Factors predicting weight loss and weight gain in bariatric surgery patients

Obesity has become an epidemic in the United States that can result in problems in multiple areas of an individual\u27s life. Bariatric surgery has been shown to be an effective weight loss treatment for obese and morbidly obese individuals; however, although many individuals obtain long-term weight loss success after surgery, there is a percentage of patients who do not obtain the expected weight loss or end up regaining the weight they had initially lost. In an attempt to identify those who may be at risk for poorer results after bariatric surgery, most surgeons require that an individual undergo a psychological evaluation before they are approved for surgery. Previous research has attempted to identify specific factors assessed in the psychological evaluation that may be used to identify those patients who are at risk for poorer surgery outcomes; however, results have been contradictory. This study examined whether specific psychological variables obtained during the psychological evaluation for gastric bypass surgery, specifically, scores on measures of disordered eating behavior, anxiety, and depression, could be used to predict short and long-term success post-surgery, as measured by the percentage of excess weight loss (EWL). This study also examined the role that behaviors engaged in after surgery: binge eating, night eating, grazing, and alcohol use play in longer term bariatric surgery success. The results of the present study did not support the majority of the hypotheses. Anxiety and depression was not found to be a predictor of EWL in the majority of hypotheses; however, anxiety post-surgery was found to predict EWL at two points post-surgery. There were some interesting significant findings when examining the variables measuring disordered eating and health. Results showed that the Binge Eating Scale and the Night Eating Questionnaire were negatively correlated with the percentage of excess weight loss at various points post-surgery. The results also showed that excess weight loss was correlated with physical and mental health. Additionally, the Grazing Questionnaire was found to be positively correlated with the Binge Eating Scale

Falling in Acute Mental Health Settings for Older People : Who falls, where, when and why?

Copyright: © 2014 Dickinson A et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Falls, slips and trips are a major patient safety concern in hospital settings accounting for 26 per cent of all reported patient safety incidents in England. Mental health conditions and their treatments add further to fall risk but we have little information regarding who falls, where and when within mental health settings. Methods: This paper presents an overview of the pattern of falls by older patients within an in-patient mental health setting in the South of England using routine records completed by staff when a fall occurs. 920 fall reports over three years were analysed, and 7 focus groups were undertaken with ward staff to explore how staff understood falls and their experiences of using the falls reporting system. Results: In terms of diagnosis 40% of fallers had a primary functional diagnosis, 46% an organic mental health diagnosis (14% non-specific diagnosis), average age was 81.7 years (range 59 to 99 years; SD 8.3) and 57% were female. Approximately one quarter, 27%, of falls were observed by staff. Falls were not evenly distributed across either day of week or time of day, with peak times for falls on Tuesday and Saturday and morning (7-8 and 9-10am) and subsidiary peaks between noon and 1pm and early evening (5-6pm). Almost half of falls occurred in private spaces in the ward such as bedrooms, and 42% in public spaces such as sitting rooms. However 60% of falls in public spaces were unseen. Reporting in these settings was problematic for staff and patients were sometimes described as placing themselves on the floor as a consequence of their mental health condition. The average time to first fall was 5 weeks. Conclusions: Routine mapping of falls could be undertaken at ward and organization level and contribute to better understanding of the local factors contributing to falls. Exploring incident report data in focus groups with staff helped us and them to interpret the data and to understand some of the decision making staff engage in everyday when reporting falls.Peer reviewedFinal Published versio

Six Years of Adult Education about the Wonders of the Salish Sea

The Wonders of the Salish Sea (WSS) is an environmental education program designed to connect residents to the Salish Sea ecosystem through community-based, awe-inspiring education. The program aims to create a community of citizens who love, care for, and want to protect the Salish Sea; and to provide an opportunity for local scientists, naturalists, environmentalists, and enthusiasts to share their passion and expertise with the general public. Started in 2016 in Vancouver BC, WSS fills a gap in education by meeting the needs of beginning youth and adult learners who want to gain an in-depth understanding of the ecosystem in which they live. The program moved to a virtual format in 2021, making it accessible to all residents of the Salish Sea and beyond. WSS is held over a 4 - 5 week period annually in the spring. Attendance has grown every year with many returnees. The response from stakeholders has been overwhelmingly positive. For example, participants have said: It has greatly increased my desire to preserve the Salish Sea and it\u27s inhabitants, I think the ripple effects of this kind of education cannot be tabulated, and I\u27ve always been careful about what I advocate for but since I took this course I\u27ve written 3 letters. This poster will highlight the program model, participant data, outcomes, stakeholder feedback, spin-off initiatives, and plans for the future

An explanatory theory of power in inter-organisation relationships: evidence from the aerospace and defence industry.

Bourlakis, Michael - Associate SupervisorThis thesis concerns the phenomenon power, heralded the most fundamental yet contested phenomenon / concept in social science. The focus is establishing the essential qualities that describe, characterize, and explain power in inter- organisation relationships (IOR-power) to inform debates on the significance of IOR-power to supply chain performance. The thesis is founded on an iterative and critical synthesis of core academic perspectives spanning 50 years and 27 practitioner perspectives obtained from three field studies, unearthing meanings and experiences attributed to IOR-power. It is argued that IOR-power standing replete with unresolved contestations has been under-theorised and under- valued in the literature and in practice. An imbued distain for IOR-power is fuelled by an untenable dichotomisation of consensual IOR-influence and coercive IOR- power – unnecessarily stripping IOR-power of much of its potency – leaving both precariously sharing the burden of explaining IOR-behaviour wherein accounts thus far are insufficient to explain IOR-outcomes of interest. Underpinned by a dialectical critical realism perspective, the main contribution is a plausible theory of IOR-power, a fundamental explanatory process building block complemented by a conceptual framework supported by evidence from the aerospace and defence industry. Advancing alignment with natural-based power, IOR-power is more comprehensively claimed to be the combination of embedded individual behaviour, human creations, and Nature, at work exploiting resources in pursuit of goal attainment – an emergent, downwardly inclusive social and natural-based process governing IOR-outcomes. Accordingly, IOR-influence is distinct from but wholly integral to IOR-power that is rendered situated, negotiated, and indeterminate. IOR-power is conferred its full weight in explaining IOR-performance across economic, social, and environmental domains rendering adopted perspective and attribution salient in IOR-power accounts. The only antithesis of IOR-power is IOR-powerlessness wherein empowerment and disempowerment stand as theoretical bridges.PhD in Leadership and Managemen

Patient medication knowledge and adherence to asthma pharmacotherapy: a pilot study in rural Australia

Asthma is a chronic disease with both inflammatory and bronchoconstrictive elements and often requires multiple medications. Most asthma regimens include medications with different therapeutic modes of action and a number of different medication delivery devices. To effectively participate in their asthma management, patients need to recognize each of their medication types, understand their purpose, adhere to their treatment regimen, and be proficient in using the required delivery devices. This study evaluated patient knowledge of asthma pharmacotherapy and adherence. An interview study was undertaken in two rural locations, in Australia, to elicit participants' knowledge, use, and inhalation device technique. Of participants, 75.9% used preventer medication and the remaining 24.1% used reliever medication only. Of those using preventer medication, 82.5% could distinguish their preventer from a range of asthma medicines. Metered dose inhalers (MDIs) were used by 80% of participants; 23% used a Turbuhaler®; 24% used an Accuhaler®; and 5% used an MDI with a spacer device. The study established poor medication knowledge, suboptimal device technique, and disturbing levels of adherence with management recommendations. Asthma education strategies need to be modified to engage patients with low asthma knowledge to achieve improved patient outcomes. Further, strategies need to motivate patients to use preventer medication during times when they feel well

Instructional Improvement Through Individual Consultation

Theoretical Bases: Theory 1: Instructional Interaction Theory 2: Student Differences Theory 3: Change The Approach An Example: Step 1: Identify the Instructor\u27s Major Concerns Step 2: Challenge Instructor\u27s Concepts of Teaching Step 3: Formulate Alternative Teaching Approaches Step 4: Evaluate New Approach Conclusions Reference

Instructional Improvement Through Individual Consultation

Theoretical Bases: Theory 1: Instructional Interaction Theory 2: Student Differences Theory 3: Change The Approach An Example: Step 1: Identify the Instructor\u27s Major Concerns Step 2: Challenge Instructor\u27s Concepts of Teaching Step 3: Formulate Alternative Teaching Approaches Step 4: Evaluate New Approach Conclusions Reference

A proteomics study of the response of North Ronaldsay sheep to copper challenge

BACKGROUND: The objective of this proteomics study was to identify proteins that changed expression as a result of copper challenge in the uniquely copper sensitive North Ronaldsay sheep and further, to compare those changes in expression with the more copper tolerant Cambridge breed. Such data gives us a proteome-centered perspective of the pathogenesis of copper-induced oxidative stress in this breed. RESULTS: Many proteins respond to copper challenge, but this study focuses on those exhibiting a differential response between the two breeds, related to liver copper content. As copper accumulated in the tissue, the pattern of expression of several proteins was markedly different, in North Ronaldsay sheep as compared to the Cambridge breed. CONCLUSION: The pattern of changes was consistent with the greatly enhanced susceptibility of North Ronaldsay sheep to copper-induced oxidative stress, focused on mitochondrial disturbance with consequent activation of hepatic stellate cells. The expression profiles were sufficiently complex that the response could not simply be explained as a hypersensitivity to copper in North Ronaldsay sheep

Characterisation of infection associated microRNA and protein cargo in extracellular vesicles of Theileria annulata infected leukocytes

The protozoan parasites, Theileria annulata and T. parva are unique amongst intracellular eukaryotic pathogens as they induce a transformation‐like phenotype in their bovine host cell. T. annulata causes tropical theileriosis, which is frequently fatal, with infected leukocytes becoming metastatic and forming foci in multiple organs resulting in destruction of the lymphoid system. Exosomes, a sub‐set of extracellular vesicles (EV), are critical in metastatic progression in many cancers. Here we characterised the cargo of EV from a control bovine lymphosarcoma cell line (BL20) and BL20 infected with T. annulata (TBL20) by comparative mass spectrometry and miRNA profiling (data available via ProteomeXchange, identifier PXD010713 and NCBI GEO, accession number GSE118456, respectively). Ingenuity Pathway Analysis that many infection‐associated proteins essential to migration and extracellular matrix digestion were upregulated in EV from TBL20 cells compared to BL20 controls. An altered repertoire of host miRNA, many with known roles in tumor and/or infection biology was also observed. Focusing on the tumor suppressor miRNA, bta‐miR‐181a and bta‐miR‐181b, we identified putative mRNA targets and confirmed the interaction of bta‐miR181a with icam‐1. We propose that EV and their miRNA cargo play an important role in the manipulation of the host cell phenotype and the pathobiology of Theileria infection