Preventive medicine
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Preventive medicine · Dec 2003
ReviewObesity in American-Indian children: prevalence, consequences, and prevention.
American Indians of all ages and both sexes have a high prevalence of obesity. The health risks associated with obesity are numerous and include Type 2 diabetes mellitus, hypertension, dyslipidemia, and respiratory problems. Obesity has become a major health problem in American Indians only in the past few generations and it is believed to be associated with the relative abundance of high-fat, high-calorie foods and the rapid change from active to sedentary lifestyles. ⋯ To be effective, educational and environmental interventions must be developed with full participation of the American-Indian communities.
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Preventive medicine · May 2003
ReviewStatus of practice guidelines in the United States: CDC guidelines as an example.
Clinical practice guidelines have proliferated in the past several decades, starting with only a handful in the 1980s to over 1000 approved through The National Guideline Clearinghouse in 2002. ⋯ An immediate mandate is to ensure that when guidelines are promulgated, they include an evaluation plan, developed by the implementer of the guideline, which takes advantage of existing qualitative and quantitative data and programs (e.g., patient-centered care, quality assurance, risk management) not limited to expensive and sophisticated clinical trials.
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Public health guidelines primarily focus on the promotion of physical activity and steady-state aerobic exercise, which enhances cardiorespiratory fitness and has some impact on body composition. However, research demonstrates that resistance exercise training has profound effects on the musculoskeletal system, contributes to the maintenance of functional abilities, and prevents osteoporosis, sarcopenia, lower-back pain, and other disabilities. ⋯ Sensible resistance training involves precise controlled movements for each major muscle group and does not require the use of very heavy resistance. Along with brief prescriptive steady-state aerobic exercise, resistance training should be a central component of public health promotion programs.
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Preventive medicine · Dec 1999
ReviewSocioeconomic considerations in the primordial prevention of cardiovascular disease.
Economic policy is an important determinant of population health; it is part of health policy. True primordial prevention of cardiovascular disease (CVD) may require regulation of the domestic and international market forces which produce and distribute CVD risk factors and their determinants. ⋯ No program of primordial prevention of smoking could possibly ignore the national and international economic interests of the tobacco industry. We need to start thinking about primordial prevention of CVD risk factors such as low physical activity, high-fat diet, and psychosocial stress in the same way.
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Preventive medicine · Mar 1998
ReviewA critical period of brain development: studies of cerebral glucose utilization with PET.
Studies with positron emission tomography indicate that the human brain undergoes a period of postnatal maturation that is much more protracted than previously suspected. In the newborn, the highest degree of glucose metabolism (representative of functional activity) is in primary sensory and motor cortex, cingulate cortex, thalamus, brain stem, cerebellar vermis, and hippocampal region. At 2 to 3 months of age, glucose utilization increases in the parietal, temporal, and primary visual cortex; basal ganglia; and cerebellar hemispheres. ⋯ Initially, there is a rise in the rates of glucose utilization from birth until about age 4 years, at which time the child's cerebral cortex uses over twice as much glucose as that of adults. From age 4 to 10 years, these very high rates of glucose consumption are maintained, and only after then is there a gradual decline of glucose metabolic rates to reach adult values by age 16-18 years. Correlations between glucose utilization rates and synaptogenesis are discussed, and the argument is made that these findings have important implications with respect to human brain plasticity following injury as well as to "critical periods" of maximal learning capacity.