Objective
To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis.
Methods
The Action for Health in Diabetes randomized clinical trial compared intensive ...lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education (DSE) in overweight or obese adults with type 2 diabetes. Annual ankle and brachial blood pressures over four years were used to compute ankle‐brachial indices (ABIs) and to assess interartery blood pressure differences in 5018 participants.
Results
ILI, compared to DSE, produced 7.8% (Year 1) to 3.6% (Year 4) greater weight losses. These did not affect prevalence of low (<0.90) ABI (3.60% in DSE versus 3.14% in ILI; P = 0.20) or elevated (>1.40) ABI (7.52% in DSE versus 7.59% in ILI: P = 0.90), but produced smaller mean (SE) maximum interartery systolic blood pressure differences among ankle sites 19.7 (0.2) mmHg for ILI versus 20.6 (0.2) mmHg for DSE (P < 0.001) and between arms 5.8 (0.1) mmHg for ILI versus 6.1 (0.1) mmHg for DSE (P = 0.01).
Conclusions
Four years of intensive behavioral weight loss intervention did not significantly alter prevalence of abnormal ABI, however, it did reduce differences in systolic blood pressures among arterial sites.
Representing an international gathering of scholars,Fields Watered with Blood-now available in paperback-constituted the first critical assessment of the full scope of Margaret Walker's literary ...career. As they discuss Walker's work, including the landmark poetry collectionFor My Peopleand the novelJubilee, the contributors reveal the complex interplay of concerns and themes in Walker's writing: folklore and prophecy, place and space, history and politics, gender and race. In addition, the contributors remark on how Walker's emphases on spirituality and on dignity in her daily life make themselves felt in her writings and show how Walker's accomplishments as a scholar, teacher, activist, mother, and family elder influenced what and how she wrote.
A brief biography, an interview with literary critic Claudia Tate, a chronology of major events in Walker's life, and a selected bibliography round out this collection, which will do much to further our understanding of the writer whom poet Nikki Giovanni once called "the most famous person nobody knows."
A challenge for even the most seasoned faculty member is dealing with a student who arrives for clinical experience in an impaired state. Little guidance is available for faculty regarding protocol ...for the immediate removal of an unfit student from the clinical setting or for subsequent actions aimed at helping the student constructively address the problem. The authors provide guidance to faculty for the development of a policy to address issues pertaining to the impaired student.
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