Bmc Med
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Government and societal efforts to combat obesity are aimed at prevention, although there is a generation for whom excess weight is the rule rather than the exception. Although measures to prevent a worsening of the current epidemic are important, management of obesity must also be prioritised. Obesity management is beset with problems ranging from attitudinal to clinical and pharmacological, and the individualisation of therapy.
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Much research is underway on the links between diet and obesity. So too are long-running disputes among nutritionists on core questions about the relationship. ⋯ The practical consequence is that, at present, frontline health professionals will not find in nutrition science agreed, actionable solutions to assist overweight patients. But research and debate continues actively.
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In this podcast we talk to Professor John Wass, co-author of the 'Action on obesity: Comprehensive care for all' report, and Chair of the Working Party for Action on Obesity in the UK. In this interview Prof Wass discusses the gaps in care for obese patients in current UK healthcare services, and outlines his recommendations on what actions should be taken to tackle these issues, including how education about nutrition and obesity should be offered to the public as well as within the formal medical education system. The podcast for this interview is available at: http://media.biomedcentral.com/content/movies/supplementary/johnwass-audio-v1.mp3.
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Meta Analysis
Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis.
Adherence to combination antiretroviral therapy (ART) is a key predictor of the success of human immunodeficiency virus (HIV) treatment, and is potentially amenable to intervention. Insight into predictors or correlates of non-adherence to ART may help guide targets for the development of adherence-enhancing interventions. Our objective was to review evidence on predictors/correlates of adherence to ART, and to aggregate findings into quantitative estimates of their impact on adherence. ⋯ These findings suggest that adherence-enhancing interventions should particularly target psychological factors such as self-efficacy and concerns/beliefs about the efficacy and safety of ART. Moreover, these findings suggest that simplification of regimens might have smaller but significant effects.
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The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. ⋯ Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.