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Bariatric Surgery: The Good, Bad, & Questionable

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Obesity has developed into a worldwide health problem that is associated with many risks. The elements causing obesity are complex and numerous including behavioral, psychological, and physiological. Traditional methods of weight loss have demonstrated short-lived positive health benefits and minimal

Obesity has developed into a worldwide health problem that is associated with many risks. The elements causing obesity are complex and numerous including behavioral, psychological, and physiological. Traditional methods of weight loss have demonstrated short-lived positive health benefits and minimal long-term weight loss, which has led to the prevalence of bariatric surgery as an answer to long-term weight loss for Class III obesity. Gastric bypass surgery has become especially popular for its numerous benefits including successful weight loss, improvements in obesity-related diseases, and increased lifespan. Bariatric surgery is still not a perfect solution. Negative effects after surgery range from surgical complications and vitamin deficiencies to altered hormonal levels and metabolic rates. Many questions regarding bariatric surgery still remain including the impact of adolescent bariatric surgery, long-term bone effects, and long-term psychosocial and lifestyle components of bariatric patients. Understanding the good, the bad, and several of the remaining questions regarding bariatric surgery, will help health professionals be more appreciative of the complexity of treating their obese patients.

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2018-05

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Effects of Menthol on Weight Regain and Maintenance of Caloric Restriction: A Pilot Study

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The prevalence of excessive weight gain (obesity) has steadily increased since about 1980. Excessive weight gain is associated with many comorbidities; thus, a successful treatment is needed. The most common form of non-surgical treatment for excessive weight gain is caloric

The prevalence of excessive weight gain (obesity) has steadily increased since about 1980. Excessive weight gain is associated with many comorbidities; thus, a successful treatment is needed. The most common form of non-surgical treatment for excessive weight gain is caloric restriction with the intent to reduce body weight by 10%. Though this treatment is successful at reducing body weight, it often fails at maintaining the weight loss. Dietary menthol has been suggested as a possible treatment for excessive weight gain and has produced promising results as a preventative method for excessive weight gain. Our studies aimed at reducing weight regain and maintaining caloric restriction by feeding male Sprague-Dawley rats 0.5% dietary menthol during a period of caloric restriction, aimed at reducing their body weight by 10%, following an experimental period where the rats were fed a high-fat diet (HFD) or low-fat diet (LFD). The effects of the dietary menthol were observed during the weight regain period following the caloric restriction period. Two studies were conducted, and both were unable to achieve a maintenance of weight loss following caloric restriction, although our first study was able to produce a delay in weight regain and did not show any evidence of increased thermogenesis in menthol-treated rats. Our findings differ from the findings of previous studies on dietary menthol which could possibly be due to species effects, differences in procedures, age effects, or effects of different fatty acid compositions. The contrasting results in our studies could be due to genetic differences between litters used or a difference in manufacturing of the menthol diet between studies. Given the partial response to menthol in the first study, it can be suggested that the concentration of 0.5% may be below the threshold of menthol sensitivity for some rats. Future research should focus on increasing the concentration of dietary menthol from 0.5% to 1%, since the current concentration did not yield a reduction in weight regain or maintenance of caloric restriction.

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Date Created
2019-05

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Language Used when Covering People with Disabilities

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News outlets frequently portray people with disabilities as either helpless victims or objects of motivation. Portrayal of people with disabilities has improved over the years, but there is still room to grow. News outlets tend to make disability the center

News outlets frequently portray people with disabilities as either helpless victims or objects of motivation. Portrayal of people with disabilities has improved over the years, but there is still room to grow. News outlets tend to make disability the center of the story. A story about a disabled person is primarily about their disability, with their other accomplishments framed by it.

As one example of the victimhood narrative, ABC News used to run a special called My Extreme Affliction as part of 20/20 until 2012. As the name implies, the specials covered people with disabilities, specifically extreme versions. One 2008 episode on Tourette’s syndrome described Tourette’s like it was some sort of demonic possession. The narrator talked about children who were “prisoners in their own bodies” and a family that was at risk of being “torn apart by Tourette’s.” I have Tourette’s syndrome myself, which made ABC’s special especially uncomfortable to watch. When not wringing their metaphorical hands over the “victims” of disability, many news outlets fall into the “supercrip” narrative. They refer to people as “heroes” who “overcome” their disabilities to achieve something that ranges from impressive to utterly mundane. The main emphasis is on the disability rather than the person who has it. These articles then exploit that disability to make readers feel good. As a person with a disability, I am aware that it impacts my life, but it is not the center of my life. The tics from my Tourette’s syndrome made it difficult to speak to people when I was younger, but even then they did not rule me.

Disability coverage, however, is still incredibly important for promoting acceptance and giving people with disabilities a voice. A little over a fifth of adults in the United States have a disability (CDC: 53 million adults in the US live with a disability), so poor coverage means marginalizing or even excluding a large amount of people. Journalists should try to reach their entire audience. The news helps shape public opinion with the stories it features. Therefore, it should provide visibility for people with disabilities in order to increase acceptance. This is a matter of civil rights. People with disabilities deserve fair and accurate representation.

My personal experience with ABC’s Tourette’s special leads me to believe that the media, especially the news, needs to be more responsible in their reporting. Even the name “My Extreme Affliction” paints a poor picture of what to expect. A show that focuses on sensationalist portrayals in pursuit of views further ostracizes people with disabilities. The emphasis should be on a person and not their condition. The National Center for Disability Journalism tells reporters to “Focus on the person you are interviewing, not the disability” (Tips for interviewing people with disabilities). This people-first approach is the way to improve disability coverage: Treat people with disabilities with the same respect as any other minority group.

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Date Created
2019-05

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The Role of UCP-1 in Human Omental Tissue

Description

The prevalence of obesity continues to increase in the United States, along with its risk for other associated cardiovascular and metabolic diseases. Several therapeutic methods are aimed at targeting and reducing obesity, now defined as a state of chronic, low-grade

The prevalence of obesity continues to increase in the United States, along with its risk for other associated cardiovascular and metabolic diseases. Several therapeutic methods are aimed at targeting and reducing obesity, now defined as a state of chronic, low-grade inflammation (in addition to BMI > 30 kg/m2). In an attempt to expand on these therapeutic methods, research on the concept of browning in white adipose tissue (WAT) and brown adipose tissue (BAT) is being conducted. Brown adipose tissue (BAT), and a newly discovered type of adipocyte, beige adipocytes, are heavily involved in thermogenesis with the use of uncoupling protein-1 (UCP-1). This paper focuses on the analysis of common browning genes, ATP-related genes, and metabolic genes in varying biological groups in mice (Chow/High-Fat Diet and Inguinal FAT and Perigonadal Fat) and in humans (Lean/Obese and Subcutaneous WAT (SC) and Omental WAT (OM)) using methods such as RT-PCR and immunohistochemistry. The data obtained shows an increase in browning in the leaner group, specifically in the subcutaneous fat. Further, browning is significantly reduced in the obese groups of subjects and mice tested, in addition to omental/perigonadal versus subcutaneous/inguinal fat depots. Interestingly, two key ATP genes, UCP-1 and COX4I1 are vastly elevated in the OM WAT, indicating that browning may not be as important in the OM, but rather may have a potential role in SC. This is contrary to prior research findings that attempt to exclude mice surrogates in future experimentation of the browning phenomenon. Further experimentation is needed to expand on the findings of this paper.

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Date Created
2019-12

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Comparing the Efficacy of the Total Stabilizing and Posterior Stabilizing Knee Prostheses in Obese and Pre-Obese Females: A Retrospective Cohort Study

Description

Obesity is a growing issue in the Western world, as well as other international countries. This is leading to increases in complications associated with obesity. One such complication is osteoarthritis (OA) of load bearing joints that requires surgical treatment by

Obesity is a growing issue in the Western world, as well as other international countries. This is leading to increases in complications associated with obesity. One such complication is osteoarthritis (OA) of load bearing joints that requires surgical treatment by total knee arthroplasty (TKA). Obesity is also associated with an increase in surgical complications that may lead to poor TKA outcomes. Additionally, the female gender is also known to be associated with increased rates of severe, clinical OA. This study was designed to determine the comparative efficacy of two knee implants in the obese female population through retrospective chart review and data analysis. The implants differ in their level of constraint, with the total stabilizing (TS) being more constrained than the posterior stabilizing (PS). We hypothesized that the TS implants would be associated with improved functional outcomes in the obese female population. The TS implant was observed to be associated with earlier improvement of both passive and active range of motion. This implant also showed greater improvement from pre-operative condition in stability, rejecting our null hypothesis and supporting our hypothesis.

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Date Created
2015-05

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Evaluating Changes in the Gut Microbial Composition, Diet, and Overall Health in Children in the Nutrition and Health Awareness Program

Description

In the United States, the prevalence of pediatric obesity has increased to 17% in the general population and even more so in the Hispanic pediatric population to 22.4%. These children are at a higher risk for associated comorbidities, including cardiovascular

In the United States, the prevalence of pediatric obesity has increased to 17% in the general population and even more so in the Hispanic pediatric population to 22.4%. These children are at a higher risk for associated comorbidities, including cardiovascular disease and insulin resistance. The purpose of the following study is to determine the effectiveness of the Nutrition and Health Awareness curriculum at reducing childhood obesity by evaluating alterations in the gut microbial composition, diet, and overall health of the students throughout the five-week program. Nutrition and Health Awareness (NHA) is a student organization that strives to reduce the prevalence of obesity, diabetes, and cardiovascular diseases, specifically in children, by providing active nutrition education services through peer mentoring in elementary schools and community programs. This study went through ASU's Institutional Review Board process and all forms were translated into Spanish. The control group maintained their normal routines and the experimental group received the 5 week NHA program and then continued with their normal routines. Anthropometric measures (Body Mass Index, waist-to-hip ratio, and blood pressure), diet measures (Hispanic food frequency questionnaire), fecal swabs, and content surveys were collected on weeks 0, 5, and 8. Contrary to expected, alpha diversity, kilocalorie intake, and macronutrient intake decreased as the study progressed for both the control and experimental groups. Anthropometric measurements were relatively stable. Though not statistically significant, the greatest difference in time points is between weeks 1 and 8. This decrease in alpha diversity and kilocalorie intake could be due to a change in environment since the children started school on week 8. Future implications of this study are that parental involvement is necessary for an effective, sustainable change in these children. More research in different settings is necessary to determine NHA's effectiveness

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Date Created
2016-05

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What Kind of Problem is the Problem of Obesity?

Description

This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed

This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed as a problem has a profound impact on the kinds of solutions that may be deemed scientifically appropriate. But frames are not entirely evidence-based, inasmuch as political and moral values infuse debates about the nature of obesity. Drawing on interdisciplinary resources from bioethics and the philosophy of science, I strive to offer strategic insight in to how to navigate the complexity of these issues.

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Date Created
2014-05

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Diet-induced alterations in energy homeostasis and central adiposity: liver and visceral adipose tissue

Description

There has been an alarming rise in the prevalence of obesity which has been attributed to the paralleled rise in consumption of high-fat foods. It’s commonly accepted that high-fat diets can lead to increased weight gain, however not all fats

There has been an alarming rise in the prevalence of obesity which has been attributed to the paralleled rise in consumption of high-fat foods. It’s commonly accepted that high-fat diets can lead to increased weight gain, however not all fats have the same physiological action. This study primarily focuses on the effect of canola oil, a monounsaturated fat, on energy homeostasis and body composition when it’s given as a supplement to a high-fat diet composed of saturated fatty acid. Rodent models were divided into three dietary groups: 1) low-fat diet (LFD), 2) high-fat diet (HFD) and 3) canola oils supplemented HFD (HF+CAN). After 4 weeks of dietary intervention, samples of epididymal fat, perinephric fat, and liver were analyzed across the three groups to see if the changes in energy homeostasis could be explained by the cellular behavior and composition of these tissues. Interestingly, the supplement of canola oil appeared to reverse the deleterious effects of a saturated fat diet, reverting energy intake, body weight gain and adipose tissue sizes to that (if not lower than that) of the LFD group. The only exception to this effect was the liver: the livers remained larger and fattier than those of the HFD. This occurrence is possibly due to a decrease in free fatty acid uptake in the adipose tissues—resulting in smaller adipose tissue sizes—and increased fatty acid uptake in the liver. The mechanism by which this occurs has yet to be elucidated and will be the primary focus of upcoming studies on the effect of monounsaturated fat on other diets.

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Date Created
2015-05

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Nutritional Factors Influencing Canine Food Preferences

Description

Dogs' health and wellbeing is of great importance to their owners. The most common nutritional problem for pet dogs is obesity, with 22-40% of pet dogs being classified as overweight or obese. With many adverse health effects associated with obesity,

Dogs' health and wellbeing is of great importance to their owners. The most common nutritional problem for pet dogs is obesity, with 22-40% of pet dogs being classified as overweight or obese. With many adverse health effects associated with obesity, this is a major concern for owners and veterinarians. The degree to which dogs enjoy consuming certain foods can have substantial implications for their body weight, so it is important to understand which aspects of foods make them appealing to dogs. This study aimed to determine whether nutritional aspects of commercial dog foods predict dogs' preferences for those foods. It was found that consumption preference is positively correlated with protein content (p < .001), therefore implying that the protein content of commercial dry dog foods may predict dogs' consumption preferences. Consumption preferences were not predicted by other available measures of food content or caloric value. Dogs' preference for foods high in protein content may be due to the satiating effect of protein. Since foods high in protein both reduce the amount of energy consumed and are found to be palatable to dogs, high-protein dog foods may offer a way for dog food manufacturers, veterinarians, and pet owners to combat obesity in pet dogs.

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Date Created
2016-05

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Analyzing Optometric Related Care in Insurance Policies

Description

Optometry is an important field in medicine as it allows people a chance to have their vision corrected and it serves as a health screening opportunity for those who receive a dilated eye examination. One of the largest barriers to

Optometry is an important field in medicine as it allows people a chance to have their vision corrected and it serves as a health screening opportunity for those who receive a dilated eye examination. One of the largest barriers to receiving a dilated eye exam is insurance coverage. Most health insurance policies have limited optometric coverage. By expanding health insurance plans to be more inclusive of optometric care, people who use these health insurance plans will have a better access of care.

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Date Created
2021-05