Bryce Hospital

Starch inclusion complexes (ICs) have a crucial influence on food processing and human health by reducing the rate of enzymatic digestion and maintaining glucose homeostasis, offering benefits for individuals suffering from type 2 diabetes. Therefore, starch ICs have become a promising approach in the fields of food science and pharmacology. This review explores the formation and structure of starch ICs and provides a comprehensive comparison of various composite methods in making starch ICs in terms of efficiency, cost, target material types, and application scope. It also discusses multidimensional characterization techniques that assess the multiscale structure, thermal properties, and digestibility of starch ICs. Finally, insights are raised for the future research direction of starch ICs, highlighting the need for improved orderliness and controllability in the final product structure of starch ICs, which remains an area needing further exploration.

Introduction: Though weight loss can improve health, weight regain is common. Primary care physicians are uniquely positioned to provide counseling for weight loss maintenance given their longitudinal care of patients, yet evidence of simple lifestyle recommendations for maintaining weight loss in primary care patients is lacking. Our objective was to characterize longitudinal associations between diet habits and weight change among primary care patients with recent, intentional weight loss of at least 5%. Methods: This was a secondary analysis of data from a weight loss maintenance clinical trial in a primary care setting that compared two interventions delivered through the electronic health record: continued coaching vs. tracking only. Dietary habits [fried foods, desserts, fruits and vegetables (F&V), and sugar-sweetened beverages (SSB)] were measured by the Connor Diet Habits Survey. Linear regression models were used to evaluate associations (overall and by randomized group) between changes in dietary habits and weight separately at 6- and 24-month follow-up, adjusted for baseline diet habit, age, gender and clinic location. Results: Participants (n=192) were 74% female, 87% white and had baseline mean (SD) age of 53 (12) years, body mass index of 30.4 (5.9) kg/m 2 , and recent weight loss of 11 (8) percent. Overall, participants had mean (SD) weight loss of 0.18 (5.04) kg at 6 months (n=169) and weight gain of 3.26 (7.60) kg at 24 months (n=140). At 6 months, a 1 serving per week increase in dessert intake was associated with 0.53 kg (p=0.030) greater weight gain. Fried foods, F&V, and SSB were not associated with 6-month weight changes. However, by 24 months, an increase of 1 serving per week was associated with greater weight gain of 0.54 kg (p=0.043) for fried foods, 0.80 kg (p=0.031) for desserts, and 2.01 kg (p=0.002) for SSB. A decrease of 1 F&V serving per day was associated with a 0.82 kg (p=0.008) greater weight gain at 24 months. When stratified by randomized group, associations were stronger in the continued coaching vs. tracking only arm. Conclusions: Increased consumption of desserts was associated with weight regain at 6 and 24 months, while increased fried foods and SSB, and decreased F&V were associated with weight regain at 24 months. These data suggest that simple strategies such as improving or at least maintaining dietary intake of fried foods, desserts, F&V, and SSB could help facilitate long-term weight loss maintenance in primary care patients.

Individually, the metabolic demands of digestion or movement can be fully supported by elevations in cardiovascular performance, but when occurring simultaneously, vascular perfusion may have to be prioritized to either the gut or skeletal muscles. Burmese pythons (Python molurus) experience similar increases in metabolic rate during the digestion of a meal as they do while crawling, hence each would have an equal demand for vascular supply when these two actions are combined. To determine, for the Burmese python, whether blood flow is prioritized when snakes are digesting and moving, we examined changes in cardiac performance and blood flow in response to digestion, movement, and the combination of digestion and movement. We used perivascular blood flow probes to measure blood flow through the left carotid artery, dorsal aorta, superior mesenteric artery and hepatic portal vein, and to calculate cardiac output, heart rate and stroke volume. Fasted pythons while crawling experienced a 2.7- and 3.3-fold increase, respectively, in heart rate and cardiac output, and a 66% decrease in superior mesenteric flow. During the digestion of a rodent meal equaling in mass to 24.7% of the snake's body mass, heart rate and cardiac output increased by 3.3- and 4.4-fold, respectively. Digestion also resulted in respective 11.6- and 14.1-fold increases in superior mesenteric and hepatic portal flow. When crawling while digesting, cardiac output and dorsal aorta flow increased by only 21% and 9%, respectively, a modest increase compared with that when they start to crawl on an empty stomach. Crawling did triggered a significant reduction in blood flow to the digesting gut, decreasing superior mesenteric and hepatic portal flow by 81% and 47%, respectively. When faced with the dual demands of digestion and crawling, Burmese pythons prioritize blood flow, apparently diverting visceral supply to the axial muscles.

Journal Article Antiparkinsonian drug prescribing in elderly inpatients receiving risperidone therapy Get access Marshall Cates, Pharm.D., BCPP, Marshall Cates, Pharm.D., BCPP Assistant Professor Department of Pharmacy Practice McWhorter School of Pharmacy Samford University 800 Lakeshore Drive Birmingham, AL 35229 Search for other works by this author on: Oxford Academic Google Scholar Robert Collins, Pharm.D., Robert Collins, Pharm.D. Director of Pharmacy Bryce Hospital 200 University Boulevard Tuscaloosa, AL 35401 Search for other works by this author on: Oxford Academic Google Scholar Thomas Woolley, Ph.D. Thomas Woolley, Ph.D. Professor of Statistics School of Business Samford University Birmingham, AL 35229 Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, Volume 56, Issue 20, 15 October 1999, Pages 2139–2140, https://doi.org/10.1093/ajhp/56.20.2139 Published: 15 October 1999

There are several important issues influencing the holding of confidences in family therapy, among them are privacy, family secrets, confidentiality, and privileged communication. Clinicians need to be aware that breach of confidentiality is considered a high-risk area in clinical practice, which could be brought within a "low profile" malpractice configuration by adopting certain risk management techniques. Family therapists have an obligation to maintain their practice under the guidance of professional ethics, agency policies/procedures, and within emerging judicial parameters. The questions of confidentiality that confront family therapists have no clear and easy answers and the legal dilemma is ever present.

Each counseling experience with a frail or dying client is a learning opportunity. In these circumstances if is the counselor who is the student.

R.N. Wool, Ph.D., Director, Department of Diagnosis and Evaluation, Partlow State School and Hospital, Tuscaloosa, Alabama 35403, USA