bluuebunny/crossref_metadata_2025 huggingface dataset:
Le parrainage informel. Les rapports donateurs occidentaux-récipiendaires tibétains exilés en Inde
Authors: Julie Humeau
Published: December 2011

Cet article examine les rapports de don entre les exilés tibétains et les Occidentaux engagés dans un parrainage informel. L’exposé invite d’abord à comprendre les logiques de cette relation de parrainage située hors de tout cadre associatif et les jeux de négociation qu’elle suppose. Il s’agit ensuite de dégager les termes de cet accord entre Occidentaux et Tibétains qui conditionnent et font perdurer le don. Peu à peu, l’analyse dévoile l’adéquation idéologique entre parrainage et don bouddhique. Ce dernier se fonde sur le rapport moine/laïc et sur l’articulation des dimensions spirituelle et matérielle. Enfin, le système du parrainage informel est mis en perspective avec les exigences politiques qu’implique l’exil. On y entrevoit comment le soutien matériel occidental renforce la conscience nationale tibétaine mais apporte aussi des dérives, dans le sens où les comportements des récipiendaires s’écartent de la norme imposée par les dirigeants tibétains.
Les hasards de la variole
Authors: Rohrbasser Jean-Marc
Published: December 2011

La nécessité d’un calcul ayant pour fin d’estimer un risque peut être révoquée en doute lorsqu’il s’agit de prendre une décision en situation d’incertitude, a fortiori lorsqu’il s’agit d’une question de vie ou de mort. Dans la controverse engagée sur l’opportunité d’inoculer la variole, la position de D’Alembert constitue un cas exemplaire de scepticisme portant sur l’application des mathématiques, et en l’occurrence du calcul des probabilités, à des décisions relatives à la vie humaine. D’Alembert, en effet, conteste aux mathématiques sociales le pouvoir de rendre compte de phénomènes humains en y cherchant des régularités et des formalisations sans dissocier les dimensions mathématiques et probabilistes des dimensions philosophiques et éthiques. En suivant le débat qui, au milieu du xviiie siècle, se déroule entre le mathématicien français et son homologue suisse Daniel Bernoulli, on assiste à l’un des épisodes de la lente gestation des notions de prise de risque, de décision et de rationalité.
Pre-B Cell Leukemia Homeobox 1 Is Associated with Lupus Susceptibility in Mice and Humans
Authors: Cuda Carla M. , Li Shiwu , Liang Shujuan , Yin Yiming , Potula Hari Hara S. K. , Xu Zhiwei , Sengupta Mayami , Chen Yifang , Butfiloski Edward , Baker Henry , Chang Lung-Ji , Dozmorov Igor , Sobel Eric S. , Morel Laurence
Published: December 2011

Sle1a.1 is part of the Sle1 susceptibility locus, which has the strongest association with lupus nephritis in the NZM2410 mouse model. In this study, we show that Sle1a.1 results in the production of activated and autoreactive CD4+ T cells. Additionally, Sle1a.1 expression reduces the peripheral regulatory T cell pool, as well as induces a defective response of CD4+ T cells to the retinoic acid expansion of TGF-β–induced regulatory T cells. At the molecular level, Sle1a.1 corresponds to an increased expression of a novel splice isoform of Pbx1, Pbx1-d. Pbx1-d overexpression is sufficient to induce an activated/inflammatory phenotype in Jurkat T cells and to decrease their apoptotic response to retinoic acid. PBX1-d is expressed more frequently in the CD4+ T cells from lupus patients than from healthy controls, and its presence correlates with an increased central memory T cell population. These findings indicate that Pbx1 is a novel lupus susceptibility gene that regulates T cell activation and tolerance.
Attenuated, Oncolytic, but Not Wild-Type Measles Virus Infection Has Pleiotropic Effects on Human Neutrophil Function
Authors: Zhang Yu , Patel Bella , Dey Aditi , Ghorani Ehsan , Rai Lena , Elham Mohammed , Castleton Anna Z. , Fielding Adele K.
Published: December 2011

We previously showed that neutrophils play a role in regression of human tumor xenografts in immunodeficient mice following oncolytic vaccine measles virus (MV-Vac) treatment. In this study, we sought, using normal human neutrophils, to identify potential neutrophil-mediated mechanisms for the attenuated MV-Vac induced effects seen in vivo, by comparison with those consequent on wild-type (WT-MV) infection. Both MV-Vac and WT-MV infected and replicated within neutrophils, despite lack of SLAM expression. In both cases, neutrophils survived longer ex vivo postinfection. Furthermore, MV-Vac (but not WT-MV) infection activated neutrophils and stimulated secretion of several specific antitumor cytokines (IL-8, TNF-α, MCP-1, and IFN-α) via induction of de novo RNA and protein synthesis. In addition, MV-Vac (but not WT-MV) infection caused TRAIL secretion in the absence of de novo synthesis by triggering release of prefabricated TRAIL, via a direct effect upon degranulation. The differences between the outcome of infection by MV-Vac and WT-MV were not entirely explained by differential infection and replication of the viruses within neutrophils. To our knowledge, this is the first demonstration of potential mechanisms of oncolytic activity of an attenuated MV as compared with its WT parent. Furthermore, our study suggests that neutrophils have an important role to play in the antitumor effects of oncolytic MV.
Localized Production of IL-10 Suppresses Early Inflammatory Cell Infiltration and Subsequent Development of IFN-γ–Mediated Lyme Arthritis
Authors: Sonderegger F. Lynn , Ma Ying , Maylor-Hagan Heather , Brewster James , Huang Xiaosong , Spangrude Gerald J. , Zachary James F. , Weis John H. , Weis Janis J.
Published: December 2011

IL-10 is a nonredundant inflammatory modulator that suppresses arthritis development in Borrelia burgdorferi-infected mice. Infected C57BL/6 (B6) IL-10−/− mice were previously found to have a prolonged IFN-inducible response in joint tissue. Infection of B6 IL-10 reporter mice identified macrophages and CD4+ T cells as the primary sources of IL-10 in the infected joint tissue, suggesting that early local production of IL-10 dampened the proarthritic IFN response. Treatment of B6 IL-10−/− mice with anti–IFN-γ reduced the increase in arthritis severity and suppressed IFN-inducible transcripts to wild-type levels, thereby linking dysregulation of IFN-γ to disease in the B6 IL-10−/− mouse. Arthritis in B6 IL-10−/− mice was associated with elevated numbers of NK cell, NKT cell, α/β T cell, and macrophage infiltration of the infected joint. FACS lineage sorting revealed NK cells and CD4+ T cells as sources of IFN-γ in the joint tissue of B6 IL-10−/− mice. These findings suggest the presence of a positive-feedback loop in the joint tissue of infected B6 IL-10−/− mice, in which production of inflammatory chemokines, infiltration of IFN-γ–producing cells, and additional production of inflammatory cytokines result in arthritis. This mechanism of arthritis is in contrast to that seen in C3H/He mice, in which arthritis development is linked to transient production of type I IFN and develops independently of IFN-γ. Due to the sustained IFN response driven by NK cells and T cells, we propose the B6 IL-10−/− mouse as a potential model to study the persistent arthritis observed in some human Lyme disease patients.
Cutting Edge: Persistence of Increased Mast Cell Numbers in Tissues Links Dermatitis to Enhanced Airway Disease in a Mouse Model of Atopy
Authors: Hershko Alon Y. , Charles Nicolas , Olivera Ana , Alvarez-Errico Damiana , Rivera Juan
Published: December 2011

The development of chronic allergic dermatitis in early life has been associated with increased onset and severity of allergic asthma later in life. However, the mechanisms linking these two diseases are poorly understood. In this study, we report that the development of oxazolone-induced chronic allergic dermatitis, in a mouse model, caused enhanced OVA-induced allergic asthma after the resolution of the former disease. Our findings show that oxazolone-induced dermatitis caused a marked increase in tissue mast cells, which persisted long after the resolution of this disease. Subsequent OVA sensitization and airway challenge of mice that had recovered from dermatitis resulted in increased allergic airway hyperreactivity. The findings demonstrate that the accumulation of mast cells during dermatitis has the detrimental effect of increasing allergic airway hypersensitivity. Importantly, our findings also show that exposure to a given allergen can modify the immune response to an unrelated allergen.
STAT6-Dependent Regulation of Th9 Development
Authors: Goswami Ritobrata , Jabeen Rukhsana , Yagi Ryoji , Pham Duy , Zhu Jinfang , Goenka Shreevrat , Kaplan Mark H.
Published: December 2011

Th cell effector subsets develop in response to specific cytokine environments. The development of a particular cytokine-secreting pattern requires an integration of signals that may promote the development of opposing pathways. A recent example of this paradigm is the IL-9–secreting Th9 cell that develops in response to TGF-β and IL-4, cytokines that, in isolation, promote the development of inducible regulatory T cells and Th2 cells, respectively. To determine how the balance of these factors results in priming for IL-9 secretion, we examined the effects of each pathway on transcription factors that regulate Th cell differentiation. We demonstrated that TGF-β induces the PU.1-encoding Sfpi1 locus and that this is independent of IL-4–induced STAT6 activation. IL-4–activated STAT6 is required for repressing the expression of T-bet and Foxp3 in Th9 cells, transcription factors that inhibit IL-9 production, and STAT6 is required for the induction of IRF4, which promotes Th9 development. These data established a transcription factor network that regulates IL-9 and demonstrated how combinations of cytokine signals generate cytokine-secreting potential by altering the expression of a panel of transcription factors.
Paratesticular Liposarcoma: A Radiologic Pathologic Correlation
Authors: Pergel Ahmet , Yucel Ahmet Fikret , Aydin Ibrahim , Sahin Dursun Ali , Gucer Hasan , Kocakusak Ahmet
Published: December 2011

Spermatic cord liposarcoma is an uncommon paratesticular tumor. Patients usually present with a painless scrotal or inguinal mass, mimicking inguinal hernia. Clinical examination suggested an inguinal hernia. Computed tomography demonstrated a fat-containing mass in the right inguinal region. The mass was surgically removed, along with the right testis and spermatic cord. Histopathological examination revealed a well-differentiated liposarcoma. No evidence of recurrence or metastases has been noted during the two-year follow-up with postoperative adjuvant therapy.
F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography Findings in a Rare Case of Penile Leiomyosarcoma
Authors: Manohar Kuruva , Mittal Bhagwant Rai , Kashyap Raghava , Bhattacharya Anish , Kakkar Nandita , Mete Uttam Kumar
Published: December 2011

Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.
Changes in Smoking Associated with Hospitalization: Quit Rates, Predictive Variables, and Intervention Implications
Authors: Glasgow Russell E. , Stevens Victor J. , Vogt Thomas M. , Mullooly John P. , Lichtenstein Edward
Published: December 2011

Background.

Hospitalization can provide one of the most opportune times to prompt smoking cessation. This study determined the frequency of various smoking cessation related behaviors occurring during and following hospitalization and identified variables associated with these outcomes.

Methods.

A sample of 526 HMO members who smoked prior to hospitalization and were hospitalized for nonpregnancy related, nonterminal conditions were surveyed to assess the natural history of smoking cessation associated with hospitalization.

Results.

Three events were studied: not smoking while hospitalized (51 % of subjects), attempting to quit following hospitalization (37%), and smoking status one year after hospitalization (16% abstinent). Similar factors were associated with not smoking in the hospital and quit attempts: older persons and patients with circulatory/respiratory diagnoses were only half as likely to smoke in the hospital as other patients and twice as likely to try to quit. Different variables predicted smoking status at follow-up: heavier smokers were significantly more likely to stop (26% cessation) than light or moderate smokers (10 % and 11 % cessation, respectively).

Discussion.

The hospital may be an effective setting for smoking cessation programs, especially those aimed at heavy smokers. Research is needed to determine whether smokefree hospital policies alter smoking rates following hospitalization. (Am J Health Promot, 1991; 6(1): 24-29).
World Views, Systems Theory, and Health Promotion
Authors: Nicholas Donald R. , Gobble David C.
Published: December 2011

As the field of health promotion grows, it is important to investigate new conceptual and theoretical models of health. To date, health promotion has relied primarily on theories and models from other fields. This limits the development of health promotion as a discipline. These limitations become apparent when health promotion programming is analyzed from three different “world views”: formism, mechanism, and organicism. The health promotion professional's “world view” affects the manner in which they plan programs. As a discipline, health promotion needs to move beyond the current dominance of the mechanistic world view to organismic or systemic thinking. In doing so, general systems theory provides a generic, contentless theoretical framework to guide newly developing health promotion programs.
Associations between Health Risk Appraisal Scores and Employee Medical Claims Costs in a Manufacturing Company
Authors: Yen Louis Tze-ching , Edington Dee W. , Witting Pam
Published: December 2011

Background.

The bivariate relationships between 18 health-related measures on a health appraisal and prospective medical claims costs were examined among 1,838 employees for three consecutive years.

Methods.

Employees were classified into high- or low-risk categories for each of the 18 health-related measures, and divided into high- or low-cost categories according to their averaged three-year medical costs respective to the mean of their sex/age subgroup.

Results.

Average annual medical costs for the 18 health-related measures were $67 to $778 higher for the employees classified at high risk. The high-cost category was statistically associated with high-risk status in 11 of 18 health-related measures with a high-cost/high-risk to high-cost/low-risk ratio of 1.26 to 2.50. The average annual medical claims costs were also significantly related to number of high-risk classifications.

Discussion.

This study provides strong statistical evidence that, regardless of age and sex, employees in this sample with positive behaviors cost less in medical claims from 11 of 18 health-related measures.
A Conceptual Framework for the Roles of Legislation and Education in Reducing Exposure to Environmental Tobacco Smoke
Authors: Pederson Linda L. , Wanklin James M. , Bull Shelley B. , Ashley Mary Jane
Published: December 2011

More and more legislation regulating smoking in public places is being enacted. A conceptual model is proposed incorporating a large number of factors that may affect smokers' compliance with resulting restrictions. The model stems from findings in our own research and from a consideration of the literature. It includes individual variables such as personality characteristics and attitudes, as well as population variables such as social norms and political and economic factors. Education about the health effects of environmental tobacco smoke and attitudes toward legislative measures regulating smoking, in the context of a supportive environment, are postulated to directly affect personal compliance with regulations. Some directions for future research and implications for public policy are presented.
Threats to Internal Validity in Worksite Health Promotion Program Research: Common Problems and Possible Solutions
Authors: Conrad Karen M. , Conrad Kendon J. , Walcott-McQuigg Jacqueline
Published: December 2011

Reviews of the research on worksite health promotion programs reveal that most studies are limited in their ability to draw clear inferences about program effects because the studies employed flawed research designs and/or analyses. Conclusions are often drawn about program effectiveness with little consideration given to alternative explanations for the findings. In an effort to promote improved research, this article uses the Cook and Campbell delineation of threats to valid causal inference to illustrate how the threats can operate in worksite health promotion program research as well as how they can be examined and controlled. Researchers, even those attempting to conduct true experiments, must consider the existence of all plausible threats to validity and control or rule them out before valid causal inferences can be drawn. The theoretical and design issues involved in worksite health promotion program research are presented, followed by a discussion of threats to internal validity.
The Inadequacy of Using Means to Compare Medical Costs of Smokers and Nonsmokers
Authors: Lynch Wendy D. , Teitelbaum Howard S. , Main Deborah S.
Published: December 2011

The costs associated with health risks have become a primary focus in the field of health promotion. Unfortunately, the nature and quality of medical cost data are not ideal for simple comparisons of health risk groups. Most health promotion professionals have had little or no training on how to interpret cost data and are thus unaware of the limitations and problems inherent in cost comparisons. This report illustrates the problems encountered when using cost data, using examples from a medical claims dataset. Specifically, the potential errors that result from comparing group means are shown. A set of alternatives for practitioners and researchers to consider when comparing costs for different groups are offered.
Maximizing Worksite Survey Response Rates through Community Organization Strategies and Multiple Contacts
Authors: Thompson Beti , Bowen Deborah J. , Croyle Robert T. , Hopp Helen P. , Fries Elizabeth
Published: December 2011

Background.

Worksites are natural settings for health promotion. In many cases, the effectiveness of such interventions is appraised by surveying employees to assess worksite-wide changes in the targeted behavior. Little attention has been paid to increasing worksite survey response rates. One way is to utilize community organization strategies, which involve enlisting the individuals within a group to work together with researchers to affect the social environment.

Methods.

Community organization strategies and multiple contacts were used to obtain responses from employees in five worksites involved in a smoking cessation project. Employee Advisory Board members in each worksite reviewed, adapted, and revised the survey distribution method, the messages that accompanied the survey, and the survey content. Three major survey waves were undertaken: a worksite effort, a home mailing (in the pilot worksite only), and a telephone call to nonrespondents.

Results.

Response rates to a worksite-wide survey in one worksite the first year and four additional worksites the next year yielded 99.3% and 98.4% response rates, respectively. In the pilot worksite, 273 employees were eligible for the survey with 366 eligible employees in the four other worksites. Chi-square or analysis of variance computations were used, as appropriate, to test for differences in characteristics of respondents in the various data collection waves.

Discussion.

These results suggest that there may be merit in adapting such community organization intervention methods for research applications.
Reporting Evaluation Results
Authors: Broughton Walter
Published: December 2011

The major purpose of program evaluation is to provide information that can be used in decision-making by program administrators and other interested parties. How to communicate that information clearly and persuasively is the subject of this article. Sensitivity to the cognitive styles of the intended audience(s) and awareness of one's own areas of uncertainty are first recommended. In addition, guidelines are offered to help achieve a clear and persuasive report, ways to effectively present results to various audiences are reviewed, and advice is provided on how to minimize the likelihood of hostile political responses to major findings. Finally, evaluation researchers are urged to share their results with others interested in the evaluation of health promotion programs through publication or presentation at professional meetings to create an influential body of cumulative research findings.
Support for Restrictive Tobacco Policies among Residents of Selected Minnesota Communities
Authors: Forster Jean L. , McBride Colleen , Jeffery Robert , Schmid Thomas L. , Pirie Phyllis L.
Published: December 2011

Background.

Tobacco related diseases remain the most important public health problem. Public policy approaches to tobacco control have been used historically, and remain a viable, though largely untested, tobacco control strategy. The purpose of this article is to report assessment of support for tobacco control policies among the general public.

Methods.

A random sample of 821 residents from seven Minnesota communities was surveyed by telephone to assess their support for 12 measures designed to restrict smoking behavior and curb demand for tobacco. Some of these policies were similar to those already in place, while others had not yet been adopted.

Results.

Over 50% of the respondents indicated that they strongly favored or some-what favored each of the measures, suggesting that a constituency exists for further regulation of tobacco. Measures that restrict tobacco advertising, prohibit smoking in public places, increase the penalties for selling tobacco to minors, and reduce access of young people to tobacco are especially popular. omen, nonsmokers, and older people form the basis of support for these measures.

Conclusions.

These results suggest that Minnesota citizens are more supportive of restrictive tobacco control policies than policy makers might believe, and that more aggressive lobbying on behalf of such measures at the state and local level is warranted.
Personal Power Imagery and Relaxation Techniques Used in Smoking Cessation Programs
Authors: Wynd Christine A.
Published: December 2011

Background.

Theoretically-based interventions are necessary for enhancing the power of self-control behaviors in smokers attempting to quit smoking cigarettes. The purpose of this study was to examine the use of guided imagery and relaxation techniques as interventions for smoking cessation. The relationship of imagery and self-control was also examined.

Methods.

A convenience sample of 84 adult smokers participated in one of three treatment conditions: power imagery (n = 28), relaxation imagery (n =29), and “placebo” control (n = 27). Treatment group members were taught imagery during a six-session smoking cessation program, and the control group was provided imagery training upon study completion.

Results.

Smoking quit rates were 67% for the power imagery group, 69 % for the relaxation group, and 27% for the control group. At a three-month follow-up, the power imagery group had a continued abstinence rate of 52 % (relapse rate = 48 %), the relaxation group had an abstinence rate of 55% (relapse rate = 45 %), and the control group cessation rate remained at 27% (relapse rate = 73%). One-way and repeated measures MANOVAs demonstrated significant differences among the three groups at posttreatment, F (8, 158) = 13.92, p < .05, and revealed that the practice of imagery treatments over time produced changes in power test scores and smoking rates, F(3, 127) = 24.67, p < .05.

Discussion.

This study demonstrated that power and relaxation imagery treatments were equally effective in reducing smoking rates. Further investigations into the therapeutic uses of imagery are recommended.
Health Messages on Television Commercials
Authors: Wallack Lawrence , Dorfman Lori
Published: December 2011

Background and Purpose.

Television is an important source of health information in the United States, yet little research has focused on the presentation of general health issues on television. This preliminary study reports on the health-related content of television commercials found on a typical television day.

Methods.

We conducted a content analysis of a composite day of television comprising 20 hours randomly selected over a three week period (April-May 1989). Findings are presented regarding health messages found in commercial time — advertisements, public service announcements (PSAs), editorials, and promotions for upcoming programs.

Results.

Overall, 31 % of the 654 commercial spots contained health messages. Most health messages were claims of good nutrition in food and beverage advertisements. PSAs comprise 1.4% of the 20-hour sample and 5.8% of the commercial time. Health messages appeared in 38% of PSAs, accounting for less than seven minutes. Not one PSA addressed tobacco, alcohol, or diet — the three leading behavioral risk factors for poor health.

Discussion.

PSAs are usually seen as a mechanism by which the public health community can alert the public to important health issues. Given the declining pool of PSA time, public health educators will need to seek alternative strategies for influencing television content, such as media advocacy. In addition, further research on audience interpretation and response to commercial messages is suggested.
Powerlessness, Empowerment, and Health: Implications for Health Promotion Programs
Authors: Wallerstein Nina
Published: December 2011

Purpose and Scope.

This article reviews the health and social science research relevant to both the role of powerlessness as a risk factor for disease, and the role of empowerment as a health-enhancing strategy. The research literature surveyed includes studies that address these key concepts from the fields of social epidemiology, occupational health, stress research, social psychology, community psychology, social support and networks, community competence and community organizing. Definitions are provided to operationalize these sometimes loosely-applied terms.

Important Findings.

Powerlessness, or lack of control over destiny, emerges as a broad-based risk factor for disease. Empowerment, though more difficult to evaluate, can also be demonstrated as an important promoter of health.

Major Conclusions.

Given the importance and currency of these concepts of powerlessness and empowerment, a model of empowerment education is proposed for health-promotion practitioners. Measurement of empowerment raises issues for researchers on how to test the multiple personal and community changes that may result from an empowering education intervention.
Comparing Medical Costs by Analyzing High-Cost Cases
Authors: Lynch Wendy D. , Teitelbaum Howard S. , Main Deborah S.
Published: December 2011

Most of the medical care expenses paid by an entire company are generated by a small percentage of employees. The most expensive employee may have costs 100 to 500 times as much as the typical employee. Instead of comparing average costs, it makes sense to investigate whether employees with unhealthy behaviors are more prone to extreme costs. This article describes methods of comparing the costs of health risk groups by examining the proportion of high-cost employees in each group. The article illustrates the methods using a health claims dataset that compares male smokers, ex-smokers, and nonsmokers.
Measuring the Diffusion of Innovative Health Promotion Programs
Authors: Steckler Allan , Goodman Robert M. , McLeroy Kenneth R. , Davis Sonia , Koch Gary
Published: December 2011

Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were develóped within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.
Smoking Cessation in Texas-Mexico Border Communities: A Quasi-Experimental Panel Study
Authors: McAlister Alfred L. , Ramirez Amelie G. , Amezcua Cesareo , Pulley LeaVonne , Stern Michael P. , Mercado Salvador
Published: December 2011

Background.

Smoking-related disease and injury is prominent among the numerous health problems on the U. S.-Mexico border, but little is known about the methods that might help promote smoking cessation among the low-income populations in this region.

Method.

Media campaigns were combined with different forms of intensive and community-wide interpersonal communication to encourage smoking cessation in a border U. S. city and in a Mexican city. Panels of moderate to heavy smokers were followed in four groups to allow quasi-experimental comparison of smoking cessation rates.

Results.

Over a five-year study period smoking cessation rates of 17% (self-reported) and 8% (verified) were observed in panels in the program community (N = 160). In the comparison community (N = 135) corresponding rates of smoking cessation were 7% (self-reported) and 1.5% (verified). Within the program community, no differences were observed in smoking cessation among smokers exposed to a community-wide program and those assigned to receive personal counseling.

Discussion.

Although the observed changes in smoking were unexpectedly small in the treatment and comparison groups, the approximately 8% effect size for the community-wide program was close to what was predicted. Results indicate that such programs may yield effects similar to those of more intensive approaches, but further research with greater statistical power will be necessary to confirm that point.
Putting Stress into Words: The Impact of Writing on Physiological, Absentee, and Self-Reported Emotional Well-Being Measures
Authors: Francis Martha E. , Pennebaker James W.
Published: December 2011

Background and Purpose.

Inhibiting or holding back one's thoughts, feelings, or behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences can reduce the negative effects of inhibition. The present study describes a unique approach to aid individuals in dealing with psychological and emotional issues that they must often face.

Methods.

Forty-one of the 81 university employees who were participating in a wellness program agreed to participate in the present study. Subjects were randomly assigned to write about either personal traumatic experiences (n = 23) or non-traumatic topics (n = 18) for 20 minutes once a week for four consecutive weeks.

Results.

Results indicate that individuals who wrote about upsetting personal experiences evidenced significant drops in selected blood measures compared to those who wrote about non-traumatic topics (e.g., for SGOT: 4.0% drop among traumatic topic group versus 13.1% increase among non-traumatic topic group, ANOVA p = .029; for SGPT: 24.5% drop versus 7.7% increase, p =. 001). During the month of writing, traumatic topic group subjects evidenced a 28.6% reduction in absentee rates from work relative to the eight months before the experiment compared with a 48.5% increase in absentee rates among non-traumatic topic subjects (p =. 04). Subjects low in emotional inhibition evidenced the greatest reductions in absentee rates following personal disclosure compared to those high in emotional inhibition (p = .011).

Discussion.

The proposed writing strategy offers a unique tool for health promotion practitioners. Individuals encouraged to let themselves go and confront traumatic experiences in their lives can potentially enhance their own health.
Health Locus of Control and Self-Efficacy Beliefs in a Healthy Elderly Sample
Authors: Waller Kathy V. , Bates R. Carson
Published: December 2011

Background.

The elderly are the fastest growing segment of the population, and this will place additional burdens on the healthcare system. It is therefore valuable to study the elderly who have reached their later years relatively free of disease and in good health.

Methods.

Health locus of control, self-efficacy beliefs, and lifestyle behaviors were studied in a sample of 57 healthy elderly subjects. Subjects completed the Multidimensional Health Locus of Control Scale, Self-Efficacy Scale, and Healthstyle Self- Test for Seniors.

Results.

Most of the subjects were characterized by an internal health locus of control belief (91.2%), high generalized self-efficacy (57.9%), and good health behaviors. As hypothesized, positive relationships were found among these variables.

Discussion.

Individuals with an internal health locus of control and high generalized self-efficacy are more likely to benefit from a health education program than those with an external locus of control and low self-efficacy. Health educators can better serve their clients by evaluating these parameters when developing programs.
Mind-Body Health: Research, Clinical, and Policy Applications
Authors: Pelletier Kenneth R.
Published: December 2011

Purpose of the Review.

This critical review presents an overview of the development in the field of mind-body medicine over the last 10 years and has taken tentative steps toward suggesting the components of a new model of health based on psychoneuroimmunology. While documenting the major shortcomings of present research design, methodology, data analysis, and subsequent hypotheses, this article points out areas of sufficient promise for practical and responsible clinical applications of the research.

Search Method Used.

A thorough review of the clinical and experimental medical literature related to the interaction between mind and body is presented, and the new and complex research in the field of psychoneuroimmunology is analyzed.

Summary of Important Findings.

Despite the mixed and sometimes conflicting findings in current research, there is an increasingly compelling body of scientific evidence indicating that mind-body interactions are at the root of both health and disease. Research demonstrates that psychological factors seem to play a causal role in the onset and course of many chronic disorders and that psychological, emotional, psychosocial, and behavioral interventions have at least as much proof of effectiveness as many purely medical treatments.

Major Conclusions.

There is a substantial growing body of scientific and clinical knowledge which demonstrates an inextricable interaction between mind and body. Such an approach empowers individuals and organizations to assume greater responsibility for health as a basis for the development of a true health care system.
Health Risk Changes with a Low-Cost Individualized Health Promotion Program: Effects at up to 30 Months
Authors: Fries James F. , Fries Sarah Tilton , Parcell Charles L. , Harrington Harry
Published: December 2011

Background and Purpose.

Health promotion programs are increasingly important components of health care in an era of predominantly chronic illness preceded by identified health risk behaviors. We report a large and relatively long experience with a low-cost intervention delivered through the mail and using sequential time-oriented risk appraisal and personalized recommendations, each six months, together with self-management materials.

Methods.

We performed a prospective, longitudinal, observational study of 103,937 consecutive program participants observed for at least six months and up to 30 months. The primary study endpoint is overall health risk score, with secondary analysis of individual risk behaviors. A concurrent comparison group utilizes the initial scores of new participants by calendar time over the study period.

Results.

Strong overall positive effects were observed, with improvement in computed health risk scores over 18 months of 14.7% (p < .0001) in those 65 and over and 18.4% (p < .0001) in those under 65. At 30 months, improvement was 18.8% (p < .0001) and 25.7% (p < .0001), respectively. There was improvement in self-report scores for all targeted health risk behaviors, except for pounds over ideal weight, including smoking; dietary fat, salt, and fiber; alcohol; exercise; cholesterol; and reported stress. There was progressive improvement approximating 5% each six-month period. Results were consistent across age groups 16–35, 36–50, 51–65, and over 65 and over different educational level. Results could not be accounted for by sequential changes in initial health habits of participants over time.

Discussion.

Low-cost health promotion programs may be practically applied to large populations with positive effects which continue to improve with time in program. Changes in senior populations are as great as in younger persons. Effects in those in lower socioeconomic classes appear as great as those in higher classes.
Using the Stages of Change Model to Increase the Adoption of Physical Activity among Community Participants
Authors: Marcus Bess H. , Banspach Stephen W. , Lefebvre R. Craig , Rossi Joseph S. , Carleton Richard A. , Abrams David B.
Published: December 2011

Purpose.

This study examined the use of the stages of change model to design an exercise intervention for community volunteers.

Design.

The “Imagine Action” campaign was a community-wide event incorporating the involvement of local worksites and community agencies. Community members registering for the campaign were enrolled in a six-week intervention program designed to encourage participation in physical activity.

Subjects.

Six hundred and ten adults aged 18 to 82 years old enrolled in the program. Seventy-seven percent of the participants were female and the average age was 41.8 years (SD = 13.8).

Setting.

The campaign was conducted in a city with a population of approximately 72,000 and was promoted throughout community worksites, area schools, organizations, and local media channels.

Measures.

One question designed to assess current stage of exercise adoption was included on the campaign registration form as were questions about subject name, address, telephone number, birthdate, and gender.

Intervention.

The intervention included written materials designed to encourage participants to initiate or increase physical activity, a resource manual describing activity options in the community, and weekly “fun walks” and “activity nights.”

Results.

A Stuart-Maxwell test for correlated proportions revealed that subjects were significantly more active after the six-week intervention. Sixty-two percent of participants in Contemplation became more active while 61 % in Preparation became more active.

Conclusions.

Most participants increased their stage of exercise adoption during the six-week intervention. This study provides preliminary support for use of the stages of change model in designing exercise interventions.
Exercise, Lipids, and Obesity in Adolescents with Parental History of Coronary Disease
Authors: Stewart Kerry J. , Goldberg Andrew P.
Published: December 2011

Purpose.

The purpose of this study is to determine 1) if adolescents of parents with clinically manifest premature coronary artery disease (CAD) are less physically fit and habitually active, and have less favorable lipid profiles and more obesity than children of nonaffected parents, and 2) if aerobic fitness and activity are related to obesity and lipids in adolescents.

Setting.

Patients were identified in the Coronary Care Unit or out-patient clinic. Adolescents were evaluated in the cardiovascular laboratories at the Francis Scott Key Medical Center.

Design.

Comparisons between groups were tested with ANOVA. Univariate and multivariate regression were used to assess relationships among study variables.

Subjects.

Thirty-six children of affected parents, ages 12 to 19 years, and 29 comparison subjects participated in the study.

Measures.

Fitness was determined by treadmill testing, fasting blood was analyzed for lipoprotein lipids, habitual physical activity was measured by self-report, and the sum of six skinfolds was used to calculate obesity.

Results.

Total and LDL cholesterol were higher in girls with a parental history of CAD. The sample size was too small to draw any definitive conclusions about differences based on parental history in lipids or fitness in the boys, or obesity in both genders. Overall, joggers were more fit and less fat than nonjoggers. Girls playing organized sports were more fit and less fat than nonparticipants. Aerobic fitness correlated negatively with obesity in both genders; fitness was independently associated with HDL cholesterol only in the boys.

Conclusion.

The relationships among parental history of premature coronary heart disease, exercise, lipids, and obesity may be gender-specific.
Relationship between Serum Cholesterol Levels and Television Viewing in 11,947 Employed Adults
Authors: Tucker Larry A. , Bagwell Marilyn
Published: December 2011

Purpose.

The purpose of this study was to determine the prevalence of hypercholesterolemia among high-, moderate-, and low-duration television viewers. The confounding effects of age, gender, income, body fat percentage, weekly exercise duration, and smoking were also examined.

Design.

A cross-sectional or correlational design was employed. Cochran-Mantel-Haenszel odds ratios were used to estimate risk of the television viewers regarding hypercholesterolemia.

Setting.

Participants were employees of over 55 corporations that had their employees screened as part of the ongoing risk-management program of Health Advancement Services (HAS), Inc.

Subjects.

Subjects were 11,947 employed adults. About 85% of the subjects eligible for participation completed the screenings and were used in the study.

Measures.

Serum cholesterol was assessed in a certified lab, and lifestyle information, including television viewing habits, was collected via a written questionnaire. Body fat was measured using skinfolds from three body sites.

Results.

High-duration television viewers were almost two times more likely to suffer from hypercholesterolemia as infrequent viewers, with and without control of multiple confounding factors. Moderate-duration viewers were at 1.5 times the risk of hypercholesterolemia compared to infrequent viewers. Neither television group was at greater risk of moderately elevated cholesterol levels (200–239) compared to the infrequent viewers with all of the potential confounders controlled.

Conclusions.

Cause-and-effect conclusions are not warranted; however, this study coupled with other investigations shows that excessive television viewing may be an important lifestyle factor linked to decreased health and functioning.
Employee Advisory Boards as a Vehicle for Organizing Worksite Health Promotion Programs
Authors: Sorensen Glorian , Hsieh Jean , Hunt Mary K. , Morris Diane H. , Harris Donald R. , Fitzgerald Gordon
Published: December 2011

Purpose.

The purpose of this article is to describe the “employee advisory board model” applied in the Treatwell program, a worksite nutrition intervention program.

Design.

The employee advisory boards of five of the seven intervention worksites participating in the Treatwell program were surveyed. Results were compared with results of employee surveys conducted in these five worksites.

Setting.

The five worksites included in this study are among 16 participating worksites from Massachusetts and Rhode Island.

Subjects.

Of the 95 board members represented in the five worksites, 88% responded to the survey. This article also presents results from the 698 respondents of the five intervention worksites where the board surveys were conducted.

Intervention.

The boards in each worksite participated in planning, promoting, and implementing this program in each worksite.

Measures.

Respondents to the board survey were asked about their participation on and satisfaction with the board and factors they thought contributed to its effectiveness. A survey of all employees included information on demographics and program participation.

Results.

Board members reported that they were highly satisfied with the board's functioning. Board member hours spent on Treatwell activities were directly related to the proportion of employees aware of the program. (r = .82). The boards' effectiveness was limited by conflicting priorities between the job and board responsibilities.

Conclusion.

The employee advisory board model povides promise for increasing worker awareness of worksite health promotion programs through enhanced worker ownership.
From Research to Public Policy: The Prevention of Motor Vehicle Injuries, Childhood Drownings, and Firearm Violence
Authors: Wintemute Garen J.
Published: December 2011

Purpose.

The purpose of this article is to review the development of the modern sciences of injury epidemiology and injury prevention and to illustrate the use of applied research in formulating effective public policy.

Search Methods.

MEDLINE searches were conducted from 1966 to 1990, and bibliographies of articles thus obtained were reviewed. Fugitive sources were identified by multiple means.

Major Findings.

Motor vehicle fatality rates on a per mile driven basis have been reduced by 50 % over the past 25 years, largely through attention to the road environment and design of motor vehicles. Passive restraint systems such as air bags promise further reductions. Drowning has emerged as a leading cause of death among young children. Complete pool fencing is expected to prevent many of these events. Firearm violence, particularly among young people, is rapidly increasing. Firearms are hazardous consumer products but are not addressed as such by our current regulatory structure and intervention agenda.

Conclusions.

Epidemiologic and other applied research can make important contributions to the development of public policies designed to prevent injury. Such policies often address the design and performance of hazardous products and environments and consider individual behavior change as only a secondary objective.