Preoperative education and its influence on perception of recovery for clients awaiting total hip and total knee replacement surgery /

The puqjose of this study was to examine the manner in which an inviting approach to a preoperative teaching and learning educational experience influenced the perception and subsequent recovery of clients who were awaiting total hip and total knee replacement surgery. An in-depth review of the internal and external factors that shape client perceptions was undertaken in this study. In addition, this study also explored whether or not the Prehab Program was preparing clients physically, socially, and psychologically for surgery. Data for this qualitative case study research were collected through preoperative interviews with 4 participants awaiting total hip replacement surgery and 1 participant awaiting total knee replacement surgery. Four postoperative interviews were conducted with the participants who had received total hip replacement surgery. The occupational therapist and physical therapist who were the coleaders of the Prehab Program at the time of this study were also interviewed. The results of this study suggest that while individuals may receive similar educational experiences, their perceptions of the manner in which they benefited from these experiences varied. This is illustrated in the research findings, which concluded that while clients benefited physically from the inviting approach used during the practical teaching session, not all clients perceived the psychological benefits of this practice session, especially clients with preexisting high levels of anxiety. In addition to increasing the understanding of the internal as well as external factors that influence the perceptions of clients, this study has also served as an opportunity for reflection on practice for the Prehab therapists and other healthcare educators.

Carbohydrate refeeding rapidly reverses the adaptive upregulation of human skeletal muscle pyruvate dehydrogenase kinase following a high fat diet

The time course for the reversal of the adaptive increase in pyruvate dehydrogenase kinase (PDK) activity following a 6d high fat diet (HP: 4.2 ± 0.2 % carbohydrate; 75.6 ± 0.4 % fat; 19.5 ± 0.8 % protein) was investigated in human skeletal muscle (vastus lateralis). HF feeding increased PDK activity by 44% (from 0.081 ± 0.025 min"' to 0.247 ± 0.025 mm\p < 0.05). Following carbohydrate re-feeding, (88% carbohydrate; 5% fat; 7% protein), PDK activity had returned to baseline (0.111 ± 0.014 min"') within 3h of re-feeding. The active fraction of pyruvate dehydrognease (PDHa) was depressed following 6d of the HF diet (from 0.89 ± 0.21 mmol/min/kg WW to 0.32 ± 0.05 mmol/min/kg ww,p <0.05) and increased to pre-HF levels by 45 min of post re-feeding (0.74 ±0.19 mmol/min/kg ww) and remained elevated for 3h. Western blotting analysis of the PDK isoforms, PDK4 and PDK2, revealed a 31% increase in PDK4 protein content following the HF diet, with no change in PDK2 protein. This adaptive increase in PDK4 protein content was reversed with carbohydrate re-feeding. It was concluded that the adaptive up-regulation in PDK activity and PDK4 protein content was fiilly reversed by 3h following carbohydrate re-feeding.

Effect of a high fat maternal diet on body composition and bone development in male offspring

Direct high fat (HF) feeding has adverse effects on body composition and bone development in rodents. However, it is unclear whether maternal HF feeding has similar effects in male rat offspring. The objectives of this thesis were to determine if maternal HF feeding altered body composition, plasma hormones, bone development, and bone fatty acid composition in male offspring at weaning and 3 months of age. Maternal HF feeding increased bone mass and altered femur fatty acid composition at weaning, without differences in fat mass, lean mass, plasma hormones, or bone mass (femur or lumbar vertebrae). However, early differences did not persist at 3 months of age or contribute to lower bone strength – following consumption of a control diet post-weaning. These findings suggest that maternal HF feeding can alter body composition and bone development in weanling male offspring, without long-lasting effects if a healthy control diet is consumed post-weaning.

Maternal High Fat Feeding: Impact of Female Offspring Body Composition and Bone Health

High fat diet (HFD) consumption in rodents alters body composition and weakens bones. Whether female offspring of mothers consuming a HFD are similarly affected at weaning and early adulthood is unclear. This research determined whether maternal HFD contributes to long-lasting alterations in body composition and bone health of female offspring. Rats were fed control or HFD for 10 weeks prior to and throughout pregnancy and lactation. Female offspring were studied at weaning or 3 months of age (consumed control diet). Main findings in female offspring: maternal HFD decreased lean mass, increased fat mass and femoral BMD at weaning, but not at 3 months; weanling femoral lipid composition reflected maternal diet, persisting to 3 months of age (decreased total and n6 polyunsaturates, increased saturates); and no differences in femoral strength at 3 months. In summary, 3 month old female offspring have similar body composition and bone health regardless of maternal diet.