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Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0–45.0 kg/m2) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed. 相似文献
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Radilaite Cammock Daysha Tonumaipe’a Cath Conn Losi Sa’uLilo El-Shadan Tautolo Shoba Nayar 《Health policy (Amsterdam, Netherlands)》2021,125(2):229-238
New Zealand is currently facing an obesity and non communicable diseases (NCDs) epidemic. Recent studies have largely attributed these health issues to insufficient food and low-quality diets that cause micronutrient deficiencies. Improving healthy diets requires broader thinking and collaboration, particularly around maintaining sustainable food systems, which signifies a shift from individualistic/behavioural approaches in health promotion. This paper aims to extend solutions addressing increasing rates of obesity and diet-related NCDs in New Zealand while considering diet and human health in concurrence with sustainability. In particular, the three pillars of sustainability—economic, environmental, and social—will be considered, alongside application of a food systems approach to analysing the epidemic and policy developments in New Zealand. Given its proximity to smaller Pacific islands in the region, New Zealand is in a unique position to work multisectorally and be a leader in considering food system approaches to tackling obesity and NCDs in the Pacific. 相似文献
145.
《BONE》2016
Aiming to identify genomic variants associated with osteoporosis, we performed a genome-wide association meta-analysis of bone mineral density (BMD) at Ward's triangle of the hip in 7175 subjects from 6 samples. We performed in silico replications with femoral neck, trochanter, and inter-trochanter BMDs in 6912 subjects from the Framingham heart study (FHS), and with forearm, femoral neck and lumbar spine BMDs in 32965 subjects from the GEFOS summary results. Combining the evidence from all samples, we identified 2 novel loci for areal BMD: 1q43 (rs1414660, discovery p = 1.20 × 10− 8, FHS p = 0.05 for trochanter BMD; rs9287237, discovery p = 3.55 × 10− 7, FHS p = 9.20 × 10− 3 for trochanter BMD, GEFOS p = 0.02 for forearm BMD, nearest gene FMN2) and 2q32.2 (rs56346965, discovery p = 7.48 × 10− 7, FHS p = 0.10 for inter-trochanter BMD, GEFOS p = 0.02 for spine BMD, nearest gene NAB1). The two lead SNPs rs1414660 and rs56346965 are eQTL sites for the genes GREM2 and NAB1 respectively. Functional annotation of GREM2 and NAB1 illustrated their involvement in BMP signaling pathway and in bone development. We also replicated three previously reported loci: 5q14.3 (rs10037512, discovery p = 3.09 × 10− 6, FHS p = 8.50 × 10− 3, GEFOS p = 1.23 × 10− 24 for femoral neck BMD, nearest gene MEF2C), 6q25.1 (rs3020340, discovery p = 1.64 × 10− 6, GEFOS p = 1.69 × 10− 3 for SPN-BMD, nearest gene ESR1) and 7q21.3 (rs13310130, discovery p = 8.79 × 10− 7, GEFOS p = 2.61 × 10− 7 for spine BMD, nearest gene SHFM1). Our findings provide additional insights that further enhance our understanding of bone development, osteoporosis, and fracture pathogenesis. 相似文献
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《Journal of manipulative and physiological therapeutics》2021,44(9):743-750
ObjectiveThe purpose of this study was to assess the immediate effect of verbal and visual feedback on pelvic floor muscles (PFM) in nulliparous women without pelvic floor dysfunction.MethodsIn this observational, single-assessor, cross-sectional study, 45 female university students were evaluated using bidigital vaginal palpation and vaginal surface electromyography (EMG). EMG assessments were performed at 2 time points (T1 and T2). According to the protocol, participants performed 5 maximal voluntary contractions (MVC) with 10-second intervals, 5 sustained voluntary contractions (SVC) for 10 seconds, and a 60-second voluntary contraction until fatigue (CUF) before (T1) and after (T2) receiving verbal instructions and visual feedback on PFM contractions. At T2, women received visual feedback on their PFM contraction. Root mean square (RMS) for each repetition (MVC and VCF) was recorded, and mean value was calculated. Compensatory mechanisms during contraction were recorded visually. The difference in mean RMS (mV) for MVC, SVC, and CUF; curve integral for MVC, SVC, and CUF; median frequency (Hz) for CUF between T1 and T2 were analyzed with repeated measures multivariate analysis of variance.ResultsBefore the instructions, most participants (95.6%) performed PFM MVC using at least 1 compensatory mechanism. PFM EMG outcomes changed at T2: RMS and curve integral were reduced in T2 (P < .05) for MVC, SVC, and CUF. The median frequency increased from T1 to T2 in the CUF group (P = .01).ConclusionVerbal and visual feedback had an immediate impact on the EMG activity of PFM in nulliparous continent women. 相似文献
149.
《Geriatric nursing (New York, N.Y.)》2021,42(2):517-523
The purpose of this study was to describe older adults’ social network and support during a physical activity intervention and its association with physical activity. Mixed methods were used for this secondary analysis of existing data from a physical activity intervention. Seventy-three participants who completed a session by telephone on using support comprised the sample. Participants reported on average approximately eight individuals in their social network. Half reported support for physical activity from a spouse/partner, adult child, or friend. Those who perceived support for self-reported physical activity tended to have greater improvements on average from baseline for mean daily minutes of physical activity than those with no perceived support. Four-fifths developed a plan for a spouse/partner, friend, adult child, or sibling to provide physical activity support. Participants reported that the session was helpful and increased their confidence in using support; over one-quarter intended to use support after the intervention ended. 相似文献
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《Geriatric nursing (New York, N.Y.)》2021,42(6):1253-1256
This study explored the use of weighted blankets as a non-pharmacological treatment for persistent vocalizations in late stage dementia. A weighted blanket was applied to three individuals with a diagnosis of dementia who had frequent and intense persistent vocalizations which were not responsive to other treatment modalities and necessitated in-patient hospitalization within a specialized behavioural unit. The evaluation found a non-statistically significant reduction in the duration of persistent vocalizations during the ten-minute application of the weighted blanket and a statistically significant reduction in the duration of persistent vocalizations during the ten minutes following the application of the weighted blanket. The use of weighted blankets may therefore be a promising non-pharmacological intervention for the treatment of persistent vocalizations in late stage dementia. 相似文献