Eating Behavior of Obese and Nonobese Retarded Adults

An obese group and a nonobese group of moderately mentally retarded adults were identified through use of body weight and tricep skinfold thickness measures. Subjects were observed individually in a sheltered workshop cafeteria during their normal lunch period. A variety of eating behavior measureswere obtained. Results indicated that the obese retarded subjects did not differ from their nonobese peers in eating rate, total meal time, or caloric intake. Large variability was observed in the measures for both groups. Implications of these data for behavioral treatments of obesity and the need for alternative explanations of an obese condition were discussed

Obesity of Mentally Retarded Individuals: Prevalence, Characteristics, and Intervention

Research on the prevalence, characteristics, and treatment of obesity of mentally retarded individuals within the context of research findings with the obese nonretarded population was selectively reviewed. According to the available literature, obesity is a prevalent problem in the retarded population, and there is a greater incidence among females than males. The literature also suggests that obese retarded subjects as a group can be distinguished from their nonobese peers by their physical condition, but not by their eating style or personality characteristics. Behavioral self-control strategies have been found to be effective in producing weight loss in obese retarded children and adults. Further research is needed to reduce the high interindividual variability observed in treatment outcome studies and to address problems of long-term maintenance of weight loss

Appropriate Classification of Obesity in Mentally Retarded Adults

Triceps skinfold thickness and body weight measures were obtained for 44 female and 40 male mentally retarded adults participating in a sheltered workshop setting. Subiects\u27 relative weights and skinfold thicknesses were found to correlate reasonably well for females and males, rs = .88 and .59, respectively. Use of only height and weight tables for determining the presence of obesity, however, resulted in 22.5 percent of the males and 13 .7 percent of the females being misclassified as nonobese. The distinction between overweight and obesity was discussed. Clinical/research implications of the findings were delineated

Simulation-Based Training in Cardiac Surgery

BACKGROUND: Operating room surgical training has significant limitations. This study hypothesized that some skills could be learned efficiently and safely by using simulation with component task training, deliberate practice, progressive complexity, and experienced coaching to produce safer cardiac surgeons. METHODS: Training modules included cardiopulmonary bypass, coronary artery bypass grafting, aortic valve replacement, massive air embolism, acute intraoperative aortic dissection, and sudden deterioration in cardiac function. Using deliberate practice, first-year cardiothoracic surgical residents at eight institutions were trained and evaluated on component tasks for each module and later on full cardiac operations. Evaluations were based on five-point Likert-scale tools indexed by module, session, task items, and repetitions. Statistical analyses relied on generalized linear model estimation and corresponding confidence intervals. RESULTS: The 27 residents who participated demonstrated improvement with practice repetitions resulting in excellent final scores per module (mean ± two SEs): cardiopulmonary bypass, 4.80 ± 0.12; coronary artery bypass grafting, 4.41 ± 0.19; aortic valve replacement, 4.51 ± 0.20; massive air embolism, 0.68 ± 0.14; acute intraoperative aortic dissection, 4.52 ± 0.17; and sudden deterioration in cardiac function, 4.76 ± 0.16. The transient detrimental effect of time away from training was also evident. CONCLUSIONS: Overall performance in component tasks and complete cardiac surgical procedures improved during simulation-based training. Simulation-based training imparts skill sets for management of adverse events and can help produce safer surgeons

Clinical and radiological outcome of conservative vs. surgical treatment of atraumatic degenerative rotator cuff rupture: design of a randomized controlled trial

Background: Subacromial impingement syndrome is a frequently observed disorder in orthopedic practice. Lasting symptoms and impairment may occur when a subsequent atraumatic rotator cuff rupture is also present. However, degenerative ruptures of the rotator cuff can also be observed in asymptomatic elderly individuals. Treatment of these symptomatic degenerative ruptures may be conservative or surgical. Acceptable results are reported for both treatment modalities. No evidence-based level-1 studies have been conducted so far to compare these treatment modalities. The objective of this study is to determine whether there is a difference in outcome between surgical reconstruction and conservative treatment of a degenerative atraumatic rotator cuff tendon rupture. Methods/Design: A randomized controlled trial will be conducted. Patients aged between 45 and 75 with a symptomatic atraumatic rotator cuff rupture as diagnosed by MRI will be included. Exclusion criteria are traumatic rotator cuff rupture, frozen shoulder and diabetes mellitus. Patients will be randomized into two groups. Conservative treatment includes physical therapy according to a standardized protocol, NSAIDs and, if indicated, subacromial infiltration with a local anesthetic and corticosteroids. Surgical reconstruction is performed under general anesthesia in combination with an interscalenus plexus block. An acromioplasty with reconstruction of the rotator cuff tendon is performed, as described by Rockwood et al. Measurements take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. The primary outcome measure is the Constant score. Secondary measures include both disease-specific and generic outcome measures, and an economic evaluation. Additionally, one year after inclusion a second MRI will be taken of all patients in order to determine whether extent and localization of the rupture as well as the amount of fatty degeneration are prognostic factors. Discussion: Both surgical as conservative treatment of a symptomatic atraumatic rotator cuff tendon rupture is used in current practice. There is a lack of level-1 studies comparing surgical vs. conservative treatment. This randomized controlled trial has been designed to determine whether the surgical treatment of a degenerative atraumatic rotator cuff tendon rupture may lead to a better functional and radiological outcome than conservative treatment after one year of follow-up

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Physical Fitness and Personality Characteristics of Obese and Nonobese Retarded Adults

Performance on a test of submaximal cardiovascular endurance and on measures of self-concept and anxiety was studied with 22 obese and 20 nonobese mentally retarded adults. Results indicated that the endurance test successfully discriminated between the obese and nonobese groups while the personality measures did not. Implications of this finding for obesity treatment were discussed