Behavioral Interventions to Improve Management of Overweight, Obesity, and Diabetes in Patients with Schizophrenia

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthetize the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, including alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting biometric outcomes such as BMI, weight, waist circumference, triglycerides, glucose, among others. Studies with at least three months of treatment were included in the meta-analysis. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43, and 2 multinational-collaborative studies. Most of the national studies have small sample sizes, and the studied strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium to high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decrease triglycerides and systolic blood pressure. Participants with obesity and hypertension can have benefic effects with antioxidants, and treatment with insulin increase weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, but the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different metabolic syndrome components, which should be analyzed in detail with the population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response.

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Positive Behavioral Interventions and Supports in Schools: A Tutorial

Language Speech and Hearing Services in Schools ◽

10.1044/2018_lshss-17-0037 ◽

2019 ◽

Vol 50 (1) ◽

pp. 1-15 ◽

Cited By ~ 3

Author(s):

Yolanda Keller-Bell ◽

Maureen Short

Keyword(s):

Behavioral Interventions ◽

School Systems ◽

Language Therapy ◽

Speech Language Pathologists ◽

School Settings ◽

Positive Behavioral Interventions ◽

Behavioral Expectations ◽

Outcomes For Children

Purpose Positive behavioral interventions and supports (PBIS) provide a framework for behavioral expectations in school systems for children with and without disabilities. Speech-language pathologists who work in school settings should be familiar with this framework as part of their role in improving the outcomes for children. The purpose of this tutorial is to discuss PBIS and its use in school settings. Method The authors provide an overview of the PBIS framework and focus on its applicability in classroom-based settings. The process of implementing PBIS in classrooms and other settings such as speech-language therapy is discussed. Conclusions This tutorial provides speech-language pathologists with an overview of PBIS and may facilitate their understanding of how to implement PBIS in nonclassroom settings.

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