Exploring the Perceptions of Bariatric Surgery for Adolescents Living with Severe Obesity
Bibliographic record
Abstract
The purpose of this thesis is to provide insights into the treatment and management of youth living with severe obesity within Quebec through the perspective of key stakeholders with a focus on the decision-making process for adolescent bariatric surgery. Semi-structured interviews were conducted with pediatricians (n=8), bariatric surgeons (n=5), healthcare administrators (n=4), and adolescents contemplating bariatric surgery (n=7). Adolescents also produced body map collages following the interview. This art-based method involves youth outlining their perceived body shape on a piece of paper (16”x20”) and using drawings and/or magazine images to represent their embodied experience with weight management. Interview results were transcribed and analysed inductively to identify emerging themes. Body maps were analysed using collage in conceptualization which resulted in the creation of an analytical collage by grouping related images from the body maps. \nResults are presented as five papers: (1) findings from a pilot study examining the feasibility of using body-map storytelling with adolescents; (2) the perceptions of pediatricians on obesity as a disease and the practice implications; (3) the perceptions of pediatricians on adolescent bariatric surgery; (4) the factors adolescents consider when deciding on bariatric surgery; and (5) a multi-stakeholder perspective on bariatric surgery for adolescents living with severe obesity. \nThere was a generally positive perception regarding bariatric surgery for adolescents with medically urgent needs across all four stakeholder groups. There were also points of divergence regarding pre-requisites for the surgery, and which factors are considered in the decision to refer, finance, or undergo the procedure. Comparison of the stakeholders demonstrated that the acceptability of bariatric surgery was inherent to a healthcare context that offered no other alternative to primary care management for adolescents struggling with weight. Thus the pathway to bariatric surgery was perceived as skipping some key steps in the care pathway. Interestingly, a group of pediatricians and adolescents did not view obesity as a disease. Implications from this study include the need for improved availability of behavioural interventions with a team of weight management experts to address the gap between primary care counseling and tertiary care surgical intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".