Attrition and Retention in Multidisciplinary Weight Management Interventions for Adults with Obesity: A Systematic Review

Background High rates of attrition undermine the success of weight management interventions (WMIs), but a comprehensive understanding of the factors that increase dropout risk remains absent. This is partly explained by heterogeneity of intervention design, and the absence of a universal definition of attrition. This systematic review aimed to identify the factors related to- and predictive of attrition and retention in multidisciplinary WMIs for adults with obesity. Methods The systematic literature search, conducted in Cochrane, Medline, PsycInfo, and Scopus, aimed to identify original research articles published between February 2008 and December 2019. Articles investigating attrition or retention in multidisciplinary WMIs were eligible for inclusion if interventions were for adults (≥18) with obesity identified by body mass index ≥30kg/M2 and lasted ≥6 months. Multidisciplinary was defined as ≥2 interventionist disciplines or professions, for the purpose of this review. Data was synthesised narratively. Results The literature search resulted in seventeen studies which satisfied the inclusion criteria. Attrition rates ranged from 10% at 3-months to 81% at 3-years. The sociodemographic factors associated with reduced risk of attrition included older age, living in less deprived areas, higher levels of education, and female gender. Poor mental health, low social support, high weight loss goals and poor or unsatisfactory results may increase the likelihood of participant dropout, but evidence was limited and inconclusive because of different methodologies, and only a small number of studies investigating some of the variables. Conclusions The scope for targeted retention strategies is limited because few variables were consistently associated with attrition. Until a comprehensive understanding of attrition emerges, WMIs should seek to reduce social inequities in the benefit of WMI provision. Future research should consider factors reported qualitatively, such as intervention expectations and satisfaction, social support, patient-clinician relationships, and logistical barriers. Adopting a universal definition of attrition and de-homogenising participant dropouts would advance future research. As qualitative evidence is limited, exploring participant experiences of WMIs would help understand how attrition rates can be reduced, and in-turn improve WMI effectiveness.

How the Lack of a Universal Definition of Childhood Neglect is Negatively Impacting U.S. Families

Social Judgment Theory can be a useful tool in understanding the ways in which judgment plays a role in how Child Protective Investigators determine if a child has been neglected. In most States, more children are removed by charges of ‘neglect only’ than for any other reason. A close examination of the States’ definitions of childhood neglect may offer insight as to how the writing of laws allows for discernment among case workers and further how their judgment is impacted by their own personal beliefs. In an effort to ensure child safety and prevent future traumas, the utilization of Social Judgment Theory should be considered in the social and psychological research of child welfare. Varying definitions of how neglect may propose a new variable in the differing outcomes of child removal between the states are discussed.

Criminal and legal protection of national security: Problems of systematization of crimes

The chief idea of criminal law is to protect the individual, society, and the state from criminal encroachment. Defined by the legislator in the field of protection - the basics of national security, life and health, public safety, environment, etc. are subject to comprehensive research to improve the effectiveness of criminal law protection, which is of great practical importance. The foundations of national security are a multifaceted construction that requires detailed analysis. This work is devoted to the study of the conceptual foundations of systematization of crimes against the foundations of national security of Ukraine as one of the fundamental aspects of the theoretical basis of the criminal law system. The work aims to study the conceptual foundations of the systematization of crimes against the foundations of national security of Ukraine. The subject of study: problematic aspects of systematization of crimes against the foundations of national security of Ukraine. The object of research: approaches to the systematization of crimes against the foundations of national security of Ukraine. The authors used the following methods: observation, generalization, analysis, synthesis, experiment, formalization. As a result of the study, the universal definition of national security, the feasibility of a system of crimes against the foundations of national security of Ukraine, determined as an experiment to develop subgroups under Section I of the Special Part of the Criminal Code.

A Scoping Review of Financial Elder Exploitation Interventions

Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as “the misappropriation of an older person’s money or property,” is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed.

Readiness of clinical laboratory diagnostics and cardiologists to implement the recommendations of the fourth universal definition of myocardial infarction

This study describes the problems of the implementation of the fourth universal definition of myocardial infarction in the medical institutions of four cities: Volgograd (with Volzhsky), Yekaterinburg, Perm, Ufa, and districts of the Volgograd region. The multicenter study was conducted in the form of a questionnaire of specialists in cardiology and laboratory services. After a survey of cardiac specialists, it was found that a third of them did not see the benefits of the hs-cTn test recommended for the diagnosis of myocardial infarction, and almost half of the specialists surveyed believed that myoglobin was a necessary test for detecting myocardial infarction. Probably, this is due to the fact that 16 clinical diagnostic laboratories from the 5 above regions still perform the determination of myoglobin in patients with suspected myocardial infarction. The material and technical support of medical and diagnostic institutions generally meets the requirements of the fourth universal definition of myocardial infarction. However, there is a problem of «qualitative» equipment of the regions of the Volgograd region, since only 3 out of 31 districts declared the possibility of carrying out a quantitative determination of hs-cTn , and qualitative analysis was carried out on platforms that are not monitored by the IFCC. It is worrying that almost half of the specialists of the clinical and diagnostic laboratories of the central district hospitals of the Volgograd region did not indicate the manufacturer of reagents for determining troponins. Thus, in the educational programs of advanced training of specialists in cardiology and laboratory services, it is necessary to include aspects related to the explanation of analytical characteristics, the characteristics of the technology for performing troponin tests and the related interpretation options for the results.

Towards a Universal Definition of Disease Activity Score Thresholds: The AS135 Score

Background Many study groups have developed scores to reflect disease activity. The result of this fragmented process is a multitude of disease activity scores, even for a single disease. Design: To identify and standardize disease activity scores in rheumatology, we conducted a literature review on disease activity criteria using both a manual approach and in-house computer software (BIBOT) that applies natural language processing to automatically identify and interpret important words in abstracts published in English between 1.1.1975 and 31.12.2018. We selected activity scores with cut-off values divided into four classes (remission and low, moderate and high disease activity). We used a linear interpolation to map disease activity scores to our new score, the AS135, and developed a smartphone application to perform the conversion. Results A total of 108 activity criteria from various fields were identified, but it was in rheumatology that we found the most pronounced separation into four classes. We built the AS135 score modification for each selected score using a linear interpolation of the existing criteria. The score modification was defined on the interval [0,10], and values of 1, 3 and 5 were used as thresholds. These arbitrary thresholds were then associated with the thresholds of the existing criteria, and an interpolation was calculated, allowing conversion of the existing criteria into the AS135 criterion. Finally, we created a mobile application. Conclusion We developed an application for clinicians that enables the use of a single disease activity score for different inflammatory rheumatic diseases using an intuitive scale.

Characteristics of Air Resistance in Aerostatic Bearings

The definition of air resistance is nonuniform when analyzing the bearing capacity, stiffness, and stability of an orifice throttling aerostatic restrictor. In this study, a capillary tube similar to the inlet section of an aerostatic restrictor is used as the research object, and the Bernoulli equation under adiabatic conditions is established. Through an experiment, the pressure and temperature of the capillary tube inlet and outlet and the flow through the capillary tube are measured. Based on the air resistance definition, the empirical formula of the coefficient k is obtained, and the theoretical air resistance of the capillary path is calculated. The relative error between the theoretical air resistance and experimental air resistance is kept within 10%. The comparison results verify the accuracy of the air resistance theory and provide a basis for the subsequent establishment of a universal definition of air resistance. Subsequently, air resistance can be used to design aerostatic bearings and help improve their characteristics.

Diagnosis and pharmacological treatment of chronic heart failure in accordance with the recommendations of ESC 2021

The article presents a new universal definition of chronic heart failure, patient’s phenotypes, algorithm for diagnostics of HF, considers the guidelines of their managements and the prognosis of the disease determiner’s factors. The article will be useful for cardiologists, doctors of the emergency departments.

Language Relativity in Legacy Literature: A Systematic Review in Multiple Languages

Since the Olympic Agenda 2020, legacy has been widely used as a justification for hosting the Olympic Games, through which sustainable development can be achieved for both events and host cities. To date, no universal definition of legacy has been established, which presents challenges for legacy-related international knowledge transfer among host cities. To address this gap, a multilingual systematic review of the literature regarding the concept of legacy was conducted in French, Japanese, Chinese, and English. Using English literature as a baseline, points of convergence and divergence among the languages were identified. While all four languages value the concept of legacy as an important facet of mega-events, significant differences were found within each language. This finding highlights the importance of strategies that align different cultures when promoting sustainable development of some global movements such as the Olympic legacy. Sport management is replete with international topics, such as international events and sport for development, and each topic is studied simultaneously in several languages and with potentially differing frameworks and perspectives. Thus, literature reviews that examine the English literature, exclusively, are innately limited in scope. The development of partnerships and resources that facilitate cross-lingual and cross-cultural consultation and collaboration is an important research agenda. More research is needed on knowledge translation across languages.