Is weight cycling associated with adverse health outcomes? A cohort study

Evidence about the health effects of weight cycling is not consistent, with some studies suggesting it is harmful for health. Here we investigated whether weight cycling was associated with weight change and mental health outcomes in 10,428 participants in the mid-age cohort of The Australian Longitudinal Study of Women's Health (ALSWH) over 12 years. In 1998 the women were asked how many times they had ever intentionally lost at least 5 kg and how many times had they regained this amount. Women were categorised into four weight pattern groups: frequent weight cyclers (FWC, three or more weight cycles), low frequency weight cyclers (LFWC, one or two weight cycles), non-weight cyclers (NWC), and weight loss only (WL). We used generalised linear modelling to investigate relationships between weight pattern group, weight change and mental health outcomes. In 1998, 15% of the women were FWC, 24% LFWC, 46% NWC and 15% were WL. Weight change was similar across weight pattern groups in women with obesity, however healthy weight and overweight FWC gained more weight than women who did not weight cycle. We found no difference in overall mental health scores between groups, but both LFWC and FWC had higher odds of depressive symptoms (adjusted OR 1.5, 95%CI: 1.1 to 1.9 and 1.7, 95%CI: 1.1 to 2.4, respectively) than NWC. Our results suggest that, although weight cycling is not associated with greater weight gain in women with obesity, it may increase depressive symptoms

'It gives me my freedom’: technology and responding to bodily limitations in Motor Neuron Disease

People living with Motor Neuron Disease (MND) experience profound and rapidly progressing impairment. In order to maintain their physical and social functioning, people so affected employ a range of technologies and technological aids (body auxiliaries) to enhance their life and maintain wellbeing. Using a phenomenological study design, we explored the experiences of 42 men and women who had been diagnosed with MND. Although many participants initially resisted the adoption of aids (often-electronic devices that enabled continued participation in daily life) or tools (the instruments that allowed achievement of specific tasks), such technologies offered a way for people with MND to overcome, to some extent, the limitations posed by their physical degeneration. Through generating a sense of ‘normality’, these kinds of ‘enabling’ technologies promoted social engagement and the maintenance of valued relationships or activities. Technologies can provide people with MND with some positive experiences within a way of being-in-the-world that has become so difficult and challenging

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Targeting DNA Damage Response and Replication Stress in Pancreatic Cancer

Background and aims: Continuing recalcitrance to therapy cements pancreatic cancer (PC) as the most lethal malignancy, which is set to become the second leading cause of cancer death in our society. The study aim was to investigate the association between DNA damage response (DDR), replication stress and novel therapeutic response in PC to develop a biomarker driven therapeutic strategy targeting DDR and replication stress in PC. Methods: We interrogated the transcriptome, genome, proteome and functional characteristics of 61 novel PC patient-derived cell lines to define novel therapeutic strategies targeting DDR and replication stress. Validation was done in patient derived xenografts and human PC organoids. Results: Patient-derived cell lines faithfully recapitulate the epithelial component of pancreatic tumors including previously described molecular subtypes. Biomarkers of DDR deficiency, including a novel signature of homologous recombination deficiency, co-segregates with response to platinum (P < 0.001) and PARP inhibitor therapy (P < 0.001) in vitro and in vivo. We generated a novel signature of replication stress with which predicts response to ATR (P < 0.018) and WEE1 inhibitor (P < 0.029) treatment in both cell lines and human PC organoids. Replication stress was enriched in the squamous subtype of PC (P < 0.001) but not associated with DDR deficiency. Conclusions: Replication stress and DDR deficiency are independent of each other, creating opportunities for therapy in DDR proficient PC, and post-platinum therapy

Touching moments: sociological phenomenology & the haptic in the lived experience of Motor Neurone Disease

Currently, there is a research lacuna with regard to phenomenological research into the lived-experience of motor neurone disease (MND), a terminal, neurodegenerative disease where the motor neurons in the cortex, brainstem and spinal cord gradually diminish in number until lost entirely. Based on a 3-year research project undertaken in the UK and in Australia involving 42 participants clinically diagnosed with MND, the aim of the study was to explore from a sociological-phenomenological perspective participants’ in-depth accounts of their own lived-body experiences of this disease. Calls have been made for sociological researchers to examine and analyse more fully and deeply the sensory dimension of the lived body, and this paper contributes to this newly developing corpus. As the social sciences in general have been accused of a high degree of ocularcentrism, in the paper we focus upon the haptic dimension, given that touch – and particularly the loss of key elements of the haptic – emerged as salient in our MND participants’ accounts. We focus on three specific haptic themes that participants identified as important in their changed mode of being-in-the-world: (i) being out of touch; (ii) the loss of dexterity of touch; and (iii) unwelcome touch by medical staff

Sociological phenomenology: analytic insights into illness, embodiment and MND

Sociological Phenomenology: Analytic insights into illness, embodiment and Motor Neurone Diseas

Losing touch: the haptic in the lived experience of motor neurone disease

Currently, there is somewhat of a research lacuna with regard to sociological phenomenological research into the lived-experience of motor neurone disease (MND), a terminal, neurodegenerative disease where the motor neurons in the cortex, brainstem and spinal cord gradually diminish in number until lost entirely. Based on data from a three-year qualitative research project undertaken in the UK and Australia, involving interviews and email correspondence with 42 participants clinically diagnosed with MND, in this paper we explore from a sociological-phenomenological perspective our participants’ in-depth accounts of their own lived-body experiences of this disease. Calls have been made for sociological researchers to examine and analyse more fully and deeply the sensory dimension of the lived-body, including within health and illness studies, and this paper contributes to this newly developing corpus. As sociology – and the social sciences in general - has been accused of a high degree of ocularcentrism, in this paper we explore the haptic dimension of the illness experience. Touch, and particularly the loss of key elements of the haptic, emerged clearly in participants’ narratives. Here we focus on two key themes identified by participants as salient in their changed mode of being-in-the-world with MND: (i) losing touch: the loss of certain forms of touch within MND; and (ii) unwelcome touch by medical staff

Pavey, A, Allen-Collinson, J and Pavey, T (2013) The lived experience of diagnosis delivery in Motor Neurone Disease: a sociological-phenomenological study, Sociological Research Online, 18 (2).

<p><strong>Abstract</strong></p> <p>Relatively few previous studies of individuals receiving a diagnosis of Motor Neurone Disease within the UK health care system have employed qualitative approaches to examine the diagnostic journey from a patient perspective. A qualitative sociological study was undertaken, involving interviews with 42 participants diagnosed with MND, to provide insight into their experiences of undergoing testing and receiving a diagnosis. </p> <p>Adopting a sociological-phenomenological perspective, this article examines key themes that emerged from participant accounts surrounding the lived experience of the diagnostic journey. The key themes that emerged were: The diagnostic quest; living with uncertainty; hearing bad news; communication difficulties; and a reified body of medical interest.</p