An analysis of DNA methylation in human adipose tissue reveals differential modification of obesity genes before and after gastric bypass and weight loss

Background Environmental factors can influence obesity by epigenetic mechanisms. Adipose tissue plays a key role in obesity-related metabolic dysfunction, and gastric bypass provides a model to investigate obesity and weight loss in humans. Results Here, we investigate DNA methylation in adipose tissue from obese women before and after gastric bypass and significant weight loss. In total, 485,577 CpG sites were profiled in matched, before and after weight loss, subcutaneous and omental adipose tissue. A paired analysis revealed significant differential methylation in omental and subcutaneous adipose tissue. A greater proportion of CpGs are hypermethylated before weight loss and increased methylation is observed in the 3′ untranslated region and gene bodies relative to promoter regions. Differential methylation is found within genes associated with obesity, epigenetic regulation and development, such as CETP, FOXP2, HDAC4, DNMT3B, KCNQ1 and HOX clusters. We identify robust correlations between changes in methylation and clinical trait, including associations between fasting glucose and HDAC4, SLC37A3 and DENND1C in subcutaneous adipose. Genes investigated with differential promoter methylation all show significantly different levels of mRNA before and after gastric bypass. Conclusions This is the first study reporting global DNA methylation profiling of adipose tissue before and after gastric bypass and associated weight loss. It provides a strong basis for future work and offers additional evidence for the role of DNA methylation of adipose tissue in obesity.

Tactics for teaching evidence-based practice : improving self-efficacy in finding and appraising evidence in a master's evidence-based practice unit

Universal application of evidence-based practice (EBP) is far from a reality with many clinicians feeling ill equipped to adopt this approach in their clinical practice (Melnyk Fineout- Overholt, Feinstein, Sadler, & Green-Hernandez, 2008; Sherriff, Wallis, & Chaboyer, 2007) and, thus, to be an intelligent consumer of evidence (Ciliska, 2005). While recognizing the benefit of EBP, many health professionals have low confidence in their skills for using evidence in clinical settings (Nagy, Lumby, McKinley, &Macfarlane, 2001). Educational initiatives are often recommended for promoting adoption of EBP with much of the focus being on providing knowledge of associated processes. Levin, Melnyk, Fineout-Overholt, Barnes, and Vetter (2011) demonstrated that providing knowledge of EBP process alone does not increase clinicians’ confidence in their ability to apply EBP to their practice...

Fusion of worlds : consumers’ self-narrative in a hybrid physical/digital world

As the Internet becomes deeply embedded into consumers’ daily life, the digital virtual world brings significant influence to consumers’ self and narrative. Prior studies look at consumer self from either from a certain online space or comparing consumers’ physical and digital virtual selves but not the integration of the physical/digital world. This paper aims to explore the meanings of the digital virtual space on consumers’ narrative as a whole (their interests, dreams, or subjectivity). We utilise a postmodern concept of the cyborg to understand the cultural complexity, subjective meanings of, and the extent to which the digital virtual space plays a role in consumers’ self-narrative. We conducted in-depth interviews and gathered three consumer narratives. Our findings indicate that consumers’ narrative contains important fragments from both physical and digital virtual worlds and their physical and digital virtual selves form a feedback loop that strengthen their overall narrative.

Implementing the self-management threshold learning outcome for law : some intentional design strategies from the current curriculum toolbox

There is a growing awareness of the high levels of psychological distress being experienced by law students and the practising profession in Australia. In this context, a Threshold Learning Outcome (TLO) on self-management has been included in the six TLOs recently articulated as minimum learning outcomes for all Australian graduates of the Bachelor of Laws degree (LLB). The TLOs were developed during 2010 as part of the Australian Learning and Teaching Council’s (ALTC’s) project funded by the Australian Government to articulate ‘Learning and Teaching Academic Standards’. The TLOs are the result of a comprehensive national consultation process led by the ALTC’s Discipline Scholars: Law, Professors Sally Kift and Mark Israel.1 The TLOs have been endorsed by the Council of Australian Law Deans (CALD) and have received broad support from members of the judiciary and practising profession, representative bodies of the legal profession, law students and recent graduates, Legal Services Commissioners and the Law Admissions Consultative Committee. At the time of writing, TLOs for the Juris Doctor (JD) are also being developed, utilising the TLOs articulated for the LLB as their starting point but restating the JD requirements as the higher order outcomes expected of graduates of a ‘Masters Degree (Extended)’, this being the award level designation for the JD now set out in the new Australian Qualifications Framework.2 As Australian law schools begin embedding the learning, teaching and assessment of the TLOs in their curricula, and seek to assure graduates’ achievement of them, guidance on the implementation of the self-management TLO is salient and timely.

The applicability of the Precaution Adoption Process Model for understanding self-regulatory driving behaviour among older drivers

1. Introduction The success of self-regulation, in terms of enhancing older drivers’ safety and maintaining their mobility, depends largely upon older drivers’ awareness of the declines in their driving abilities. Therefore, interventions targeted at increasing older drivers’ safety should aim to enhance their awareness of their physical, sensory and cognitive limitations. Moreover, previous research suggests that driving behaviour change may occur through stages and that interventions and feedback may be perceived differently at each stage. 2. Study aims To further understand the process of driving self-regulation among older adults by exploring their perceptions and experiences of self-regulation, using the PAPM as a framework. To investigate the possible impact of feedback on their driving on their decision making process. 3. Methodology Research tool: Qualitative focus groups (n=5 sessions) Recruitment: Posters, media, newspaper advertisement and emails Inclusion criteria: Aged 70 or more, English-speaking, current drivers Participants: Convenience sample of 27 men and women aged 74 to 90 in the Sunshine Coast and Brisbane city, Queensland, Australia. 4. Analysis Thematic analysis was conducted following the process outlined by Braun and Clarke (2006) to identify, analyse and report themes within the data. Four main themes were identified.

How Gordon Ramsay appeals to consumers : effects of self-concept clarity and celebrity meaning on celebrity endorsements

How do celebrities like Gordon Ramsay appeal to consumers? This article examines one explanation. We study how celebrities appeal to consumers in the context of celebrity chefs. We examine how a consumer's self-concept clarity (SCC) interacts with their perception of the meaning that a celebrity endorser possesses. An experiment comparing fictional ads endorsed by different celebrity chefs yields the surprising result that consumers with a clear sense of who they are (high-SCC consumers) are more influenced by an ad featuring a celebrity high in meaning (Ramsay), whereas low-SCC consumers are influenced to slightly higher levels by a celebrity with lower levels of celebrity meaning.

Consumer’s persistence in solving their own problem with self‐service technology

An increasing range of technology services are now offered on a self-service basis. However, problems with self-service technologies (SSTs) occur at times due to the technical error, staff error, or consumers’ own mistakes. Considering the role of consumers as co-producers in the SST context, we aim to study consumer’s behaviours, strategies, and decision making in solving their problem with SST and identify the factors contributing to their persistence in solving the problem. This study contributes to the information systems research, as it is the first study that aims to identify such a process and the factors affecting consumers’ persistence in solving their problem with SST. A focus group with user support staff has been conducted, yielding some initial results that helped to conduct the next phases of the study. Next, using Critical Incident Technique, data will be gathered through focus groups with users, diary method, and think-aloud method.

Exercise barriers self-efficacy : development and validation of a subcale for individuals with cancer-related lymphedema

Background No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers. Methods A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale. Results The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (> 0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach’s alpha=0.93) and test-retest reliability (ICC=0.67, p< 0.01). Conclusions A valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.

Relationships between maternal overweight prior to pregnancy, feeding mode and infant feeding beliefs and practices

Aim To examine whether pre-pregnancy weight status was associated with maternal feeding beliefs and practices in the early post-partum period. Methods Secondary analysis of longitudinal data from Australian mothers. Participants (N=486) were divided into two weight status groups based on self-reported pre-pregnancy weight and measured height: healthy weight (BMI <25kg/m2; n=321) and overweight (BMI>25kg/m2; n=165). Feeding beliefs and practices were self-reported via an established questionnaire that assessed concerns about infant overeating and undereating, awareness of infant cues, feeding to a schedule, and using food to calm. Results Infants of overweight mothers were more likely to have been given solid foods in the previous 24hrs (29% vs 20%) and fewer were fully breastfed (50% vs 64%). Multivariable regression analyses (adjusted for maternal education, parity, average infant weekly weight gain, feeding mode and introduction of solids) revealed pre-pregnancy weight status was not associated with using food to calm, concern about undereating, awareness of infant cues or feeding to a schedule. However feeding mode was associated with feeding beliefs and practices. Conclusions Although no evidence for a relationship between maternal weight status and early maternal feeding beliefs and practices was observed, differences in feeding mode and early introduction of solids was observed. The emergence of a relationship between feeding practices and maternal weight status may occur when the children are older, solid feeding is established and they become more independent in feeding.

Food neophobia and its association with diet quality and weight in children aged 24 months : a cross sectional study

Background Food neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight. Methods Secondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates. Results At 24 months, more neophobic children were found to have lower variety of fruits (β=-0.16, p=0.003) and vegetables (β=-0.29, p<0.001) but have a greater proportion of daily energy from discretionary foods (β=0.11, p=0.04). There was no significant association between BMI Z-score and CFNS score. Conclusions Neophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.

The Threshold Learning Outcome on self-management for the Bachelor of Laws degree : a proposed focus for teaching strategies in the first year law curriculum

The Australian Learning and Teaching Council (ALTC) Discipline Scholars for Law, Professors Sally Kift and Mark Israel, articulated six Threshold Learning Outcomes (TLOs) for the Bachelor of Laws degree as part of the ALTC’s 2010 project on Learning and Teaching Academic Standards. One of these TLOs promotes the learning, teaching and assessment of self-management skills in Australian law schools. This paper explores the concept of self-management and how it can be relevantly applied in the first year of legal education. Recent literature from the United States (US) and Australia provides insights into the types of issues facing law students, as well as potential antidotes to these problems. Based on these findings, I argue that designing a pedagogical framework for the first year law curriculum that promotes students’ connection with their intrinsic interests, values, motivations and purposes will facilitate student success in terms of their personal well-being, ethical dispositions and academic engagement.

Characterising resistance to overconsumption : a biopsychological analysis

This thesis investigated biopsychological factors involved in successfully resisting overconsumption in an environment promoting obesity, and differences between individuals who were and were not able to resist overconsumption. Results showed that self control was a key factor in successful resistance, whereas sensitivity to food reward was associated with overconsumption susceptibility. Reduced self control may be a consequence as well as a cause of obesity, and may not recover following weight loss. Self control was not enhanced through an exercise programme that aimed to ameliorate brain fitness through improved cardiovascular fitness.

Self and other in communication and cognition : the role of auto-communication and intersubjectivity in autopoiesis of psychic systems

By referring to Niklas Luhmann's theory of self-referential systems, Aldo Mascareño (2008, submitted for publication) gives an account of system-environment interrelatedness, explaining how social and individual constitute each other through the process of communication and co-creation of meanings. Two possible extensions to his account are discussed. Firstly, auto-communication within the system that happens without any external reference needs to be taken into account while describing the existence and constant re-creation of psychic systems. Secondly, in order for the system and environment or two systems to communicate, an imagined and temporary intersubjectivity between the two needs to be assumed.