-dimensional scaling (MDS). Emotional adaptation clustered with positive traits and an outward focus, and was negatively associated with negative traits and an inward focus. Emotional adaptation was conceptually located in close proximity to active and adaptive coping, and furthest away from maladaptive coping. In Study 4 (n = 30 separated parents embarking on mediation), high, medium, and low emotional adaptation to relationship dissolution categories correlated highly with mediators’ professional judgement, offering triangulated face validity. Finally, in Study 5, EARDA scores were found to mediate between separation characteristics (time since break up, whether it was a shock, and who initiated the break up) and co-parenting conflict in Sample 1, supporting the proposed model. The theoretical innovation of this work is the introduction of a new construct that bridges the gap between relationship dissolution and co-parenting. Practical implications include the use of the measure proposed to triage levels of support in a family law setting

Engagement climate in service settings

This study explores the issue of drivers of service employee behaviour and performance, as antecedents of customer experiences that constitute key strategic outputs for service organizations. A proposed new construct, Engagement Climate, was developed and put forth as the "behavioural foundation" that the Service Climate model needs in the prediction of service employee behaviour and performance. The construct stems from the interpretation of engagement as an affect-based motivational process, and from the conceptualization of its antecedents as a specific type of psychological climate. Engagement Climate comprises a set of affectively charged psychological perceptions of the work environment, or engagement climate dimensions, which are conducive to the experience of engagement, a motivational state that triggers the investment of personal resources into the job role. Engagement Climate, as a latent social psychological construct, should virtually transcend the context of any one organisation or sector. However, given the nature of service work, Engagement Climate may most readily be observed (and fostered) in the context of services, in particular among front-line employees.The empirical study, consisting of a cross-sectional statistical survey, aimed to develop and pilot-test a questionnaire measure of Engagement Climate and to investigate its factor structure within a service organization. Data were collected from a total of 544 travel agents from a leading travel group in Spain. The factorial validity of the model comprising ten dimensions, namely Autonomy, Supervisor support, Clarity, Cohesion, Fairness, Trust, Challenge, Recognition, Self-expression, and Overload, was demonstrated using confirmatory factor analyses (CFA). The scale and subscales comprising the measurement model all showed good internal consistency and reliability values. Also, the hypothesized direct effects of engagement climate on personal engagement, as well as the relatively weaker effect of engagement climate on job satisfaction, were both confirmed using structural equation modelling (SEM).This study explores the issue of drivers of service employee behaviour and performance, as antecedents of customer experiences that constitute key strategic outputs for service organizations. A proposed new construct, Engagement Climate, was developed and put forth as the "behavioural foundation" that the Service Climate model needs in the prediction of service employee behaviour and performance. The construct stems from the interpretation of engagement as an affect-based motivational process, and from the conceptualization of its antecedents as a specific type of psychological climate. Engagement Climate comprises a set of affectively charged psychological perceptions of the work environment, or engagement climate dimensions, which are conducive to the experience of engagement, a motivational state that triggers the investment of personal resources into the job role. Engagement Climate, as a latent social psychological construct, should virtually transcend the context of any one organisation or sector. However, given the nature of service work, Engagement Climate may most readily be observed (and fostered) in the context of services, in particular among front-line employees.The empirical study, consisting of a cross-sectional statistical survey, aimed to develop and pilot-test a questionnaire measure of Engagement Climate and to investigate its factor structure within a service organization. Data were collected from a total of 544 travel agents from a leading travel group in Spain. The factorial validity of the model comprising ten dimensions, namely Autonomy, Supervisor support, Clarity, Cohesion, Fairness, Trust, Challenge, Recognition, Self-expression, and Overload, was demonstrated using confirmatory factor analyses (CFA). The scale and subscales comprising the measurement model all showed good internal consistency and reliability values. Also, the hypothesized direct effects of engagement climate on personal engagement, as well as the relatively weaker effect of engagement climate on job satisfaction, were both confirmed using structural equation modelling (SEM)

Molecular mechanisms of ovarian cancer prevention

Combined oral contraceptive pill (COCP) lowers the risk of ovarian cancer. The risk reduction has been reported as between 33 - 41%. The duration of use affects the risk reduction. The mechanism of risk reduction has been theorised. According to the incessant ovulation theory, repeated ovulation causes inflammation, which causes mutations and subsequent carcinogenesis. COCP prevents ovulation, reducing cancer risk. It was previously shown that COCP decreased genome-wide CpG methylation, suggesting that COCP could regulate gene expression through epigenetic mechanisms. This study hypothesised that COCP intake would affect CpG methylation depending on tissues. It was hypothesised that differential CpG methylation was linked to differential gene expression, which could in turn affect tissue organisation. Reduced representation bisulphite sequencing (RRBS) and pyrosequencing were used to measure the methylation in mice. RNA sequencing (RNAseq) and quantitative reverse transcription PCR (RT-qPCR) were used to study gene expression. Haematoxylin & eosin (H&E) staining and light microscopy were used to detect changes in tissue organisation. Hypomethylation was observed across the genome. CpGs were differentially methylated in COCP treated mice compared to untreated mice. RNAseq revealed that COCP treatment for 5 weeks altered gene expression. In several genes, epigenetic changes were linked to altered gene expression. Subsequent RT-qPCR validated these findings, shown by up-regulation of Kallikrein 1 (KLK1) and fibroblast growth factor (FGF7). There were alterations in the number of ovarian follicles and tissue structures, with a significant change in antral follicle count. In conclusion, COCP changed CpG methylation and gene expression in mice. This was the first study which investigated the effect of COCP in the fallopian tubes. Future studies may build on the fallopian tube specific gene expression and investigate what roles they play in protection against ovarian cancer.Open Acces

Operationalisation of Hybrid Peacebuilding in Asia

This open access book explores common critiques in the literature of hybrid peacebuilding, especially the lack of connection between hybridity in theory and practice. Through using a complexity-informed framework, the foundation for introducing the mid-space actor typology is established. Mid-space actors as insider-partial mediators are perceived to be vital agents for peace processes in conflict-affected areas and thus can be important power brokers and focal points for outside actors. In this book, two insider views are examined through analysing mid-space actors in the peacebuilding process in Cambodia and in Mindanao, the Philippines. First, it explores the process of identity-building of Cambodian monks and how such a process enables or hinders the monks to bridge existing cleavages. Then, in the case study of Mindanao, the roles of civil society actors are considered. The next step is to introduce the outsider’s perspective on hybrid peacebuilding and how Asian peacebuilding actors such as China and Japan are engaging with mid-space actors who provide key bridges in peacebuilding

Nordic Mediation Research

Peer reviewe

Bayesian Analysis of Parental Drinking Motives and Children\u27s Adjustment

Harm reduction strategies can mitigate against some of the deleterious effects of alcohol on families. These strategies are most feasible and cost-effective when they can be targeted at those who are most at risk. Previous studies examining the relation between parents’ alcohol use and their children’s psychological adjustment have failed to consider important contextual questions such as drinking motives. The current investigation set out to identify the extent to which parents’ drinking motives predict internalizing and externalizing psychopathology in their children. The investigation consisted of cross sectional analysis of parents’ drinking motives and their children’s adjustment using data from 154 families recruited from the local community. Utilizing Bayesian data analytic techniques, we examined the role of parents’ drinking motives along with possible mediating variables including familial conflict, parental depression, and parenting style. Results showed that maternal social drinking motives were better predictors of children’s maladjustment than either coping or enhancement drinking motives. Unexpectedly, maternal enhancement drinking motives were associated with fewer adjustment problems. Maternal enhancement drinking motives also predicted higher levels of collaborative conflict resolution and lower levels of parental depression, both of which were associated with reduced levels of children’s externalizing problems. Paternal alcohol consumption and drinking motives were not associated with children’s internalizing or externalizing problems. Clinical implications and directions for future research are discussed

The dynamics of mixed group work in British higher education

This study examines culturally diverse groups, teams formed by home students and international students completing group tasks in Higher Education, referred to as mixed groups. This investigation differs from previous studies, and hence contributes to the existing knowledge in the field, in that it combines observational data and the use of Activity Theory as an analytical framework for furthering our understanding of group dynamics and task completion of mixed groups. This research addresses four research questions: what are students' experiences of mixed group work? What are the group dynamics in mixed groups? How do students mediate during mixed group work? What factors influences task completion in mixed groups? The study is based upon two group case studies, consisting of a non-assessed written group task and an assessed group presentation. Both case studies involved postgraduate students within the same British university. Qualitative analysis of observation and interview data revealed that students had different experiences of their group work, even among co-workers. Few group interactions were related to discussing cultural issues, highlighting the limitations that mixed group work may have in fostering internationalisation. The group dynamics described include students' interactions around: achieving a common understanding of the task, sanctioning members and conflicts regarding tool use. Both home and international students mediated in task completion in the following ways: a) acting as sources of knowledge, b) helping other members to understand the activity, and c) helping others use and learn about artefacts required in the completion of the group task and other university activities. Factors that appeared to influence mixed group work (MGW) included international students' self confidence in their spoken English, familiarity, students' positioning of self and other colleagues, expected roles, task and assessment design, and students' engagement in clarification during task completion. Some of these findings are consistent with existing literature. Finally, Activity Theory (AT) as an analytical framework was found to be useful