Potential direct secondary care cost benefits of HealthyWeightHub - Virtual Hospital 2.0 digital lifestyle intervention

Peer reviewe

Weight Loss Trajectories in Healthy Weight Coaching : Cohort Study

Background: As global obesity prevalence continues to increase, there is a need for accessible and affordable weight management interventions, such as web-based programs. Objective: This paper aims to assess the outcomes of healthy weight coaching (HWC), a web-based obesity management program integrated into standard Finnish clinical care. Methods: HWC is an ongoing, structured digital 12-month program based on acceptance and commitment therapy. It includes weekly training sessions focused on lifestyle, general health, and psychological factors. Participants received remote one-on-one support from a personal coach. In this real-life, single-arm, prospective cohort study, we examined the total weight loss, weight loss profiles, and variables associated with weight loss success and program retention in 1189 adults (963 women) with a BMI >25 kg/m(2) among participants of the program between October 2016 and March 2019. Absolute (kg) and relative (%) weight loss from the baseline were the primary outcomes. We also examined the weight loss profiles, clustered based on the dynamic time-warping distance, and the possible variables associated with greater weight loss success and program retention. We compared different groups using the Mann-Whitney test or Kruskal-Wallis test for continuous variables and the chi-squared test for categorical variables. We analyzed changes in medication using the McNemar test. Results: Among those having reached the 12-month time point (n=173), the mean weight loss was 4.6% (SE 0.5%), with 43% (n=75) achieving clinically relevant weight loss (>= 5%). Baseline BMI >= 40 kg/m(2) was associated with a greater weight loss than a lower BMI (mean 6.6%, SE 0.9%, vs mean 3.2%, SE 0.6%; P=.02). In addition, more frequent weight reporting was associated with greater weight loss. No significant differences in weight loss were observed according to sex, age, baseline disease, or medication use. The total dropout rate was 29.1%. Dropouts were slightly younger than continuers (47.2, SE 0.6 years vs 49.2, SE 0.4 years; P=.01) and reported their weight less frequently (3.0, SE 0.1 entries per month vs 3.3, SE 0.1 entries per month; P Conclusions: A comprehensive web-based program such as HWC is a potential addition to the repertoire of obesity management in a clinical setting. Heavier patients lost more weight, but weight loss success was otherwise independent of baseline characteristics.Peer reviewe

Weight Loss Trajectories in Healthy Weight Coaching: Cohort Study

BACKGROUNDAs global obesity prevalence continues to increase, there is a need for accessible and affordable weight management interventions, such as web-based programs.OBJECTIVEThis paper aims to assess the outcomes of healthy weight coaching (HWC), a web-based obesity management program integrated into standard Finnish clinical care.METHODSHWC is an ongoing, structured digital 12-month program based on acceptance and commitment therapy. It includes weekly training sessions focused on lifestyle, general health, and psychological factors. Participants received remote one-on-one support from a personal coach. In this real-life, single-arm, prospective cohort study, we examined the total weight loss, weight loss profiles, and variables associated with weight loss success and program retention in 1189 adults (963 women) with a BMI >25 kg/m² among participants of the program between October 2016 and March 2019. Absolute (kg) and relative (%) weight loss from the baseline were the primary outcomes. We also examined the weight loss profiles, clustered based on the dynamic time-warping distance, and the possible variables associated with greater weight loss success and program retention. We compared different groups using the Mann-Whitney test or Kruskal-Wallis test for continuous variables and the chi-squared test for categorical variables. We analyzed changes in medication using the McNemar test.RESULTSAmong those having reached the 12-month time point (n=173), the mean weight loss was 4.6% (SE 0.5%), with 43% (n=75) achieving clinically relevant weight loss (≥5%). Baseline BMI ≥40 kg/m² was associated with a greater weight loss than a lower BMI (mean 6.6%, SE 0.9%, vs mean 3.2%, SE 0.6%; P=.02). In addition, more frequent weight reporting was associated with greater weight loss. No significant differences in weight loss were observed according to sex, age, baseline disease, or medication use. The total dropout rate was 29.1%. Dropouts were slightly younger than continuers (47.2, SE 0.6 years vs 49.2, SE 0.4 years; P=.01) and reported their weight less frequently (3.0, SE 0.1 entries per month vs 3.3, SE 0.1 entries per month; PCONCLUSIONA comprehensive web-based program such as HWC is a potential addition to the repertoire of obesity management in a clinical setting. Heavier patients lost more weight, but weight loss success was otherwise independent of baseline characteristics.</p

Fiesta y trabajo: la oposición entre conquistadores y conquistados. Parte II

Segunda parte del trabajo en el que se aborda la relación fiesta-trabajo en la cultura rarámuri como oposición a la cultura occidental. En este bloque se habla del trabajo como la religión del hombre blanco, considerada actividad fundamental para la subsistencia e instrumento único para la humanización de la sociedad. Desde esta perspectiva, el trabajo es planteado como camino único hacia la liberación de la necesidad traducida generalmente en términos de fiesta o supresión del trabajo. Se habla de los resultados y consecuencias del proyecto occidental del trabajo en comparación con la concepción de esta actividad en otros grupos humanos

Kuinka valmistaudun tähystykseen? : opaslehtinen tähystykseen tulevalle lapselle

Opinnäytetyömme käsittelee leikki-ikäisten ja kouluikäisten lasten valmistamista tähystystutkimukseen. Suurin osa tähystystutkimuksista tehdään päiväkirurgiassa. Päiväkirurgia on suuri haaste lapsen ja perheen ohjaukselle, sillä vanhempien rooli lapsen valmistamisessa toimenpiteeseen ja sen jälkeiseen hoitoon on suuri. Hoitajilla tulee olla valmiuksia antaa yksilöllistä ohjausta lapsen kehitystaso huomioon ottaen hoidon eri vaiheissa ja oikein ajoitettuna. Opinnäytetyön tuotos on tehty yhteistyössä Päijät-Hämeen sosiaali- ja terveysyhtymän lastentautien osasto 12:n kanssa. Tuotoksen teoreettisen viitekehyksen pohjalta laadittiin uudet kirjalliset opaslehtiset gastro- ja kolonoskopiaan tuleville lapsille. Opaslehtiset on jaettu neljään ryhmään: alle 10-vuotiaille, 10-16 -vuotiaille, gastroskopiaan tai kolonoskopiaan tuleville lapsille. Lehtisen avulla vanhemmat voivat käydä lapsen kanssa läpi sairaalassaoloaikaa ja toimenpidettä. Opaslehtisestä selviää lapselle, mitä sairaalassa tapahtuu ennen toimenpidettä, toimenpiteen aikana sekä toimenpiteen jälkeen. Tavoitteena on selkeyttää osaston toimintatapoja tähystykseen tulevan lapsen ohjauksessa ja näin ollen tukea hoitajien työtä. Opaslehtinen tuntui meistä hyvältä tavalta edistää tiedonsaantia, koska lasten saama suullinen ohjaus osastolta kaipasi lisäksi kirjallista tukea.Our thesis talks about the preparation of infants and school aged children for endoscopy. Most of the endoscopies are made in day surgery. Day surgery is a great challenge for guiding a child and his parents, because parents’ role is major in preparing a child for operation and nursing afterwards. Nurses should have preparedness to give individual guiding at different points of treatment considering child’s development stage. The product was made in co-operation with Päijät-Hämeen Social and Health Care department and it’s children’s ward 12. We created new written leaflets for children who will have an edoscopy, based on our theoretical context. The leaflets have been divided into four sections: for under 10 year olds and from 10 to 16 years old children coming to gastroscopy or colonoscopy. Parents can go through the upcoming stay in hospital and operation with the help of these leaflets. The leaflets explain what happens in the hospital before operation, during the operation and afterwards. Our purpose was to clarify the division’s procedures of guiding a child who is coming for an endoscopy and also to support nurse’s work. We consider the leaflet a good way of improving information, because spoken information for children received on the childeren’s ward needed a written supplement

The Effectiveness of eHealth Interventions for Weight Loss and Weight Loss Maintenance in Adults with Overweight or Obesity : A Systematic Review of Systematic Reviews

Purpose of ReviewThe purpose of this study is to evaluate the effectiveness of eHealth interventions for weight loss and weight loss maintenance among adults with overweight or obesity through a systematic review of systematic reviews.Recent FindingsThis study included 26 systematic reviews, covering a total of 338 original studies, published between 2018 and 2023. The review indicates that eHealth interventions are more effective than control interventions or no care and comparable to face-to-face interventions. The effect sizes remain relatively small when comparing eHealth interventions to any control conditions, with mean differences of weight loss results from - 0.12 kg (95% CI - 0.64 to 0.41 kg) in a review comparing eHealth interventions to face-to-face care to - 4.32 kg (- 5.08 kg to - 3.57 kg) in a review comparing eHealth interventions to no care. The methodological quality of the included studies varies considerably. However, it can be concluded that interventions with human contact work better than those that are fully automated.In conclusion, this systematic review of systematic reviews provides an updated understanding of the development of digital interventions in recent years and their effectiveness for weight loss and weight loss maintenance among adults with overweight or obesity. The findings suggest that eHealth interventions can be a valuable tool for delivering obesity care to more patients economically. Further research is needed to determine which specific types of eHealth interventions are most effective and how to best integrate them into clinical practice.Peer reviewe

Development and validation of a weight-loss predictor to assist weight loss management

Abstract This study aims to develop and validate a modeling framework to predict long-term weight change on the basis of self-reported weight data. The aim is to enable focusing resources of health systems on individuals that are at risk of not achieving their goals in weight loss interventions, which would help both health professionals and the individuals in weight loss management. The weight loss prediction models were built on 327 participants, aged 21–78, from a Finnish weight coaching cohort, with at least 9 months of self-reported follow-up weight data during weight loss intervention. With these data, we used six machine learning methods to predict weight loss after 9 months and selected the best performing models for implementation as modeling framework. We trained the models to predict either three classes of weight change (weight loss, insufficient weight loss, weight gain) or five classes (high/moderate/insufficient weight loss, high/low weight gain). Finally, the prediction accuracy was validated with an independent cohort of overweight UK adults (n = 184). Of the six tested modeling approaches, logistic regression performed the best. Most three-class prediction models achieved prediction accuracy of > 50% already with half a month of data and up to 97% with 8 months. The five-class prediction models achieved accuracies from 39% (0.5 months) to 89% (8 months). Our approach provides an accurate prediction method for long-term weight loss, with potential for easier and more efficient management of weight loss interventions in the future. A web application is available: https://elolab.shinyapps.io/WeightChangePredictor/ . The trial is registered at clinicaltrials.gov/ct2/show/NCT04019249 (Clinical Trials Identifier NCT04019249), first posted on 15/07/2019

Universal membrane-labeling combined with expression of Katushka far-red fluorescent protein enables non-invasive dynamic and longitudinal quantitative 3D dual-color fluorescent imaging of multiple bacterial strains in mouse intestine

Background: The human gastrointestinal (GI) tract microbiota has been a subject of intense research throughout the 3rd Millennium. Now that a general picture about microbiota composition in health and disease is emerging, questions about factors determining development of microbiotas with specific community structures will be addressed. To this end, usage of murine models for colonization studies remains crucial. Optical in vivo imaging of either bioluminescent or fluorescent bacteria is the basis for non-invasive detection of intestinal colonization of bacteria. Although recent advances in in vivo fluorescence imaging have overcome many limitations encountered in bioluminescent imaging of intestinal bacteria, such as requirement for live cells, high signal attenuation and 2D imaging, the method is still restricted to bacteria for which molecular cloning tools are available. Results: Here, we present usage of a lipophilic fluorescent dye together with Katushka far-red fluorescent protein to establish a dual-color in vivo imaging system to monitor GI transit of different bacterial strains, suitable also for strains resistant to genetic labeling. Using this system, we were able to distinguish two different E. coli strains simultaneously and show their unique transit patterns. Combined with fluorescence molecular tomography, these distinct strains could be spatially and temporally resolved and quantified in 3D. Conclusions: Developed novel method for labeling microbes and identify their passage both temporally and spatially in vivo makes now possible to monitor all culturable bacterial strains, also those that are resistant to conventional genetic labeling.Peer reviewe