Maintaining Health and Wellness in College

This covers my lesson on what health and wellness is, different types of health, how to maintain it and helpful campus resources.https://digitalcommons.cortland.edu/corslides/1012/thumbnail.jp

Treatment of severe obesity in adolescents; a mixed method approach

Adolescent obesity is a public health problem associated with significant immediate and long-term health complications (Kelly et al. 2013). Amongst obese adolescents, a third are severely obese (BMI >99.6th centile UK90 reference charts) (Ogden et al. 2012) with severe obesity the fastest growing classification in this age group (Wang et al. 2011). The evidence for managing and treating child and adolescent obesity generally is poor, with multidisciplinary lifestyle programmes failing to derive significant and sustained weight loss and often reporting high attrition (Luttikhuis et al. 2009). Furthermore, this evidence has predominantly focused on young people as a whole with little differentiation of treatment and outcomes by age and severity of obesity. As a result, successful treatments for severely obese adolescents are lacking with permanent bariatric surgery increasingly considered. This thesis aimed to enhance the understanding of the needs of obese adolescents, contribute to what is known about current treatment options for severely obese adolescents specifically and pilot a novel treatment approach within this population. A qualitative enquiry (Study 1) of the lived experiences of obese adolescents (n = 12) reinforced the complexity of the impact of obesity on the lives of obese adolescents across social, emotional, behavioural and cultural contexts. All participants experienced low self-esteem and feelings of shame and there were frequent accounts of debilitating bullying. Adolescents required intensive support to develop skills for coping and managing emotional choices, and the importance of family-support within treatment was highlighted. Data confirmed weight loss programmes need to consider the complex experience of obese adolescents in their design, focusing on how to implement long-term lifestyle changes into their ‘real’ lives. Informed by the findings from Study 1 and a comprehensive review of existing treatment options for severely obese adolescents, the use of an intra-gastric balloon alongside a lifestyle support programme (BOB; Study 2) to promote weight loss was piloted in 12 severely obese adolescents (5 males, 7 females; mean age 15 yrs; BMI >3.5 SD; puberty stage 4 or above). Mean weight loss at 12 months (n=9) was 3.05 kg ± 14.69; d=0.002 with improvements in psychosocial health, physical activity and cardiorespiratory fitness also maintained at 12 months. Although, the use of an intra-gastric balloon as an adjunct to a lifestyle programme was well tolerated by participants, large variations in outcome data suggest alternative treatment solutions in this population are warranted. That said, the comprehensive reporting of the intervention and the focus on validated behaviour change techniques to support change is a strength of this study. The qualitative experiences of treatment for participants and their family members were captured throughout treatment (Study 3). All participants acknowledged the experience was harder than anticipated, but recognised the importance of creating shared ownership over making lifestyle changes. Single case data pointed to successful and sustained weight loss where the whole family were actively engaged in treatment, modelling positive lifestyle changes alongside the adolescent. Future studies are encouraged to explore the most effective methods for engaging family members in treatment

Bright Spots: Physical activity investments that work : Active for health Rotherham; Be active to stay healthy

Programme card: Active for Health Rotherham, Be active to stay healthy Country/locality/coverage Rotherham, South Yorkshire, United Kingdom which has an estimated population over 262,000. Target population People living in Rotherham with one or more of the following seven long term conditions; Cardiac, heart failure, stroke, COPD, cancer, lower back pain and a recent fall and/or fracture. What modes/types/domains of physical activity does the program promote? Functional physical activity delivered in community venues aimed at improving rehabilitation and recovery. Which of the 7 best investments the program addresses? Community wide programs and Healthcare What sectors does it involve? The project involves health professionals and exercise specialists by developing a pathway that bridges the gap between National Health Service (NHS) rehabilitation and community physical activity opportunities. Estimated program reach The programme reaches over 1000 patients a year, improving their health and wellbeing. At the time of this publication, 695 patients had registered for the programme and consented to participate in the evaluation. What is special about this program? The programme aims to revolutionise the role that physical activity plays in rehabilitation and recovery, by providing safe, effective and quality assured services in local communities resulting in notable improvements in health and wellbeing. Key programme details Programme website www.rotherhamgetactive.co.uk/activeforhealth #activeforhealth www.facebook.com/activeforhealth

Protocol for: The use of intra-gastric balloons as an adjunct to a lifestyle support programme to promote weight loss in severely obese adolescents

Background: Severe childhood and adolescent obesity (BMI>3.5SD) remains a significant public health priority with an increasing incidence [1] and is associated with significant morbidity including immediate and long-term cardiovascular, metabolic and psychological consequences [2]. Current non-invasive treatments including lifestyle modification and pharmaceutical intervention are of limited effectiveness in this population, which leaves permanent bariatric surgery as the only viable option. As an alternative, intra-gastric balloons offer a reversible, potentially safer and less invasive option for severely obese adolescents for whom all other available treatments have been exhausted. Methods/design: - BOB is a non-randomised pilot study. A cohort of 12 obese adolescents (BMI > 3.5SD, puberty stage 4 or more) aged 13 - 16 years, will be recruited to the study, where an intragastric balloon (ORBERA – inflated to 500-700ml) will be inserted into the stomach for 6 months, whilst receiving intense, weekly, behavioural support for the family. Follow-up will continue for 18 months after balloon removal with reduced behavioural support. The primary outcome measure will be the change in body weight and BMI standard deviation score from baseline following six months with the intragastric balloon and lifestyle therapy. Secondary outcome measures include the assessment of weight maintenance at 18 months post balloon removal, biomedical outcomes including blood glucose levels, physical activity and physical fitness, and psychosocial outcomes such as paediatric health-related quality of life

Evidence on the reach and impact of the social physical activity phenomenon parkrun : a scoping review

The aim of this study was to conduct a scoping review of parkrun literature for evidence of its reach, health impact and appeal whilst identifying gaps for future research. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Six databases were searched according to search terms set a priori. Empirical studies of any design were included if they provided data on participation in, or benefits of, parkrun and were in English. Two authors conducted the searches independently and screened results by title and abstract, followed by full text reviews. A total of 235 records were screened and 15 studies were eligible; 12 were conducted in the UK and three in Australia. Seven were qualitative interview studies, six were quantitative, and two used mixed methods. parkrun reaches groups traditionally underrepresented in other organised sports or physical activity such as women, the insufficiently active and those aged over 35 years. Participants showed sustained improvements in fitness, physical activity levels, and body mass index with a dose–response effect with participation frequency. Qualitative data shows parkrun's location in pleasant environments with opportunities for informal social interaction engages priority groups such as individuals with mental health issues, women and children. The small evidence base suggests parkrun has good reach, and can positively impact participants’ health and wellbeing. The data, however, are currently UK-centric and gaps in research on non-participants, long term health impacts and operationally relevant factors should be addressed

Intragastric balloon as an adjunct to lifestyle programme in severely obese adolescents: Impact on biomedical outcomes, and skeletal health"

Intragastric Balloons are a temporary, reversible, and safer option compared to bariatric surgery to promote significant weight loss leading to improved metabolic outcomes. However due to subsequent weight regain, alternative procedures are now preferred in adults. In adolescents, more amenable to lifestyle change, balloons may be an alternative to less reversible procedures. Our aim was to assess the tolerability and efficacy of the intragastric balloon in severely obese adolescents and the impact of associated weight loss on biomedical outcomes (glucose metabolism, blood pressure, lipid profiles) and bone density. A 2-year cohort study of 12 adolescents (BMI >3.5 s.d., Tanner stage >4) following 6 months intragastric balloon placement was carried out. Subjects underwent anthropometry, oral glucose tolerance test, and DEXA scans at 0, 6 and 24 months. Results showed clinically relevant improvements in blood pressure, insulin: glucose metabolism, liver function and sleep apnoea at 6 months. Changes were not sustained at 2 years though some parameters (Diastolic BP, HBA1c, insulin AUC) demonstrated longer-term improvement despite weight regain. Despite weight loss, bone mass accrual showed age appropriate increases. In conclusion, the intra-gastric balloon was safe, well tolerated and effective in supporting short-term weight loss and clinically relevant improvement in obesity related complications, which resolved in some individuals. Benefits were not sustained in the majority at 2 years.International Journal of Obesity accepted article preview online, 05 September 2017. doi:10.1038/ijo.2017.215