Modifiable lifestyle factors associated with risk of sessile serrated polyps, conventional adenomas, and hyperplastic polyps

Objective: To identify modifiable factors associated with sessile serrated polyps (SSPs), and compare the association of these factors to conventional adenomas (ADs) and hyperplastic polyps (HPs). Design: We utilized data from the Tennessee Colorectal Polyp Study, a colonoscopy-based case-control study. Included were 214 SSP cases, 1779 AD cases, 560 HP cases and 3851 polyp-free controls. Results: Cigarette smoking was associated with increased risk for all polyps and was stronger for SSPs than for ADs (OR 1.74. 95% CI: 1.16-2.62, for current vs. never, ptrend=0.008). Current regular use of nonsteroidal anti-inflammatories (NSAID) was associated with a 40% reduction in SSPs risk in comparison to never-users (OR 0.68, 95% CI 0.48-0.96, ptrend=0.03), similar to the association with AD. Red meat intake was strongly associated with SSPs risk (OR 2.59, 95% CI 1.41-4.74 for highest vs. lowest intake, ptrend<0.001) and the association with SSP was stronger than with AD (ptrend=0.003). Obesity, folate intake, fiber intake, and fat intake were not associated with SSP risk after adjustment for other factors. Exercise, alcohol use, and calcium intake were not associated with risk for SSPs. Conclusion: SSPs share some modifiable risk factors for ADs, some of which are more strongly associated with SSPs than ADs. Thus, preventive efforts to reduce risk for ADs may also be applicable to SSPs. Additionally, SSPs have some distinctive risk factors. Future studies should evaluate the preventive strategies for these factors. The findings from this study also contribute to an understanding of the etiology and biology of SSPs.

College Lifestyle and Attitudinal National (CLAN) Survey.

The aims of the CLAN survey were to establish a national student profile of lifestyle habits. The survey was undertaken by the Department of Health and Children among undergraduate full-time students during the academic year 2002/2003 in 21 third level colleges in Ireland. The results of the study showed that cannabis was the most common illegal drugs used by students, with 37% reporting that they had used in the past 12 months, and 20% during the past 30 days. Drug use in the student population was much higher than in the 2003 NACD drug prevalence survey. The survey also measured alocohol related harm, such as effects on study and financial probles.

A systematic review of the effectiveness of lifestyle interventions for the prevention of type 2 diabetes mellitus (T2DM) in routine practice.

This document updates and extends a previously conducted systematic review and meta-analysis assessing the effectiveness of ‘real-world’ interventions for the prevention of type 2 diabetes mellitus (T2DM) in high risk populations.

Joint Leverage and Maturity Choices in Real Estate Firms: The Role of the REIT Status

We explore the interdependence of leverage and debt maturity choices in Real Estate Investment Trusts (REITs) and unregulated listed real estate investment companies in the U.S. for the period 1973-2011. We find that the leverage and maturity choices of all listed real estate firms are interdependent, but in contrast to industrial firms, they are not made simultaneously. Across the different types of real estate firms considered, we find substantial differences in the nature of the relationship between leverage and maturity. Leverage determines maturity in non-REITs, whereas maturity is a determinant of leverage in REITs. We suggest that the observed differences reflect the effects of the REIT regulation, rather than solely being a function of real estate as the underlying asset class. We also present novel evidence that the relationship between leverage and maturity in both firm types can be used to moderate the effects of other exogenous financing policies.

REIT Capital Structure Choices: Preparation Matters

Sun, Titman, and Twite (2015) find that capital structure risks, namely high leverage and a high share of short-term debt, reduced the cumulative total return of US REITs in the 2007-2009 financial crisis. We find that mitigating capital structure risks ahead of the crisis by reducing leverage and extending debt maturity in 2006, was associated with a significantly higher cumulative total return 2007-2009, after controlling for the levels of those variables at the start of the financial crisis. We further identify two systematic cross-sectional differences between those REITs that reduced capital structure risks prior to the financial crisis and those that did not: the exposure to capital structure risks and the strength of corporate governance. On balance, our findings are consistent with the interpretation of risk-reducing adjustments to capital structure ahead of the crisis as a component of managerial skill and discipline with significant implications for firm value during the crisis.

The governance of adaptation: choices, reasons, and effects. Introduction to the Special Feature

The governance of climate adaptation involves the collective efforts of multiple societal actors to address problems, or to reap the benefits, associated with impacts of climate change. Governing involves the creation of institutions, rules and organizations, and the selection of normative principles to guide problem solution and institution building. We argue that actors involved in governing climate change adaptation, as climate change governance regimes evolve, inevitably must engage in making choices, for instance on problem definitions, jurisdictional levels, on modes of governance and policy instruments, and on the timing of interventions. Yet little is known about how and why these choices are made in practice, and how such choices affect the outcomes of our efforts to govern adaptation. In this introduction we review the current state of evidence and the specific contribution of the articles published in this Special Feature, which are aimed at bringing greater clarity in these matters, and thereby informing both governance theory and practice. Collectively, the contributing papers suggest that the way issues are defined has important consequences for the support for governance interventions, and their effectiveness. The articles suggest that currently the emphasis in adaptation governance is on the local and regional levels, while underscoring the benefits of interventions and governance at higher jurisdictional levels in terms of visioning and scaling-up effective approaches. The articles suggest that there is a central role of government agencies in leading governance interventions to address spillover effects, to provide public goods, and to promote the long-term perspectives for planning. They highlight the issue of justice in the governance of adaptation showing how governance measures have wide distributional consequences, including the potential to amplify existing inequalities, access to resources, or generating new injustices through distribution of risks. For several of these findings, future research directions are suggested.

Exercise and Lifestyle Therapy Improves Weight Maintenance in Young People With Psychosis: A Service Evaluation

INTRODUCTION Young people with psychosis typically have higher rates of premature cardiovascular disease and metabolic disorders compared to non-psychotic peers. This has been primarily due to a sedentary lifestyle, poor diet composition, misuse of harmful substances and higher rates of obesity and smoking. When prescribed obesogenic antipsychotic medication, a weight gain of >12 kg within 2 years is typical. PURPOSE: To examine the benefits of a 12 wk exercise and lifestyle intervention entitled ‘Supporting Health and Promoting Exercise’ (SHAPE) for young people recently diagnosed with psychosis. METHODS Participants (n=26; 8 females; mean age 27.7 ± 5.1) engaged in weekly 45’ education sessions on healthy lifestyle behaviors, including: managing anxiety and depression, mindfulness and relaxation training, substance misuse, smoking cessation, healthy eating and nutritional advice, dental and sexual health care. This was followed by a 45’ exercise session including activities such as circuit and resistance training, yoga, and badminton, led by qualified exercise instructors. Anthropometric data were measured at baseline, 12 wk and 12 month post-intervention. Lifestyle behaviors and clinical measurements, including resting heart rate, blood pressure, total cholesterol, triglycerides, HbA1c and prolactin, were assessed at baseline and 12 months post-intervention as part of their routine clinical care plan. Significant differences over time were assessed using Paired Sample t-tests. RESULTS SHAPE participants (n=26) presented with first episode psychosis (n=11), schizophrenia (n=11), bipolar disorder (n=2), at risk mental state (n=1), and persistent delusion disorder (n=1) of which 52% were prescribed highly obesogenic antipsychotic medications (Clozapine and Olanzepine). Mean baseline data suggests participants were at an increased health risk due to elevated values in mean BMI (70% were overweight or obese), waist circumference, resting heart rate, and triglycerides (see Table 1 & 2). Over 50% reported smoking daily and 85% had elevated resting blood pressure (>120/80 mm Hg). At 12 wk post-intervention, no changes were observed in mean BMI or waist circumference (see Table 1); 19 participants either maintained (mean 0.5 kg: range ± 2 kg) or decreased (mean -5.7 kg: range 2-7 kg) weight; 7 participants increased weight (mean 4.9 kg: range 2.0-9.6 kg). At 12 month post-intervention (n=16), no change was evident in mean BMI, waist circumference, or any other clinical variable (see Table 2). Positive impacts on lifestyle behaviors included 7 participants eating ~400g of fruit/vegetables daily, 2 ceased substance use, 2 ceased alcohol use, 4 ceased smoking and 5 were less sedentary. CONCLUSION At the start of the programme, participants were already at an increased risk for cardiometabolic disorders. Findings suggest that SHAPE supported young people with psychosis to: -attenuate their physical health risk following a 12 wk exercise and lifestyle intervention which were sustained at 12 months follow up. -make positive lifestyle behavior changes leading to sustained improvements in weight maintenance and physical health.

Can cognitive skills and risk aversion explain inconsistent choices?: an experiment

Estudia la coherencia de las preferencias de riesgo entre universitarios en un país en vías de desarrollo. El diseño permite obtener la coherencia a nivel individual, en el que cada sujeto selecciona sus opciones preferidas de dos diferentes, pero relacionadas tareas de obtención de riesgo. En la primera tarea, los sujetos eligen una opción entre seis alternativas, descartando así la inconsistencia. La segunda tarea, es una transformación de la primera, que está destinada a examinar si la elección en la primera tarea también se revela como preferida. Al usar estas opciones, se construye medidas de preferencias incoherentes y analiza su correlación con las habilidades cognitivas (medido según Frederick (2005) en Cognitive Reflection Test—CRT scores and students’ GPAs) y las preferencias de riesgo. Se encontró que una puntuación CRT baja y un pobre rendimiento académico son, generalmente buenos predictores de decisiones inconsistentes. Los resultados son contradictorios en términos del papel de la aversión al riesgo.

Second choices in a visual span of apprehension task

Four Ss were run in a visual span of apprehension experiment to determine whether second choices made following incorrect first responses are at the chance level, as implied by various high threshold models proposed for this situation. The relationships between response biases on first and second choices, and between first choice biases on trials with two or three possible responses, were also examined in terms of Luce's (1959) choice theory. The results were: (a) second choice performance in this task appears to be determined by response bias alone, i.e., second choices were at the chance level; (b)first and second choice response biases were not related according to Luce's choice axiom; and (c) the choice axiom predicted with reasonable accuracy the relationships between first choice response biases corresponding to trials with different numbers of possible response alternatives. © 1967 Psychonomic Society, Inc.

Prioritizing Purposes: Two American History Teachers' Choices Among Subject Matter and Classroom-Related Purposes

This study explores how two American history teachers - one novice and one experienced – make in-the-moment choices among their history subject matter and classroom-related purposes during the teaching of an American history unit. Using classroom observations, lesson artifacts, student work products, and deep, retrospective interviews with the teachers as they watched videos of their teaching, this study maps out in detail the teachers’ purposes, both within and across different lesson activity structures. This study finds that the novice and the experienced teacher navigated among their purposes differently from each other, and that the characteristics of each teacher’s purposes navigation aligned with student outcomes in that teacher’s class. The novice teacher acted more like a juggler, with visible, reactive navigation among each purpose operational throughout his teaching; student outcomes in his class were similarly fragmented and discrete. The experienced teacher presented more like an orchestra conductor, interweaving his purposes and anticipating the navigation decisions that would create a more seamless whole; student outcomes in his class were aligned with his holistic navigation of purposes. Findings from this study have important implications for education research and teacher practice, including the relationship between teachers’ navigation among purposes and desired student outcomes, the integral role of classroom-related purposes interwoven with history subject matter purposes in teachers’ decision-making, and the differences in purposes navigation between a novice and an experienced history teacher.

Preventing weed spread: a survey of lifestyle and commercial landholders about Nassella trichotoma in the Northern Tablelands of New South Wales, Australia

Nassella trichotoma (Nees) Hack. ex Arechav. (common name, serrated tussock) occupies large areas of south-eastern Australia and has considerable scope for expansion in the Northern Tablelands of New South Wales. This highly invasive grass reduces pasture productivity and has the potential to severely affect the region’s economy by decreasing the livestock carrying capacity of grazing land. Other potential consequences of this invasion include increased fuel loads and displacement of native plants, thereby threatening biodiversity. Rural property owners in the Northern Tablelands were sent a mail questionnaire that examined use of measures to prevent new outbreaks of the weed. The questionnaire was sent to professional farmers as well as lifestyle farmers (owners of rural residential blocks and hobby farms) and 271 responses were obtained (a response rate of 18%). Key findings were respondents’ limited capacity to detect N. trichotoma, and low adoption of precautions to control seed spread by livestock, vehicles and machinery. This was particularly the case among lifestyle farmers. There have been considerable recent changes to biosecurity governance arrangements in New South Wales, and now is an ideal time for regulators and information providers to consider how to foster regional communities’ engagement in biosecurity, including the adoption of measures that have the capacity to curtail the spread of N. trichotoma.

Personality and the healthy lifestyle as predictors of physical health: Can the healthy lifestyle be explained by personality?

In health and epidemiological research, the Healthy Lifestyle (HLS) is often invoked as an explanation for inconsistent effects. Modifiable components of the HLS are advocated as a panacea for the most common threats to public health. Biases resulting from the HLS are theorized to result from covariance among its components. This covariance has not yet been formally modeled. Furthermore, no mechanism has been proposed to explain this covariance among these factors. Using three large nationally representative samples, I evaluated the HLS as a latent variable. Using structural equation modeling (SEM) I evaluated the degree to which the shared variance of HLS components is accounted for by personality traits, and tested the HLS as a mediator of the personality health relationship. Across all three samples, the HLS fits well as a latent variable, is partially accounted for by personality traits, and mediates the effects of personality traits on health. In all cases personality traits have direct effects on health independent of the HLS. These results suggest that the utility of personality traits as predictors of health exceeds that provided by commonly used lifestyle predictors.

Lifestyle factors, adiposity and cardiometabolic risk factors in South Asian women living in Scotland

South Asians migrating to the Western world have a 3 to 5-fold higher risk of developing type 2 diabetes and double the risk of cardiovascular disease (CVD) than the background population of White European descent, without exhibiting a proportional higher prevalence of conventional cardiometabolic risk factors. Notably, women of South Asian descent are more likely to be diagnosed with type 2 diabetes as they grow older compared with South Asian men and, in addition, they have lost the cardio-protective effects of being females. Despite South Asian women in Western countries being a high risk group for developing future type 2 diabetes and CVD, they have been largely overlooked. The aims of this thesis were to compare lifestyle factors, body composition and cardiometabolic risk factors in healthy South Asian and European women who reside in Scotland, to examine whether ethnicity modifies the associations between modifiable environmental factors and cardiometabolic risks and to assess whether vascular reactivity is altered by ethnicity or other conventional and novel CVD risks. I conducted a cross-sectional study and recruited 92 women of South Asian and 87 women of White European descent without diagnosed diabetes or CVD. Women on hormone replacement therapy or hormonal contraceptives were excluded too. Age and body mass index (BMI) did not differ between the two ethnic groups. Physical activity was assessed and with self-reported questionnaires and objectively with the use of accelerometers. Cardiorespiratory fitness was quantified with the predicted maximal oxygen uptake (VO2 max) during a submaximal test (Chester step test). Body composition was assessed with skinfolds measured at seven body sites, five body circumferences, measurement of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) with the use of magnetic resonance imaging (MRI) and liver fat with the use MR spectroscopy. Dietary density was assessed with food frequency questionnaires. Vascular response was assessed by measuring the response to acetylcholine and sodium nitroprusside with the use of Laser Doppler Imaging with Iontophoresis (LDI-ION) and the response to shear stress with the use of Peripheral Arterial Tonometry (EndoPAT). The South Asian women exhibited a metabolic profile consistent with the insulin resistant phenotype, characterised by greater levels of fasting insulin, lower levels of high density lipoprotein (HDL) and higher levels of triglycerides (TG) compared with their European counterparts. In addition, the South Asians had greater levels of glycated haemoglobin (HbA1c) for any given level of fasting glucose. The South Asian women engaged less time weekly with moderate to vigorous physical activity (MVPA) and had lower levels of cardiorespiratory fitness for any given level of physical activity than the women of White descent. In addition, they accumulated more fat centrally for any given BMI. Notably, the South Asians had equivalent SAT with the European women but greater VAT and hepatic fat for any given BMI. Dietary density did not differ among the groups. Increasing central adiposity had the largest effect on insulin resistance in both ethic groups compared with physical inactivity or decreased cardiorespiratory fitness. Interestingly, ethnicity modified the association between central adiposity and insulin resistance index with a similar increase in central adiposity having a substantially larger effect on insulin resistance index in the South Asian women than in the Europeans. I subsequently examined whether ethnic specific thresholds are required for lifestyle modifications and demonstrated that South Asian women need to engage with MVPA for around 195 min.week-1 in order to equate their cardiometabolic risk with that of the Europeans exercising 150 min.week-1. In addition, lower thresholds of abdominal adiposity and BMI should apply for the South Asians compared with the conventional thresholds. Although the South Asians displayed an adverse metabolic profile, vascular reactivity measured with both methods did not differ among the two groups. An additional finding was that menopausal women with hot flushing of both ethnic groups showed a paradoxical vascular profile with enhanced skin perfusion (measured with LDI-ION) but decreased reactive hyperaemia index (measured with EndoPAT) compared with asymptomatic menopausal women. The latter association was independent of conventional CVD risk factors. To conclude, South Asian women without overt disease who live in Scotland display an adverse metabolic profile with steeper associations between lifestyle risk factors and adverse cardiometabolic outcomes compared with their White counterparts. Further work in exploring ethnic specific thresholds in lifestyle interventions or in disease diagnosis is warranted.

choose MyPlate : 10 tips to a great plate

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips : balance calories, enjoy your food, but eat less, avoid oversized portions, foods to eat more often, make half your plate fruits and vegetables, switch to fat-free or low-fat (1%) milk, make half your grains whole grains, foods to eat less often, compare sodium in foods, drink water instead of sugary drinks.