Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model.

Introduction: Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods: The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results: The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion: Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Multiple and differentiated contributions to the male gene pool of pastoral and farmer populations of the African Sahel.

The African Sahel is conducive to studies of divergence/admixture genetic events as a result of its population history being so closely related with past climatic changes. Today, it is a place of the co-existence of two differing food-producing subsistence systems, i.e., that of sedentary farmers and nomadic pastoralists, whose populations have likely been formed from several dispersed indigenous hunter-gatherer groups. Using new methodology, we show here that the male gene pool of the extant populations of the African Sahel harbors signatures of multiple and differentiated contributions from different genetic sources. We also show that even if the Fulani pastoralists and their neighboring farmers share high frequencies of four Y chromosome subhaplogroups of E, they have drawn on molecularly differentiated subgroups at different times. These findings, based on combinations of SNP and STR polymorphisms, add to our previous knowledge and highlight the role of differences in the demographic history and displacements of the Sahelian populations as a major factor in the segregation of the Y chromosome lineages in Africa. Interestingly, within the Fulani pastoralist population as a whole, a differentiation of the groups from Niger is characterized by their high presence of R1b-M343 and E1b1b1-M35. Moreover, the R1b-M343 is represented in our dataset exclusively in the Fulani group and our analyses infer a north-to-south African migration route during a recent past.

Postoperative Outcome of High-Risk Octogenarians Undergoing Cardiac Surgery: A Multicenter Observational Retrospective Study.

PURPOSE: Cardiac surgery in octogenarians with severely deteriorated functional status is increasingly common, but outcome data are still limited. The aim of this study was to compare postoperative outcome, survival, and quality of life of low-, medium-, and high-risk octogenarians undergoing cardiac surgery. METHODS: In all, 285 Czech octogenarians who underwent any cardiac surgical procedure between January 2011 and December 2012 were included in the study. Five out of all twelve national adult cardiac surgical centers participated in the study, representing almost half of all octogenarians operated in our country in that period. Patients' perioperative data were analyzed retrospectively. Follow-up was performed by interviewing patients by telephone. RESULTS: There was higher 30-day mortality (20% vs. 6.4% vs. 5.2%, respectively, p <0.001), lower 2-year survival (60% vs. 84.0% vs. 85.4%, respectively, p <0.05), and lower Karnofsky score (44.4 vs. 70.1 vs. 70.6, respectively, p <0.001) in high-risk group compared with medium- and low-risk groups, respectively. Greater improvement in New York Heart Association (NYHA) status was noted in high- and medium-risk groups compared with low-risk group (51% vs. 45% vs. 24%, respectively, p <0.05). CONCLUSION: High perioperative mortality, poor 2-year survival, and low postoperative quality of life have been observed in high-risk octogenarians undergoing cardiac surgery.