Perceptions and beliefs about body size, weight, and weight loss among obese African American women: a qualitative inquiry.

The purpose of this qualitative study was to explore perceptions and beliefs about body size, weight, and weight loss among obese African American women in order to form a design of weight loss intervention with this target population. Six focus groups were conducted at a community health clinic. Participants were predominantly middle-aged with a mean Body Mass Index of 40.3 +/- 9.2 kg/m(2). Findings suggest that participants (a) believe that people can be attractive and healthy at larger sizes; (b) still feel dissatisfied with their weight and self-conscious about their bodies; (c) emphasize eating behavior as the primary cause for weight gain; (d) view pregnancy, motherhood, and caregiving as major precursors to weight gain; (e) view health as the most important reason to lose weight; (f) have mixed experiences and expectations for social support for weight loss; and (g) prefer treatments that incorporate long-term lifestyle modification rather than fad diets or medication.     

Tissue deformation and shape models in image-guided interventions: a discussion paper

This paper promotes the concept of active models in image-guided interventions. We outline the limitations of the rigid body assumption in image-guided interventions and describe how intraoperative imaging provides a rich source of information on spatial location of anatomical structures and therapy devices, allowing a preoperative plan to be updated during an intervention. Soft tissue deformation and variation from an atlas to a particular individual can both be determined using non-rigid registration. Established methods using free-form deformations have a very large number of degrees of freedom. Three examples of deformable models--motion models, biomechanical models and statistical shape models--are used to illustrate how prior information can be used to restrict the number of degrees of freedom of the registration algorithm and thus provide active models for image-guided interventions. We provide preliminary results from applications for each type of model.     

Multiparity modifies contractile properties of pelvic muscles affecting the genesis of vaginal pressure in rabbits

Aims

To characterize the contractile properties of the bulbospongiosus (Bsm), isquiocavernosus (Ism), and pubococcygeus muscles (Pcm), and their involvement in the genesis of vaginal pressure in nulliparous and multiparous rabbits.

Methods

Age‐matched nulliparous and multiparous rabbits were used to record the isometric contractile responses of each muscle as well as the intravaginal pressure evoked by single square electrical pulses and stimulation trains of ascending frequency. To establish significant differences between groups, two‐tail unpaired Student t tests were carried out. The linear correlation between intravaginal pressure and muscle contractile force was analyzed with Pearson correlation tests. For all cases, a P ≤ 0.05 was set as statistically significant.

Results

Multiparity decreased the contractile force of Bsm and Ism generated by high‐frequency stimulation trains. The normalized force of the Pcm increased when evoked at 1, 4, and 10 Hz while this decreased at higher frequencies (20, 50, and 100 Hz). The contraction of both Bsm and Ism raised particularly the pressure on the perineal vagina while that of the Pcm increased the pressure in the pelvic vagina. Such a functional segregation is still present in multiparous rabbits albeit it was modified.

Conclusions

Multiparity induces changes in the contractile responses of Bsm, Ism, and Pcm, which alterates the vaginal pressure.     

Food Insecurity Is Associated with the Quality of Diet of Non-Institutionalized Older Adults from a Southern Chilean Commune: A Cross-Sectional Study

As the population ages, greater attention to age-related health problems related to diet and lifestyles is needed. Here, we sought to evaluate the associations between demographic and clinical characteristics and food insecurity with the quality of diet of non-institutionalized elderly from a southern Chilean commune. We performed an analytical cross-sectional study in a sample of 376 older adults. Nutritional status was evaluated through anthropometric measurements. Quality of diet was determined by the healthy eating index (HEI), obtained through the frequency of consumption questionnaire. Socioeconomic, demographic, and lifestyle variables were also collected. Ordinal logistic and Poisson regression models were applied to study associations with quality of diet. The sample consisted of more women (81.6%) than men (18.4%). Most older adults were found to live in a situation of vulnerability or poverty (82.4%), with most having food security (65.7%). According to the HEI, only 14.1% had a good quality of diet, 83.8% had diet in need of improvement, and 2.1% had an unhealthy diet. There was an association of food insecurity and cardiovascular risk (according to waist circumference) with lower quality of diet categories. However, an association with the unhealthy quality of diet category was not confirmed with Poisson regression analysis, which was possibly due to the low number of subjects in that category (n = 8, 2.1%). Other modifiable factors like physical activity, hours of sleep, and polypharmacy were not associated with lower quality of diet categories. Socioeconomic status, which is a structural health determinant, was not associated with decreased quality of diet. Since this was a cross-sectional study performed on a small sample from a Chilean commune, directionality of associations cannot be discerned, and future longitudinal studies could aim to better characterize these associations in larger samples of elderly patients.     

Association of Differences in Dietary Behaviours and Lifestyle with Self-Reported Weight Gain during the COVID-19 Lockdown in a University Community from Chile: A Cross-Sectional Study

Domiciliary confinement of people is one of the main strategies to limit the impact of COVID-19. Lockdowns have led to changes in lifestyle, emotional health, and eating habits. We aimed to evaluate the association of differences in dietary behaviours and lifestyle with self-reported weight gain during the COVID-19 lockdown in Chile. In this cross-sectional analytical study, five previously validated surveys were condensed into a single 86-item online questionnaire. The survey was sent to 1000 potential participants of the university community; it was kept online for 28 days to be answered. Of the 639 respondents, the mean self-reported weight gain during confinement was 1.99 kg (standard deviation [SE]: 0.17) and 0.7 (SE: 0.06) units of body mass index (BMI) (both p < 0.001) and the median difference in body weight during lockdown was 3.3% (interquartile range [IQR]: 0.0–6.7). The differences of intake of most food groups before and during lockdown were associated with greater self-reported weight, BMI and percentage weight gain. Differences in lifestyle (odds ratio [OR] = 14.21, 95% confidence interval [95%CI]: 2.35–85.82) worsening eating habits (OR = 3.43, 95%CI: 2.31–5.09), and more consumption of sweet or filled cookies and cakes during lockdown (OR = 2.11, 95%CI: 1.42–3.13) were associated with self-reported weight gain. In conclusion, different dietary behaviours (mainly consumption of industrialized foods) during lockdown, as well as quality of life deterioration were the main factors associated with self-reported weight gain during lockdown.     

Review

Les Bébés à Risque Autistique [Babies at Risk of Autism] Delion, P. (Ed.): Collection Mille et Un Bebes (P. Ben Soussan, Series Editor); Ramonville‐Sainte‐Agne: Editions Erès, 1998 122pp ISBN 2–86586–640–8.

La Maman et son Bébé: un Regard [The Mother and her Baby: A Glance] Sandri, R. Lyon: Cesura, 1991 311 pp ISBN 2–905709–55–3.

Psychoanalysis and developmental therapy (Ed.) Anne Hurry, London: Karnac Books, 1998 237 pp ISBN 1 85575 213 1

Jungian Psychotherapy and Contemporary Infant Research: Basic Patterns of Emotional Exchange By Mario Jacoby. London: Routledge, 1999 206 pp ISBN O‐415–20142‐X (hbk)     

An integrated platform for image-guided cardiac resynchronization therapy

Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7?mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets by computing the registration error of the LV pacing lead electrodes which was found to be 2.2 ± 0.9?mm. Furthermore, the use of Unfold Navigation was demonstrated in real-time for four clinical cases.     

Effect of orange juice,folic acid,and oral contraceptives on serum folate in women taking a folate-restricted diet.

The effect of folate intake from orange juice on serum folate was evaluated in 60 women (age 20-39) during 9 weeks of a folate-restricted diet. Twenty-one were users of oral contraceptives (OCA). Folate intake from the restricted diet was 159 +/? 5 micrograms/day, as assessed by dietary surveys. Serum folate of women taking OCA was lower than in nonusers at the inception of the study (P less than 0.01). During the initial 2 weeks of restricted diet, serum folates decreased significantly (13.8 +/? 1.8 to 8.5 +/? 0.4 ng/ml; P less than 0.002). This decrease was further prevented by supplementation of the diet for 7 weeks with 100 micrograms/day of total folate from reconstituted frozen orange juice or synthetic folic acid (PteGlu). Both folate supplements were effective (P less than 0.05) in increasing serum folate (9.4 +/? 1.0 to 14.5 +/? 1.4 ng/ml, orange juice; 8.4 +/? 0.7 to 20.5 +/? 5.8 ng/ml, folic acid). Serum folates were similar in women taking either orange juice or folic acid. Serum folate of nonsupplemented women decreased from 10.2 +/? 0.8 to 8.3 +/? 0.4 ng/ml (P less than 0.05). No difference between serum folates of OCA users and nonusers was detected during the restricted diet or folate supplementation. These data indicate that folate in reconstituted orange juice was as available as folic acid, and that utilization of both folate forms and folate in a mixed diet was unaffected by oral contraceptives.     

Extended-Field-of-View Three-Dimensional Transesophageal Echocardiography Using Image-Based X-Ray Probe Tracking

The use of ultrasound imaging for guidance of cardiac interventional procedures is limited by the small field of view of the ultrasound volume. A larger view can be created by image-based registration of several partially overlapping volumes, but automatic registration is likely to fail unless the registration is initialized close to the volumes' correct alignment. In this article, we use X-ray images to track a transesophageal ultrasound probe and thereby provide initial position information for the registration of the ultrasound volumes. The tracking is possible using multiple X-rays or just a single X-ray for each probe position. We test the method in a phantom experiment and find that with at least 50% overlap, 88% of volume pairs are correctly registered when tracked using three X-rays and 86% when using single X-rays. Excluding failed registrations with errors greater than 10 mm, the average registration accuracy is 2.92 mm between ultrasound volumes and 4.75 mm for locating an ultrasound volume in X-ray space. We conclude that the accuracy and robustness of the registrations are sufficient to provide useful images for interventional guidance.