Http Dx Doi Org 10 1080 15555240 2014 898568, May 2, 2014
ABSTRACT Firefighters face a number of occupational risks including the impact of being exposed t... more ABSTRACT Firefighters face a number of occupational risks including the impact of being exposed to traumatic experiences. Critical incident stress debriefing (CISD) was previously introduced as a viable option for intervention postincident; however, concern has been raised about the efficacy of such debriefings. This study uses focus groups and key informant interviews with a national sample of firefighters to examine firefighters’ perceptions about behavioral health interventions. Although some firefighters reported positive experiences with CISD, other personnel reported finding the intervention intrusive and reported feeling more distressed after the intervention than before. Personnel reported experiencing benefits from peer support and using the crew for bonding after negative incidents as particularly useful. Findings suggest that while components (e.g., peer debriefing) of CISD may be useful, caution is warranted in employing the CISD model as designed.
Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (W... more Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (WL). However, it is not known whether this putative effect of ghrelin is sustained after weight stabilization. The objective of this study was to investigate the relationship of plasma ghrelin concentrations to active WL and weight maintenance in obese subjects. RESEARCH METHODS AND PROCEDURES: This study was a randomized clinical trial, with a 12-month follow-up period. Obese Mexican-American women matched for age and BMI were randomized to a 12-month WL program (n = 25) or no intervention (controls, n = 23). Interventions included diet, exercise, and orlistat. Body weight and fasting ghrelin, leptin, insulin, and glucose concentrations were measured at baseline and 6 and 12 months. RESULTS: The WL group lost 8.5% of body weight after 6 months and maintained the new weight for the next 6 months. Ghrelin concentrations increased significantly at 6 months but returned to baseline at 12 months. Baseline ghrelin concentrations were directly related to the degree of WL achieved after 12 months. Controls experienced no change in BMI or ghrelin levels. There were no associations between plasma ghrelin and leptin or insulin concentrations. DISCUSSION: Consistent with previous results, ghrelin rises in response to WL, perhaps as a counterregulatory mechanism. However, the present results indicate that ghrelin concentrations return to baseline with sustained weight maintenance, suggesting that its effects are unlikely to regulate long-term energy balance. Baseline ghrelin concentrations are related to the degree of WL that can be achieved by active weight reduction
The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 52... more The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 529 Hispanic American college students aged 18 to 25 years. According to self-report responses, 46.7% of the sample did not engage in vigorous physical activity and 16.7% were physically inactive. Among women, ethnic-specific rates of physical inactivity were Asian, 28.1%; African, 23.5%; White, 17.4%; and Hispanic, 20.3%. For men, rates of inactivity were Asian 11.7%; African, 7.7%; White, 12.0%; and Hispanic, 13.8. Weight-training activity, youthful physical activity, and TV viewing accounted for a significant portion of the variance in physical activity levels (13.1% for women and 14.8% for men). The results of this study support the need for physical activity interventions for college students, particularly minorities.
Although submaximal cycle ergometry testing (CET) can provide a good estimate of an individual&am... more Although submaximal cycle ergometry testing (CET) can provide a good estimate of an individual's physical fitness, anticipatory heart rate increases accompanying pre-test anxiety can negatively affect the outcome of a submaximal CET. The present study evaluated the efficacy of a low-cost, technician-administered anxiety reduction intervention in the natural setting to reduce false-positives by removing heart rate feedback, and offering cognitive distraction and controlled breathing techniques. There were consistent findings for removing heart rate (HR) feedback and offering relaxation and distraction techniques on increasing the passing rate and decreasing HR at minute 1. Furthermore, when evaluated by gender, this minimal intervention also had an effect on increasing VO2max estimates, decreasing average HR, and increasing the passing rate for the female subjects. Interestingly, there were no effects found for any of the treatment conditions for the male subjects. The intervention's implications and future research directions are discussed.
International journal of fertility and women's medicine
Obesity is the number one public health concern in the United States, affecting over one-third of... more Obesity is the number one public health concern in the United States, affecting over one-third of women. Minorities are at highest risk, with nearly 50% of African-American and Mexican-American women obese. Obesity significantly increases risk for mortality and morbidity in women, including several gynecological and reproductive disorders and infertility. Obesity, with the resultant hyperinsulinemia and hyperandrogenemia, negatively affects normal menstrual function and fertility. In addition, maternal adiposity may increase risk in offspring through perinatal mechanisms, resulting in a never-ending cycle of obesity. Data suggest that modest weight losses of about 10% of initial weight are effective in improving hormonal profiles, menstrual regularity, ovulation, and pregnancy rates. Available treatments include life-style modification programs, with a focus on eating a healthful diet and increasing physical activity, plus adjunctive pharmacotherapies.
Obesity is a chronic disease that affects a substantial number of Americans. Obesity significantl... more Obesity is a chronic disease that affects a substantial number of Americans. Obesity significantly increases a person's risk of cardiovascular diseases and morbidity. Modification of lifestyle behaviors that contribute to obesity (e.g., inappropriate diet and inactivity) is the cornerstone of treatment. Behavior modification involves using such techniques as self-monitoring, stimulus control, cognitive restructuring, stress management and social support to systematically alter obesity-related behaviors. In addition, adjunctive pharmacotherapy can play an important role in the routine medical management of obesity.
Fenfluramine and dexfenfluramine were popular and widely used antiobesity agents until they were ... more Fenfluramine and dexfenfluramine were popular and widely used antiobesity agents until they were withdrawn from the market in 1997. Even though early research appeared to demonstrate their safety, serious concerns were raised about these medications. Primary pulmonary hypertension (PPH) was a known side effect, but it was believed that the health benefits of weight loss compensated for the risk of PPH. With widespread use of these agents, 2 other conditions--valvular heart disease and neurotoxicity--were reported as potential side effects. In this paper, we review the evidence for these adverse events and whether the current data meet federal and Texas legal standards for admissibility. We discuss also the basis for health claims against physicians, and the scientific and legal challenges faced by both plaintiffs and defendants.
Both genetic and environmental factors have been hypothesized to explain the higher prevalence of... more Both genetic and environmental factors have been hypothesized to explain the higher prevalence of hypertension in US African Americans compared to populations still residing in western Africa. Studies of first-generation immigrants can help to identify risk factors for increased chronic disease expression in the developed world. Since we could identify no prior studies of hypertension in African immigrants to the United States, we conducted a cross-sectional survey of African-born and US-born African-American health professionals to compare the two groups for the prevalence of hypertension (blood pressure > or = 140/90 mm Hg or use of antihypertensive medication) and risk factors for hypertension (body mass index, lifestyle factors, and psychosocial variables hypothesized to relate to hypertension). Subjects were registered pharmacists and nurses recruited by mail. For the 182 individuals who completed study measurements (95 US-born and 87 African-born), the unadjusted odds ratio for hypertension associated with birthplace was 2.16 (95% CI = 1.12, 3.98). After adjustment for body mass index and age, the OR for birthplace was 1.92 (95% CI = 0.92, 4.00). No lifestyle or psychosocial variables were associated with hypertension prevalence. We conclude that there is a lower prevalence of hypertension in first-generation African immigrants that cannot be readily explained by the environmental effects measured in this study. Larger scale studies with African immigrants could advance understanding of the causes of the increased hypertension prevalence in US-born African Americans.
Http Dx Doi Org 10 1080 15555240 2014 898568, May 2, 2014
ABSTRACT Firefighters face a number of occupational risks including the impact of being exposed t... more ABSTRACT Firefighters face a number of occupational risks including the impact of being exposed to traumatic experiences. Critical incident stress debriefing (CISD) was previously introduced as a viable option for intervention postincident; however, concern has been raised about the efficacy of such debriefings. This study uses focus groups and key informant interviews with a national sample of firefighters to examine firefighters’ perceptions about behavioral health interventions. Although some firefighters reported positive experiences with CISD, other personnel reported finding the intervention intrusive and reported feeling more distressed after the intervention than before. Personnel reported experiencing benefits from peer support and using the crew for bonding after negative incidents as particularly useful. Findings suggest that while components (e.g., peer debriefing) of CISD may be useful, caution is warranted in employing the CISD model as designed.
Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (W... more Ghrelin is postulated to be an orexigenic signal that promotes weight regain after weight loss (WL). However, it is not known whether this putative effect of ghrelin is sustained after weight stabilization. The objective of this study was to investigate the relationship of plasma ghrelin concentrations to active WL and weight maintenance in obese subjects. RESEARCH METHODS AND PROCEDURES: This study was a randomized clinical trial, with a 12-month follow-up period. Obese Mexican-American women matched for age and BMI were randomized to a 12-month WL program (n = 25) or no intervention (controls, n = 23). Interventions included diet, exercise, and orlistat. Body weight and fasting ghrelin, leptin, insulin, and glucose concentrations were measured at baseline and 6 and 12 months. RESULTS: The WL group lost 8.5% of body weight after 6 months and maintained the new weight for the next 6 months. Ghrelin concentrations increased significantly at 6 months but returned to baseline at 12 months. Baseline ghrelin concentrations were directly related to the degree of WL achieved after 12 months. Controls experienced no change in BMI or ghrelin levels. There were no associations between plasma ghrelin and leptin or insulin concentrations. DISCUSSION: Consistent with previous results, ghrelin rises in response to WL, perhaps as a counterregulatory mechanism. However, the present results indicate that ghrelin concentrations return to baseline with sustained weight maintenance, suggesting that its effects are unlikely to regulate long-term energy balance. Baseline ghrelin concentrations are related to the degree of WL that can be achieved by active weight reduction
The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 52... more The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 529 Hispanic American college students aged 18 to 25 years. According to self-report responses, 46.7% of the sample did not engage in vigorous physical activity and 16.7% were physically inactive. Among women, ethnic-specific rates of physical inactivity were Asian, 28.1%; African, 23.5%; White, 17.4%; and Hispanic, 20.3%. For men, rates of inactivity were Asian 11.7%; African, 7.7%; White, 12.0%; and Hispanic, 13.8. Weight-training activity, youthful physical activity, and TV viewing accounted for a significant portion of the variance in physical activity levels (13.1% for women and 14.8% for men). The results of this study support the need for physical activity interventions for college students, particularly minorities.
Although submaximal cycle ergometry testing (CET) can provide a good estimate of an individual&am... more Although submaximal cycle ergometry testing (CET) can provide a good estimate of an individual's physical fitness, anticipatory heart rate increases accompanying pre-test anxiety can negatively affect the outcome of a submaximal CET. The present study evaluated the efficacy of a low-cost, technician-administered anxiety reduction intervention in the natural setting to reduce false-positives by removing heart rate feedback, and offering cognitive distraction and controlled breathing techniques. There were consistent findings for removing heart rate (HR) feedback and offering relaxation and distraction techniques on increasing the passing rate and decreasing HR at minute 1. Furthermore, when evaluated by gender, this minimal intervention also had an effect on increasing VO2max estimates, decreasing average HR, and increasing the passing rate for the female subjects. Interestingly, there were no effects found for any of the treatment conditions for the male subjects. The intervention's implications and future research directions are discussed.
International journal of fertility and women's medicine
Obesity is the number one public health concern in the United States, affecting over one-third of... more Obesity is the number one public health concern in the United States, affecting over one-third of women. Minorities are at highest risk, with nearly 50% of African-American and Mexican-American women obese. Obesity significantly increases risk for mortality and morbidity in women, including several gynecological and reproductive disorders and infertility. Obesity, with the resultant hyperinsulinemia and hyperandrogenemia, negatively affects normal menstrual function and fertility. In addition, maternal adiposity may increase risk in offspring through perinatal mechanisms, resulting in a never-ending cycle of obesity. Data suggest that modest weight losses of about 10% of initial weight are effective in improving hormonal profiles, menstrual regularity, ovulation, and pregnancy rates. Available treatments include life-style modification programs, with a focus on eating a healthful diet and increasing physical activity, plus adjunctive pharmacotherapies.
Obesity is a chronic disease that affects a substantial number of Americans. Obesity significantl... more Obesity is a chronic disease that affects a substantial number of Americans. Obesity significantly increases a person's risk of cardiovascular diseases and morbidity. Modification of lifestyle behaviors that contribute to obesity (e.g., inappropriate diet and inactivity) is the cornerstone of treatment. Behavior modification involves using such techniques as self-monitoring, stimulus control, cognitive restructuring, stress management and social support to systematically alter obesity-related behaviors. In addition, adjunctive pharmacotherapy can play an important role in the routine medical management of obesity.
Fenfluramine and dexfenfluramine were popular and widely used antiobesity agents until they were ... more Fenfluramine and dexfenfluramine were popular and widely used antiobesity agents until they were withdrawn from the market in 1997. Even though early research appeared to demonstrate their safety, serious concerns were raised about these medications. Primary pulmonary hypertension (PPH) was a known side effect, but it was believed that the health benefits of weight loss compensated for the risk of PPH. With widespread use of these agents, 2 other conditions--valvular heart disease and neurotoxicity--were reported as potential side effects. In this paper, we review the evidence for these adverse events and whether the current data meet federal and Texas legal standards for admissibility. We discuss also the basis for health claims against physicians, and the scientific and legal challenges faced by both plaintiffs and defendants.
Both genetic and environmental factors have been hypothesized to explain the higher prevalence of... more Both genetic and environmental factors have been hypothesized to explain the higher prevalence of hypertension in US African Americans compared to populations still residing in western Africa. Studies of first-generation immigrants can help to identify risk factors for increased chronic disease expression in the developed world. Since we could identify no prior studies of hypertension in African immigrants to the United States, we conducted a cross-sectional survey of African-born and US-born African-American health professionals to compare the two groups for the prevalence of hypertension (blood pressure > or = 140/90 mm Hg or use of antihypertensive medication) and risk factors for hypertension (body mass index, lifestyle factors, and psychosocial variables hypothesized to relate to hypertension). Subjects were registered pharmacists and nurses recruited by mail. For the 182 individuals who completed study measurements (95 US-born and 87 African-born), the unadjusted odds ratio for hypertension associated with birthplace was 2.16 (95% CI = 1.12, 3.98). After adjustment for body mass index and age, the OR for birthplace was 1.92 (95% CI = 0.92, 4.00). No lifestyle or psychosocial variables were associated with hypertension prevalence. We conclude that there is a lower prevalence of hypertension in first-generation African immigrants that cannot be readily explained by the environmental effects measured in this study. Larger scale studies with African immigrants could advance understanding of the causes of the increased hypertension prevalence in US-born African Americans.
Uploads
RESEARCH METHODS AND PROCEDURES:
This study was a randomized clinical trial, with a 12-month follow-up period. Obese Mexican-American women matched for age and BMI were randomized to a 12-month WL program (n = 25) or no intervention (controls, n = 23). Interventions included diet, exercise, and orlistat. Body weight and fasting ghrelin, leptin, insulin, and glucose concentrations were measured at baseline and 6 and 12 months.
RESULTS:
The WL group lost 8.5% of body weight after 6 months and maintained the new weight for the next 6 months. Ghrelin concentrations increased significantly at 6 months but returned to baseline at 12 months. Baseline ghrelin concentrations were directly related to the degree of WL achieved after 12 months. Controls experienced no change in BMI or ghrelin levels. There were no associations between plasma ghrelin and leptin or insulin concentrations.
DISCUSSION:
Consistent with previous results, ghrelin rises in response to WL, perhaps as a counterregulatory mechanism. However, the present results indicate that ghrelin concentrations return to baseline with sustained weight maintenance, suggesting that its effects are unlikely to regulate long-term energy balance. Baseline ghrelin concentrations are related to the degree of WL that can be achieved by active weight reduction
RESEARCH METHODS AND PROCEDURES:
This study was a randomized clinical trial, with a 12-month follow-up period. Obese Mexican-American women matched for age and BMI were randomized to a 12-month WL program (n = 25) or no intervention (controls, n = 23). Interventions included diet, exercise, and orlistat. Body weight and fasting ghrelin, leptin, insulin, and glucose concentrations were measured at baseline and 6 and 12 months.
RESULTS:
The WL group lost 8.5% of body weight after 6 months and maintained the new weight for the next 6 months. Ghrelin concentrations increased significantly at 6 months but returned to baseline at 12 months. Baseline ghrelin concentrations were directly related to the degree of WL achieved after 12 months. Controls experienced no change in BMI or ghrelin levels. There were no associations between plasma ghrelin and leptin or insulin concentrations.
DISCUSSION:
Consistent with previous results, ghrelin rises in response to WL, perhaps as a counterregulatory mechanism. However, the present results indicate that ghrelin concentrations return to baseline with sustained weight maintenance, suggesting that its effects are unlikely to regulate long-term energy balance. Baseline ghrelin concentrations are related to the degree of WL that can be achieved by active weight reduction