Holiday weight management by successful weight losers and normal weight individuals

This study compared weight control strategies during the winter holidays among successful weight losers (SWL) in the National Weight Control Registry and normal weight individuals (NW) with no history of obesity. SWL (n = 178) had lost a mean of 34.9 kg and had kept > or = 13.6 kg off for a mean of 5.9 years. NW (n = 101) had a body mass index of 18.5-24.9 kg/m(2). More SWL than NW reported plans to be extremely strict in maintaining their usual dietary routine (27.3% vs. 0%) and exercise routine (59.1% vs. 14.3%) over the holidays. Main effects for group indicated that SWL maintained greater exercise, greater attention to weight and eating, greater stimulus control, and greater dietary restraint, both before and during the holidays. A Group x Time interaction indicated that, over the holidays, attention to weight and eating declined significantly more in SW than in NW. More SWL (38.9%) than NW (16.7%) gained > or = 1 kg over the holidays, and this effect persisted 1 month later (28.3% and 10.7%, respectively). SWL worked harder than NW did to manage their weight, but they appeared more vulnerable to weight gain during the holidays.     

Insurance reimbursement in a university-based pediatric weight management clinic

OBJECTIVES: To compare third-party payor reimbursement for patients evaluated in a university-based pediatric weight management clinic in central Kentucky. STUDY DESIGN: Demographic and reimbursement data were reviewed for 120 patients evaluated January to December 2004. Statistical analysis included Kruskal-Wallis test and Friedman's test. RESULTS: Overall, median reimbursement was 60%. For new appointments, contracted (56%) and capitated (60%) reimbursements were higher than Medicaid (55%). For established appointments, Medicaid reimbursement (100%) was higher than contracted (37%) and capitated (58%). CONCLUSION: Our data suggest that reimbursement is influenced by regional factors and is improving in central Kentucky.     

Morality and accountability in a commercial weight management group

Talk about food and eating behaviours invariably contains some reference to morality or accountability. However, there are very few studies that focus upon ;mundane dieting'. This research addresses this by examining 37.83 hours of naturally occurring interaction of how women construct and orient to food and their dieting practices within an everyday type setting. Group members produced accounts with reference to a moral evaluation, such as blame or culpability. It became apparent that both the group leaders and group members could not orient to their behaviour or food without reference to a moral or accountable framework. Implications for health promotion literature and programmes, along with weight management groups are considered.     

Stories of weight management: factors associated with successful and unsuccessful weight maintenance

Objective. Although behavioural interventions are successful in achieving short‐term weight loss, most individuals regain most or all of their weight within a few years. Our aim was to investigate factors that can help in long‐term weight maintenance. Design. Qualitative interviews were conducted in order to elicit experiences, successes, and difficulties associated with weight control over the lifespan. Methods. Participants were 20 adult volunteers (aged 30–67) including lifelong weight maintainers, active weight maintainers who have maintained weight loss, and weight gainers. Thematic analysis was used to highlight differences between weight groups. Results. Successful weight maintainers adopt a staged approach to weight management, including monitoring weight fluctuations and having a clear alarm signal for weight gain that triggers immediate action. They have several behavioural strategies for weight control, comprising relatively small adjustments to diet and/or exercise behaviour and also have clear strategies for coping with lifestyle interruptions. In contrast, unsuccessful weight maintainers display negative cognitive factors, including erratic or inconsistent weight vigilance, failure to respond to warning signs of weight gain, and failure to restrict weight unless in a positive mindset. Further, their coping strategies for weight gain or failed actions are poor. Conclusions. The results suggest that successful weight maintainers, irrespective of current weight band, adopt a staged behavioural approach to weight management that allows them to maintain a fairly stable weight. Encouraging the use of such strategies in those who typically regain weight after dieting may aid them in maintaining weight loss.     

Barriers engaging families and GPs in childhood weight management strategies

Background

The rapid increase in the prevalence of childhood obesity in recent years has led to inconclusive debate about the most effective way to manage the condition and the most appropriate care setting. Primary care has been suggested as a key site to identify and treat obesity in children.

Aim

To identify children from general practice databases with a body mass index (BMI) categorised as ‘obese’, and invite them for a primary care consultation and possible referral to a specialist secondary care clinic.

Design and setting

Targeted screening of GP practice databases for obese children in 12 general practices in Bristol, UK.

Method

Participating GP practices searched databases for children''s BMIs which were then screened by the study team to identify obese children (≥98th centile). Practices invited families of obese children to consult their GP with the potential for referral to a specialist clinic. Follow-up data was recorded with respect to: consultations; consultations about child''s weight; and referrals to specialist clinic; and other referrals.

Results

A total of 285 letters inviting families to consult their GP were sent; 134 patients consulted their GP in the follow-up period (minimum 3 months), and 42 of these consultations discussed the child''s weight. Nineteen patients received a secondary care referral and six received an alternative weight-management referral.

Conclusion

The low take-up following the mail-out of an invitation to consult highlights the inherent difficulties of engaging families and their obese children in care pathways that facilitate long-term weight management.     

The helper-therapy principle applied to weight management specialists

One hundred twenty applicants to a weight management specialist training program were studied over a 33-month period. Following a nine-month training period, Specialists (N = 29; those leading at least one posttraining weight management group) were compared to Contact Controls (N = 31; persons participating in the weight management program, but not in the helper role) and No Contact Controls (N = 60; those not accepted into the training program and whose only contact with the program was for data collection purposes) in a test of the helper-therapy principle. The major question was, "What are the long-term physical, psychological, and behavioral effects on overweight and formerly overweight individuals involved in helping other persons manage their weight?" Data gathered at 12 and 24 months post-training revealed few differences between the total group of specialists and persons in the two control groups. However, when the data were analyzed by the amount of commitment to the specialist role, it was found that the Higher Involved Specialists (N = 16; those who led two or more weight management groups in the year posttraining) were significantly more likely to lose additional weight (or maintain earlier weight losses), to be more consistent in their adherence to the eating and activity levels advocated by the program, to feel better about themselves and their bodies, and to maintain their levels of general well-being than control subjects or the Lesser Involved Specialists. These latter individuals (N = 13) were significantly the worse for having gone through specialist training, but not fully carrying out the specialist role.     

大学生自我效能感的Meta分析

目的:运用Meta分析的方法探讨大学生自我效能感在性别、专业和城乡上的差异。方法:通过检索和筛选文献,共纳入21篇文献,使用Review Manage 5.3软件进行统计分析。结果:男生自我效能感显著高于女生(Z=14.75,P0.001),文科生自我效能感显著高于理科生(Z=4.92,P0.001)。但是大学生自我效能感在城乡差异上不显著(Z=1.08,P=0.28)。结论:大学生自我效能感中,男生和文科生自我效能感高于女生和理科生。     

Self-efficacy effects on feeling states in women

In this study, exercise self-efficacy was manipulated in a laboratory setting and its effects on feeling state responses were examined. A sample consisting largely of Non-Latina White and Latina women (N = 59) were randomly assigned to a low- or high-efficacy condition, and efficacy was manipulated by provision of false feedback and computer data. Feeling state responses were assessed before and after exercise. Efficacy was successfully manipulated, and participants in the high-efficacy condition reported more positive well-being and energy and less psychological distress and fatigue than those in the low-efficacy condition. There wereno significant differences between the two ethnic groups for self-efficacy and feeling state responses. In addition, no clear pattern of relations emerged between efficacy and feeling state responses. The results support structuring exercise treatments in such a way that mastery experiences and positive feedback are maximized to enhance self-efficacy and improve subjective experiences.     

How useful is weight reduction in the management of hypertension?

A group of previously untreated obese hypertensive patients were started on a weight reduction programme supervised by two dietitians working in a general practice surgery. It was stressed from the beginning of the programme that reducing blood pressure was the purpose of the diet. The results of follow-up after six months are presented together with results for a control group of obese hypertensive patients not receiving dietary advice or drug therapy, but being followed by the general practitioner. The weight, systolic blood pressure and diastolic blood pressure of the dieting hypertensive group were significantly lower than those of the non-dieting group after six months. However, the drop-out rate was significantly higher for the dieting group than for the non-dieting group.

The results of a separate comparison between a control group of obese normotensive patients following the same dietary programme and the group of dieting obese hypertensive patients are also presented. Attendance rates and weight loss achieved were significantly better for the hypertensive group than for the normotensive group after 12 months.

Weight reduction appears to be an effective first-line therapy for approximately 50% of obese patients with mild to moderate hypertension, and raised blood pressure appears to provide motivation for such patients to attend a dietitian's clinic and to lose weight.

     

住院精神分裂症患者自我效能感

目的了解住院精神分裂症患者的一般自我效能感及相关因素。方法采用一般自我效能感量表对224例住院精神分裂症患者进行问卷调查,并使用功能大体评定量表(GAF)及阴性症状量表进行评定。结果精神分裂症患者一般自我效能感平均分明显低于常模(t=7.18,P<0.001);且高自我效能感患者GSES得分与SANS得分呈正相关(r=0.563,P<0.01),与GAF得分呈负相关(r=-0.628,P<0.01)。结论住院精神分裂症患者的一般自我效能感较低,且有异常增高现象。     

谈自我效能理论在护理管理中的应用

目的 探讨自我效能理论,培养和提高护士职业自我效能.方法 以自我效能理论为依据,阐述自我效能理论在护理管理中的应用,激发护士积极学习的动机,发挥其工作的潜能.结果 在临床护理管理中应用自我效能理论有着良好的发展空间.结论 培养和提高护士职业自我效能感,能增强护士的自信和个人成就感,充分发挥护理工作的价值.     

教育领域中的自我效能研究进展

本文的目的是对近年来教育领域中的自我效能感研究进行综述。笔者在查阅了国内外大量文献的基础上 ,对自我效能理论背景 ,教师的自我效能信念和学生的自我效能信念对学生学业成就的影响 ,以及学业自我效能的性别差异进行了阐述。简要指出了该领域存在的问题及有待深入研究之处     

体重管理在骨科慢性病防治中的作用

目的:分析体重管理在骨科慢性病防治中的临床作用,为骨科慢性病患者建立良好的饮食和运动习惯.方法:选择2012年6月至2015年6月期间在南京军区南京总医院体检中发现的648例骨科慢性病患者,随机分为对照组和观察组,每组324例.对照组体检后继续现有饮食、运动习惯;观察组体检后进行严格的体重管理,包括个性化的膳食和运动锻炼指导,管理时间均为12个月.比较两组干预前后体重、关节疼痛感、关节活动功能等指标.结果:对照组干预前、干预后6个月、干预后12个月时各指标变化不显著(P＞0.05).观察组干预前、干预后6个月、干预后12个月时的肥胖情况差异显著(P＜0.05),其中以超重、肥胖比例变化最为明显.观察组干预前、干预6个月、干预12个月时的VAS评分(7.40±1.68 vs.6.94±1.42 vs.6.16±1.49)、BI指数(68.84±4.73 vs.74.82±5.33 vs.79.52±5.41)、关节功能优良率(56.48％ vs.65.74％ vs.75.00％)差异显著(P＜0.05).结论:体重管理干预能够有效改善患者的肥胖情况,减轻患者骨科慢性病症状,缓解疼痛,改善生活质量,值得临床重视.     

The effects of weight management programs on self-esteem in pediatric overweight populations

OBJECTIVE: Review published findings on self-esteem and pediatric overweight, and changes in self-esteem subsequent to weight management programs. METHODS: We used PsycInfo and MedLine searches to identify peer-reviewed journal articles examining self-esteem changes following participation in weight management programs. RESULTS: Data regarding the relationship between self-esteem and obesity is mixed. Factors that place overweight children "at-risk" for low self-esteem include early adolescence, female gender, identification with majority cultural standards of body shape, exposure to teasing and peer victimization, a history of greater parental control over feeding, and internal attributions about weight status. Data from intervention studies suggest positive effects on self-esteem across settings. Components related to self-esteem improvements include weight change, parent involvement, and group intervention format. CONCLUSIONS: Well-designed, longitudinal studies using multidimensional measures of self-esteem, and following CONSORT guidelines are needed to confirm and expand these findings. Emphasis should be placed on examining mediators and moderators of self-esteem change.     

Improving reproductive performance in overweight/obese women with effective weight management

Obesity and overweight are common conditions in the developed countries and they carry many health consequences, including some reproductive disorders. There is a very high prevalence of obese women in the infertile population and many studies have highlighted the link between obesity and infertility. A large proportion of infertile women have polycystic ovary syndrome (PCOS) which is also linked with increased risk of obesity and other metabolic anomalies. The association between obesity and/or PCOS and hyperinsulinaemia, hyper androgenism and abnormal secretion of other hormones, such as leptin, underlies many reproductive disorders observed in this population. It has been demonstrated that weight loss can improve the fertility of obese women through the recovery of spontaneous ovulation, whereas others will have improved response to ovarian stimulation in infertility treatment. Therefore, it is proposed that following the initial assessment of infertility and body mass index or other measurement of obesity, various weight management interventions, including diet, exercise or pharmacotherapeutic approaches, should be considered for overweight and obese infertile women.     

The role of gold weight implants in the management of paralytic lagophthalmos

Background/aimThe study aims to evaluate the usage of gold weight implants and monitor complaints and comfort of patients.Materials and methodsA hundred and ninety-one implantations performed between January 2009 and January 2019 were analyzed. Seventy-eight patients included in this study The average age of the patients was 51.3 ± 14.5 years. Forty-five (57.7%) of them were male and 33 (42.3%) female. Patient satisfaction was measured with a questionnaire containing the most common complaints related to gold weight in the literature through telephone surveys.ResultsThe average follow-up time was 74.5 months. Ninety-three-point-five percent of subjects had operational causes, among which the most widespread was acoustic neuroma (44.9%). The average time between facial paralysis and implantation was 141.1 days. Implantation was performed 26.6 days on average after acoustic neuroma surgery and 3.2 days on average after temporal zone malignancy surgery. Thirty-eight patients had their implants removed over either complication (n = 14) or recovery (n = 24). Recovery was the fastest after facial nerve decompression (mean= 4.75 ± 3.6 (2–10) months) and the slowest after 7–12 cranial nerve transfer (mean= 18.3 ± 8.2 (3–31) months). Twenty-six-point-nine percent (n = 21) of patients had complications, of which the most common was extrusion (n = 10). The overall satisfaction rate was 88.5% with the highest in visual acuity and the lowest in continuous requirement for artificial tear. ConclusionThe gold weight implantation is an effective, reversible, and easy procedure significantly reducing complaints regarding paralytic lagophthalmos. Early implementation may be beneficial for ocular complications. A dynamic facial reanimation could terminate need of implant.