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1.
Alexandra B. Morshed Rachel G. Tabak Cynthia D. Schwarz Debra Haire-Joshu 《Journal of nutrition education and behavior》2019,51(2):237-244
Objective
To examine whether a healthy weight intervention embedded in the Parents as Teachers (PAT) home visiting program, which was previously found to improve mothers’ body mass index (BMI) and obesity-related behaviors, changed the BMI of preschool children or maternal feeding practices.Methods
This stratified randomized trial included preschool-aged children at risk for overweight whose mothers were overweight or had obesity (n?=?179). The Healthy Eating and Active Living Taught at Home (HEALTH) intervention was based on the Diabetes Prevention Program. Differences were examined using repeated-measures mixed-ANOVA models.Results
Compared with PAT usual care, the HEALTH intervention had no effect on children's BMI or maternal feeding practices. However, combined analyses showed that children's BMI percentile decreased (P??=?.007), BMI z-scores were maintained (P??=?.19), and 3 of 8 feeding practices improved over time (P < .05).Conclusions and Implications
Additional research is needed to assess the effectiveness of PAT to prevent preschool-age obesity using rigorous designs (eg, group-randomized trials) and to identify its active components. HEALTH is ready to be scaled up to prevent maternal weight gain through embedding within the national PAT program. 相似文献2.
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Rebecca Wright Caleb Ferguson Mustafa Bodrick Hanan Balkhy Debra Jackson Patricia M. Davidson 《Journal of clinical nursing》2020,29(13-14):2723-2729
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There is some evidence suggesting that Parkinson's disease (PD) patients exhibit lower body weight when compared to age-matched healthy subjects. Low body mass index (BMI) is correlated with low bone mineral density, both of which are major risk factors for hip fractures. Possible determinants of weight loss in PD patients include hyposmia, impaired hand-mouth coordination, difficulty chewing, dysphagia, intestinal hypomotility, depression, decreased reward processing of dopaminergic mesolimbic regions, nausea, and anorexia as the side effects of medication, and increased energy requirements due to muscular rigidity and involuntary movements. It is unclear whether PD patients in general, or only a subgroup of those affected, definitely show lower BMI in the advanced stages of the disease. We therefore recommend that the body weight of PD patients be monitored monthly as the disease progresses, and that a patient's nutrition should be supplemented with sufficient amounts of vitamin D and calcium to reduce the risk of hip fractures and strengthen bone density. Because meal times may coincide with unpredictable off periods associated with akinesia and impaired hand-mouth coordination, PD patients also need flexible food schedules that accommodate the associated symptoms of this disease. 相似文献
8.
Debra L. Roter Richard M. Frankel Judith A. Hall David Sluyter 《Journal of general internal medicine》2006,21(1):28-34
Relationship-centered care reflects both knowing and feeling: the knowledge that physician and patient bring from their respective domains of expertise, and the physician’s and patient’s experience, expression, and perception of emotions during the medical encounter. These processes are conveyed and reciprocated in the care process through verbal and nonverbal communication. We suggest that the emotional context of care is especially related to nonverbal communication and that emotion-related communication skills, including sending and receiving nonverbal messages and emotional self-awareness, are critical elements of high-quality care. Although nonverbal behavior has received far less study than other care processes, the current review argues that it holds significance for the therapeutic relationship and influences important outcomes including satisfaction, adherence, and clinical outcomes of care. 相似文献
9.
A Decade of Change in Obesity Surgery 总被引:4,自引:0,他引:4
Edward E Mason MD PhD Shenghui Tang MS Kathleen E Renquist BS Dwight T Barnes Joseph J Cullen MD Cornelius Doherty MD James W Maher MD 《Obesity surgery》1997,7(3):189-197
Background: The International (formerly National) Bariatric Surgery Registry began collecting data in January 1986. The aim
of this study was to examine changes in the practice of surgical treatment of severe obesity that occurred during the decade
of 1986 through 1995, as observed in the IBSR data. Methods: All data submitted to the IBSR during the decade were transferred
to the IBM mainframe computer for analysis. Characteristics of operative type populations were compared over time using analysis
of variance (ANOVA) for age, body mass index (BMI), operative weight and Chi-square (χ2) test for gender. Results: There has been a steady increase over the decade in mean patient weight. The operations used have
changed from predominantly ‘simple’ operations to more frequent use of ‘complex’ operations. Within the categories of ‘simple’
and ‘complex’, an increase in the variety of operations occurred. As a group, patients with ‘simple’ operations have been
heavier, more often male and public pay patients than those who have undergone ‘complex’ operations. One year weight loss
was greater for Roux-en-Y gastric bypass (RGB) than vertical banded gastroplasty (VBG), but follow-up rates were too low to
study the relative merits of the operations used. The reported incidence of operative mortality and serious complications
(leak with peritonitis, abscess and pulmonary embolism) remained low. Conclusions: These observations and their implications
can be summarized in three statements which relate to action for improved patient care in the beginning of the new century:
(1) increasing weight of candidates for surgical treatment during this decade indicates the need for earlier use of operative
treatment before irreversible complications of obesity can develop; (2) low risk of obesity surgery, decreasing postoperative
hospital stay, and early weight control support the continued and increased use of surgical treatment; (3) continued widespread
use of both ‘simple’ and ‘complex’ operations with increased modifications of standard RGB and VBG procedures emphasizes the
need for standardized long-term data and analyses regarding both weight control and postoperative side-effects. 相似文献
10.
Because of its neurocognitive enhancing effects, Gingko biloba has emerged as amongst the most commonly used herbal products. We report a liver transplant recipient with potentially life-threatening toxicity resulting from Gingko biloba use. Seven days after a second liver transplantation for recurrent hepatitisB virus infection, subphrenic hematoma was documented in a 59-year-old Korean patient. Failure to control bleeding with CT-guided drainage necessitated exploratory laparotomy for the evacuation of a large subphrenic hematoma. Three weeks later, an episode of vitreous hemorrhage was documented. Unbeknownst to his care providers, the patient had been consuming Gingko biloba throughout the postoperative period. No further bleeding episodes occurred after the cessation of Gingko biloba use. Unrecognized use of herbal products may be associated with serious side effects and adverse clinical sequelae in transplant recipients. Given their increasing popularity, the use of herbal products should be routinely sought as part of the history in transplant recipients. 相似文献