Given that retention rates for weight-loss trials have not significantly improved in the past 20 years, identifying effective techniques to enhance retention is critical. This paper describes a conceptual and practical advance that may have improved retention in a behavioral weight-loss trial-the novel application of motivational interviewing techniques to diffuse ambivalence during interactive group-based orientation sessions prior to randomization. These orientation sessions addressed ambivalence about making eating and exercise behavior changes, ambivalence about joining a randomized controlled trial, and unrealistic weight-loss expectations. During these sessions, overweight and obese men and women learned about the health benefits of modest weight loss as well as trial design, the importance of a control condition, random assignment and the impact of dropouts. Participants were then divided into groups of three or four, and asked to generate two pros and two cons of being assigned to a control condition and an active condition. Participants shared their pros and cons with the larger group, while the investigator asked open-ended questions, engaged in reflective listening and avoided taking a 'pro-change' position. Retention was high, with 96% of the participants (N = 162) completing 18-month clinic visits.
This review discusses key findings and recommendations related to the role of physical activity in weight gain prevention, weight loss, and weight-loss maintenance across the lifespan. For weight gain prevention, epidemiological and clinical studies suggest that regular physical activity is critical, with increases above the recommended 30 min daily for health (e.g., to 45 to 60 min daily) potentially desirable for curtailing weight gain. For weight loss, clinical studies suggest that physical activity interventions alone usually produce only modest results. Combining physical activity with dietary interventions increases the chance of success, especially at higher levels of physical activity (e.g., 200 to 300 min or more weekly). For weightloss maintenance, high levels of physical activity (e.g., 40 to 90 min daily) may be necessary. To manage weight across the lifespan, a comprehensive approach to physical activity is needed supported by public policy interventions that help make physical activity a part of daily life.
Globally, 6.4 million tons of fishing gear are lost in the oceans annually. This gear (i.e., ghost nets), whether accidently lost, abandoned, or deliberately discarded, threatens marine wildlife as it drifts with prevailing currents and continues to entangle marine organisms indiscriminately. Northern Australia has some of the highest densities of ghost nets in the world, with up to 3 tons washing ashore per kilometer of shoreline annually. This region supports globally significant populations of internationally threatened marine fauna, including 6 of the 7 extant marine turtles. We examined the threat ghost nets pose to marine turtles and assessed whether nets associated with particular fisheries are linked with turtle entanglement by analyzing the capture rates of turtles and potential source fisheries from nearly 9000 nets found on Australia's northern coast. Nets with relatively larger mesh and smaller twine sizes (e.g., pelagic drift nets) had the highest probability of entanglement for marine turtles. Net size was important; larger nets appeared to attract turtles, which further increased their catch rates. Our results point to issues with trawl and drift-net fisheries, the former due to the large number of nets and fragments found and the latter due to the very high catch rates resulting from the net design. Catch rates for fine-mesh gill nets can reach as high as 4 turtles/100 m of net length. We estimated that the total number of turtles caught by the 8690 ghost nets we sampled was between 4866 and 14,600, assuming nets drift for 1 year. Ghost nets continue to accumulate on Australia's northern shore due to both legal and illegal fishing; over 13,000 nets have been removed since 2005. This is an important and ongoing transboundary threat to biodiversity in the region that requires attention from the countries surrounding the Arafura and Timor Seas.
Walking for exercise is becoming widely recognized for bestowing health benefits. This study examined the association of walking for exercise and mood in sedentary, ethnic minority women over a five-month period. Ethnic minority women (N = 102) participated in a randomized, controlled trial of a 7-week behaviorally based telephone and mail intervention that promoted the adoption of walking for exercise compared to a non-behavioral minimal intervention. At 2-month post-test and 5-month follow-up, participants reported significant decreases in depressive mood and increases in vigor. Increase in walking over the course of the study was associated with change in vigor. Limited evidence was found to support a relationship between walking for exercise and mood improvement in ethnic-minority women.
This study examined whether symptoms of depression and concomitant anxiety differed between older and younger medical outpatients referred to a behavioral medicine clinic. In a sample of 178 male veterans aged 21-83 years, older adults (> or = 60 years) reported lower overall depressive symptoms on the Beck Depression Inventory (BDI) and anxiety symptoms on the State-Trait Anxiety Inventory than did younger adults ( < 60 years). Depressive symptoms were highly prevalent. Among older adults, 60.0% scored 10 or higher on BDI and 33.8% scored 16 or higher. Among younger adults, 70.8% scored 10 or higher on BDI, and 48.7% scored 16 or higher. The age difference in overall depressive symptoms was driven by cognitive-affective symptoms. While older adults had lower cognitive-affective symptoms than did younger adults, the two groups did not differ on somatic-performance symptoms. these results suggest the importance of assessing cognitive-affective depressive symptoms in both older and younger male medical outpatients.
No significant difference exists among emergency department (ED) patients treated for acute pain, at five hours, with celecoxib 200 mg, celecoxib 400 mg, or ibuprofen 600 mg, though the power of the study to detect a change was low, 36%. However, the magnitude of pain relief for celecoxib, coupled with the cost of the medication, questions its use in the immediate ED setting.
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