The effect of an 8 week prescribed exercise and low-carbohydrate diet on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals: A randomised controlled trial
Description:
Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
Description:
Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
Description:
The Australian Fitness Industry Risk Management (AFIRM) Project was set up to explore the operation of rules and regulations for the delivery of safe fitness services. This article summarises the results of recent focus group research and a national survey of risk management practices by the AFIRM Project. Our focus group research in four States identified the following most important concerns: (1) the competency of fitness professionals; (2) the effectiveness of pre-exercise screening and the management of de-conditioned clients; (3) poor supervision of fitness service users and incorrect use of equipment; (4) fitness trainers failing to remain within their scope of practice; (5) equipment misuse (as distinct from incorrect use); and (6) poor fitness training environments. This information was then used to develop 45 specific items for a questionnaire that was disseminated throughout the fitness industry. The survey, which is the largest ever conducted in the Australian fitness industry (n = 1,178), identified similar concerns. Our research indicates that efforts to improve risk management in the fitness industry should focus, first and foremost, on the development and monitoring of safety policy, and improvements in the education and training of fitness instructors to ensure that they can incorporate risk management practices.
Description:
Background: How willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? There is a lack of evidence of students' views by discipline despite this being a priority task for higher education sectors. This study explored the views of nursing, midwifery, nursing-emergency health (paramedic), medical, physiotherapy and nutrition-dietetics students. Methods: Senior undergraduate students from six disciplines at one university completed the Readiness for Interprofessional Learning Scale prior to participating in interprofessional clinical learning modules. Results: For 741 students, the highest ranked response was agreement about a need for teamwork (mean 4.42 of 5 points). Nursing students held significantly more positive attitudes towards Teamwork/ Collaboration, and were more positive about Professional Identity than medical students (p < .001). Midwifery and nursing-emergency-health students rejected uncertainty about Roles/Responsibilities compared with medical students (p < .001). One-third of all students who had prior experience of interprofessional learning held more positive attitudes in each of four attitude domains (p < .05). Conclusion: Overall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. Early introduction of IPL is recommended. Further studies should explore the trajectory of students' attitudes throughout the university degree.
Prospective application of a five-step regulatory assessment model to a proposed federal sperm donor registry in Australia: Is it in the public interest?
Description:
It has been proposed that a nationally mandated donor registry be established in Australia to provide data for estimating the possible number of inadvertent half-sibling matings resulting from the multiple use of anonymous donors in donor insemination and to assist identity-release donors and their donor-inseminated children to establish contact. A five-step regulatory assessment model, as described by Johnson and Petersen in 2008, was applied prospectively to the proposed donor registry to identify public interest issues. The resultant issues concern the public ethical interest in child welfare; the public health interest in avoiding genetic abnormalities/disease; public socio-political and legal interests in avoiding inadvertent consanguineous relationships; public ethical and health interests in avoiding identity issues in the donor-inseminated child; and public socio-ethical interests in providing nationally mandated, comprehensive records of donor insemination outcomes. These results provide a basis for further discussion in regard to donor insemination legislation at the federal level.
Description:
It has been proposed that a nationally mandated donor registry be established in Australia to provide data for estimating the possible number of inadvertent half-sibling matings resulting from the multiple use of anonymous donors in donor insemination and to assist identity-release donors and their donor-inseminated children to establish contact. A five-step regulatory assessment model, as described by Johnson and Petersen in 2008, was applied prospectively to the proposed donor registry to identify public interest issues. The resultant issues concern the public ethical interest in child welfare; the public health interest in avoiding genetic abnormalities/disease; public socio-political and legal interests in avoiding inadvertent consanguineous relationships; public ethical and health interests in avoiding identity issues in the donor-inseminated child; and public socio-ethical interests in providing nationally mandated, comprehensive records of donor insemination outcomes. These results provide a basis for further discussion in regard to donor insemination legislation at the federal level.
Description:
This is the first study of attitudes of Australian heterosexuals toward heterosexual, gay male, and lesbian parents and the children raised by these parents. A sample of Australian heterosexual males and females read one of six vignettes describing a family situation. Participants assessed the parents' emotional stability, responsibility, and competence; how loving, sensitive, and nurturing they were; the amount of quality time they spent with their child; and their ability to be good role models. Results indicated participants held negative attitudes toward gay male and lesbian same-sex parents. Participants believed that children raised by same-sex parents are more likely to experience confusion over their sexual orientation and gender identity, more likely to be homosexual, and more likely to experience strained peer relationships as well as stigma and teasing than children raised by heterosexual parents. Level of sexual prejudice was the key predictor of attitudes toward same-sex parents and the expected outcomes for their children. Being male, older, and having fewer children were additional predictors of attitudes towards same-sex parents, whereas being older and less religiouswas associatedwith expected negative outcomes for the children. Substantial attitudinal shifts are required before gay male and lesbian parents and their children are fully accepted into Australian communities.
Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms
Description:
Objective: To investigate changes in mental health and other needs, as well as clinical and diagnostic 'caseness', in a sample of adolescents over a 6-month period following entry into a Young Offenders Institution in the UK. Design: Prospective cohort study. Setting: One Young Offenders Institution between November 2006 and August 2009. Participants: 219 male adolescents aged 15-18 years (M=16.56; SD=0.6) were assessed at baseline (median=4; range 0-26 days following reception into custody) on the Salford Needs Assessment Schedule for Adolescents (SNASA) and Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Participants were then reassessed at 3-month and 6-month postbaseline to document any change in mental health. Results: Of the initial baseline sample, 132 were still in the study at 3-month postbaseline and 63 were still available for assessment at 6 months. There were no differences between those who were not available for assessment at the three key stages in terms of demographic and criminological data. Over time there was a general improvement in mental health. While the proportion of participants with a mental health need (SNASA) did not change over time, symptom severity as measured by the SNASA did reduce significantly. When we assessed diagnostic 'caseness' using the K-SADS, three young people showed significant mental health deterioration. Conclusions: In line with previous studies, we found that symptoms in prison generally improved over time. Prison may provide an opportunity for young people previously leading chaotic lifestyles to settle into a stable routine and engage with services; however, it is unclear if these would be maintained either within the prison or on release into the community.
Description:
Abstract Objectives To evaluate the associations between an objective measure of different intensities of physical activity, upper- and lower-limb muscle strength and psychomotor performance and set-shifting domains of cognitive executive function in older adults. Design A cross-sectional study. Methods From the Tasmanian Older Adult Cohort Study, 188 community-dwelling older adults (53.7% female mean age ± SD 63.98 ± 7.3 years) undertook 7-day physical activity behaviour monitoring using an accelerometer. Dynamometers were used to assess leg extension strength. The Trail Maker Tests were used to measure psychomotor processing speed and set-shifting performance. Results When controlling for age, smoking history, alcohol intake, educational achievement and neuropsychological functioning, higher levels of light physical activity, but not sedentary behaviour or moderate or vigorous physical activity, was found to be associated with better set-shifting performance. Neither physical activity behaviour or muscle strength were found to be associated with psychomotor performance. In addition, older age, greater alcohol intake, and lower levels of educational attainment, verbal learning and memory performance were significantly associated with lower scores on the set-shifting task whereas older age and reduced neuropsychological functioning were associated with lower psychomotor processing speed scores. Conclusions Light physical activity is associated with higher executive functioning in community-dwelling older adults and this strengthens the evidence supporting exercise as a neuroprotective agent. Further studies are needed to understand why light physical activity behaviour positively influences executive functioning, and how such physical activity can be implemented into the daily routine of older adults.
Description:
Objective: Parents who lose an only child in China are stressed and traumatized due to social identity threat (SIT). This qualitative study aimed to interpret their experience to inform culturally and socially sensitive intervention strategies. Methods: Using a phenomenological approach, 17 bereaved parents who lost an only child were interviewed. The transcripts were analyzed using Colaizzi's method. Results: Three themes were identified, namely, "assuming a new social identity," "triggering social identity threat," and "resisting social identity threat and maintaining resilience." The study showed that SIT initially began with identity reconstruction, where self-identity and social identity occurred 1 after another. Once labeled with such social identity, the bereaved parents suffered social identity threat triggered by inner inferiority and external stigmatization. The bereaved parents undertook a variety of coping strategies to resist the threat and to maintain resilience of these strategies, 4 patterns depicting resilience and threat were interpreted. Conclusion: The findings offer an understanding of the multifaceted bereavement dilemma and lay a foundation for developing intervention strategies. Promoting or maintaining resilience and alleviating SIT are 2 important ways that help parents move on. To help them with identity reconstruction, the development of culturally sensitive resilience-based programs and the linking of social resources to solve practical problems are recommended. Community health professionals should encourage parents to maintain good health management to prevent their predicament from worsening. Raising economic assistance, building an elderly care support system, and promoting social acceptance are strategies that could be considered by policymakers. Clinical Impact StatementThe bereaved parents who have lost an only child in China is facing a multifaceted dilemma, which involves psychological, economic and cultural issues. This study applies the construct of social identity threat to interpretive lived experience of parents in China who have lost their only child. The study contributes to better understanding of their multifaceted bereavement dilemma, and lay the foundation for developing psycho-behavioural intervention strategies, which potentially also benefit other marginalized or traumatized bereaved groups. Results in this study offered several recommendations for psychological counselors, community workers, community health professionals, and government policymakers.
Description:
Although several studies have demonstrated an association between the 7-repeat (7R) allele in the 48-bp variable number of tandem repeats (VNTRs) in the exon 3 at dopamine receptor D4 (DRD4) gene and attention-deficit/ hyperactivity disorder (ADHD), others failed to replicate this finding. In this study, a total of 786 individuals with ADHD were genotyped for DRD4 exon 3 VNTR. All 7R homozygous subjects were selected for VNTR re-sequencing. Subjects homozygous for the 4R allele were selected paired by age, ancestry and disorder subtypes in order to have a sample as homogeneous as possible with 7R/7R individuals. Using these criteria, 103 individuals (66 with ADHD and 37 control individuals) were further investigated. An excess of rare variants were observed in the 7R alleles of ADHD patient when compared with controls (P = 0.031). This difference was not observed in 4R allele. Furthermore, nucleotide changes that predict synonymous and non-synonymous substitutions were more common in the 7R sample (P = 0.008 for total substitutions and P = 0.043 for non-synonymous substitutions). In silico prediction of structural/functional alterations caused by these variants have also been observed. Our findings suggest that not only repeat length but also DNA sequence should be assessed to better understand the role of DRD4 exon 3 VNTR in ADHD genetic susceptibility.
Description:
Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.
Description:
The Emotional Availability Scales (EAS) are the most widely reported observational assessment measure of parent-child relationships and has been of particular interest in understanding differences between samples of depressed and nondepressed mothers and their offspring. Despite its widespread use, psychometric validation of the factor structure in normative samples and the measurement of invariance within clinical samples has not been published. We evaluated the internal structure (dimensionality, reliability, convergent, and discriminant validity) of the EAS fourth edition using a nondepressed sample of 157 Australian women and their infants aged 6 months, including testing the measurement invariance of the EAS between the same nondepressed sample (n = 157), and a depressed group (n = 185) of mother-infant dyads, using MPlus. Participants were recruited from tertiary hospitals, and depression status was established using a diagnostic measure. Higher-order confirmatory factor analyses on the EAS' six dimensions supported a unidimensional factor solution in our data. Full measurement invariance was not demonstrated due to metric noninvariance of the maternal nonintrusiveness and child responsiveness dimensions. Full scalar invariance supported mean comparisons, and a medium effect of .78SD lower mean emotional availability for the depressed group was found Cohen's d = .63, 95% CI [.41, .85]. While arguments exist for the clinical utility of differentiating between multiple dimensions of emotional availability, the current findings do not support a multidimensional factor structure or full multigroup measurement invariance of the EAS. Similar psychometric investigations of the EAS in clinical and nonclinical samples are needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).