bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project
Authors: MIDTGAARD JULIE , TVETERÅS ANDERS , RØRTH MIKAEL , STELTER REINHARD , ADAMSEN LIS
Published: April 2008

Background:Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship.

Objective:This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project.

Methods:Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale—HADS). Patient statements were selected that best illustrated trends found in the statistical material.

Results:There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression.

Significance of research:Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.
Art therapy improves coping resources: A randomized, controlled
study among women with breast cancer
Authors: ÖSTER INGER , SVENSK ANN-CHRISTINE , MAGNUSSON EVA , THYME KARIN EGBERG , SJÕDIN MARIE , ÅSTRÖM STURE , LINDH JACK
Published: April 2008

Objective: Women with breast cancer suffer from considerable
stress related to the diagnosis, surgery, and medical treatment. It is
important to develop strategies to strengthen coping resources among these
women. Research in art therapy has shown outcomes such as an increase in
self-esteem and cohesion, significant improvement in global health, and a
decrease in anxiety and depression. The aim of the present article was to
describe the effects of an art therapy intervention program on coping
resources in women with primary breast cancer.

Method: In this article, we report some of the results from a
study including 41 women, aged 37–69 years old, with nonmetastatic
primary breast cancer, referred to the Department of Oncology at
Umeå University Hospital in Sweden for postoperative radiotherapy.
The women represented various socioeconomic backgrounds. They were
randomized to a study group (n = 20) with individual art therapy
for 1 h/week during postoperative radiotherapy or to a control group
(n = 21). The article focuses on changes in coping resources, as
measured by the Coping Resources Inventory (CRI) before and 2 and 6 months
after the start of radiotherapy. The study protocol was approved by the
Umeå University Ethical Committee at the Medical Faculty (archive
number 99–386).

Results: There was an overall increase in coping resources
among women with breast cancer after taking part in the art therapy
intervention. Significant differences were seen between the study and
control groups in the social domain on the second and third occasions.
Significant differences were also observed in the total score on the
second occasion.

Significance of results: This study shows that individual art
therapy provided by a trained art therapist in a clinical setting can give
beneficial support to women with primary breast cancer undergoing
radiotherapy, as it can improve their coping resources.
The physician's role in the assessment and treatment of spiritual distress at the end of life
Authors: BROWN ANTHONY E. , WHITNEY SIMON N. , DUFFY JAMES D.
Published: April 2008

Objective:Patients at the end of their life typically endure physical, emotional, interpersonal, and spiritual challenges. Although physicians assume a clearly defined role in approaching the physical aspects of terminal illness, the responsibility for helping their patients' spiritual adaptation is also important.

Methods:This article (1) describes the terms and definitions that have clinical utility in assessing the spiritual needs of dying patients, (2) reviews the justifications that support physicians assuming an active role in addressing the spiritual needs of their patients, and (3) reviews clinical tools that provide physicians with a structured approach to the assessment and treatment of spiritual distress.

Results:This review suggests that physicians can and should be equipped to play a key role in relieving suffering at the end of life.

Significance of results:Physicians can help their patients achieve a sense of completed purpose and peace.
A special issue of Palliative & Supportive Care: The
lessons of the Terri Schiavo case
Authors: BREITBART WILLIAM
Published: April 2008

This past fall (October 2005), my good friend and colleague Lewis
Cohen, M.D., of Baystate Medical Center, helped organize a unique
conference (cosponsored by the Smith College of Social Work) that
represented an early attempt by psychosocial palliative care clinicians,
ethicists, and legal experts to grapple with the issues raised by the
Terri Schiavo case, which had so captured the attention of the nation and
raised tremendous disagreement and debate. As editor-in-chief of
Palliative & Supportive Care, I was, of course, quite
thrilled when Dr. Cohen proposed the possibility of our journal publishing
the main papers from this unique and timely conference. As the readers of
Palliative & Supportive Care will recall, this journal has
expressed the opinion that the case of Terri Schiavo represented a
watershed event in palliative care practice and research (Breitbart, 2005), and we called for more research into the
experience of patients who die of dehydration. Of course, the issues
raised by the Schiavo case are so much broader and do, in fact, range from
palliative care practice and research to ethics and spiritual issues to
legal issues regarding decision making at the end of life.
Shattering the consensus on end-of-life care: Was the Schiavo case
palliative medicine's Humpty Dumpty?
Authors: COHEN LEWIS M.
Published: April 2008

In October of 2005, a two-day conference, “Controversies in
End-of-Life Care: Terri Schiavo's Lessons,” was jointly
sponsored by Baystate Medical Center and the Smith College School for
Social Work. Both the conference and this special issue of the journal are
prompted by recognition that the Schiavo case has clearly generated
considerable national attention, and it consequently offers palliative
medicine, social work, psychiatry, neurology, and allied disciplines a
singular opportunity to reflect on our clinical practices and assumptions
about the management of catastrophically ill individuals. At the core of
the Schiavo case was a bitter family feud, but before it ended, it became
a legal battle, a political fight, a disability rights issue, and a
macabre media circus. It is heartbreaking that Congress held a midnight
session about the health care of one irreparably brain-damaged woman,
Terri Schiavo, while ignoring the health crisis of 40 million uninsured
Americans (Friedman, 2005).
Artificial nutrition and hydration at the end of life: Ethics and evidence
Authors: GANZINI LINDA
Published: April 2008

The case of Terri Schiavo resulted in substantial media attention about the use of artificial nutrition and hydration (ANH) especially by percutaneous endoscopic gastrostomy (PEG). In this article, I review ethical and legal principles governing decisions to choose or forgo ANH at the end of life, including issues of autonomy and decision-making capacity, similarities and differences between ANH and other medical treatments, the role of proxies when patients lack decision-making capacity, and the equivalence of withholding and withdrawing treatment. Evidence for palliative or life-sustaining benefits for ANH are reviewed in three disease processes: amyotrophic lateral sclerosis (ALS), cancer, and dementias, including Alzheimer's disease. Although more recent studies suggest a possible palliative role for ANH in ALS and terminal cancer, feeding tubes do not appear to prolong survival or increase comfort in advanced dementia of the Alzheimer's type.
Legal and policy lessons from the Schiavo case: Is our right to choose the medical care we want seriously at risk?
Authors: LAZZARINI ZITA , ARONS STEPHEN , WISNIEWSKI ALICE
Published: April 2008

The article explores the individual patient's right to refuse, withdraw, or insist on medical treatment where there is conflict over these issues involving health care personnel or institutions, family members, legal requirements, or third parties concerned with public policy or religious/ideological/political interests. Issues of physician assistance in dying and medical futility are considered. The basis and the current legal status of these rights is examined, and it is concluded that threats to the autonomy of patients, to the privacy of the doctor/patient relationship, and to the quality of medical care should be taken seriously by individuals, medical practitioners, and others concerned with developing and maintaining reasonable, effective, and ethical health care policy.
End-of-life issues in elderly patients
Authors: LIPTZIN BENJAMIN
Published: April 2008

Objective: To describe elderly-specific issues in end-of-life
care.

Methods: Literature review and case examples.

Results: There is great heterogeneity in elderly
patients' responses to end-of-life care.

Significance of results: Developmental and individual issues
need to be considered in end-of-life discussions.
Development of a spiritual pain assessment sheet for terminal cancer
patients: Targeting terminal cancer patients admitted to palliative care
units in Japan
Authors: TAMURA KEIKO , ICHIHARA KAORI , MAETAKI EIKO , TAKAYAMA KEIKO , TANISAWA KUMI , IKENAGA MASAYUKI
Published: April 2008

Objective: This research explores the potential benefit of a
spiritual pain assessment sheet to clinical practice. With spiritual pain
defined as “pain caused by extinction of the being and meaning of
the self,” the spiritual pain assessment sheet was developed by
Hisayuki Murata from his conceptual framework reflecting the three
dimensions of a human being as a being founded on temporality, a being in
relationship, and a being with autonomy. The assessment sheet was
developed from reviews of the literature and examinations from a
philosophical perspective on the structure of spiritual pain.

Methods: Patients admitted to palliative care units in Japan
were interviewed using the assessment sheet. The responses were analyzed
qualitatively. The usefulness of the assessment sheet and the burden
placed on the patients by its use were also investigated.

Results: The spiritual pain elucidated by the assessment
sheet was the same as that revealed in the earlier research of Morita. The
patients reported that they did not find the use of the assessment sheet a
burden, and more than half reported that it was useful. The burden of the
assessment sheet on the subjects was thus determined to be low. Positive
feedback on the assessment sheet was also received from the nurses who
conducted the patient interviews, who said the assessment sheet made it
easier to talk with the patients about their spiritual pain.

Significance of research: The research results indicate that
the spiritual pain assessment sheet provided an appropriate assessment of
spiritual pain among terminal cancer patients, showing that such a sheet
could be used as an assessment tool in the future.
Of rats and men: A narrative journey
Authors: WILLISON KATHLEEN BABA
Published: April 2008

Palliative care clinicians are often challenged in this evidence-based
world to find studies that are generalizable to our population. And yet,
there is much to be learned from the unique situations that we encounter.
This narrative reflects upon the application of palliative principles to
one special rat model.
BEYOND BLACK AND WHITE: Racial Conflict in the New Multi-ethnic City
Authors: Fox Cybelle
Published: April 2008

Claire Jean Kim,Bitter Fruit: The Politics of Black-Korean Conflict in New York City. New Haven: Yale University Press, 2000, 300 pages, ISBN 0-300-07406-9, $45.00.

Jennifer Lee,Civility in the City: Blacks, Jews, and Koreans in Urban America. Cambridge: Harvard University Press, 2002, 270 pages, ISBN 0-674-00897-9, $35.00.

In-Jin Yoon,On My Own: Korean Businesses and Race Relations in America. Chicago: Chicago University Press, 1997, 274 pages, ISBN 0-226-959279-9, $45.00.

During the past decade, scholars of ethno-racial relations have increasingly grappled with the thorny issue of Black-Korean conflict. This attention is no doubt the result of a number of high profile, sometimes violent, and often prolonged clashes between Blacks and Koreans in large urban settings. On January 18, 1990, an incident between a Black customer and a Korean storeowner at the Family Red Apple Inc. grocery store touched off a yearlong boycott of two Korean businesses in the Flatbush section of Brooklyn, NY. The 1992 Los Angeles Rebellion, which was originally sparked by the acquittal of four White police officers accused of beating Black motorist, Rodney King, led to three days of looting, arson, and violence. The event quickly became framed in terms of a conflict between Blacks and Koreans, however, as Koreans owned more than half of the stores that were burned or looted. While the evidence of real and often acute tensions between these groups is irrefutable, in many instances the media has tended to distort the nature, scale, and significance of the clashes by over-dramatizing Black-Korean conflict (Lee 2002), obfuscating Korean-Latino conflict (Bobo et al., 1994; Oliver et al., 1993), and ignoring and therefore silencing Korean voices (Abelmann and Lie, 1995). Thankfully, careful, scholarly analyses of these incidents and the tensions that precipitate them are starting to emerge.Civility in the City,Bitter Fruit, andOn My Ownare some of the best recent examples of this new literature and are each valuable attempts to increase understanding about the nature of merchant-customer relations in predominantly Black urban neighborhoods.
ALL THINGS EQUAL?
Authors: Sanders Lynn M.
Published: April 2008

Michael K. Brown, Martin Carnoy, Elliott Currie, Troy Duster,
David B. Oppenheimer, Marjorie M. Shultz, and David Wellman,
Whitewashing Race: The Myth of a Color-blind Society.
Berkeley: University of California Press, 2003, 349 pages, ISBN
0-520-23706-4, $27.50.

Paul M. Sniderman and Thomas Piazza, Black Pride and
Black Prejudice. Princeton: Princeton University Press, 2002, 192
pages, ISBN 0-691-09261-3, $24.95.

These two texts represent a somewhat unlikely pairing. What could an
empirically detailed but wide-ranging, really indignant indictment of
new right-wing homilies about racial politics—that's
Whitewashing Race—have in common with what inquiring
minds want to know about Black Pride and Black Prejudice, a
carefully stepping report of results mostly from a 1997 survey, posing
and answering such questions as whether African Americans share the
“larger culture's” values, succumb to conspiratorial
thinking, or are anti-Semitic? At the level of pure geography trivia,
it so happens that all of the authors involved in generating these new
books have some claim to Northern California roots or associations. But
beyond that, do they have anything in common?
THE COMPLEXITY OF RACIAL ATTITUDES: Continuing Progress or the Calm Before the Storm?
Authors: Hutchings Vincent L.
Published: April 2008

Carol M. Swain,The New White Nationalism in America: Its Challenge to Integration. Cambridge: Cambridge University Press, 2002, 526 pages, ISBN 0-521-80886-3, $30.00.

Paul M. Kellstedt,The Mass Media and the Dynamics of American Racial Attitudes. Cambridge: Cambridge University Press, 2003, 174 pages, ISBN 0-521-82171-1, $60.00.

Carol M. Swain's book,The New White Nationalism in American: Its Challenge to Integration, is an ambitious and, in many ways, novel blend of traditional social science and social advocacy. At the outset, Swain informs the reader that this book breaks with “… the tradition of impersonal, value-free social science insofar as I do not pretend to be neutral and do not hesitate to interject many personal observations and comments into the body of the text.” She does not disappoint on this score. This nearly 500-page book combines original interviews and survey and focus group data, with Swain's reflections on a range of topics including reparations, affirmative action, racial hate crimes, and the redemptive power of religion. To Swain's credit, she also steps outside her role as a (nominally) dispassionate social scientist to offer a range of policy prescriptions near the end of her book to combat what she views as the potentially alarming growth of the White power movement. In many ways, Swain's passion for her subject is refreshing, and even commendable. Unfortunately, her passion is also the source of the principal weakness of this book: its inability to match its uncompromising rhetoric with persuasive, or even plausible, supportive evidence for readers who do not already agree with her arguments.
STATEMENT FROM THE DIRECTOR OF THE W. E. B. DU BOIS INSTITUTE
Authors: Gates Henry Louis
Published: April 2008

In 1903, William Edward Burghardt Du Bois famously predicted that
the problem of the twentieth century would be the problem of the color
line. Indeed, during the past century, matters of race were frequently
the cause of intense conflict and the stimulus for public policy
decisions not only in the United States, but throughout the world. The
founding of the Du Bois Review: Social Science Research on
Race at the beginning of the twenty-first century acknowledges the
continuing impact of Du Bois's prophecy, his pioneering role as
one of the founders of the discipline of sociology in the American
academy, and the considerable work that remains to be done as we
confront the “problem” that Du Bois identified over a
century ago.
SCHOLARSHIP ABOVE THE VEIL
Authors: Bobo Lawrence D. , Dawson Michael C.
Published: April 2008

W. E. B. Du Bois is a figure of legendary stature, with
accomplishments that run from the purely academic to the profoundly
political. In the Du Bois Review: Social Science Research on
Race, we at once memorialize and aim to continuously re-energize
one core strand of the great man's life work: namely, Du
Bois's legacy as a producer and catalyst for critical scholarship
on the global problem of race. As had no other social scientist of his
generation when he began, nor any other over his long life course, Du
Bois gazed with the most penetrating intensity into what may
figuratively be called “the soul” of the problem of race
and he saw just how central a role race would play in the future of
human affairs far into an unwritten future.
A TASTE FOR PUNISHMENT: Black and White Americans' Views on the Death Penalty and the War on Drugs
Authors: Bobo Lawrence D. , Johnson Devon
Published: April 2008

It is commonly accepted that Black and White Americans hold divergent views about the criminal justice system. Furthermore, many accept the view that U.S. public opinion is unflinchingly punitive where issues of criminal justice policy are concerned, with this punitiveness among White Americans deriving to a significant degree from anti-Black prejudice. Using a series of survey-based experiments and large, nationally representative samples of White and African American respondents, we subject the questions of Black-White polarization, unyielding punitiveness, and the influence of racial prejudice to close scrutiny. Our results, first, confirm large Black-White differences in opinion with Blacks consistently less punitive than Whites. These differences are substantially a result of beliefs about the extent of racial bias in the criminal justice system. Second, the framing experiments suggest that responses to the death penalty are very different than responses to drug-related crimes like crack or powder cocaine use, with the former exhibiting far less malleability than the latter. Third, racial prejudice is a consistently large influence on White public opinion and a weaker, but sometimes important influence among Blacks as well. Implications for discourse on race and crime are also discussed.
REPRESENTING BLACK INTERESTS AND PROMOTING BLACK CULTURE: The Importance of African American Descriptive Representation in the U.S. House
Authors: Baker Andy , Cook Corey
Published: April 2008

Despite considerable examination, scholars have yet to definitively establish the relationship between a legislator's racial background and his or her legislative activities. We assess the relationship between descriptive and substantive representation by discerning whether Black members of the U.S. House are more likely to promote group interests in their varied capacities as elected officials than are similarly positioned non-Black legislators. Our empirical tests utilize the most appropriate econometric models and techniques to analyze data from four Congresses spanning two distinctive districting regimes and incorporating several elements of representational behaviors. The findings are clear: Black members represent group interests more vociferously than non-Black members, including liberal non-Black Democrats from similar districts. Moreover, because Black members do not receive electoral benefits for engaging in such behavior, these legislators have policy-based motivation for representing Black interests. These results have profound practical implications for minority political representation and the future of identity politics.
Effekte einer metakognitiven Promptingmaßnahme beim situierten, beispielbasierten Lernen im Bereich Korrelationsrechnung
Authors: Stark Robin , Tyroller Michael , Krause Ulrike-Marie , Mandl Heinz
Published: April 2008

Ausgehend von einer Analyse von Verständnisschwierigkeiten und Fehlkonzepten Studierender im Bereich Korrelationsrechnung wurde auf der Basis eines Ansatzes situierten, beispielbasierten Lernens eine computerbasierte Lernumgebung («Koralle») konzipiert. Um einen reflektierten und metakognitiv kontrollierten Umgang mit Koralle zu induzieren, wurde eine Promptingmaßnahme in die Lernumgebung integriert. 57 Studierende der Pädagogik und Pädagogischen Psychologie wurden zufällig auf zwei experimentelle Bedingungen verteilt: 28 bearbeiteten Koralle mit Begründungsprompts (EG 1), 29 ohne (EG 2). 67 Studierende bildeten eine Kontrollgruppe (KG), die keinen Zugriff auf Koralle hatte. EG 1 schnitt in einem Nachtest signifikant besser ab als EG 2, die Promptingeffekte waren praktisch relevant und auch noch in einer Follow-up-Messung feststellbar. Der Einfluss der Begründungsprompts auf den Wissenserwerb wurde von der metakognitiven Kompetenz der Studierenden moderiert. Auf Lernzeit und Nutzungsverhalten hatten die Prompts keinen Einfluss. Qualitative Auswertungen der Begründungen sprechen dafür, dass die Prompts primär metakognitive Kontrollaktivitäten induzierten.
Eine Kurzform des Prüfungsängstlichkeitsinventars TAI-G
Authors: Wacker Alois , Jaunzeme Jelena , Jaksztat Steffen
Published: April 2008

Psychometrische Eigenschaften und Faktorenstruktur des 1991 von Hodapp vorgestellten Prüfungsängstlichkeitsinventars TAI-G wurden an einer Stichprobe von N = 720 Studierenden verschiedener Studiengänge überprüft. Die bekannte faktorielle Struktur der Skala konnte repliziert werden. Gesamtskala und die vier Subskalen Aufgeregtheit, Besorgtheit, Mangel an Zuversicht und Interferenz weisen eine hohe interne Konsistenz auf. Auf Grundlage der item- und skalenanalytischen Befunde wird eine TAI-G-Kurzskala mit 15 Items vorgeschlagen. Diese weist eine klarere Faktorenstruktur ohne Doppelladungen auf und besitzt eine hohe interne Konsistenz. Die Kurzskala korreliert zu r = .98 mit der Originalversion. Zusammenhänge zwischen den vier Subskalen und den soziodemographischen Angaben entsprechen den aus der Prüfungsängstlichkeitsforschung bekannten Mustern.
Reziprokes Gruppentraining oder Einzeltraining?
Authors: Marx Edeltrud
Published: April 2008

Das vorliegende Experiment überprüft unter Verwendung eines Trainings zum induktiven Denken die Hypothesen, (1) dass ein reziprokes Gruppentraining die Effekte eines Einzeltrainings übertrifft, (2) dass die Effekte beider Trainings längerfristig abnehmen werden. Die Untersuchung mit 45 Erstklässlern zeigt unerwarteterweise kurz- und längerfristig keine signifikanten Effektunterschiede zwischen dem Einzeltraining und dem reziproken Gruppentraining bei der Lösung induktiver Aufgaben. Beide Trainingsbedingungen erreichen kurz- und längerfristig überdurchschnittlich hohe Effektstärken im Vergleich zu einer Wartekontrollgruppe.
BMI and Health‐Related Quality of Life in Adults 65 Years and Older
Authors: Yan Lijing L. , Daviglus Martha L. , Liu Kiang , Pirzada Amber , Garside Daniel B. , Schiffer Linda , Dyer Alan R. , Greenland Philip
Published: April 2008

Objective: To examine relationships of BMI with health‐related quality of life in adults 65 years and older.

Research Methods and Procedures: In 1996, a health survey was mailed to all surviving participants ≥ 65 years old from the Chicago Heart Association Detection Project in Industry Study (1967 to 1973). The response rate was 60%, and the sample included 3981 male and 3099 female respondents. BMI (kilograms per meter squared) was classified into four groups: underweight (<18.5), normal weight (18.5 to 24.9), overweight (25.0 to 29.9), and obese (≥30.0). Main outcome measures were Health Status Questionnaire‐12 scores (ranging from 0 to 100) assessing eight domains: health perception, physical functioning, role limitations‐physical, bodily pain, energy/fatigue, social functioning, role limitations‐mental, and mental health. The higher the score, the better the outcome.

Results: With adjustment for age, race, education, smoking, and alcohol intake, obesity was associated with lower health perception and poorer physical and social functioning (women only) but not impaired mental health. Overweight was associated with impaired physical well‐being among women only. Both underweight men and women reported impairment in physical, social, and mental well‐being. For example, multivariable‐adjusted health perception domain scores for women were 50.8 (underweight), 62.7 (normal weight), 60.5 (overweight), and 52.1 (obese), respectively. Associations weakened but remained significant with further adjustment for comorbidities.

Discussion: Compared with normal‐weight people, both underweight and obese older adults reported impaired quality of life, particularly worse physical functioning and physical well‐being. These results reinforce the importance of normal body weight in older age.
Insulin Sensitivity, Body Fat Distribution, and Family Diabetes History: The IRAS Family Study
Authors: Mitchell Braxton D. , Zaccaro Daniel , Wagenknecht Lynne E. , Scherzinger Ann L. , Bergman Richard N. , Haffner Steven M. , Hokanson John , Norris Jill M. , Rotter Jerome I. , Saad Mohammed F.
Published: April 2008

Objectives: Markers of insulin resistance are often apparent in nondiabetic relatives of subjects with type 2 diabetes. Whether diabetes family history (FH) also predicts visceral fat accumulation and, if so, whether the increased insulin resistance in relatives of diabetic subjects occurs independently of visceral fat accumulation are not known.

Research Methods and Procedures: To examine this issue, we studied the relationship of diabetes FH with insulin sensitivity and fat measures, measured by minimal model analysis and computed tomography, respectively, in families participating in the Insulin Resistance Atherosclerosis (IRAS) Family Study. FH scores were based on the diabetes status of the participants’ parents and older siblings.

Results: FH scores were significantly correlated with reduced insulin sensitivity (p < 0.05) and increased subcutaneous (p < 0.05) and visceral (p < 0.05, San Antonio only) fat in families from San Antonio and Los Angeles but not in the leaner Hispanic families from San Luis Valley. There was no evidence for a stronger association of FH score with visceral fat accumulation than with subcutaneous fat or insulin resistance.

Discussion: The absence of an association between FH score and insulin resistance/fat accumulation in San Luis Valley is consistent with the idea that the expression of transmitted diabetes genes may be suppressed in leaner, more physically active populations.
Resting Metabolic Rate in Severely Obese Diabetic and Nondiabetic Subjects
Authors: Huang Kuo‐Chin , Kormas Nic , Steinbeck Katharine , Loughnan Georgina , Caterson Ian D.
Published: April 2008

Objectives: To compare the resting metabolic rate (RMR) between diabetic and nondiabetic obese subjects and to develop a predictive equation of RMR for these subjects.

Research Methods and Procedures: Obese adults (1088; mean age = 44.9 ± 12.7 years) with BMI ≥ 35 kg/m2 (mean BMI = 46.4 ± 8.4 kg/m2) were recruited. One hundred forty‐two subjects (61 men, 81 women) were diagnosed with type 2 diabetes (DM), giving the prevalence of DM in this clinic population as 13.7%. RMR was measured by indirect calorimetry, and several multivariate linear regression models were performed using age, gender, weight, height, BMI, fat mass, fat mass percentage, and fat‐free mass as independent variables.

Results: The severely obese patients with DM had consistently higher RMR after adjustment for all other variables. The best predictive equation for the severely obese was RMR = 71.767 − 2.337 × age + 257.293 × gender (women = 0 and men = 1) + 9.996 × weight (in kilograms) + 4.132 × height (in centimeters) + 145.959 × DM (nondiabetic = 0 and diabetic = 1). The age, weight, and height‐adjusted least square means of RMR between diabetic and nondiabetic groups were significantly different in both genders.

Discussion: Severely obese patients with type 2 diabetes had higher RMR than those without diabetes. The RMR of severely obese subjects was best predicted by an equation using age, gender, weight, height, and DM as variables.
Height and Adiposity among Children
Authors: Freedman David S. , Thornton John C. , Mei Zuguo , Wang Jack , Dietz William H. , Pierson Richard N. , Horlick Mary
Published: April 2008

Objectives: Although BMI (kilograms per meter squared) is widely used as a surrogate measure of adiposity, it is moderately associated (r ∼ 0.3) with height among children. We examined whether the resulting preferential classification of taller children as overweight, based on a BMI ≥95th percentile, is appropriate.

Research Methods and Procedures: We assessed the cross‐sectional relation of height among 5‐ to 18‐year‐old subjects (n = 1180) to levels of BMI, the sum of 10 skinfold thicknesses, and percentage body fat as determined by DXA.

Results: The prevalence of a BMI level ≥95th percentile was substantially higher among 5‐ to 11‐year‐old subjects who were relatively tall for their age than among shorter children. Among 5‐ to 8‐year‐old boys, for example, each SD increase in height‐for‐age was associated with a 4.6‐fold increase in the prevalence of overweight (p < 0.001). Height not only was associated with BMI but also showed similar correlations with the skinfold sum and with percentage body fat; furthermore, the magnitudes of these associations decreased with age. We also found that the association between percentage body fat and BMI (r = 0.85 to 0.90) was close to the maximum correlation that can be achieved by any weight‐height index.

Discussion: The use of BMI, which preferentially classifies taller young children as overweight, is appropriate because height and adiposity are correlated before the age of 12 years.
Insulin Sensitivity, Cardiorespiratory Fitness, and Physical Activity in Overweight Hispanic Youth
Authors: Ball Geoff D.C. , Shaibi Gabriel Q. , Cruz Martha L. , Watkins Michael P. , Weigensberg Marc J. , Goran Michael I.
Published: April 2008

Objective: To determine whether cardiorespiratory fitness and/or physical activity (PA) were related to measures of insulin sensitivity and secretion independent of body composition in overweight Hispanic children.

Research Methods and Procedures: Ninety‐five Hispanic children (n = 55 boys; n = 40 girls; 8 to 13 years old) participated in this investigation. The frequently sampled intravenous glucose tolerance test was used to determine the insulin sensitivity index (SI), the acute insulin response, and the disposition index. Cardiorespiratory fitness [maximal oxygen uptake (Vo2max)] was evaluated using a treadmill protocol, and PA was determined by an interviewer‐administered questionnaire. Body composition was measured using DXA.

Results: Unadjusted correlations indicated that Vo2max (milliliters of O2 per minute) was negatively related to SI (r = −0.46, p < 0.05) and disposition index (r = −0.31, p < 0.05) and positively associated with fasting insulin (r = 0.29, p < 0.05), but these relationships were no longer significant once gender, Tanner stage, fat mass, and soft lean tissue mass were included as covariates (all p > 0.05). Multivariate linear regression analysis showed that body fat mass explained 53% of the variance in SI and that Vo2max (milliliters of O2 per minute) was not independently related to SI. Cardiorespiratory fitness was positively related to both fat mass (r = 0.43, p < 0.001) and soft lean tissue mass (r = 0.89, p < 0.001). PA was not related to any measure of insulin sensitivity and secretion.

Discussion: Cardiorespiratory fitness, as determined by Vo2max (milliliters of O2 per minute), was not independently related to insulin sensitivity or secretion, suggesting that Vo2max influences insulin dynamics indirectly through fat mass.
Racial Differences in Adipocyte Size and Relationship to the Metabolic Syndrome in Obese Women
Authors: Tittelbach Thomas J. , Berman Dora M. , Nicklas Barbara J. , Ryan Alice S. , Goldberg Andrew P.
Published: April 2008

Objective: To determine whether racial differences exist in the relationship of the abnormalities defining the metabolic syndrome (MS) to regional adiposity and fat cell size (FCS) in obese postmenopausal women.

Research Methods and Procedures: We determined the relationship of metabolic variables associated with the MS to regional body composition and abdominal (ABD) and gluteal (GLT) FCS in 25 white (CAU) and 25 African‐American (AF‐AMER) older women matched for age (58 ± 5 years; mean ± SD) and BMI (35 ± 4 kg/m2).

Results: MS was present in 36% of the AF‐AMER and 57% of the CAU women. There were no differences in total body, trunk, gluteofemoral fat mass or regional FCS, but AF‐AMER women had 22% lower visceral fat, 24% higher insulin, and 31% lower triglyceride levels than CAU women (p < 0.05). Multiple regression analysis with body fat, visceral ABD fat area, and FCS as independent variables showed that GLT FCS was independently correlated with 2‐hour insulin (r = 0.56), triglyceride (r = 0.62), and high‐density lipoprotein cholesterol (r = −0.72) levels in AF‐AMER women but not in CAU women, where only systolic blood pressure correlated with subcutaneous ABD fat area (r = 0.57) (p < 0.05).

Discussion: The associations between GLT FCS and metabolic dysfunction in obese AF‐AMER but not CAU women suggest that central obesity is a less valid predictor of the MS in obese postmenopausal AF‐AMER women than in CAU women and that GLT FCS may be a more sensitive indicator of risk for the MS in AF‐AMER women.
A Randomized Controlled Trial of a Commercial Internet Weight Loss Program
Authors: Womble Leslie G. , Wadden Thomas A. , McGuckin Brian G. , Sargent Stephanie L. , Rothman Rebecca A. , Krauthamer‐Ewing E. Stephanie
Published: April 2008

Objective: To assess, in a 1‐year randomized controlled trial, the efficacy of eDiets.com (a commercial Internet weight loss program) in improving weight, cardiovascular health, and quality of life.

Research Methods and Procedures: Participants were 47 women with a mean age of 43.7 ± 10.2 (SD) years and a mean BMI of 33.5 ± 3.1 kg/m2. They were randomly assigned to either: 1) eDiets.com, a commercial Internet‐based program available to the public; or 2) a weight loss manual (i.e., LEARN Program for Weight Control 2000). At baseline, participants in both groups met briefly with a psychologist who instructed them to follow the components of their program as closely as possible. Additional brief visits were provided at weeks 8, 16, 26, and 52 to review their progress. Change in weight was the main outcome measure.

Results: At week 16, participants in eDiets.com lost 0.9 ± 3.2% of initial weight compared with 3.6 ± 4.0% for women assigned to the weight loss manual. At week 52, losses increased to 1.1 ± 4.0% and 4.0 ± 5.1%, respectively. Results of a last‐observation‐carried‐forward analysis found that women in the manual group lost significantly (p < 0.05) more weight (at both times) than those treated by eDiets.com. (Results, however, of baseline‐carried‐forward and completers analyses did not reach statistical significance.) There were no significant differences between groups in changes in cardiovascular risk factors or quality of life.

Discussion: This study provides consumers with important information about the probable benefits they can expect from participating in a popular Internet‐based weight loss program.
Mediators of Weight Loss in a Family‐Based Intervention Presented over the Internet
Authors: White Marney A. , Martin Pamela D. , Newton Robert L. , Walden Heather M. , York‐Crowe Emily E. , Gordon Stewart T. , Ryan Donna H. , Williamson Donald A.
Published: April 2008

Objective: To assess the process variables involved in a weight loss program for African‐American adolescent girls. Several process variables have been identified as affecting success in in vivo weight loss programs for adults and children, including program adherence, self‐efficacy, and social support. The current study sought to broaden the understanding of these process variables as they pertain to an intervention program that is presented using the Internet. It was hypothesized that variables such as program adherence, dietary self‐efficacy, psychological factors, and family environment factors would mediate the effect of the experimental condition on weight loss.

Research Methods and Procedures: Participants were 57 adolescent African‐American girls who joined the program with one obese parent; family pairs were randomized to either a behavioral or control condition in an Internet‐based weight loss program. Outcome data (weight loss) are reported for the first 6 months of the intervention.

Results: Results partially supported the hypotheses. For weight loss among adolescents, parent variables pertaining to life and family satisfaction were the strongest mediating variables. For parental weight loss, changes in dietary practices over the course of 6 months were the strongest mediators.

Discussion: The identification of factors that enhance or impede weight loss for adolescents is an important step in improving weight loss programs for this group. The current findings suggest that family/parental variables exert a strong influence on weight loss efforts for adolescents and should be considered in developing future programs.
Taurine Alters Respiratory Gas Exchange and Nutrient Metabolism in Type 2 Diabetic Rats
Authors: Harada Nagakatsu , Ninomiya Chika , Osako Yoshie , Morishima Masaki , Mawatari Kazuaki , Takahashi Akira , Nakaya Yutaka
Published: April 2008

Objective: To assess the effect of taurine supplementation on respiratory gas exchange, which might reflect the improved metabolism of glucose and/or lipid in the type 2 diabetic Otsuka Long‐Evans Tokushima Fatty (OLETF) rats.

Research Methods and Procedures: Male OLETF rats (16 weeks of age) were randomly divided into two groups: unsupplemented group and taurine‐supplemented (3% in drinking water) group. After 9 weeks of treatment, indirect calorimetry and insulin tolerance tests were conducted. The amounts of visceral fat pads, tissue glycogen, the blood concentrations of glucose, triacylglycerol, taurine, and electrolytes, and the level of hematocrit were compared between groups. A nondiabetic rat strain (Long‐Evans Tokushima Otsuka) was used as the age‐matched normal control.

Results: The indirect calorimetry showed that the treatment of OLETF rats with taurine could reduce a part of postprandial glucose oxidation possibly responsible for the increase of triacylglycerol synthesis in the body. Taurine supplementation also improved hyperglycemia and insulin resistance and increased muscle glycogen content in the OLETF rats. Supplementation with taurine increased the blood concentration of taurine and electrolyte and fluid volume, all of which were considered to be related to the improvement of metabolic disturbance in OLETF rats.

Discussion: Taurine supplementation may be an effective treatment for glucose intolerance and fat/lipid accumulation observed in type 2 diabetes associated with obesity. These metabolic changes might be ascribed, in part, to the alteration of circulating blood profiles, where the improved hyperglycemia and/or the blood accumulation of taurine itself would play roles.
Development of Health‐Related Waist Circumference Thresholds Within BMI Categories
Authors: Ardern Chris I. , Janssen Ian , Ross Robert , Katzmarzyk Peter T.
Published: April 2008

Objective: To develop and cross‐validate waist circumference (WC) thresholds within BMI categories. The utility of the derived values was compared with the single WC thresholds (women, 88 cm; men, 102 cm) recommended by NIH and Health Canada.

Research Methods and Procedures: The sample included adults classified as normal weight (BMI = 18.5 to 24.9), overweight (BMI = 25 to 29.9), obese I (BMI = 30 to 34.9), and obese II+ (BMI ≥ 35) from the Third U.S. National Health and Nutrition Examination Survey (NHANES III; n = 11, 968) and the Canadian Heart Health Surveys (CHHS; n = 6286). Receiver operating characteristic curves were used to determine the optimal WC thresholds that predicted high risk of coronary events (top quintile of Framingham scores) within BMI categories using the NHANES III. The BMI‐specific WC thresholds were cross‐validated using the CHHS.

Results: The optimal WC thresholds increased across BMI categories from 87 to 124 cm in men and from 79 to 115 cm in women. The validation study indicated improved sensitivity and specificity with the BMI‐specific WC thresholds compared with the single thresholds.

Discussion: Compared with the recommended WC thresholds, the BMI‐specific values improved the identification of health risk. In normal weight, overweight, obese I, and obese II+ patients, WC cut‐offs of 90, 100, 110, and 125 cm in men and 80, 90, 105, and 115 cm in women, respectively, can be used to identify those at increased risk.
Short‐Term Effects of Gastric Bypass Surgery on Circulating Ghrelin Levels
Authors: Morínigo Rosa , Casamitjana Roser , Moizé Violeta , Lacy Antonio M. , Delgado Salvadora , Gomis Ramon , Vidal Josep
Published: April 2008

Objective: To prospectively evaluate the short‐term effects of Roux‐en‐Y gastric bypass (RYGBP) on ghrelin secretion and its relevance on food intake and body weight changes.

Research Methods and Procedures: Ghrelin response to a standardized test meal was evaluated in eight obese patients (BMI, 43.5 to 59.1 kg/m2) before and 6 weeks after RYGBP. Ghrelin response was compared with that of an age‐matched group of six normal weight individuals (BMI, 19.6 to 24.9 kg/m2).

Results: Fasting serum ghrelin levels were lower in obese subjects compared with controls (p < 0.05). Meal ingestion significantly suppressed ghrelin concentration in controls (p < 0.05) and obese subjects (p < 0.05), albeit to a lesser degree in the latter group (p < 0.05). Despite a 10.3 ± 1.5% weight loss, fasting serum ghrelin levels were paradoxically further decreased in obese subjects 6 weeks after RYGBP (p < 0.05). Moreover, at this time‐point, food intake did not elicit a significant ghrelin suppression. The changes in ghrelin secretion after RYGBP correlated with changes in insulin sensitivity (p < 0.05) and caloric intake (p < 0.05).

Discussion: This study showed that the adaptive response of ghrelin to body weight loss was already impaired 6 weeks after RYGBP. Our study provides circumstantial evidence for the potential role of ghrelin in the negative energy balance in RYGBP‐operated patients.
Adult Obesity and the Burden of Disability throughout Life
Authors: Peeters Anna , Bonneux Luc , Nusselder Wilma J. , De Laet Chris , Barendregt Jan J.
Published: April 2008

Objective: To analyze the prevalence of disability throughout life and life expectancy free of disability, associated with obesity at ages 30 to 49 years.

Research Methods and Procedures: We used 46 and 20 years of mortality follow‐up, respectively, for 3521 Original and 3013 Offspring Framingham Heart Study participants 30 to 49 years and classified as normal weight, overweight, or obese at baseline. Disability measures were available between 36 and 46 years of follow‐up for 1352 Original participants and at 20 years of follow‐up for 2268 Offspring participants. We measured the odds of disability in the Original cohort after 46 years follow‐up, and we estimated life expectancy with and without disability from age 50. Two disability measures were used, one representing limitations with mobility only and the second representing limitations with activities of daily living (ADL).

Results: Obesity at ages 30 to 49 years was associated with a 2.01‐fold increase in the odds of ADL limitations 46 years later. Nonsmoking adults who were obese between 30 and 49 years lived 5.70 (95% confidence interval, 4.11 to 7.35) (men) and 5.02 (95% confidence interval, 3.36 to 6.61) (women) fewer years free of ADL limitations from age 50 than their normal‐weight counterparts. There was no significant difference in the total number of years lived with disability throughout life between those obese or normal weight, due to both higher disability prevalence and higher mortality in the obese population.

Discussion: Obesity in adulthood is associated with an increased risk of disability throughout life and a reduction in the length of time spent free of disability, but no substantial change in the length of time spent with disability.