A theory of planned behaviour perspective on practitioners' beliefs toward the integration of the WIXX communication campaign messages and activities into daily practice.

OBJECTIVES: To favour the dissemination and the implementation of the WIXX multimedia communication campaign, the aim of this study was to examine practitioners' beliefs towards the integration of the WIXX campaign activities into daily practice. STUDY DESIGN: An exploratory qualitative study. METHODS: Overall, 58 community-based practitioners completed an online questionnaire based on the theory of planned behaviour guidelines pertaining to perceived advantages/disadvantages and perceived barriers/facilitators toward the campaign. A content analysis was performed by two independent coders to extract modal beliefs. Results were validated by a third coder. RESULTS: Local partners had a positive attitude toward the WIXX campaign, but significant barriers remained and needed to be addressed to ensure full implementation of this campaign (e.g. lack of time or resources, additional workload, complexity of the registration process and so forth). Beliefs were fragmented and diversified, indicating that they were highly context dependent. CONCLUSIONS: To conclude, some remaining challenges regarding the full implementation of the WIXX communication campaign were identified, suggesting that additional efforts might be needed to ensure the full adoption of the campaign by local practitioners.

Is visceral obesity a physiological adaptation to stress?

Visceral obesity represents an important risk factor associated with hypertension, diabetes and cardiovascular diseases. Since this condition is associated with a disruption of the functioning of the HPA axis, stress-induced HPA axis activation has been identified to play an important role in this preferential body fat accumulation. HPA axis activation increases cortisol (corticosterone) production which has been shown to exert hyperphagic and antithermogenic effects. Since abdominal adipose tissue has more cells per mass units, higher blood flow and more glucocorticoid receptors, glucocorticoids affect abdominal fat to a greater extent than subcutaneous adipose tissue. Cushing's syndrome in humans is the best evidence showing a link between hypercortisolemia and accumulation of central fat. The Hervey's hypothesis which suggests that fat cells take up and catabolize glucocorticoids is one of the possible regulatory effect that supports the adaptive role of visceral fat in response to stress. This is also supported by other evidence showing that abdominal obesity is associated with an increased cortisol clearance. Hormonal and enzymatic changes have been implicated in this preferential body fat accumulation in response to stress. Specific genetic background may also accentuate this visceral fat accumulation in some individuals exposed to stress. Alternatively, obesity could also be a source of stress promoting the visceral fat accumulation since visceral fat is able to release cytokines which stimulate the HPA axis. Even if the available literature does not permit to establish clearly which comes first, it suggests that visceral obesity could represent a non optimal physiological adaptation to stress. In this context, visceral obesity treatment should focus on stress management and weight loss strategies in order to stop this vicious circle.

Blood and urinary cadmium levels in Inuit living in Kuujjuaq, Canada.

Blood and urine cadmium concentrations have been determined in a group of 85 Inuit residents of Kuujjuaq, Quebec, Canada, drawn from actively hunting households. Mean blood cadmium values are high at 39.4 nmol/l, varying between 6.6 in non-smokers and 60.3 in smokers. No association of blood cadmium with self-reported offal consumption could be found. Median urine cadmium concentrations are elevated at 2.3 mumol/mol creatinine and rise substantially with age: 0.9 in the 30-39 age group; 3.2 among the 40-59 age group; and 4.1 in the 60 and over.