Obesity, knee osteoarthritis, and polypathology: factors favoring weight loss in older people

Aim: We aimed to explore the meaning of obesity in elderly persons with knee osteoarthritis (KO) and to determine the factors that encourage or discourage weight loss. Background: Various studies have demonstrated that body mass index is related to KO and that weight loss improves symptoms and functional capacity. However, dietary habits are difficult to modify and most education programs are ineffective. Design: A phenomenological qualitative study was conducted. Intentional sampling was performed in ten older persons with KO who had lost weight and improved their health-related quality of life after participating in a health education program. A thematic content analysis was conducted following the stages proposed by Miles and Huberman. Findings: Participants understood obesity as a risk factor for health problems and stigma. They believed that the cause of obesity was multifactorial and criticized health professionals for labeling them as “obese” and for assigning a moral value to slimness and diet. The factors identified as contributing to the effectiveness of the program were a tolerant attitude among health professionals, group education that encouraged motivation, quantitative dietary recommendations, and a meaningful learning model based on social learning theories. Conclusion: Dietary self-management without prohibitions helped participants to make changes in the quantity and timing of some food intake and to lose weight without sacrificing some foods that were deeply rooted in their culture and preferences. Dietary education programs should focus on health-related quality of life and include scientific knowledge but should also consider affective factors and the problems perceived as priorities by patients.

Main ecological gradients and landscape matrix affect wild rabbit Oryctolagus cuniculus (Linnaeus, 1758) (Mammalia: Leporidae) abundance in a coastal region (South-East Spain)

Landscape analysis with transects, in the Marina Baja area (province of Alicante, Spain), has contributed to establish the influence of different landscape matrices and some environmental gradients on wild rabbit Oryctolagus cuniculus (Linnaeus, 1758) (Mammalia: Leporidae) abundance (kilometric abundance index, KAI). Transects (n = 396) were developed to estimate the abundance of this species in the study area from 2006 to 2008.Our analysis shows that rabbits have preferences for a specific land use matrix (irrigated: KAI = 3.47 ± 1.14 rabbits/km). They prefer the coastal area (KAI = 3.82 ± 1.71 rabbits/km), which coincides with thermo-Mediterranean (a bioclimatic belt with a tempered winter and a hot and dry summer with high human density), as opposed to areas in the interior (continental climate with lower human occupation). Their preference for the southern area of the region was also noted (KAI = 8.22 ± 3.90 rabbits/km), which coincides with the upper semi-arid area, as opposed to the northern and intermediate areas (the north of the region coinciding with the upper dry and the intermediate area with the lower dry). On the other hand, we found that the number of rabbits increased during the 3-year study period, with the highest abundance (KAI = 2.71 ± 1.30 rabbits/km) inMay. Thus, this study will enable more precise knowledge of the ecological factors (habitat variables) that intervene in the distribution of wild rabbit populations in a poorly studied area.