Impact of a Lifestyle Modification Intervention on Health Behaviors and Health Outcomes in a Mexican American population: A Mixed-methods Study

Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population. The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants. Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes. Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS

Intraperitoneal instillation of local anaesthetic (IPILA) in bariatric surgery and the effect on post-operative pain scores: A randomised control trial

Background Effective analgesia during bariatric procedures may be vital as it could reduce post-operative opioid use. This can lead to less nausea which may be associated with shorter post- operative length of stay (LOS). Understanding analgesic requirements in patients with obesity is important due to the varied physiology and increased number of comorbidities. Objectives The aim of this study was to evaluate the efficacy of IntraPeritoneal Instillation of Local Anaesthetic (IPILA) to reduce opioid requirements in patients undergoing laparoscopic bariatric surgery. Methods A double-blinded randomised control trial was conducted to compare intraperitoneal instillation of ropivacaine to normal saline in 104 patients undergoing bariatric surgery. The primary endpoint was pain in recovery with secondary endpoints at 1, 2, 4, 6, 24 and 48 hrs post-operatively. Further endpoints were post-operative analgesic use and LOS. Safety endpoints included unexpected reoperation or readmission, complications and mortality. Results There were 54 patients in the placebo arm and 50 in IPILA. Pain scores were significantly lower in the IPILA group both at rest (p=0.04) and on movement (p=0.02) in recovery with no difference seen at subsequent time points. Equally, IPILA was independently associated with reducing severe postoperative pain at rest and movement (adjusted odds ratio [aOR] 0.28,95%CI 0.11-0.69,p=0.007 and aOR 0.25,95%CI 0.09-0.62,p=0.004, respectively). There was no significant difference in LOS, opioid use, antiemetic use, morbidity or mortality between the intervention and placebo groups. Conclusion The administration of ropivacaine intraperitoneally during laparoscopic bariatric surgery reduces post-operative pain in the recovery room but does not reduce opioid use nor LOS. Key WordsBariatric surgery, intraperitoneal instillation, ropivacaine, post-operative pain Key Points • Intraperitoneal local anaesthetic reduces severe post-operative pain in the recovery room • There is no change in post-operative pain beyond 1 hour • There is no change in overall use of opioids nor length of sta

Autobiographical Memory in Children with Epilepsy

Autobiographical memory involves the recall of personal facts (semantic memory) and re-experiencing of specific personal events (episodic memory). An increasing amount of research has explored autobiographical memory in adults with epilepsy, however little work has been done in children with epilepsy. In the current study 10 children with generalized and focal epilepsy and 10 age and sex-matched controls were administered the Childrens Autobiographical Memory Interview. Children with epilepsy showed deficits in the recall of episodic, but not semantic autobiographical memory in comparison to controls. Children with generalized epilepsy showed impairments in episodic autobiographical memory in contrast to patients with focal epilepsy. Exploratory analyses revealed that verbal memory and language, and age of first seizure were related to episodic autobiographical events. These results have implications for the adjustment of children with epilepsy, so that earlier diagnosis and intervention programs may be placed in order to allow these children to function maximall

DESIGN AND EXPLORATION OF NEW MODELS FOR SECURITY AND PRIVACY-SENSITIVE COLLABORATION SYSTEMS

Collaboration has been an area of interest in many domains including education, research, healthcare supply chain, Internet of things, and music etc. It enhances problem solving through expertise sharing, ideas sharing, learning and resource sharing, and improved decision making. To address the limitations in the existing literature, this dissertation presents a design science artifact and a conceptual model for collaborative environment. The first artifact is a blockchain based collaborative information exchange system that utilizes blockchain technology and semi-automated ontology mappings to enable secure and interoperable health information exchange among different health care institutions. The conceptual model proposed in this dissertation explores the factors that influences professionals continued use of video- conferencing applications. The conceptual model investigates the role the perceived risks and benefits play in influencing professionals’ attitude towards VC apps and consequently its active and automatic use

TENSE MARKERS AMONG HINDI SPEAKING TYPICALLY DEVELOPING CHILDREN

In grammar, tense is a category that expresses time reference with reference to the moment of speaking. Tenses are usually manifested by the use of specific forms of verbs, particularly in their conjugation patterns. Most of the previous research reveals that tenses develop with age and thus older children had more accurate speech and fewer error patterns in their speech. However, in Indian contexts, limited studies are noted in the area of language development in children with intellectual disability Hindi-speaking children. Thus, the present study aims to explore tense markers in Hindi speaking intellectually disabled children and its comparison across mental age (MA) matched typically developing children. The results revealed that syntax develops significantly with the age. Comparison across the two groups showed higher occurrences of tense forms among TD children when compared to the children with ID.  Related studies are discussed clearly in the paper which reveals a number of studies supporting the finding. The present study has significant implications for the assessment of developmental speech disorders among Hindi-speaking group of Indian population

EFFECT OF LOVASTATIN NANO DRUG DELIVERY SYSTEM ON BONE MINERAL DENSITY (BMD) AND BIOMECHANICAL PROPERTIES OF TIBIA BONES OF WISTAR RATS

Objective: In the present study, transdermal nanoemulsion (NE) gel of lovastatin was investigated for its anti-osteoporosis effect on the long bones of rat i.e. tibia. Methods: Male wistar rats (n=30, weighing 180-200g) were taken for this study and grouped as: 1) control (normal saline daily), 2) Dex (dexamethasone sodium; 25 mg/kg subcutaneously twice a week), 3) Dex+LNG5 (lovastatin nanoemulsion gel; 5 mg/kg/d transdermally daily), 4) Dex+LNG10 (lovastatin nanoemulsion gel; 10 mg/kg/d transdermally daily), and 5) Dex+ALN (alendronate sodium; 0.03 mg/kg/d orally daily). All the treatments were carried out for 60 d. At the end of the experiment, all animals were anesthetized using diethyl ether and collected blood samples from retro-orbital venous plexus of rats in dry eppendorf tubes followed by the sacrifice of animals by cervical dislocation method and collected tibia bones of both the legs for analysis. Results: Bone formation biomarkers (OC: osteocalcin, b-ALP: bone-specific alkaline phosphatase, PINP: N-terminal propeptides of type I procollagen) were significantly improved and resorption biomarkers (CTx: C-terminal cross-linking telopeptides of type-I collagen, TRAcP5b: isoform 5b of tartarate resistant acid phosphatase) were significantly reduced in the LNG5 (p<0.05) and LNG10 (p<0.05) treatment groups when compared to Dex. In vivo anti-osteoporotic results demonstrated the formation of new bone in osteoporotic rat tibias. Biomechanical strength testing demonstrated increased load-bearing capacity of rat tibias in the treated animals in comparison with the osteoporotic group (p<0.05 for LNG5 and p<0.01 for LNG10). Conclusion: Thus, the transdermal NE gel formulation of lovastatin demonstrated the greater potential for the treatment of osteoporosis