Fitness and Fatness in Relation to Health: Implications for a Paradigm Shift

Health care professionals most often approach health promotion for large persons in the context that health improvement can be attained only through weight loss. Unequivocal acceptance of the notion that thinness equals health and fitness has been the only health intervention strategy available for many large men and women. The apparent ineffectiveness of traditional diet and exercise programming to reduce body weight has caused many health care providers, obesity researchers, and lay persons to challenge the further use of diet and exercise for the sole purpose of reducing body weight in the large person. A brief survey of the most popular dieting techniques used over the past 40 years shows that most techniques cycle in and out of popularity, and that many of these techniques are hazardous to health. Data from the scientific community indicate that diet and exercise programs for weight loss are ineffective in producing reduced weight maintenance after a period of 3 to 5 years. On the other hand, there are data indicating that overweight men and women can become healthy without losing significant amounts of weight. Furthermore, epidemiological studies indicate that fitness, not fatness, is related to disease and mortality. Any intervention strategy for the obese should be one that promotes the development of a healthy lifestyle. The outcome parameters used to evaluate the success of such an intervention should be specific to disease risk and symptomatologies and not limited to medically ambiguous variables like body weight or body composition.     

Research newsnotes

The authors describe the curricular changes made as part of a 20-year commitment by Smith College School for Social Work (SCSSW), a graduate school with a clinical social work specialization, to become an antiracism institution. Unaware of precedents, faculty, administration, and students needed to develop structures and processes to confront inherent institutional racism at the SCSSW. In addition to multiple administrative actions, every aspect of the curriculum was reevaluated, leading to changes in courses offered and everything about them, from syllabi to pedagogy, as well as how faculty are trained and supported. The authors found that explicit and implicit curriculum must work together in intentional and synchronous ways. Critical intention across design, implementation, evaluation, accountability, and openness to process is emphasized here. They conclude that an antiracism commitment requires continuous engagement, connection, challenge, learning, and teaching and a curriculum that is fluid, flexible, proactive, and responsive.     

THE PROCESS OF CHANGE IN COUPLES THERAPY: A QUALITATIVE INVESTIGATION

Open-ended interviews with 24 couples therapy clients regarding their experience of the process of change revealed shifts in clusters of affect, communication, and cognition. Six additional contextual preconditions for change were also identified. The change process within couples was uniformly reported to be gradual.     

The family educator: a professional resource for families.

The family educator works with the client's family members to help in their understanding of their ill relative and to assist with managing the stress of the caregiver role. Families come to understand that they can join forces with the clinical team in helping their relative engage in a trial of treatment. Each treatment recommendation is explained to the family and decisions are arrived at by consensus through partnership meetings. Role modeling effective interaction approaches and providing assistance in generating alternative solutions to problematic situations are important functions of the family educator.     

Why social status matters for understanding the interrelationships between testosterone,economic risk‐taking,and gender

We conduct an extensive review of the literature on testosterone and economic risk‐taking behavior. In sum, there is evidence of a positive association between testosterone and economic risk taking, although it is unlikely to be a strong association given the abundance of null results. However, we argue that the existing literature may overstate the causal effects of testosterone on economic risk taking (or even report a spurious correlation) because this research has not considered the potentially confounding role of social status. Status could concurrently influence both testosterone and economic risk taking, given that testosterone is a social hormone with a reciprocal relationship with social status, and social status has been found to drive risk‐taking behavior. We also argue against using findings from this literature to make gender essentialist claims, primarily because social phenomena influence the size—and existence—of gender differences in economic risk‐taking behavior. We conclude with suggestions for future research.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

The trouble with foster care: the impact of stressful 'events' on foster carers

Summary The article draws on the first stages of a large-scale longitudinalstudy into foster care with 'looked after' children. It usesdata supplied by 950 foster carers in response to a postal questionnairedesigned to document the proportions who had experienced oneor more of six potentially stressful 'events': breakdowns ordisruptions, allegations, relationship with birth parents, familytensions, 'tug of love' cases, and other disagreements withsocial services. The article uses carers' comments to describetheir reaction to the 'events'. It then examines the relationshipbetween the 'events' and measures of carer stress, satisfactionwith fostering, and intentions to continue fostering. Overall,two-thirds of the sample had experienced one or more of these'events' and these were associated with a measure of mentalill-health and with attitudes towards continuing fostering.     

Thank God you're here: the coming generation and their role in future‐proofing Australia from the challenges of population ageing

Like much of the industrialised world, Australia's population is ageing, the implications of which are twofold: increasing demand for publicly funded services and a decline in the supply of prime working‐age people. In grappling with the challenges of a diminishing workforce, the Australian Government is currently relying on its migration programs to provide both the much‐needed labour and skills for the resource boom and also to stimulate the economy through population growth. However, there may be another, not yet fully considered solution to the upcoming demographic problem. This paper investigates how the grandchildren of the baby boomers, termed here the Thank God You're Here generation (Gen TGYH), might impact on Australia's predicted workforce shortage. This generation of workers will enter the labour force as the last of the baby boomers reach retirement age, and will not only be bigger in size than preceding generations (Y, X and Baby Boomers), but also potentially be better educated than the retiring generation. This paper will also canvas the opportunities for both Gen TGYH and employers as well as the challenges for policymakers and governments in maximising the opportunity provided by this generation in the Australian economy.