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Public Policy for Obesity Prevention in Lebanon
Get PDFBackground: In Lebanon, the population is experiencing nutrition transition and a high prevalence of obesity. Studies have shown that the Lebanese people are shifting their dietary behaviours from the traditional Lebanese diet, a variation of the Mediterranean diet, towards a westernised diet and are being physically inactive. To achieve a population behaviour change and
address the obesity epidemic, the root causes of these behaviours and food choices should be explored and addressed. This approach requires joint efforts from different sectors such as the government, healthcare, and civil society to develop action plans and enact policies. In Lebanon, the factors that influence eating behaviours and physical activity are still not explored, national level policies are still lacking, and researchers have called for an urgent need to implement policies to halt the rise of obesity prevalence.
Aims and objectives: The general aim of this thesis is to explore the perceived factors that influence adults’ eating behaviours and physical activity using the socio-ecological model as the conceptual framework. In addition, this PhD research explores the relevant contribution and the position of different stakeholders towards obesity prevention in Lebanon. Finally, this thesis
draws on lessons learned from countries worldwide that help in developing guidelines for obesity prevention in Lebanon.
Methods: Two studies were conducted for this PhD research. In the first study, the Photovoice method was used to engage Lebanese adults from the North Governorate to explore different factors that influence their eating behaviours and physical activity and to identify their perceptions towards the actions needed to address obesity. The second study involved a series
of one-to-one face-to-face semi-structured interviews which were conducted with key stakeholders from different public and private sectors (government, civil society, education, and healthcare). These interviews aimed to explore the key stakeholders’ perceptions towards obesity and its causes, their relevant contribution towards obesity prevention, their priority of action to address obesity, and finally the barriers to effective action to reduce obesity in Lebanon.
Results: The findings of the two qualitative studies show that obesity is commonly perceived as a body image issue rather than a health issue. Some of the main factors that were perceived to influence Lebanese adults’ eating behaviours and physical activity were: females’ (wives’ and mothers’) employment, social gatherings, and social norms (e.g. food and meal sharing), safety
concerns, the availability of countless unhealthy food options that are relatively cheaper than healthy food, the lack of a physical environment that encourages physical activity, and food marketing and advertisements. The results of the stakeholder’s interviews show that the key stakeholders are aware of the nutrition transition and some of the underlying environmental
factors that caused these behaviour changes. Yet, most of the key stakeholders framed obesity in an “individualistic approach” by focusing on unhealthy dietary behaviours, the physical inactivity and placed the responsibility on individuals for their lifestyle. Due to their approach, most of them focused their actions on raising awareness such as the role of education. Some of
the barriers to effective policy action to address obesity in Lebanon are the political instability, lack of public demand for action, and lack of coordinated multi-sectoral actions.
Implications: The recognition of obesity as a disease as well as strengthening the public, stakeholders’, and policymakers’ support towards obesity prevention strategies are essential to overcome the “policy inertia” in Lebanon. The key areas that need to be addressed for obesity prevention are raising awareness on obesity health consequences, increasing access to healthy
food in public and private settings, limiting unhealthy food advertisements, and fiscal measures such as taxing unhealthy food and subsidising healthy food. To facilitate the implementation of policies that aim to prevent obesity, a systematic plan of action should be developed. To engage stakeholders from different sectors and establish a national multi-sectoral collaboration, national strategies and policies that follow a Health in all Policies Approach (HiPA) are recommended. This requires strong leadership from the government.
Conclusions: There is an urgent need to shift the actions beyond targeting the individual by implementing public policies to address the obesogenic environment in Lebanon. Recommendations for research, policy actions, and practice are provided to guide the action towards establishing an appropriate public policy that recognises the need to adopt a socioecological
model of implementation
The Effects of Midline Cerebellar rTMS on Human Pharyngeal Cortical Activity in the Intact Swallowing Motor System
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: registration 2020-09-09, accepted 2020-09-09, online 2020-09-26, pub-electronic 2020-09-26, pub-print 2021-02Publication status: PublishedFunder: Medical Research Council; doi: http://dx.doi.org/10.13039/501100000265; Grant(s): MR/P006183/1Abstract: We sought to compare the effects of 10 Hz cerebellar vermis (vs. unilateral hemispheric and sham) repetitive transcranial magnetic stimulation (rTMS) on cortical neuroelectrical activity and thereafter 10 Hz cerebellar vermis (vs. sham) rTMS on swallowing behaviour. Healthy participants (n = 25) were randomly allocated to receive vermis, unilateral hemisphere or sham 10 Hz cerebellar rTMS. Recordings were made using pharyngeal electromyography and manometry catheters, obtaining motor-evoked potentials (MEPs) and pressure recordings. The amplitudes of MEPs elicited using single-pulse TMS delivered to the pharyngeal areas of the motor cortex bilaterally were measured pre- and post-cerebellar stimulation. As in previous studies, abductor policis brevis (APB) MEPs were measured to assess post-rTMS modulation specificity. Swallowing was assessed using a swallowing accuracy task. Measurements were made at baseline and 15-min intervals for an hour post-intervention. Measurements involved TMS being used to elicit 10 MEPs bilaterally over the pharyngeal areas of the motor cortex, over the APB cortical representation adjacent to the pharyngeal area with the lowest resting motor threshold and 5 MEPs bilaterally over pharyngeal areas of the cerebellar hemispheres. Swallowing accuracy was assessed by giving participants 10 attempts to swallow and hit a digital target. Cerebellar vermis rTMS caused significant suppression of cortical pharyngeal MEP amplitudes compared with unilateral rTMS and sham (P = 0.0005, 0.002). APB and cerebellar MEP amplitudes were unaffected as were pharyngeal and APB MEP latencies. Following cerebellar vermis rTMS there was a significant reduction in swallowing accuracy compared with sham (P = 0.001). Our findings demonstrate cerebellar vermis rTMS exerts a suppressive effect on pharyngeal motor cortical activity and swallowing behaviour
The introduction of risk stratified screening into the NHS breast screening Programme: views from British-Pakistani women
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2019-12-16, accepted 2020-05-13, registration 2020-05-14, pub-electronic 2020-05-20, online 2020-05-20, collection 2020-12Publication status: PublishedFunder: NIHR Programme Grants for Applied Research (GB); Grant(s): RP-PG-1214-200016Funder: Manchester Biomedical Research Centre; doi: http://dx.doi.org/10.13039/100014653; Grant(s): IS-BRC-1215-20007Abstract: Background: UK national guidelines suggest women at high-risk of breast cancer should be offered more frequent screening or preventative medications. Currently, only 1 in 6 high-risk women are identified. One route to identify more high-risk women is via multifactorial risk assessment as part of the UK’s NHS Breast Screening Programme (NHSBSP). As lower socioeconomic and minority ethnic populations continue to experience barriers to screening, it is important that any new service does not exacerbate issues further. To inform service development, this study explored views of women from underserved backgrounds regarding the introduction of risk stratification into the NHSBSP. Methods: Nineteen semi-structured interviews were conducted with British-Pakistani women from low socioeconomic backgrounds from East Lancashire, UK. Fourteen interviews were conducted via an interpreter. Results: Thematic analysis produced three themes. Attitudes toward risk awareness concerns the positive views women have toward the idea of receiving personalised breast cancer risk information. Anticipated barriers to accessibility emphasises the difficulties associated with women’s limited English skills for accessing information, and their I.T proficiency for completing an online risk assessment questionnaire. Acceptability of risk communication strategy highlights the diversity of opinion regarding the suitability of receiving risk results via letter, with the option for support from a healthcare professional deemed essential. Conclusions: The idea of risk stratification was favourable amongst this underserved community. To avoid exacerbating inequities, this new service should provide information in multiple languages and modalities and offer women the opportunity to speak to a healthcare professional about risk. This service should also enable completion of personal risk information via paper questionnaires, as well as online
A Teleological Mode of Conditionality in Early Buddhism
No full textIn addition to the twelve links (nidānas) of dependent arising (paṭicca-samuppāda), early Buddhist texts record a series of stages of the path to awakening, called “preconditions” (upanisās), which in the Pāli Upanisā Sutta (S 12: 23; pts ii.29–31) are joined in one series. Modern western Buddhists take this one series to imply that nidānas and upanisās exemplify an over-arching principle of conditionality. In this article I argue that the upanisās exemplify a distinctively teleological mode of conditionality. I investigate (i) the images of a tree coming to full growth and rain flowing to the seas used to illustrate the upanisās, (ii) the distinctly goal-directed language used in relation to the stages of the path, and finally (iii), I propose, via a discussion of Aristotle on teleology, that the upanisās represent a teleological mode of conditionality, such that each stage of the path becomes the condition for the next, in relation to an aim or goal of awakening. I argue that the series of upanisās has a normative, rather than phenomenological, character, and I compare the series to a recipe. I conclude with the suggestion that the similarity between upanisās and nidānas lies in their being necessary conditions, and that this similarity constitutes a “family resemblance” (in Wittgenstein’s phrase). The over-arching principle of conditionality is not a feature of reality over and above such a family resemblance
Investor regret, share performance and the role of corporate agreeableness
No full textDrawing on regret and reputation literatures, the authors demonstrate how positive corporate associations can mitigate the effects of share performance on investor regret. Three studies are presented, the first involved the observation of six investment club meetings. The second is a survey of investors exploring some of the findings of the first study, specifically the relationship between investor regret and corporate associations. The final study uses an experimental design to test whether corporate social responsibility (CSR) messaging can influence regret in the context of disappointing share performance by influencing corporate agreeableness. The main findings are that a range of corporate associations are important to investors, more so than actual share performance, in their decision-making. Specifically, the more agreeable (e.g. trustworthy, supportive) the company is perceived to be, the lower will be any regret felt over share performance. Finally, CSR information was found to affect regret via an influence on agreeableness
Enhancing interfacial strength between AA5083 and cryogenic adhesive via anodic oxidation and silanization
No full textAA5083 aluminum alloy was treated in turn with phosphoric-sulfuric acid anodic oxidation and then with silanization using the silane coupling agent KH560. A chemical bond (Si-O-Al) was created between the aluminum alloy and silane film, and a dehydration condensation reaction occurred between the silane film and cryogenic adhesive to enhance the bonding strength between the aluminum alloy and the cryogenic adhesive. Scanning electron microscopy, Energy dispersive spectroscopy, and Fourier transform infrared spectroscopy were used to explore the interfacial characteristics of the aluminum alloy both with and without the applied treatment. Furthermore, single lap shear tests and durability tests were performed to assess the adhesive strength of the interface between the aluminum alloy and the cryogenic adhesive at low temperature. The most improved interfacial strength using the anodic oxidation and the silanization treatments reached 33.96 MPa at −60 °C. The interface strength with the same treatments after the durability test was 25.4 MPa
The effects of in-season, low-volume sprint interval training with and without sport-specific actions on the physical characteristics of elite academy rugby league players
Get PDFAccepted author manuscript version reprinted, by permission, from International Journal of Sports Physiology and Performance, 2020 (ahead of print). © Human Kinetics, Inc.Purpose: To determine the utility of a running and rugby-specific, in-season sprint interval interventions in professional rugby league players. Methods: Thirty-one professional academy rugby players were assigned to a rugby-specific (SITr/s, n = 16) or running (SITr, n = 15) sprint interval training group. Measures of speed, power, change of direction (CoD) ability, prone Yo-Yo IR1 performance and heart rate recovery (HRR) were taken before and after the 2-week intervention as were sub-maximal responses to the prone Yo-Yo IR1. Internal, external and perceptual responses were collected during SITr/s/SITr, with wellbeing and neuromuscular function assessed before each session. Results: Despite contrasting (possible to most likely) internal, external and perceptual responses to the SIT interventions, possible to most likely within-group improvements in physical characteristics, HRR and sub-maximal responses to the prone Yo-Yo IR1 were observed after both interventions. Between-group analysis favoured the SITr/s intervention (trivial to moderate) for changes in 10 m sprint time, CMJ, change of direction and medicine ball throw as well as sub-maximal (280-440 m) high metabolic power, PlayerLoad™ and acceleratory distance during the prone Yo-Yo IR1. Overall changes in wellbeing or neuromuscular function were unclear.
Conclusion: Two-weeks of SITr/s and SITr was effective for improving physical characteristics, HRR and sub-maximal responses to the prone Yo-Yo IR1, with no clear change in wellbeing and neuromuscular function. Between-group analysis favoured the SITr/s group, suggesting that the inclusion of sport- specific actions should be considered for in-season conditioning of rugby league players
Multiphysics vibration FE model of piezoelectric macro fibre composite on carbon fibre composite structures
No full textThis paper presents a finite element (FE) model developed using commercial FE software COMSOL to simulate the multiphysical process of pieozoelectric vibration energy harvesting (PVEH), involving the dynamic mechanical and electrical behaviours of piezoelectric macro fibre composite (MFC) on carbon fibre composite structures. The integration of MFC enables energy harvesting, sensing and actuation capabilities, with applications found in aerospace, automotive and renewable energy. There is an existing gap in the literature on modelling the dynamic response of PVEH in relation to real-world vibration data. Most simulations were either semi-analytical MATLAB models that are geometry unspecific, or basic FE simulations limited to sinusoidal analysis. However, the use of representative environment vibration data is crucial to predict practical behaviour for industrial development. Piezoelectric device physics involving solid mechanics and electrostatics were combined with electrical circuit defined in this FE model. The structure was dynamically excited by interpolated vibration data files, while orthotropic material properties for MFC and carbon fibre composite were individually defined for accuracy. The simulation results were validated by experiments with <10﹪ deviation, providing confidence for the proposed multiphysical FE model to design and optimise PVEH smart composite structures
Combining bioacoustics and occupancy modelling for improved monitoring of rare breeding bird populations
Get PDFEffective monitoring of rare and declining species is critical to enable their conservation, but can often be difficult due to detectability or survey constraints. However, developments in acoustic recorders are enabling an important new approach for improved monitoring that is especially applicable for long-term studies, and for use in difficult environments or with cryptic species.
Bioacoustic data may be effectively analysed within an occupancy modelling framework, as presence/absence can be determined, and repeated survey events can be accommodated. Hence, both occupancy and detectability estimates can be produced from large, coherent datasets. However, the most effective methods for the practical detection and identification of call data are still far from established. We assessed a novel combination of automated clustering and manual verification to detect and identify heathland bird vocalizations, covering a period of six days at 44 sampling locations
Occupancy (Ψ) and detectability (p ) were modelled for each species, and the best fit models provided values of: nightjar Ψ=0.684, p=0.740, Dartford warbler Ψ=0.449 p=0.196 and woodlark Ψ=0.13 p=0.996. Including environmental covariates within the occupancy models indicated that tree, wetland and heather cover were important variables, particularly influencing detectability.
The protocol used here allowed robust and consistent survey data to be gathered, with limited fieldwork resourcing, allowing population estimates to be generated for the target bird species. The combination of bioacoustics and occupancy modelling can provide a valuable new monitoring approach, allowing population trends to be identified, and the effects of environmental change and site management to be assessed
Going it Alone or Working as Part of a Team: The Impact of Human Capital on Entrepreneurial Decision Making
Get PDFThis paper endeavours to measure the effect that human capital has on the decision taken by the
entrepreneur to pursue new venture creation either in a lone capacity or collaboratively. This study
applies a logit model to investigate the research relationships. The results show that three factors
(experience, social perception and extrinsic motivation) are relevant in the decision to initiate a new
venture either in a lone capacity or as part of a collaborative undertaking. The results indicate that
previous experience holds the greatest significance on the decision taken by entrepreneurs to ‘go it
alone’, with factors relating to social perception and extrinsic motivation chiefly predicting a decision
to work collaboratively. The findings of this study provide new insight and evidence with regard to the
factors that influence a key decision in the start-up process: that of continuing in a lone capacity, or
proceeding as part of an entrepreneurial team.This paper endeavours to measure the effect that human capital has on the decision taken by the entrepreneur to pursue new venture creation either in a lone capacity or collaboratively. This study applies a logit model to investigate the research relationships. The results show that three factors (experience, social perception and extrinsic motivation) are relevant in the decision to initiate a new venture either in a lone capacity or as part of a collaborative undertaking. The results indicate that previous experience holds the greatest significance on the decision taken by entrepreneurs to ‘go it alone’, with factors relating to social perception and extrinsic motivation chiefly predicting a decision to work collaboratively. The findings of this study provide new insight and evidence with regard to the
factors that influence a key decision in the start-up process: that of continuing in a lone capacity, or proceeding as part of an entrepreneurial team
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