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1.
J Pediatr Psychol ; 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38960723

ABSTRACT

OBJECTIVE: Household chaos, defined as a lack of organization, structure, and predictability, has been linked to deleterious childhood health outcomes and may hinder attempts to initiate and maintain healthy lifestyle changes. This study examined the associations of household chaos and obesity-related health conditions in a sample of youth being treated for obesity. METHODS: Participants were 715 patients (61.8% girls; Mage = 12.3 years; 68.7% non-Hispanic Black; M% of 95th BMI %-ile = 146.9%) enrolled in a pediatric weight management clinic. Caregiver report of household chaos was measured using the Confusion, Hubbub and Order Scale (CHAOS). Physiological obesity-related comorbidities (e.g., insulin resistance, hypertension, dyslipidemia) were assessed by a medical clinician and abstracted from electronic medical records; health conditions were dichotomized as present or not present. Psychological functioning was measured with the Pediatric Symptom Checklist, a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention concerns. RESULTS: The Wilcoxon rank-sum test was used to test differences in household chaos scores for each obesity-related health condition. Caregivers of youth diagnosed with hypertension and obstructive sleep apnea reported significantly lower levels of household chaos, while caregivers who reported clinical levels of psychological dysfunction reported higher levels of chaos. CONCLUSIONS: Traditional management of childhood obesity requires changes across multiple health domains (e.g., dietary, exercise, sleep), and such change may be facilitated by structure and consistency. Present findings suggest that psychological resources within pediatric weight management settings should address individual patient-level factors associated with physiological and mental health as well as household functioning.

2.
Chaos ; 34(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38587537

ABSTRACT

We explore the nonlinear interactions of an optomechanical microresonator driven by two external optical signals. Optical whispering-gallery waves are coupled to acoustic surface waves of a fused silica medium in the equatorial plane of a generic microresonator. The system exhibits coexisting attractors whose behaviors include limit cycles, steady states, tori, quasi-chaos, and fully developed chaos with ghost orbits of a known attractor. Bifurcation diagrams demonstrate the existence of self-similarity, periodic windows, and coexisting attractors and show high-density lines within chaos that suggests a potential ghost orbit. In addition, the Lyapunov spectral components as a function of control parameter illuminate the dynamic nature of attractors and periodic windows with symmetric and asymmetric formations, their domains of existence, their bifurcations, and other nonlinear effects. We show that the power-shift method can access accurately and efficiently attractors in the optomechanical system as it does in other nonlinear systems. To test whether the ghost orbit is the link between two attractors interrupted by chaos, we examine the elements of the bifurcation diagrams as a function of control parameter. We also use detuning as a second control parameter to avoid the chaotic region and clarify that the two attractors are one.

3.
Br Poult Sci ; 65(2): 144-153, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38053490

ABSTRACT

1. This study evaluated the effect of wheat dilution increasing in particle size in low crude protein diets on growth performance, digestive tract, nitrogen efficiency and litter quality in broiler chickens.2. Ross 308 male broiler chicks (n = 336) were allocated to one of four dietary treatments (each with 7 pens, 12 chicks per pen); Control (CON; commercial pellet diet with standard crude protein, CP: 22.50%), W578 (CON +20% wheat of geometric mean diameter (GMD) of 578 µm; CP: 20.25%), W1326 (CON +20% wheat of GMD 1326 µm; CP: 20.25%) and WW (CON +20% whole wheat, CP: 20.25%), from d 0 to 21 of age.3. Body weight gain was increased (P < 0.05) for birds fed CON compared to the low crude protein diets. However, WW increased (P < 0.05) body weight gain compared to W578 and W1326, while feed intake and feed conversion ratio on CON and WW were similar (P > 0.05). Birds fed W1326 showed the poorest (P < 0.05) FCR compared to CON, W578 and WW.4. Gizzard relative weight (g/kg body weight) was increased (P < 0.05) on WW compared to CON on d 14 and 21, whereas gastric isthmus diameter was significantly reduced on W1326 and WW compared with CON and W578.5. There were no differences (P > 0.05) in the depth of gizzard mucosa of lamina propria between CON and WW at d 14 and 21. Birds fed WW increased (P < 0.05) gizzard tensile strength compared to W578 and W1326, whereas no difference was observed between WW and CON on d 14.6. No significant differences were seen for ileum villus height and mucosal layer between CON and WW on d 21, however, feeding CON increased the extent of the mucosal layer compared to W578 and W1326.7. Nitrogen excretion (g/kg BWG) was significantly lower (P > 0.05) on W1326 and WW compared with CON and W578. Litter nitrogen, moisture, and footpad scores significantly decreased (P < 0.05) for birds fed WW compared with CON.8. Diluting dietary protein content from 22.50 to 20.25% resulted in lower body weight gain in broilers. However, dilution with whole wheat resulted in comparable FCR, reduced nitrogen excretion, litter moisture and footpad dermatitis compared with a standard protein diet.


Subject(s)
Chickens , Diet, Protein-Restricted , Animals , Male , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Body Weight , Diet/veterinary , Diet, Protein-Restricted/veterinary , Nitrogen/metabolism , Triticum/metabolism
4.
Br Poult Sci ; : 1-10, 2024 May 24.
Article in English | MEDLINE | ID: mdl-38787391

ABSTRACT

1. This study evaluated the efficacy of maize differing in particle size in low-density protein diets on performance, the digestive tract and litter characteristics in broilers. Four dietary treatments; control commercial diet with a typical crude protein content 22.50% (CON); CON + 20% maize with particle size 350 µm (M350), crude protein 19.90%; CON + 20% maize with particle size 2600 µm (M2600), crude protein 19.90%); CON + 20% whole maize (WM), crude protein 19.90%, were fed ad libitum to broiler chicks up to 21 d of age.2. No differences in body weight gain, feed intake and FCR were found between the WM and CON. WM increased body weight gain compared to M350 and M2600. M350, M2600 and WM increased (p = 0.004) gizzard relative weight compared with CON on day 14. Both WM and M2600 reduced (p = 0.001) gastric isthmus diameter on d 14 and 21 compared with CON and M350.3. No differences were seen in mucosa for the Lamina propria and the extent of Tunica muscularis of gizzard on d 21 and ileum mucosal depth on d 14 between WM and CON diets. However, WM reduced villus-to-crypt ratio compared with CON on d 21. The M350 reduced (p < 0.05) gizzard digesta particle size compared with CON, M2600 and WM on d 14.4. Both WM and M350 decreased (p < 0.05) nitrogen excretion compared to birds fed CON. Feeding WM increased nitrogen efficiency compared with M350 and M2600 diets, but was similar to birds fed CON. Feeding M350, M2600 or WM decreased (p < 0.05) litter moisture and footpad dermatitis (FPD) scores compared with results from birds fed CON.5. Overall, diluting the protein level in broiler diets with whole maize appeared better than fine or coarse maize in terms of growth performance, digestive tract development, nitrogen excretion and litter parameters. This may lead to economic benefits by reducing grinding costs and dependence on rich protein resources contributing to sustainable meat production and food security.

5.
Ann Oncol ; 34(9): 796-805, 2023 09.
Article in English | MEDLINE | ID: mdl-37414216

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized the management of advanced melanoma (AM). However, data on ICI effectiveness have largely been restricted to clinical trials, thereby excluding patients with co-existing malignancies. Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia and is associated with increased risk of melanoma. CLL alters systemic immunity and can induce T-cell exhaustion, which may limit the efficacy of ICIs in patients with CLL. We, therefore, sought to examine the efficacy of ICI in patients with these co-occurring diagnoses. PATIENTS AND METHODS: In this international multicenter study, a retrospective review of clinical databases identified patients with concomitant diagnoses of CLL and AM treated with ICI (US-MD Anderson Cancer Center, N = 24; US-Mayo Clinic, N = 15; AUS, N = 19). Objective response rates (ORRs), assessed by RECIST v1.1, and survival outcomes [overall survival (OS) and progression-free survival (PFS)] among patients with CLL and AM were assessed. Clinical factors associated with improved ORR and survival were explored. Additionally, ORR and survival outcomes were compared between the Australian CLL/AM cohort and a control cohort of 148 Australian patients with AM alone. RESULTS: Between 1997 and 2020, 58 patients with concomitant CLL and AM were treated with ICI. ORRs were comparable between AUS-CLL/AM and AM control cohorts (53% versus 48%, P = 0.81). PFS and OS from ICI initiation were also comparable between cohorts. Among CLL/AM patients, a majority were untreated for their CLL (64%) at the time of ICI. Patients with prior history of chemoimmunotherapy treatment for CLL (19%) had significantly reduced ORRs, PFS, and OS. CONCLUSIONS: Our case series of patients with concomitant CLL and melanoma demonstrate frequent, durable clinical responses to ICI. However, those with prior chemoimmunotherapy treatment for CLL had significantly worse outcomes. We found that CLL disease course is largely unchanged by treatment with ICI.


Subject(s)
Leukemia, Lymphocytic, Chronic, B-Cell , Melanoma , Adult , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Immune Checkpoint Inhibitors/therapeutic use , Australia , Melanoma/pathology , Progression-Free Survival , Retrospective Studies
6.
Immunity ; 40(2): 289-302, 2014 Feb 20.
Article in English | MEDLINE | ID: mdl-24530057

ABSTRACT

T cell exhaustion is common during chronic infections. Although CD4(+) T cells are critical for controlling viral load during chronic viral infections, less is known about their differentiation and transcriptional program. We defined the phenotypic, functional, and molecular profiles of exhausted CD4(+) T cells. Global transcriptional analysis demonstrated a molecular profile distinct from effector and memory CD4(+) T cells and also from exhausted CD8(+) T cells, though some common features of CD4(+) and CD8(+) T cell exhaustion were revealed. We have demonstrated unappreciated roles for transcription factors (TFs) including Helios, type I interferon (IFN-I) signaling, and a diverse set of coinhibitory and costimulatory molecules during CD4(+) T cell exhaustion. Moreover, the signature of CD4(+) T cell exhaustion was found to be distinct from that of other CD4(+) T cell lineage subsets and was associated with TF heterogeneity. This study provides a framework for therapeutic interventions targeting exhausted CD4(+) T cells.


Subject(s)
Bacterial Infections/immunology , CD4-Positive T-Lymphocytes/immunology , Communicable Diseases/immunology , Virus Diseases/immunology , Bacterial Load , CD4-Positive T-Lymphocytes/cytology , Chronic Disease , Communicable Diseases/physiopathology , Humans , Viral Load
7.
Behav Med ; 49(4): 381-391, 2023.
Article in English | MEDLINE | ID: mdl-35792894

ABSTRACT

Adverse Childhood Experiences (ACEs) affect almost half of youth in the U.S. and are linked to a host of deleterious medical and psychosocial outcomes. The current study examines the relationships among ACEs, childhood obesity, and modifiable lifestyle behaviors to inform clinical care, future research, and policy. Using data from the 2016-2018 National Survey of Children's Health (NSCH), associations between children's ACEs, weight status, and health behaviors that may influence the link between ACEs and obesity were examined. In the NSCH data, 25.3% of youth aged 10-17 years experienced one ACE with another 25.9% experiencing two or more ACEs. Having ACEs was related to excess screen time and inadequate sleep, and independently associated with obesity. Findings highlight the importance of providers screening and finding ways to intervene on behalf of youth with obesity. The present provides guidelines for providers on intervening with youth experiencing ACEs.

8.
J Surg Res ; 273: 119-126, 2022 05.
Article in English | MEDLINE | ID: mdl-35065317

ABSTRACT

INTRODUCTION: Upper gastrointestinal (UGI) pathologies are common in adolescents with obesity. This study aims to determine the prevalence of UGI inflammation on preoperative esophagogastroduodenoscopy (EGD) in adolescents undergoing sleeve gastrectomy (SG) and to assess weight loss outcomes. METHODS: This is a retrospective analysis of pathology reports from EGD biopsies performed prior to SG from September 2017 to August 2020. Percentage weight loss was measured at 3, 6, and 12 mo after surgery. Percent total body weight loss (TBWL) was compared between patients with and without UGI inflammation. RESULTS: Thirty adolescents underwent laparoscopic SG. Mean TBWL was 22% of total body weight 12 mo after surgery. Preoperative EGD identified 9 (30%) patients with esophagitis, 10 (33%) with gastritis, and 9 (30%) with duodenitis. Twenty-one patients (70%) had inflammation of at least one area, 5 (17%) were Helicobacter pylori positive, and 1 (3%) had a gastric ulcer that delayed surgery. Five (17%) patients were taking antacids prior to EGD. Patients with preoperative gastric or duodenal inflammation had significantly less TBWL 12 mo after SG compared to patients without gastric (24.6% versus 16.7%, P = 0.04) or duodenal inflammation (25.7% versus 14.1%, P = 0.02). CONCLUSIONS: There is a high prevalence of UGI inflammation in adolescents undergoing SG. Gastric and duodenal inflammation is associated with less TBWL after SG.


Subject(s)
Gastric Bypass , Laparoscopy , Obesity, Morbid , Adolescent , Gastrectomy/adverse effects , Humans , Inflammation/epidemiology , Inflammation/etiology , Inflammation/surgery , Obesity/surgery , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , Prevalence , Retrospective Studies , Weight Loss
9.
South Med J ; 115(5): 310-314, 2022 05.
Article in English | MEDLINE | ID: mdl-35504611

ABSTRACT

OBJECTIVES: Adolescents and young adults represent the largest group of new human immunodeficiency virus (HIV) infections in the United States, especially in the South. We wanted to determine whether abstinence only until marriage (AOUM) sex education programs were effective in reducing HIV vulnerability among youth in Mississippi. METHODS: Using the 2015 Mississippi Youth Risk Behavior Surveillance System, we examined the effect of AOUM sex education among a sample of youth ages 12 to 18 years on 4 HIV-related sexual risk behaviors. RESULTS: Compared with youth not enrolled in AOUM sex education, we found no statistically significant differences on sexual risk behaviors. Race, age, and gender were significant risk factors in predicting sexual risk behavior. CONCLUSIONS: AOUM sex education programs are ineffective in reducing HIV vulnerability among youth in Mississippi. There is an urgent need to implement comprehensive sex education if we are to reduce the numbers of new HIV infections among youth and achieve our goals of ending the HIV epidemic by 2030.


Subject(s)
HIV Infections , Sex Education , Adolescent , Child , Educational Status , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Risk-Taking , Sexual Behavior , United States , Young Adult
10.
BMC Pediatr ; 21(1): 416, 2021 09 22.
Article in English | MEDLINE | ID: mdl-34551757

ABSTRACT

BACKGROUND: This study evaluates implementation of an orientation session to address a waitlist of more than 2000 referrals to a pediatric weight management clinic in the Mid-South United States. METHODS: An hour-long group-based orientation to the pediatric weight management clinic was implemented to provide information about the structure and expectations of the clinic as well as education on healthy lifestyle recommendations. Families were contacted from the waitlist by telephone and invited to attend an orientation session prior to scheduling a clinic appointment. RESULTS: Of 2251 patients contacted from the waitlist, 768 scheduled an orientation session, of which 264 (34 %) attended. Of the 264 orientation participants, 246 (93 %) scheduled a clinic appointment. Of those, 193 (79 %) completed a clinic visit. Waitlist times decreased from 297.8 ± 219.4 days prior to implementation of orientation sessions to 104.1 ± 219.4 days after. CONCLUSIONS: Orientation has been an effective and efficient way to triage patient referrals while maximizing attendance in limited clinic slots for patients and families demonstrating interest and motivation. Elements of this approach are likely generalizable to other pediatric clinical settings that must strategically manage a large volume of patient referrals.


Subject(s)
Ambulatory Care Facilities , Appointments and Schedules , Ambulatory Care , Child , Humans , Motivation , Referral and Consultation , United States
11.
Chaos ; 31(1): 013120, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33754793

ABSTRACT

Coexisting attractors are studied in a single-mode coherent model of a laser with an injected signal. We report that every attractor has a unique Lyapunov exponent (LE) pattern that is choreographed by the subtle variations in the attractor's dynamics and circumscribed by a common Lyapunov spectral pattern that begins and ends with two-zero LEs. Lyapunov spectra form symmetric-like and asymmetric bubbles; the former foreshadows an attractor's proximity to the cusp of an eminent change in dynamics and the latter indicates the presence of a bifurcation. We show that the peak values of the asymmetric bubbles are always associated with two-zero LEs; in fact, they are allied inseparably in forecasting period-doubling episodes. The two-zero LEs' predictor of torus dynamics is refined to include the convergence of three LEs to a triplet of zeros as a precursor to the two-zero spectra. We report that the long-standing two-zero LEs' signature is a necessary but not sufficient condition for predicting attractors and their dynamic conditions. The evolution of the attractor volume as a function of the injected signal is compared to the spectral formation of the attractor; we report slope changes and points of inflections in the volume trajectory where spectral changes indicate dynamic changes. Attractor viability is tested preliminarily by including random low-level noise in the frequency of the injected signal.

12.
Prev Sci ; 22(3): 367-377, 2021 04.
Article in English | MEDLINE | ID: mdl-32671672

ABSTRACT

While African American and Hispanic adolescents and young adults living in the USA are exposed to myriad stressors that may increase their risk for mental health difficulties, few studies have examined nonsuicidal self-injury (NSSI) among these youth. The purpose of this systematic review was to critically examine and synthesize current literature on NSSI among these understudied youth. Using multiple search terms related to NSSI, race/ethnicity, and developmental stage, electronic literature searches of PubMed, PsychINFO, and Google Scholar databases retrieved 3036 relevant articles published in the English language between 2000 and 2018; manual reference checks yielded an additional 17 articles. Ultimately, a total of 52 full-text studies were assessed for eligibility, and 15 articles were included in the present review. Although the majority of studies reported higher prevalence of NSSI among non-Hispanic White youth, evidence suggests that African American males are also at high risk of engaging in self-harm. Emotional dysregulation emerged as a common risk factor, while social support and feelings of connection were protective for some African American and Hispanic youth. Although racism and discrimination were not linked to NSSI in the reviewed studies, this remains an important area of future research for prevention and intervention efforts.


Subject(s)
Black or African American , Hispanic or Latino , Self-Injurious Behavior , Adolescent , Emotions , Female , Humans , Male , Risk Factors , Self-Injurious Behavior/epidemiology , Young Adult
13.
Behav Med ; 46(2): 92-99, 2020.
Article in English | MEDLINE | ID: mdl-30726172

ABSTRACT

Youth with obesity are more likely than normal-weight peers to experience psychosocial problems. Empirically-based recommendations for addressing pediatric obesity include intensive interdisciplinary weight management comprising medical, behavioral health, nutrition, and exercise components. The present study examined changes in psychosocial functioning associated with frequency of participation in an interdisciplinary pediatric weight management program. Participants were 86 patients (55.8% females; median age = 11.5 years; 67.4% Non-Hispanic Black; median BMI percentile = 99.5) enrolled in an interdisciplinary pediatric weight management program for at least one year. Psychosocial functioning was measured with the Pediatric Symptom Checklist (PSC-17), a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention difficulties as well as global functioning. The PSC-17 was completed at the initial clinic visit (baseline) and repeated one-year later (annual). The Wilcoxon Signed Rank test indicated that annual PSC-17 scores were significantly lower than baseline scores across all domains. Spearman correlation coefficients revealed no significant association between total number of clinic visits and PSC-17 global or subscale scores. However, the number of visits for exercise-only sessions was significantly correlated with caregiver-reported improvement in internalizing behaviors. Findings suggest that participation in interdisciplinary pediatric weight management may improve psychosocial functioning in youth with obesity and that attending supervised exercise sessions may be especially beneficial for improving internalizing behavior symptoms.


Subject(s)
Behavior Therapy , Exercise Therapy , Nutrition Therapy , Obesity Management/methods , Pediatric Obesity/therapy , Psychosocial Functioning , Adolescent , Child , Child, Preschool , Female , Humans , Male , Patient Care Team , Pediatric Obesity/psychology , Young Adult
14.
Br Poult Sci ; 61(6): 719-724, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32706262

ABSTRACT

1. The essentiality of silicon for skeletal development has been established, but the adequacy of bioavailable silicon supply in broiler diets has not been considered for 30 years, despite average daily weight gain of birds increasing by almost a third over that time. Therefore, two studies were undertaken to investigate whether modern strains of broiler chicken benefit from diet supplementation with bioavailable silica. 2. Trial 1 was a 2x2x2 factorial study where six replicate pens of seven chicks were fed one of the eight freshly prepared diets from hatch to 21 days of age, with bodyweight gain and feed intake recorded weekly. Diets combined the following factors: silicon supplement fed at 0 ppm or 1000 ppm, phytase levels of either 0 FTU/kg or 1500 FTU/kg and either 0.6% or 0.7% Ca. Tibia were analysed for bone breaking strength, extent of tibial dyschondroplasia and feet measured for bone ash and pododermatitis score. 3. Trial 2 used a 0.7% Ca with 1500 FTU phytase diet as the control and compared this with the same diet containing either 1000 ppm silicon (MONO-Si) freshly added each week or 1000 ppm silicon added in a single, advance-prepared batch per feeding phase. Each diet was fed to nine pens of seven birds from 0 to 35 d with feed consumption and weight recorded weekly. Two birds per pen were euthanised on d 14, 21 and 35 and tibias collected for measurement of bone breaking strength, ash and mineral content. Serum was collected for Si content. 4. Univariate analysis of means from each trial showed that silica supplementation improved bird weight gain over the starter phase, though there was no effect on feed conversion. 5. Bone strength improved with added silica in both studies, without affecting bone mineral content; indicating that modern strains of broiler may require dietary supplementation with bioavailable silicon.


Subject(s)
Animal Feed , Bone Development , Chickens , 6-Phytase , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Chickens/growth & development , Diet/veterinary , Dietary Supplements , Silicon Dioxide
15.
Br Poult Sci ; 61(4): 414-423, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32178525

ABSTRACT

1. The potential of lecithin and lysolecithin to improve lipid digestion and growth performance was investigated in three experiments: 1. an in vitro model that mimics the intestinal conditions of the chick, 2. a digestibility trial with chicks (5-7 days of age), and 3. a performance trial until 21 days of age. 2. In experiment 1, palm oil (PO), palm oil with lecithin (PO+L), and palm oil with lysolecithin (PO+LY) were subjected to in vitro hydrolysis and applied to Caco-2 monolayers to assess lipid absorption. 3. The in vitro hydrolysis rate of triglycerides was higher in PO+LY (k = 11.76 × 103/min) than in either PO (k = 9.73 × 103/min) or PO+L (k = 8.41 × 103/min), and the absorption of monoglycerides and free fatty acids was highest (P < 0.01) for PO+LY. In experiment 2, 90 broilers were assigned to three dietary treatments: a basal diet with 4% palm oil, and the basal diet supplemented with either 250 ppm lecithin or lysolecithin. 4. ATTD of crude fat was higher in broilers supplemented with lysolecithin, but was lower in broilers supplemented with lecithin. DM digestibility and AMEn in birds supplemented with lysolecithin were significantly higher (3.03% and 0.47 MJ/kg, respectively). 5. In experiment 3, 480 broilers were randomly allocated to four dietary treatments: basal diet with soybean oil (2%), basal diet with lecithin (2%), soybean oil diet with 250 ppm lysolecithin, or lecithin oil diet with 250 ppm lysolecithin. 6. Lecithin diets significantly reduced weight at day 10 and 21 compared with soybean oil. However, the addition of lysolecithin to lecithin-containing diets significantly improved bird performance. 7. The results of these studies showed that, in contrast to lecithin, lysolecithin was able to significantly improve the digestibility and energy values of feed in young broilers.


Subject(s)
Animal Feed , Animal Nutritional Physiological Phenomena , Chickens , Lecithins , Animals , Animal Feed/analysis , Caco-2 Cells , Diet , Dietary Supplements , Digestion , Lysophosphatidylcholines , Nutrients
16.
J Clin Psychol Med Settings ; 27(2): 235-246, 2020 06.
Article in English | MEDLINE | ID: mdl-32333235

ABSTRACT

The rising rates of severe obesity among adolescents in the United States indicate a dire need for more intensive weight management strategies. While current evidence suggests that bariatric surgery is a safe and efficacious intervention for adolescents, the linkages with psychopathology before and after surgery are not well understood. Psychologists are an integral part of the interdisciplinary surgery team and play an important role in preparing youth for bariatric surgery as well as supporting adolescents post-surgery. The present manuscript reviews the literature on psychopathology in the context of adolescent bariatric surgery, discusses consideration of psychopathology as a contraindication for surgery, and provides recommendations on how psychologist members of the bariatric surgery team may balance attention to motivation and adherence to medical recommendations with assessment and treatment of psychopathology. Finally, the importance of continued research to confirm clinical consensus regarding decision-making and expansion of psychological resources within adolescent bariatric surgery programs are discussed.


Subject(s)
Bariatric Surgery , Mental Disorders , Obesity, Morbid , Adolescent , Bariatric Surgery/psychology , Humans , Mental Disorders/complications , Obesity, Morbid/psychology , United States
17.
J Clin Psychol Med Settings ; 27(2): 217-225, 2020 06.
Article in English | MEDLINE | ID: mdl-31907745

ABSTRACT

The current report presents the case of "Tisha," an 18-year-old African American young woman with severe obesity and cardiomyopathy. While the emotional distress associated with chronic health conditions can lead youth to engage in maladaptive behaviors as well as impede adherence to medical recommendations, psychological interventions have shown promise in improvement of both negative affect and adherence. Tisha reported engaging in maladaptive overeating patterns in response to emotional distress associated with her medical conditions. Upon participating in an intervention that applied dialectical behavior therapy skills to address binge-eating behaviors, Tisha reported that radical acceptance was a particularly useful skill that taught her the importance of acknowledging and accepting the reality of her health condition and thereby reducing engagement in binge-eating behaviors. Post-intervention behavioral ratings also demonstrated clinically significant improvement in depressive problems. The results of this case report highlight the need for simultaneous treatment of physical and psychological symptoms and underscore the importance of early intervention.


Subject(s)
Binge-Eating Disorder , Depression , Obesity , Adolescent , Adult , Binge-Eating Disorder/psychology , Depression/complications , Emotions , Feeding Behavior , Female , Humans , Male , Obesity/psychology , Obesity, Morbid , Self Concept
18.
Eat Disord ; 28(2): 184-201, 2020.
Article in English | MEDLINE | ID: mdl-32151205

ABSTRACT

Emotional overeating, or eating in excess to soothe negative emotions, is a high-risk behavior for the future development of the binge-eating disorder (BED). The Emotional Overeating Intervention (EOI) is a culturally responsive, 10-week condensed dialectical behavior therapy (DBT) skills group intervention for adolescents endorsing emotional-overeating and binge-eating behaviors. The present study served as a secondary analysis of the intervention data, with the aim of using quantitative measures and qualitative interviews to examine intervention acceptability and DBT skill acquisition. Data were analyzed using descriptive statistics for quantitative surveys and qualitative content analysis for interviews. Among the 15 adolescents (Mage = 15.40 years; 73.3% identifying as female; 100% identifying as Black) who participated in the EOI pilot trial, most identified learning acceptance-based DBT skills, particularly radical acceptance, as both highly acceptable and the most useful aspect of treatment. Participants reported increases in distress tolerance appraisal and emotion regulation cognitive reappraisal scale scores from baseline to post-intervention. Accordingly, acceptance-based DBT skills may be associated with change-based cognitive strategies, which may contribute to improvements in emerging BED pathology. Findings serve as an initial step in informing preventative models of scalable interventions for subthreshold BED among adolescents, by identifying variables that warrant investigation as potential mechanisms of change.


Subject(s)
Binge-Eating Disorder/therapy , Dialectical Behavior Therapy , Emotional Regulation , Patient Acceptance of Health Care , Adolescent , Binge-Eating Disorder/psychology , Culture , Female , Humans , Male , Psychotherapy, Group
19.
J Relig Health ; 59(1): 223-233, 2020 Feb.
Article in English | MEDLINE | ID: mdl-30649707

ABSTRACT

Recent studies suggest that religion and spirituality can yield health benefits for young African-Americans. We examined the relationship between religious practices, spirituality, and excess weight among African-American adolescents (N = 212) residing in the Deep South. Results from modified Poisson regression analysis indicate that adolescents who prayed daily had a lower prevalence of excess weight (PR 0.77 [95% CI 0.62-0.96]) than those who did not. This relationship was only significant for 12-15 year-old participants in age-stratified analysis. These findings suggest that preventive interventions offered to children and younger adolescents can have implications for weight status across the lifespan.


Subject(s)
Black or African American/psychology , Body Weight , Health Status Disparities , Pediatric Obesity/ethnology , Spirituality , Adolescent , Child , Female , Humans , Male , Mississippi/epidemiology , Pediatric Obesity/psychology , Pilot Projects , Population Health , Prevalence , Religion
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