Randi Koeske

A comparison of lifestyle exercise, aerobic exercise, and calisthenics on weight loss in obese children*

Previous research has shown that lifestyle exercise is superior to programmed aerobic exercise programs for the long-term treatment of childhood obesity. The present study is designed to evaluate the reliability of this finding, with the addition of a low-intensity calisthenics group to control for nonspecific aspects of participating in an exercise program. Results showed similar and significant weight changes across the exercise conditions during the year of treatment for parents and children. However, during the next year of observation, children in the lifestyle group maintained their weight change, while children in the other two groups gained significant amounts of weight. Similar trends were observed for parents. The results for children replicate the positive effects of lifestyle exercise on child weight control.

A comparison of lifestyle change and programmed aerobic exercise on weight and fitness changes in obese children

The effects of lifestyle or programmed aerobic exercise, with or without, a diet, on weight, fitness, and exercise adherence were assessed with 37 obese 8− to 12− year-old children over a 17-month period. The lifestyle program allowed the child to increase energy expenditure by engaging in a wide variety of daily games and activities, while the programmed aerobic alternative required the child to perform an aerobic exercise daily. The exercise programs differed in the flexibility of scheduling exercise, type of exercise, and intensity of exercise. Results showed equivalent weight and relative weight changes across all groups during the 8-week intensive treatment, with lifestyle subjects losing more additional weight and maintaining their wight loss better than the programmed exercise subjects during maintenance and follow-up. Fitness changes, as measured by heart rate during maintenance and follow-up. Fitness changes, as measured by heart rate during exercise and recovey, improved more during intensive treatment for the programmed than the lifestyle exercise groups. During maintenance, however, fitness of the programmed exercise group deteriorated, while fitness of the lifestyle group was maintained. The results suggest the utility of lifestyle exercise as a way to increase energy expenditure and long-term weight maintenance independent of diet.

Construct Validity of the Maslach Burnout Inventory: A Critical Review and Reconceptualization:

This article presents an evaluation of the construct validity of the Maslach Burnout Inventory (MBI). The authors base this critique on previously published findings and data collected through five studies carried out during an eight-year period, for which 328 social workers acted as respondents. Factor analyses and correlational studies designed to test predictions provided fairly consistent evidence for the utility of the MBI subscale measures of emotional exhaustion, personal accomplishment, and depersonalization. Additional analyses supported a reconceptualization of burnout and the MBI, one that regards exhaustion as the essence of burnout and treats accomplishment and depersonalization as related variables, but not as elements of burnout.

Does self-monitoring of blood glucose levels improve dietary compliance for obese patients with type II diabetes?

Self-monitoring of blood glucose levels is currently being recommended for obese patients with type II diabetes to improve weight loss and glycemic control. To determine whether self-monitoring of blood glucose levels improves dietary compliance in these patients, 50 obese patients with type II diabetes were randomly assigned either to a standard behavioral weight control program or to a weight control program that included self-monitoring of blood glucose levels and focused on the weight-blood glucose relationship. Both groups lost significant amounts of weight and maintained their losses for at least one year; reductions in medication could be made for 70 percent of patients. These data suggest that the behavioral weight control used in this study may be of benefit to patients with type II diabetes. However, there was no evidence that the addition of self-monitoring of blood glucose levels to the treatment program improved the outcome in terms of weight loss, reduction in medication, dietary compliance, or mood state.

subclinical Eating Disorders and Glycemic Control in Adolescents with Type I Diabetes

Several recent case reports have shown that anorexia nervosa and bulimia negatively affect glycemic control in diabetic patients. However, there have been no systematic studies to assess the prevalence of clinical or subclinical eating disorders among diabetic patients or to determine the impact of such disturbances on glycemic control. This study reports a survey of 202 adolescents, aged 12–18 yr, seen in the Diabetes Clinic, Childrens Hospital of Pittsburgh, who were asked to complete the Binge Eating Scale (BES) and the EAT-26 questionnaire. Responses of diabetic patients to the EAT-26 questionnaire were compared with those of a nondiabetic control group and were related to measures of glycemic control. Diabetic subjects scored higher on the total EAT-26 than nondiabetic control subjects, ordinarily indicative of more eating pathology. However, diabetic subjects scored higher only on the dieting subscale of this questionnaire, probably reflecting adherence to the diabetes dietary regimen. Subjects with diabetes scored lower, or did not differ significantly, from nondiabetic control subjects on measures of oral control and bulimia. Among diabetic subjects, self-reported bulimic behaviors were related to poorer glycemic control. Patients with the highest scores on the BES had an average HbA1 of 13.1% compared with 11.8% for age- and sex-matched patients at the 50th percentile, and 10.8% for patients in the lowest 10th percentile. Further studies are needed to determine whether modification of these eating behaviors would improve glycemic control.

The effect of family variables on child weight change.

Previous research has shown that family size, the number of obese persons living at home, and parental weight influence the development of childhood obesity. Our study reports the relevance of these factors to child weight loss during a 1-year treatment period. Multiple linear regression procedures showed that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. These results suggest that family size may interact with treatment to determine weight change. The effects of family size on outcome may be operating simply by reducing the amount of time that a parent has to spend with the child in promoting behavior change. Likewise, increased family size may be operating as a stressor, reducing the effectiveness of parents in effectively managing their children.

Effects of family-based behavioral treatment on obese 5-to-8-year-old children

The purpose of this study was to evaluate the effectiveness of family-based treatment for childhood obesity for 5-to-8-year-old children. Nineteen obese 5-to 8-year-old girls were randomly assigned to one of two treatments: a behaviorally oriented program which emphasized parent management, and a control group which provided equal education and attention, but not behavioral principles. The treatment group showed better weight loss and relative weight changes than the control group at the 8 and 12 month observations. These results show that the family-based treatment developed for 8-to-12-year-olds can be generalized to 5-to-8-year-old children.

Student “burnout” as a mediator of the stress-outcome relationship

One hundred thirty-six graduate social work students participated in a questionnaire study designed to test the mediating influence of student burnout (strain) in the impact of student-specific stress on negative consequences. Consistent with the proposed stress→strain (burnout)→outcome model, burnout was significantly related to each of three stress indicators and to two outcome measures (intention to quit school and physical and psychological symptoms). In five of six tests, thedirect stress-to-outcome relationship was small and nonsignificant, consistent with the crucial mediating role of burnout. Contrary to previous model tests involving parenting, work, and student stress, there was only very limited evidence for a buffering influence of social support. Implications were drawn for stress theory and for policy focusing on assessment of student burnout and benefits arising from its alleviation.

Underestimation of Social Support Buffering

Most theory and practice in the helping professions assumes that informal social support acts as a buffer against stress, reducing its negative consequences on the stressed individual Despite many social psychological studies, the validity of this assumption has been difficult to establish empirically. This article argues that skepticism regarding the genuineness and importance of this hypothesized support buffering interaction is misplaced. This skepticism has been answered by well-designed and analyzed research. The article offers an analysis of why the significance of this buffering interaction may have been underestimated in earlier research, including hypotheses concerning the effect of stress severity on buffering.

Working and Non-Working Students: Roles, Support and Well-Being

Abstract A questionnaire containing measures of physical and psychological symptoms and social support was completed by 142 MSW students. Students were grouped into three categories: Full-time students with no job, full-time students with part-time jobs, and part-time students with full-time jobs. Full-time students with part-time jobs reported more symptoms than full-time students with no jobs, a finding interpreted as consistent with a demands/resources analysis of stress. The latter group did not differ from part-time students with full-time jobs, despite the difference in number of roles held. Analysis controlling for associated variables indicated that it was the specific combination of full-time student and part-time work, not the total number of roles occupied, that was associated with higher distress. Evidence for a “buffering” effect of social support was found only for this high distress group. Results are discussed in terms of recent formulations concerning stress and multiple role occupancy, a...