published_or_final_version / Nursing Studies / Master / Master of Nursing

Background: Lifestyle intervention is recommended as one important approach for Diabetes Mellitus management. Type 2 Diabetes Mellitus could be controlled and maintained by lifestyle intervention with no or less medications. It can delay the onset of diabetes related complications. Meal Replacement is one important lifestyle intervention. It modifies the composition and amount of nutrition intake, through daily meal, in order to control body weight and other metabolic indices. Effectiveness of meal replacement was examined by randomized controlled trials. Reviewing these studies systematically would demonstrate the clinical implication and other benefit of meal replacement, further more to guide the implementation in practice. Method: Search the online literature databases for related Randomized Controlled Trials. Analyze and compare different strategies of these interventions, as well as the outcomes. The effect of MR would be categorized into on body weight, on blood glucose, on serum lipid and on hypoglycemic medication and prognosis. The economic benefit would also be one important objective. Result: MR intervention achieved body weight reduction, and considerable controlling effect on glucose and lipid. Majority of studies also reduced the hypoglycemic medication and improved prognosis. Conclusion: MR is one considerable intervention for T2DM and Intermediate Hyperglycemia patients. It could be integrated into structured lifestyle intervention for prevention and treatment. It also brings economic benefit so that reduce health care burden. Further research is needed for better effectiveness in practice. / published_or_final_version / Public Health / Master / Master of Public Health

As rates of obesity have increased this disease has become a common problem that physicians are faced with treating. This paper aims to review the different options for patients and determine the best treatments for obesity. Modalities that are considered include dietary treatment, exercise, pharmacologic treatment, and weight loss surgery. This study compares reduced calorie diets, low fat diets, low glycemic index/load diets, the Mediterranean diet, and low carbohydrate diets. The validity of exercise as an effective prescription for obesity is evaluated and debunked. Pharmacologic treatments that are contrasted include those drug therapies that are currently approved by the United States Food and Drug Administration for the long-term treatment of obesity. Those are orlistat, lorcaserin and phentermine/topiramate. The surgical treatments reviewed include vertical banded gastroplasty, adjustable gastric banding, Roux-en Y gastric bypass, biliopancreatic diversion, and biliopancreatic diversion with duodenal switch. After a comprehensive review of the literature the conclusion reached was that treatment for obesity should begin with the least invasive options and those that have the least potential for harm. That is, diet should be a first course of action. Among diets a Mediterranean diet or another culturally adapted low glycemic index/load diet is best. However, more studies are needed to determine how to translate the diets for different cultures and individual tastes. When diets are unable to produce enough weight loss, pharmacologic treatments are considered. Among them, lorcaserin and phentermine/topiramate do not have enough long-term studies to warrant a strong recommendation as of the publishing of this paper. The only other option available, orlistat, comes with many uncomfortable gastrointestinal side effects, so it is also not an ideal option. In addition, orlistat does not produce the amount of weight loss that is seen with surgical procedures. Patients and physicians considering surgical treatment for obesity will find that the best option is laparoscopic adjustable gastric banding.

Treatments for depression are not overly effective. Thus, aptitude-by-treatment interactions (ATIs), or interactions between particular treatments and client characteristics may be key to increasing treatment outcomes. Aptitudes of particular interest are 1) emotional and 2) etiological factors. Emotional factors related to positivity (i.e., fear of happiness, fear of positive evaluation, anticipatory anhedonia) are of practical interest due to recent increases in positivity-based treatments and of theoretical interest due to reward devaluation theory, which states that depressed individuals may be motivated to be fearful/avoidant of positivity. Etiological beliefs regarding causes of depression (i.e., physical, childhood, characterological) are of interest due to budding literature boasting the treatment benefits of matching relevant treatments to etiological beliefs. In the current study, participants were provided with four depression treatment descriptions and were asked about the personal fit, preference, and effectiveness of these treatments as well as completed an online battery of questionnaires. Emotional hypotheses supported reward devaluation theory, as individuals who were highly fearful of happiness and positivity were less interested in treatments specifically targeting positivity than other treatments, differing from the overall group preferences. Some evidence from etiological hypotheses also supported use of these beliefs in treatment planning, as individuals with childhood etiological beliefs were more interested in pastocused treatments, as well as those with characterological beliefs (after accounting for other clinical variables). Thus, incorporating emotional and etiological factors into treatment planning may allow for an enhanced discussion of why treatments in direct contrast with clients’ etiological beliefs or preferences may be the treatments that they need the most.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Master / Master of Dental Surgery

4 pp. / Arizona Know Your Water. / Today, homeowners have access to several water treatment systems to help control minerals and contaminants and to disinfect their water. Nearly half of the homes in the U.S. have some type of water treatment device. Mistrust of public water utilities, uncertainty over water quality standards, concerns about general health issues and limited understanding about home water treatment systems have all played a role in this increasing demand for home water treatment systems. Private well owners also need to provide safe drinking water for their families and have to make decisions as to how to treat their own water sources to meet this need. However, choosing a water treatment system is no easy task. Depending of the volume of water and degree of contamination, the homeowner should consider professional assistance in selecting and installing well water treatment systems. The process of selection is often confounded by incomplete or misleading information about water quality, treatment options, and costs. The following paragraphs outline the major well water treatment options. Further details on types, uses (point of use) and costs of these home water treatment systems are provided in the Arizona Know Your Water booklet. Additional information about Arizonas water sources that can help private well owners make decisions about home water treatment options, can be found in Arizona Well Owners Guide to Water Supply booklet (see references section).

Provoked vestibulodynia (PVD) is the most common condition leading to painful intercourse and is currently best understood within a biopsychosocial framework. Although the usefulness of non-medical treatment options for vulvar pain is recognized by many, there is limited research investigating the effectiveness of these treatments using a biopsychosocial approach to outcome measurement. Furthermore, there is little evidence to support the mechanisms by which these treatments lead to pain reduction. This study aimed to address these gaps by investigating two non-medical treatment options: individual cognitive-behavioural therapy (ICBT) and pelvic floor rehabilitation (PFR). Twenty women with PVD were randomly assigned to eight sessions of either ICBT or PFR. Participants were assessed at pre-treatment, post-treatment, and 6-month follow-up via gynecological examination, structured interviews and standardized questionnaires measuring pain, psychological, and sexual variables, quantitative sensory testing, and a pelvic floor muscle (PFM) evaluation. The primary outcome was change in intercourse pain intensity. Secondary outcomes included changes in other features of vestibular pain (e.g., frequency), cotton-swab test pain intensity, vestibular sensitivity, sexual functioning, PFM functioning, and pain cognitions. Changes in psychosexual and PFM functioning were investigated as predictors of treatment outcome. Results indicated no differences in the effectiveness of the treatment groups with respect to pain outcomes, with both groups demonstrating significant reductions in pain. Between-group differences were minimal in other areas, with some suggestion that participants in the ICBT group fared better with respect to sexual functioning, while participants in the PFR group demonstrated more improvements in PFM tone. Participants in both groups demonstrated meaningful improvements in pain cognitions, with the ICBT group demonstrating greater changes in rumination. The study was not able to detect significant predictors of treatment outcome. The results of the study suggest that both ICBT and PFR may lead to clinically meaningful improvements in pain, as well as in other areas of psychosexual functioning. Future treatment studies should consider incorporating general chronic pain clinical trial recommendations to allow for better comparison of outcomes with other studies. / Thesis (Ph.D, Psychology) -- Queen's University, 2013-11-19 18:16:18.353

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M.Tech.