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

Peer reviewe

The use of patient specific polyetheretherketone implants for reconstruction of maxillofacial deformities

Purpose: The aim of this study was to evaluate polyetheretherketone (PEEK) as a patient-specific implant (PSI) material in maxillofacial reconstructive surgery. Materials and methods: The retrospective study included a cohort of 24 patients who underwent maxillofacial surgery using PEEK PSIs. Each patient underwent preoperative multislice computed tomography (CT) with 0 degrees tilt of gantry. Based on the CT scan, the PEEK PSIs were planned and manufactured using three-dimensional (3D) modeling and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. All procedures were performed under general anesthesia. Implants were placed intraorally, extraorally or through subciliary, transconjuctival or coronal incisions. Results: In 22 of 24 cases, the PEEK PSI fit well without adjustments. Although the fit to the surrounding bone was perfect in almost all of the cases, the outer contour of the PSI was modified in nine cases before fixation. However, intraoperative implant modification did not affect the infection rate. In two cases, postoperative wound dehiscence and infection needed additional treatment and healed without removal of the implants. Conclusion: The follow-up data in this study showed good outcomes with reliable results for PSI made of PEEK in the maxillofacial region. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd.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

Training the Trainers in Embedding Assessment Literacy into Module Design: A Case Study of a Collaborative Transcreation Project

Translator trainers are being asked to respond in their course and module design to a variety of changing requirements, including institutional, professional and pedagogical ones. This paper proposes a way that translator trainers can respond to two sets of these new requirements. The first are those for a widening conception of translation brought about by the rapid globalisation of markets and the needs for intercultural mediators (Katan, 2016; Massey et al., 2017; Massey & Wieder, 2019). Indeed, Katan finishes the paper with the startling statement ‘There is really no question about it: if T/Is are going to survive they must make the transcreational turn’ (ibid.: 378). The second set of requirements comes from the process of articulating what attributes a graduate should possess and how these attributes are developed (Hughes, 2010). As the Higher Education Academy (HEA, 2012; see also Elkington, 2016) state, one way to ensure that the graduate skills are developed is through new assessment practices based on assessment for learning and assessment literacy. New assessment practices mean that assessment ‘does not just contribute to learning at university, but develops learning and evaluative skills essential for employment and lifelong learning’ (ibid.: 10). This paper offers translation trainers an approach to module design which can address both these sets of demands. The module is designed with a collaborative transcreation project at its core and has incorporated assessment literacy into the design. The study is supported with quantitative and qualitative data gained from a survey of participating students. By introducing the case study of our module design and linking the design to the underlying theories which informed it, the paper provides trainers with a set of concepts which could be applied to their own curricula needs in order to future proof their students in the changing employment market

Ethics and social responsibility in practice: interpreters and translators engaging with and beyond the professions

Interpreting and translation are unregulated activities in most countries, yet interpreters and translators perform challenging work in sensitive domains, such as the law, medicine and social work. Other professionals working in these sectors must complete formal ethics training to qualify, then subscribe to Codes of Practice or Ethics. When they face ethical challenges in their work, they can access ongoing support. They must undertake regular refresher training in ethics. Interpreters and translators rarely have access to this sort of ethical infrastructure. This places the onus on interpreters and translators to reflect on ethical aspects of their practice, for reasons related to both professional performance and social responsibility. This contribution presents original UK-based research with one type of professional ‘clients’ who rely on interpreters and translators, social workers and social work students prior to their first work experience placement. Findings suggest that insufficient attention has been paid to such professional clients and that ethical aspects of professional communication can be compromised as a result. By framing ethics training and ongoing support in terms of social responsibility, we point to some ways in which the different professional groups might communicate and work more effectively with one another and with service users

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

Teaching Intercultural Competence in Translator Training

In this position paper we define an interculturally competent translator as one that demonstrates a high level of intercultural knowledge, skills, attitude and flexibility throughout his or her professional engagements. We argue that to attain this goal in translator training intercultural competence needs to be introduced into the curriculum explicitly and in a conceptually clear manner. In this article we provide an overview of earlier attempts at discussing the role of intercultural communication in translator training curricula and we discuss the various pedagogical and practical challenges involved. We also look at some future challenges, identifying increasing societal diversity as both a source of added urgency into intercultural training and a challenge for traditional biculturally based notions of translators’ intercultural competence and we argue for the central role of empathy. Finally, and importantly, we introduce the contributions to the special issue

Effectiveness of a web-based real-life weight management program : Study design, methods, and participants' baseline characteristics

Obesity is an important public health concern with limited effective treatment options. Internet-based technologies offer a cost-effective means to treat obesity. However, most of the online programs have been of short duration, have focused on a limited number of treatment modalities, and have not utilized the potential of coaching as part of the intervention. In this paper, we present the design, methods and participants' baseline characteristics in a real-life internet-based weight management program. Healthy Weight Coaching (HWC) is a 12-month web-based intervention for the management of obesity. The program is based on the Acceptance and Commitment Therapy and includes themes important for weight loss, including diet, physical activity, psychological factors, and sleep. In addition to the automated, interactive program, a personal coach is allocated to each participant. The participants are nationally enrolled through referrals from primary care, occupational health, hospitals, and private health care units. Adult individuals with BMI >= 25 kg/m(2) without severe complications are included. On a weekly basis, participants submit their weight logs, training sessions, and lifestyle targets to the internet portal and are scheduled to have online discussions with their coaches 26 times over the course of a year. Questionnaires on lifestyle, diet, physical activity, psychological factors, sleep, and quality of life are completed at baseline, 3, 6, 9, and 12 months, and thereafter yearly until 5 years. Additionally, log data on the use of the service and discussions with the coach are collected. The main outcome is weight change from baseline to 12 months. Recruitment to the HWC is ongoing. Baseline data of the participants recruited between Oct 2016 and Mar 2019 (n = 1189) are provided. This research will bring insight into how internet-based technologies can be implemented in the virtual management of obesity.Peer reviewe