Findings from the Nutrition Challenge Program

Obesity is an epidemic in the United States. Over 61% of U.S. adults and 58% of Nevada adults have Body Mass Index’s (BMI) that classify them as either overweight or obese (Behavioral Risk Factor Surveillance System [BRFSS], 2005). According to a recent article published in the Journal of the American Medical Association, obesity was the second leading cause of preventable death in the United States behind tobacco use (Mokdad, Marks, Stroup & Gerberding, 2004). While obesity and overweight are complex, multi-factorial health conditions, an important contributor to the overweight and obesity epidemic is poor dietary habits. One of the major public health nutrition education efforts in the past few years has been to encourage Americans to eat more fruits and vegetables. Current dietary guidelines recommend consuming between 5 and 9 servings of fruits and vegetables each day depending on age and gender. A person’s physical activity level and age determine how many calories they need each day and their calorie needs determine how many servings of fruits and vegetables they should eat each day. Only 23% of adults nationwide and 22% of Nevada adults are currently meeting that recommendation, most at the low end (BRFSS, 2005)

Joint Attention, Union with God, and the Dark Night of the Soul

Eleonore Stump has argued that the fulfilment of union between God and human beings requires a mode of relatedness that can be compared to joint attention, a phenomenon studied in contemporary experimental psychology. Stump’s account of union, however, is challenged by the fact that mother Teresa, despite her apparent manifestation of the love of God to others, herself experienced an interior ”dark night of the soul’ during which God seemed to be absent and to have rejected her completely. The dark night of the soul poses a problem for Stump’s account, since, if anyone had a union of divine love with God, it would seem that mother Teresa did. Nevertheless, I argue that the isolation and abandonment of mother Teresa’s dark night are contrary to the conditions assumed to be required for joint attention with God. As an alternative to Stump’s account, I suggest that the dark night of the soul might be better understood by reference to a combination of joint attention and blindsight, according to which interpersonal closeness might be realized through a consistent pattern of external actions without, however, a direct awareness of one person by the other

The Contributions of Two Public Health Pioneers: John Snow and Joseph Goldberger

Similar to many professional disciplines, public health was shaped by pioneers who made important contributions. Two trailblazers, whose work current public health officials should be aware of are Drs. John Snow and Joseph Goldberger. Although Snow is a well known public health figure, mentions of his work in contemporary health promotion and public health text books are generally limited and typically comment only on his study of the Broad Street Pump (BSP) cholera outbreak. The accomplishments of Joseph Goldberger receive even less coverage than those of Snow. Goldberger’s work in identifying the cause of pellagra was instrumental in creating the field of nutritional epidemiology (Elmore, & Feinstein, 1994). Because of the scant coverage of these men’s accomplishments, and their importance, these two men’s professional contributions and similarities in their lives and careers will be discussed in this paper

The Effects of Environmental Prompts on Stair Usage

Experts have advocated exercise with little success, and have turned to encouraging physical activity by incorporating it into daily activities such as taking the stairs over elevators. Much literature exists suggesting that environmental prompts can encourage the use of stairs and literature has established that some messages may be more effective than others. This study aimed to assess the effects of selected signage prompts on stair usage. Methods: Stair and elevator use were monitored in three, two-story buildings. One building served as a control, while a fitness message was placed in another building, and the final building received a weight control message. Observations took place twice per week for the seven weeks of the study. Results: Predictors of stair usage included age (

Endocrine markers of ovarian function: Clinical and biological aspects with focus on Anti Müllerian hormone

Declining birthrates and infertility are now a common problem in the Western World. Due to the tendency to postpone childbearing an increasing age of women who consider motherhood is generally seen. A factor closely related to female fertility is the ovarian reserve, a term used to designate both quantitative as well as qualitative aspects of the remaining gametes in the female gonads. Despite a natural age-dependent decline in terms of the amount of gametes, a substantial variability exists between individuals as to the age at which the actual decrease starts. In this setting biomarkers to assess the individual fertility potential are often requested. Currently the antral follicle count and the Anti Müllerian Hormone (AMH) level are considered to be the most predictive markers. The two markers roughly describe the same issue as they are both related to certain developmental stages of the folliculogenisis. Furthermore, the number of growing follicles is closely related to the activity of the hypothalamic-pituitary axis which controls the secretion of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). The aim of the present thesis was firstly to explore the age-related circadian variation of AMH in normally ovulating women and patients with Polycystic Ovarian syndrome (PCOS) and its relation to gonadotropin secretion; secondly to explore the inter- and intra-cyclic variation of AMH related to the number of antral follicles measured by ultrasound; thirdly to explore AMH as a marker of time to pregnancy in fertile women, and finally, to examine the significance of mid-follicular phase LH levels in patients undergoing IVF. The results show that, in contrast to women with PCOS, normally ovulating women reveal a significant circadian variation in AMH. The co-variation with androgens and LH, may indicate that LH masters the secretion of AMH. Moreover, in normally ovulating women, AMH shows a significant intra-and inter-cyclic variation which may question the current use of one measurement of the hormone as sufficient to evaluate the ovarian reserve. A significant positive correlation was found between AMH and the number of small antral follicles. Moreover, in a cohort of spontaneously pregnant women, AMH was found to be related to the number of menstrual cycles required to obtain a pregnancy. In women undergoing a long pituitary down-regulation with GnRHa and hormonal stimulation with gonadotropins to obtain multi-follicuar development prior to In Vitro Fertilization, the clinical pregnancy rate as well as the consumption of exogenous gonadotropins was inversely correlated to the mid-follicular LH levels. In conclusion, the present results demonstrate that normally ovulating women have circadian as well as intra- and inter-cyclic variations in AMH. Moreover, the AMH level seems to be related to time to pregnancy and closely linked to LH as a key player during folliculogenesi

Sperm DNA Integrity Assessment: A New Tool in Diagnosis and Treatment of Fertility

Infertility affects 15% of all couples. Although male infertility factors with reduced semen quality are contributing to about half of all involuntary childlessness, the value of standard semen parameters in prediction of fertility in vivo and choice of proper method for assisted reproduction is limited. In the search for better markers of male fertility, during the last 10 years, assessment of sperm DNA integrity has emerged as a strong new biomarker of semen quality that may have the potential to discriminate between infertile and fertile men. Sperm DNA Fragmentation Index (DFI) as assessed by the flow cytometric Sperm Chromatin Structure Assay (SCSA) can be used for evaluation of sperm chromatin integrity. The biological background for abnormal DFI is not completely known, but clinical data show that DFI above 30% is associated with very low chance for achieving pregnancy in natural way or by insemination, but not in vitro. Already when the DFI is above 20%, the chance of natural pregnancy may be reduced, despite other sperm parameters being normal. Thus this method may explain a significant proportion of cases of unexplained infertility and can be beneficial in counselling involuntary childless couples need of in vitro fertilisation

Environmental Correlates of Physical Activity Among African-American Adults

The purpose of this cross-sectional study was to identify perceived environmental correlates of meeting physical activity guidelines among African-American adults living in Southern Nevada. Trained interviewers phoned potential participants who lived in the 12 zip codes of Clark County, Nevada with the highest proportions of African-American residents. Respondents (n=237) answered 52 health-related and demographic questions. Slightly less than 50% of participants met physical activity guidelines. A factor analysis procedure produced two environmental variables, neighborhood safety and environmental supports for physical activity. Age, gender and educational attainment (p\u3c.05) predicted the meeting of those guidelines (R2=.214), while neighborhood support for physical activity, neighborhood safety, and BMI failed to do so. This finding suggests that environmental factors are not strong predictors of physical activity among African- American adults, although environmental supports for physical activity approached significance. Future studies should consider assessing additional aspects of the built environment as an influence on physical activity