Can general practitioners influence the nation's health through a population approach to the provision of lifestyle advice?

BACKGROUND: Lifestyle advice from general practitioners (GPs) has been shown to have a positive effect on population health. In practice, GPs provide lifestyle advice to a minority of their patients only, those who are high risk or already have symptoms. AIM: To look in depth at GPs' attitudes towards adopting a population approach to lifestyle advice and to use these results to identify ways of maximising the potential of GPs to affect population health. METHOD: Thirty-six GPs, purposively sampled by identifying characteristics likely to affect their health promotion activity, participated in a focus group study. Data from the focus groups were transcribed verbatim and analysed using standard methods. RESULTS: The main themes that emerged suggested that GPs do not take a population approach to lifestyle advice because they prefer a high risk approach and doubt their ability to be effective in a population approach. GPs believed that social, cultural, and environmental factors were the most important determinants of population health. Furthermore, they were concerned about the detrimental effects on the doctor-patient relationship of providing lifestyle advice to all patients. GPs believed that a multi-agency, centrally co-ordinated approach was the preferred way to improve population health and that their role should be limited to secondary prevention. CONCLUSION: Large amounts of resources would be necessary to convince GPs to adopt a population approach to lifestyle advice. Measures to tackle the social and environmental determinants of health may be a more effective and efficient means of improving the nation's health

What Works? A Study of Effective Early Childhood Mental Health Consultation Programs

Examines factors that lead to desirable outcomes in mental health consultation programs: solid program infrastructure, highly qualified consultants, and quality support services. Analyzes targeted outcomes, measurements, and intensity of interventions

Gratitude to God, Self‐Rated Health, and Depressive Symptoms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107511/1/jssr12110.pd

Impact of Small Group Size on Neighborhood Influences in Multilevel Models

Objective: Although there is a growing body of literature on sample size in multilevel or hierarchical modeling, few studies have examined the impact of group sizeMultilevel, Neighborhood, Body Weight, Obesity, Sample Size

Arterial stiffness and wave reflection 1 year after a pregnancy complicated by hypertension.

Hypertensive disorders of pregnancy (HDP) are associated with cardiovascular disease (CVD) later in life. The authors investigated the association of HDP with blood pressure (BP) and arterial stiffness 1-year postpartum. Seventy-four participants, 33 with an HDP and 41 with uncomplicated pregnancies, were examined using applanation tonometry to measure BP, carotid-femoral pulse wave velocity (cfPWV), and augmentation index (AIx). On average, women with HDP had a 9 mm higher systolic BP (

The Spitzer c2d Survey of Large, Nearby, Interstellar Clouds. VIII. Serpens Observed with MIPS

We present maps of 1.5 deg^2 of the Serpens dark cloud at 24, 70, and 160 μm observed with the Spitzer Space Telescope MIPS camera. We describe the observations and briefly discuss the data processing carried out by the c2d team on these data. More than 2400 compact sources have been extracted at 24 μm, nearly 100 at 70 μm, and four at 160 μm. We estimate completeness limits for our 24 μm survey from Monte Carlo tests with artificial sources inserted into the Spitzer maps. We compare source counts, colors, and magnitudes in the Serpens cloud to two reference data sets: a 0.50 deg^2 set on a low-extinction region near the dark cloud, and a 5.3 deg^2 subset of the SWIRE ELAIS N1 data that was processed through our pipeline. These results show that there is an easily identifiable population of young stellar object candidates in the Serpens cloud that is not present in either of the reference data sets. We also show a comparison of visual extinction and cool dust emission illustrating a close correlation between the two and find that the most embedded YSO candidates are located in the areas of highest visual extinction

From Molecular Cores to Planet-forming Disks: An SIRTF Legacy Program

Crucial steps in the formation of stars and planets can be studied only at mid‐ to far‐infrared wavelengths, where the Space Infrared Telescope (SIRTF) provides an unprecedented improvement in sensitivity. We will use all three SIRTF instruments (Infrared Array Camera [IRAC], Multiband Imaging Photometer for SIRTF [MIPS], and Infrared Spectrograph [IRS]) to observe sources that span the evolutionary sequence from molecular cores to protoplanetary disks, encompassing a wide range of cloud masses, stellar masses, and star‐forming environments. In addition to targeting about 150 known compact cores, we will survey with IRAC and MIPS (3.6–70 μm) the entire areas of five of the nearest large molecular clouds for new candidate protostars and substellar objects as faint as 0.001 solar luminosities. We will also observe with IRAC and MIPS about 190 systems likely to be in the early stages of planetary system formation (ages up to about 10 Myr), probing the evolution of the circumstellar dust, the raw material for planetary cores. Candidate planet‐forming disks as small as 0.1 lunar masses will be detectable. Spectroscopy with IRS of new objects found in the surveys and of a select group of known objects will add vital information on the changing chemical and physical conditions in the disks and envelopes. The resulting data products will include catalogs of thousands of previously unknown sources, multiwavelength maps of about 20 deg^2 of molecular clouds, photometry of about 190 known young stars, spectra of at least 170 sources, ancillary data from ground‐based telescopes, and new tools for analysis and modeling. These products will constitute the foundations for many follow‐up studies with ground‐based telescopes, as well as with SIRTF itself and other space missions such as SIM, JWST, Herschel, and TPF/Darwin

The Spitzer c2d survey of Large, Nearby, Interstellar Clouds. V. Chamaeleon II Observed with IRAC

We present IRAC (3.6, 4.5, 5.8, and 8.0 micron) observations of the Chamaeleon II molecular cloud. The observed area covers about 1 square degree defined by $A_V >2$. Analysis of the data in the 2005 c2d catalogs reveals a small number of sources (40) with properties similar to those of young stellaror substellar objects (YSOs). The surface density of these YSO candidates is low, and contamination by background galaxies appears to be substantial, especially for sources classified as Class I or flat SED. We discuss this problem in some detail and conclude that very few of the candidate YSOs in early evolutionary stages are actually in the Cha II cloud. Using a refined set of criteria, we define a smaller, but more reliable, set of 24 YSO candidates.Comment: 19 pages, 10 figures, in press Ap

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5±11.2 mg/dL versus 47.1±14.8 mg/dL), and higher body fat percentage (29.2±7.9% versus 23.2±7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk

The Spitzer c2d Survey of Weak-line T Tauri Stars II: New Constraints on the Timescale for Planet Building

One of the central goals of the Spitzer Legacy Project ``From Molecular Cores to Planet-forming Disks'' (c2d) is to determine the frequency of remnant circumstellar disks around weak-line T Tauri stars (wTTs) and to study the properties and evolutionary status of these disks. Here we present a census of disks for a sample of over 230 spectroscopically identified wTTs located in the c2d IRAC (3.6, 4.5, 4.8, and 8.0 um) and MIPS (24 um) maps of the Ophiuchus, Lupus, and Perseus Molecular Clouds. We find that ~20% of the wTTs in a magnitude limited subsample have noticeable IR-excesses at IRAC wavelengths indicating the presence of a circumstellar disk. The disk frequencies we find in these 3 regions are ~3-6 times larger than that recently found for a sample of 83 relatively isolated wTTs located, for the most part, outside the highest extinction regions covered by the c2d IRAC and MIPS maps. The disk fractions we find are more consistent with those obtained in recent Spitzer studies of wTTs in young clusters such as IC 348 and Tr 37. From their location in the H-R diagram, we find that, in our sample, the wTTs with excesses are among the younger part of the age distribution. Still, up to ~50% of the apparently youngest stars in the sample show no evidence of IR excess, suggesting that the circumstellar disks of a sizable fraction of pre-main-sequence stars dissipate in a timescale of ~1 Myr. We also find that none of the stars in our sample apparently older than ~10 Myrs have detectable circumstellar disks at wavelengths < 24 um. Also, we find that the wTTs disks in our sample exhibit a wide range of properties (SED morphology, inner radius, L_DISK/L*, etc) which bridge the gaps observed between the cTTs and the debris disk regimes.Comment: 54 pages, 13 figures, Accepted by Ap