The U.S. Preventive Services Task Force has recommended that primary care clinicians screen all adults for obesity and provide those affected intensive multicomponent behavioral interventions. ...Approximately 95 million U.S. adults qualify for such care, also referred to as lifestyle modification. Using the Guidelines (2013) for Managing Overweight and Obesity in Adults (hereafter, Obesity Guidelines) as a framework, this article reviews the principal components of comprehensive lifestyle modification, which include diet, physical activity, and behavior therapy. To lose weight, the Obesity Guidelines recommend participation for 6 months in high-intensity programs that provide 14 or more counseling sessions with a trained interventionist. When provided face-to-face individual or group treatment, participants lose up to 8 kg (8% of weight) in 6 months and experience improvements in cardiovascular disease risk factors and quality of life. To prevent weight regain, the Obesity Guidelines recommend participation for 1 year in weight-loss-maintenance programs that provide at least monthly counseling. High levels of physical activity, frequent monitoring of body weight, and consumption of a reduced-calorie diet are associated with long-term weight loss. Investigators currently are seeking to increase the availability of lifestyle modification by delivering it in community-based programs, as well as on digital platforms (e.g., Internet and Smartphone). Digitally delivered programs lower costs and expand treatment reach; their efficacy is likely to improve further with the addition of new technologies for monitoring food intake, activity, and weight. Ultimately, to improve long-term weight management, individual lifestyle counseling must be joined with collective and institutional efforts to improve the nation's eating and activity environments.
Public Significance Statement
This review describes lifestyle modification approaches for overweight and obesity. Such programs provide instruction in cognitive-behavioral strategies designed to facilitate the individual's consumption of a satisfying, reduced-calorie diet and to increase physical activity. Treatment that offers 14 or more counseling contacts in 6 months helps individuals lose an average of 5%-8% of initial weight (e.g., 10-16 lb), which is associated with improvements in health and quality of life.
The study of transverse momentum spectra is crucial to understand the nature of matter produced during heavy-ion collisions. The pT-spectra in a heavy-ion collision consists of a low pT-region where ...soft processes dominate particle production, whereas the high pT-region is mostly dominated by hard processes. Single and multi-component models based on statistical thermodynamics are extensively used to characterize the spectra. In this work, we have introduced a unified non-extensive statistical approach using the Pearson distribution as a tool to study pT-spectra. The goodness-of-fit of the proposed distribution as compared to previously used models makes it an interesting method providing strong insights into the underlying physics of heavy-ion collisions. This generalized approach provides a strong correlation with other observables by comparing the predictions of the methods in pT-distributions with various harmonics of azimuthal distributions.
Semaglutide for the treatment of obesity Chao, Ariana M.; Tronieri, Jena S.; Amaro, Anastassia ...
Trends in cardiovascular medicine,
04/2023, Letnik:
33, Številka:
3
Journal Article
Recenzirano
Semaglutide is a glucagon-like peptide-1 receptor agonist that was recently approved by the US Food and Drug Administration for chronic weight management. This paper reviews data on the mechanism of ...action, weight-loss and cardiometabolic efficacy, and safety of semaglutide 2.4 mg/week for obesity. Semaglutide has demonstrated the largest weight loss of any obesity medication to date with reductions of approximately 15% of initial weight at 68 weeks, accompanied by improvements in cardiovascular risks factors and physical functioning. The approval of this medication provides patients with greater options for weight management.
Coping Cat‐cognitive behavior therapy (CBT) is a 16‐week program, which has been used widely and has proven its efficacy in helping children in overcoming anxiety disorders. This research study ...intends to explore its efficacy on Indian school children with high anxiety in Delhi. The study aims at qualitative assessment of the experience of children with anxiety after intervention with Coping Cat‐CBT. After the Coping Cat‐CBT intervention, semistructured interviews were conducted with the children. Participants: Children aged 11–13 years exhibiting the symptoms of high anxiety were enrolled in the study. They were asked to write down their experience after the Coping Cat‐CBT intervention. Data were analyzed using the inductive approach of qualitative content analysis. Participants expressed that the intervention was beneficial in terms of their ability to combat anxiety experienced in day‐to‐day life, and reported improvements in various domains of life such as scholastic performance, interpersonal relationships, and successful use of coping skills in handling fearful situations and relaxation techniques in overcoming anxiety. The data provided empirical evidence that Indian children with anxiety‐related problems could benefit from the therapy. Coping Cat‐CBT was efficacious in reducing their symptoms of anxiety.
Practitioner points
“Coping Cat”‐cognitive behavior therapy (CBT) proved to be an effective treatment for high anxiety in Indian school children (11–13 years age group).
Post “Coping Cat”‐CBT, qualitative content analysis of children's experiences proved that the program besides helping them to cope with anxiety had a positive impact on their academics, social, personal, school, and family lives.
“Coping Cat”‐CBT has been found to be applicable with ease in Indian schools for children with anxiety‐related problems.
The aim of the study was to investigate the relationship between socioeconomic status (SES) and executive functioning, focusing specifically on performance monitoring, error detection, and their ...association with mid-frontal theta and error-related negativity (ERN). Employing the widely used flanker task, the research involved two phases with participants aged 10-16 years (15 individuals in the pilot phase and 35 in the second phase). Electroencephalogram (EEG) recordings from distinct brain regions were analyzed during various conditions. The study revealed a notable increase in both absolute and relative theta power at Fcz during the flanker task, with a stronger effect observed during incorrect trials. Furthermore, it underscored the influence of socioeconomic status (SES) on mid-frontal theta, highlighting interactions between SES, gender, and experimental conditions impacting both absolute and relative theta. Intriguingly, the research disclosed a positive correlation between parental occupation and error-related negativity (ERN), as well as between age and ERN. These findings underscore the significance of SES, gender, and age in shaping the neural mechanisms associated with performance monitoring and executive functions. The study contributes valuable insights into the intricate interplay between socio-demographic factors and cognitive processes, shedding light on their impact on goal-directed behaviors and brain activity.
Objective: To test the effects of a cognitive-behavioral intervention for weight bias internalization (WBI; i.e., self-stigma) combined with behavioral weight loss (BWL). Method: Adults with obesity ...and elevated WBI were randomly assigned to BWL alone or combined with the Weight Bias Internalization and Stigma Program (BWL + BIAS). Participants attended weekly group meetings for 12 weeks, followed by 2 biweekly and 2 monthly meetings (26 weeks total). Changes at Week 12 on the Weight Bias Internalization Scale (WBIS) and Weight Self-Stigma Questionnaire (WSSQ) were the principal outcomes, with changes at Week 26 assessed as secondary outcomes. Other outcomes included changes in mood, body image, eating behaviors, self-monitoring, and weight. Results: Seventy-two participants were randomized (84.7% female, 66.7% Black, mean age = 47.1 ± 11.5 years) Linear mixed models showed no significant differences between the BWL + BIAS and BWL groups in WBIS changes at Week 12 (−1.3 ± 0.2 vs. −1.0 ± 0.2) or week 26 (−1.5 ± 0.2 vs. −1.3 ± 0.2). BWL + BIAS participants had greater reductions in WSSQ total scores at Week 12 (p = .03), with greater changes on the self-devaluation subscale at Weeks 12 and 26 (p ≤ .03). BWL + BIAS participants reported significantly greater benefits on measures of eating and self-monitoring. Percent weight loss at Week 26 did not differ significantly between groups (BWL + BIAS = −4.5 ± 1.0%, BWL = −5.9 ± 1.0%, p = .28). Conclusion: A psychological intervention for WBI produced short-term reductions in some aspects of weight self-stigma in persons with obesity.
What is the public health significance of this article?
This study demonstrates the efficacy of a cognitive-behavioral weight stigma-reduction intervention, combined with behavioral weight loss.
Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care bundle aimed at the early recovery of patients. Well accepted in gastric and pelvic surgeries, there is minimal evidence in ...neurosurgery and neurocritical care barring spinal surgeries. We wished to compare the length of intensive care unit (ICU) or high dependency unit (HDU) stay of patients undergoing elective craniotomy for supratentorial neurosurgery: ERAS protocol versus routine care. The secondary objective was to compare the postoperative pain scores, opioid use, glycemic control, and the duration of postoperative hospital stay between the two groups.
In this pragmatic non-randomized controlled trial (CTRI/2017/07/015451), consenting adult patients scheduled for elective supratentorial intracranial tumor excision were enrolled prospectively after institutional ethical clearance and consent. Elements-of-care in the ERAS group were- Preoperative -family education, complex-carbohydrate drink, flupiritine; Intraoperative - scalp blocks, limited opioids, rigorous fluid and temperature regulation; Postoperative- flupiritine, early mobilization, removal of catheters, and initiation of feeds. Apart from these, all perioperative protocols and management strategies were similar between groups. The two groups were compared with regards to the length of ICU stay, pain scores in ICU, opioid requirement, glycemic control, and hospital stay duration. The decision for discharge from ICU and hospital, data collection, and analysis was by independent assessors blind to the patient group.
Seventy patients were enrolled. Baseline demographics - age, sex, tumor volume, and comorbidities were comparable between the groups. The proportion of patients staying in the ICU for less than 48 h after surgery, the cumulative insulin requirement, and the episodes of VAS scores > 4 in the first 48 h after surgery was significantly less in the ERAS group - 40.6% vs. 65.7%, 0.6 (±2.5) units vs. 3.6 (±8.1) units, and one vs. ten episodes (p = 0.04, 0.001, 0.004 respectively). The total hospital stay was similar in both groups.
The study demonstrated a significant reduction in the proportion of patients requiring ICU/ HDU stay > 48 h. Better pain and glycemic control in the postoperative period may have contributed to a decreased stay. More extensive randomized studies may be designed to confirm these results.
Clinical Trial Registry of India ( CTRI/2018/04/013247 ), registered retrospectively on April 2018.
Background: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often ...stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. Objectives: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. Methods: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. Results: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). Conclusions: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.
Radio-Frequency Plasma Enhanced Chemical Vapour Deposition (RF-PECVD), and Pulsed Laser Deposition (PLD) techniques were used to deposit boron carbide (BxC) thin films. Films were investigated to ...compare crystallinity, chemical composition, optical properties, and residual stress. X-ray diffraction analysis revealed that the film deposited by PLD was amorphous, while PECVD technique yielded crystalline BxC film. PLD technique provided films with better stoichiometric purity with B4C being the most dominant phase, as observed in XPS spectra. However, super-stoichiometric phase (BxC (x > 4)) was dominant in PECVD film. Moreover, the PECVD film had greater adhesion (Lc3 ~29.5 N), hardness (~2798 HK), and lubricity (COF~ 0.03) compared to PLD deposited film. Optically, PECVD deposited film have higher value of refractive indices (1.82 at 600 nm) and lower extinction coefficient. Finally, residual stress measured via substrate curvature method revealed that for PLD 400 C film, the stress was compressive in nature while the same for PECVD -100 V film was tensile, with 10 times less in magnitude. Ultimately, this study provides the user with opportunity to weigh the advantages and disadvantages of PECVD and PLD techniques for deposition of functional BxC films.
Display omitted
•Comparative study of BxC thin films deposited by PECVD and PLD techniques.•PECVD yielded crystalline, super-hard BxC films, at a high deposition rate.•PLD was found to be useful for near-stoichiometric BxC thin film deposition.•PECVD films have higher refractive index and low absorption in comparison.•Residual stress found to be dependent on deposition rate and energy of adatoms.
Objective
The aim of this study was to investigate the 6‐month nonintervention follow‐up effects of a cognitive behavioral intervention for weight bias internalization (WBI; i.e., self‐stigma) ...combined with behavioral weight loss (BWL).
Methods
Adults with obesity and elevated WBI were previously randomized to receive BWL alone or in combination with the Weight Bias Internalization and Stigma program (BWL + BIAS). Participants attended weekly group meetings for 12 weeks, followed by two biweekly and two monthly meetings (26 weeks total). Follow‐up assessments were conducted at week 52. Changes on the Weight Bias Internalization Scale and Weight Self‐Stigma Questionnaire at week 52 were the principal outcomes. Other outcomes included changes in eating, coping, and weight.
Results
Of 72 randomized participants, 54 (75%) completed week 52 assessments. Linear mixed models showed improvements across groups, but no significant differences between groups, in week 52 change on the Weight Bias Internalization Scale (P = 0.25) or Weight Self‐Stigma Questionnaire (P = 0.27). BWL + BIAS participants reported significantly greater benefits than BWL participants on measures of eating and affective coping with weight stigma. Percent weight loss at week 52 did not differ significantly between groups (BWL + BIAS = −3.1% SE 1.0%, BWL = −4.0% SE 1.0%, P = 0.53).
Conclusions
Reductions in WBI did not differ between groups at 6‐month follow‐up. Further research is needed to determine the potential benefits of a stigma‐reduction intervention beyond BWL.
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