Effectiveness of Lifestyle Interventions in an Active Duty Air Force Population

2021 ◽  
pp. 089011712199730
Author(s):  
Nicole H. Armitage ◽  
M. Kaye Kramer ◽  
Mary S. Nelson ◽  
DawnKimberly Hopkins ◽  
Ruby Langeslay ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Diabetes Prevention Program ◽  
Well Being ◽  
Active Duty ◽  
Intervention Programs ◽  
Abdominal Circumference ◽  
Military Population ◽  
Improvement Program ◽  
Changes Over Time ◽  
Over Time

Purpose: To examine the effectiveness of 3 lifestyle intervention programs in an active duty military population. Design: Experimental design with stratified random assignment to 1 of 3 intervention groups. Measures were taken at baseline, 3 months and 6 months. Setting: A Military Treatment Facility in the western U.S. Subjects/Intervention: 122 active duty service members were enrolled and randomly assigned to 1 of 3 lifestyle intervention programs: the Diabetes Prevention Program-Group Lifestyle Balance (DPP-GLB), the Better Body Better Life (BBBL) program or the Fitness Improvement Program (FIP). Measures: weight, abdominal circumference, lipid and HbA1c levels, physical activity, and well-being as measured by the RAND SF-36 questionnaire. Analysis: Statistical analyses were performed to assess changes over time. Results: 83 participants completed the study (BBBL N = 23, FIP N = 30, DPP-GLB N = 30). The DPP-GLB participants had statistically significant decreases in weight (-3.1 pounds, p = .01) and abdominal circumference (-0.9 inches; p = .01) over time. HbA1c was also significantly lower in this group at 6 months compared to baseline ( p = .036). There were no statistically significant changes in weight, abdominal circumference, or HbA1c in the FIP or BBBL groups. No significant changes were observed in lipids in any of the groups. Conclusion: Results from this study indicate that the DPP-GLB program may be effective in reducing weight, abdominal circumference, and HbA1c in an active duty U.S. military population.

Effect of Erythropoietin Treatment on Nutritional Status of Continuous Ambulatory Peritoneal Dialysis Patients

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 544-549 ◽  
Author(s):  
Elias V. Balaskas ◽  
I. Rogers Melamed ◽  
Amit Gupta ◽  
Joanne Bargman ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Absolute Lymphocyte Count ◽  
Well Being ◽  
Underlying Disease ◽  
Phosphate Binders ◽  
Self Assessment ◽  
Erythropoietin Treatment ◽  
Changes Over Time ◽  
Over Time

Seventeen patients -10 females, 7 males -mean age 52 years (range: 21–77 years), on CAPD for an average of 35 months (range 10–160 months) were studied. Mean initial dose of EPO was 114±45 U/kg/week subcutaneously (range: 59–209). The dose was adjusted to achieve and maintain a target Hb of 100 g/L and Hct 30%. Fifteen of the patients (88.2%) achieved this target within 6 months [baseline to month 6 changes: Hb 72±10 g/L to 107±12 g/L (p=0.0001); Hct 22±3% to 33±4% (p=0.0001)]. Serum total protein also increased significantly over the time of EPO use (p=0.0133); changes from baseline were significant by the fourth month [68±9 g/L to 72±9 g/L (p=0.0115)]. Serum albumin also increased significantly over time (p=0.0157). The change from the baseline result (37±4 g/L) was statistically significant by month 2 (p=0.0060) and was maintained over the following 4 months [month 6 result: 40±3 g/L (p=0.0180)]. The increase was greater for 8 patients with initial serum albumin <35 g/L (mean change 5.75 g/L) than for the 9 subjects with levels >35 g/L (mean change 0.11 g/L). In a comparison group of 17 patients (matched for age, sex, duration of CAPD, underlying disease and antihypertensive treatment), who did not receive EPO treatment, albumin and protein did not appear to increase over time. Mean body weight increased from 60.9± 14.0 kg at the start to 62.1± 13.9 kg at month 6 (p=0.281) and the absolute lymphocyte count from 1.6±0.8 x 109/L to 1.8±1.0 x 109/L (p=0.0472). Serum potassium, urea, creatinine, phosphorus, cholesterol, tri. glycerides, WBC and platelets did not show significant changes over time. Serum phosphorus increased at the end of the second and third months (from 1.6±0.5 mmol/L to 1.9±0.4 and 1.8±0.4 mmol/L and then decreased at the sixth month (1.7±0.5 mmol/L); this is probably due to an increase in phosphate binders in 9 of 17 patients. An improvement in appetite, sleep and well-being, by patients’ self-assessment, was noted during the treatment. We conclude that the treatment with EPO is associated with improvement of the nutritional status of patients on CAPD.

scholarly journals Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1420-e1427
Author(s):  
Sean Wilkes ◽  
Celia Ona ◽  
Michael Yang ◽  
Pingyang Liu ◽  
Amber Benton ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Active Duty ◽  
Ptsd Symptoms ◽  
Refractory Depression ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Changes Over Time ◽  
Over Time

Abstract Introduction Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment. Materials and Methods A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender. Results The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P &lt; 0.001 15, 30, and 45 days after TMS treatment was initiated. Overall, 44% of patients experienced a reduction ≥10 points on BDI, and 38% experienced a reduction ≥10 points on PCL. Additionally, scores fell similarly regardless of whether or not patients had a comorbid diagnosis of PTSD. Conclusions Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications.

Mood and Psychiatric Disturbance in HIV and AIDS: Changes Over Time

1993 ◽  
Vol 162 (5) ◽  
pp. 604-610 ◽  
Author(s):  
Mary Fell ◽  
Stanton Newman ◽  
Mary Herns ◽  
Pauline Durrance ◽  
Hadi Manji ◽  
...  
Keyword(s):  
Well Being ◽  
Hiv And Aids ◽  
Psychiatric History ◽  
Bisexual Men ◽  
Psychiatric Disturbance ◽  
Symptomatic Group ◽  
And Bisexual ◽  
Changes Over Time ◽  
Hiv Seropositive ◽  
Over Time

A sample of 26 HIV seronegative, 59 HIV seropositive asymptomatic and 7 HIV seropositive symptomatic homosexual and bisexual men were assessed over two visits, a mean of 11 months apart, using the BDI, STAI, and CIS. Significant differences emerged between the symptomatic group and the other two groups. Past psychiatric history and the somatic items in the assessments accounted for some of these differences. The seropositive asymptomatic and the seronegative groups did not differ on any of the mood or psychiatric assessments, suggesting minimal effect on psychological well-being of seroconversion in the absence of symptoms.

Trained Volunteers With Type 2 Diabetes Experience Significant Health Benefits When Providing Peer Support

2021 ◽  
pp. 109019812110488
Author(s):  
Nikki J. Garner ◽  
Martin Pond ◽  
Sara Auckland ◽  
Mike Sampson
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Self Efficacy ◽  
Diabetes Prevention ◽  
Health Benefits ◽  
Diabetes Prevention Program ◽  
Well Being ◽  
Lifestyle Changes ◽  
Potential Health

Trained lay volunteers may have value in supporting lifestyle change programs in the prevention of type 2 diabetes, but the potential health benefits (or harms) experienced by these lay volunteers have not been well described. This is important, as this is an appealing model in terms of workforce planning. The aim of the prespecified quantitative study reported here, was to examine the possible health benefits or harms experienced by these trained lay volunteers with type 2 diabetes. In a large type 2 diabetes prevention program, we recruited and trained 104 lay volunteers with type 2 diabetes themselves, to act as diabetes prevention mentors and codeliver the lifestyle intervention. Mentors made motivational telephone calls to 461 participants randomized to one of the trial arms to encourage lifestyle changes. Weight, diet, physical activity, well-being, quality of life, diabetes-specific self-efficacy, and glycaemic control were measured at baseline, 12 and 24 months. Average mentor age was 62.0 years, 57 (54.8%) were male, 92 (88.5%) were overweight or obese (BMI>30 kg/m2). At 12 months, mentor dietary behaviors (fat and fiber intake) improved significantly, sedentary time spent fell significantly, and diabetes specific self-efficacy scores significantly increased. These significant improvements, with no evidence of harms, suggest lay volunteers with type 2 diabetes codelivering a lifestyle intervention, may themselves experience health benefits from volunteering.

scholarly journals Tracking and treating malnutrition: a retrospective observational study of the nutritional status of vulnerable people accessing a meals-on-wheels (MOW) service

2020 ◽  
Vol 21 ◽  
Author(s):  
Michelle Dewar ◽  
Angela Dickinson ◽  
Nigel Smeeton
Keyword(s):  
Nutritional Status ◽  
Well Being ◽  
Initial Visit ◽  
Meals On Wheels ◽  
Need For Support ◽  
The Uk ◽  
Changes Over Time ◽  
Health And Well Being ◽  
Over Time

Abstract Aim: The aims of the study were to describe the characteristics of meals-on-wheels (MOW) recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) and to explore whether the NWS had an impact on the nutritional status (malnutrition risk) of recipients over time. Background: Support services, for example, MOW, play an important role in the prevention and treatment of malnutrition in the community. In the UK, MOW services are under threat. However, little is known about how they support the health and well-being of older people. This study reports on the characteristics of MOW recipients and investigates change in nutritional status over time. Methods: A retrospective study of MOW recipients of nutritional concern who were offered a check through the NWS was conducted. Demographic, social and health information were gathered at the initial visit. Nutritional status (risk of malnutrition) was obtained using the validated Malnutrition Universal Screening Tool (MUST), at the initial and subsequent visits. Changes over time were investigated for recipients receiving at least two follow-up visits. Findings: An initial visit was made to 399 MOW recipients, and 148 recipients had two or more follow-up visits. At initial screening, 177 (44%) of recipients were at medium or high risk of malnutrition. Frailty was significantly related to malnutrition risk (P = 0.049). At follow-up, there was a reduction in malnutrition risk. Conclusions: The MOW service was associated with a reduction in malnutrition risk. By offering well-being visits within a MOW service, malnutrition can be identified early. Future studies into how MOW services might delay or prevent the need for support from acute health services and social care are warranted.

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