Obesity and discrimination - a systematic review and meta-analysis of observational studies.

BACKGROUND: Research on obesity has shown that stigma often accompanies obesity and impacts many life domains. No previous research has systematically reviewed published literature about the prevalence and the nature of perceived weight discrimination in individuals with obesity. This systematic review and meta-analysis aims to fill that gap. METHODS: A systematic literature search was conducted without time limits using the databases Medline, ISI Web of Knowledge and the Cochrane Library. Meta-analyses were performed using random effect models. Observational studies pertaining to (i) prevalence estimates and (ii) forms of perceived weight discrimination among individuals with obesity were included. RESULTS: Of 4393 citations retrieved, nine citations retrieved, nine studies met inclusion criteria. Pooled prevalence was 19.2% (95% confidence interval (CI) 11.7 to 29.8%) for individuals with class I obesity (Body mass index [BMI] = 30-35 kg m(-2) ) and 41.8% (95% CI 36.9 to 46.9%) for individuals with more extreme obesity (BMI > 35 kg m(-2) ). Findings from nationally representative US samples revealed higher prevalence estimates in individuals with higher BMI values (BMI > 35 kg m(-2) ) and in women. CONCLUSIONS: The results provide evidence that perceptions of weight discrimination by individuals with obesity were common, and its negative consequences are highly relevant issues within society and need to be the focus of potential interventions. © 2015 World Obesity.

Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder.

OBJECTIVE: This study investigates whether hyperactivity, i.e. an increased level of motor activity, can be observed in adults with attention-deficit/hyperactivity disorder (ADHD). METHOD: An infrared motion-tracking system was used to measure motor activity in 20 unmedicated adults with ADHD and 20 matched healthy controls (HC) during a 1-back working memory task. RESULTS: Motor activity was higher in ADHD. It increased with the duration of testing and co-varied with cognitive performance in ADHD only. Subjective and objective measurements of motor activity were related in HC, but not in ADHD. CONCLUSION: Higher levels of motor activity in ADHD are objectively measurable not only in children, but in adults as well. It is linked to cognitive performance arguing against distinguishable diagnostic subtypes. The objective measurement of motor activity seems to extend the description of ADHD symptoms derived from rating scales and might thus help to bridge the gap between psychopathological symptom description and neurobiological alterations.

Despite some PR fallout, proponents say MD walkouts increase awareness and may improve health care.

This fall Ontario braced for possible strikes by public servants and teachers. A year earlier, the province's physicians were preparing their own job action. Walkouts by physicians, which have not been uncommon since the introduction of medicare, create two camps. In one are physicians who say legal job actions are ethical and often improve health care for patients. In the other are some doctors and ethicists who question whether doctors have an ethical right to withdraw services, even if it is legal to do so. Nicole Baer interviewed members of both camps.

MDs seen as key players in move to encourage active living in Canada.

Despite participACTION's preaching about the need to stay physically active, only a small percentage of Canadians exercise regularly at the level recommended for fitness. Nicole Baer discusses the issue with physicians and experts in the field, and also looks at American efforts to introduce Physician-based Assessment and Counselling for Exercise.

Weep for Adonais.

A 1995 motor-vehicle crash brought a tragic end to the promising medical career of Michael Agapitos, a specialist in physical medicine and rehabilitation who graduated from the University of Ottawa in 1982. The death of the popular young Ottawa physician and the subsequent court case involving the driver of the other vehicle have had a major impact on the victim's family and patients, Nicole Baer reports.

Disability payments continue to climb. "Tell us what you see, not what you think," CPP tells MDs.

Growing concern about the sustainability of the Canada Pension Plan has led to a closer look at the disability benefits it provides. The federal auditor general reported recently that the number of recipients has almost doubled in the past 10 years, and disability payments have more than tripled, to $3 billion annually. This article looks at the role physicians play in determining whether an applicant is disabled.

Fraud worries insurance companies but should concern physicians too, industry says.

The amount of insurance fraud is increasing in Canada. This should worry physicians, because all personal-injury claims must be substantiated by a medical certificate. The vast majority of physicians are honest and ethical, fraud investigators say, but some are being duped as patients scheme to cheat the insurance industry. In one sensational auto-insurance-fraud case, some Ontario physicians are being investigated about possible involvement in a self-referral scheme. Nicole Baer looks at insurance fraud and the challenges it poses for doctors.

Debate about placebos points to issue surrounded by many shades of grey.

Dr. Kenneth Rothman, a critic of the use of placebos in clinical trials, recently discussed the issue with Health Canada employees. Some researchers insist this is not a black-and-white issue, and that in some cases patients who receive a placebo are the lucky ones.

Insecurity now way of life in hospitals as professionals ponder an uncertain future.

Physicians aren't the only health care workers affected by cuts in health care spending. In Alberta, the number of registered nurses has dropped 13% since 1993. Although the vast changes in Canada's hospital sector create opportunities for some workers, such as nursing assistants, others such as laboratory workers face a gloomy future. Nicole Baer reports that many Canadian health care workers are voting with their feet and leaving the country, while others are moving to new careers.

As hospitals shrink, consolidate or close, physicians are swept up in the turmoil.

Hospital closures are causing great uncertainty among Canadian physicians. As anatomical pathologist Vivien Frenkel told Nicole Baer, "the main thing now is that nobody knows what's going to happen, and that creates a lot of anxiety." Baer studies the impact hospital closures have had and are likely to have on physicians as the restructuring of Canada's health care system continues.

New draft code for research involving humans proved a major challenge.

A new draft code of conduct for research involving humans aims to bring a fresh vision to the ethics field. The code is a joint endeavour of the Medical Research Council, the Natural Sciences and Engineering Research Council and the Social Sciences and Humanities Research Council and supersedes all three agencies' earlier ethics statements. Once the draft code is revised and approved, likely by the end of the year, investigators will have a more refined understanding of the ethical limits of acceptable research.

Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents.

This article reviews major risk factors for cigarette smoking, alcohol, and other drug abuse and promising community-based approaches to primary prevention. In a longitudinal experimental study, 8 representative Kansas City communities were assigned randomly to program (school, parent, mass media, and community organization) and control (mass media and community organization only) conditions. Programs were delivered at either 6th or 7th grade, and panels were followed through Grade 9 or 10. The primary findings were (a) significant reductions at 3 years in tobacco and marijuana use and (b) equivalent reductions for youth at different levels of risk. This study provides evidence that a comprehensive community program-based approach can prevent the onset of substance abuse and that the benefits are experienced equally by youth at high and low risk.