scholarly journals Monitoring BMI Trends in a Midwest Regional Head Start Population: The Results of a Healthy Lifestyle Intervention

2020 ◽  
Vol 11 ◽  
pp. 215013272096286
Author(s):  
Antonela Miccoli ◽  
Loren L. Toussaint ◽  
Carina K. Hansen ◽  
Latasha M. Smith ◽  
Brian A. Lynch
Keyword(s):  
Head Start ◽  
The United States ◽  
Community Action ◽  
Overweight And Obesity ◽  
First Year ◽  
Wellness Program ◽  
Health Crisis ◽  
Second Year ◽  
The Impact

Background Childhood obesity represents a public health crisis in the United States. Thus, focusing on early childhood is crucial to modify the consequences associated with obesity. The Food and Fitness Initiative (FFI) is a community-based wellness program implemented in Northeast Iowa since 2009. FFI focuses on healthy eating and physical activity. Our aim is to describe the impact on body mass index (BMI) after implementing FFI in a Northeast Iowa Community Action Head Start (HS) population. Methods Retrospective BMI data was collected from all children attending 14 HS sites from 2012 to 2018. Children with BMI measurements during July to December of the first year in HS were included in the study. Follow-up data the second year in HS was obtained. Overweight and obesity prevalence, as well as, BMI changes between year 1 and 2 in HS were analyzed. Results Data from 1013 children were collected, 850 (84%) had qualifying BMI measurements during their first year in HS and 352 of those children (41%) had follow-up data in their second year. There was a decrease in BMI between years 1 and 2 in HS that approached statistical significance ( t = 1.83, P = .07, d = .10). There were no statistically significant changes in the percent of overweight (Wald χ2 = .50, P = .48) or obese (Wald χ2 = 1.71, P = .19) children between the first and second year. Conclusion The FFI wellness program can be feasibly integrated into the HS curriculum and shows promising short-term results in improving BMI, but not to a statistically significant level when evaluated over 1 year.

Psychological Well-Being, Health Behaviors, and Weight Loss Among Participants in a Residential, Kripalu Yoga-Based Weight Loss Program

2012 ◽  
Vol 22 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Tosca Braun ◽  
Crystal Park ◽  
Lisa Ann Conboy
Keyword(s):  
Weight Loss ◽  
Health Behaviors ◽  
Well Being ◽  
The United States ◽  
Overweight And Obesity ◽  
Weight Loss Program ◽  
Health Concern ◽  
Psychological Well Being ◽  
The Impact

The increasing prevalence of overweight and obesity in humans is a growing public health concern in the United States. Concomitants include poor health behaviors and reduced psychological well-being. Preliminary evidence suggests yoga and treatment paradigms incorporating mindfulness, self-compassion (SC), acceptance, non-dieting, and intuitive eating may improve these ancillary correlates, which may promote long-term weight loss. Methods: We explored the impact of a 5-day residential weight loss program, which was multifaceted and based on Kripalu yoga, on health behaviors, weight loss, and psychological well-being in overweight/obese individuals. Thirty-seven overweight/obese program participants (age 32-65, BMI<25) completed validated mind-fulness, SC, lifestyle behavior, and mood questionnaires at baseline, post-program, and 3-month follow-up and reported their weight 1 year after program completion. Results: Significant improvements in nutrition behaviors, SC, mindfulness, stress management, and spiritual growth were observed immediately post-program (n = 31, 84% retention), with medium to large effect sizes. At 3-month follow-up (n = 18, 49% retention), most changes persisted. Physical activity and mood disturbance had improved significantly post-program but failed to reach significance at 3-month follow-up. Self-report weight loss at 1 year (n = 19, 51% retention) was significant. Conclusion: These findings suggest a Kripalu yoga-based, residential weight loss program may foster psychological well-being, improved nutrition behaviors, and weight loss. Given the exploratory nature of this investigation, more rigorous work in this area is warranted.

BMI changes in paediatric type 1 narcolepsy under sodium oxybate treatment

SLEEP ◽  
2021 ◽  
Author(s):  
Virginia Ponziani ◽  
Fabio Pizza ◽  
Corrado Zenesini ◽  
Luca Vignatelli ◽  
Andrea Pession ◽  
...  
Keyword(s):  
Combined Therapy ◽  
Overweight And Obesity ◽  
Sodium Oxybate ◽  
First Year ◽  
Z Score ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Abstract Paediatric Type 1 Narcolepsy (NT1) is often associated with overweight and obesity. Sodium oxybate (SO), approved for the treatment of narcolepsy with cataplexy from the age of 7 years old in US, has been associated with weight loss, although longitudinal paediatric studies are lacking. We report a retrospective cohort of 129 consecutive patients with a 4 years follow-up, to analyse the impact of different pharmacological treatments on BMI z-score. At baseline the prevalence of obesity and overweight was 26.4 % (34/129) and 29.5% (38/129), respectively. Patients were divided in 3 groups: children treated with SO alone (group 1), with SO-combined therapy (group 2), and without SO (group 3). At the end of the first year of follow-up, group 1 and group 2 showed a significant BMI z-score reduction compared to baseline: from 1.2±1.1 to 0.4±1.4 for group 1 (p < 0.001), and from 1.4±1.1 to 1±1.3 for group 2 (p = 0.002), independently from baseline clinical features. In the second year only group 2 experienced a further and significant BMI z-score decrease (from 1.0±1.2 to 0.6 ± 1.2, p = 0.037). No further significant BMI z-score changes were observed in SO treated patients in the following years. Instead, children treated without SO developed a significant weight increase between the second and third year of therapy (BMI z-score from 0.3±0.9 to 0.5±0.9). In conclusion, SO treatment in paediatric NT1 is associated with a favourable weight reduction in the first year of treatment.

scholarly journals Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gerhard Müller ◽  
Manuela Bombana ◽  
Monika Heinzel-Gutenbrenner ◽  
Nikolaus Kleindienst ◽  
Martin Bohus ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Distress ◽  
Linear Models ◽  
Longitudinal Research ◽  
Depression Scale ◽  
Routine Data ◽  
Medical Costs ◽  
First Year ◽  
Second Year ◽  
The Impact

Abstract Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

scholarly journals Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment: Results from the European Network for the Investigation of Gender Incongruence (ENIGI)

2021 ◽  
Vol 10 (2) ◽  
pp. 296
Author(s):  
Imke Matthys ◽  
Justine Defreyne ◽  
Els Elaut ◽  
Alessandra Daphne Fisher ◽  
Baudewijntje P. C. Kreukels ◽  
...  
Keyword(s):  
Negative Affect ◽  
Sex Steroids ◽  
Hormonal Treatment ◽  
Control Group ◽  
First Year ◽  
Positive And Negative Affect ◽  
European Network ◽  
Psychological Burden ◽  
The Impact

Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) study, we prospectively collected data of 873 participants (451 transwomen (TW) and 422 transmen (TM)). At baseline, psychological questionnaires including the Positive and Negative Affect Schedule (PANAS) were administered. The PANAS, levels of sex steroids and physical changes were registered at each follow-up visit during a 3-year follow-up period, starting at the initiation of hormonal therapy. Data were analyzed cross-sectionally and prospectively. Over the first three months, we observed a decline in positive affect (PA) in both TM and TW. Thereafter, PA reached a steady state in TW, whereas in TM there was also a second decline at 18 months. In both TM and TW there was no persisting difference comparing baseline to the 36-months results. Concerning negative affect (NA), we observed a decline during the first year in TM, which sustained during the second year and was not different anymore at 36 months compared to baseline. In TW though, we did not find any change of NA during the entire follow-up. Even if some of these results show significant differences, they should be considered with caution, since there was no control group and the absolute differences are small. No association between affect and the level of sex steroids was observed. Baseline QoL and psychological burden are related to affect independently from gender but are not necessarily good predictors of the evolution of one’s affect during the gender-affirming process. Further research is necessary to investigate these preliminary results.

Are Future Doctors Prepared to Address Patients’ Nutritional Needs? Cooking and Nutritional Knowledge and Habits in Medical Students

2021 ◽  
pp. 155982762110181
Author(s):  
Sam Sugimoto ◽  
Drew Recker ◽  
Elizabeth E. Halvorson ◽  
Joseph A. Skelton
Keyword(s):  
Medical Students ◽  
Prior Knowledge ◽  
The United States ◽  
First Year ◽  
Nutritional Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nutritional Needs ◽  
Second Year ◽  
First Year Medical Students

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students’ prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students’ prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.

scholarly journals 90. Impact of Discrepant Rapid Diagnostic Test (RDT) Results on Antimicrobial Stewardship Program (ASP) Interventions in Patients with Bloodstream Infections (BSI) due to Gram-Negative Bacilli (GNB)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S61-S61
Author(s):  
Evan D Robinson ◽  
Heather L Cox ◽  
April E Attai ◽  
Lindsay Donohue ◽  
Megan Shah ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Bloodstream Infections ◽  
Standard Of Care ◽  
First Year ◽  
Beta Lactam ◽  
Gram Negative ◽  
Stewardship Program ◽  
Few Data ◽  
The Impact

Abstract Background Implementation of the Accelerate PhenoTM Gram-negative platform (AXDX) paired with ASP intervention projects to improve time to definitive institutional-preferred antimicrobial therapy (IPT). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing. Here we evaluate the prescribing outcomes for discrepant results following the first year of AXDX + ASP implementation. Methods Consecutive, non-duplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention were included (July 2018 – July 2019). AXDX results were emailed to the ASP in real time then released into the EMR upon ASP review and communication with the treating team. SOC identification (ID; Vitek® MS/Vitek® 2) and antimicrobial susceptibility testing (AST; Trek SensititreTM) followed RDT as the reference standard. IPT was defined as the narrowest susceptible beta-lactam, and a discrepancy was characterized when there was categorical disagreement between RDT and SOC methods. When IPT by AXDX was found to be non-susceptible on SOC, this was characterized as “false susceptible“. Conversely, “false resistance” was assessed when a narrower-spectrum agent was susceptible by SOC. Results were also deemed discrepant when the AXDX provided no/incorrect ID for on-panel organisms, no AST, or a polymicrobial specimen was missed. Results Sixty-nine of 250 patients (28%) had a discrepancy in organism ID or AST: false resistance (9%), false susceptible (5%), no AST (5%), no ID (4%), incorrect ID (2%), and missed polymicrobial (2%). A prescribing impact occurred in 55% of cases (Table 1), where unnecessarily broad therapy was continued most often. Erroneous escalation (7%) and de-escalation to inactive therapy (7%) occurred less frequently. In-hospital mortality occurred in 4 cases, none of which followed an inappropriate transition to inactive therapy. Conclusion Though the AXDX platform provides rapid ID and AST results, close coordination with Clinical Microbiology and continued ASP follow up are needed to optimize therapy. Although uncommon, the potential for erroneous ASP recommendations to de-escalate to inactive therapy following AXDX results warrants further investigation. Disclosures Amy J. Mathers, MD, D(ABMM), Accelerate Diagnostics (Consultant)

scholarly journals TRUMP’S FOREIGN POLICY: PLANS AND REALITIES

2018 ◽  
pp. 73-82 ◽  
Author(s):  
E. V. Emelianov
Keyword(s):  
Foreign Trade ◽  
The United States ◽  
First Year ◽  
Solar Panels ◽  
White House ◽  
Trade Law ◽  
The Us ◽  
Second Year ◽  
Trade Partners

The article considers the changes in US foreign trade policy at the beginning of the Trump’s presidency. Exporting is a critical component for the long-term growth and the U.S. economy overall, and supporting millions of jobs in US. Though D. Trump campaigned for president as a protectionist, there was no such steps the first year of his presidency. But his second year in the White House began with announcing new tariffs on solar panels, washing machines, then on steel, aluminium. As concerning steel products, the United States being the world’s largest steel importer have persistent trade deficit.The US trade law allows the president to limit imports in case if domestic industries are threatened, against unfair foreign trade practices for a period of time, but such measures were not frequent in US practice. Meanwhile new protectionist measures are debated. Trump’s policy is being opposed not only by trade partners of the US, but in the US as well, by those who argue that protectionist measures will complicate international relationships.

Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year

2018 ◽  
Vol 35 (12) ◽  
pp. 1168-1172 ◽  
Author(s):  
Francesca Bevilacqua ◽  
Francesco Morini ◽  
Antonio Zaccara ◽  
Chiara De Marchis ◽  
Annabella Braguglia ◽  
...  
Keyword(s):  
First Year ◽  
Stressful Situation ◽  
Ptsd Symptoms ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Stress Symptoms ◽  
Parental Gender ◽  
Set Up ◽  
The Impact

Objective The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth. Study Design A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale—Revised (IES-R). Results Thirty-four couples form the object of the study. At 6 months, half of mothers (52.9%) and fathers (44.1%) reported traumatic stress symptoms above the clinical cutoff. Percentages remained stable at 12 months. When parental gender and length of follow-up were compared with two-factor analysis of variance, none had an impact on IES-R score, nor an interaction between these factors was found. A significant correlation of IES-R total score was present within the couple both at 6 and 12 months (6 months—r: 0.6842, p < 0.0001 and 12 months—r: 0.4045, p = 0.0177). Conclusion Having a child with a repaired malformation represents a complex prolonged stressful situation with persistent burden for both parents who are at high risk of developing PTSD symptoms.

COMPLICATIONS OF SMALLPOX VACCINATION UNITED STATES 1963

PEDIATRICS ◽  
1967 ◽  
Vol 39 (6) ◽  
pp. 916-923
Author(s):  
John M. Neff ◽  
Ronald H. Levine ◽  
J. Michael Lane ◽  
Ernest A. Ager ◽  
Helen Moore ◽  
...  
Keyword(s):  
United States ◽  
High Frequency ◽  
Primary Vaccination ◽  
The United States ◽  
Smallpox Vaccination ◽  
First Year ◽  
Common Complication ◽  
More Care ◽  
First Year Of Life

Four thousand nine hundred physicians in four states, representing 4.8% of the population of the United States, were surveyed in order to assess the frequency and types of complications that occurred during 1963 in association with smallpox vaccination. Four hundred ninety-one physicians initially reported observing 810 complications during this year. On follow-up of these cases, many were not actually complications or were complications that occurred in a year other than 1963. Accidental infection was the most common complication. Generalized vaccinia and eczema vaccinatum occurred at a frequency of 238 and 80, respectively, per million primary vaccinations. Severe complications were infrequent. No deaths and only one case each of post-vaccinal encephalitis and vaccinia necrosum were detected. The high frequency of many preventable complications and the disproportionate frequency of complications in infants suggest that morbidity and mortality now associated with smallpox vaccination could be significantly reduced if primary vaccination could be deferred until after the first year of life and if more care were taken to detect individuals in whom complications can be expected to occur.

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