bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cost–Utility of Adjuvant Chemotherapy Using Docetaxel and Cyclophosphamide Compared with Doxorubicin and Cyclophosphamide in Breast Cancer
Authors: Younis T. , Rayson D. , Skedgel C.
Published: December 2011

Purpose: The adoption of a chemotherapeutic regimen in oncologic practice is a function of both its clinical and its economic impacts on cancer management. For breast cancer, U.S. Oncology trial 9735 reported significant improvements in disease-free and overall survival favoring adjuvant tc (docetaxel 75 mg/m2 and cyclophosphamide 600 mg/m2 every 3 weeks for 4 cycles) compared with ac (doxorubicin 60 mg/ m2 and cyclophosphamide 600 mg/m2 every 3 weeks for 4 cycles). We carried out an economic evaluation to examine the cost–utility of adjuvant tc relative to ac, in terms of cost per quality-adjusted life year (qaly) gained, given the improved breast cancer outcomes and higher costs associated with the tc regimen. Methods: A Markov model was developed to calculate the cumulative costs and qalys gained over a 10-year horizon for hypothetical cohorts of women with breast cancer treated with ac or with tc. Event rates, costs, and utilities were derived from the literature and local resources. Efficacy and adverse events were based on results reported from U.S. Oncology trial 9735. The model takes a third-party direct payer perspective and reports its results in 2008 Canadian dollars. Costs and benefits were both discounted at 3%. Results: At a 10-year horizon, tc was associated with $3,960 incremental costs and a 0.24 qaly gain compared with ac, for a favorable cost–utility of $16,753 per qaly gained. Results were robust to model assumptions and input parameters. Conclusions: Relative to ac, tc is a cost-effective adjuvant chemotherapy regimen, with a cost-effectiveness ratio well below commonly applied thresholds.
Assessment and Management of Febrile Neutropenia in Emergency Departments within a Regional Health Authority—A Benchmark Analysis
Authors: Szwajcer D. , Czaykowski P. , Turner D.
Published: December 2011

Objectives: Febrile neutropenia is considered an oncologic emergency, for which prompt initiation of antibiotics is essential. Methods: We conducted a retrospective cohort study for the 2006 calendar year involving all adult oncology patients presenting with febrile neutropenia to a regional health authority’s emergency departments. The objective was to determine the time from triage to antibiotic administration and its impact on patient outcomes. Results: We identified 68 patients presenting with febrile neutropenia, most of whom (76%) were seen in tertiary care centers. Of those patients, 65% were triaged to be seen within 15 minutes of arrival in the emergency room; however, the median time to reassessment was 57 minutes. The median time from triage to antibiotic administration was 5 hours (range: 1.23–22.8 hours). No increased risk of death or increased length of hospital stay was associated with delayed antibiotic administration. Older patients and patients without caregiver support were more likely to experience delayed antibiotic administration (odds ratio: 3.8 and 12.7 respectively). Conclusions: We were not able to show a deleterious effect of delay in antibiotic administration, but our analysis identified several points at which patient flow through the emergency room could be improved.
Non-Calcified Coronary Plaque Volume Inversely Related to Cd4+ T-Cell Count in HIV Infection
Authors: Duarte Horacio , Matta Jatin R , Muldoon Nancy , Masur Henry , Hadigan Colleen , Gharib Ahmed M
Published: December 2011

Background

Non-calcified coronary artery plaque (NCAP) might be an important predictor of cardiovascular events; however, few studies have directly measured NCAP in HIV-infected individuals.

Methods

We completed a prospective cross-sectional evaluation of NCAP and coronary calcium scores using computed tomography angiography in HIV-infected patients ( n=26) without known coronary artery disease (CAD), but who had one or more CAD risk factor(s), and compared them with controls matched on age, race, sex, body mass index and Framingham Risk Score ( n=26).

Results

There was no difference in coronary calcium scores (114 ±218 versus 124 ±298; P=0.89) or NCAP volume (65 ±86 mm3 versus 63 ±82 mm3; P=0.38) between HIV-infected patients and controls, respectively. Among HIV-infected patients, lower CD4+ T-cell count was associated with increased NCAP volume ( r=-0.52, P=0.006). The CD4+ T-cell count remained a significant predictor of NCAP in a multivariate analysis that adjusted for age and duration of antiretroviral therapy.

Conclusions

Plaque burden is similar between HIV-infected and uninfected individuals when matched on traditional CAD risk factors; however, immune function might mediate the development of atherosclerosis in HIV infection.
Antibiotic susceptibility of different lactic acid bacteria strains
Authors: Karapetkov N. , Georgieva R. , Rumyan N. , Karaivanova E.
Published: December 2011

Five lactic acid bacteria (LAB) strains belonging to species Lactobacillus acidophilus, Lactobacillus helveticus,
Lactobacillus delbrueckii subsp. bulgaricus, Lactobacillus delbrueckii subsp. lactis and Streptococcus thermophilus
were tested for their susceptibility to 27 antibiotics. The minimum inhibitory concentrations of each antimicrobial
were determined using a microdilution test. Among the strains a high susceptibility was detected for most of the
cell-wall synthesis inhibitors (penicillins, cefoxitin and vancomycin) and resistance toward inhibitors of DNA
synthesis (trimethoprim/sulfonamides and fluoroquinolones). Generally, the Lactobacillus strains were inhibited
by antibiotics such as chloramphenicol, erythromycin and tetracycline at breakpoint levels lower or equal to the
levels defined by the European Food Safety Authority. Despite the very similar profile of S. thermophilus LC201
to lactobacilli, the detection of resistance toward erythromycin necessitates the performance of additional tests in
order to prove the absence of transferable resistance genes.
Bacterial diversity in Philippine fermented mustard (burong mustasa) as revealed by 16S rRNA gene analysis
Authors: Larcia II L.L. , Estacio R. , Dalmacio L.M.
Published: December 2011

Previous studies on the bacterial profile of burong mustasa, a traditional Philippine fermented food, had been
conducted using culture-dependent techniques. Since these methods may underestimate the total microbiota of
a sample, a culture-independent study was done to determine the bacterial diversity in burong mustasa through
molecular biology techniques. Bacterial DNA was isolated from fermented mustard samples at different stages of
fermentation. The isolated genomic DNA was amplified by PCR using specific primers for the 16S ribosomal RNA
gene (16S rDNA). The 1.5 kb amplicons obtained were subjected to nested PCR using primers for the internal
variable region of the 16S rDNA. The 585 bp nested PCR amplicons were then subjected to denaturing gradient gel
electrophoresis (DGGE) to separate the different bacteria present in each sample. Distinct and unique bands in the
DGGE profile were excised, reamplified, purified and sequenced for bacterial identification. Molecular cloning of
the 1.5 kb 16S rDNA was also performed using the pGEM-T Easy Vector System. The cloned gene was sequenced
for bacterial identification. The identified microbiota in burong mustasa at different stages of fermentation include
lactic acid bacteria and several uncultured bacteria (initial up to the final stages); acetic acid bacteria (middle stage);
and Streptobacillus and Fusobacterium species (initial stage). The potential probiotic bacteria found in burong
mustasa are Weissella and Lactobacillus.
An Information System for Coping with Student Dropout
Authors: Aflalo Ester , Gabay Eyal
Published: December 2011

Student dropout prevention is one of the most important challenges of the education system. This study examines the effectiveness of a Local Authority Information Center (LAIC), developed in Israel to cope with that problem. The research population included 418 regular attendance officers (RAOs), educators who deal with students who drop out and those who are at risk of dropping out. The RAOs were divided into an experimental group, who performed their work using the information system, and a control group who used manual means. The research findings show that the information system improved the comprehensive nature of the information and its relevance for students at risk of dropping out, and resulted in an increase in the number of students treated by the RAOs. This improvement was maintained over a period of three years. The LAIC is likely to offer an effective and professional approach to reducing the problem of student dropout.
A Parallel Thrombolysis Protocol with Nurse Practitioners As Coordinators Minimized Door-to-Needle Time for Acute Ischemic Stroke
Authors: Sung Sheng-Feng , Huang Ying-Chieh , Ong Cheung-Ter , Chen Yu-Wei
Published: December 2011

Introduction. Quick thrombolysis after stroke improved clinical outcomes. The study objective was to shorten door-to-needle time for thrombolysis.Methods. After identifying the sources of in-hospital delays, we developed a protocol with a parallel algorithm and recruited nurse practitioners into the acute stroke team. We applied the new protocol on stroke patients from October 2009 to September 2010. Patients from the previous two years were used for comparison.Results. For ischemic stroke patients within 3 hours of onset, the median time from arrival to computed tomography scanning was reduced from 29 to 20 minutes () and the median time from arrival to neurology evaluation decreased from 61 to 43 minutes (). For those patients who received thrombolysis, the median door-to-needle time was shortened from 68.5 to 58 minutes ().Conclusions. The parallel thrombolysis protocol successfully improved the median door-to-needle time to below the guideline-recommended 60 minutes.
Osteoblastic and Vascular Endothelial Niches, Their Control on Normal Hematopoietic Stem Cells, and Their Consequences on the Development of Leukemia
Authors: Guerrouahen Bella S. , Al-Hijji Ibrahim , Tabrizi Arash Rafii
Published: December 2011

Stem cell self-renewal is regulated by intrinsic mechanisms and extrinsic signals mediated via specialized microenvironments called “niches.” The best-characterized stem cell is the hematopoietic stem cell (HSC). Self-renewal and differentiation ability of HSC are regulated by two major elements: endosteal and vascular regulatory elements. The osteoblastic niche localized at the inner surface of the bone cavity might serve as a reservoir for long-term HSC storage in a quiescent state. Whereas the vascular niche, which consists of sinusoidal endothelial cell lining blood vessel, provides an environment for short-term HSC proliferation and differentiation. Both niches act together to maintain hematopoietic homeostasis. In this paper, we provide some principles applying to the hematopoietic niches, which will be useful in the study and understanding of other stem cell niches. We will discuss altered microenvironment signaling leading to myeloid lineage disease. And finally, we will review some data on the development of acute myeloid leukemia from a subpopulation called leukemia-initiating cells (LIC), and we will discuss on the emerging evidences supporting the influence of the microenvironment on chemotherapy resistance.
Identifying pathological biomarkers: histochemistry still ranks high in the omics era
Authors: Pellicciari C. , Malatesta M.
Published: December 2011

In recent years, omic analyses have been proposed as possible approaches to diagnosis, in particular for tumours, as they should be able to provide quantitative tools to detect and measure abnormalities in gene and protein expression, through the evaluation of transcription and translation products in the abnormal vs normal tissues. Unfortunately, this approach proved to be much less powerful than expected, due to both intrinsic technical limits and the nature itself of the pathological tissues to be investigated, the heterogeneity deriving from polyclonality and tissue phenotype variability between patients being a major limiting factor in the search for unique omic biomarkers. Especially in the last few years, the application of refined techniques for investigating gene expression in situ has greatly increased the diagnostic/prognostic potential of histochemistry, while the progress in light microscopy technology and in the methods for imaging molecules in vivo have provided valuable tools for elucidating the molecular events and the basic mechanisms leading to a pathological condition. Histochemical techniques thus remain irreplaceable in pathologistâ€™s armamentarium, and it may be expected that even in the future histochemistry will keep a leading position among the methodological approaches for clinical pathology.
An instrumental approach to modelling the derivative in Sketchpad
Authors: Ndlovu Mdutshekelwa , Wessels Dirk , De Villiers Michael
Published: December 2011

Encouragement to integrate information and communication technologies into mathematics education curricula is an increasingly universal phenomenon. As a contribution to the discourse, this article discusses the potential use in the classroom of The Geometer’s Sketchpad® (Key Curriculum Press, Emeryville, CA, United States) mathematics software in modelling the derivative and related concepts in introductory calculus. In an empirical study involving first-year non-mathematics major undergraduate science students, a hypothetical learning trajectory (HLT) was conjectured and implemented for students to experience the visualisation and multiple representations of calculus concepts on the Cartesian plane with a computer graphic interface. The utilisation scheme is interpreted through the lens of the instrumental1 approach proposed by Trouche. The HLT was partly informed by the historical development of the derivative as synthesised from the literature on the history of calculus and partly by the affordances, enablements, constraints and potentialities of Sketchpad itself. The findings of the study suggest that when exposed to the capabilities of this software, learners can experience Geometer’s Sketchpad® as an effective visualisation tool or instrument for the representation and learning of the derivative and related concepts in introductory calculus. However, the effectiveness of this tool is not a given or a foregone conclusion − it is a product of the teacher’s instrumental orchestration, gradual learner mastery of the software syntax and careful resolution of theoretical-computational conflicts that can arise during early use of the instrument.
Delivery of MicroRNA-10b with Polylysine Nanoparticles for Inhibition of Breast Cancer Cell Wound Healing
Authors: Jin Hongjun , Yu Yuehua , Chrisler William B. , Xiong Yijia , Hu Dehong , Lei Chenghong
Published: December 2011

Recent studies revealed that micro RNA-10b (mir-10b) is highly expressed in metastatic breast cancer cells and positively regulates breast cancer cell migration and invasion through inhibition of HOXD10 target synthesis. In this study we designed anti-mir-10b molecules and combined them with poly L-lysine (PLL) to test the delivery effectiveness. An RNA molecule sequence exactly matching the mature mir-10b minor antisense showed strong inhibition when mixed with PLL in a wound-healing assay with human breast cell line MDA-MB-231. The resulting PLL-RNA nanoparticles delivered the anti-microRNA molecules into cytoplasm of breast cancer cells in a concentration-dependent manner that displayed sustainable effectiveness.
Curve shortening flow in heterogeneous media
Authors: Cesaroni Annalisa , Novaga Matteo , Valdinoci Enrico
Published: December 2011

In recent years, there has been a growing interest in geometric evolutions in heterogeneous media. Here we consider curvature driven flows of planar curves with an additional space-dependent forcing term, and we look for estimates which depend only on the

L^\infty

-norm of the forcing term. Our motivation comes from a homogenization problem, which we can rigorously solve in the special case when the initial curve is a graph and the forcing term does not depend on the vertical direction. In such case, we are also able to define a solution of the evolution even if the forcing term is just a bounded function, not necessarily continuous.
Distributional equation in the limit of phase transition for fluids
Authors: Alt Hans Wilhelm , Witterstein Gabriele
Published: December 2011

We study the convergence of a diffusive interface model to a sharp interface model. The model consists of the conservation of mass and momentum, where the mass undergoes a phase transition. The equations were considered in [W3] and in the diffuse case consist of the compressible Navier–Stokes system coupled with an Allen–Cahn equation. In the sharp interface limit a jump in the mass density as well as in the velocity occurs. The convergence of mass and momentum is considered in the distributional sense. The convergence of the free energy to a limit is shown in a separate paper. The procedure in this paper works also in other general situations.
Arithmetic Groups vs. Mapping Class Groups: Similarities, Analogies and Differences
Authors: Farb Benson , Ji Lizhen , Leuzinger Enrico , Müller Werner
Published: December 2011

Arithmetic groups arise naturally in many fields such as number theory, algebraic geometry, and analysis. Mapping class groups arise in both low dimensional topology and geometric group theory. They have been studied intensively by different groups of people. The purpose of this workshop is to bring experts and aspiring young mathematicians together to interact and develop further exchanges and new collaboration.
The Transtheoretical Model of Health Behavior Change
Authors: Prochaska James O. , Velicer Wayne F.
Published: December 2011

The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment procedures. The most promising outcomes to date have been found with computer-based individualized and interactive interventions. The most promising enhancement to the computer-based programs are personalized counselors. One of the most striking results to date for stage-matched programs is the similarity between participants reactively recruited who reached us for help and those proactively recruited who we reached out to help. If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.
Stages of Change, Decisional Balance, and Self-Efficacy across Four Health Behaviors in a Worksite Environment
Authors: Herrick Andrew B. , Stone William J. , Mettler Miles M.
Published: December 2011

Purpose.

This study examined differences in decisional balance and self-efficacy scores across the five stages of change and across four health behaviors (exercise, protection from sun exposure, smoking, and dietary fat consumption), and explored the relationship between the frequency of subjects at each stage across four health behaviors.

Design.

Data for this study were collected as part of a health behavior survey of employees.

Setting.

The study was conducted in a municipal government worksite in Arizona.

Subjects.

A total of 393 employees completed the survey. The sample was predominantly white (84.9%) and male (64.4%), with an average age of 42.2 years and a median annual household income of between $40,000 and $59,999.

Measures.

Previously validated questions to measure stages of change, decisional balance, and self-efficacy were administered, along with questions about demographic variables.

Results.

Significant differences were found for decisional balance and self-efficacy scores across the five stages of change, but they were not significantly different between the four health behaviors. A minority of subjects (18.6%) were in the same stage of change for all four health behaviors.

Conclusions.

This study provides preliminary evidence that there is considerable stage specificity across multiple health behaviors. Because employees at each stage of change possess differences in terms of their pros, cons, and self-efficacy, wellness programs need to focus on stage-specific interventions.
What Makes a Good Staging Algorithm: Examples from Regular Exercise
Authors: Reed Gabrielle Richards , Velicer Wayne F. , Prochaska James O. , Rossi Joseph S. , Marcus Bess H.
Published: December 2011

Purpose.

This study retrospectively compared subjects from three unrelated studies using eight algorithms to stage exercise behavior.

Subjects and settings.

Study One included 936 employees involved in a smoking cessation study at four worksites—a medical center, retail store, manufacturing firm, and a government agency. Study Two included 19,212 members of a New England HMO; and Study Three included a convenience sample of 327 adult New Englanders.

Measures.

The eight algorithms used different descriptions of stages based on the transtheoretical model, as well as different definitions of exercise and response formats.

Results.

Algorithms using longer, more precise definitions of exercise resulted in larger numbers of subjects being staged in precontemplation and contemplation in comparison to algorithms using shorter definitions, which tended to stage subjects in preparation and action. Maintenance was the most and preparation the least consistently described stage across algorithms.

Conclusions.

Alteration of the descriptions of stage and the definition of exercise has consequences for the staging of subjects. Definitions need to be explicit, stating all parameters needed to meet criterion, and subjects must be able to assess themselves. Either a 5-Choice or a true/false response format is effective in assessing stage.
Construct Validity of Stages of Change for Exercise Behavior
Authors: Cardinal Bradley J.
Published: December 2011

Purpose.

Previous research examining the transtheoretical model of behavior change within the exercise domain has been limited by use of self-report measures exclusively and inconsistent practices with regard to stage of exercise assessment. The present study was designed to partially circumvent these limitations and extend the current literature by determining the degree of association among stage of exercise and body mass index, cardiorespiratory fitness, exercise behavior, relapse, barriers, and self-efficacy, after controlling for several potential confounders.

Design.

A descriptive, cross-sectional study.

Subjects.

Two hundred thirty-five adults (M age = 34.7 years) volunteered to participate.

Measures.

Participants were classified by stage of exercise and compared on two behavioral, two biometrical, and three psychological variables while statistically controlling for social desirability and demographic differences.

Results.

Significant between-stage differences were found for the overall set of dependent variables (p <.0001) and for each dependent variable separately (p <.01). The proportion of variance accounted for by the dependent variables ranged from .06 to .53.

Conclusions.

This study offers objective support for the stage-of-change model within the exercise domain. By acknowledging and accurately assessing stage of exercise, researchers and clinicians may be able to improve physical activity promotion efforts.
Predicting the Adoption and Maintenance of Exercise Participation Using Self-Efficacy and Previous Exercise Participation Rates
Authors: Oman Roy F. , King Abby C.
Published: December 2011

Objectives.

To investigate the relationships among self-efficacy, changes in self-efficacy, past exercise participation, future exercise adherence, and exercise program format.

Methods.

Two-year randomized trial involving subjects (n = 63) participating in an aerobic exercise program. Subjects were randomly assigned to one of three exercise conditions: higher-intensity home-based exercise, higher-intensity class-based exercise, or lower-intensity home-based exercise.

Results.

Results indicated that baseline self-efficacy and exercise format had significant (p <.02), independent effects on adherence during the adoption and early maintenance phases of exercise behavior. In contrast, in predicting long-term exercise program maintenance, a significant (p <.05) self-efficacy X exercise format interaction indicated that self-efficacy predicted adherence only in the supervised home-based exercise conditions. Results also suggest that baseline self-efficacy, independent of the effect of past adherence, significantly (p <.03) predicted exercise adherence during the adoption phase, but not early maintenance phase, of exercise behavior. Finally, adherence change during the adoption phase of exercise behavior significantly (p <.04) predicted Year-one levels of self-efficacy even after adjusting far the effect of baseline self-efficacy.

Conclusions.

These results suggest that exercise program format as well as an individual's initial cognitive and behavioral experiences in an exercise program play significant roles in determining exercise adherence.
Prohibiting Smoking in Restaurants: Effects on Restaurant Sales
Authors: Sciacca John P. , Ratliff Michael I.
Published: December 2011

Purpose.

The purpose of this study was to assess the impact of prohibiting smoking in restaurants on total restaurant sales in Flagstaff, Arizona.

Design.

Flagstaff restaurant and retail sales data were collected for periods approximately 3.5 years prior to enactment of a no-smoking-in-restaurants ordinance and 1.5 years after enactment of the ordinance. Data were compared with six comparison areas utilizing four methods of analyses.

Setting.

The city of Flagstaff Arizona, was the community in this study that prohibited smoking in restaurants.

Subjects.

Flagstaff restaurant and retail sales were compared to sales in two similar Arizona cities, three counties, and the entire state of Arizona.

Intervention.

A city ordinance that prohibited smoking in all Flagstaff, Arizona, restaurants.

Measures.

Taxable restaurant sales were collected from Flagstaff and all comparison areas. Retail sales data were also collected to determine if changes occurred in the ratio of restaurant to retail sales.

Results.

All analyses resulted in the same conclusions: prohibiting smoking in restaurants did not affect restaurant sales.

Conclusions.

Study findings indicate that prohibiting smoking in Flagstaff, Arizona, restaurants has had no effect on restaurant sales.
A Stage-of-Change Classification System Based on Actions and Beliefs regarding Dietary Fat and Fiber
Authors: Auld Garry W. , Nitzke Susan A. , McNulty Judiann , Bock Margaret A. , Bruhn Christine M. , Gabel Kathe , Lauritzen Georgia , Lee Yuen F. , Medeiros Denis , Newman Rosemary , Ortiz Melchor , Read Marsha , Schutz Howard , Sheehan Edward
Published: December 2011

Purpose.

The objectives of this study were to develop a stage-of-change classification system and to determine the degree to which various adult subgroups have adopted the behavioral changes necessary to achieve a low-fat and/or high-fiber diet as recommended by the Dietary Guidelines for Americans.

Design.

The study used a mail survey randomly sent to 7110 adults.

Setting.

The survey was conducted in 11 states and the District of Columbia.

Subjects.

The random sample included males and females over age 18. Of the eligible respondents, 3198 (51.5%) were included in this analysis, with 2004 and 2066 unambiguously classified into stages of change for fat and fiber, respectively.

Measures.

Stage of change was defined by an algorithm based on self-reported intent and behaviors to limit fat and/or increase fiber.

Results.

45% of the respondents were classified as being in action/maintenance for fat and 38% for fiber. Women, older adults, individuals with advanced education, persons with diet-related chronic disease, people with higher levels of relevant nutrition knowledge and attitudes, and persons who indicated that health concerns were a primary influence on their diet were more likely to be in action/maintenance than other respondents.

Conclusions.

The algorithm in this study presents a model that more closely reflects the proportions of the adult population that have achieved low-fat diets and classifies a greater proportion in the preparation stage than classification systems in previous studies.
Obesity and Absenteeism: An Epidemiologic Study of 10,825 Employed Adults
Authors: Tucker Larry A. , Friedman Glenn M.
Published: December 2011

Purpose.

This study was conducted to determine the extent of the relationship between obesity and absenteeism due to illness. A secondary objective was to ascertain the extent to which age, gender, family income, length of workweek, and cigarette smoking influenced the obesity-absenteeism association.

Design.

A cross-sectional design was used. Data regarding obesity, absenteeism, and the potential confounding factors were collected during the same time period.

Setting.

Data were collected within workplaces throughout the U.S., and at the headquarters of Health Advancement Services, Inc. (HAS).

Subjects.

Subjects were 10,825 employed men and women who participated in an ongoing wellness screening program administered by HAS.

Measures.

The three-site skinfold technique was used to estimate body fat percentage. Absenteeism due to illness and the potential confounding variables were assessed using a structured paper-pencil questionnaire.

Results.

Without controlling for any potential confounders, obese employees were more than twice as likely to experience high-level absenteeism (seven or more absences due to illness during the past 6 months), and 1.49 times more likely to suffer from moderate absenteeism (three to six absences due to illness during the last 6 months) than were lean employees. With all of the potential confounders controlled simultaneously, obese employees were 1.74 and 1.61 times more likely to experience high and moderate levels of absenteeism, respectively, than were lean individuals.

Conclusions.

Obese employees tend to be absent from work due to illness substantially more than their counterparts.
A Prediction Equation for Estimating Body Fat Percentage Using Readily Accessible Measures: A Multivariate Study of 200 Adult Women
Authors: Tucker Larry A. , Demers Denise S. , Kelly K. Patrick
Published: December 2011

Purpose.

This study was conducted to develop a regression equation that accurately estimates body fat percentage using relatively easy and inexpensive methods that do not require women to remove clothing.

Design.

A cross-sectional design was employed.

Setting.

All data were collected at the University.

Subjects.

Subjects were 200 white women ages 20 to 65 years. The sample was equally distributed across four age groups, 20–29, 30–39, 40–49, and 50–65, and within each age group, one-third of the women were lean, one-third were of average weight, and one-third were obese.

Measures.

Subjects were hydrostatically weighed and participated in a variety of anthropometric and lifestyle assessments, including skinfolds, circumferences, and questionnaire responses.

Results.

The full regression model included six measures: hip circumference, triceps skinfold (observed and quadratic), age (quadratic), self-reported physical activity, and calf skinfold (quadratic). This equation accounted for 81 % of the variance in body weight measured by hydrostatic weighing (SEE = 3.5%). A simpler, five-variable equation was also formed that did not include the calf skinfold assessment (R2 = .800, SEE = 3.6%).

Conclusions.

The prediction equations in this study afford accurate and relatively easy and inexpensive means of estimating body fat percentage in a wide range of white women without having them remove their clothing.
Evaluation of Motivationally Tailored vs. Standard Self-Help Physical Activity Interventions at the Workplace
Authors: Marcus Bess H. , Emmons Karen M. , Simkin-Silverman Laurey R. , Linnan Laura A. , Taylor Elaine R. , Bock Beth C. , Roberts Mary B. , Rossi Joseph S. , Abrams David B.
Published: December 2011

Purpose.

This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention.

Design.

Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months.

Setting.

Eleven worksites participating in the Working Healthy Research Trial.

Subjects.

Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions.

Intervention.

Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard).

Measures.

Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall.

Results.

Among intervention completers (n = 903), chi-square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self-reported time spent in exercise.

Conclusions.

This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.
The Association between Physical Fitness and Diagnosed Chronic Disease in Health Maintenance Organization Members
Authors: Pronk Nicolaas P. , Boyle Raymond B. , O'Connor Patrick J.
Published: December 2011

Purpose.

The purpose of this investigation was to determine the relationship between predicted cardiorespiratory fitness (predicted VO2max) and diagnosed chronic disease.

Design.

A stratified random sample of individuals was surveyed.

Setting.

Large Health Maintenance Organization (HMO) in the upper Midwest.

Subjects.

HMO members (N = 8000), age 40 and over, with none, one, or two or more of the following diagnosed chronic conditions: hypertension, diabetes, dyslipidemia, and heart disease.

Measures.

Predicted VO2max was estimated for those respondents who completed the survey providing all critical data elements (n = 4121; representing 51.5% of total sample). Predicted VO2max was compared across chronic conditions using analysis of variance. The proportion of subjects across fitness quintiles by number of chronic conditions was tested using the χ2 test.

Results.

Subjects without chronic conditions showed higher predicted VO2max values (29.8 ± 7.7 ml/kg/min) than those with one (25.9 ± 7.8 ml/kg/min) or two or more conditions (25.7 ±7.9 ml/kg/min) (p < .0001). Subjects with diabetes, hypertension, and heart disease reported lower predicted VO2max than their healthier counterparts (p < .0001), but this was not the case for dyslipidemia subjects (27.6 ± 7.6 vs. 27.4 ± 8.2 ml/kg/min, respectively; p < .58). A larger proportion of diseased subjects was in the lowest fitness quintile for diabetes, hypertension, and heart disease, but not for dyslipidemia.

Conclusions.

As a group, chronic disease patients appear to have lower levels of physical fitness than subjects without chronic disease. Physical fitness improvement in diseased populations should be supported in the clinical setting.
The Use and Impact of Incentives in Population-Based Smoking Cessation Programs: A Review
Authors: Bains Namrata , Pickett William , Hoey John
Published: December 2011

Purpose.

This review discusses current published literature on population-based smoking cessation interventions that involve incentives and examines whether such interventions are effective in reducing the prevalence of smoking.

Search Method.

Studies published between 1975 and Spring 1997 were identified through a computerized search of four electronic databases (MEDLINE, HEALTH, CINAHL, and PSYCINFO) and reference lists of key articles using the following key words: (smoking cessation OR quit smoking) AND (contest OR competition OR incentive OR lottery OR quit and win). This search yielded 79 articles. To be included, studies had to be published in English and had to have presented either quit rates or participation rates for an incentive-based program that used population-based recruitment. Of the 79 articles, 17 met these criteria.

Findings.

Population-based interventions generally attract 1 to 2% of the target population, but these participation rates can potentially be increased through the use of innovative recruitment techniques. No specific type of recruitment strategy was shown to be consistently more effective than others. There is no evidence that particular types of incentives are able to influence participation or quit rates, but the size of an incentive does appear to be important, with larger incentives viewed as more effectively motivating smokers to quit and stay smoke free than smaller ones. Estimates of the cost per quitter have ranged from less than $20 to over $400. There are some indications that the costs of such programs compare favorably with smoking cessation classes or clinic-based approaches.

Conclusion.

Incentive-based smoking cessation programs that target an entire community have the advantage of reaching a large and diverse group of smokers. They may, however, attract only smokers who are already motivated to quit. Realistically, incentive-based programs aimed at the general population can expect 1 % of all their smokers to quit smoking. Quit rates among participants may initially be high (i.e., mean quit rate of 34% at 1-month follow-up) but decrease over time (i.e., mean rate of 23% at 1 year). The results of this review suggest a continued need to establish standard and valid criteria for the evaluation of smoking cessation interventions. Methodological differences among existing studies make them difficult to compare and interpret.
Association of the Health-Promoting Workplace with Trade Unionism and other Industrial Factors
Authors: Holman C. D'Arcy J. , Corti Billie , Donovan Robert J. , Jalleh Geoffrey
Published: December 2011

Purpose.

The study examines associations of five healthy workplace attributes with trade unionism and nine other industrial and sociodemographic factors. The aims were to illustrate the measurement of workplace health promotion indicators in Western Australia and to identify associations leading to a better understanding of determinants of the healthy workplace.

Design.

Personal and telephone cross-sectional surveys were performed using population-based sampling frames. The overall response rate was 72%.

Setting.

Workplaces in Western Australia.

Subjects.

Random samples of household respondents aged 16 to 69 years in 1992 (n = 1310) and 1994 (n = 1113).

Measures.

Measures of association between healthy workplace attributes and trade unionism were adjusted for workplace location, size, sector, and industrial classification.

Results.

Trade unionism was strongly associated with healthy catering practices (adjusted OR 2.05; 95% CI 1.30 to 3.23), sun protection practices (2.66; 1.69 to 4.17), disability access (1.47; 1.10 to 1.95), and worksite health promotion programs (2.56; 2.07 to 3.17). A weak and nonsignificant association was observed with restrictive smoking policies (1.21; .95 to 1.55). Generally, healthy workplace attributes were reported less often by respondents working in rural locations, in the private sector, and at small worksites. There was no consistent relationship with sociodemographic factors, including an index of social disadvantage, but members of blue-collar occupations experienced a low prevalence of restrictive smoking policies.

Conclusions.

The study raises the hypothesis, but cannot confirm, that trade unions could provide a means for employees to pursue the creation of a health-promoting workplace. Small business represents an excellent target for health promotion activities.
Are Health Risks Related to Medical Care Charges in the Short-Term? Challenging Traditional Assumptions
Authors: Terry Paul E. , Fowler Elizabeth J. , Fowles Jinnet B.
Published: December 2011

Purpose.

This study examines the association between self-reported health risks and short-term use of medical resources.

Design.

Cross-sectional study comparing responses from a mailed survey with medical encounter and expenditure data. Bivariate analyses and multivariate linear and logistic regressions controlling for age, gender, and health status were conducted to illustrate the relationship between selected risk factors and resource use.

Setting.

A group network model health maintenance organization (HMO) in Minneapolis, Minnesota.

Subjects.

The study population was comprised of a randomly selected sample of nonsenior adults (18 to 64 years old, n = 3825) and seniors (65 years and older, n = 1955) who were enrolled in an HMO. The response rate was 72%.

Measures.

Five independent variables: smoking alcohol use, obesity, lack of physical activity, and unhappiness were derived from a questionnaire designed to assess health status and health risks. Outcome measures were medical care charges and use of hospital services.

Results.

Obesity, physical inactivity, and unhappiness were related to higher charges among seniors. These relationships dissipated to some degree after controlling for age, gender, and health status. Unexpected differences were found for alcohol use among both age groups, with those considered to be “not at risk” accruing higher charges and demonstrating a higher likelihood of using inpatient hospital services than those defined to be at risk.

Conclusions.

Bivariate and multivariate regression results demonstrated that traditional risk factors are weak and inconsistent predictors of short-term medical charges. Charging smokers and other high risk individuals a higher annual insurance premium than is offered for those at low risk raises questions about fairness when such risk factors are not necessarily good predictors of short-term resource use. The rationale for insurance cost-shifting should be supported with reliable data connecting risks to charges.
Children's Television Viewing, Body Fat, and Physical Fitness
Authors: Armstrong Colin A. , Sallis James F. , Alcaraz John E. , Kolody Bohdan , McKenzie Thomas L. , Hovell Melbourne F.
Published: December 2011

Purpose.

The study examines the relationship between children's television (TV) viewing and physical fitness.

Design.

Cross-sectional data from questionnaires and objective measures were analyzed.

Setting.

Data were collected during the fall of 1990 from public elementary school students in a suburban California city.

Subjects.

Approximately 98% of eligible students participated. Of these, 10% were dropped due to missing data, yielding a final sample of 284 girls and 304 boys.

Measures.

Children reported their amount of TV viewing on a typical summer day; parents reported their child's TV viewing on a typical weekday during the school year. Cardiovascular fitness was the 1-mile run/walk. Body fat was both the child's body mass index (BMI) and skinfolds. Additional measures included muscular strength/endurance and flexibility.

Results.

Mile run/walk times were associated with both parental (η2 = . 051 and . 031 for boys and girls, respectively) and child reports (η2 = . 020 and . 028) of the child's amount of TV viewing. Parental reports, but not child reports, of the child's TV viewing were related to BMI (η2 = .041 and .058) and skinfolds (η2 = .050 and .029). Neither measure of children's TV viewing was related to muscular strength/endurance or flexibility.

Conclusions.

Children's TV viewing seems to be weakly and inconsistently related to various components of physical fitness. However, given the tracking of cardiovascular disease risk factors from childhood into adulthood and the high proportion of children who watch television, these relationships are worthy of further study.
Project Salsa: Development and Institutionalization of a Nutritional Health Promotion Project in a Latino Community
Authors: Elder John P. , Campbell Nadia R. , Candelaria Jeanette I. , Talavera Gregory A. , Mayer Joni A. , Moreno Carmen , Medel Yvonne R. , Lyons Geanne K.
Published: December 2011

Purpose.

Project Salsa was a community-based effort seeking to promote health through nutritional behavior change in a Latino community of San Diego, California. The purpose of this article is to report on program factors related to long-term institutionalization of Project Salsa interventions.

Design.

Project Salsa was a demonstration rather than an experimental project. To ensure maximum sensitivity to the needs and values of the community, Project Salsa began with an extensive health needs assessment, including development of an advisory council, telephone survey, archival research, and key informant interviews.

Setting.

Project Salsa interventions took place in San Ysidro, California, located near the U.S.-Mexico border adjacent to Tijuana from 1987 to 1992.

Subjects.

The intervention community had 14,500 residents, of which nearly 83% were Latino.

Interventions.

Interventions included coronary heart disease risk factor screenings, meal preparation classes, newspaper columns, point-of-purchase education, school health and cafeteria programs, and breast-feeding promotion.

Measures.

Institutionalization of intervention components.

Results.

Two of the interventions, the risk factor screenings and school health programs, are still in operation 4 years after the end of project funding.

Conclusions.

Four factors common to institutionalized components are presented in the paper.
Longitudinal Changes in Stages of Change for Condom Use in Women
Authors: Evers Kerry E. , Harlow Lisa L. , Redding Colleen A. , LaForge Robert G.
Published: December 2011

Purpose.

This study identifies how women naturally progress through the Transtheoretical Model stages of condom use over a 1 year period, using the longitudinal dynamic methodology of latent transition analysis (LTA).

Design.

As part of a larger study of human immunodeficiency virus risk in women, participants were assessed for their stage of condom use two times, 1 year apart.

Subjects.

A total of 491 women who completed both assessments of the study were included in this analysis.

Measures.

Stage of condom use was assessed using two questions, which placed women into one of five stages of change for condom use (α = .90).

Results.

Latent transition analysis identified the best-fitting model of naturalistic stage progression, which included both forward and backward movement. Precontemplation and maintenance were found to be the most stable stages (more than 50% of the participants remaining in that stage 1 year later), and the action stage was the least stable (15 % remaining in this stage). Transition probabilities for all stages showed a high rate of relapse in the sample.

Conclusions.

A high proportion of women will remain within their stage of condom use over a 1-year period if no intervention is introduced. Interventions that are aimed at increasing condom use in women need to incorporate relapse prevention. In addition, the transition probabilities for the stages will help establish reasonable rates of change for intervention programs.