The Impact of Obesity on Physiologic Indicators

Obesity results in an alteration in the stress response that often results in adverse perinatal outcomes. This study investigated physiologic changes in 21 obese and 20 overweight women during pregnancy and the impact on vagal response (heart period and respiratory sinus arrhythmia), oxygenation, hemoglobin A1c (HbA1c) and systolic blood pressure at 20, 28 and 36 weeks of gestation. The impact of obesity on perinatal outcomes was investigated. Blood oxygen, systolic blood pressure, and HbA1c levels were significantly higher for the obese women as compared with overweight women. Monitoring physiologic mal-adaptation may permit early detection and intervention to improve perinatal outcomes

Student Nurses Participate in Public Health Research and Practice Through a School-Based Screening Program

Obesity has reached epidemic proportions among children in minority populations, placing them at risk for diabetes and hypertension. The importance of educating a generation of nurses who have the knowledge, skills, and passion to address this public health need is crucial to the profession and to America\u27s health. This article describes the use of a Community Partnership Model to frame baccalaureate nursing students\u27 (B.S.N.) service learning within the context of a research study to screen middle- and high-school students for health risks. The missions of education, research, and practice are linked together in the model by three processes: evidence-based practice, service learning, and scholarly teaching. The aim of the project was early identification of obesity, hypertension, and type 2 diabetes and their predictors in a high-risk student population, between 12 and 19 years of age. Early evidence indicates that the model is feasible and effective for directing student learning and addressing public health problems in the community

Sex differences in factors associated with use of medical care and alternative illness behaviors

In many previous investigations of illness behavior the dependent variable has been restricted to use or nonuse of physicians' services. The purpose of this study was to determine how males and females differ in the tendency to respond to their symptoms when self-treatment and lay consultation as well as medical care are considered. The sample consisted of all white, married individuals (n = 532) participating in a household survey who reported at least one symptom episode during a 4-week recall period. An important feature of this survey data set is that there were no proxy respondents. Similar distributions of behavioral responses to symptom episodes were found for men and women. Multinomial logit analysis was used to identify the factors associated with specific illness behaviors. The independent variables were: (1) characteristics of the individual and family such as number of children. social class and employment status; (2) characteristics and perceptions of the symptom episode including discomfort, disability and belief that a physician could do something to relieve it; and (3) access to, and attitudes toward medical care. Belief that a physician could do something to relieve the symptoms, number of days of disability and number of component symptoms in the complex were positively related to use of medical care and duration of the symptom episode was negatively related to use of medical care for both men and women. Several of the independent variables affected only one sex group or had differential effects on males and females. Sex differences were most pronounced with respect to use of lay consultants. Among men, higher social class was associated with use of medical care, whereas, among women, those in higher social classes were more likely to use lay consultants. Other things being equal, women who rated their symptom complexes high on discomfort and seriousness visited a physician, those worried about their symptoms sought lay consultation. An unexpected finding was that the presence of children in the home had a significant effect on men but not women. Employment status, number of children and age of the youngest child did not have significant effects on illness behaviors of men or women These findings should not be generalized beyond similar groups of white, primarily working class adults living in nuclear families in the early seventies. However, this data set provided an opportunity to explore gender differences in the factors associated with alternative illness behaviors including self-treatment and lay consultation in addition to use of medical care. In this sample sex differences in illness behavior were most pronounced with respect to the factors associated with use of the lay network to cope with illness. Further study is warranted.family health services accessibility health services research role sex factors social environment socioeconomic factors

Individual and community characteristics associated with premature natural and drug-related deaths in 25-59 year old decedents.

The purpose of the study was to identify circumstances of death, disease states, and sociodemographic characteristics associated with premature natural and drug-related deaths among 25-59 year olds. The study also aimed to address the paucity of research on personal, community-based, and societal factors contributing to premature death. A population-based retrospective chart review of medical examiner deaths within a highly populated and ethnically diverse county [in Texas] was undertaken to identify individuals dying prematurely and circumstances surrounding cause of death [in 2013]. The sample data (n = 1282) allowed for analysis of decedent demographic variables as well as community characteristics. Descriptive statistics, multivariable logistic regression, and geospatial analyses were used to test for associations between the type of death (natural or drug-related) and demographics, circumstances of death, disease types and community characteristics. Census tract data were used to determine community characteristics. Highly clustered premature deaths were concentrated in areas with low income and under-educated population characteristics. Two-thirds of decedents whose death were due to disease had not seen a healthcare provider 30 days before death despite recent illness manifestations. Opioids were found in 187 (50.5%) of the drug-related deaths, with 92.5% of deaths by opioids occurring in combination with other substances. The study findings went beyond the cause of death to identify circumstances surrounding death, which present a more comprehensive picture of the decedent disease states and external circumstances. In turn, these findings may influence the initiation of interventions for medically underserved and impoverished communities

Interventions to Promote Physical Activity and Dietary Lifestyle Changes for Cardiovascular Risk Factor Reduction in Adults: A Scientific Statement from the American Heart Association

Even modest sustained lifestyle changes can substantially reduce cardiovascular disease (CVD) morbidity and mortality. Because many of the beneficial effects of lifestyle changes accrue over time, long-term adherence maximizes individual and population benefits. Interventions targeting dietary patterns, weight reduction, and new PA habits often result in impressive rates of initial behavior changes, but frequently are not translated into long-term behavioral maintenance. Both adoption and maintenance of new cardiovascular risk-reducing behaviors pose challenges for many individuals. According to the National Center for Health Statistics, life expectancy could increase by almost 7 years if all forms of major CVD were eliminated.5 Improvements in morbidity and quality of life would also be substantial. In order to achieve these goals, healthcare providers must focus on reducing CVD risk factors such as overweight and obesity, poor dietary habits, and physical inactivity by helping individuals begin and maintain dietary and PA changes. The purpose of this scientific statement is to provide evidence-based recommendations on implementing PA and dietary interventions among adult individuals, including adults of racial/ethnic minority and/or socioeconomically disadvantaged populations. The most efficacious and effective strategies are summarized, and guidelines are provided to translate these strategies into practice. Individual, provider, and environmental factors that may influence the design of the interventions, as well as implications for policy and for future research, also are briefly addressed