Integrating Lifestyle Medicine in Cardiovascular Health and Disease Prevention

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Author :
Publisher : CRC Press
ISBN 13 : 1000813932
Total Pages : 300 pages
Book Rating : 4.0/5 (8 download)

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Book Synopsis Integrating Lifestyle Medicine in Cardiovascular Health and Disease Prevention by : James M. Rippe

Download or read book Integrating Lifestyle Medicine in Cardiovascular Health and Disease Prevention written by James M. Rippe and published by CRC Press. This book was released on 2022-12-30 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States and around the world. Major risk factors for CVD result from poor lifestyle habits and practices, but the area of lifestyle medicine has emerged to help clinicians and their patients understand the power of positive lifestyle habits and actions. Written by cardiologist and lifestyle medicine pioneer, Dr. James Rippe, Integrating Lifestyle Medicine in Cardiovascular Health and Disease Prevention introduces the principles of lifestyle medicine with the practice of cardiology to help lower the risk of heart disease and, if already present, assist in its treatment. This book provides evidence-based information on both the prevention and treatment of CVD through lifestyle measures such as regular physical activity, sound nutrition, weight management and avoidance of tobacco products. This information aids physicians and patients to better understand multiple linkages between poor habits and practices, employing them with associated behavioral techniques to lessen the likelihood of developing CVD. Features: Summarizes major issues in CVD including heart attack, stroke, atrial fibrillation, high blood pressure, lipid abnormalities and obesity. Provides protocols for overcoming a sedentary lifestyle and using lifestyle medicine techniques to optimize brain health. Empowers clinicians with vital information for consultations on the power of lifestyle medicine practices, both to treat symptoms if already present or to prevent major components of CVD from developing in the future. Written for practitioners at all levels, this user-friendly volume in the Lifestyle Medicine series is valuable to practitioners in general medicine or subspecialty practices including lifestyle medicine and cardiology.

Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts

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Author :
Publisher : Jones & Bartlett Learning
ISBN 13 : 1284299759
Total Pages : 1161 pages
Book Rating : 4.2/5 (842 download)

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Book Synopsis Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts by : Loureen Downes

Download or read book Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts written by Loureen Downes and published by Jones & Bartlett Learning. This book was released on 2023-10-05 with total page 1161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Promotion and Disease Prevention for Advanced Practice: Integrating Evidence-Based Lifestyle Concepts is a unique new resource that is not afraid to address lifestyle concepts that can change the trajectory of healthcare in the United States and globally. It provides practical, evidence-based approaches to reduce the pandemic of preventable lifestyle-related chronic diseases such as heart disease, hypertension, some strokes, type 2 diabetes, obesity, and multiple types of cancer. It provides nurse practitioners and physician assistants with the lifestyle management tools needed to contribute to a higher level of care to promote health and prevent disease. The authors take a deep dive into the literature regarding lifestyle concepts and practical management of lifestyle-related chronic diseases. They discuss the root causes of diseases and approaches for patient-centered care, strategies for health promotion reimbursement, and trending telehealth delivery of health care.

Integrating Lifestyle Medicine for Prediabetes, Type 2 Diabetes, and Cardiometabolic Disease

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Author :
Publisher : CRC Press
ISBN 13 : 1000876098
Total Pages : 459 pages
Book Rating : 4.0/5 (8 download)

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Book Synopsis Integrating Lifestyle Medicine for Prediabetes, Type 2 Diabetes, and Cardiometabolic Disease by : Michael A. Via

Download or read book Integrating Lifestyle Medicine for Prediabetes, Type 2 Diabetes, and Cardiometabolic Disease written by Michael A. Via and published by CRC Press. This book was released on 2023-05-12 with total page 459 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lifestyle change is universally recommended for patients with type 2 diabetes and cardiometabolic disease, yet, the majority of clinical practice, educational programs, and clinical trials within these chronic disease spaces focus on medication use and procedures, with insufficient emphasis on lifestyle medicine. The concept of lifestyle medicine can serve as a countermeasure, acting through aspects of personal choice, natural and built environments, cultural traditions, and socioeconomic influences that affect the metabolic health of an individual. Integrating Lifestyle Medicine for Prediabetes, Type 2 Diabetes, and Cardiometabolic Disease provides clinical evidence for and a mechanistic understanding of the six pillars of lifestyle medicine. It guides the reader to identify opportunities for early intervention rather than focus on the diagnosis and treatment of the established disease. Interventions at earlier points have the potential to mitigate progression, prevent complications, reduce costs, and improve a patient’s overall health at all points in their lifetime. Key Features Provides mechanistic, epidemiological, and clinical understanding of all pillars of lifestyle medicine Presents information on mechanisms for lifestyle medicine in cardiometabolic disease Features a unique model that includes recognition of predisease and even pre-predisease with rationale for intervention Promotes evidence-based recommendations for all stages of cardiometabolic disease This volume in the Lifestyle Medicine series is an essential resource for clinicians and students, providing them with information to help them to prevent complications, reduce costs, and improve a patient’s overall health at all points in their lifetime.

Promoting Cardiovascular Health in the Developing World

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Author :
Publisher : National Academies Press
ISBN 13 : 0309157617
Total Pages : 483 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Promoting Cardiovascular Health in the Developing World by : Institute of Medicine

Download or read book Promoting Cardiovascular Health in the Developing World written by Institute of Medicine and published by National Academies Press. This book was released on 2010-06-29 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. In this report, the IOM recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals: creating environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases, and building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. To meet these goals, the IOM recommends several steps, including improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. Without better efforts to promote cardiovascular health, global health as a whole will be undermined.

Encyclopedia of Lifestyle Medicine and Health

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Author :
Publisher : SAGE
ISBN 13 : 1412950236
Total Pages : 1297 pages
Book Rating : 4.4/5 (129 download)

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Book Synopsis Encyclopedia of Lifestyle Medicine and Health by : James M. Rippe

Download or read book Encyclopedia of Lifestyle Medicine and Health written by James M. Rippe and published by SAGE. This book was released on 2012-02-14 with total page 1297 pages. Available in PDF, EPUB and Kindle. Book excerpt: These three volumes sort out the science behind nightly news reports and magazine cover stories, and help define the interdisciplinary field of lifestyle medicine and health.

Lifestyle Medicine

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Author :
Publisher : Springer
ISBN 13 : 3319246879
Total Pages : 363 pages
Book Rating : 4.3/5 (192 download)

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Book Synopsis Lifestyle Medicine by : Jeffrey I. Mechanick

Download or read book Lifestyle Medicine written by Jeffrey I. Mechanick and published by Springer. This book was released on 2016-03-18 with total page 363 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lifestyle – the manner in which people live – is fundamental to health, wellness, and prevention of disease. It follows that attention to lifestyle is critically important to effective and successful health care. But here’s the challenge: health care professionals receive very little, if any, formal training about lifestyle counseling and therefore are ill equipped to incorporate lifestyle issues into clinical practice. In response, “Lifestyle Medicine” is evolving as a means to fill this knowledge gap. Lifestyle medicine approaches health and wellness by harnessing the power of lifestyle-related behaviors and influencing the environment we live in. It is a formal approach that promises to enhance and strengthen a re-invigorated health care system that is still outpaced by the epidemic proportions and complexity of chronic diseases like obesity, diabetes, depression, hypertension, and cancer, among others. Lifestyle Medicine: A Manual for Clinical Practice presents this formal approach in a pragmatic context. This unique and practical manual provides clear and succinct guidance on nearly all aspects of lifestyle medicine. The approach is both explanatory and pragmatic, providing case studies and bulleted translation of academic information into clinical practice recommendations. There is an emphasis on scientific evidence wherever possible as well as opinions by the expert chapter authors who practice lifestyle medicine. There is a “how-to” rationality to the book, consistent with a premise that any and all health care professionals should, and perhaps must, incorporate lifestyle medicine. A valuable checklist is included at the close of the book that summarizes key points and provides a practical tool for routine patient encounters.

Lifestyle Medicine, Third Edition

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Author :
Publisher : CRC Press
ISBN 13 : 1351780999
Total Pages : 2152 pages
Book Rating : 4.3/5 (517 download)

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Book Synopsis Lifestyle Medicine, Third Edition by : James M. Rippe

Download or read book Lifestyle Medicine, Third Edition written by James M. Rippe and published by CRC Press. This book was released on 2019-04-17 with total page 2152 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of lifestyle medicine, which is the study of how daily habits and actions impact on both short- and long-term health and quality of life, continues to expand globally. The scientific and medical literature that supports the success of these lifestyle habits and actions is now overwhelming. Thousands of studies provide evidence that regular physical activity, maintenance of a health body weight, following sound nutritional practices, stress reduction, and other good practices all profoundly impact both health and quality of life. Following its predecessors, Lifestyle Medicine, Third Edition, is edited by lifestyle medicine pioneer, cardiologist Dr. James Rippe. This edition has been thoroughly updated and represents the expert opinions of 20 section editors as well as more than 150 expert chapter authors whose knowledge span all aspects of this emerging discipline. Topics cover lifestyle medicine practices including regular physical activity, proper nutrition, and weight management. These principles are applied to the prevention and or treatment of a wide variety of chronic conditions ranging from heart disease and diabetes to cancer, mental health, addiction, and injury prevention. This book serves as evidence base for individuals who wish to practice lifestyle medicine or incorporate some of its principles into either general medicine or subspecialty practice. It provides valuable information to healthcare workers in the fields of nutrition, exercise physiology, psychology, behavioral medicine, health promotion, and public policy where lifestyle medicine principles play an ever-increasing role.

Manual of Lifestyle Medicine

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Author :
Publisher : CRC Press
ISBN 13 : 1000381404
Total Pages : 223 pages
Book Rating : 4.0/5 (3 download)

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Book Synopsis Manual of Lifestyle Medicine by : James M. Rippe

Download or read book Manual of Lifestyle Medicine written by James M. Rippe and published by CRC Press. This book was released on 2021-05-06 with total page 223 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental premise of lifestyle medicine is that daily habits profoundly impact health and quality of life both in the short-term and long-term. Written by lifestyle medicine pioneer and cardiologist , Dr. James Rippe, this book provides a clinically oriented, evidence-based look into key lifestyle factors and how to prescribe them to individuals of all ages. Written for professionals working at all levels of medical and healthcare practice, this manual summarizes the major components of lifestyle medicine, from physical activity and nutrition to weight management and the avoidance of tobacco products. It includes clinical guidelines and practices for using lifestyle medicine principles to lower the risk of numerous chronic conditions. The manual also provides information on behavior change, approaches to lowering the risk of dementia, treatment of addictions and injury prevention. Features: Explains how lifestyle medicine can reduce the risk of heart disease, diabetes, cancer, osteoarthritis, dementia and many other chronic conditions. Chapters begin with bulleted key points and conclude with a list of clinical applications. Provides strategies for prescribing physical activity and helping patients improve their nutrition, lose weight if necessary and reduce stress. Includes clinically relevant sections on “Treating Addiction, Preventing Injury and Improving Brain Health”. This book provides updated and clinically targeted summaries used in conjunction with Dr. Rippe's major academic textbook Lifestyle Medicine, now in its third edition, published by CRC Press/Taylor & Francis Group, LLC.

Lifestyle Medicine

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Publisher : Academic Press
ISBN 13 : 0128104260
Total Pages : 484 pages
Book Rating : 4.1/5 (281 download)

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Book Synopsis Lifestyle Medicine by : Garry Egger

Download or read book Lifestyle Medicine written by Garry Egger and published by Academic Press. This book was released on 2017-03-18 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease, Third Edition, is an adjunct approach to health practice that seeks to deal with the more complex modern determinants of chronic diseases—primarily lifestyle and the environments driving such lifestyles—in contrast to the microbial ‘causes’ of infectious disease. Our lifestyle choices have a profound effect on our health. As we live longer, one thing is clear: many of us will spend time living with injury and chronic illness due to our own choices. Changes in health patterns typically follow shifts in living conditions. Disease patterns have changed worldwide, from infectious to chronic diseases such as obesity, diabetes, and heart disease. This change has been so emphatic—nearly 70% of all presentations to a doctor in modern western societies are now chronic disease related—that medical services are being forced to change to accommodate this. New chapters in this third edition explain the link between energy intake and expenditure; consider how modern technology are determinants of chronic disease; show how environmental influences, such as endocrine disruptors, influence our health; and summarize recent research on early childhood experiences and chronic disease. Explores the relationship between lifestyle and environmental drivers and the major modern chronic diseases Outlines the knowledge and skills bases required by health professionals to deal with lifestyle and environmental determinants of chronic disease, as well as the tools and procedures available for doing this Develops pedagogy for Lifestyle Medicine that will enable it to become a practical adjunct to conventional health and medical practice Features new chapters explaining the link between energy intake and expenditure, and more

Lifestyle Medicine for Chronic Diseases: An Introduction to the Evidence-Based Approach of Managing Chronic Diseases with Lifestyle Therapeutics, Second Edition

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Author :
Publisher : Lulu.com
ISBN 13 : 0359239722
Total Pages : 192 pages
Book Rating : 4.3/5 (592 download)

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Book Synopsis Lifestyle Medicine for Chronic Diseases: An Introduction to the Evidence-Based Approach of Managing Chronic Diseases with Lifestyle Therapeutics, Second Edition by : Thomas Lenz

Download or read book Lifestyle Medicine for Chronic Diseases: An Introduction to the Evidence-Based Approach of Managing Chronic Diseases with Lifestyle Therapeutics, Second Edition written by Thomas Lenz and published by Lulu.com. This book was released on 2018-11-20 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lifestyle medicine is the use of lifestyle behaviors to prevent, treat, and manage chronic disease. A particularly important aspect of lifestyle medicine is the use of an evidence-based approach to inform and guide lifestyle behavior strategies. The purpose of Lifestyle Medicine for Chronic Diseases is to provide foundational knowledge at an introductory level to those interested in using lifestyle therapeutics in the treatment plan of individuals with chronic diseases. The most up-to-date information on the core elements of lifestyle therapeutics are presented and applied to chronic diseases in an evidence-based approach. The Lifestyle Medicine Toolbox at the end of the text provides practical tools that can be used when implementing lifestyle strategies.

Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease

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Publisher :
ISBN 13 :
Total Pages : 8 pages
Book Rating : 4.3/5 (121 download)

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Book Synopsis Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease by : Cheryl D. Fryar

Download or read book Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease written by Cheryl D. Fryar and published by . This book was released on 2012 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Integrative Preventive Medicine

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Publisher : Oxford University Press
ISBN 13 : 019024125X
Total Pages : 585 pages
Book Rating : 4.1/5 (92 download)

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Book Synopsis Integrative Preventive Medicine by : Richard H. Carmona

Download or read book Integrative Preventive Medicine written by Richard H. Carmona and published by Oxford University Press. This book was released on 2017-12-12 with total page 585 pages. Available in PDF, EPUB and Kindle. Book excerpt: For most clinicians, the science and evidence for many integrative therapies is largely unknown or considered suspect. Most physicians don't have time to learn integrative approaches and aren't sure what to recommend or which approaches have merit or improved outcomes. Here, clinicians have easy access to the best practices in integrative medicine and expectations for outcomes

Nutrition in Lifestyle Medicine

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Publisher : Humana Press
ISBN 13 : 3319430270
Total Pages : 433 pages
Book Rating : 4.3/5 (194 download)

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Book Synopsis Nutrition in Lifestyle Medicine by : James M. Rippe

Download or read book Nutrition in Lifestyle Medicine written by James M. Rippe and published by Humana Press. This book was released on 2016-12-29 with total page 433 pages. Available in PDF, EPUB and Kindle. Book excerpt: This newest addition to the Nutrition and Health series focuses on nutrition’s key role in lifestyle interventions to prevent and manage diseases. The book pays particular attention to nutritional considerations related to obesity, diabetes, and cardiovascular disease. Edited by cardiologist, Dr. James Rippe, a well-known expert in the nascent specialty of Lifestyle Medicine, Nutrition in Lifestyle Medicine will also focus on a variety of specialized areas such as nutrition for athletes and physically active individuals, hydration, and nutrition throughout the life cycle (spanning from children to individuals over the age of 60). In addition, chapters will be included on controversies in nutrition, such as health effects of added sugars and saturated fatty acids in the diet. Finally, specialized chapters will be included in such areas as nutrition for women, nutrition for men, nutrition for latinos, the use of supplements, communication about nutrition, public policy issues, and the interface between nutrition and physical activity. Lifestyle Medicine, supported by the American Journal of Lifestyle Medicine, Dr. Rippe’s textbook Lifestyle Medicine (CRC Press, 2013) and American College of Lifestyle Medicine (ACLM), is a new national medicine specialty that stresses the use of lifestyle interventions in the treatment and management of disease. Its practitioners effectively manage medical treatments alongside the lifestyle interventions, for example lowering insulin treatment for patients with diabetes, reducing the dose of anti-hypertension medications for people with hypertension, and prescribing certain medical interventions that aid in smoking cessation.

Creating a Lifestyle Medicine Center

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Author :
Publisher : Springer Nature
ISBN 13 : 3030480887
Total Pages : 374 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Creating a Lifestyle Medicine Center by : Jeffrey I. Mechanick

Download or read book Creating a Lifestyle Medicine Center written by Jeffrey I. Mechanick and published by Springer Nature. This book was released on 2020-09-04 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the groundbreaking work Lifestyle Medicine (2016), this unique new book bridges the gap between theory and practice by providing detailed information on the real-world development and creation of a Lifestyle Medicine Center, whether independently or as part of an established medical program or department. Part one sets the stage by establishing the rationale for creating a Lifestyle Medicine Center as well as the medical and economic burden it seeks to alleviate. The construction of the physical facility and all of the myriad details of the program and its key players are covered in part two, from the structural to the aesthetic, including informatics, developing patient resources and education tools, current technologies and applications, the role of the dietitian and exercise physiologist, inpatient consultation, the importance of community engagement, and more. Part three is comprised of case studies of existing, successful Lifestyle Medicine Centers across the country, with detailed descriptions of their history, development, programs and challenges. Chapters are supported with plentiful figures, tables and useful links. The burden of chronic disease in the U.S. and globally is growing, with pervasive direct and indirect multi-scale adverse effects on health and well-being, economics, and quality of life. Notwithstanding the remarkable progress in biomedical technology, the role of lifestyle medicine in managing chronic disease in a preventive care model is paramount; however, the relevant and effective education in lifestyle medicine is lacking. Translating the theory into action steps, instantiated by case studies with critical interpretations and problem-solving tools, Creating a Lifestyle Medicine Center is the go-to resource for family and primary care physicians, internal medicine physicians, and all clinical specialties interested in planning and developing a lifestyle medicine program.

Improving Women’s Health Across the Lifespan

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Author :
Publisher : CRC Press
ISBN 13 : 1000472493
Total Pages : 460 pages
Book Rating : 4.0/5 (4 download)

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Book Synopsis Improving Women’s Health Across the Lifespan by : Michelle Tollefson

Download or read book Improving Women’s Health Across the Lifespan written by Michelle Tollefson and published by CRC Press. This book was released on 2021-10-24 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book is an evidence-based source of information on women’s health issues for health professionals already practicing lifestyle medicine, as well as an entry level textbook for those new to the field of lifestyle medicine. The collective expertise of each of the editors along with content provided by leaders within the American College of Lifestyle Medicine fills a much-needed void within the specialty of Lifestyle Medicine and is for providers of women’s health globally.

Personalized and Precision Integrative Cardiovascular Medicine

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Author :
Publisher : LWW
ISBN 13 : 9781975115289
Total Pages : 0 pages
Book Rating : 4.1/5 (152 download)

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Book Synopsis Personalized and Precision Integrative Cardiovascular Medicine by : Mark C. Houston

Download or read book Personalized and Precision Integrative Cardiovascular Medicine written by Mark C. Houston and published by LWW. This book was released on 2019-12-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Personalized and Precision Integrative Cardiovascular Medicine embraces a systems-oriented medical approach that works to identify and understand the underlying or root causes of disease. It takes into account the personalization of healthcare as each patient is unique. It employs in-depth health history taking, scientific testing and environmental and lifestyle review. It is used as disease prevention and for the treatment of chronic conditions (such as heart disease) through nutrition, supplementation, life-style changes, and stress management. Integrative Medicine is a model of healthcare in which conventional Western medicine is integrated with non-conventional or alternative modalities. And Metabolic Medicine/Cardiology is a newer field of medicine which concentrates on the prevention, management and treatment of cardiovascular disease at the cellular level through biochemical interventions. All three of these complementary approaches to Cardiovascular Medicine will be covered in this new title"--

Increasing Physical Activity: A Practical Guide

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Author :
Publisher : CRC Press
ISBN 13 : 1000224473
Total Pages : 216 pages
Book Rating : 4.0/5 (2 download)

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Book Synopsis Increasing Physical Activity: A Practical Guide by : James M. Rippe

Download or read book Increasing Physical Activity: A Practical Guide written by James M. Rippe and published by CRC Press. This book was released on 2020-11-17 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: Only a fifth of adults in the United States do enough physical activity to meet the guidelines set by Centers for Disease Control. The health benefits of regular physical activity are beyond dispute, yet less than 40% of physicians routinely counsel their patients on the importance of physical activity. Increasing Physical Activity: A Practical Guide equips healthcare practitioners to include physical activity counseling in the daily practice of medicine. Written by lifestyle medicine pioneer and cardiologist, Dr James Rippe, this book proves inactivity is a stronger risk factor than other lifestyle factors for cardiovascular disease, diabetes, and many other diseases. It provides evidence-based information on the role of physical activity in preventing and treating chronic conditions and includes practical strategies for healthcare practitioners to prescribe this powerful method to enhance both short and long-term health and quality of life. Features: Specific chapters explain the role of physical activity in reduction of risk of heart disease, diabetes, cancer, osteoarthritis, dementia and many other chronic conditions. Chapters begin with bulleted, key points and conclude with a list of clinical applications. Strategies are provided to encourage previously sedentary individuals to adopt regular physical activity. Physical activity is placed in the context of other lifestyle medicine concepts including maintenance of a healthy body weight, following sound nutritional practices, stress reduction and other practices which impact on health and quality of life. Written for healthcare practitioners at all levels, this is a user-friendly, evidence-based manual for healthcare practitioners looking to incorporate more physical activity counseling into either general medicine or subspecialty practices.