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Biomedical subjects

J Dwyer

Publications and source records attributed to J Dwyer.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Policy and healthy weight.

"Policy" is a definite course of action adopted for reasons of expedience, prudence, or common sense. This presentation reviews policy issues related to healthy weights for which there is already a consensus and other evidence which might be useful for formulating practical public health recommendations.

Adult↗
PubMedDate not supplied

Impact of fat reduction on micronutrient density of children's diets: the CATCH Study.

BACKGROUND: The purpose of this study was to examine the impact of fat reduction on vitamin and mineral density in the diets of groups of children who participated in the CATCH school-based intervention study for 2 1/2 years. METHODS: Twenty-four-hour dietary recalls were collected on 1,182 children residing in four states and with diverse ethnic backgrounds, at baseline when they were in third grade and again at follow-up when they were in fifth grade. RESULTS: With a 2.4% reduction in total fat intake from baseline levels in the intervention group, mean changes in vitamin and mineral intakes per 1,000 kcal of this group were small yet significant compared with the control group. As mean fat intake decreased, the nutrient density of most vitamins and minerals increased; the sole exceptions were vitamin E and sodium. Mean intake of all vitamins and minerals studied exceeded 2/3 of the RDA at both baseline and follow- up for both the intervention and the control groups. No significant differences were noted between treatment groups for the percentages of children meeting 2/3 or more of the RDA at both baseline and follow-up periods. CONCLUSIONS: CATCH was successful in maintaining mean vitamin and mineral intakes of intervention group children when total dietary fat was reduced.

Adolescent↗
PubMedDate not supplied

Nonsurgical factors that influence the outcome of bariatric surgery: a review.

OBJECTIVE: Severe obesity (ie, at least 100% overweight or body mass index > or =40 kg/m2) is associated with significant morbidity and increased mortality. It is apparently becoming more common in this country. Conventional weight-loss treatments are usually ineffective for severe obesity and bariatric surgery is recommended as a treatment option. However, longitudinal data on the long-term outcome of bariatric surgery are sparse. Available data indicate that the outcome of bariatric surgery, although usually favorable in the short term, is variable and weight regain sometimes occurs at 2 years after surgery. The objective of this study is to present a review of the outcome of bariatric surgery in three areas: weight loss and improvement in health status, changes in eating behavior, and psychosocial adjustment. The study will also review how eating behavior, energy metabolism, and psychosocial functioning may affect the outcome of bariatric surgery. Suggestions for additional research in these areas are made. METHOD: Literature review. RESULTS: On average, most patients lose 60% of excess weight after gastric bypass and 40% after vertical banded gastroplasty. In about 30% of patients, weight regain occurs at 18 months to 2 years after surgery. Binge eating behavior, which is common among the morbidly obese, may recur after surgery and is associated with weight regain. Energy metabolism may affect the outcome of bariatric surgery, but it has not been systematically studied in this population. Presurgery psychosocial functioning does not seem to affect the outcome of surgery, and psychosocial outcome is generally encouraging over the short term, but there are reports of poor adjustment after weight loss, including alcohol abuse and suicide. CONCLUSIONS: Factors leading to poor outcome of bariatric surgery, such as binge eating and lowered energy metabolism, should be studied to improve patient selection and outcome. Long-term outcome data on psychosocial functioning are lacking. Longitudinal studies to examine the long-term outcome of bariatric surgery and the prognostic indicators are needed.

Feeding Behavior↗
PubMedDate not supplied

Failure of hyperoxic gas to alter the arterial lactate anaerobic threshold.

PURPOSE: Oxygen-enriched gases enable patients and healthy individuals to exercise submaximally with reduced lactate concentration, lower minute ventilation (VE), and less subjective stress compared to normoxia. These findings suggest that hyperoxia may raise the lactate accumulation threshold, also known as the anaerobic threshold (AT). METHODS: This study measured the anaerobic threshold by gas exchange (Gx-AT) and arterial lactate (Lac-AT) methods in normoxia (FIO2 = 0.209) and the Lac-AT in hyperoxia (FIO2 = 0.40). Eight healthy males (age = 30.6 +/- 3.5 years; weight = 73.4 +/- 5.2 kg; VO2max = 41.3 +/- 6.6 mL/kg/min) worked incrementally (25 Watts [W] x 2 minutes) on a cycle ergometer with the legs on three occasions: once in normoxia, twice in hyperoxia. The latter situation enabled a reliability analysis of hyperoxic anaerobic threshold by arterial lactate methods that yielded a correlation coefficient (r) of 0.94 and nonsignificant paired t-ratio. Gas exchange and arterial lactate methods of detecting the anaerobic threshold in normoxia yielded nearly identical VO2 (21.8 +/- 5.4 mL/kg/min vs 21.5 +/- 5.5 mL/kg/min) with an r of 0.98. RESULTS: Contrary to the study's hypothesis, the normoxic Lac-AT (134.4 +/- 35.2 W), expressed in power output at which the lactate threshold occurred, was not significantly different with hyperoxic gas (128.1 +/- 32.7 W). Furthermore, arterial lactate concentration at the breakpoint in normoxia (1.74 +/- 0.50 mmol.l-1) was not significantly affected by hyperoxia (1.68 +/- 1.03 mmol.l-1) nor was it different between the two hyperoxic tests. No significant differences in VE, HR, or CO2-ventilation equivalent at Lac-AT were found between the two FIO2 conditions. CONCLUSIONS: The elevation of estimated PaO2 to 200 mm Hg does not alter the Lac-AT, compared to the normoxic condition, nor does it affect the arterial lactate concentration at its systematic break point in incremental cycling. Lac-AT is a reliable measurement and it can be estimated accurately using the VE/VO2 in conjunction with VE/VCO2.

Adult↗
PubMedDate not supplied

Return to flight status after cardiac rehabilitation: three case histories.

A pilot's license to operate aircraft is not valid unless it is accompanied by a medical certificate. This certificate is revoked if a pilot is diagnosed with a cardiovascular illness. After a lengthy waiting period, the medical certificate may be reinstated if the pilot meets rigid standards. For many pilots, participation in a cardiac rehabilitation program is essential to achieve the minimal functional capacity in exercise testing (10.0 metabolic equivalents), document tolerance of medications, and achieve successful rehabilitation. Our staff has assisted 11 pilots in their quest to resume commercial or recreational flying after heart surgery, pacemaker implantation, or angioplasty. This article summarizes the case histories of three pilots who returned to fight status, in three Federal Aviation Administration categories (FAA), after a cardiac illness. The principle goals of our rehabilitation program for pilots are: (1) to achieve the highest possible outcome of the rehabilitation process; (2) to establish a safe and effective independent exercise program; (3) to obtain measures of compliance and success with the independent exercise program; (4) to document tolerance of medications and ensure that medications are acceptable to the FAA; (5) to document stability of the serum glucose in diabetic patients engaged in rigorous, prolonged exercise; and (6) prepare the patient for performance of a treadmill test in which 100% predicted maximum heart rate is achieved without symptoms of cardiovascular distress. An inherent effect of pursuing these goals is dramatic risk factor modification including improved blood pressure and lipid status and reduced body mass index. After resumption of flying, none of our pilot-patients have experienced cardiac symptoms during flight, nor have they required emergency department visits or hospitalization for any reason.

Aerospace Medicine↗
PubMedDate not supplied

Effect of experimental limbic epilepsy on the estrus cycle and reproductive success in rats.

Epilepsy was induced in female rats by the injection of tetanus toxin (5 mouse LD50) unilaterally into the ventral hippocampus under anesthesia. During the 2-4 weeks that the rats exhibited intermittent spontaneous convulsions, daily vaginal smear tests showed that their estrous cycle was interrupted. In control rats such interruption only occurred for just a few days after the operation. Investigation of mating behavior, on the first night of proestrus, which occurred after 7 weeks from the operation, showed that there were fewer mounts, intromissions or ejaculations from the males, which were caged with previously epileptic animals. These females produced slightly smaller litters than their controls and there was a marked failure of their young to thrive in comparison with those of the control females. This failure appeared to be related to relatively high "stress" levels in the general laboratory environment. The impairment of reproductive success only lasted about 3 months after the original induction of epilepsy since subsequent litters to the same animals thrived normally.

Animals↗
PubMedDate not supplied

A systematic review of the effectiveness of environmental awareness interventions.

PURPOSE: To evaluate and summarize evidence on the effectiveness of interventions available to public health staff regarding the protection of the public from environmental risks. METHOD: This systematic review involved a comprehensive literature search, screening for relevance, quality assessment of relevant studies, data extraction and synthesis. RESULTS: Fourteen of 65 relevant studies were of 'moderate' or 'strong' quality. Intervention types in these 14 studies included: mass campaign, counselling, school curriculum, educational sessions, and distribution of printed materials. Short-term improvements in awareness or knowledge were observed in 13 of the 14 studies. Eight of 13 studies that examined behavioural outcomes observed short-term improvements in self-reported behavioural outcomes. CONCLUSIONS: Positive short-term changes in health-protective awareness, knowledge and self-reported behaviour appear to be associated with relatively intensive interventions that use multiple methods and settings, and/or are delivered over multiple sessions.

Awareness↗
PubMedDate not supplied

Ignore the law.

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Aged↗