Weight Management Treatment Representations: A Novel Use of the Common Sense Model

We used the Common Sense Model to understand weight management treatment representations of diverse patients, conducting semistructured interviews with 24 veterans with obesity, recruited from multiple U.S. Veterans Health Administration facilities. We performed a directed content analysis to summarize representations and assess differences across demographic groups. Patients' representations were impacted by gender, socioeconomic status, and disability status, creating group differences in available treatment (e.g., disability-related limitations), negative consequences (e.g., expense), treatment timeline (e.g., men emphasized long-term lifestyle changes), and treatment models (e.g., women described medically driven models). Patients identified conventional representations aligning with medical recommendations and relating to positive consequences, long-term treatment timelines, and medically driven models. Finally, patients discussed risky representations, including undesirable attitudes related to short-term positive and negative consequences and long-term negative consequences. Applying the Common Sense Model emphasized diverse representations, influenced by patients' identities. Understanding representations may improve treatment to meet the needs of diverse preferences.

Isolation and in-silico approach of Modified Embelin derivative from Embelia ribes fruits as anti-Alzheimer agent

Embelin is one of the primary compounds present in the Embelia ribes fruit. Embelin has a broader pharmacological activity such as Anti-inflammatory, anti-bacterial, antioxidant, and many more. The ultimate aim of the study is to ensure the impact of reduced embelin in the management of Alzheimer's disease. Embelin was isolated and modified by the reduction method, and the Modified Embelin derivative (MED) 3-Undecylcyclohexa-2,5-diene-1,2,4,5-tetraol was analysed through FT-IR, NMR, and Mass Spectroscopic techniques. MED was docked against acetylcholinesterase (AChE) amyloid beta (Aβ) receptors PDB ID: 1EVE & 1B68, respectively. The docking scores remain similar to that of positive standards galantamine and Donepezil.

Common Sense Models of Obesity: a Qualitative Investigation of Illness Representations

BACKGROUND

The Common Sense Model provides a framework to understand health beliefs and behaviors. It includes illness representations comprised of five domains (identity, cause, consequences, timeline, and control/cure). While widely used, it is rarely applied to obesity, yet could explain self-management decisions and inform treatments. This study answered the question, what are patients' illness representations of obesity?; and examined the Common Sense Model's utility in the context of obesity.

METHODS

Twenty-four participants with obesity completed semi-structured phone interviews (12 women, 12 men). Directed content analysis of transcripts/notes was used to understand obesity illness representations across the five illness domains. Potential differences by gender and race/ethnicity were assessed.

RESULTS

Participants did not use clinical terms to discuss weight. Participants' experiences across domains were interconnected. Most described interacting life systems as causing weight problems and used negative consequences of obesity to identify it as a health threat. The control/cure of obesity was discussed within every domain. Participants focused on health and appearance consequences (the former most salient to older, the latter most salient to younger adults). Weight-related timelines were generally chronic. Women more often described negative illness representations and episodic causes (e.g., pregnancy). No patterns were identified by race/ethnicity.

CONCLUSIONS

The Common Sense Model is useful in the context of obesity. Obesity illness representations highlighted complex causes and consequences of obesity and its management. To improve weight-related care, researchers and clinicians should focus on these beliefs in relation to preferred labels for obesity, obesity's most salient consequences, and ways of monitoring change.

Adoption and Appropriateness of mHealth for Weight Management in the Real World: A Qualitative Investigation of Patient Perspectives

Background

Mobile health (mHealth) interventions for weight management can result in weight loss outcomes comparable to in-person treatments. However, there is little information on implementing these treatments in real-world settings.

Objective

This work aimed to answer two implementation research questions related to mHealth for weight management: (1) what are barriers and facilitators to mHealth adoption (initial use) and engagement (continued use)? and (2) what are patient beliefs about the appropriateness (ie, perceived fit, relevance, or compatibility) of mHealth for weight management?

Methods

We conducted semistructured interviews with patients with obesity at a single facility in an integrated health care system (the Veterans Health Administration). All participants had been referred to a new mHealth program, which included access to a live coach. We performed a rapid qualitative analysis of interviews to identify themes related to the adoption of, engagement with, and appropriateness of mHealth for weight management.

Results

We interviewed 24 veterans, seven of whom used the mHealth program. Almost all participants were ≥45 years of age and two-thirds were White. Rapid analysis identified three themes: (1) coaching both facilitates and prevents mHealth adoption and engagement by promoting accountability but leading to guilt among those not meeting goals; (2) preferences regarding the mode of treatment delivery, usability, and treatment content were barriers to mHealth appropriateness and adoption, including preferences for in-person care and a dislike of self-monitoring; and (3) a single invitation was not sufficient to facilitate adoption of a new mHealth program. Themes were unrelated to participants’ age, race, or ethnicity.

Conclusions

In a study assessing real-world use of mHealth in a group of middle-aged and older adults, we found that—despite free access to mHealth with a live coach—most did not complete the registration process. Our findings suggest that implementing mHealth for weight management requires more than one information session. Findings also suggest that focusing on the coaching relationship and how users’ lives and goals change over time may be an important way to facilitate engagement and improved health. Most participants thought mHealth was appropriate for weight management, with some nevertheless preferring in-person care. Therefore, the best way to guarantee equitable care will be to ensure multiple routes to achieving the same behavioral health goals. Veterans Health Administration patients have the option of using mHealth for weight management, but can also attend group weight management programs or single-session nutrition classes or access fitness facilities. Health care policy does not allow such access for most people in the United States; however, expanded access to behavioral weight management is an important long-term goal to ensure health for all.

Functioning of adults in alcohol use disorder treatment: Role of concerned others

OBJECTIVE

This study examined patients in treatment for alcohol use disorders ("Patients") and their "concerned others" (COs-family and friends): (1) Did Patients' functioning differ according to COs' study participation? Among Patients with participating COs, (2) did Patients and COs agree on Patients' functioning, and (3) was Patients' functioning associated with COs' functioning and quality of CO-Patient relationships?

METHOD

Four-hundred and two Patients (mean age = 44, majority white men) and 277 COs (mean age = 52, majority white women) completed validated assessments.

RESULTS

(1) Unexpectedly, Patients who did not identify a CO for potential study participation had more protective factors against future substance use and more readiness to participate in Alcoholics Anonymous (AA) than patients who did identify a CO. (2) Patients had higher scores than COs did when rating the Patient's protective factors, viewed the Patient-CO relationship as having more resources and fewer stressors than COs did, and reported fewer incidents of violence toward the CO than the CO did. (3) Patients had higher risk factors scores when their COs binge drank, and the Patient-CO relationship had more stressors and violence. Patients had higher protective factors scores when COs had greater readiness for Al-Anon participation, and Patients had attended more AA meetings, reported more resources in their relationship with their CO, and used more negotiation tactics when in conflict with their CO.

CONCLUSIONS

Findings suggest that interventions to improve Patients' functioning should be broadened beyond COs who are spouses or partners, decrease COs' binge drinking, facilitate 12-step participation, decrease relationship stressors and conflict, and increase relationship resources.

1H-Benzotriazole–4-hydroxybenzoic acid (1/1)

The asymmetric unit of the title compound, C₆H₅N₃·C₇H₆O₃, comprises independent benzotriazole and 4-hydroxybenzoic acid molecules. The dihedral angle between the benzene ring and the benzotriazole ring system is 15.18 (7)°. The mean plane of the carb­oxyl group is twisted at an angle of 18.55 (1)° with respect to the benzene ring. The crystal structure is stabilized by weak inter­molecular N—H⋯N, O—H⋯N, O—H⋯O and C—H⋯O inter­actions, forming a three-dimensional network.

2-Phenyl-ethanaminium 4-hy-droxy-benzoate

In the title salt, C8H12N(+)·C7H5O3 (-), the cation is disordered over two orientations with site occupancies of 0.565 (7) and 0.435 (7). In the anion, the carboxyl-ate group makes the dihedral angle of 4.19 (18)° with the benzene ring. In the crystal, the ions are connected by N-H⋯O and O-H⋯O hydrogen bonds, forming a three-dimensional network.

4-Methyl-pyridinium 4-hy-droxy-benzoate

In the crystal structure of the title salt, C(6)H(8)N(+)·C(7)H(5)O(3) (-), the anions and cations are linked by classical N-H⋯O hydrogen bonds. The anions are connected by pairs of C-H⋯O hydrogen bonds into inversion dimers and further linked by classical O-H⋯O hydrogen bonds. Weak π-π inter-actions [centroid-centroid distances = 3.740 (3) and 3.855 (3) Å] also occur. The dihedral angle between the CO(2) (-) group and the benzene ring to which it is attached is 20.95 (8)°.

1-Methyl-4-(4-methylstyryl)pyridinium 4-methylbenzenesulfonate

In the title salt, C₁₅H₁₆N⁺·C₇H₇O₃S⁻, the dihedral angle between the pyridine and benzene rings of the cation is 5.98 (18)°. In the crystal, adjacent anions and cations are linked by weak non-classical C—H⋯O hydrogen bonds and π–π inter­actions, with a centroid–centroid distance of 3.749 (2) Å.

2-Carboxypyridinium maleate

In the title mol­ecular salt, C₆H₆NO₂^+.C₄H₃O₄⁻, the 2-carb­oxy­pyridinium cation is essentially planar with a maximum deviation of 0.003 (3) Å. In the crystal, adjacent cations and anions are linked by an extensive system of weak N—H⋯O, O—H⋯O and C—H⋯O inter­actions, forming a layer parallel to the ab plane.

4-Nitroaniliniump-toluenesulfonate

In the cation of the title salt, C₆H₇N₂O₂⁺·C₇H₇O₃S⁻, the benzene ring makes a dihedral angle of 10.2 (2)° with the nitro group. In the crystal, the cations and anions are linked by weak N—H⋯O hydrogen bonds, forming a layer parallel to the ac plane. A weak C—H⋯O inter­action and π–π inter­actions [centroid–centroid distances of 3.738 (3) and 3.748 (3) Å] also observed within the layer.

Semi-automatic determination of detailed vertebral shape from lumbar radiographs using active appearance models

SUMMARY

The vertebral endplates in lumbar radiographs were located by a semi-automatic annotation method using statistical shape models.

INTRODUCTION

Vertebral fractures are common osteoporotic fractures, but current quantitative detection methods (morphometry) lack specificity. We have previously developed more specific quantitative classifiers of vertebral fracture using shape and appearance models. This method has only been applied to DXA vertebral fracture assessment (VFA) images and not to spinal radiographs. The classifiers require a detailed annotation of the outline of the vertebral endplate, so we investigated the application of similar semi-automated annotation methods to lumbar radiographs as the initial step in the generalisation of the statistical classifiers used in VFA images.

METHODS

The vertebral body outlines in a training set of 670 lumbar radiographs were manually annotated by expert radiologists. This training set was used to build statistical models of vertebral shape and appearance using triplets of vertebrae. In order to segment vertebrae, the models were refitted using a sequence of active appearance models of vertebral triplets, using a miss-40-out train/test cross-validation experiment. The accuracy was evaluated against the manual annotation and analysed by fracture grade.

RESULTS

Good accuracy was obtained for normal vertebrae (0.82 mm) and fracture grades 1 and 2 (1.19 mm), but the localisation accuracy deteriorated for grade 3 fractures to 2.12 mm.

CONCLUSION

Vertebral body shape annotation can be substantially automated on lumbar radiographs. However, an occasional manual correction may be required, typically with either severe fractures, or when there is a high degree of projectional tilting or scoliosis. The located detailed shapes may enable the development of more powerful quantitative classifiers of osteoporotic vertebral fracture.

Detection of vertebral fractures in DXA VFA images using statistical models of appearance and a semi-automatic segmentation

SUMMARY

Morphometric methods of vertebral fracture diagnosis lack specificity. We used detailed shape and image texture model parameters to improve the specificity of quantitative fracture identification. Two radiologists visually classified all vertebrae for system training and evaluation. The vertebral endplates were located by a semi-automatic segmentation method to obtain classifier inputs.

INTRODUCTION

Vertebral fractures are common osteoporotic fractures, but current quantitative detection methods (morphometry) lack specificity. We used detailed shape and texture information to develop more specific quantitative classifiers of vertebral fracture to improve the objectivity of vertebral fracture diagnosis. These classifiers require a detailed segmentation of the vertebral endplate, and so we investigated the use of semi-automated segmentation methods as part of the diagnosis.

METHODS

The vertebrae in a training set of 360 dual energy X-ray absorptiometry images were manually segmented. The shape and image texture of vertebrae were statistically modelled using Appearance Models. The vertebrae were given a gold standard classification by two radiologists. Linear discriminant classifiers to detect fractures were trained on the vertebral appearance model parameters. Classifier performance was evaluated by cross-validation for manual and semi-automatic segmentations, the latter derived using Active Appearance Models (AAM). Results were compared with a morphometric algorithm using the signs test.

RESULTS

With manual segmentation, the false positive rates (FPR) at 95% sensitivity were: 5% (appearance) and 18% (morphometry). With semi-automatic segmentations the sensitivities at 5% FPR were: 88% (appearance) and 79% (morphometry).

CONCLUSION

Specificity and sensitivity are improved by using an appearance-based classifier compared to standard height ratio morphometry. An overall sensitivity loss of 7% occurs (at 95% specificity) when using a semi-automatic (AAM) segmentation compared to expert annotation, due to segmentation error. However, the classifier sensitivity is still adequate for a computer-assisted diagnosis system for vertebral fracture, especially if used in a triage approach.

Insect antifeedant and growth regulating activities of salannobutyrolactone and desacetylsalannobutyrolactone

Salannobutyrolactone and its deacetylderivative were tested for insect antifeedant and growth regulatory activities against the tobacco cutworm, Spodoptera litura. Salannobutyrolactone was the most effective antifeedant. Desacetylsalannobutyrolactone increased larval duration and larval mortality.