20100707
Will you lose more pounds at a bigger diet center?
NEW YORK (Reuters Health) - Weight loss loves company, hints new research.
For every additional 10 people signed up at a clinical center for a weight loss trial, the average person loses half a percent more weight, the study found.
Dr. Arne Astrup of the University of Copenhagen in Denmark and his colleagues delved into a database of 22 weight-loss centers across five countries, gathered in a previous large clinical trial.
Each center served between 4 and 85 men and women, and all of the more than 600 total participants were instructed to follow a nutritionally balanced diet of 800 to 1,000 calories a day. (Typical recommendations for non-dieters range from 1,600 to 2,400 calories per day, depending on gender, age, and level of activity.)
The average participant started the trial weighing 242 pounds, and lost 24 pounds (10 percent of their body weight) after 2 months on the low-calorie diet. Average weight loss among the centers ranged from 6 percent to 12 percent.
Taking into account age, initial body mass index (a measure of weight in relation to height) and sex, the researchers found that 10 more participants at a center translated into a modest half a percent climb in weight loss for the average person at that center. An average 200-pound woman, for example, would have dropped one extra pound over those 2 months.
The idea to investigate such a link came to the team of Danish and Belgian researchers after they noticed the relative performance of weight loss, or bariatric, surgeons. Those who have more experience, they write in the journal Obesity, tend to provide safer and more effective treatments.
Weight loss center size may reflect quality of care in a similar way, Astrup told Reuters Health by email. He noted that investigators, study coordinators and dieticians working at weight loss centers serving large numbers of participants would tend to be more experienced than those at smaller centers.While he notes that the study is "the first of its kind," Pedro Teixeira of the Technical University of Lisbon, in Portugal, is concerned that 2 months is too short to determine a diet's effectiveness.
Teixeira, who was not involved in the study, also suggests that other factors left unaccounted for could explain some of the differences seen across centers. In separate studies, he has identified a set of weight loss predictors, including self-motivation and realistic expectations.
The researchers, too, point to other possible explanations for their preliminary findings. A larger center may have a larger pool of subjects, for example, allowing them to recruit more highly motivated individuals than smaller centers.
Regardless, if an obese or overweight person seeking treatment is given the option, "larger centers with more patient flow are probably the best," advised Astrup. "Go for the big ones."
Source: Will you lose more pounds at a bigger diet center?
For every additional 10 people signed up at a clinical center for a weight loss trial, the average person loses half a percent more weight, the study found.
Dr. Arne Astrup of the University of Copenhagen in Denmark and his colleagues delved into a database of 22 weight-loss centers across five countries, gathered in a previous large clinical trial.
Each center served between 4 and 85 men and women, and all of the more than 600 total participants were instructed to follow a nutritionally balanced diet of 800 to 1,000 calories a day. (Typical recommendations for non-dieters range from 1,600 to 2,400 calories per day, depending on gender, age, and level of activity.)
The average participant started the trial weighing 242 pounds, and lost 24 pounds (10 percent of their body weight) after 2 months on the low-calorie diet. Average weight loss among the centers ranged from 6 percent to 12 percent.
Taking into account age, initial body mass index (a measure of weight in relation to height) and sex, the researchers found that 10 more participants at a center translated into a modest half a percent climb in weight loss for the average person at that center. An average 200-pound woman, for example, would have dropped one extra pound over those 2 months.
The idea to investigate such a link came to the team of Danish and Belgian researchers after they noticed the relative performance of weight loss, or bariatric, surgeons. Those who have more experience, they write in the journal Obesity, tend to provide safer and more effective treatments.
Weight loss center size may reflect quality of care in a similar way, Astrup told Reuters Health by email. He noted that investigators, study coordinators and dieticians working at weight loss centers serving large numbers of participants would tend to be more experienced than those at smaller centers.While he notes that the study is "the first of its kind," Pedro Teixeira of the Technical University of Lisbon, in Portugal, is concerned that 2 months is too short to determine a diet's effectiveness.
Teixeira, who was not involved in the study, also suggests that other factors left unaccounted for could explain some of the differences seen across centers. In separate studies, he has identified a set of weight loss predictors, including self-motivation and realistic expectations.
The researchers, too, point to other possible explanations for their preliminary findings. A larger center may have a larger pool of subjects, for example, allowing them to recruit more highly motivated individuals than smaller centers.
Regardless, if an obese or overweight person seeking treatment is given the option, "larger centers with more patient flow are probably the best," advised Astrup. "Go for the big ones."
Source: Will you lose more pounds at a bigger diet center?
Napan and crew win military honors for heroic rescue in Afghanistan
The call came while Napa pilot Scott St. Aubin and his four-man California National Guard Blackhawk medical helicopter crew were flying back to base after a two-day support mission in northeastern Afghanistan.
A 16-man U.S. Army squad was pinned down in an ambush in the rugged Pech River Valley and needed to get one of their soldiers out for immediate medical treatment.
Any rescue attempt would have to navigate difficult terrain in the heat of an intense battle.
It would be an effort that would be different from the vast majority of medevac missions, where ground and air units kill or run off the enemy before an unarmed medical helicopter lands.
Months earlier in their year-long 2009 Afghanistan tour, the crew of Dustoff 24 had mentally prepared for the decision they made that day, vowing to risk their lives and go in during a battle if necessary to save a life.
According to crew-member interviews and official accounts of the rescue mission from California National Guard, Dustoff 24 not only rescued five incapacitated soldiers without landing, but helped direct air support attacks and drop off ammunition to the beleaguered U.S. Army squad while dodging rifle fire and avoiding rocket-propelled grenades.
What’s more, Dustoff 24 went into the ambush six times with unforgiving terrain that only allowed the helicopter one way in and out of the narrow valley — making it easy for Taliban fighters to know where the helicopter would appear next.
“It really was by the grace of God that we weren’t hit,” Chief Warrant Officer Scott St. Aubin said in an interview, recounting that neither his crew nor the helicopter were struck by a single bullet.St. Aubin and two of his crew recently earned the prestigious Distinguished Flying Cross medal for their efforts, while medic Emmett Spraktes of Dixon earned the Silver Star for tending to his patients in the middle of combat.
Finishing what he started
St. Aubin, 38, like much of his crew, is different from the average U.S. Army soldier. As a member of the California National Guard, he holds a regular job as a probation officer with Solano County and has lived in Napa with his wife and daughter since he moved here in 1999.
“Most of our people are either cops or firefighters as well,” he said. For example, Staff Sgt. Spraktes, 48, is an officer with the California Highway Patrol.
To St. Aubin, the National Guard was a way to stay involved with the military after cutbacks in the ‘90s convinced him to curtail a would-be career with the Air Force, where he served before leaving for college in 1995. When he finished school, the military was going through a reduction in force and the Air Force told him they had little room. So, even though he came from an Air Force family, St. Aubin settled into civilian life.
“Right around that time, I met my wife and moved to California,” he said.
Then came Sept. 11 and the global war on terror.
“I started watching what was going on,” he said. “I really wanted to go back and fly helicopters for the military.”
The California National Guard put him in the cockpit.
“It really allows me to give back,” St. Aubin said. “I’m the constant citizen-soldier, at the same time I’m allowed not to be thrown to the wind like an active-duty soldier.”
Being in the National Guard, on that year-long tour in Afghanistan, he said, allowed him to “kinda try and finish something I started a long time ago.”
Suspended in mid-air
The crew of Dustoff 24 didn’t know how bad things were when they first heard the call for help that July day in 2009 — but they soon learned.
“Initially we didn’t understand there was a critical patient,” St. Aubin said, adding as Dustoff 24 got closer, the radio traffic from attack helicopters also informed them that there was a heavy firefight in the area.
The soldiers were halfway up a mountain, at about 1,000 feet, St. Aubin estimates, and no other ground combat units could get to them because of the terrain.
Spraktes said the way in was very narrow.
“The area was very steep and rugged,” he said. “The only way in ... it was pointing toward where we think the main body of Taliban fighters were.”
That meant the crew wouldn’t be landing. They would be doing an uncommon maneuver called a “combat hoist.” The medic is lowered at a slow speed as the helicopter approaches the wounded soldier, reducing the amount of time the helicopter ends up stationary over the drop zone.
Something went wrong that time, however, Spraktes recalled.
“As we’re making the final approach, they’re lowering me down ... about two-thirds of the way down the hoist stops.”
Suspended in mid-air, with bullets crackling past him, Spraktes said he called up to the crew on his radio.
“I said ‘Get me on the ground now. I am like a (expletive) piñata down here.’”
Spraktes said the crew member in the helicopter operating the hoist had to hit the deck to avoid incoming fire, stopping the hoist. For Spraktes, watching bullets hit the landscape around him, it was an eternity. In retrospect, he figures that eternity lasted for 15 seconds before the hoist lowered him to the ground.
He was a welcome sight for the soldiers, and in some ways, entertainment.
“I imagine from their perspective watching me come down the wire, it must have been a good show. A couple of them raised their hands and said ‘Man, that was badass.’”
The combat situation was not as good, Spraktes said.
“There are 16 guys down there and most of them are the age of my oldest son, in their mid-20s. Two of their (other) guys are injured and there are two heat casualties.”
No ‘Blackhawk Down’
Up above, the rest of the crew of Dustoff 24 could see a group of Taliban fighters breaking off to flank the soldiers, and Taliban armed with RPGs coming up in the rear. The squad was getting low on ammunition and in the searing heat, wearing all their gear, they were out of water.
Not wasting time, Spraktes said he directed the soldiers to take different cover so their position could be better defended. But the most gravely wounded soldier worried him. Spraktes knew that he would die if not flown to a field hospital immediately. He placed the soldier on a stretcher-like apparatus to be hoisted to the helicopter.
Meanwhile, St. Aubin noticed Taliban on a ridge and helped direct an attack from two OH-58 Kiowa Warrior helicopters armed with cannons and rockets that had arrived to help. An Apache helicopter also aided the group.
With their help, the flow of the battle created lulls where there was less danger. With repeated evacuations, Dustoff 24 was also able to hoist a soldier shot in the leg and one with an open fracture of his ankle, plus two men rendered listless from heat exhaustion.
On one run, Dustoff 24 flew low and slow near the ground and dropped off ammunition and water.
Eventually, the remaining members of the squad on the ground had an opportunity to move out of the area and return to base.
St. Aubin attributes Dustoff 24’s success to the ability of soldiers and air support to keep the enemy pinned down, making the Taliban rely on what he calls “spray and pray,” where fighters hunker down behind cover and shoot without aiming.
Nonetheless, St. Aubin and the crew were well aware of the danger if their helicopter had been hit and forced to crash land.
“We’re the rescue effort,” he said. “We don’t want to become the effort. You’ve seen the movie ‘Blackhawk Down.’ Once a Blackhawk goes down, that becomes the effort.”
It’s not clear how many Taliban fighters there were in the area, but Spraktes believes there were at least 11 Taliban casualties noted on a sweep of the area.
“For me, I can honestly say that day, my crew and I were doing what we normally would do,” St. Aubin said. “We were not trying to earn any medals ... It was valuable to me to do that mission even if I didn’t earn any medals. We were just trying to get these kids home, that’s all.”
Source: Napan and crew win military honors for heroic rescue in Afghanistan
A 16-man U.S. Army squad was pinned down in an ambush in the rugged Pech River Valley and needed to get one of their soldiers out for immediate medical treatment.
Any rescue attempt would have to navigate difficult terrain in the heat of an intense battle.
It would be an effort that would be different from the vast majority of medevac missions, where ground and air units kill or run off the enemy before an unarmed medical helicopter lands.
Months earlier in their year-long 2009 Afghanistan tour, the crew of Dustoff 24 had mentally prepared for the decision they made that day, vowing to risk their lives and go in during a battle if necessary to save a life.
According to crew-member interviews and official accounts of the rescue mission from California National Guard, Dustoff 24 not only rescued five incapacitated soldiers without landing, but helped direct air support attacks and drop off ammunition to the beleaguered U.S. Army squad while dodging rifle fire and avoiding rocket-propelled grenades.
What’s more, Dustoff 24 went into the ambush six times with unforgiving terrain that only allowed the helicopter one way in and out of the narrow valley — making it easy for Taliban fighters to know where the helicopter would appear next.
“It really was by the grace of God that we weren’t hit,” Chief Warrant Officer Scott St. Aubin said in an interview, recounting that neither his crew nor the helicopter were struck by a single bullet.St. Aubin and two of his crew recently earned the prestigious Distinguished Flying Cross medal for their efforts, while medic Emmett Spraktes of Dixon earned the Silver Star for tending to his patients in the middle of combat.
Finishing what he started
St. Aubin, 38, like much of his crew, is different from the average U.S. Army soldier. As a member of the California National Guard, he holds a regular job as a probation officer with Solano County and has lived in Napa with his wife and daughter since he moved here in 1999.
“Most of our people are either cops or firefighters as well,” he said. For example, Staff Sgt. Spraktes, 48, is an officer with the California Highway Patrol.
To St. Aubin, the National Guard was a way to stay involved with the military after cutbacks in the ‘90s convinced him to curtail a would-be career with the Air Force, where he served before leaving for college in 1995. When he finished school, the military was going through a reduction in force and the Air Force told him they had little room. So, even though he came from an Air Force family, St. Aubin settled into civilian life.
“Right around that time, I met my wife and moved to California,” he said.
Then came Sept. 11 and the global war on terror.
“I started watching what was going on,” he said. “I really wanted to go back and fly helicopters for the military.”
The California National Guard put him in the cockpit.
“It really allows me to give back,” St. Aubin said. “I’m the constant citizen-soldier, at the same time I’m allowed not to be thrown to the wind like an active-duty soldier.”
Being in the National Guard, on that year-long tour in Afghanistan, he said, allowed him to “kinda try and finish something I started a long time ago.”
Suspended in mid-air
The crew of Dustoff 24 didn’t know how bad things were when they first heard the call for help that July day in 2009 — but they soon learned.
“Initially we didn’t understand there was a critical patient,” St. Aubin said, adding as Dustoff 24 got closer, the radio traffic from attack helicopters also informed them that there was a heavy firefight in the area.
The soldiers were halfway up a mountain, at about 1,000 feet, St. Aubin estimates, and no other ground combat units could get to them because of the terrain.
Spraktes said the way in was very narrow.
“The area was very steep and rugged,” he said. “The only way in ... it was pointing toward where we think the main body of Taliban fighters were.”
That meant the crew wouldn’t be landing. They would be doing an uncommon maneuver called a “combat hoist.” The medic is lowered at a slow speed as the helicopter approaches the wounded soldier, reducing the amount of time the helicopter ends up stationary over the drop zone.
Something went wrong that time, however, Spraktes recalled.
“As we’re making the final approach, they’re lowering me down ... about two-thirds of the way down the hoist stops.”
Suspended in mid-air, with bullets crackling past him, Spraktes said he called up to the crew on his radio.
“I said ‘Get me on the ground now. I am like a (expletive) piñata down here.’”
Spraktes said the crew member in the helicopter operating the hoist had to hit the deck to avoid incoming fire, stopping the hoist. For Spraktes, watching bullets hit the landscape around him, it was an eternity. In retrospect, he figures that eternity lasted for 15 seconds before the hoist lowered him to the ground.
He was a welcome sight for the soldiers, and in some ways, entertainment.
“I imagine from their perspective watching me come down the wire, it must have been a good show. A couple of them raised their hands and said ‘Man, that was badass.’”
The combat situation was not as good, Spraktes said.
“There are 16 guys down there and most of them are the age of my oldest son, in their mid-20s. Two of their (other) guys are injured and there are two heat casualties.”
No ‘Blackhawk Down’
Up above, the rest of the crew of Dustoff 24 could see a group of Taliban fighters breaking off to flank the soldiers, and Taliban armed with RPGs coming up in the rear. The squad was getting low on ammunition and in the searing heat, wearing all their gear, they were out of water.
Not wasting time, Spraktes said he directed the soldiers to take different cover so their position could be better defended. But the most gravely wounded soldier worried him. Spraktes knew that he would die if not flown to a field hospital immediately. He placed the soldier on a stretcher-like apparatus to be hoisted to the helicopter.
Meanwhile, St. Aubin noticed Taliban on a ridge and helped direct an attack from two OH-58 Kiowa Warrior helicopters armed with cannons and rockets that had arrived to help. An Apache helicopter also aided the group.
With their help, the flow of the battle created lulls where there was less danger. With repeated evacuations, Dustoff 24 was also able to hoist a soldier shot in the leg and one with an open fracture of his ankle, plus two men rendered listless from heat exhaustion.
On one run, Dustoff 24 flew low and slow near the ground and dropped off ammunition and water.
Eventually, the remaining members of the squad on the ground had an opportunity to move out of the area and return to base.
St. Aubin attributes Dustoff 24’s success to the ability of soldiers and air support to keep the enemy pinned down, making the Taliban rely on what he calls “spray and pray,” where fighters hunker down behind cover and shoot without aiming.
Nonetheless, St. Aubin and the crew were well aware of the danger if their helicopter had been hit and forced to crash land.
“We’re the rescue effort,” he said. “We don’t want to become the effort. You’ve seen the movie ‘Blackhawk Down.’ Once a Blackhawk goes down, that becomes the effort.”
It’s not clear how many Taliban fighters there were in the area, but Spraktes believes there were at least 11 Taliban casualties noted on a sweep of the area.
“For me, I can honestly say that day, my crew and I were doing what we normally would do,” St. Aubin said. “We were not trying to earn any medals ... It was valuable to me to do that mission even if I didn’t earn any medals. We were just trying to get these kids home, that’s all.”
Source: Napan and crew win military honors for heroic rescue in Afghanistan
Deadline Is July 10 To File Requests For Public Assistance After May Storms
State agencies, local and tribal governments as well as certain private nonprofits in Oklahoma counties hit hard by the May 10-13 storms and tornadoes have just a few days remaining to file their official requests for federal assistance.
The deadline to file a Request for Public Assistance (RPA) is Saturday, July 10.
Filing such a request with the state is the first step in the process of applying for federal reimbursements under the Federal Emergency Management Agency's (FEMA) Public Assistance (PA) Grant Program.
Applicants must file RPAs within 30 days of a Public Assistance amendment to a presidential disaster declaration. President Obama issued Oklahoma's major disaster declaration on May 24 and amended it June 11 to include PA for Alfalfa, Cleveland, Grant, Major, McIntosh, Noble, Okfuskee, Osage, Pottawatomie and Seminole counties.
"We would like all eligible applicants to get in their requests for assistance quickly," said Federal Coordinating Officer Gregory W. Eaton. "The sooner those forms get to state specialists, the sooner we can start the process of getting their eligible costs reimbursed."The grants are obligated to the state to reimburse applicants for expenses they incurred while taking emergency measures to protect lives and property; cleaning up downed trees, power poles and other debris; and making repairs to public infrastructure, including roads, bridges and public utilities.
Although the program is oriented to public entities, private nonprofit organizations may apply directly to FEMA via the RPA for uninsured costs of debris removal and emergency protective measures. Additionally, nonprofits may qualify for FEMA assistance to make infrastructure repairs if they provide critical services, such as fire and emergency rescue; medical treatment; power, water and sewer resources; and communications systems.
Source: Deadline Is July 10 To File Requests For Public Assistance After May Storms
The deadline to file a Request for Public Assistance (RPA) is Saturday, July 10.
Filing such a request with the state is the first step in the process of applying for federal reimbursements under the Federal Emergency Management Agency's (FEMA) Public Assistance (PA) Grant Program.
Applicants must file RPAs within 30 days of a Public Assistance amendment to a presidential disaster declaration. President Obama issued Oklahoma's major disaster declaration on May 24 and amended it June 11 to include PA for Alfalfa, Cleveland, Grant, Major, McIntosh, Noble, Okfuskee, Osage, Pottawatomie and Seminole counties.
"We would like all eligible applicants to get in their requests for assistance quickly," said Federal Coordinating Officer Gregory W. Eaton. "The sooner those forms get to state specialists, the sooner we can start the process of getting their eligible costs reimbursed."The grants are obligated to the state to reimburse applicants for expenses they incurred while taking emergency measures to protect lives and property; cleaning up downed trees, power poles and other debris; and making repairs to public infrastructure, including roads, bridges and public utilities.
Although the program is oriented to public entities, private nonprofit organizations may apply directly to FEMA via the RPA for uninsured costs of debris removal and emergency protective measures. Additionally, nonprofits may qualify for FEMA assistance to make infrastructure repairs if they provide critical services, such as fire and emergency rescue; medical treatment; power, water and sewer resources; and communications systems.
Source: Deadline Is July 10 To File Requests For Public Assistance After May Storms
Many With Early Breast Cancer Don't Complete Therapy
Slightly less than half of early-stage breast cancer patients complete their full prescribed course of hormone therapy, finds a new study.
U.S. researchers examined the automated pharmacy records of 8,769 women diagnosed with stage 1, 2 or 3 hormone-sensitive breast cancer between 1996 and 2007. Each woman filled at least one prescription for hormone therapy within a year of breast cancer diagnosis. The women used tamoxifen (43 percent), aromatase inhibitors (26 percent) or both (30 percent).
Overall, only about 49 percent of the women completed their full prescribed regimen of hormone therapy, the study found. After 4.5 years, 32 percent of the women had stopped taking their hormone therapy. Of those who did not stop, 72 percent finished on schedule (meaning they took their medication more than 80 percent of the time).
Those most likely to discontinue hormone therapy early were found to be women younger than 40. Among these women and women older than 75, those who had a lumpectomy rather than a mastectomy and those who had other medical illnesses were more likely to discontinue the therapy. Those most likely to complete 4.5 years of hormone therapy were Asian/Pacific Islanders, women who'd undergone chemotherapy in the past, those who were married and women who had longer prescription refill intervals.
In general, the researchers said, women stop hormone therapy early for a variety of reasons, including such side effects such as joint pain, hot flashes and fatigue; a lack of understanding about the benefits of the therapy; and the high cost of medications and insurance co-payments.
"Physicians are often unaware of patient compliance, and this is becoming an increasingly important issue in cancer," the study's leader, Dr. Dawn Hershman, an associate professor of medicine and epidemiology at Columbia University Medical Center, said in a news release from the Journal of Clinical Oncology. The study appears online June 28 in the journal.
"It's very disturbing that patients under 40 had the highest discontinuation rates because those patients have the longest life expectancy," Hershman said. "If we can better understand the issues surrounding compliance with hormonal therapy, this might help us understand why patients don't adhere to other treatments that are moving out of the clinic and into the home, such as oral chemotherapy, as often as we would like."
SOURCE: Journal of Clinical Oncology, June 28, 2010, news release.
HealthDay
U.S. researchers examined the automated pharmacy records of 8,769 women diagnosed with stage 1, 2 or 3 hormone-sensitive breast cancer between 1996 and 2007. Each woman filled at least one prescription for hormone therapy within a year of breast cancer diagnosis. The women used tamoxifen (43 percent), aromatase inhibitors (26 percent) or both (30 percent).
Overall, only about 49 percent of the women completed their full prescribed regimen of hormone therapy, the study found. After 4.5 years, 32 percent of the women had stopped taking their hormone therapy. Of those who did not stop, 72 percent finished on schedule (meaning they took their medication more than 80 percent of the time).
Those most likely to discontinue hormone therapy early were found to be women younger than 40. Among these women and women older than 75, those who had a lumpectomy rather than a mastectomy and those who had other medical illnesses were more likely to discontinue the therapy. Those most likely to complete 4.5 years of hormone therapy were Asian/Pacific Islanders, women who'd undergone chemotherapy in the past, those who were married and women who had longer prescription refill intervals.
In general, the researchers said, women stop hormone therapy early for a variety of reasons, including such side effects such as joint pain, hot flashes and fatigue; a lack of understanding about the benefits of the therapy; and the high cost of medications and insurance co-payments.
"Physicians are often unaware of patient compliance, and this is becoming an increasingly important issue in cancer," the study's leader, Dr. Dawn Hershman, an associate professor of medicine and epidemiology at Columbia University Medical Center, said in a news release from the Journal of Clinical Oncology. The study appears online June 28 in the journal.
"It's very disturbing that patients under 40 had the highest discontinuation rates because those patients have the longest life expectancy," Hershman said. "If we can better understand the issues surrounding compliance with hormonal therapy, this might help us understand why patients don't adhere to other treatments that are moving out of the clinic and into the home, such as oral chemotherapy, as often as we would like."
SOURCE: Journal of Clinical Oncology, June 28, 2010, news release.
HealthDay
Subscribe to:
Posts (Atom)