Are individual or group interventions more effective for long-term weight loss in adults with obesity? : A systematic review

ACKNOWLEDGEMENTS The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Southern California Edison SONGS ISFSI Project

Tu14a Addendum to 9-15-0228 - This addendum provides correspondence on the above-referenced staff report, ex parte communications, proposed revisions to the staff report, and staff’s response to comments. The proposed modifications to the staff report do not change staff’s recommendation that the Commission approve CDP # 9-15-0228, as conditioned

The lived experiences of families and individuals affected by haemophilia in relation to the availability of genetic testing services

Ill health may be related to a combination of genetic and environmental factors. Haemophilia, a rare congenital bleeding disorder, predominantly affects males and females may be identified as carriers. Genetic testing is available for individuals and family members who are interested to know their predisposition to the condition Thirty-nine members of a cohesive haemophilia community in Victoria, Australia, were interviewed about their attitudes towards genetic testing. The transcripts were analysed using thematic and narrative analysis techniques. The themes reflected the meanings people attached both to the disease itself and to the use of genetic testing to detect it. Narrative analysis was then employed to investigate these patterns of meaning further. We identified three typical narratives models within this haemophilia community: those of a male with haemophilia, of a female carrier and of a female non-obligate carrier (female without a familial predisposition to haemophilia). Close examination revealed a distinct pattern where aspects of the narratives tended to ʻclusterʼ according to thematic categories. While people in the haemophilia community are broadly in favour of genetic testing and genetic counselling, males with haemophilia have concerns that arise in relation to biological data banks, female carriers are cautious about antenatal testing and support greater communication of risk within families, and female non-obligate carriers are specially concerned about the safety of obstetric practices. The pattern of responses we have identified indicates that, despite the proliferation of issues and themes across the narratives, the number of possible personal narratives in which they are embedded is in fact quite limited. In this sense narrative analysis offers a supplementary dimension to thematic analysis in the elucidation of qualitative data

Make Art Real

The Make Art Real project aims to introduce new audiences to the arts. It supports Theme II of VCU’s Quest for Distinction by promoting and fostering creative expression through innovative collaborations. The project involves displaying existing connections between art and non-art disciplines, as well as making new connections. These unusual pairings are then placed on exhibition through a lunch-time lecture series named “Unexpected_Connections,” which allow faculty, staff, and students to lead and participate in discussions about the reality of art. The lecture series is the first sustainable and reoccurring program to be held in the Depot building, a multidisciplinary facility which is intended to foster interdisciplinary collaborations. The targeted audience includes faculty, staff, students, and members of the greater VCU community

Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men

<b>Background</b><p></p> Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services.<p></p> <b>Objective</b><p></p> The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base.<p></p> <b>Data sources</b><p></p> Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted.<p></p> <b>Review methods</b><p></p> Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis.<p></p> <b>Results</b><p></p> From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two linked reports, and 22 qualitative studies were included. Men were more likely than women to benefit if physical activity was part of a weight-loss programme. Reducing diets tended to produce more favourable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise programme -3.2 kg, 95% CI -4.8 kg to -1.6 kg). The type of reducing diet did not affect long-term weight loss. A reducing diet plus physical activity and behaviour change gave the most effective results. Low-fat reducing diets, some with meal replacements, combined with physical activity and behaviour change training gave the most effective long-term weight change in men [-5.2 kg (standard error 0.2 kg) after 4 years]. Such trials may prevent type 2 diabetes in men and improve erectile dysfunction. Although fewer men joined weight-loss programmes, once recruited they were less likely to drop out than women (difference 11%, 95% CI 8% to 14%). The perception of having a health problem (e.g. being defined as obese by a health professional), the impact of weight loss on health problems and desire to improve personal appearance without looking too thin were motivators for weight loss amongst men. The key components differ from those found for women, with men preferring more factual information on how to lose weight and more emphasis on physical activity programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings. Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice assisted weight loss in some studies. Generally, men preferred interventions that were individualised, fact-based and flexible, which used business-like language and which included simple to understand information. Preferences for men-only versus mixed-sex weight-loss group programmes were divided. In terms of context, programmes which were cited in a sporting context where participants have a strong sense of affiliation showed low drop out rates and high satisfaction. Although some men preferred weight-loss programmes delivered in an NHS context, the evidence comparing NHS and commercial programmes for men was unclear. The effect of family and friends on participants in weight-loss programmes was inconsistent in the evidence reviewed - benefits were shown in some cases, but the social role of food in maintaining relationships may also act as a barrier to weight loss. Evidence on the economics of managing obesity in men was limited and heterogeneous.<p></p> <b>Limitations</b><p></p> The main limitations were the limited quantity and quality of the evidence base and narrow outcome reporting, particularly for men from disadvantaged and minority groups. Few of the studies were undertaken in the UK.<p></p> <b>Conclusions</b><p></p> Weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques. Tailoring interventions and settings for men may enhance effectiveness, though further research is needed to better understand the influence of context and content. Future studies should include cost-effectiveness analyses in the UK setting

Respondent Understanding in Discrete Choice Experiments : A Scoping Review

Acknowledgements The authors would like to acknowledge the contributions of Brendan Mulhern, who gave feedback on the initial project proposal and helped with the full-text reviews, and Bernadette Carr, the librarian who gave assistance developing and implementing the search strategy. Funding During part of this project, Alison Pearce was supported by a University of Technology Sydney Chancellor’s Postdoctoral Research Fellowship and the University of Technology Sydney International Researcher Development Scheme. Mark Harrison is supported by a Michael Smith Foundation for Health Research Scholar Award 2017 (#16813), and holds the UBC Professorship in Sustainable Health Care, which, between 2014 and 2017, was funded by Amgen Canada, AstraZeneca Canada, Eli Lilly Canada, GlaxoSmithKline, Merck Canada, Novartis Pharmaceuticals Canada, Pfizer Canada, Boehringer Ingelheim (Canada), Hoffman-La Roche, LifeScan Canada, and Lundbeck Canada. The Health Economics Research Unit (HERU) receives funding from the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

The effect of deposition conditions on atmospheric pitting corrosion location under Evans droplets on 304L stainless steel

Pit location during atmospheric corrosion of Type 304L stainless steel under MgCl2 droplets depends on initial droplet concentration. Pits formed predominantly in the center of the droplet for concentrations ≥4 M, closer to the perimeter for 1.5 M to 3 M, and were randomly distributed for concentrations ≤1 M. Pits initiated only after the droplets had evaporated to a critical concentration &amp;gt;3 M, where droplets deposited with lower initial concentrations were thinner. The results can be explained in terms of “differential aeration” and IR drop effects, showing that corrosion in “splash zones” may differ from that under aerosol salt deposit layers that deliquesce forming initially saturated solutions.</jats:p

Development and management of systemic lupus erythematosus in an HIV-infected man with hepatitis C and B co-infection following interferon therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>The association of human immunodeficiency virus and immune dysfunction leading to development of autoimmune markers is well described, but human immunodeficiency virus infection is relatively protective for the development of systemic lupus erythematosus. In contrast, development of systemic lupus erythematosus with hepatitis C and with interferon therapy is well described in a number of case reports. We here describe the first case of systemic lupus erythematosus developing in a man infected with human immunodeficiency virus, hepatitis C and hepatitis B co-infection where the onset seems to have been temporally related to interferon therapy.</p> <p>Case presentation</p> <p>We report the occurrence of systemic lupus erythematosus complicating interferon-α therapy for hepatitis C in a 47-year-old asplenic male with haemophilia co-infected with human immunodeficiency virus and hepatitis B. He presented with a truncal rash, abdominal pains and headache and later developed grade IV lupus nephritis requiring haemodialysis, mycophenolate mofetil and steroid therapy. We were able to successfully withdraw dialysis and mycophenolate while maintaining stable renal function.</p> <p>Conclusion</p> <p>Interferon-α is critical in antiviral immunity against hepatitis C but also acts as a pathogenic mediator for systemic lupus erythematosus, a condition associated with activation of plasmacytoid dendritic cells that are depleted in human immunodeficiency virus infection. The occurrence of auto-antibodies and lupus-like features in the coinfections with hepatitis C require careful assessment. Immunosuppressant therapy for lupus risks exacerbating underlying infections in patients with concurrent human immunodeficiency virus, hepatitis B and C.</p