To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Health-care access is associated with improved control of multiple chronic diseases, but the association between health-care access and weight change is unclear. The present study aims to test the association between health-care access and weight change.
The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a multicentre population-based prospective study. Weight change was calculated at 3 and 13 years after CARDIA year 7 (1992–1993). Health-care access was defined as no barriers or one or more barriers to access (health insurance gap, no usual source of care, not seeking care due to expense). Intermediary variables evaluated included history of dieting and use of diet pills, meal replacements or weight-control programmes.
Four cities in the USA.
Participants were aged 18–30 years at baseline (1985–1986). Analyses include 3922 black and white men and women with relevant data from CARDIA years 7, 10 and 20 (1992–1993, 1995–1996 and 2005–2006, respectively).
Mean weight change was +2·22 kg (+4·9 lb) by 3 years and +8·48 kg (+18·7 lb) by 13 years, with no differences by health-care access. Being on a weight-reducing diet was not consistently associated with health-care access across examinations. Use of diet pills, meal replacements or organized weight-control programmes was low, and did not vary by health-care access.
Weight gain was high irrespective of health-care access. Public health and clinical approaches are needed to address weight gain.
Prior studies examining the association between self-reported experiences of racial/ethnic discrimination and obesity have had mixed results and primarily been cross-sectional. This study tests the hypothesis that an increase in self-reported experiences of racial/ethnic discrimination predicts gains in waist circumference and body mass index in Black and White women and men over eight years. In race/ethnicity- and gender-stratified models, this study examined whether change in self-reported experiences of racial/ethnic discrimination predicts changes in waist circumference and body mass index over time using a fixed-effects regression approach in SAS statistical software, providing control for both measured and unmeasured time-invariant covariates. Between 1992–93 and 2000–01, self-reported experiences of racial/ethnic discrimination decreased among 843 Black women (75% to 73%), 601 Black men (80% to 77%), 893 White women (30% to 23%) and 856 White men (28% to 23%). In fixed-effects regression models, controlling for all time-invariant covariates, social desirability bias, and changes in education and parity (women only) over time, an increase in self-reported experiences of racial/ethnic discrimination over time was significantly associated with an increase in waist circumference (β=1.09, 95% CI: 0.00–2.19, p=0.05) and an increase in body mass index (β=0.67, 95% CI: 0.19–1.16, p=0.007) among Black women. No associations were observed among Black men and White women and men. These findings suggest that an increase in self-reported experiences of racial/ethnic discrimination may be associated with increases in waist circumference and body mass index among Black women over time.
The current medical environment makes information retrieval a matter of
practical importance for clinicians. Many avenues present themselves to the
clinician, but here we focus on MEDLINE by summarizing the current state of
the art and providing an innovative approach for skill enhancement. Because
new search engines appear rapidly, we focus on generic principles that can be
easily adapted to various systems, even those not yet available. We propose an
idealized classification system for the results of a MEDLINE search. Type A
searches produce a few articles of high quality that are directly focused on
the immediate question. Type B searches yield a large number of articles, some
more relevant than others. Type C searches produce few or no articles, and
those that are located are not germane. Providing that relevant, high-quality
articles do exist, type B and C searches may often be improved with attention
to search technique. Problems stem from poor recall and poor precision. The
most daunting task lies in achieving the balance between too few and too many
articles. By providing a theoretical framework and several practical examples,
we prepare the searcher to overcome the following barriers: a) failure to
begin with a well-built question; b) failure to use the Medical Subject
Headings; c) failure to leverage the relationship between recall and
precision; and d) failure to apply proper limits to the search. Thought and
practice will increase the utility and enjoyment of searching MEDLINE.
Email your librarian or administrator to recommend adding this to your organisation's collection.