Indicators of abdominal adiposity in middle-aged participants of the SU.VI.MAX study: relationships with educational level, smoking status and physical inactivity

OBJECTIVES: Abdominal fat accumulation is a risk factor for type 2 diabetes and cardiovascular disease. Identifying the demographic and lifestyle correlates of abdominal adiposity is an important step to target at-risk populations in prevention programs. There are few data of this kind in France. METHODS: Anthropometric indicators of overall (body mass index, BMI) and abdominal (waist hip ratio, WHR; waist circumference, WC) adiposity, educational level, smoking status, and physical activity were assessed in 6,705 middle-aged men and women participating in the SU.VI.MAX study. RESULTS: The likelihood of being obese was increased more than twice in physically inactive subjects of both genders after adjustment for age, smoking status and educational level (OR=2.22, CI95%: 1.74-2.83 in men; OR=2.38, CI95%: 1.84-3.09 in women). Having a high WHR (>=0.95 in men, >=0.80 in women) was more likely in subjects >=50 y, in current smokers, and less likely in men with higher education. The likelihood of having a high WHR was also increased in physically inactive subjects of both genders after adjustment for age, BMI, smoking status and educational level (OR=1.33, CI95%: 1.10-1.60 in men; OR=1.46, CI95%: 1.22-1.74 in women). Having a high WC (>=102 cm in men, >=88 cm in women) was positively associated with age and also with physical inactivity (OR=1.63, CI95%: 1.20-2.22 in women). CONCLUSIONS: These cross-sectional data suggest significant positive associations of physical inactivity with both the WHR and WC, independently of overall adiposity as assessed by the BMI.     

Addressing mental health issues in primary care: An initial curriculum for medical residents

Objective

Many express concern that modern medicine fails to provide adequate psychosocial and mental health care. Our educational system has not trained the primary care providers who care for most of these patients. Our objective here is to propose a quantum change: prepare residents and students during all years of training so that they are as effective in treating psychosocial and mental health issues as they are medical problems.

Method

We operationalize this objective, following Kern, by developing an intensive 3-year curriculum in psychosocial and mental health care for medical residents based on models with a strong evidence-base.

Results

We report an intensive curriculum that can guide others with similar training interests and also initiate the conversation about how best to prepare residency graduates to provide effective mental health and psychosocial care.

Conclusion

Identifying specific curricula informs education policy-makers of the specific requirements they will need to meet if psychosocial and mental health training are to improve.

Practice Implications

Training residents in mental health will lead to improved care for this very prevalent primary care population.     

Effect of protamine on blood lipoproteins in A model of atherosclerosis

Laboratory of Biochemistry, Research Institute of Neurology and Psychiatry, Khar'kov. (Presented by Academician of the Academy of Medical Sciences of the USSR A. A Korzh.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 112, No. 7, pp. 44–46, July, 1991.