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Clary-Muronda V, Smith HR. An interprofessional approach to teaching genetics in an undergraduate nursing curriculum. J Prof Nurs 2024; 54:224-227. [PMID: 39266094 DOI: 10.1016/j.profnurs.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Precision health is rapidly becoming a means to individualized approaches to managing health and thus necessitating a nursing workforce with an understanding of genomics and genetics. However, today's nurse in has limited knowledge in precision health, impacting the ability to educate patients and families. METHOD To address this gap, an interprofessional PhD-prepared faculty team comprised of a nurse educator and a molecular biologist developed an undergraduate genetics course. The multiple teaching strategies include active learning modules, problem-based learning and a final debate. RESULTS The teaching methods were augmented multiple times based on student feedback. The debate activity replaced a poster assignment and student feedback has been overwhelmingly positive. CONCLUSION Multiple strategies were used to deliver genomics and genetics content to nursing students that culminate in application-based activities such as case studies and the debate activity have potential to broaden student perspectives. Prospective course changes include increasing the credits for the course, adding time during the debate for rebuttal development and inviting speakers.
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Affiliation(s)
| | - Hannah R Smith
- Jefferson College of Nursing, Philadelphia, PA, United States of America.
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2
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Medina-Aedo M, Beltran J, Valli C, Canelo-Aybar C, Song Y, Ballester M, Bowman-Busato J, Christogiannis C, Grammatikopoulou MG, Groene O, Heijmans M, Hoogendorn M, Killeen SL, Kontouli KM, Mavridis D, Miñambres I, Mueller BS, Niño de Guzman E, Noordman J, Orrego C, Perestelo-Perez L, Saz-Parkinson Z, Seitidis G, Suñol R, Tsokani S, Alonso-Coello P. Recommendations on self-management interventions for adults living with obesity: COMPAR-EU project. Clin Obes 2024; 14:e12667. [PMID: 38757917 DOI: 10.1111/cob.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/29/2024] [Accepted: 03/29/2024] [Indexed: 05/18/2024]
Abstract
Self-management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence-based recommendations for SMIs within the context of the COMPAR-EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR-EU core outcome set and established decision thresholds for each outcome. Recommendations were informed by systematic reviews of effects, cost-effectiveness, and a contextual assessment. To assess the certainty of the evidence and formulate the recommendations, we used the GRADE approach guidance. Overall, SMIs were deemed to have a small impact, but the absence of harmful effects and potential cumulative benefits indicated a favourable balance of effects, despite low certainty. SMIs showed variations in structure, intensity, and resource utilisation, but overall are likely to be cost-effective. Adapting SMIs to local contexts would enhance equity, acceptability, and feasibility, considering patients' values, and availability of resources and teamwork. Consequently, the panel made conditional recommendations favouring SMIs over usual care. The rigorous and explicit recommendations demonstrated the effectiveness of SMIs for adults living with obesity. However, the gaps in the literature influenced the panel to make only conditional recommendations in favour of SMIs. Further research is needed to strengthen the evidence base and improve recommendations' certainty and applicability.
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Affiliation(s)
- Melixa Medina-Aedo
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Jessica Beltran
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Claudia Valli
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Yang Song
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | | | - Christos Christogiannis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Maria G Grammatikopoulou
- Immunonutrition and Clinical Nutrition Unit, Department of Rheumatology and Clinical Immunology, Medical School, University of Thessaly, Biopolis Campus, Larissa, Greece
| | | | - Monique Heijmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Martine Hoogendorn
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Katerina-Maria Kontouli
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Dimitris Mavridis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Inka Miñambres
- Endocrinology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Barcelona, Spain
| | - Beate Sigrid Mueller
- Institute of General Practice, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ena Niño de Guzman
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Janneke Noordman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Lilisbeth Perestelo-Perez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Canary Islands, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | | | - Georgios Seitidis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Rosa Suñol
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Sofia Tsokani
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
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Cooke S, Golusin N, Rattray G, Blyth J, Parkinson M, Hargrave C. The development and implementation of a radiation therapy bariatric protocol. J Med Radiat Sci 2024. [PMID: 39003637 DOI: 10.1002/jmrs.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 06/27/2024] [Indexed: 07/15/2024] Open
Abstract
The rate of obesity is increasing in the Australian population, and this also includes patients with cancer. The safety and dignity of this cohort of patients is paramount as well as the timely acquisition of equipment required to assist patients with obesity to complete a course of radiation therapy (RT). The design and manufacture of equipment used in most RT departments is not suitable for the weight or BMI of all patients presenting for treatment. RT also operates under a unique set of circumstances that differs from the routine hospital environment which prompted the design of an RT bariatric protocol for use in our department. The protocol is based on the mapping of a patient's pathway from simulation and treatment. Treatment technique and equipment limitations as well as information relating to a patient with high BMI are used as trigger points that direct a patient pathway. The bariatric protocol provides the RT team with decision-making support for appropriate resource utilisation ensuring safe and efficient treatment delivery for both the patient and staff. This paper will outline how the RT bariatric protocol was developed and implemented in our department, highlighting areas that required more attention due to the RT-specific environment.
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Affiliation(s)
- Stacey Cooke
- Royal Brisbane and Womens Hospital, Herston, Queensland, Australia
| | | | - Greg Rattray
- Royal Brisbane and Womens Hospital, Herston, Queensland, Australia
| | - Jemma Blyth
- Royal Brisbane and Womens Hospital, Herston, Queensland, Australia
| | | | - Catriona Hargrave
- Mater Health Services, Mater Adult Hospital, Brisbane, Queensland, Australia
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Carrard I, Bayard A, Grisel A, Jotterand Chaparro C, Bucher Della Torre S, Chatelan A. Associations Between Body Weight Dissatisfaction and Diet Quality in Women With a Body Mass Index in the Healthy Weight Category: Results From the 2014-2015 Swiss National Nutrition Survey. J Acad Nutr Diet 2024:S2212-2672(24)00257-0. [PMID: 38830533 DOI: 10.1016/j.jand.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/02/2024] [Accepted: 05/30/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Few studies have examined whether diet quality is lower in women with body weight dissatisfaction compared with women without body weight dissatisfaction. OBJECTIVES (1) Examine the association between body weight dissatisfaction and diet quality among women (18-65 years old) in the healthy weight body mass index (BMI) category, and (2) explore dietary and behavioral patterns among women with body weight dissatisfaction. DESIGN Data were extracted from the cross-sectional 2014-2015 Swiss National Nutrition Survey. PARTICIPANTS/SETTING Population-based sample of 507 women with BMI ≥ 18.5 and < 25. OUTCOME MEASURES Dietary intakes assessed by registered dietitians using 2 nonconsecutive computer-assisted multi-pass 24-hour dietary recalls. Diet quality was measured with a slightly modified version of the Healthy Eating Index (HEI)-2020. STATISTICAL ANALYSES PERFORMED Multiple linear regressions were performed to test the association between body weight dissatisfaction and total HEI-2020 score. Hierarchical cluster analysis was used to identify subgroups of women with body weight dissatisfaction. RESULTS Body weight dissatisfaction was not found to be associated with diet quality (β = -1.73 [-4.18; 0.71], P = .16). However, women who were dissatisfied with their body weight had lower scores for the HEI-2020 total fruits (P = .050) and whole grains (P = .014) components than women who were satisfied with their body weight. Four profiles with different dietary patterns were identified among women with body weight dissatisfaction: "Unhealthy diet with dairy," "Protein and fat," "Vegetables without protein," and "Healthier diet without dairy." CONCLUSIONS Among women with a BMI in the healthy weight category, overall diet quality was not observed to differ between those with or without body weight dissatisfaction. More research is needed to explore the different profiles of dietary intake in women with body weight dissatisfaction.
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Affiliation(s)
- Isabelle Carrard
- Department of Nutrition and Dietetics, School of Health Sciences (HEdS-GE), HES-SO University of Applied Sciences and Arts Western Switzerland Carouge-Geneva, Switzerland.
| | - Alejandra Bayard
- HES-SO, University of Applied Sciences and Arts Western Switzerland, University of Lausanne, Lausanne, Switzerlan
| | - Alexia Grisel
- HES-SO, University of Applied Sciences and Arts Western Switzerland, University of Lausanne, Lausanne, Switzerlan
| | - Corinne Jotterand Chaparro
- Department of Nutrition and Dietetics, School of Health Sciences (HEdS-GE), HES-SO University of Applied Sciences and Arts Western Switzerland Carouge-Geneva, Switzerland
| | - Sophie Bucher Della Torre
- Department of Nutrition and Dietetics, School of Health Sciences (HEdS-GE), HES-SO University of Applied Sciences and Arts Western Switzerland Carouge-Geneva, Switzerland
| | - Angeline Chatelan
- Department of Nutrition and Dietetics, School of Health Sciences (HEdS-GE), HES-SO University of Applied Sciences and Arts Western Switzerland Carouge-Geneva, Switzerland
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Telo GH, Friedrich Fontoura L, Avila GO, Gheno V, Bertuzzo Brum MA, Teixeira JB, Erthal IN, Alessi J, Telo GH. Obesity bias: How can this underestimated problem affect medical decisions in healthcare? A systematic review. Obes Rev 2024; 25:e13696. [PMID: 38272850 DOI: 10.1111/obr.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Obesity is often labeled as a physical characteristic of a patient rather than a disease and it is subject to obesity bias by health providers, which harms the equality of healthcare in this population. OBJECTIVE Identifying whether obesity bias interferes in clinical decision-making in the treatment of patients with obesity. METHODS A systematic review of observational studies published between 1993 and 2023 in MEDLINE, Embase, and Cochrane Library on obesity bias and therapeutic decisions was carried out. The last search was conducted on June 30, 2023. The main outcome was the difference between clinical decisions in the treatment of individuals with and without obesity. The Newcastle-Ottawa scale for observational studies was used to assess for quality. After the selection process, articles were presented in narrative and thematic synthesis categories to better organize the descriptive analysis. RESULTS Of the 2546 records identified, 13 were included. The findings showed fewer screening exams for cancer in patients with obesity, who were also susceptible to less frequent pharmacological treatment intensification in the management of diabetes. Women with obesity received fewer pelvic exams and evidence of diminished visual contact and physician confidence in treatment adherence was reported. Some studies found no disparities in treatment for abdominal pain and tension headaches between patients presented with and without obesity. CONCLUSION The presence of obesity bias has negative effects on medical decision-making and on the quality of care provided to patients with obesity. These findings reveal the urgent necessity for reflection and development of strategies to mitigate its adverse impacts. (The protocol was registered with the international prospective register of systematic reviews, PROSPERO, under the number CRD42022307567).
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Affiliation(s)
- Guilherme Heiden Telo
- Medicine and Health Sciences Graduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Friedrich Fontoura
- Medicine and Health Sciences Graduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Georgia Oliveira Avila
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vicenzo Gheno
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Julia Belato Teixeira
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isadora Nunes Erthal
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Janine Alessi
- Medicine and Health Sciences Graduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Endocrinology Division, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- General Internal Medicine Division, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela Heiden Telo
- Medicine and Health Sciences Graduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- General Internal Medicine Division, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Miao L, Niu X, Huang M, Cao G, Fu C. Association between body mass index and burnout among nurses in China: a cross-sectional study. BMJ Open 2024; 14:e081203. [PMID: 38471687 DOI: 10.1136/bmjopen-2023-081203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES Body mass index (BMI) can affect an individual's health. The night shift is a characteristic of the nursing profession, which is associated with an abnormal BMI. However, few studies have investigated the association between BMI and burnout in Chinese nurses. This study examined the association between BMI and burnout among Chinese nurses. METHODS A total of 1863 nurses from 12 tertiary hospitals in Shandong Province of China were selected. BMI was calculated as body weight divided by height squared. The Maslach Burnout Service Inventory General Survey (MBI-GS) was used to measure the level of burnout among nurses. Ordinal logistic regression was used to analyse the association between BMI and burnout. RESULTS In this study, the prevalence of normal BMI, underweight, overweight, and obesity was 69.2%, 7.5%, 18.2%, and 5.2%, respectively. The prevalence of high emotional exhaustion, high cynicism, and low personal accomplishment among nurses was 26.1%, 38.7%, and 35.6%, respectively. Nurses who were obese were more likely to have high levels of emotional exhaustion (OR=1.493, 95% CI: 1.011 to 2.206) and cynicism (OR=1.511, 95% CI: 1.014 to 2.253), and nurses who were underweight were more likely to have high levels of cynicism (OR=1.593, 95% CI: 1.137 to 2.232) compared with those who were normal weight. CONCLUSIONS Obesity was positively associated with emotional exhaustion and cynicism, and being underweight was only positively associated with cynicism among Chinese nurses. Hospital administrators should consider BMI when taking effective measures to reduce burnout among nurses.
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Affiliation(s)
| | - Xiaogui Niu
- Department of Pediatric Hematology, Binzhou Medical University Hospital, Binzhou, China
| | - Minxiang Huang
- Department of Pediatric Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Gaofang Cao
- School of Health and Management, Binzhou Medical University, Yantai, China
| | - Chang Fu
- School of Health and Management, Binzhou Medical University, Yantai, China
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Saxena I, Swaroop R, Kumar A, Gupta AK, Kumari S, Kumar M. Sensitization Lectures for Reducing Weight Bias in Undergraduate Medical Students. Cureus 2024; 16:e56431. [PMID: 38505142 PMCID: PMC10949035 DOI: 10.7759/cureus.56431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Discrimination exists in one form or another in every society, usually against those who are weaker, in fewer numbers, or different from the rest. Most physicians are empathetic towards their patients but can either not keep an eye on their subordinates or lack the power to act against such employees. Persons experiencing discrimination in healthcare centers may try to avoid or postpone future visits, resulting in delayed diagnosis and treatment of ailments. Obesity bias present in society has crept into healthcare centers and intimidates persons with obesity who are seeking medical aid. Implicit and explicit obesity bias has been recorded in healthcare students. METHODS Data from 102 undergraduate medical students (23 female) who completed this study was analyzed. Implicit bias (tested online using the Implicit Association Test) and explicit bias (measured using four types of tool kits) were measured before and after conducting an obesity sensitization program (OSP) comprising four lectures on the causes and consequences of obesity and obesity discrimination and its consequences. RESULTS The change in implicit bias was not significant. However, a significant reduction was noted in the four different types of tools for explicit bias after conducting the OSP. CONCLUSION OSP helped medical students identify obesity bias and reduce explicit bias. Sensitization lectures conducted in medical colleges and schools can help reduce such discrimination in healthcare centers.
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Affiliation(s)
- Indu Saxena
- Biochemistry, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Rohit Swaroop
- Medicine, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Apurva Kumar
- Medicine, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Arun K Gupta
- Medicine, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Shweta Kumari
- Medicine, All India Institute of Medical Sciences, Gorakhpur, IND
| | - Manoj Kumar
- Physiology, Maharshi Vashishtha Autonomous State Medical College, Rampur, IND
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Dunham M. Obesity bias awareness decreases nursing students' bias toward patients with obesity. Nursing 2024; 54:56-60. [PMID: 38271133 DOI: 10.1097/01.nurse.0000998024.65699.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
PURPOSE To determine if obesity bias scores among nursing students changed after education was delivered and to what degree body mass index (BMI) was associated with a personal experience of bias during a student's healthcare history. METHODS A quantitative, quasi-experimental design was used to analyze sociodemographic information and Implicit Association Test scores of junior, senior, and full-time accelerated coursework track nursing students. RESULTS Generally, obesity bias declined among the group. However, bias increased regarding increasing BMI. CONCLUSION Obesity bias awareness and obesity education can decrease obesity bias among nursing students.
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Affiliation(s)
- Marguerite Dunham
- Marguerite Dunham is an NP and the program coordinator in Bariatric Surgery for Comprehensive Weight Management at Jefferson Health-Abington
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Phillips J. Weight bias and stigma in healthcare: What are we doing about it? Work 2024; 77:731-733. [PMID: 38393880 DOI: 10.3233/wor-246004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Weight bias and weight stigma is present in healthcare settings negatively affecting people with obesity. Healthcare professionals should be aware of how their potential bias and stigma may be impacting clients with obesity. With obesity projected to rise among the world, the healthcare environment needs to be more accepting and accommodating.
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Alick CL, Braxton D, Skinner H, Alexander R, Ammerman AS, Keyserling TC, Samuel-Hodge CD. Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics. Am J Health Promot 2023; 37:1060-1069. [PMID: 37505193 PMCID: PMC10631280 DOI: 10.1177/08901171231190597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. DESIGN Cross-sectional study. SETTING Rural Southeastern United States. SUBJECTS Participants included 289 African American women with a mean age of 56 years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6 kg/m2; 35% (n = 102) were classified with Class 3 obesity. MEASURES We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. ANALYSIS Chi-Square analysis for categorical variables and analysis of variance (ANOVA) - via multiple linear regression - for continuous variables. RESULTS There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58 y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4 min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences - lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity (P = .02). CONCLUSION For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.
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Affiliation(s)
- Candice L. Alick
- Center for Health Promotion & Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Danielle Braxton
- Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Harlyn Skinner
- Department of Biological Science, Center for Human Health and the Environment, North Carolina State University, Chapel Hill, NC, USA
| | - Ramine Alexander
- Department of Family and Consumer Sciences, Food and Nutritional Sciences, North Carolina Agricultural & Technical State University, Greensboro, NC, USA
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Keyserling
- Internal Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Carmen D. Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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Rindler GA, Gries A, Freidl W. Associations between overweight, obesity, and mental health: a retrospective study among European adults aged 50. Front Public Health 2023; 11:1206283. [PMID: 37533526 PMCID: PMC10390701 DOI: 10.3389/fpubh.2023.1206283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background The comorbidities associated with overweight and obesity have been well researched and scientifically proven while their relationship to mental health is still not verified. Methods This study is aimed at investigating reciprocal associations between obesity and mental health, and is intended to further analyze possible long-term effects using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). In order to do that, waves 4 and 8, conducted in 2010 and 2019/20 of this survey, were analyzed in a cross-lagged panel approach including 16,184 adult Europeans (50+) using multiple linear regression analysis focusing on the Body Mass Index (BMI), depression status and quality of life (QoL). Results Findings yield significant cross-lagged effects in one direction regarding BMI predicting QoL and depression state, whereas depression state and QoL do not significantly predict BMI. Findings include people living with obesity, overweight, and underweight showing significantly decreased levels of QoL as well as increased depression scores compared to people of normal weight over a lag time of 10 years, where people living with obesity indicate the strongest effect. Conclusions However, results do not confirm reciprocal associations in the long term. Hence, there is a strong need to carry out further research on this issue.
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Affiliation(s)
| | - Anna Gries
- Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University, Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University, Graz, Austria
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The Pervasive Impact of the Stigmatization of Gastrointestinal Diseases-A Patient's Perspective. Gastroenterol Clin North Am 2022; 51:681-695. [PMID: 36375989 DOI: 10.1016/j.gtc.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Stigma is a centuries-old phenomenon that pervades chronic digestive diseases, regardless of classification. Patients with gastrointestinal (GI) illness perceive others hold stigmatizing beliefs about them and their illness, including from medical professionals, and may go on to internalize or believe these negative stereotypes as true. These perceptions seem to be based on the thought that the public views GI diseases negatively. The effects of GI stigma are substantial and influence quality of life, psychological distress, treatment adherence, disease severity, and health-care utilization. These realities underscore the need for stigma to be addressed by the GI community and measures taken to mitigate its impacts.
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Mulrooney H. Understanding obesity and addressing stigma: the role of healthcare professionals. Nurs Stand 2022; 37:61-65. [PMID: 36184948 DOI: 10.7748/ns.2022.e11962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/09/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has further emphasised the importance of recognising obesity as a health issue for adults and children, with associated increases in obesity prevalence and risk of severe illness and death from COVID-19. Obesity is highly visible and highly stigmatised. It is frequently regarded as a result of lifestyle choices and behaviours, with a focus on personal responsibility rather than as a complex, multifactorial disease with a strong genetic component. Healthcare professionals, including nurses, have an important role in supporting behaviour changes, and discussing weight with patients in neutral and respectful ways. This article outlines the effects of the COVID-19 pandemic on weight and weight-related behaviours and discusses the complexity of obesity and weight stigma. It also emphasises the importance of nurses advocating for action to address the obesogenic environment.
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Affiliation(s)
- Hilda Mulrooney
- School of Life Sciences, Chemistry and Pharmacy, Faculty of Health, Science, Social Care and Education, Kingston University, Kingston upon Thames, England
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Haar M, Hercman R. Awkward Topics. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Smith JA, Eikenberry SA, Scott KA, Baumer-Harrison C, de Lartigue G, de Kloet AD, Krause EG. Oxytocin and cardiometabolic interoception: Knowing oneself affects ingestive and social behaviors. Appetite 2022; 175:106054. [PMID: 35447163 DOI: 10.1016/j.appet.2022.106054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/22/2022] [Accepted: 04/14/2022] [Indexed: 01/22/2023]
Abstract
Maintaining homeostasis while navigating one's environment involves accurately assessing and interacting with external stimuli while remaining consciously in tune with internal signals such as hunger and thirst. Both atypical social interactions and unhealthy eating patterns emerge as a result of dysregulation in factors that mediate the prioritization and attention to salient stimuli. Oxytocin is an evolutionarily conserved peptide that regulates attention to exteroceptive and interoceptive stimuli in a social environment by functioning in the brain as a modulatory neuropeptide to control social behavior, but also in the periphery as a hormone acting at oxytocin receptors (Oxtr) expressed in the heart, gut, and peripheral ganglia. Specialized sensory afferent nerve endings of Oxtr-expressing nodose ganglia cells transmit cardiometabolic signals via the Vagus nerve to integrative regions in the brain that also express Oxtr(s). These brain regions are influenced by vagal sensory pathways and coordinate with external events such as those demanding attention to social stimuli, thus the sensations related to cardiometabolic function and social interactions are influenced by oxytocin signaling. This review investigates the literature supporting the idea that oxytocin mediates the interoception of cardiovascular and gastrointestinal systems, and that the modulation of this awareness likewise influences social cognition. These concepts are then considered in relation to Autism Spectrum Disorder, exploring how atypical social behavior is comorbid with cardiometabolic dysfunction.
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Affiliation(s)
- Justin A Smith
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Sophia A Eikenberry
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Karen A Scott
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Caitlin Baumer-Harrison
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA
| | - Annette D de Kloet
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Eric G Krause
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
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Hoffmann K, Paczkowska A, Bryl W, Marzec K, Raakow J, Pross M, Berghaus R, Nowakowska E, Kus K, Michalak M. Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study. Nutrients 2022; 14:2775. [PMID: 35807955 PMCID: PMC9268827 DOI: 10.3390/nu14132775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.
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Affiliation(s)
- Karolina Hoffmann
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Wiesław Bryl
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Kinga Marzec
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Jonas Raakow
- Department of Surgery, Campus Charité Mitte, Campus Virchow Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Matthias Pross
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Rafael Berghaus
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Elżbieta Nowakowska
- Department of Pharmacology and Toxicology, Institute of Health Sciences, Collegium Medicum, University of Zielona Góra, 65-516 Zielona Góra, Poland;
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
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