Cognitive Behavior Modification and Exercise + Group Counseling for Patients After Bariatric Surgery

The growing obesity epidemic is paralleled by an increasing number of bariatric surgeries. Patients lose significant weight within the first 12-18 months post-surgery with corresponding resolution of many co-morbidities. However, weight loss stabilizes after 18-24 months and 50% or more of patients eventually regain weight (Bond, Phelan, Leahey, Hill, & Wing, 2009; Magro, et al., 2008). Weight regain after loss is associated with return of co-morbidities and deteriorations in health-related quality of life and mood (Karlsson, Taft, Ryden, Sjostrom, & Sullivan, 2007). The purpose of this pilot study was to analyze the effects of a post-surgical behavioral plus counseling intervention on bariatric surgery patients who are struggling to maintain their weight loss ≥ 2 years after surgery. Methods: Project REACH (Relearn how to Eat, increase Activity and Create better Habits) was a 12-week intervention designed to change psychosocial mediators of health behaviors and fitness variables. Patients met for 1 hr each week for cognitive behavior modification and exercise instruction and practice followed by 1 hr of a closed counseling session. Psychosocial variables and fitness were measured before and after the intervention. Descriptive statistics, paired-samples t-tests, and Cohen’s d were applied to the data. Results: Eight women aged 39-68 yr (M = 54.37, SD = 9.62), BMI range 24.4-50.5 kg/m2 (M = 38.16, SD = 7.61) self-selected into the program. At the pre-test, BMI was correlated with diet/lifestyle self-efficacy (r = -.913, p = .002), social support for exercise-friends (r = -.800, p = .017), and exercise planning (r = -.730, p = .040). Distance walked in 6 min (6MWT) increased for the 4 women who completed the post-test (p = .040, d = 1.68). Changes in some fitness (e.g., BMI: d = -0.77) and psychosocial variables (e.g., exercise planning: d = 1.02; dietary cognitive restraint: d = 0.73) had medium and large effects. Conclusions: Targeting exercise, nutrition, and psychological issues together in an intervention can have positive effects on fitness and psychosocial factors that may help patients more than 2 yr post-surgery manage their weight

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Thoracolumbar syndrome

Groin pain in patients can be caused by inguinal pathology as well as referred pain from spinal pathology. Thoracolumbar syndrome is defined by a dysfunction of the thoracolumbar junction referring pain to the dermatomes of T10–L2. Low back pain is the most common complaint and is usually associated with a rotational twisting motion. Pain is unilateral, located in the low lumbar region, and may radiate to the lateral thigh. Pain is often worse with extension. Referred pain to the groin follows the dermatomes of T12 and L1. Most radiological studies will be normal and the diagnosis is made clinically. Criteria for diagnosis include a positive pinch–roll test, posterior iliac crest point tenderness, localized tenderness over affected thoracolumbar segment, and tenderness in the facet joints at the affected level. Diagnostic nerve block over the painful facet joint can confirm diagnosis. Treatments include spinal manipulative therapy, corticosteroid injection around painful facet joint, nonsteroidal anti-inflammatory agents, and physical therapy. Surgical treatment is rarely indicated

Transoral surgery for morbid obesity

Obesity is a serious health problem in the United States. Although laparoscopic surgical procedures are effective in achieving weight loss and improving obesity-related co-morbidities, they are not without their limitations and consequently there is a growing demand for less invasive approaches. Transoral techniques, as both primary and revisional procedures, are promising in this regard as they may provide a safer and more cost-effective means of achieving meaningful weight loss. The aim of this paper is to review the currently available transoral approaches to weight loss, with a particular focus on those applied in human trials