Structure and thermal stability of natural rubber reinforced with in situ generated zinc sorbate

In situ prepared zinc disorbate (ZDS) in natural rubber (NR) by the reaction of zinc oxide and sorbic acid was used to reinforce the dicumyl peroxide-cured NR vulcanizate. The changes in mechanical properties of NR vulcanizates after ageing and were determined and the structures and thermal stability of vulcanizates were also analyzed using scanning electron microscope and thermal gravimetric analyzer. The change ratios in tensile strength and elongation at break of NR vulcanizate with theoretic formation of ZDS of 21phr can be increased to -33 from -44 and -27 from -38 after ageing and the initial weight loss temperature of NR vulcanizate can be increased for about 7°C as compared to un-reinforced NR vulcanizate, indicating that the antioxidative behavior and thermal stability of NR can be improved significantly with theoretic formation of ZDS of 21phr.

Correlates of socio-economic inequalities in women’s television viewing : a study of intrapersonal, social and environmental mediators

Introduction

Socio-economically disadvantaged women are at a greater risk of spending excess time engaged in television viewing, a behavior linked to several adverse health outcomes. However, the factors which explain socio-economic differences in television viewing are unknown. This study aimed to investigate the contribution of intrapersonal, social and environmental factors to mediating socio-economic (educational) inequalities in women's television viewing.
Methods

Cross-sectional data were provided by 1,554 women (aged 18-65) who participated in the 'Socio-economic Status and Activity in Women study' of 2004. Based on an ecological framework, women self-reported their socio-economic position (highest education level), television viewing, as well as a number of potential intrapersonal (enjoyment of television viewing, preference for leisure-time sedentary behavior, depression, stress, weight status), social (social participation, interpersonal trust, social cohesion, social support for physical activity from friends and from family) and physical activity environmental factors (safety, aesthetics, distance to places of interest, and distance to physical activity facilities).
Results

Multiple mediating analyses showed that two intrapersonal factors (enjoyment of television viewing and weight status) and two social factors (social cohesion and social support from friends for physical activity) partly explained the educational inequalities in women's television viewing. No physical activity environmental factors mediated educational variations in television viewing.
Conclusions

Acknowledging the cross-sectional nature of this study, these findings suggest that health promotion interventions aimed at reducing educational inequalities in television viewing should focus on intrapersonal and social strategies, particularly providing enjoyable alternatives to television viewing, weight-loss/management information, increasing social cohesion in the neighborhood and promoting friend support for activity.

"The solution needs to be complex." Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity

Background
Previous studies of public perceptions of obesity interventions have been quantitative and based on general population surveys. This study aims to explore the opinions and attitudes of obese individuals towards population and individual interventions for obesity in Australia.

Methods
Qualitative methods using in-depth semi-structured telephone interviews with a community sample of obese adults (Body Mass Index ≥30). Theoretical, purposive and strategic recruitment techniques were used to ensure a broad sample of obese individuals with different types of experiences with their obesity. Participants were asked about their attitudes towards three population based interventions (regulation, media campaigns, and public health initiatives) and three individual interventions (tailored fitness programs, commercial dieting, and gastric banding surgery), and the effectiveness of these interventions.

Results
One hundred and forty two individuals (19-75 years) were interviewed. Participants strongly supported non-commercial interventions that were focused on encouraging individuals to make healthy lifestyle changes (regulation, physical activity programs, and public health initiatives). There was less support for interventions perceived to be invasive or high risk (gastric band surgery), stigmatising (media campaigns), or commercially motivated and promoting weight loss techniques (commercial diets and gastric banding surgery).

Conclusion
Obese adults support non-commercial, non-stigmatising interventions which are designed to improve lifestyles, rather than promote weight loss.

Cheapening the struggle : obese people's attitudes towards The Biggest Loser

Once the domain of clinicians and researchers, we must now accept that ‘obesity’ has become ingrained in popular culture. An example is the emergence of a feast of reality television shows about obesity and weight loss. The most popular show is The Biggest Loser, where contestants compete to lose weight and win cash.

Cultural influences on body dissatisfaction, body change behaviours and disordered eating of Japanese adolescents

We administered a paper-and-pencil questionnaire to 133 female and 99 male Japanese high school students 13–18 years old (M = 15.9, SD = 1.57) from the Kansai area to examine cultural influences on their body image and body change behaviours. Our aim was to ascertain the independent and combined influences from traditional Japanese, modern Japanese, and Western values. Cluster analyses identified four ‘acculturative’ groups: ‘anti-modern’, ‘traditional’, ‘pro-modern/anti-traditional’, and ‘pro-Western/anti-Japanese’. Pro-modern and pro-Western adolescents were most dissatisfied with their bodies, and pro-Western adolescents were also most likely to attempt weight loss. The results demonstrate the value of assessing cultural interactions in Japan along three dimensions.

Patient-reported outcomes in trials of incretin-based therapies in patients with type 2 diabetes mellitus

Incretin-based therapies have a glucose-dependent mode of action that results in excellent glucose-lowering efficacy with very low risk of hypoglycaemia, and weight neutrality [dipeptidyl peptidase-4 (DPP-4) inhibitors] or weight loss [glucagon-like peptide-1 (GLP-1) receptor agonists], in people with type 2 diabetes mellitus (T2DM). Patient-reported outcomes (PROs) complement physician evaluations of efficacy and tolerability and offer insights into the subjective experience of using modern diabetes treatments. We conducted a systematic search of clinical trials of the GLP-1 receptor agonists liraglutide, exenatide and long-acting exenatide, one of which included the oral DPP-4 inhibitor sitagliptin as a comparator. No other PRO data for DPP-4 inhibitors were identified. This review summarizes PRO data from eight clinical trials, the majority of which used the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and/or Impact of Weight on Quality of Life-Lite (IWQOL-Lite) to evaluate patient experience. People with T2DM were highly satisfied with modern incretin-based therapies compared with traditional therapies. Treatment satisfaction (including perceptions of convenience and flexibility) was high and generally higher with GLP-1 agonists in association with their greater glucose-lowering efficacy and tendency to facilitate weight loss. Weight-related quality of life (QoL) also improved in people using incretin therapies. The glycaemic improvements achieved with GLP-1 receptor agonists, coupled with the low incidence of hypoglycaemia and ability to cause weight loss, seemed to offset potential concern about injections. It is plausible that superior patient-reported benefits found in clinical trials may translate into improved, clinically meaningful, long-term outcomes through increased treatment acceptability. Long-term, prospective data are needed to ascertain whether this is the case in practice.

Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways

It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers.

Pregnancy : physical and body image changes

Body dissatisfaction is often associated with negative psychological functioning, such as depression, and maladaptive behaviors, such as unhealthy eating and extreme weight loss behaviors, which have serious negative implications for women’s health and well-being, and potentially also for the unborn fetus during pregnancy. This article summarizes contemporary research in the area of body image during pregnancy, showing the development of knowledge in this area with increasing research interest in this topic in more recent times.

Use of electrochemical impedance spectroscopy for study of CO2 corrosion prevention by batch treatment inhibitor films

Electrochemical impedance spectroscopy (EIS) was used to study and evaluate commercial batch treatment inhibitors which are used for protecting oil wells, gas wells, and pipelines from CO2 corrosion, focusing on the evaluation of inhibitor film persistency. It was found that theformation and deterioration of batch treatment inhibitor films were accompanied by typical impedance spectral changes. During the formation of inhibitor films, electrode impedance showed a rapid increase and the Bode phase angle plots also showed a sudden change. Thus, the formation of inhibitor film was a very fast process. During the deterioration of inhibitor films, electrode impedance showed a gradual decrease and the Bode phase angle plots showed changes which characterised the three stages of the inhibitor film deterioration process. The relationships between EIS and corrosion rate are discussed, including comparisons with weight loss measurements. Based on the experimental findings in the present work, a method is suggested for estimating the persistency of inhibitor films by monitoring the characteristic changes in the Bode phase angle plots and by measuring electrochemical charge transfer resistance at the second and third stages of the inhibitor film deterioration process.

Electrochemical impedance spectroscopy and surface characterization techniques to study carbon dioxide corrosion product scales

Electrochemical impedance spectroscopy (EIS) was used to study carbon dioxide (CO2) corrosion product scales and their effects on further CO2 corrosion. Objectives were to determine the suitability of EIS for studying corrosion scales and to investigate the influence of environmental factors on scale formation. EIS provided useful information about protective abilities and electrochemical properties of corrosion scales. CO2 corrosion scales formed at high-temperature and pressure provided better protection than those formed at low-temperature and pressure. The level of protection of the scale formed at higher temperature and pressure increased with exposure time. EIS results were compared with coupon weight-loss measurements. Scales were analyzed using a combination of Fourier transform infrared (FTIR) analysis, x-ray diffraction (XRD), and electron microscopy.

Studies of CO2 corrosion product scales using electrochemical impedance spectroscopy and surface characterisation techniques

Electrochemical impedance spectroscopy (EIS) was used to study carbon dioxide (CO2) corrosion product scales and their effects on further CO2 corrosion. Objectives were to determine the suitability of EIS for studying corrosion scales and to investigate the influence of environmental factors on scale formation. EIS provided useful information about protective abilities and electrochemical properties of corrosion scales. CO2 corrosion scales formed at high-temperature and pressure provided better protection than those formed at low-temperature and pressure. The level of protection of the scale formed at higher temperature and pressure increased with exposure time. EIS results were compared with coupon weight-loss measurements. Scales were analyzed using a combination of Fourier transform infrared (FTIR) analysis, x-ray diffraction (XRD), and electron microscopy

Health care use during 20 years following bariatric surgery

Context Bariatric surgery results in sustained weight loss; reduced incidence of diabetes, cardiovascular events, and cancer; and improved survival. The long-term effect on health care use is unknown.

Objective To assess health care use over 20 years by obese patients treated conventionally or with bariatric surgery.

Design, Setting, and Participants The Swedish Obese Subjects study is an ongoing, prospective, nonrandomized, controlled intervention study conducted in the Swedish health care system that included 2010 adults who underwent bariatric surgery and 2037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Exclusion criteria were identical in both groups.

Interventions Of the surgery patients, 13% underwent gastric bypass, 19% gastric banding, and 68% vertical-banded gastroplasty. Controls received conventional obesity treatment.

Main Outcome Measures Annual hospital days (follow-up years 1 to 20; data capture 1987-2009; median follow-up 15 years) and nonprimary care outpatient visits (years 2-20; data capture 2001-2009; median follow-up 9 years) were retrieved from the National Patient Register, and drug costs from the Prescribed Drug Register (years 7-20; data capture 2005-2011; median follow-up 6 years). Registry linkage was complete for more than 99% of patients (4044 of 4047). Mean differences were adjusted for baseline age, sex, smoking, diabetes status, body mass index, inclusion period, and (for the inpatient care analysis) hospital days the year before the index date.

Results In the 20 years following their bariatric procedure, surgery patients used a total of 54 mean cumulative hospital days compared with 40 used by those in the control group (adjusted difference, 15; 95% CI, 2-27; P = .03). During the years 2 through 6, surgery patients had an accumulated annual mean of 1.7 hospital days vs 1.2 days among control patients (adjusted difference, 0.5; 95% CI, 0.2 to 0.7; P < .001). From year 7 to 20, both groups had a mean annual 1.8 hospital days (adjusted difference, 0.0; 95% CI, −0.3 to 0.3; P = .95). Surgery patients had a mean annual 1.3 nonprimary care outpatient visits during the years 2 through 6 vs 1.1 among the controls (adjusted difference, 0.3; 95% CI, 0.1 to 0.4; P = .003), but from year 7, the 2 groups did not differ (1.8 vs 1.9 mean annual visits; adjusted difference, −0.2; 95% CI, −0.4 to 0.1; P = .12). From year 7 to 20, the surgery group incurred a mean annual drug cost of US $930; the control patients, $1123 (adjusted difference, −$228; 95% CI, −$335 to −$121; P < .001).

Conclusions Compared with controls, surgically treated patients used more inpatient and nonprimary outpatient care during the first 6-year period after undergoing bariatric surgery but not thereafter. Drug costs from years 7 through 20 were lower for surgery patients than for control patients.

Promoting physical activity and reducing sedentary behavior in disadvantaged neighborhoods : a qualitative study of what women want

Since women living in socioeconomically disadvantaged neighborhoods are more likely to be physically inactive and engage in higher levels of sedentary behavior than women living in more advantaged neighborhoods, it is important to develop and test the feasibility of strategies aimed to promote physical activity and reduce sedentary behavior amongst this high-risk target group. Thirty-seven women (aged 19–85) living in a disadvantaged neighborhood, and five key stakeholders, received a suite of potential intervention materials and completed a qualitative questionnaire assessing the perceived feasibility of strategies aimed to increase physical activity and reduce sedentary behavior. Thematic analyses were performed. Women perceived the use of a locally-relevant information booklet as a feasible strategy to increase physical activity and reduce sedentary behavior. Including weight-loss information was suggested to motivate women to be active. Half the women felt the best delivery method was mailed leaflets. Other suggestions included reference books and websites. Many women mentioned that an online activity calendar was motivational but too time-consuming to commit to. Most women preferred the information booklet as a strategy to increase physical activity/reduce sedentary behavior, yet several suggested that using the booklet together with the online calendar may be more effective. These findings make an important contribution to research informing the development of intervention strategies to increase physical activity and reduce sedentary behavior amongst women living in disadvantaged neighborhoods.

Scaling-up from an implementation trial to state-wide coverage : results from the preliminary Melbourne Diabetes Prevention Study

Background
The successful Greater Green Triangle Diabetes Prevention Program (GGT DPP), a small implementation trial, has been scaled-up to the Victorian state-wide ‘Life!’ programme with over 10,000 individuals enrolled. The Melbourne Diabetes Prevention Study (MDPS) is an evaluation of the translation from the GGT DPP to the Life! programme. We report results from the preliminary phase (pMDPS) of this evaluation.
Methods
The pMDPS is a randomised controlled trial with 92 individuals aged 50 to 75 at high risk of developing type 2 diabetes randomised to Life! or usual care. Intervention consisted of six structured 90-minute group sessions: five fortnightly sessions and the final session at 8 months. Participants underwent anthropometric and laboratory tests at baseline and 12 months, and provided self-reported psychosocial, dietary, and physical activity measures. Intervention group participants additionally underwent these tests at 3 months. Paired t tests were used to analyse within-group changes over time. Chi-square tests were used to analyse differences between groups in goals met at 12 months. Differences between groups for changes over time were tested with generalised estimating equations and analysis of covariance.
Results
Intervention participants significantly improved at 12 months in mean body mass index (−0.98 kg/m2, standard error (SE) = 0.26), weight (−2.65 kg, SE = 0.72), waist circumference (−7.45 cm, SE = 1.15), and systolic blood pressure (−3.18 mmHg, SE = 1.26), increased high-density lipoprotein-cholesterol (0.07 mmol/l, SE = 0.03), reduced energy from total (−2.00%, SE = 0.78) and saturated fat (−1.54%, SE = 0.41), and increased fibre intake (1.98 g/1,000 kcal energy, SE = 0.47). In controls, oral glucose at 2 hours deteriorated (0.59 mmol/l, SE = 0.27). Only waist circumference reduced significantly (−4.02 cm, SE = 0.95).

Intervention participants significantly outperformed controls over 12 months for body mass index and fibre intake. After baseline adjustment, they also showed greater weight loss and reduced saturated fat versus total energy intake.

At least 5% weight loss was achieved by 32% of intervention participants versus 0% controls.
Conclusions
pMDPS results indicate that scaling-up from implementation trial to state-wide programme is possible. The system design for Life! was fit for purpose of scaling-up from efficacy to effectiveness.

Self-monitoring in the treatment of overweight adolescents

The aim of this study was to explore the relationship between the quantity and quality of self-monitoring and per cent fat loss in overweight and obese adolescents participating in a weight-loss intervention. Participants were 55 (33F) overweight and obese adolescents taking part in a 20-week cognitive–behavioural intervention aimed at improving eating and physical activity behaviours. Food and physical activity self-monitoring from the first 9 weeks of the intervention was coded using 24 components assessing the quantity (20) and quality (4) of selfmonitoring. Those who completed treatment (n = 42) were split into groups: Losers (n = 30) and Gainers (n = 12) of per cent body fat as measured by DXA. Group analyses showed that Losers and Gainers could be differentiated by both quantitative and qualitative measures of self-monitoring. The strongest associations were with the classifications of food and drink items into food groups. The number of days monitored and the average number of items recorded did not differentiate the groups. Quantity and quality measures of self-monitoring completed early in treatment could also differentiate those who completed treatment and those who did not complete treatment (n = 13), and the strongest associations were with the amounts of food and drink items recorded, an association not found with treatment outcome. The results indicate that both quantity and quality of self-monitoring may be important predictors of both treatment completion and outcome. Based on these findings a framework of self-monitoring requirements is offered to reduce homework burden while maximising treatment efficacy.