A Retrospective Comparative Analysis on the Effectiveness of Pharmacologic Weight Loss

PURPOSE:Obesity costs the U.S. roughly $147 billion in health care spending annually. There has been a call for healthcare providers to initiate all possible weight loss interventions. One treatment strategy not used to its fullest potential is that of prescribing antiobesity medications. The purpose of this project was to examine and evaluate the effectiveness of three common weight loss medications used in the treatment of obesity, including discussion and recommendations. METHODS: This project was a single-center retrospective study comparing three different groups of patients seen at a rural weight loss clinic. The sample consisted of 84 patients seen between September 2014 to September 2017. Three groups taking Adipex, Adipex + Contrave, and Apidex + Saxenda were evaluated for effectiveness on weight loss, BMI, and waist circumference. Compliance to medications, diet, and exercise were evaluated. RESULTS: Each medication group proved to be effective in treating obesity. On average, patients taking Adipex had 7.2% weight loss, Adipex + Contrave had 7.2% weight loss, and Adipex + Saxenda averaged 9.1% weight loss. Compliance to diet and exercise was a determinant for weight loss success. Those that did not comply to the medication regimen or a diet and exercise plan did not decrease obesity measures. CONCLUSION: Pharmacotherapy is an adjunctive therapy to diet and exercise. No differences in the effectiveness of medication between groups was found; however, each medication was statistically proven to be effective in obesity reduction. Adipex, while proving just as effective as combination therapy, is the most affordable and when applicable should be considered along with diet and exercise for those seeking weight loss

Effect of Political Ideology, Femininity, and Gender on Abortion Stigma

Effect of Political Ideology, Femininity, and Gender on Abortion Stigma Rym Yousfi, Dept. of Psychology, Emily Beatty, and Allison Patev and Chelsie Dunn, Dept. of Psychology Graduate Students, with Dr. Kristina Hood, Dept. of Psychology Abortion stigma is a negative characteristic attributed to individuals who terminate a pregnancy that marks them as inferior to social ideals of womanhood (Kumar et al, 2009). One factor influencing abortion stigma is political ideology. Conservative individuals display more opposition to abortion and hold more abortion stigmatizing attitudes, when compared to their liberal counterparts (Bessett et al, 2015). Further, individuals’ gender may impact endorsement of these stigmatizing attitudes towards individuals who have had an abortion. Women have less stigma likely due to the fact that they could need to have an abortion (Patev, Hood, & Hall, 2019). Although gender seems to predict abortion stigma, it is unclear how individuals’ endorsement of traditional feminine characteristics may relate to abortion stigma, independent of gender. Abortion violates fundamental entities of womanhood, such as being a nurturing mother and being sexually pure (Kumar et al, 2009). Feminine ideals indicate that women should not have control over their own reproduction and sexuality, leading to increased stigmatizing attitudes towards women who have an abortion (Norris et al, 2011). Therefore, the endorsement of traditional feminine ideals may lead to increased abortion stigma, regardless of political ideology or gender. Limited study has examined the relationship between feminine characteristics and abortion stigma. Better understanding abortion stigma is essential; as, research has shown that stigmatizing attitudes can greatly affect the health of individuals who have had an abortion (Major & Gramzow, 1999; O’Donnell et al., 2018). The current study sought to determine the effect of femininity on abortion stigmatizing attitudes, beyond the effects of political ideology and gender. We initially projected that individuals with more traditional feminine values would hold more abortion stigma. Participants (N= 305) were recruited via Amazon Mechanical Turk and completed an online survey. The survey included the Stigmatizing Attitudes, Beliefs, and Actions Scale (Shellenberg et al., 2014) to assess abortion stigma, the Personal Attributes Questionnaire (Spence et al., 1974) to assess femininity, one item assessing gender (i.e., men coded as 1 and women coded as 2), and one item assessing political ideology (e.g., lower scores indicate conservative ideology). A hierarchical regression was conducted to determine how individuals’ femininity impacts abortion stigma, beyond the effects of gender and political ideology. Political ideology was entered in the first step, and was significant,b= -.54, SE= .28, p\u3c .001, with more of a conservative ideology related to increased abortion stigma. Political ideology accounted for 29.1% of the variability in abortion stigma. Gender was entered in the second step, controlling for political ideology, and was found to be significant, b = -.11, SE= 1.29,p= .03, with women holding less stigma than men. Gender accounted for an additional 1.1% of the variability in abortion stigma, beyond the effects of political ideology. Finally, femininity was added into the third step, controlling for gender and political ideology, and significantly predicted abortion stigma, b = -.11, SE= .16, p= .03, and accounted for an additional 1.0% of the variance in abortion stigma. However, this finding was not in the predicted direction. We found a negative relationship, indicating that individuals with more femininity held less abortion stigma. This is counter to our original prediction, where we projected that individuals with more traditional feminine characteristics would hold more abortion stigma. These findings extend on previous work determining factors that predict abortion stigma. Having a better understanding of these factors combined influence will aid in decreasing abortion stigma. These results could help to create educational programs on sexual and reproductive health that can reduce abortion stigma and bias, and ultimately could lead to reducing negative health outcomes for individuals who have had an abortion.https://scholarscompass.vcu.edu/uresposters/1338/thumbnail.jp

The manifestations of fatigue in amateur boxing performance

A subjective method of judgment, the “Ten Point Must-System” (TPMS), was introduced into amateur boxing in 2013. To be successful, boxers must deliver forceful punches and exert dominance over an opponent. There has been limited research examining the strategies used by boxers to win fights under the TPMS and whether these strategies induce fatigue that is sufficient to significantly affect punch force. The overall objective of the five studies contained in this thesis was to describe, in relation to fatigue, the performance characteristics of male amateur boxers under the TPMS, and improve our understanding of the physical characteristics associated with punch force production in highly-trained male amateur boxers. The first study describes technical and behavioural patterns as well as perceptions of effort and fatigue in winning and losing boxers during competition bouts. Winners were found to punch more accurately than losers (33% vs. 23% of punches were landed and 17% vs. 27% were air punches) but the total number of punches were similar. Clinch time, guard drops, and perceptions of effort and fatigue all increased, and bouncing decreased in all boxers over rounds. Regression analysis revealed that in combination, the percentage of punches landed and movement style correctly classified 85% of bout outcomes. Boxers appear to use tactical strategies throughout bouts to pace their effort and minimise fatigue, but these did not influence bout outcome. Thus, judges use several performance indicators, including punch accuracy (but not number) and movement style to (subjectively) assess dominance and determine a winner. To understand the interaction between punch force and fatigue-related behaviour, a boxingspecific, laboratory-based test (3-min punch test; 3MPT) was designed to measure punch force (N) and force-time variables (i.e. impulse and various rate of force development variables; RFD). The punch force measurement system had high mechanical reliability and accuracy (CV \u3c 0.1%). Typical error and smallest worthwhile changes comparisons revealed that the 3MPT could detect moderate and large changes in performance, however within-day reliability improved from day 1 - 2 (CVs of 3.1 - 13.8% vs. 2.3 - 5.1%), indicating a possible learning effect. Thus, repeat-trial familiarisation is suggested to reduce between-test variability. Studies 3 - 5 then utilised this system to examine factors that may influence punch force delivery. In Study 3, correlation and regression analyses revealed significant (p \u3c 0.05) relationships between peak punch force and forces measured in countermovement jump and isometric mid thigh pull tests (i.e. lower-body strength) as well as body mass, but not RFD, in the lower body. No meaningful relationships between punch performance characteristics and any upper-body strength or power parameters were identified. The results of Study 3 show lower-body strength, but not RFD was significantly and positively related to peak punch force, however upper-body strength and power did not discriminate between boxers who punched with higher or lower peak force. In Study 4, punch force characteristics, were measured in the 3MPT of highlytrained male amateur boxers before (ROWpre) and after (ROWpost) 9 × 1-min bouts of rowing. This was designed to induce fatigue in lower limb, trunk, and arm flexion muscles whilst leaving arm extensor muscles (primary punch muscles) non-fatigued. Significant reductions in punch force were found ROWpost compared to ROWpre for all punch types, and significant delays in the time to reach specific force levels and relative percentages of peak force (i.e. RFD) occurred in all punches except the jab. Thus, punches that particularly rely on lower-limb force production and trunk rotation (crosses and hooks) were most affected. Speculatively, ground reaction force generation was affected by fatigue, however since the jab relies predominantly on arm extension, punch force was less affected by lower-limb fatigue. In Study 5, the effect of non-specific muscle fatigue (rowing; ROW; as described in Study 4) on punch force production was also examined using the 3MPT, with additional comparisons between control (CON; 75 min rest) and boxing (BOX; competitive boxing bout [3 × 3 min]) conditions in a population of highly-trained male amateur boxers. Significant punch force reductions from ROWpre to ROWpost in lead-hand hooks and jabs were observed, however no significant differences were present in CON or BOX, and RFD variables remained unchanged in all conditions. These results suggest that reductions in punch performance after rowing arise from fatigue in the lower body and trunk muscles, whilst boxing is likely to cause fatigue in other body segments that have less influence on punch force production; it is also speculated that boxers use pacing strategies to maintain punch force during fatiguing boxing bouts. The general findings of this thesis were: technical and behavioural (possibly altered by fatigue) actions influence judge perception under the TPMS, and success requires high levels of punch accuracy; lower-body (but not upper-body) strength rather than RFD was associated with punch force production; lower-body and trunk fatigue significantly reduced punch force, supporting the theory lower-body strength is important to produce punch force; and, boxers maintained the ability to produce punch force throughout a boxing bout, possibly because fatigue was not accumulated in the lower limb and trunk muscles (partly due to boxers using pacing strategies)

Sedentary Behaviour, Physical Activity, and Mobile Apps Among University Students

Prolonged sedentary behaviour (SB) poses health risks independent of physical activity (PA) levels (Owen et al., 2010). University students in particular are at risk of engaging in prolonged SB due to the demands of school. Due to the pervasiveness of smartphones, and ability of mobile applications (apps) to target SB (Bond et al., 2014), apps may be used to encourage less SB in this population. Apps for PA have been coded for behaviour change techniques (BCTs) (Conroy et al., 2014; Middelweerd et al., 2014; Yang et al., 2015), however, apps for SB have yet to be assessed for BCTs. The purpose of this study was two-fold. The first aim was review smartphone apps designed to reduce SB for the presence of BCTs. The second aim was to gain an understanding of university students’ SB, PA and experiences with apps, and trial an SB app as a pilot intervention in this population. To address the first aim, systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free (n=36) and paid (n=14) app descriptions using a taxonomy of 93 BCTs (Michie et al., 2012). A subsample (n=4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs. In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0-6) per app. The BCTs coded most frequently were “prompts/cues” (n=43), “information about health consequences” (n=31), and “self-monitoring of behaviour” (n=17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: “graded tasks”, “focus on past successes”, and “behaviour substitution”. These SB apps have fewer BCTs compared to PA apps(Conroy et al., 2014; Middelweerd et al., 2014; Yang et al., 2015) and traditional (i.e., non-app) PA and healthy eating interventions (Michie et al., 2009). To address the second aim, students from WLU (n=177) completed an online survey of questions about self-report levels of PA, SB, and experiences with and perceptions of apps. Following this, participants were asked to participate in a follow-up study and were randomly assigned to a trial group (n=53) or a control group (n=74). The trial group was asked to use the app Rise & Recharge® for two weeks. After two weeks, participants in trial (n=18) and control groups (n=37) completed a second online survey that repeated the self-report PA and SB questions. Participants in the trial group also responded to additional questions about their app experience. A two-way mixed repeated measures ANOVA found no significant difference in PA in either group from ‘time 1’ to ‘time 2’ (p\u3e0.05). However, another two-way mixed repeated measures ANOVA for SB determined there was no main effect of time or group (p\u3e0.05), but a significant interaction between group and time (F(1,33)=6.81, p=0.014, ηp2= 0.171), in which the trial group (n=11) decreased in SB from ‘time 1’ to ‘time 2’, whereas the control group (n=24) increased in ‘time 1’ to ‘time 2’. Despite this, participants in the trial group rated the app as only ‘slightly influential’. Further, students’ open-ended responses showed that they perceive a lack of control over their own SB due to the demands of university. Overall, the present study sheds light on behaviour change potential of SB apps and provides practical insight about coding for BCTs in apps, and provides insight into PA an SB among university students and into the potential of using apps to influence this behaviour

Bicarbonate or Carbonate Processes for Coupling Carbon Dioxide Capture and Electrochemical Conversion

Designing a scalable system to capture CO₂ from the air and convert it into valuable chemicals, fuels, and materials could be transformational for mitigating climate change. Climate models predict that negative greenhouse gas emissions will be required by the year 2050 in order to stay below a 2 °C change in global temperature. The processes of CO₂ capture, CO₂ conversion, and finally product separation all require significant energy inputs; devising a system that simultaneously minimizes the energy required for all steps is an important challenge. To date, a variety of prototype or pilot-level CO₂ capture and/or conversion systems have been designed and built targeting the individual objectives of either capture or conversion. One approach has focused on CO₂ removal from the atmosphere and storage of pure pressurized CO₂. Other efforts have concentrated on CO₂ conversion processes, such as electrochemical reduction or fermentation. Only a few concepts or analyses have been developed for complete end-to-end processes that perform both CO₂ capture and transformation

Emissions trading as a policy option for greenhouse gas mitigation in South Africa

An emissions trading scheme (ETS) is based on the allocation of allowances to emit pollutants, which in the case of climate change are greenhouse gases. Allowances are allocated to a defined set of emitters, who are required to hold sufficient allowances to cover their emissions at the end of a compliance period, or face penalties. Scarcity is created in the scheme through the allocation of fewer allowances than emissions, resulting in emitters having to choose between reducing their emissions in line with their allowance allocations, or purchasing additional allowances to cover their excess emissions levels

White certificates and white certificate trading schemes as greenhouse gas mitigation policy options for South Africa

A white certificate, which is also referred to as an Energy Saving Certificate (ESC), or an Energy Efficiency Credit (EEC), is an instrument awarded by an authorisation body to guarantee that a specific amount of energy savings has been achieved. Each certificate is a unique and traceable commodity carrying a property right over a certain amount of additional energy savings and certifying that the benefit of these savings has not been accounted for elsewhere (EuroWhiteCert Project, 2006)

Supporting carers who care for children and young people who are looked after

Volume One contains the research component, comprising of three research papers focused on understanding wellbeing in carers and young people who are looked after. The first paper is a meta-analysis examining the effectiveness of attachment-based interventions with foster and adoptive families on children’s relational, emotional and behaviour functioning. The second paper is an empirical research study investigating the role of mentalization in the development of compassion fatigue in residential carer workers who care for young people who are looked after. The third paper is written to disseminate the findings of the meta-analyses and empirical paper to foster and adoptive families, residential care workers and residential care organisations