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Find video protocols related to scientific articles indexed in Pubmed.
Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention.
Appetite
PUBLISHED: 08-19-2014
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Individuals undertaking a weight loss effort have a choice among proven dietary approaches. Factors contributing to choice of either a low-fat/low-calorie diet or a low-carbohydrate diet, two of the most studied and popular dietary approaches, are unknown. The current study used data from participants randomized to the 'choice' arm of a trial examining whether being able to choose a diet regimen yields higher weight loss than being randomly assigned to a diet. At study entry, participants attended a group session during which they were provided tailored feedback indicating which diet was most consistent with their food preferences using the Geiselman Food Preference Questionnaire (FPQ), information about both diets, and example meals for each diet. One week later, they indicated which diet they chose to follow during the 48-week study, with the option of switching diets after 12 weeks. Of 105 choice arm participants, 44 (42%) chose the low-fat/low-calorie diet and 61 (58%) chose the low-carbohydrate diet. In bivariate analyses, diet choice was not associated with age, race, sex, education, BMI, or diabetes (all p?>?0.05). Low-carbohydrate diet choice was associated with baseline higher percent fat intake (p?=?0.007), lower percent carbohydrate intake (p?=?0.02), and food preferences consistent with a low-carbohydrate diet according to FPQ (p?
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Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.
Contemp Clin Trials
PUBLISHED: 08-10-2014
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Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein.
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A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial.
Diabetes Care
PUBLISHED: 07-28-2014
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To comprehensively compare the effects of a very low-carbohydrate, high-unsaturated/low-saturated fat diet (LC) with those of a high-unrefined carbohydrate, low-fat diet (HC) on glycemic control and cardiovascular disease (CVD) risk factors in type 2 diabetes (T2DM).
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Obesity-related health status changes and weight-loss treatment utilization.
Am J Prev Med
PUBLISHED: 04-22-2014
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Behavioral weight-loss treatment can improve health, yet it is underutilized. Factors leading to initiation of weight-loss treatment are not well characterized. In particular, it is unknown whether changes in obesity-related health status contribute to weight-loss treatment initiation.
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The association of comorbid conditions with patient-reported outcomes in Veterans with hip and knee osteoarthritis.
Clin. Rheumatol.
PUBLISHED: 03-20-2014
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There is limited understanding of how comorbid health conditions affect osteoarthritis (OA)-related outcomes. This study examined associations of different comorbidity measures with baseline OA-related patient-reported outcomes (PROs) among patients with hip and knee OA. Data were from patients (N?=?300, 9 % female, mean age = 61.1; SD?=?9.2) enrolled in a randomized control trial at the Durham Veterans Affairs Medical Center. Separate multivariable regression models, adjusted for demographic and clinical characteristics, examined the association of each comorbidity measure with baseline PROs: pain, physical function, depressive symptoms, fatigue, and insomnia. Comorbidity measures included the Self-Administered Comorbidity Questionnaire (SACQ), conditions reported as activity-limiting (SACQ-AL), and indicators of depression, diabetes, hypertension, and back pain. Mean (SD) numbers of comorbid conditions and activity-limiting conditions were 3.4 (1.8) and 1.6 (1.4), respectively. Comorbidity scores (SACQ overall and SACQ-AL) and individual comorbidity conditions were each associated with worse OA-related PROs adjusting for demographic and clinical factors. Worse SACQ overall and SACQ-AL scores were associated with worse mean scores for pain, depressive symptoms, fatigue, and insomnia (p values <0.01). Additionally, increasing SACQ-AL scores were associated with worse mean scores for function (p?
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Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions.
Patient Prefer Adherence
PUBLISHED: 01-01-2014
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Little is known about weekly variability in medication nonadherence both between and within persons.
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Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept.
Health Educ Behav
PUBLISHED: 12-16-2013
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Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without intervention. We posit that health behavior initiation and maintenance require separate psychological processes and skills. To determine the value of operationalizing maintenance as a process separate from initiation, we conducted a pilot study of a telephone-delivered intervention to assist people in transitioning from behavior initiation to maintenance. Participants were 20 veterans who had initiated lifestyle changes during a randomized controlled trial of a cholesterol reduction intervention. After completing the randomized controlled trial, these participants were enrolled in the pilot maintenance intervention, which involved three monthly telephone calls from a nurse interventionist focusing on behavioral maintenance skills. To evaluate the feasibility and acceptability of this intervention, we assessed recruitment and retention rates as well as 4-month pre-post changes in health behaviors and associated psychological processes. We also conducted individual interviews with participants after study completion. Although not powered to detect significant changes, there was evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes. Participants accepted the intervention and desired ongoing contact to maintain accountability. This pilot maintenance intervention warrants further evaluation in a randomized controlled trial.
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Nutrition therapy recommendations for the management of adults with diabetes.
Diabetes Care
PUBLISHED: 10-09-2013
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There is no standard meal plan or eating pattern that works universally for all people with diabetes. In order to be effective, nutrition therapy should be individualized for each patient/client based on his or her individual health goals; personal and cultural preferences; health literacy and numeracy; access to healthful choices; and readiness, willingness, and ability to change. Nutrition interventions should emphasize a variety of minimally processed nutrient dense foods in appropriate portion sizes as part of a healthful eating pattern and provide the individual with diabetes with practical tools for day-to-day food plan and behavior change that can be maintained over the long term.
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Impact of behavioral interventions in the management of adults with type 2 diabetes mellitus.
Curr. Diab. Rep.
PUBLISHED: 09-28-2013
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Research on the role of behavior change as an efficacious intervention for adults with type 2 diabetes is evolving. Searching PubMed and Ovid Medline, we identified and reviewed primarily randomized controlled trials from 2010 to 2013 of adults managing type 2 diabetes without insulin. All studies are evaluated in terms of the rigor of their design and their impact on glycosylated hemoglobin. The most efficacious interventions appear to be low-carbohydrate/glycemic load diets, combined aerobic and resistance training, and self-monitoring of blood glucose, which educates patients about the impact of their food selections and physical activity on their blood glucose.
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Efficacy and Tolerability of Treatments for Chronic Cough: A Systematic Review and Meta-analysis.
Chest
PUBLISHED: 08-10-2013
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Understanding the comparative effectiveness of treatments for patients with unexplained or refractory cough is important to increase awareness of proven therapies and their potential adverse effects in this unique population.
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Evaluating cough assessment tools: a systematic review.
Chest
PUBLISHED: 08-10-2013
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Little is known about the comparative validity, reliability, or responsiveness of instruments for assessing cough frequency or impact, where the term impact encompasses both cough severity and the impact of cough on health-related quality of life.
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The influence of a physician and patient intervention program on dietary intake.
J Acad Nutr Diet
PUBLISHED: 06-06-2013
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Efficient dietary interventions for patients with hypertension in clinical settings are needed.
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Recruitment and retention rates in behavioral trials involving patients and a support person: a systematic review.
Contemp Clin Trials
PUBLISHED: 04-06-2013
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Recruitment and retention challenges impede the study of behavioral interventions among patient-support person dyads.
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Demand for weight loss counseling after copayment elimination.
Prev Chronic Dis
PUBLISHED: 04-06-2013
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Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Our objective was to examine whether copayment elimination increased use of a weight loss clinic by veterans.
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Achieving health for a lifetime: a community engagement assessment focusing on school-age children to decrease obesity in Durham, North Carolina.
N C Med J
PUBLISHED: 03-28-2013
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Obesity is a prominent problem in the United States and in North Carolina. One way of combating it is with community-engaged interventions that foster collaboration between health-oriented organizations and community residents.
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Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice.
Contemp Clin Trials
PUBLISHED: 02-11-2013
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A variety of diet approaches achieve moderate weight loss in many individuals. Yet, most diet interventions fail to achieve meaningful weight loss in more than a few individuals, likely due to inadequate adherence to the diet. It is widely conjectured that targeting the diet to an individuals food preferences will enhance adherence, thereby improving weight loss. This article describes the design considerations of a study protocol aimed at testing this hypothesis. The study is a 2-arm randomized trial recruiting 216 medical outpatients with BMI ?30 kg/m(2) followed for 48 weeks. Participants in the experimental arm (Choice) select from two of the most widely studied diets for weight loss, a low-carbohydrate, calorie-unrestricted diet (LCD) or a low-fat, reduced-calorie diet (LFD). The participants choice is informed by results from a validated food preference questionnaire and a discussion of diet options with trained personnel. Choice participants are given the option to switch to the other diet after three months, if desired. Participants in the Control arm are randomly assigned to follow one of the two diets for the duration of follow-up. The primary outcome is weight assessed every 2-4 weeks for 48 weeks. Secondary outcomes include adherence to diet by food frequency questionnaire and obesity-specific health-related quality of life. If assisting patients to choose their diet enhances adherence and increases weight loss, the results will support the provision of diet options to patients who desire weight loss, and bring us one step closer to remediating the obesity epidemic faced by our healthcare systems.
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Trends in energy and macronutrient intakes by weight status over four decades.
Public Health Nutr
PUBLISHED: 01-16-2013
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OBJECTIVE: To examine whether the recent increasing prevalence of obesity was accompanied by variations in energy and macronutrient intakes by weight status. DESIGN: Time series of cross-sectional surveys. SETTING: National Health and Nutrition Examination Surveys (NHANES) in the USA. SUBJECTS: Adult participants of NHANES I (1971-1974), II (1976-1980), III (1988-1994) and continuous (1999-2004). RESULTS: Daily energy intake increased over time for men (9832 to 11 652 kJ, P < 0·01) and women (6418 to 8142 kJ, P < 0·01) in all BMI classes. Percentage of energy intake from carbohydrate increased over time (men: 42·7 % to 48·0 %, P < 0·01; women: 45·4 % to 50·6 %, P < 0·01), whereas percentage of energy intake from fat (men: 36·7 % to 33·1 %, P < 0·01; women: 36·1 % to 33·8 %, P < 0·01) and protein (men: 16·4 % to 15·1 %, P < 0·01; women: 16·9 % to 14·7 %, P < 0·01) decreased. With surveys combined, daily energy intake varied among BMI classes for women (underweight/normal weight: 7460 kJ; overweight: 6799 kJ; obese I: 7033 kJ; obese II/III: 7401 kJ; P < 0·01) but not men. Percentage of energy intake from carbohydrate decreased with increasing BMI class (men: 46·6 % to 45·5 %, P < 0·01; women: 49·0 % to 48·6 %, P < 0·01) whereas percentage of energy intake from fat (men: 34·3 % to 36·5 %, P < 0·01; women: 34·4 % to 35·4 %, P < 0·01) and protein (men: 15·3 % to 16·5 %, P < 0·01; women: 15·2 % to 16·0 %, P < 0·01) increased. Interactions of survey period and BMI class were not statistically significant. CONCLUSIONS: Time trends in energy and macronutrient intakes were similar across BMI classes. Research examining how individuals respond differently to varying dietary compositions may provide greater insight about contributors to the rise in obesity.
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Updated report on comparative effectiveness of ACE inhibitors, ARBs, and direct renin inhibitors for patients with essential hypertension: much more data, little new information.
J Gen Intern Med
PUBLISHED: 10-26-2011
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A 2007 systematic review compared angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in patients with hypertension. Direct renin inhibitors (DRIs) have since been introduced, and significant new research has been published. We sought to update and expand the 2007 review.
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Lessons learned when innovations go awry: a baseline description of a behavioral trial-the Enhancing Fitness in Older Overweight Veterans with Impaired Fasting Glucose study.
Transl Behav Med
PUBLISHED: 03-22-2011
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Individuals diagnosed with impaired glucose tolerance (i.e., prediabetes) are at increased risk for developing diabetes. We proposed a clinical trial with a novel adaptive randomization designed to examine the impact of a home-based physical activity (PA) counseling intervention on metabolic risk in prediabetic elders. This manuscript details the lessons learned relative to recruitment, study design, and implementation of a 12-month randomized controlled PA counseling trial. A detailed discussion on how we responded to unforeseen challenges is provided. A total of 302 older patients with prediabetes were randomly assigned to either PA counseling or usual care. A novel adaptive design that reallocated counseling intensity based on self-report of adherence to PA was initiated but revised when rates of non-response were lower than projected. This study presents baseline participant characteristics and discusses unwelcome adaptations to a highly innovative study design to increase PA and enhance glucose metabolism when the best-laid plans went awry.
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Preventive care in relation to obesity: an analysis of a large, national survey.
Am J Prev Med
PUBLISHED: 02-11-2011
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Reports from the 1990s observed lower receipt of preventive care services among obese individuals, but a few recent studies in older adults and Department of Veterans Affairs (VA) patients have failed to do so. Additional studies, using population-based samples, are needed to understand whether disparities in care by obesity continue to exist in the U.S.
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Longitudinal adherence to fecal occult blood testing impacts colorectal cancer screening quality.
Am. J. Gastroenterol.
PUBLISHED: 02-08-2011
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Existing cross-sectional quality measures for colorectal cancer (CRC) screening do not assess longitudinal adherence and thus may overestimate the quality of care. Our goal was to evaluate the adherence to repeated yearly fecal occult blood tests (FOBTs) in order to better understand the extent to which longitudinal adherence may impact screening quality.
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Effects of counseling techniques on patients weight-related attitudes and behaviors in a primary care clinic.
Patient Educ Couns
PUBLISHED: 01-17-2011
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Examine primary care physicians use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts.
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Physician characteristics as predictors of blood pressure control in patients enrolled in the hypertension improvement project (HIP).
J Clin Hypertens (Greenwich)
PUBLISHED: 11-04-2010
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The authors sought to examine the relationship between physician characteristics and patient blood pressure (BP) in participants enrolled in the Hypertension Improvement Project (HIP). In this cross-sectional study using baseline data of HIP participants, the authors used multiple linear regression to examine how patient BP was related to physician characteristics, including experience, practice patterns, and clinic load. Patients had significantly lower systolic BP (SBP) (-0.2 mm Hg for every 1% increase, P=.008) and diastolic BP (DBP) (-0.1 mm Hg for every 1% increase, P=.0007) when seen by physicians with a higher percentage of patients with hypertension. Patients had significantly higher SBP (0.8 mm Hg for every 1% increase, P=.002) when seen by physicians with a higher number of total clinic visits per day. Patients had significantly lower DBP (-4.4 mm Hg decrease, P=.0002) when seen by physicians with inpatient duties. Physicians volume of patients with hypertension was related to better BP control. However, two indicators of a busy practice had conflicting relationships with BP control. Given the increasing time demands on physicians, future research should examine how physicians with a busy practice are able to successfully address BP in their patients.
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Improving the measurement of self-reported medication nonadherence.
J Clin Epidemiol
PUBLISHED: 07-23-2010
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Medication nonadherence is a significant clinical problem in chronic disease management. Self-report measures have inadequate reliability and poor distributional properties. We demonstrate how two fundamental measurement issues have limited the usefulness of self-reported medication nonadherence measures and offer recommendations for improving measurement.
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Do diabetic veterans use the Internet? Self-reported usage, skills, and interest in using My HealtheVet Web portal.
Telemed J E Health
PUBLISHED: 06-26-2010
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The Veterans Health Administration has developed My HealtheVet (MHV), a Web-based portal that links veterans to their care in the veteran affairs (VA) system. The objective of this study was to measure diabetic veterans access to and use of the Internet, and their interest in using MHV to help manage their diabetes.
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The trials and tribulations of enrolling couples in a randomized, controlled trial: a self-management program for hyperlipidemia as a model.
Patient Educ Couns
PUBLISHED: 05-27-2010
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Capitalizing on spousal support may enhance the effectiveness of interventions for chronic disease management. However, couples-based interventions present logistical challenges. We describe our experience and lessons learned while recruiting couples into the Couples Partnering for Lipid-Enhancing Strategies (CouPLES) trial.
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Obesity and receipt of clinical preventive services in veterans.
Obesity (Silver Spring)
PUBLISHED: 03-04-2010
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Although obese individuals utilize health care at higher rates than their normal weight counterparts, they may be less likely to receive certain preventive services. We conducted a retrospective cohort study of veterans with visits to 136 national Veterans Affairs (VA) outpatient clinics in the United States in the year 2000. The cohort included 1,699,219 patients: 94% men, 48% white, and 76% overweight or obese. Overweight and obese patients had higher adjusted odds of receiving each of the targeted clinical preventive services as recommended over 5 years compared with normal weight patients. The odds for receiving vaccinations increased linearly with BMI category: influenza (men: odds ratio (OR) = 1.13 for overweight to OR = 1.42 for obese class 3; women: OR = 1.15 for overweight to OR = 1.61 for obese class 3) and pneumococcus (men: OR = 1.02 for overweight to OR = 1.15 for obese class 3; women: OR = 1.08 for overweight to OR = 1.28 for obese class 3). The odds for receiving the cancer screening services typically peaked in the mild-moderately obese categories. The highest OR for prostate cancer screening was in obese class 2 (OR = 1.29); for colorectal cancer, obese class 1 (men: OR = 1.15; women OR = 1.10); for breast cancer screening, obese class 2 (OR = 1.19); and for cervical cancer screening, obese class 2 (OR = 1.06). In a large national sample, obese patients received preventive services at higher, not lower, rates than their normal weight peers. This may be due to the VA health service coverage and performance directives, a more homogeneous patient demographic profile, and/or unmeasured factors related to service receipt.
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A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss.
Arch. Intern. Med.
PUBLISHED: 01-27-2010
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Two potent weight loss therapies, a low-carbohydrate, ketogenic diet (LCKD) and orlistat therapy combined with a low-fat diet (O + LFD), are available to the public but, to our knowledge, have never been compared.
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Hypertension improvement project: randomized trial of quality improvement for physicians and lifestyle modification for patients.
Hypertension
PUBLISHED: 11-19-2009
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Despite widely publicized hypertension treatment guidelines for physicians and lifestyle recommendations for patients, blood pressure control rates remain low. In community-based primary care clinics, we performed a nested, 2 x 2 randomized, controlled trial of physician intervention versus control and/or patient intervention versus control. Physician intervention included internet-based training, self-monitoring, and quarterly feedback reports. Patient intervention included 20 weekly group sessions followed by 12 monthly telephone counseling contacts and focused on weight loss, Dietary Approaches to Stop Hypertension dietary pattern, exercise, and reduced sodium intake. The primary outcome was change in systolic blood pressure at 6 months. Eight primary care practices (32 physicians) were randomized to physician intervention or control groups. Within those practices, 574 patients were randomized to patient intervention or control groups. Patient mean age was 60 years, 61% were women, and 37% were black. Blood pressure data were available for 91% of patients at 6 months. The main effect of physician intervention on systolic blood pressure at 6 months, adjusted for baseline pressure, was 0.3 mm Hg (95% CI: 1.5 to 2.2; P=0.72). The main effect of the patient intervention was 2.6 mm Hg (95% CI: 4.4 to 0.7; P=0.01). The interaction of the 2 interventions was significant (P=0.03); the largest impact was observed with the combination of physician and patient intervention (9.7 +/- 12.7 mm Hg). Differences between treatment groups did not persist at 18 months. Combined physician and patient interventions lowers blood pressure; future research should focus on enhancing effectiveness and sustainability of these interventions.
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Carbohydrate-restricted diets for obesity and related diseases: an update.
Curr Atheroscler Rep
PUBLISHED: 10-27-2009
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Basic, clinical, and epidemiologic research on carbohydrate-restricted dietary patterns continues to grow, evaluating the impact of this way of eating on weight loss, obesity-associated comorbidities, and development of any adverse effects. Randomized, controlled, dietary weight loss trials conducted in adults in the past 2 years reinforce previous findings that carbohydrate-restricted diets (CRDs) promote weight loss while increasing serum high-density lipoprotein cholesterol, lowering serum triglycerides, and improving glucose homeostasis. Studies showing that reduction of dietary carbohydrate leads to reduced postprandial serum glucose and insulin levels have spurred further research on CRDs in patients with type 2 diabetes. Emerging interest into the effect of diet on endothelial function has spawned studies that are harnessing new technologies, such as flow-mediated vascular dilation, to gain insight into the impact of diet on long-term cardiovascular disease outcomes. Studies on the effect of a CRD on appetite, health-related quality of life, bone density and turnover, acid-base metabolism, and potassium equilibrium help clinicians better weigh the perceived risks of the diet with the recognized benefits. This review synthesizes important clinical and physiologic studies on CRDs published between January 2007 and May 2009.
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Hypertension Improvement Project (HIP): study protocol and implementation challenges.
Trials
PUBLISHED: 02-26-2009
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Hypertension affects 29% of the adult U.S. population and is a leading cause of heart disease, stroke, and kidney failure. Despite numerous effective treatments, only 53% of people with hypertension are at goal blood pressure. The chronic care model suggests that blood pressure control can be achieved by improving how patients and physicians address patient self-care.
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A branched-chain amino acid-related metabolic signature that differentiates obese and lean humans and contributes to insulin resistance.
Cell Metab.
PUBLISHED: 02-10-2009
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Metabolomic profiling of obese versus lean humans reveals a branched-chain amino acid (BCAA)-related metabolite signature that is suggestive of increased catabolism of BCAA and correlated with insulin resistance. To test its impact on metabolic homeostasis, we fed rats on high-fat (HF), HF with supplemented BCAA (HF/BCAA), or standard chow (SC) diets. Despite having reduced food intake and a low rate of weight gain equivalent to the SC group, HF/BCAA rats were as insulin resistant as HF rats. Pair-feeding of HF diet to match the HF/BCAA animals or BCAA addition to SC diet did not cause insulin resistance. Insulin resistance induced by HF/BCAA feeding was accompanied by chronic phosphorylation of mTOR, JNK, and IRS1Ser307 and by accumulation of multiple acylcarnitines in muscle, and it was reversed by the mTOR inhibitor, rapamycin. Our findings show that in the context of a dietary pattern that includes high fat consumption, BCAA contributes to development of obesity-associated insulin resistance.
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Study protocol: Couples Partnering for Lipid Enhancing Strategies (CouPLES) - a randomized, controlled trial.
Trials
PUBLISHED: 02-06-2009
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Almost 50% of Americans have elevated low-density lipoprotein cholesterol (LDL-C). The behaviors required to lower LDL-C levels may be difficult to adhere to if they are inconsistent with spouses health practices, and, alternatively, may be enhanced by enlisting support from the spouse. This trial extends previous trials by requiring spouse enrollment, teaching spouses how to provide emotional and instrumental support, allowing patients to decide which component of the intervention they would like to receive, and having patients determine their own goals and action plans.
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A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome.
Clin. Gastroenterol. Hepatol.
PUBLISHED: 01-21-2009
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Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) anecdotally report symptom improvement after initiating a very low-carbohydrate diet (VLCD). This study prospectively evaluated a VLCD in IBS-D.
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Effects of two weight-loss diets on health-related quality of life.
Qual Life Res
PUBLISHED: 01-21-2009
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To compare the effects of two diets on health-related quality of life (HRQOL).
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Short communication: from wasting to obesity: initial antiretroviral therapy and weight gain in HIV-infected persons.
AIDS Res. Hum. Retroviruses
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Data on weight gain and the progression to overweight/obesity in HIV-infected persons during initial combination antiretroviral therapy (cART) are limited, and comparisons to the general population are inconclusive. Weight and body mass index (BMI) changes were studied in HIV-infected adults who remained on initial cART for 12 consecutive months and in an HIV-uninfected cohort receiving care at Duke University Medical Center between 1998 and 2008. Overweight/obesity was defined as BMI ?25 kg/m(2). Variables were analyzed by Chi-square and Students t-tests. Ninety-two HIV-infected persons (median age 38.2 years) met inclusion criteria. Weight and BMI increased during 12 months of cART (80.0 to 84.4 kg, p<0.0001; 26.4 to 27.9 kg/m(2), p<0.0001; respectively). Weight gain was greater in HIV-infected females compared to males (8.6 vs. 3.6 kg, p=0.04), in persons treated with protease inhibitor (PI)-based cART compared to non-PI-based cART (9.0 vs. 2.7 kg, p=0.001), and in persons with a pretreatment CD4 count <200 cells/mm(3) compared to ?200 cells/mm(3) (8.9 vs. 0.3 kg, p<0.0001). Overweight/obesity prevalence increased from 52% to 66% during 12 months of initial cART, a 27% relative increase (p=0.002). HIV-infected persons had a lower prevalence of pretreatment overweight/obesity compared to 94 age-matched control subjects (52% vs. 91%, p<0.001); however, there was no change in weight (92.7 vs. 93.0 kg, p=0.5) or overweight/obesity prevalence (91% to 92%, p>0.9) during 12 months in the control cohort. Management should anticipate excess weight gain during the first year of cART in persons who are female, have a pretreatment CD4 <200 cells/mm(3), or will initiate PI-based cART.
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Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials.
Am. J. Epidemiol.
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The effects of low-carbohydrate diets (?45% of energy from carbohydrates) versus low-fat diets (?30% of energy from fat) on metabolic risk factors were compared in a meta-analysis of randomized controlled trials. Twenty-three trials from multiple countries with a total of 2,788 participants met the predetermined eligibility criteria (from January 1, 1966 to June 20, 2011) and were included in the analyses. Data abstraction was conducted in duplicate by independent investigators. Both low-carbohydrate and low-fat diets lowered weight and improved metabolic risk factors. Compared with participants on low-fat diets, persons on low-carbohydrate diets experienced a slightly but statistically significantly lower reduction in total cholesterol (2.7 mg/dL; 95% confidence interval: 0.8, 4.6), and low density lipoprotein cholesterol (3.7 mg/dL; 95% confidence interval: 1.0, 6.4), but a greater increase in high density lipoprotein cholesterol (3.3 mg/dL; 95% confidence interval: 1.9, 4.7) and a greater decrease in triglycerides (-14.0 mg/dL; 95% confidence interval: -19.4, -8.7). Reductions in body weight, waist circumference and other metabolic risk factors were not significantly different between the 2 diets. These findings suggest that low-carbohydrate diets are at least as effective as low-fat diets at reducing weight and improving metabolic risk factors. Low-carbohydrate diets could be recommended to obese persons with abnormal metabolic risk factors for the purpose of weight loss. Studies demonstrating long-term effects of low-carbohydrate diets on cardiovascular events were warranted.
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Correlates of daily leisure-time physical activity in a community sample: Narrow personality traits and practical barriers.
Health Psychol
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Previous studies examining correlates of leisure time physical activity (LTPA) have identified personality factors that are correlated with LTPA and practical factors that impede LTPA. The purpose of the present study was to test how several narrow traits predict daily reports of LTPA and to test whether traits that predict LTPA moderate the effects of practical barriers.
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Patient self-efficacy and spouse perception of spousal support are associated with lower patient weight: baseline results from a spousal support behavioral intervention.
Psychol Health Med
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Obesity and related chronic illnesses are leading causes of death and excessive health care costs, necessitating identification of factors that can help patients achieve and maintain healthy weight. Greater self-efficacy and perceived spousal support in patients have been associated with successful weight management. The current study also assesses self-efficacy and perceived support in spouses and whether these factors are related to patient weight. At baseline of a spousal support trial, patients and spouses (N = 255 couples) each completed measures of self-efficacy and spousal support for their own exercise and healthy eating behaviors. We fit a multivariable regression model to examine the relationship between these factors and patient weight. Patients were 95% males and 65% Whites, with average age of 61 years (SD = 12) and weight of 212 lbs (SD = 42). Spouses were 64% Whites, with average age of 59 years (SD = 12). Factors associated with lower patient weight were older patient age (estimate = -0.8 lbs, p < .01), normal blood pressure (estimate = -17.6 lbs, p < .01), higher patient self-efficacy for eating healthy (estimate = -3.8 lbs, p = .02), and spouse greater perceived support for eating healthy (estimate = -10.0 lbs, p = .03). Future research should explore the causal pathways between perceived support and health outcomes to establish whether patient support behaviors could be a point of intervention for weight management.
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Initial validation of a self-report measure of the extent of and reasons for medication nonadherence.
Med Care
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Self-report measures of medication nonadherence confound the extent of and reasons for medication nonadherence. Each construct is assessed with a different type of psychometric model, which dictates how to establish reliability and validity.
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Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial.
Trials
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We describe the study design, procedures, and development of the risk counseling protocol used in a randomized controlled trial to evaluate the impact of genetic testing for diabetes mellitus (DM) on psychological, health behavior, and clinical outcomes.
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Age and sex differences in prospective effects of health goals and motivations on daily leisure-time physical activity.
Prev Med
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To examine relationships between health goals, types of motivation for those goals, and daily leisure-time physical activity (LTPA), and whether these relationships differ by age or sex.
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Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.
BMC Musculoskelet Disord
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Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some recommended therapies are under-utilized in clinical settings, and the majority of patients with hip and knee OA are overweight and physically inactive. Consequently, interventions at the provider-level and patient-level both have potential for improving outcomes. This manuscript describes two ongoing randomized clinical trials being conducted in two different health care systems, examining patient-based and provider-based interventions for managing hip and knee OA in primary care.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.