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Biomedical subjects

Diane Berry

Publications and source records attributed to Diane Berry.

8 recordsLinked to original sources

Epidemiologic perspectives of risk for developing diabetes and diabetes complications.

The incidence and prevalence of diabetes is increasing worldwide. National recommendations for screening and diagnosis of diabetes, hypertension, and dyslipidemia provide a basis for early detection, treatment, and intervention that may potentially decrease related complications, and personal and economic costs of the disease. Most important is that knowledge exists about who is at risk for diabetes by weight, family history of diabetes, ethnicity, and history of gestational diabetes that allows for the development and implementation of diabetes primary prevention programs. Multiple national health care providers, systems of care, and communities that can be used to guide such prevention, early screening, and disease detection and intervention programs aimed at decreasing the burden of diabetes.

Cardiovascular Diseases↗

Anthropometric and psychosocial changes in obese adolescents enrolled in a Weight Management Program.

OBJECTIVE: To determine short- and long-term effects of the Bright Bodies Weight Management Program on obese adolescents and to further observe if a diet or nondiet approach is more successful. DESIGN: Twenty-five obese adolescents completed a 1-year, comprehensive weight-management program and returned for a 2-year follow-up. Adolescents were 11 to 16 years old (17 female, eight male) with mixed ethnic backgrounds. Although the program emphasizes a nondiet approach, eight children requested a structured meal plan (diet approach), while 17 were taught to make better food choices (nondiet approach). Body mass index (BMI) z score, body fat percent, and self-concept were measured at 0, 1, and 2 years. Outcomes were analyzed for the entire group and by diet method groups. STATISTICAL ANALYSIS: Changes in outcome variables were evaluated using covariance pattern models for repeated measures. RESULTS: At 1 year, the entire group (N=25) demonstrated a decrease in BMI z score (P <.001) and body fat percent (P <.001), while self-concept scores increased (P <.001). At 2 years, the decrease in BMI z score was still significant (P =.004) and body fat percent and self-concept scores remained improved, although not significant compared to baseline (P =.15 and P =.10, respectively). When comparing dietary approaches, the dieting group (n=8) tended to show favorable results short-term for BMI z score at year 1 (P =.11), but by year 2, the nondieting group (n=17) further improved BMI z score (P =.006), while the dieting group reverted toward baseline. CONCLUSIONS: The Bright Bodies Weight Management Program was successful at decreasing BMI z scores both short and long term. In a separate analysis, dieting showed more superior short-term results, but a nondiet approach demonstrated improved long-term results.

Adipose Tissue↗

Coping skills training and problem solving in diabetes.

Diabetes requires a substantial degree of patient involvement for effective self-management. Although diabetes education has been the standard of care, it is clear that provision of knowledge alone does not change behavior. Coping skills training is a cognitive-behavioral intervention that focuses on improving competence and mastery by retraining inappropriate or nonconstructive coping styles and patterns of behavior into more constructive behavior. Children, adolescents, and parents caring for children with type 1 diabetes demonstrated improved metabolic and psychosocial outcomes after coping skills training. Similar results have been found in adults with type 2 diabetes. Principles of this technique can be applied in practice to assist patients with diabetes to improve their self-management.

Adaptation, Psychological↗

Obesity in youth: implications for the advanced practice nurse in primary care.

PURPOSE: To discuss the advanced practice nurse's diagnosis and management of obesity in youth in primary care. DATA SOURCES: Review of current scientific literature, practice guidelines, and a case study. CONCLUSIONS: Obesity in youth is difficult to manage. Recent research suggests a genetic and environmental etiology associated with impaired glucose tolerance, type 2 diabetes, hypertension, hyperlipidemia, and hypertriglyceridemia. Nutrition education, increasing physical activity, decreasing sedentary behaviors, and behavioral modification have been used with varying success. Management is directed at healthy lifestyle behavior change for youth and their families. IMPLICATIONS FOR PRACTICE: If obesity, impaired glucose tolerance, hypertension, hypercholesterolemia, and hypertriglyceridemia are left untreated, youth may develop type 2 diabetes and coronary artery disease later in life and suffer early morbidity and mortality.

Adolescent↗

Preliminary testing of a program to prevent type 2 diabetes among high-risk youth.

Type 2 diabetes is increasing among youth, with minority youth at highest risk. This preliminary study tested the feasibility of a school-based program to prevent type 2 diabetes in youth at risk. Forty-one participants (age 12.6 +/- 1.1 years; 63% female, 51% African American, 44% Hispanic, and 5% Caucasian) were randomly assigned to one of two groups. Both the experimental and control groups received nutrition education and exercise training. The experimental group also received coping skills training. Data collected included body mass index (BMI), insulin resistance, dietary intake (24-Hour Food Recall), self-efficacy (Health Behavior Questionnaire), activity (Revised Godin-Shepard Activity Survey), and parents' health promoting behaviors (Health Promoting Lifestyle Profile III). At baseline BMI ranged from 27 to 53 (M = 36.2 +/- 6.0), and 95% (n = 39) demonstrated insulin resistance or pre-diabetes on an oral glucose tolerance test. After 12 months, the experimental group showed trends in improved usual food choices (p = .1) and increased dietary knowledge (p = .3). They also demonstrated lower glucose (p = .07) and insulin levels (p = .2). Experimental group parents demonstrated improved health responsibility (p = .03), healthier nutrition choices (p = .05), improved stress management skills (p = .05), increased activity (p = .2), and increased spirituality (p = .2). Data suggest a school-based program tailored to multiethnic youth may prove successful in helping these youth increase activity, improve nutrition status, and stabilize glucose and insulin metabolism, and also may be effective in changing parent health behavior.

Analysis of Variance↗

An emerging model of behavior change in women maintaining weight loss.

This study is based on and expands Newman's theory of health as expanding consciousness with women who maintained weight loss for at least 1 year. The researcher engaged in two in-depth interviews with twenty women. Individual patterns for participants who maintained weight loss revealed a personal journey of self-discovery and control with initial chaos, choice, and then emergence of behaviors reflecting expanded consciousness. Looking across participants, six patterns emerged from the data with evolution of a model of change that has implications for nursing practice at defined times within the change process of weight loss.

Adaptation, Psychological↗

Understanding the development and prevention of type 2 diabetes in youth (part 1).

The prevalence of being at risk of overweight, overweight, pre-diabetes, and type 2 diabetes is increasing in the United States in youth. Primary care providers must understand how the emerging epidemic of type 2 diabetes developed during the past several decades to accurately diagnose it in young patients. Primary, secondary, and tertiary prevention interventions are needed to address the emerging epidemic of type 2 diabetes in youth. Primary prevention involves delaying the development of type 2 diabetes by reducing the prevalence of overweight. Secondary prevention is aimed at preventing those with pre-diabetes from developing diabetes, and tertiary prevention is aimed at preventing the complications of type 2 diabetes.

Adolescent↗

Management of type 2 diabetes in youth (part 2).

Type 2 diabetes is increasing at an alarming rate in minority youth in the United States. Early diagnosis is important so that a treatment plan including diabetes self-management education, medical nutrition therapy, exercise, and behavioral modification can be developed to optimize blood glucose level. Prevention and treatment of hypertension and dyslipidemia may decrease cardiovascular disease later in life. Management of type 2 diabetes requires a team approach that is patient and family centered with the health care provider, a registered dietitian, an exercise physiologist, a social worker, and a psychologist available.

Adolescent↗