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The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

The U.S. public health enterprise is a complex system of public and private partners, loosely coupled, which work together to improve the public's health. This scoping review utilized peer‐reviewed and grey literature to understand systems approaches may be used in the design or enhancement of public health governance structures and service delivery mechanisms. Titles and abstracts were screened against the research question and retained materials were reviewed in full. The final analytic sample included 34 articles from an initial pool of 1128 unique citations that collectively described 25 systems approaches. The findings indicate that few avenues may be present to guide design or enhancement of public health systems when needs arise, such as in response to the COVID‐19 pandemic. Scarcity of literature on this topic presents a challenge, and further analytical studies are needed to inform evidence‐based systems design strategies and applications. [ABSTRACT FROM AUTHOR]

The laboratory mouse is a facultative daily heterotherm in that it experiences bouts of torpor under caloric restriction. Mice are the most frequently studied laboratory mammal, and often, genetically modified mice are used to investigate many physiological functions related to weight loss and caloric intake. As such, research documenting the cardiovascular changes during fasting-induced torpor in mice is warranted. In the current study, C57BL/6 mice were implanted either with EKG/temperature telemeters or blood pressure telemeters. Upon fasting and exposure to an ambient temperature ([T.sub.a]) of 19[degrees]C, mice entered torpor bouts as assessed by core body temperature ([T.sub.b]). Core [T.sub.b] fell from 36.6 [+ or -] 0.2[degrees]C to a minimum of 25.9 [+ or -] 0.9[degrees]C during the fast, with a concomitant fall in heart rate from 607 [+ or -] 12 beats per minute (bpm) to a minimum of 158 [+ or -] 20 bpm. Below a core Tb of 31[degrees]C, heart rate fell exponentially with [T.sub.b], and the [Q.sub.10] was 2.61 [+ or -] 0.18. Further, mice implanted with blood pressure telemeters exhibited similar heart rate and activity profiles as those implanted with EKG/temperature telemeters, and the fall in heart rate and core Tb during entrance into torpor was paralleled by a fall in blood pressure. The minimum systolic, mean, and diastolic blood pressures of torpid mice were 62.3 [+ or -] 10.2, 51.9 [+ or -] 9.2, 41.0 [+ or -] 7.5 mmHg, respectively. Torpid mice had a significantly lower heart rate (25-35%) than when euthermic at mean arterial pressures from 75 to 100 mmHg, suggesting that total peripheral resistance is elevated during torpor. These data provide new and significant insight into the cardiovascular adjustments that occur in torpid mice. hibernation; heart rate; systolic; diastolic; fasting; radiotelemetry

Objective: The objective of this study was to test the effect of an online education intervention on providers’ attitudes, beliefs, knowledge, and practices pertaining to antenatal physical activity. Study design: A sample of 181 providers (ie, obstetricians, family medicine physicians, and certified nurse-midwives) was directed to view an online training on antenatal physical activity guidelines, counseling methods, and resources. Providers completed surveys before and 12 weeks after viewing the educational website material. Repeated-measures analyses were conducted to examine the effects of the online education. Results: A total of 164 providers (87.2%) completed baseline and follow-up surveys. After viewing the online training, participants more strongly agreed that it was their responsibility to encourage engagement in antenatal physical activity (P = .02) and believed that women would follow their advice about beginning antenatal physical activity (P = .01). Viewing the website material facilitated an increased confidence in ability to effectively talk with overweight and obese women about physical activity (P = .04) and more frequent advising to begin a moderate-intensity physical activity program for sedentary women (P = .02). Knowledge on antenatal physical activity guidelines also improved. Conclusion: Findings suggest that online educational interventions may be an effective tool in altering providers’ knowledge and practices pertaining to antenatal physical activity. [ABSTRACT FROM AUTHOR]

The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n=3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components. [ABSTRACT FROM AUTHOR]

Approximately 41% of adults aged 18-24 years in the United States are enrolled in a college or university (1). Wearing a face mask can reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (2), and many colleges and universities mandate mask use in public locations and outdoors when within six feet of others. Studies based on self-report have described mask use ranging from 69.1% to 86.1% among adults aged 18-29 years (3); however, more objective measures are needed. Direct observation by trained observers is the accepted standard for monitoring behaviors such as hand hygiene (4). In this investigation, direct observation was used to estimate the proportion of persons wearing masks and the proportion of persons wearing masks correctly (i.e., covering the nose and mouth and secured under the chin*) on campus and at nearby off-campus locations at six rural and suburban universities with mask mandates in the southern and western United States. Trained student observers recorded mask use for up to 8 weeks from fixed sites on campus and nearby. Among 17,200 observed persons, 85.5% wore masks, with 89.7% of those persons wearing the mask correctly (overall correct mask use: 76.7%). Among persons observed indoors, 91.7% wore masks correctly. The proportion correctly wearing masks indoors varied by mask type, from 96.8% for N95-type masks and 92.2% for cloth masks to 78.9% for bandanas, scarves, and similar face coverings. Observed indoor mask use was high at these six universities with mask mandates. Colleges and universities can use direct observation findings to tailor training and messaging toward increasing correct mask use., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

Torpor, a controlled rapid drop in metabolic rate and body temperature (Tb), is a hypometabolic adaptation to stressful environmental conditions, which occurs in many small mammals, marsupials, and birds. To date, signaling pathways required for torpor have not been identified. We examined the role of the sympathetic nervous system (SNS) in mediating the torpor adaptation to fasting by telemetrically monitoring the Tb of dopamine beta-hydroxylase knock-out (Dbh-/-) mice, which lack the ability to produce the SNS transmitters, norepinephrine (NE), and epinephrine. Control (Dbh+/-) mice readily reduced serum leptin levels and entered torpor after a fast in a cool environment. In contrast, Dbh-/- mice failed to reduce serum leptin and enter torpor under fasting conditions, whereas restoration of peripheral but not central NE lowered serum leptin levels and rescued the torpor response. Torpor was expressed in fasted Dbh-/- mice immediately after administration of either the nonselective beta-adrenergic receptor agonist isoproterenol or the beta3-adrenergic receptor (AR)-specific agonist CL 316243 [disodium (RR)-5-[2-[[2-(3-chlorophenyl)-2-hydroxyethyl]-amino]propyl]-1,3-benzodioxazole-2,2-dicarboxylate], but not after administration of beta1, beta2, or alpha1 agonists. Importantly, the beta3-specific antagonist SR 59230A [3-(2-ethylphenoxy)-1-[(1,S)-1,2,3,4-tetrahydronapth-1-ylamino]-2S-2-propanol oxalate] severely blunted fasting-induced torpor in control mice, whereas other AR antagonists were ineffective. These results define a critical role of peripheral SNS activity at beta3-AR-containing tissues in the torpor adaptation to limited energy availability and cool ambient temperature.