20 resultados para Pathway Model


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Binge eating is a significant problem in both eating disordered and community populations alike. Extensive support exists for the dual pathway model of binge eating in both adolescent and adult clinical and nonclinical populations. However, the restrained eating pathway to binge eating in particular has failed to be confirmed in some studies. In particular, the dual pathway model may not be applicable to overweight binge eaters. The current study examined the applicability of the dual pathway model in a sample of healthy and overweight binge eaters. A total of 260 (115 healthy weight; 145 overweight or obese) adult binge eaters completed an online survey. Mediation analyses indicated support for both the dietary restraint and negative affect pathways in the healthy weight sample but only the latter pathway was supported in the overweight sample. Therefore, the full dual pathway model may only be applicable to healthy weight binge eaters.

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Objectives: To outline the development, structure, data assumptions, and application of an Australian economic model for stroke (Model of Resource Utilization, Costs, and Outcomes for Stroke [MORUCOS]). Methods: The model has a linked spreadsheet format with four modules to describe the disease burden and treatment pathways, estimate prevalence-based and incidence-based costs, and derive life expectancy and quality of life consequences. The model uses patient-level, community-based, stroke cohort data and macro-level simulations. An interventions module allows options for change to be consistently evaluated by modifying aspects of the other modules. To date, model validation has included sensitivity testing, face validity, and peer review. Further validation of technical and predictive accuracy is needed. The generic pathway model was assessed by comparison with a stroke subtypes (ischemic, hemorrhagic, or undetermined) approach and used to determine the relative cost-effectiveness of four interventions. Results: The generic pathway model produced lower costs compared with a subtypes version (total average first-year costs/case AUD$15,117 versus AUD$17,786, respectively). Optimal evidence-based uptake of anticoagulation therapy for primary and secondary stroke prevention and intravenous thrombolytic therapy within 3 hours of stroke were more cost-effective than current practice (base year, 1997). Conclusions: MORUCOS is transparent and flexible in describing Australian stroke care and can effectively be used to systematically evaluate a range of different interventions. Adjusting results to account for stroke subtypes, as they influence cost estimates, could enhance the generic model.

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Purpose
The present study tests several competing, explanatory models—dual pathways, escape from awareness, and objectification theory—for the established link between body dissatisfaction and binge eating.

Methods
408 women aged between 18 and 40 years completed a survey designed to assess contributions of proposed mediators (dietary restraint and negative affect from the dual pathway model, self-distraction from the escape from awareness model, and interoceptive deficits from objectification theory) for the body dissatisfaction–binge eating relationship.

Results
Although mediation analyses supported the dual pathway model and objectification theory when tested separately, the dual pathway model most strongly predicted the body dissatisfaction–binge eating relationship. Both model-implied mediators (dietary restraint and negative affect) made significant unique contributions, accounting for roughly one-quarter of the shared variance between body dissatisfaction and binge eating when tested separately from other mediators. Improvements in variance explained were negligible once other proposed mediators were included in a test of models combined.

Conclusions
Collectively, these findings suggest the superiority of the dual pathway model over objectification theory and the escape model, but the remaining unaccounted for covariance suggests need to consider alternative mechanisms that may also account for the relationship between body dissatisfaction and binge eating.

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 This thesis explored the association between body dissatisfaction and binge eating by comparing three competing theoretical frameworks. Study I utilised a cross-sectional design and collectively these findings suggest the superiority of the dual pathway model (dietary restraint and negative affect) over the objectification theory and the escape model. The purpose of Study II was then to extend on the findings from Study I by further examining in real-time the model/theory that most strongly explained the body dissatisfaction-binge eating relationship. Participants were prompted at random intervals seven times daily across the course of a week to self-report their state body dissatisfaction, current mood experiences, and eating practices. Results revealed that negative mood, but not dietary restraint, significantly mediated the state body dissatisfaction-binge eating relationship. These results highlight that the dual pathway model is robust, but raise the possibility that the dietary restraint path in the model is not well operationalized. In light of the non-significant mediating effect of dietary restraint, this led the researcher to identify various modeling alternatives to further understand the mediating influences of the pathways of negative affect and dietary restraint.

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Stice's dual pathway model of dietary restraint and negative affect was examined in both adolescent girls and boys. Self-report measures assessing body dissatisfaction, dietary restraint, negative affect and bulimic behavior were administered to 267 girls and 199 boys aged between 12 and 16 years. The findings for the girls were consistent with Stice's model, in that they indicated that both dietary restraint and negative affect mediated the relationship between body dissatisfaction and bulimic behavior. For the boys who desired a thinner body size, only negative affect was found to mediate the relationship between body dissatisfaction and bulimic behavior. On the other hand, for boys who desired a larger body size, both body dissatisfaction and dietary restraint were found to exert an independent effect on bulimic behavior. As boys can aspire to two contrasting and seemingly opposite body size ideals, the findings highlight that the relationship between body dissatisfaction, dietary restraint, negative affect and bulimic behavior are more complex in males than in females. Further research using longitudinal designs is needed in order to test the directional and bidirectional nature of the observed interrelationships.

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A representative sample (N=801) of the Beijing adult population was used to empirically test and validate a proposed hierarchical model of relationships between values, lifestyles, possessions and food consumption. The theoretical contribution of the present study is the development and an empirically supported paradigm, which explains consumers' consumption behaviour. A further outcome is the substantiation of a pathway model involving hierarchical relationship between values, lifestyle, and demographic variables on material possessions and food consumption.

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The unicellular green alga Chlamydomonas reinhardtii is a valuable model for studying metal metabolism in a photosynthetic background. A search of the Chlamydomonas expressed sequence tag database led to the identification of several components that form a copper-dependent iron assimilation pathway related to the high-affinity iron uptake pathway defined originally for Saccharomyces cerevisiae. They include a multicopper ferroxidase (encoded by Fox1), an iron permease (encoded by Ftr1), a copper chaperone (encoded by Atx1), and a copper-transporting ATPase. A cDNA, Fer1, encoding ferritin for iron storage also was identified. Expression analysis demonstrated that Fox1 and Ftr1 were coordinately induced by iron deficiency, as were Atx1 and Fer1, although to lesser extents. In addition, Fox1 abundance was regulated at the posttranscriptional level by copper availability. Each component exhibited sequence relationship with its yeast, mammalian, or plant counterparts to various degrees; Atx1 of C. reinhardtii is also functionally related with respect to copper chaperone and antioxidant activities. Fox1 is most highly related to the mammalian homologues hephaestin and ceruloplasmin; its occurrence and pattern of expression in Chlamydomonas indicate, for the first time, a role for copper in iron assimilation in a photosynthetic species. Nevertheless, growth of C. reinhardtii under copper- and iron-limiting conditions showed that, unlike the situation in yeast and mammals, where copper deficiency results in a secondary iron deficiency, copper-deficient Chlamydomonas cells do not exhibit symptoms of iron deficiency. We propose the existence of a copper-independent iron assimilation pathway in this organism.

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Objective: To identify the strengths and limitations of health care and related services provided to young adults with a disability during the period of transition from the care of a paediatrician to the mainstream health system.
Design: A descriptive design was used to address the study objectives.
Setting: Barwon and south-western region of Victoria.
Subjects: Twelve focus group discussions, with young adults with a disability, carers of young adults with a disability and health care service providers. Each focus group involved eight to 10 participants.
Results: The findings revealed a number of problems with the transition period. All participants acknowledged the supportive, coordinating role of the paediatrician. In the absence of this type of role, carers felt they lacked the knowledge and support to manage the adolescent with a disability. Communication problems between all service providers were identified as being problematical. The general lack of continuity of care between providers made it difficult for individuals to negotiate the transition period and increased the burden of care on carers.
Conclusion: There is a need for policy makers to address these transition problems and develop appropriate services that improve the situation for young adults with a disability and their carers.
What is already known: It is well documented that the transition period from paediatrician to adult health care services is problematic for the young adult with a disability and their carer. The difficulties experienced are attributed to poor communication between service providers and a lack of continuity of care.
What does this study add: This study provides insights from a number of different consumer and health care professionals' perspectives. The findings identify service delivery gaps and a need to develop health care services that could assist the young adult with the disability negotiate this transition from the paediatric services to mainstream health care services in rural and regional settings in Victoria.

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Two theoretical developments, the Self-Regulation Model of the Offence and Relapse Process and the Good Lives Model, have recently offered promise in the advancement of sex offender treatment. The present paper represents a preliminary attempt to operationalize these theoretical principles by developing a number of practical treatment procedures. We have employed the method of a life map, which traces personal development from birth and which incorporates long-term future projections. This includes all actions, events, incidents and skills (whether positive or negative), which have led to a sense of self-esteem and the development of personal values. These will include risk factors and criminogenic needs which lead to offending as well as positive experiences and self-resources which can be incorporated into a future Good Lives Pathway. Two case illustrations are presented, which demonstrate the way in which all experiences from the past can be incorporated into alternative future pathways. These pathways will include positive self-resources and protective variables which develop into a non-offending future and negative self-resources with risk variables which develop into an offending future. The cases illustrate the way in which GLM and self-regulation pathways can be combined in a robust practical treatment procedure. Practical difficulties inherent in the procedure are also discussed.

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Purpose: Motor skills are considered a prerequisite to physical activity, yet the relationship may be reciprocal and perceived sports competence might mediate associations.
Methods: In 2006/2007, 215 adolescents completed motor skill proficiency (Get Skilled Get Active), perceived sport competence (Physical Self-Perception Profile) and physical activity assessments (Adolescent Physical Activity Recall Questionnaire) as part of the Physical Activity and Skills Study. Using AMOS (Version 7.0), reciprocal relationships were examined between motor skill (object control and locomotor) and moderate to vigorous physical activity (MVPA). Both models were then run in different versions to understand the role of perceived sports competence as a potential mediator.
Results: Mean age was 16.4 yr (SD = 0.6), 51.6% (111/215) were females. A reciprocal relationship between object control and MVPA and a one-way relationship from MVPA to locomotor skill was found. When perceived sports competence was examined as a mediator, the best-fitting model versions explained 16% (R² = 0.16)
MVPA variation, and 30% object control (R² = 0.30), and 12% locomotor skill variation (R² = 0.12) (reverse relationship). Perceived sports competence partially mediates the relationship between object control proficiency and physical activity for both directions and fully mediates the relationship between physical activity and locomotor skill; but only when locomotor skill is the outcome.
Conclusions: If the relationship between object control skill and physical activity is viewed as a ‘‘positive feedback loop,’’ skill development and increasing physical activity should simultaneously be targeted in physical activity interventions. Increasing perceived sport competence should also be an intervention focus.

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By utilizing the zebrafish as a research model, the function of specific cell signalling pathway components in development was investigated. This revealed new roles for the so-called Jak2/Stat5/Cis pathway in blood and sensory organ development, and a conserved prolactin pathway despite divergent functions between species.

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Nitric oxide is implicated in the pathogenesis of various neuropathologies characterized by oxidative stress. Although nitric oxide has been reported to be involved in the exacerbation of oxidative stress observed in several neuropathologies, existent data fail to provide a holistic description of how nitrergic pathobiology elicits neuronal injury. Here we provide a comprehensive description of mechanisms contributing to nitric oxide induced neuronal injury by global transcriptomic profiling. Microarray analyses were undertaken on RNA from murine primary cortical neurons treated with the nitric oxide generator DETA-NONOate (NOC-18, 0.5 mM) for 8–24 hrs. Biological pathway analysis focused upon 3672 gene probes which demonstrated at least a ±1.5-fold expression in a minimum of one out of three time-points and passed statistical analysis (one-way anova, P < 0.05). Numerous enriched processes potentially determining nitric oxide mediated neuronal injury were identified from the transcriptomic profile: cell death, developmental growth and survival, cell cycle, calcium ion homeostasis, endoplasmic reticulum stress, oxidative stress, mitochondrial homeostasis, ubiquitin-mediated proteolysis, and GSH and nitric oxide metabolism. Our detailed time-course study of nitric oxide induced neuronal injury allowed us to provide the first time a holistic description of the temporal sequence of cellular events contributing to nitrergic injury. These data form a foundation for the development of screening platforms and define targets for intervention in nitric oxide neuropathologies where nitric oxide mediated injury is causative.

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Cancer cachexia is a wasting condition, driven by systemic inflammation and oxidative stress. This study investigated eicosapentaenoic acid (EPA) in combination with oxypurinol as a treatment in a mouse model of cancer cachexia. Mice with cancer cachexia were randomized into 4 treatment groups (EPA (0.4 g/kg/day), oxypurinol (1 mmol/L ad-lib), combination, or control), and euthanized after 29 days. Analysis of oxidative damage to DNA, mRNA analysis of pro-oxidant, antioxidant and proteolytic pathway components, along with enzyme activity of pro- and antioxidants were completed on gastrocnemius muscle. The control group displayed earlier onset of tumor compared to EPA and oxypurinol groups (P<0.001). The EPA group maintained body weight for an extended duration (20 days) compared to the oxypurinol (5 days) and combination (8 days) groups (P<0.05). EPA (18.2±3.2 pg/ml) and combination (18.4±3.7 pg/ml) groups had significantly higher 8-OH-dG levels than the control group (12.9±1.4 pg/ml, P≤0.05) indicating increased oxidative damage to DNA. mRNA levels of GPx1, MURF1 and MAFbx were higher following EPA treatment compared to control (P≤0.05). Whereas oxypurinol was associated with higher GPx1, MnSOD, CAT, XDH, MURF1, MAFbx and UbB mRNA compared to control (P≤0.05). Activity of total SOD was higher in the oxypurinol group (32.2±1.5 U/ml) compared to control (27.0±1.3 U/ml, P<0.01), GPx activity was lower in the EPA group (8.76±2.0 U/ml) compared to control (14.0±1.9 U/ml, P<0.05), and catalase activity was lower in the combination group (14.4±2.8 U/ml) compared to control (20.9±2.0 U/ml, P<0.01). There was no change in XO activity. The increased rate of weight decline in mice treated with oxypurinol indicates that XO may play a protective role during the progression of cancer cachexia, and its inhibition is detrimental to outcomes. In combination with EPA, there was little significant improvement from control, indicating oxypurinol is unlikely to be a viable treatment compound in cancer cachexia.

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Along with the massification of higher education comes a need for new models to support the success of greater numbers of diverse students. A greater proportion of these students are ‘non-traditional’ in terms of preparedness, socioeconomic status  and geography. This paper introduces an Associate Degree model designed to support this new higher education reality of broader student cohorts, thin regional markets and cross-sectoral collaboration. Background literature on challenges facing the higher education sector and its prospective students is presented, with a particular focus on regionality. An argument is made for the role of curriculum and pedagogy as enablers of non-traditional student success. This is supported by the results of a mixed-methods exploratory study. This Associate Degree model was attractive to students and institutes. Students experienced similar levels of challenge, workload and progress to their traditional peers. While technology was essential for the success of the model, it played a supporting role to the relationships and multiple modes of learning it facilitated. This article provides insights for institutions seeking to address the broadening participation agenda.