212 research outputs found

    Entry Into Romantic Partnership Is Associated With Obesity

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    Body mass index is highly correlated between spouses; however, less is understood about the underlying mechanism(s) by which the development of obesity in one individual increases the risk of obesity in his/her spouse. The objective of this study is to investigate whether romantic partnership and duration of cohabitation are related to incident obesity and obesity-promoting behaviors. We used two datasets from the National Longitudinal Study of Adolescent Health: 1) 6,949 U.S. adolescents (wave II, 1996) followed into adulthood (wave III, 2001−02) and 2) 1,293 dating, cohabiting, and married romantic couples from wave III, including measured anthropometry and self-report behavior data. In the longitudinal cohort, we used sex-stratified logistic regression models to examine the risk of incident obesity by longitudinal romantic relationship status and duration of time spent living with a romantic partner. In the Couples Sample, we used multinomial logistic regression to predict concordance in outcomes: obesity, moderate-to-vigorous physical activity, and screen time by romantic partnership and duration of time living with a romantic partner. Individuals who transitioned from single/dating to cohabiting or married were more likely to become obese than those who were dating at both waves. Partner concordance for negative, obesity-related behaviors was strongest for married couples and couples who lived together ≥2 years. The shared household environment may increase the likelihood of becoming obese and influence partner concordance and may be an important target for obesity intervention

    Longitudinal Trends in Obesity in the United States From Adolescence to the Third Decade of Life

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    No longitudinal analyses using national data have evaluated the increase in obesity from adolescence into early adulthood. We examined obesity incidence, persistence, and reversal in a nationally representative cohort of US teens followed into their early 30’s, using measured height and weight data, in individuals enrolled in wave II (1996; 12–21 years), wave III (2001; 17–26 years), and wave IV (2008 early release data; 24–32 years) of the National Longitudinal Study of Adolescent Health [N=8,675]. Obesity was defined as a BMI≥95th percentile of the 2000 CDC/NCHS growth charts for adolescents or ≥30 kg/m2for individuals ≤20 years and ≥30 kg/m2 in individuals>20 years. In 1996, 13.3% of adolescents were obese. By 2008, obesity prevalence increased to 36.1%, and was highest among non-Hispanic black females (54.8%). Ninety percent of the obese adolescents remained obese in 2008. While annual obesity incidence did not decline in the total sample across the 2 study intervals (2.3% per year 1996–2001 vs. 2.2% per year 2001–2008), rates among white females declined (2.7% to 1.9% per year) and were highest among non-Hispanic black and Hispanic females (3.8% and 2.7% per year, 1996–2001 vs. 3.0% and 2.6% per year, respectively, 2002–2008). Obesity prevalence doubled from adolescence to the early 20’s, and doubled again from the early to late 20’s or early 30’s, with strong tracking from adolescence into adulthood. This trend is likely to continue owing to high rates of pediatric obesity. Effective preventive and treatment efforts are critically needed

    Association of Adolescent Obesity With Risk of Severe Obesity in Adulthood

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    Although the prevalence of obesity has increased in recent years, individuals who are obese early in life have not been followed over time to determine whether they develop severe obesity in adulthood, thus limiting effective interventions to reduce severe obesity incidence and its potentially life-threatening associated conditions

    A cluster randomized controlled trial of the effectiveness and cost-effectiveness of Intermediate Care Clinics for Diabetes (ICCD) : study protocol for a randomized controlled trial

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    Background World-wide healthcare systems are faced with an epidemic of type 2 diabetes. In the United Kingdom, clinical care is primarily provided by general practitioners (GPs) rather than hospital specialists. Intermediate care clinics for diabetes (ICCD) potentially provide a model for supporting GPs in their care of people with poorly controlled type 2 diabetes and in their management of cardiovascular risk factors. This study aims to (1) compare patients with type 2 diabetes registered with practices that have access to an ICCD service with those that have access only to usual hospital care; (2) assess the cost-effectiveness of the intervention; and (3) explore the views and experiences of patients, health professionals and other stakeholders. Methods/Design This two-arm cluster randomized controlled trial (with integral economic evaluation and qualitative study) is set in general practices in three UK Primary Care Trusts. Practices are randomized to one of two groups with patients referred to either an ICCD (intervention) or to hospital care (control). Intervention group: GP practices in the intervention arm have the opportunity to refer patients to an ICCD - a multidisciplinary team led by a specialist nurse and a diabetologist. Patients are reviewed and managed in the ICCD for a short period with a goal of improving diabetes and cardiovascular risk factor control and are then referred back to practice. or Control group: Standard GP care, with referral to secondary care as required, but no access to ICCD. Participants are adults aged 18 years or older who have type 2 diabetes that is difficult for their GPs to control. The primary outcome is the proportion of participants reaching three risk factor targets: HbA1c (≤7.0%); blood pressure (<140/80); and cholesterol (<4 mmol/l), at the end of the 18-month intervention period. The main secondary outcomes are the proportion of participants reaching individual risk factor targets and the overall 10-year risks for coronary heart disease(CHD) and stroke assessed by the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Other secondary outcomes include body mass index and waist circumference, use of medication, reported smoking, emotional adjustment, patient satisfaction and views on continuity, costs and health related quality of life. We aimed to randomize 50 practices and recruit 2,555 patients

    The relationship between socioeconomic status and white matter microstructure in pre-reading children: A longitudinal investigation

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    Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white-matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white-matter FA and second-grade reading outcomes were investigated in an SES-diverse sample of 125 children. The three left-hemisphere white-matter tracts most associated with reading, and their right-hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF). There was a significant and positive association between SES and fractional anisotropy (FA) in the bilateral ILF in kindergarten. SES moderated the association between kindergarten ILF and second grade reading performance, such that it was positive in lower-SES children, but not significant in higher-SES children. These results have implications for understanding the role of the environment in the development of the neural pathways that support reading

    Correlates of Medical Nutrition Therapy and Cardiovascular Outcomes in Youth With Type 1 Diabetes

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    To examine whether the types of medical nutrition therapies (MNTs) taught to and used by youth with type 1 diabetes (T1D) varies by socio-demographic characteristics and cardiovascular (CVD) risk factor

    Microbial interaction with terrestrial and extraterrestrial rocks on the International Space Station

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    As space agencies plan to expand human presence in space and to settle on the Moon first and Mars later, developing strategies to achieve this goal in a sustainable way is necessary. These include in situ resource utilization (ISRU) and recovering of materials by waste recycling (1). Microbe based technologies may be pivotal to the success of human space exploration. Potential roles of microorganisms in space include manufacturing, as building blocks of ecosystems, in waste recycling and in biomining (2). Understanding microbial response to space conditions is therefore essential to harness their potential. [...

    Body Mass Index Z-Score Modifies the Association Between Added Sugar Intake and Arterial Stiffness in Youth With Type 1 Diabetes: The Search Nutrition Ancillary Study

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    The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D(n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. Separate interaction terms were included to test for effect modification by body mass index (BMI) z-score and physical activity (PA). Overall, there was no association between added sugar and arterial stiffness (P \u3e 0.05); however, the association between added sugar and arterial stiffness differed by BMI z-score (P for interaction = 0.003). For participants with lower BMI z-scores, added sugar intake was positively associated with PWV trunk measurements, whereas there was no association for those who had a higher BMI z-score. PA did not significantly modify the association between added sugar and arterial stiffness. Further research is needed to determine the longitudinal relationship and to confirm that obesity differentially affects this association

    Interventions in randomised controlled trials in surgery: issues to consider during trial design

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    Until recently, insufficient attention has been paid to the fact that surgical interventions are complex. This complexity has several implications, including the way in which surgical interventions are described and delivered in trials. In order for surgeons to adopt trial findings, interventions need to be described in sufficient detail to enable accurate replication; however, it may be permissible to allow some aspects to be delivered according to local practice. Accumulating work in this area has identified the need for general guidance on the design of surgical interventions in trial protocols and reports. Key issues to consider when designing surgical interventions include the identification of each surgical intervention and their components, who will deliver the interventions, and where and how the interventions will be standardised and monitored during the trial. The trial design (pragmatic and explanatory), comparator and stage of innovation may also influence the extent of detail required. Thoughtful consideration of surgical interventions in this way may help with the interpretation of trial results and the adoption of successful interventions into clinical practice
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