Nine female runners and ten walkers completed a 60 min moderate-intensity (70% VO2max) run or walk, or 60 min rest in counterbalanced order. Plasma concentrations of the orexogenic peptide ghrelin, anorexogenic peptides peptide YY (PYY), glucagon-like peptide-1 (GLP-1), and appetite ratings were measured at 30 min interval for 120 min, followed by a free-choice meal. Both orexogenic and anorexogenic peptides were elevated after running, but no changes were observed after walking. Relative energy intake (adjusted for cost of exercise/rest) was negative in the meal following running (−194 ± 206 kcal) versus walking (41 ± 196 kcal) (P = 0.015), although both were suppressed (P < 0.05) compared to rest (299 ± 308 and 284 ± 121 kcal, resp.). The average rate of change in PYY and GLP-1 over time predicted appetite in runners, but only the change in GLP-1 predicted hunger (P = 0.05) in walkers. Results provide evidence that exercise-induced alterations in appetite are likely driven by complex changes in appetite-regulating hormones rather than change in a single gut peptide.

ObjectiveThe presence of appetite hormones, namely glucagon-like peptide-1 (GLP-1), peptide YY (PYY) and leptin in breast milk may be important in infant feeding regulation and infant growth. This study evaluated whether concentrations of GLP-1, PYY and leptin change across a single feeding (from fore- to hindmilk), and are associated with maternal and infant anthropometrics.Design and MethodsThirteen postpartum women (mean ± SD: 25.6 ± 4.5 y, 72.0 ± 11.9 kg) provided fore- and hindmilk samples 4-5 weeks after delivery and underwent measurements of body weight and composition by Dual X-ray Absorptiometry. GLP-1, PYY, and leptin concentrations were measured by radioimmunoassay, and milk fat content was determined by creamatocrit.ResultsConcentration of GLP-1 and content of milk fat was higher in hindmilk than foremilk (p≤0.05). PYY and leptin concentrations did not change between fore- and hindmilk. Both leptin concentration and milk fat content were correlated with indices of maternal adiposity, including body mass index (r= 0.65-0.85, p<0.02), and fat mass (r= 0.65-0.84, p<0.02). Hindmilk GLP-1 was correlated with infant weight gain from birth to six months (r= −0.67, p=0.034).ConclusionThe presence of appetite hormones in breast milk may be important in infant appetite and growth regulation.

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Our results indicate that formal NP education is not preparing new NPs to feel ready for practice and suggests several areas where NP educational programs need to be strengthened. Practicing NPs are the basis of the NP profession, and their views need to be sought, listened to, and reflected upon as we advance toward expanded preparation at the doctoral level.

Background/Objective: Although the literature supports that nurse practitioners provide quality primary care resulting in excellent outcomes, the transition from nurse pracitioner education to practice is often difficult. Postgraduate residency programs have been suggested to help new nurse practitioners successfully transition, and studies indicate that most new nurse practitioners are interested in postgraduate residencies; however, little is known about how residencies facilitate transitioning. We sought to understand the experience of nurse practitioners in a residency program in the United States and how the program facilitated their transition to the role of primary care provider. Methods: Reflective journals of 24 Residents who completed the first primary care nurse practitioner residency in the United States were analyzed using Content Analysis. Results: Four to nine themes for each month and one theme for each yearly quarter were identified. Residents went from feeling shocked and overwhelmed to becoming confident, competent primary care providers, committed to underserved populations. Transitioning conditions (e.g., on-call experience) and specific facilitators (e.g., engaged preceptors) and stressors (e.g., managing chronic pain and reqests for opioids) that impacted their transition were also identified. Conclusions: The findings are significant as the United States addresses the shortage of primary care providers and models for postgraduate residencies and fellowships for nurse practitioners and other advanced practice registerered nurses emerge. The findings also represent the first qualitative data that reflect the experience of nurse practitioner Residents and provide rich insight into the overall experience of a one year residency, as well as facilitating and stressful factors. Organizations that are developing or refining nurse practitioner residencies or fellowships should consider these findings and discuss ways to address them with both nurse practitioner Residents and preceptors, as well as program and organizational leadership.

NPs should counsel their patients that regular vitamin C consumption may decrease the duration of cold symptoms, but does not affect symptom severity or act as a prophylaxis.

Alterations in meal-induced responses of ghrelin and PYY(3-36) but not meal-induced thermogenesis may be responsible in part for the potential "obesity protective" effect(s) of honey consumption. A blunted glycemic response may be beneficial for reducing glucose intolerance. Further research is required to determine if these findings hold true for obese individuals, for males, or with habitual consumption.

Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.