Batemanmonroe4314

Background Studies have raised the concern that dieting and weight-loss programs may be a potential risk factor for developing eating disorders, and may have a potential to affect siblings as well. This study assessed the long-term risk of developing disordered eating among children with overweight and obesity and their siblings as well as the change in the obesogenic environment following a family-based intervention program. Methods In a 30-month retrospective follow-up study (n=18 families in intervention group, n=26 families in control group, total of 81 children and siblings) and a 14-month prospective follow-up study (n=42 families, 78 children and siblings), families with one or more children with overweight or obesity ages 8-14 years participated in a multidisciplinary parent-child program called "Maccabi Active". Children's version of the eating-attitude-test (ChEAT) questionnaire, family eating-and-activity-habits questionnaire (FEAHQ) and BMI z-score were measured. Results in the retrospective study, no difference between groups with respect to ChEAT scores in children and siblings was found. In the prospective study, the FEAHQ score significantly decreased after completion of the program (ΔFEAHQ=-16.2±4.9, p=0.001) and continued to decrease in the 8-month follow-up (ΔFEAHQ=-23.2±5.7, p=0.001). BMI z-scores decreased after 6 months (ΔBMI z-score=-0.3±0.1, p=0.014), and did not increase in the 8-month follow-up. Conclusions Our findings suggest no exacerbation in disordered eating behaviors among children with overweight or obesity or their siblings, thus alleviating concerns surrounding the development of disordered eating after participating in a family-based intervention. Moreover, improvement in obesogenic environment suggests potential benefits to the entire family.Objective To examine the impact front-of-package nutrition labels (FOPLs) have on decision-making abilities among low-income parents in a virtual supermarket. Design A 4-by-2 experimental design with 3 FOPLs (summary, nutrient-specific, hybrid) and a no-FOPL comparison. Within the FOPL condition, participants either shopped with a time limit (10 minutes) or with no time limit. Setting A web-based, 3-dimensional virtual supermarket. Participants Parents (n = 1,452) from low-income households with at least 1 child aged 4-12 years. Main outcomes measured Index derived from the United Kingdom's Nutrient Profiling Model that summarized the overall nutrient profile of the participant's shopping basket. Analysis Analysis of covariance with post hoc estimations (pairwise) of condition means adjusted for multiple comparisons. Results All FOPLs led to healthier nutrient profiles than the no-FOPL condition (P less then .001). Simple FOPLs (ie, summary, hybrid) led to healthier nutrient profiles than nutrient-specific FOPLs (P = .02 and P less then .001, respectively). Among parents exposed to simple FOPLs, those under time pressure made less healthy choices than those who were not under time pressure (P = .05 and P = .03, respectively). Time pressure did not affect parents exposed to nutrient-specific FOPLs (P = .69). Conclusions and implications Front-of-package nutrition labels can aid parents in selecting healthier products. Simple FOPLs provide greater utility for selecting healthier products than FOPLs that present an array of nutrient information. Time pressure can influence how parents interact with different types of label information.Objective Primary dysmenorrhea and provoked vestibulodynia (PVD) are common pain conditions in young women. The purpose of this study was to document the severity of dysmenorrhea in women with confirmed PVD to further clarify reports of comorbidity. Since central sensitisation (CS) of the nervous system is present in both conditions, diagnosis of either, but especially both conditions, may reflect past chronic stress. Methods We investigated this comorbidity in a sample of 63 women who met diagnostic criteria for PVD, and a comparison group of 89 women with low sexual desire and arousal but no pain during sex. All women completed questionnaires about the history and severity of their dysmenorrhea. Results Of the women with PVD, 28.6% recalled moderate and 34.9% severe dysmenorrhea. Valproate ic50 For women in the comparison group, these figures were 22.5% and 19.1%, respectively. Women with PVD reported that the periods they experienced as teenagers were more painful, longer, more debilitating, and persistently painful for more years than those recalled by women in the comparison group. Conclusions Our findings suggest that the origins of the early-onset CS require serious investigation. Research into the potential to reduce future chronic pain conditions through early effective treatment of primary dysmenorrhea is also needed.In this commentary, we briefly summarize knowledge on stigma associated with human papillomavirus (HPV). In addition, we provide suggestions for health care providers to de-stigmatize HPV and improve the delivery of care.Background and objectives The perioperative cardiac arrest (CA) and mortality rates in Brazil, a developing country, are higher than in developed countries. The hypothesis of this review was that knowledge of the epidemiology of perioperative CA and mortality in Brazil enables the comparison with developed countries. The systematic review aimed to verify, in studies conducted in Brazil, the epidemiology of perioperative CA and mortality. Method and results A search strategy was carried out on different databases (PubMed, EMBASE, SciELO and LILACS) to identify observational studies that reported perioperative CA and/or mortality up to 48 hours postoperatively in Brazil. The primary outcomes were data on epidemiology of perioperative CA and mortality. In 8 Brazilian studies, there was a higher occurrence of perioperative CA and mortality in males; in extremes of age; in patients in worse physical status according to the American Society of Anesthesiologists (ASA); in emergency surgeries; in general anesthesia; and in cardiac, thoracic, vascular, abdominal and neurological surgeries. The patient's disease/condition was the main triggering factor, with sepsis and trauma as the main causes. Conclusions The epidemiology of both perioperative CA and mortality events reported in Brazilian studies does not show important differences and, in general, is similar to studies in developed countries. However, sepsis represents one of the major causes of perioperative CA and mortality in Brazilian studies, contrasting with studies in developed countries in which sepsis is a secondary cause.Background Effective pain management is essential for successful rehabilitation and enhanced recovery after joint arthroplasty. The Quadratus Lumborum Block (QLB) has mostly been described for abdominal surgery, but has also recently been applied to hip surgery patients. Methods In the following cases series, we suggest a modification of the TQL block described as Paraspinous Sagittal Shift QL block. We hypothesize that this approach may allow better LA spread to the lumbar nerve roots. Such technique involves a craniocaudal approach of LA injection between the QL and PM muscles behind the Anterior Thoracolumbar Fascia (ATLF) at the level of L4. Cases were provided with combined GA and PSSS modification of QL block via a single shot or catheter technique. Results Sensory distribution of the block in the four patients studied was found to cover the area between the T11-12 and L4-5 dermatomes. Spread of the injectate was confirmed via an A-P fluoroscopy imaging of the lumbosacral spine after injection of a mixture of LA and a contrast in the plane between the QL and PM muscles in two cases. Conclusions The PSSS technique for TQL block may be beneficial as a part of multimodal analgesia for hip surgeries. This technique may be a safe alternative to psoas compartment block; however, future comparative studies are recommended. The PSSS technique for TQL block also may provide an easy access for catheter insertion.Morbid obesity is associated with various pathophysiological changes which affect the outcome of anesthesia and surgery. So it's challenging to give anesthesia to such patients. We present a 59-year-old adult morbidly obese, hypertensive, diabetic female with hypothyroidism operated for proximal humerus fracture and now presented with non-union of fracture, requiring percutaneous injection of bone marrow aspirate from the iliac crest to the site of non-union. The patient was extremely anxious and refused to undergo the procedure under local anesthesia or sedation and demanded anesthesia. Given her comorbidities general anesthesia (GA) was avoided and the procedure was accomplished using Ultrasound (USG) guided Transversus abdominis plane (TAP) block and Lateral Femoral Cutaneous Nerve (LFCN) block for the bone marrow aspirate from the iliac crest and Intercostobrachial nerve block (T2) was given to prevent pain while injecting the aspirate into the non-union site. Dexmedetomidine and ketamine were given for deep level sedation and analgesia. TAP block and LFCN block is generally used for post-op analgesia but can be also used for surgical anesthesia instead of General anesthesia in specific scenarios. Its perioperative application and its potential use instead of GA have been discussed.Background There is currently no gold standard instrument for assessing pain in severely cognitively impaired adults who are unable to provide self-report. Aims To determine interrater reliability of the PACSLAC and PAINAD in assessing pain behaviors in patients with the same pain stimulus, determine the consistency of the reliable changes between and within the instruments and assess nurse preference for either instrument. Design A single-group, within-subjects repeated-measures design was implemented. Setting The study took place in a small suburban hospital. Participants/subjects Pain levels were observed at 24, 48, and 72 hours postsurgery using two instruments Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) and Pain Assessment in Advanced Dementia Scale (PAINAD). These instruments were selected because they are among the most commonly recommended tools for clinical use. link2 Interrater reliability was analyzed along with reliable changes in pain for each period, and the study concluded with the nurse raters completing a preference survey. Methods A convenience sample of 30 patients was used with a diagnosis of severe dementia rendering the patient unable to reliably express pain, 60+ years of age, recovering from hip fracture surgery. Results Greater interrater reliability was found for the PACSLAC, with reliable change potentially affected by the type and level of pain medication. The nurses' preference for the tool was split. Conclusions The results of this study indicate that the PACSLAC may be the more reliable tool over the PAINAD; however, rater training and familiarity with the tool is critical.Objective The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. link3 Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners.