Platform for Health and Wellbeing pilot study: provision of weight management support via the workplace

Introduction: The role of the workplace as an opportunity for improving health has been highlighted in recent reports. The East Midlands Platform for Health and Wellbeing is a network of private, public and voluntary sector organisations working to improve health and reduce obesity. Member organisations commit to undertake actions to improve health and wellbeing of employees, individuals and/or communities. As part of Slimming World’s commitment, this pilot assessed the merits of providing weight management support via the workplace at two large regional employers. Methods: 278 British Gas and Nottingham University Hospitals NHS Trust employees were offered 12 weeks’ support at either a bespoke workplace group or established community-based Slimming World group. Weight change was recorded weekly. Dietary and physical activity behaviours, along with aspects of psychological health were assessed by questionnaire pre and post-programme. Results: 121 employees (meeting inclusion criteria) joined a workplace-based group and 114 a community-based group. Weight and attendance: Mean joining BMI was 32.4kg/m2. 138 (59%) participants completed the programme (attended within final 4 weeks).Behaviour changes: Participants who completed both questionnaires (n=87), reported positive changes in dietary and physical activity behaviours (all p<.001) (figure 1), and psychological health (mental wellbeing, self-worth and self-esteem, all p<0.05). There were no significant differences between worksite and community intervention groups for any outcomes. Conclusion: Providing weight management support via the workplace significantly reduced weight of participants (-3.9%). Completer analysis also revealed positive changes in healthy eating habits and activity levels, and also importantly psychological health, which may impact on working life. The Slimming World programme works effectively within both the work setting and via community-based provision when employees are recruited via the workplace

Stepping outside normative neoliberal discourse: youth and disability meet – the case of Jody McIntyre

In May 2010, amidst the ‘global financial crisis’ a Conservative/Liberal Democrat coalition government succeeded a 12-year reign of New Labour in the United Kingdom, and ushered in massive welfare cuts. Although New Labour tabled major welfare and disability benefit reform, they arguably did not activate the harshest of these. This paper focuses on the backlash of youth and disability in the form of demonstrations; two groups that are being hit hard by the political shift to work-first welfare in an era of employment scarcity. The case of young disabled activist Jody McIntyre is used to explore parallels and divergences in neoliberal and ‘populist’ discourses of ‘risky’, troubling’ youth and disability

RCOG Workforce Report 2022

Since the last RCOG workforce report in 2018, the O&G profession has faced many challenges. Although the birth rate is falling nationally, there are rising levels of clinical complexity, budget cuts and staffing shortages of doctors, midwives, nurses and other allied professionals. Whilst demand for services in some areas is declining, there are increased requirements in other areas due to demographic shifts, an aging population and rising levels of obesity. All of this has been magnified and compounded by the Covid-19 pandemic which has required health professionals to work differently and adapt services to continue to provide care to women

Adding Spirituality, Religious Diversity, and Interfaith Engagement to Student Affairs Courses

Gaduate school curricula provide the baseline knowledge for profes-sionals in the field of higher education and student affairs (HESA). Before beginning their careers, student affairs practitioners build their core competencies around a variety of relevant topics including, quite significantly, college student identity and diversity. ACPA–College Student Educators International (2018) offers an online syllabus clearinghouse as an open-access resource for faculty seeking to develop courses in HESA programs. Although 20 of the 29 clearinghouse syllabi that align with the courses discussed in this chapter mention religion, spirituality, or related top-ics, the type of inclusion ranges dramatically from a substantive element of a course, including readings, assignments, and discussions, to a mere mention of religion as one in a list of elements of student or campus diversity...https://scholarworks.wm.edu/educationbookchapters/1050/thumbnail.jp

Regional Platform for Health and Wellbeing pilot study: provision of online weight management support via the workplace

Introduction The workplace presents an opportunity for improving health and wellbeing, including supporting employees with their weight management. The East Midlands Platform for Health and Wellbeing is a unique regional network of private, public and voluntary sector organisations working to improve health and reduce obesity. Member organisations commit to actions that improve the health and wellbeing of employees, individuals and/or communities. As part of Slimming World’s commitment to the platform, and building on a previous workplace group-based weight management study (Lavin et al, 2013), this pilot assessed the merits of providing online weight management support via the workplace at a large regional employer. Methods 73 Nottingham City Council employees were offered 12 weeks’ weight management support with Slimming World’s online programme. The programme allows unlimited access to behaviour change support around diet and physical activity and requests a once weekly weigh-in. Weight change was self-reported weekly using Slimming World calibrated scales placed within each worksite. Dietary and physical activity behaviours, along with aspects of psychological wellbeing were assessed by questionnaires pre-and post-programme. Results 57 participants (meeting inclusion criteria) took part in the trial and were included within the analysis. 16 employees were excluded from the analysis due to; non completion of baseline questionnaire, not being able/did not wish to join the online programme, requesting to be removed, or because they did not submit any weight changes. Weight change and online participation: Mean (SD) joining BMI was 35.3 (5.9) kg/m2. 44 participants (77%) were classed as completing the programme (logged into the online programme and submitted at least 1 weight change within the final 4 weeks). Conclusion Providing online weight management support via the workplace resulted in individuals achieving significant weight loss (-3.9%). Those who completed the programme and both pre-and postprogramme questionnaires showed positive changes in behavioural outcomes, including healthy eating and physical activity habits, and psychological wellbeing, which may impact on working life. These results suggest that the Slimming World online weight management programme could be a practical option within workplace health and wellbeing programmes

Providing weight management via the workplace

Purpose Assess the feasibility and benefits of providing weight management support via the workplace. Design Quasi-experimental design using non-random assignment to a 12 week Slimming World (SW) weight management programme, either within the workplace or at a regular community group. Weight was recorded weekly and a 39-item questionnaire focussed on mental and emotional health, self-esteem, dietary habits and physical activity habits administered at baseline, 12 weeks, 6 and 12 months. Findings 243 participants enrolled (workplace n=129, community n=114) with 138 completers (defined as those weighing-in at baseline and attending at least once within the last 4 weeks; workplace n=76, community n=62. Completers reported a mean weight change of -4.9kg ± 3.4 or -5.7% ± 3.8. Mental and emotional health scores increased (P<0.05) from baseline to 12 weeks. Self-worth scores increased (P<0.05) from baseline to 12 weeks, 6 months and 12 months. Healthy dietary habit scores increased and unhealthy dietary habit scores decreased (P<0.05) from baseline to 12 weeks, 6 months and 12 months. Healthy physical activity habit scores improved (P<0.05) from baseline to 12 weeks and 6 months. There were no significant differences between groups. Research limitations Participant demographic was predominantly female (94%) aged 42.3 years, with only 13 men participating. Practical implications The results support the use of a 12 week SW weight management programme as a credible option for employers wanting to support employees to achieve weight loss and improve psycho-social health outcomes which could lead to improvements in quality of life and work performance Originality/value Provides evidence for the delivery of weight management support via the workplace

The cation diffusion facilitator protein MamM's cytoplasmic domain exhibits metal-type dependent binding modes and discriminates against Mn2+

Cation diffusion facilitator (CDF) proteins are a conserved family of divalent transition metal cation transporters. CDF proteins are usually composed of two domains: the transmembrane domain (TMD), in which the metal cations are transported through, and a regulatory cytoplasmic C-terminal domain (CTD). Each CDF protein transports either one specific metal, or multiple metals, from the cytoplasm, and it is not known if the CTD takes an active regulatory role in metal recognition and discrimination during cation transport. Here, the model CDF protein MamM, an iron transporter from magnetotactic bacteria, was used to probe the role of the CTD in metal recognition and selectivity. Using a combination of biophysical and structural approaches, the binding of different metals to MamM CTD was characterized. Results reveal that different metals bind distinctively to MamM CTD in terms of their binding sites, thermodynamics and binding-dependent conformations, both in crystal form and in solution, which suggests a varying level of functional discrimination between CDF domains. Furthermore, these results provide the first direct evidence that CDF CTDs play a role in metal selectivity. We demonstrate that MamM's CTD can discriminate against Mn2+, supporting its postulated role in preventing magnetite formation poisoning in magnetotactic bacteria via Mn2+ incorporation

Laparoscopic adjustable gastric banding – should a second chance be given?

Background: Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods: The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results: A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions: Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB

Effective implementation of peri-operative local guidelines for metabolic surgery in patients with diabetes mellitus in a tier 4 setting demonstrate improved work efficiency and resource allocation

Background Dynamic changes in glycaemia predominate peri-operatively in patients with type 2 diabetes mellitus (T2DM) undergoing metabolic surgery. There is a lack of consensus and clear guidance on effective glycaemic management of such patients. The aim of this study was to design, pilot, and implement a proforma to improve consistency of glycaemic management and clarity of communication with healthcare professionals following metabolic surgery in patients with T2DM, thereby reducing unnecessary diabetes specialist nurse (DSN) referrals. Methods A proforma was designed and piloted for 12 months to guide healthcare professionals on managing glycaemic therapies for T2DM patients undergoing metabolic surgery. Glycaemic control (HbA1c) and glycaemic therapies were reviewed 3 weeks pre-operatively and a proforma was completed accordingly. Results Of the patients with T2DM (n = 34) who underwent metabolic surgery prior to the new proforma being implemented, 71% (n = 24) had a DSN referral. Half of these referrals were deemed unnecessary by the DSNs. Of the patients with T2DM (n = 33) who underwent metabolic surgery following implementation of the proforma, 21% (n = 7) had a DSN referral. Only 10% of these were deemed unnecessary. Despite the reduced DSN input, no diabetes-related complications were reported. Conclusion Implementation of our proforma effectively halved the proportion of patients with T2DM requiring a DSN referral. Additionally, there was a 40% absolute reduction in the proportion of unnecessary DSN referrals. The proforma improved clarity of communication and guidance for healthcare professionals in the glycaemic management of patients. This also facilitated improved work efficiency and resource allocation

Metal binding to the dynamic cytoplasmic domain of the cation diffusion facilitator (CDF) protein MamM induces a 'locked-in' configuration

Cation diffusion facilitator (CDF) proteins are a conserved family of transmembrane transporters that ensure cellular homeostasis of divalent transition metal cations. Metal cations bind to CDF protein's cytoplasmic C-terminal domain (CTD), leading to closure from its apo open V-shaped dimer to a tighter packed structure, followed by a conformational change of the transmembrane domain thus enabling transport of the metal cation. By implementing a comprehensive range of biochemical and biophysical methods, we studied the molecular mechanism of metal binding to the magnetotactic bacterial CDF protein MamM CTD. Our results reveal that the CTD is rather dynamic in its apo form, and that two dependent metal binding sites, a single central binding site and two symmetrical, peripheral sites, are available for metal binding. However, only cation binding to the peripheral sites leads to conformational changes that lock the protein in a compact state. Thus, this work reveals how metal binding is regulating the sequential uptakes of metal cations by MamM, and extends our understanding of the complex regulation mechanism of CDF proteins. This article is protected by copyright. All rights reserved