Susan S. Deusinger

Weight Changes, Exercise, and Dietary Patterns During Freshman and Sophomore Years of College

Weight gain and behavioral patterns during college may contribute to overweight and obesity in adulthood. The aims of this study were to assess weight, exercise, and dietary patterns of 764 college students (53% women, 47% men) during freshman and sophomore years. Students had their weight and height measured and completed questionnaires about their recent exercise and dietary patterns. At the beginning of freshman year, 29% of students reported not exercising, 70% ate fewer than 5 fruits and vegetables daily, and more than 50% ate fried or high-fat fast foods at least 3 times during the previous week. By the end of their sophomore year, 70% of the 290 students who were reassessed had gained weight (4.1 ± 3.6 kg, p> .001), but there was no apparent association with exercise or dietary patterns. Future research is needed to assess the contributions of fat, muscle, and bone mass to observed weight gain and to determine the health implications of these findings.

Changes in Weight and Health Behaviors from Freshman through Senior Year of College.

OBJECTIVE To assess weight changes, exercise and diet behaviors among college students from the beginning of freshman year until the end of senior year. DESIGN Longitudinal observational study. SETTING Private university in St. Louis, Missouri. PARTICIPANTS College students (138 females, 66 males). MAIN OUTCOME MEASURES Weight and height were measured, body mass index (BMI) was calculated, and exercise and dietary behaviors were assessed by questionnaire. ANALYSIS Changes in weight, BMI, exercise, and dietary patterns from the beginning of freshman year to the end of senior year. RESULTS Females gained 1.7 +/- 4.5 kg (3.75 +/- 9.92 lb) [mean +/- SD] from freshman to senior year, and males gained 4.2 +/- 6.4 kg (9.26 +/- 14.11 lb) (both P < .001). Weight changes were highly variable between students, however, ranging from -13.2 kg to +20.9 kg (-29.10 to +46.08 lb). CONCLUSIONS AND IMPLICATIONS Weight gain was common but variable among college students. Importantly, exercise and dietary patterns did not meet the recommended guidelines for many college students, which may have long-term health implications.

Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

OBJECTIVE To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. METHODS In St Louis, Missouri from 2005 to 2006, 151 employees (134 F, 17 M, 81% overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers(R) meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. RESULTS 123 participants, aged 45+/-9 yr, with BMI 32.9+/-8.8 kg/m(2) completed 1 year. Improvements (P< or =0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites. CONCLUSION A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention.

Physical therapy in the emergency department: development of a novel practice venue.

Background and Purpose The American Physical Therapy Associations Vision 2020 advocates that physical therapists be integral members of health care teams responsible for diagnosing and managing movement and functional disorders. This report details the design and early implementation of a physical therapist service in the emergency department (ED) of a large, urban hospital and presents recommendations for assessing the effectiveness of physical therapists in this setting. Case Description Emergency departments serve multiple purposes in the American health care system, including care of patients with non–life-threatening illnesses. Physical therapists have expertise in screening for problems that are not amenable to physical therapy and in addressing a wide range of acute and chronic musculoskeletal pain problems. This expertise invites inclusion into the culture of ED practice. This administrative case report describes planning and early implementation of a physical therapist practice in an ED, shares preliminary outcomes, and provides suggestions for expansion and effectiveness testing of practice in this novel venue. Outcomes Referrals have increased and length of stay has decreased for patients receiving physical therapy. Preliminary surveys suggest high patient and practitioner satisfaction with physical therapy services. Outpatient physical therapy follow-up options were developed. Educating ED personnel to triage patients who show deficits in pain and functional mobility to physical therapy has challenged the usual culture of ED processes. Discussion Practice in the hospital ED enables physical therapists to fully use their knowledge, diagnostic skills, and ability to manage acute pain and musculoskeletal injury. Recommendations for future action are made to encourage more institutions across the country to incorporate physical therapy in EDs to enhance the process and outcome of nonemergent care.

Analyzing errors in practice. A vehicle for assessing and enhancing the quality of care.

Failures are inevitable in health care. When failure occurs as a result of practitioner error, quality in patient care may be compromised. This article proposes that analyzing clinical errors may contribute to quality assurance. Examples from physical therapy illustrate how information gained from analyzing errors can enhance patient care.

Exercise and Cardiometabolic Risk Factors in Graduate Students: A Longitudinal, Observational Study

Abstract Objective: To evaluate cardiometabolic risk of students longitudinally and compare them with age-matched national samples. Participants: Participants are 134 graduate students enrolled between August 2005 and May 2010. Methods: Students were assessed at the beginning and end of their 3-year curriculum. Comparative samples included 966 National Health and Nutrition Examination Survey participants and 5,154 National College Health Assessment respondents. Results: Most students had desirable weight, blood glucose, lipids, and fitness at both time points. However, 26.9% had elevated blood pressure, 29.9% performed aerobic exercise < 3 days/week, and 80.6% consumed < 5 fruits/vegetables daily. Relative to young adults nationwide, these students exhibited more favorable exercise patterns, dietary patterns, and cardiometabolic indices. Over time, increases in adiposity and decreases in exercise frequency correlated with adverse changes in lipid concentrations and fitness. Conclusions: Small changes in lifestyle behaviors and adiposity within a healthy cohort of young adults significantly influenced cardiometabolic indices during their graduate career.

Exercise intervention for management of obesity.

Obesity touches the lives of most Americans regardless of age. In adults, accrual of co‐morbidities, including frank disability, impacts health in ways that mandate aggressive public health action. In children, the rising prevalence of overweight and obesity raises serious prospective concerns for life as these children enter adulthood. Action is imperative to provide medical interventions and preventive strategies to reduce the threat this condition poses to future generations. Obesity primarily results from an energy regulation imbalance within the body; understanding its origin and effects requires considering both the intake (via eating) and output (via moving) of energy. This article focuses on how exercise and physical activity (i.e., energy output) can influence the primary condition of obesity and its health sequelae. Components, strategies, and expected outcomes of exercise and lifestyle activity are addressed. Successful long‐term participation in daily movement requires matching exercise regimens and physical activity outlets to individual preferences and environmental conditions. Activity habits of Americans must change at home and in the workplace, schools and the community to positively influence health. Although the goals of Healthy People 2010 to reduce sedentary behavior have not been met, success of other public health interventions (e.g., immunizations, use of bicycle helmets) suggests that social change to alter activity habits can be achieved. Failure to reach our public health goals should serve as a catalyst for broad‐based action to help children, adolescents, and adults attain and maintain behaviors that reduce the risk of obesity and its health insults. Pediatr Blood Cancer 2012; 58: 135–139.

Meeting contemporary expectations for physical therapists: Imperatives, challenges, and proposed solutions for professional education

Background and Purpose. Advances in medical science and shifts in the structure of health care have required adjustment of the realities of practice to fit the changing demographics of health, illness, and disability. Emerging changes in health care policy and regulation require continual response to new expectations and accountabilities in clinical practice. The intimate relationship between practice and professional education demands adoption of new teaching and learning strategies to prepare graduates to respond to the contemporary patterns of health and complexities of health care. This position paper advocates change in physical therapist education to enable practitioners to capture opportunities to promote the health of our patients via new delivery models—and thus lead the evolution of our profession. Position and Rationale. To lead, physical therapists must (1) demonstrate interprofessional competence in what is certain to be an interdisciplinary industry, (2) assume new roles and accountabilities within new structures of the health care system, and (3) devise models of care, particularly for patients with highly prevalent and chronic conditions, that address movement and function across the full continuum of health and life. In turn, professional education must require (1) early and persistent exposure to, and clinical mentorship by, practitioners in other disciplines; (2) accountability for expected treatment outcomes embedded in the Affordable Care Act; and (3) skill development in community health assessments, health promotion, and prevention of disability and disease across the lifespan. Discussion and Conclusion. The mission of health care is to improve the health of individuals and of populations. As science progresses and a more global view of human health emerges, change in professional education is inevitable and essential to meet this mission. Such change will be a catalyst to create and capture opportunities to use new delivery models to optimize the health of our patients.