bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction of Human, Machine, and Environment in Automated Driving Systems
Authors: Lank Christian , Haberstroh Max , Wille Matthias
Published: December 2011

In view of the increase in traffic volume and growing demands on traffic, alternative mobility concepts such as automation of the driving task are increasingly being investigated. In line with this course of development project KONVOI was initiated, where an interdisciplinary research team carried out the electronic coupling of trucks. Because the technical feasibility of such automated systems had already been proved, project KONVOI focused on quantifying the impact of automated systems on traffic and on the interaction between humans and machines. Technical development of the system took place with preferential consideration of the human being. The KONVOI system was analyzed for acceptance and the potential workload by using test people in a driving simulator. The test results had a direct effect on the technical development of the system. After approval of the prototype, the traffic effects of the KONVOI system were examined in the context of real German highways. The results of this impact analysis served as a comparison of the developmental concept and evaluation of the system. Open questions concerning the effects of the KONVOI system on car drivers were investigated through additional test drives in the driving simulator. In project KONVOI, an automated system was run in real traffic for the first time in Europe. This testing and the strong consideration of the human being in the development process have provided new insights into the development of driver assistant systems and automated driving systems.
Uniform Vehicle Code and State Statutes Governing Bicycling, 2010
Authors: Chapman Jeremy R.
Published: December 2011

The legal framework in which the users of bicycles and motorized vehicles operate varies widely from state to state. For laws governing vehicles on roads, the National Committee on Uniform Traffic Laws and Ordinances has created the Uniform Vehicle Code (UVC). The UVC was developed as a framework that each state can adopt fully or in part or ignore completely as best serves the state. Most states have adopted the majority of the UVC without alteration, but standards applied by various states to the operation of bicycles tend to deviate from the UVC. Twelve areas of the UVC and how the 50 states have each chosen to treat these areas through their state codes were examined. As the rules of the road are made nearly uniform, especially regarding the operation of and interaction with bicycles, the goals of promoting safety and uniformity are advanced. This consistency also mitigates the potential for confusion, as the expectancy for operators of vehicles and bicycles will likely not be violated. This research showed that not every state had placed the same priority on the safety of all road users. This analysis showed that although much progress was being made to alleviate inadequacies, there was still much work to be done. Without a national focus on the uniformity of traffic laws related to bicycling, the continued patchwork covering the nation would remain and leave serious holes that would ultimately make the roads less safe for everyone.
China's Hangzhou Public Bicycle
Authors: Shaheen Susan A. , Zhang Hua , Martin Elliot , Guzman Stacey
Published: December 2011

Over the past 20 years, China has experienced a steady decline in bicycle use. To address this trend, China's central and local government for urban transportation created Public Transit Priority to encourage public transport initiatives. As part of this effort, the government of the city of Hangzhou launched Hangzhou Public Bicycle in 2008. This service allows members to access a shared fleet of bicycles. As of March 2011, Hangzhou Public Bicycle operated 60,600 bicycles with 2,416 fixed stations in eight core districts. To understand factors leading to bikesharing adoption and barriers to adoption, the authors conducted an intercept survey in Hangzhou between January and March 2010. Two separate questionnaires were issued to bikesharing members and nonmembers to identify key differences and similarities between these groups. In total, 806 surveys were completed by 666 members and 140 nonmembers. The authors found that bikesharing was capturing modal share from bus transit, walking, autos, and taxis. Approximately 30% of members had incorporated bikesharing into their most common commute. Members indicated that they most frequently used a bikesharing station closest to either home (40%) or work (40%). These modal shifts suggested that bikesharing acted as both a competitor and a complement to existing public transit. Members exhibited a higher rate of auto ownership than nonmembers. This finding suggested that bikesharing was attractive to car owners. Recommendations for improving bikesharing in Hangzhou included adding stations and real-time bike and parking availability technologies, improving bike maintenance and locking mechanisms, and extending operational hours.
Weather or Not to Cycle
Authors: Miranda-Moreno Luis F. , Nosal Thomas
Published: December 2011

This study investigated the relationship between weather conditions and cycling ridership, as well as the hourly, daily, monthly, and yearly trends for use of urban bicycle facilities. A unique data set of cyclist ridership, collected at five automatic counting stations on primarily utilitarian bike facilities in the city of Montreal, Canada, was used. Absolute and relative ridership models were used to analyze the direct and lagging effects of weather variables and extreme weather conditions on hourly cyclist volumes. Precipitation, temperature, and humidity had significant effects on bicycle ridership. After other factors were controlled for, when the temperature doubled, a 43% to 50% increase in ridership could be expected; however, the temperature had a negative effect when it was higher than 28°C and humidity was greater than 60%. The results also showed that bicycle volumes in a given hour were significantly affected not only by the presence of rain in the same hour but also by the presence of rain in the previous 3 h or in the morning only. Daily bicycle volumes were 65% to 89% lower on weekend days than on Monday, the weekday with lowest ridership. This finding confirmed that the analyzed facilities were primarily utilitarian. Further, bicycle volumes peaked in the summer months, with an additional ridership of 32% to 39% with respect to April. Finally, bicycle volumes increased by approximately 20% to 27% in 2009 and 35% to 40% in 2010 with respect to 2008 in the cycling facilities under analysis.
Bicycle Parking Analysis with Time Series Photography
Authors: Moskovitz David A. , Wheeler Nikki
Published: December 2011

Data and analysis of bicycle parking are necessary to evaluate facility designs and parking plans and for analysis of bicycle use more generally. Data and analysis of bicycle parking inform efforts to promote bicycle use and provide direction for policy makers and planners. However, there is a lack of research and data related to bicycle parking, and no standardized methodology exists for data collection. Measures such as duration and turnover have long been identified with vehicular parking studies, but these measures have not been standardized in the literature related to bicycle parking. This paper proposes a methodology for collecting detailed bicycle parking data. This methodology uses digital photography to capture parking data, including arrival and departure times, parking durations, and turnover rates. A trial data collection suggested ways in which the data could be used to answer specific research questions. In addition, the feasibility of the proposed methodology was evaluated, and the work effort needed to perform the collection and analysis was quantified. The methodology appeared to be useful for further academic research related to bicycle parking and had potential to provide valuable information for universities and public transportation agencies as they planned for, monitored, or improved bicycle parking facilities.
Much-Anticipated Marriage of Cycling and Transit
Authors: Bachand-Marleau Julie , Larsen Jacob , El-Geneidy Ahmed M.
Published: December 2011

In response to the environmental, economic, and social costs associated with overreliance on the automobile, planners and transportation professionals are promoting sustainable alternatives such as walking, cycling, and public transit, either as single modes or in combination. It has been argued that the marriage between cycling and transit presents opportunities for synergy by enlarging catchment areas of transit stations while drawing in new users to both of these green modes. However, because of the marginality of combining cycling and transit in North America, there is a shortage of reliable empirical studies in this area. The present study addressed this gap through an analysis of travel behavior and preferences related to cycle–transit (C-T) integration. An online survey was conducted in the region of Montreal, Canada, during the summer of 2010. The questionnaire included a section on Montreal's public bicycle sharing system, Bixi (bicycle taxi), and its potential for integration with transit. Three current or potential C-T user groups were identified through a factor–cluster analysis: current parking bike-and-riders, Bixi users, and car drivers. Bringing a bicycle on transit was the preferred form of integration; however, scenarios involving bicycle parking (or using a public bicycle) were likely to be used more regularly. To accommodate the greatest number of bicycle–transit trips, measures that facilitated parking at transit stops and those that enabled the bringing of bicycles on board transit vehicles were recommended in tandem.
Are Cycle Centers Effective Transport Interventions?
Authors: Burke Matthew I.
Published: December 2011

Cycle centers have emerged as a new travel demand management (TDM) intervention in U.S. and Australian cities in recent years. These large end-of-trip facilities for cyclists offer bicycle storage, changing rooms, lockers, showers, bicycle repair, and other amenities, on a user-pays basis. The effectiveness of these centers as a TDM measure is not known. Australia's first cycle center opened at King George Square in Brisbane's central business district in 2008. Operated by the private sector and marketed as cycle2city, the center provided storage for 420 bicycles. An evaluation framework was derived directly from the stated aims and objectives of the funders and manager–operators of the center. In April 2009, a questionnaire was sent to cycle2city members. The questionnaire was supplemented by interviews with funding agencies, the center's operators, and members. Route maps collected information on trip distances and the routes members chose to ride. The results showed who had been using the center, the travel modes they had been attracted from, and the transport benefits. Most users were men in white-collar jobs. The majority of members had commenced commuter cycling on joining cycle2city, at which time they switched from transit and the private car. Congestion-reduction benefits were small. The facility was not generating enough revenues to meet operating costs some 2 years after opening. The findings had direct implications for transport policy regarding the role and potential use of cycle centers for TDM in cities.
Studies of Modified Hydrogen Storage Intermetallic Compounds Used as Fuel Cell Anodes
Authors: Chen Yun , Santos Diogo M. F. , Sequeira César A. C. , Lobo Rui F. M.
Published: December 2011

The possibility of substituting Pt/C with the hydrogen storage alloy MlNi3.6Co0.85Al0.3Mn0.3 as the anode active material of a proton exchange membrane fuel cell system has been analyzed. The electrochemical properties indicate that a much more electrochemically active anode is obtained by impregnating the active material loaded anode in a Nafion proton conducting polymer. Such performance improvement might result from the increase of three-phase boundary sites or length in the gas diffusion electrode where the electrochemical reaction occurs. The experimental data revealed that the membrane electrode assembly (MEA) shows better results when the anode active material, MlNi3.6Co0.85Al0.3Mn0.3, is treated with a hot alkaline KBH4 solution, and then chemically coated with 3 wt.% Pd. The MEA with the aforesaid modification presents an enhanced surface capability for hydrogen adsorption, and has been studied by molecular beam-thermal desorption spectrometry.
Synthesis and Biological Activity of Some 3-(4-(Substituted)-piperazin-1-yl)cinnolines
Authors: Awad Eman D. , El-Abadelah Mustafa M. , Matar Suzan , Zihlif Malek A. , Naffa Randa G. , Al-Momani Ehab Q. , Mubarak Mohammad S.
Published: December 2011

A new series of 6-substituted-4-methyl-3-(4-arylpiperazin-1-yl)cinnolines 8–10 were synthesized as potential antifungal agents via intramolecular cyclization of the respective 1-(2-arylhydrazono)-1-(4-arylpiperazin-1-yl)propan-2-ones 5–7, mediated by polyphosphoric acid (PPA). The amidrazones themselves were synthesized via direct interaction of the appropriate hydrazonoyl chlorides 4a–d with the corresponding N-substituted piperazine in the presence of triethylamine. The structures of the new prepared compounds were confirmed by elemental analyses, 1H-NMR, 13C-NMR, and ESI-HRMS spectral data. The antitumor, antibacterial, and antifungal activity of the newly synthesized compounds was evaluated.
Vitamin D and Allergic Disease: Sunlight at the End of the Tunnel?
Authors: Jones Anderson P. , Tulic Meri K. , Rueter Kristina , Prescott Susan L.
Published: December 2011

A role for vitamin D in the regulation of immune function was first proposed after the identification of Vitamin D Receptors in lymphocytes. It has since been recognized that the active form of vitamin D, 1α,25(OH)2D3, has direct affects on naïve and activated helper T cells, regulatory T cells, activated B cells and dendritic cells. There is a growing body of literature linking vitamin D (serum 25(OH)D, oral intake and surrogate indicators such as latitude) to various immune-related conditions, including allergy, although the nature of this relationship is still unclear. This review explores the findings of epidemiological, clinical and laboratory research, and the potential role of vitamin D in promoting the inappropriate immune responses which underpin the rise in a broad range of immune diseases.
Anti-HCV RNA Aptamers Targeting the Genomic cis-Acting Replication Element
Authors: Marton Soledad , Berzal-Herranz Beatriz , Garmendia Eva , Cueto Francisco J. , Berzal-Herranz Alfredo
Published: December 2011

Hepatitis C virus (HCV) replication is dependent on the existence of several highly conserved functional genomic RNA domains. The cis-acting replication element (CRE), located within the 3' end of the NS5B coding region of the HCV genome, has been shown essential for efficient viral replication. Its sequence and structural features determine its involvement in functional interactions with viral RNA-dependent RNA polymerase and distant RNA domains of the viral genome. This work reports the use of an in vitro selection strategy to select aptamer RNA molecules against the complete HCV-CRE. After six selection cycles, five potential target sites were identified within this domain. Inhibition assays using a sample of representative aptamers showed that the selected RNAs significantly inhibit the replication (>80%) of a subgenomic HCV replicon in Huh-7 cell cultures. These results highlight the potential of aptamer RNA molecules as therapeutic antiviral agents.
The What, Who, and How of Ecological Action Space
Authors: Skill Karin
Published: December 2011

This text presents an analytical concept which is aimed at analysis of the construction of environmental responsibility—ecological action space. The concept makes it possible to analyze what environmental activities householders perform, who takes on the environmental responsibility, and how they motivate and justify everyday practices in relation to other actors. The concept builds on structuration theory, and is useful in studies of sustainable development in everyday life, and in investigations about how actors perceive their role in creating and solving environmental problems, and what actions they take in light of this. The concept should be used for empirical rather than normative studies. Relevant questions for a study about ecological action space are: What activities are considered environmentally friendly? How do the actors conceive of their opportunities to act in environmentally friendly ways and what constraints do they express? These questions are relevant not just for outspoken activists. When promoting increased participation, it is valuable to discuss when, where and how people are expected to get involved.
De la curiosité infantile à la science
Authors: Dupont Judith
Published: December 2011

Résumé Les psychanalystes font preuve d’une remarquable curiosité pour la vie privée et les motivations profondes de leurs prédécesseurs dans la profession. Pour la comprendre, faut-il remonter à la curiosité infantile pour la vie privée des parents?? Faut-il voir dans cette curiosité infantile un des mobiles du choix du métier d’analyste?? Comment concilier curiosité et respect pour la vie privée d’autrui?? Combien d’années faut-il pour que la vie privée devienne de l’Histoire?? Paul Roazen, professeur en sciences sociales et politiques, s’est fait historien de la psychanalyse pour partager cette curiosité, menant ses recherches avec le plus d’exactitude possible.
Homophobie à l'école
Authors: Gross Martine
Published: December 2011

Résumé Avoir des enfants quand on est gay ou lesbienne oblige à reconsidérer les stratégies de visibilité ou d’invisibilité qu’on avait mises en place pour se protéger soi-même de la stigmatisation. Des entretiens menés auprès de mères membres de l’Association de parents gays et lesbiens permettent d’explorer ces stratégies dans la manière de présenter l’enfant et sa famille aux professionnels de la petite enfance, à la direction de l’école maternelle ou à l’enseignant de l’école primaire. Lorsque l’enfant est jeune, la plupart des mères interrogées signalent le contexte familial particulier de l’enfant, car l’invisibilité n’est pas jouable. Avec l’âge et selon la localisation, la divulgation sélective remplace la visibilité totale. D’autres stratégies complémentaires sont mises en œuvre par les parents?: la «?maison ouverte?» et l’implication dans l’univers scolaire.
Être parent après une lésion cérébrale
Authors: Oppenheim-Gluckman Hélène
Published: December 2011

Résumé Y a-t-il risque de stigmatisation du parent cérébro-lésé?? La clinique montre une relation patient-entourage (famille, mais aussi soignants) souvent inégale et aliénante. Elle montre le risque de rupture des processus d’interreconnaissance entre le patient et son entourage et de bouleversement de la succession des générations, mais aussi les tentatives de lutte de chacun pour le maintien des repères identitaires et symboliques.
Failures in incentive transmission along Brazil's quality beef chain
Authors: de Queiroz Caleman Silvia Morales , Zylbersztajn Decio
Published: December 2011

Coordination mechanisms are key factors that affect the competitiveness of agrisystems. Brazilian beef chains are associated with less formal contractual relations compared to other food chains, resulting in frequent conflicts between cattle farmers and the processing industry. This study identifies the reasons for this phenomenon, raising the question of whether the observed incentive structures actually promote cooperation between production and industry. The study aims to explore the role of institutions and incentive structures in coordination failures within beef quality programs coordinated by the meatpacking industry. The issue is treated by considering the principal-agent theory and Transaction Costs Economics. We propose a model of incentive structures for the production of quality beef which considers specific investments made by cattle raisers and the meatpacking industry. In addition to specific investments, we also consider the role institutions play in reducing organizational failures. We adopt a mathematical and a strategic model to which game theory is applied. Quality is addressed using a multidimensional approach, since different product attributes are considered. The theoretical model is then validated in a multiple case study with three quality beef programs. The findings suggest that the complexity of designing efficient incentive structures makes the maintenance of beef quality programs an arduous task. The institutional role represented by formal contracts and horizontal coordination is a relevant aspect that has yet to be considered in preventing organizational failures. This study has academic and managerial implications.
How well do food retailers know their customers? The case of mountain food products in Europe
Authors: Baritaux Virginie , Tebby Cleo , Revoredo-Giha Cesar
Published: December 2011

The issue of how well retailers predict consumers' preferences and requirements for food products has seldom been examined in literature. This paper deals with this issue focusing on the specific case of mountain food products (MFP) in Europe. Due to consumers' imperfect knowledge of MFP and the absence of an official definition of these products, retailers are surrounded with uncertainty about how to market these products and especially about how consumers perceive and assess MFP. In this paper, we analyse retailers' perceptions as regards MFP and the extent to which they match consumers' views. Results reveal that retailers' perceptions differ by country. They also show that retailers associated with 'alternative' supply chains seem to have a more accurate perception of consumers' preferences as regards MFP.
Cyber Situation Awareness through Instance-Based Learning
Authors: Dutt Varun , Gonzalez Cleotilde
Published: December 2011

In a corporate network, the situation awareness (SA) of a security analyst is of particular interest. The current work describes a cognitive Instance-Based Learning (IBL) model of an analyst’s recognition and comprehension processes in a cyber-attack scenario. The IBL model first recognizes network events based upon events’ situation attributes and their similarity to past experiences (instances) stored in the model’s memory. Then, the model comprehends a sequence of observed events as being a cyber-attack or not, based upon instances retrieved from its memory, similarity mechanism used, and the model’s risk-tolerance. The execution of the model generates predictions about the recognition and comprehension processes of an analyst in a cyber-attack. A security analyst’s decisions in the model are evaluated based upon two cyber-SA metrics of accuracy and timeliness. The chapter highlights the potential of this research for design of training and decision support tools for security analysts.
Connectedness: Some Skills for Spiritual Health
Authors: Bellingham Richard , Cohen Barry , Jones Todd , Spaniol LeRoy
Published: December 2011

This article explores the relationship between connectedness and spiritual health. Three forms of connectedness are discussed: connecting with oneself, with others, and with a larger meaning or purpose. Eight connectedness skills are suggested. Combined, these skills may lead to an enhanced sense of spiritual well-being.
Health Promotion Data for State Health Departments: Telephone versus in-Person Survey Estimates of Smoking and Alcohol Use
Authors: Anda Robert F. , Dodson Dennis L. , Williamson David F. , Remington Patrick L.
Published: December 2011

During 1988, more than 40 state health departments conducted telephone surveys to obtain state-specific population estimates of the prevalence of adult health behaviors and health practices. However, the comparability of estimates obtained from these telephone surveys with more expensive in-person surveys has not been assessed in an applied setting.

This study compared the prevalence estimates of smoking and binge drinking obtained from a telephone survey (N = 1,492) with an in-person survey (N = 2,802) which were conducted by the state of Michigan during 1982–1983.

Although the standard errors for the differences in the estimates for the two surveys were relatively large, the actual differences were consistently small within most age-, sex-, and education-specific groups.

Despite certain limitations, telephone surveys provide a reasonable alternative to in-person surveys for estimating the prevalence of health behaviors. The data obtained from these surveys are being used to set state health objectives, to plan statewide health promotion programs, and to support public health legislation.
Economic Incentives to Reduce Employee Smoking: A Health Insurance Surcharge for Tobacco Using State of Kansas Employees
Authors: Penner Maurice
Published: December 2011

Cigarette smoking has been clearly established as the single most important, preventable cause of morbidity and mortality. Employers are actively working to reduce smoking among current employees, and a growing number will not hire smokers. While most efforts have focused on either 1) helping smokers overcome their habit, or 2) banning or severely limiting worksite smoking, very little has been done to provide strong economic incentives for current employees to give up smoking. This paper reports on the planning and implementation of a $10 per month surcharge added to employee contributions for health insurance for persons employed by the State of Kansas. Family coverage is not affected. Also discussed is a similiar effort in the Colorado state employee group health plan.
Establishing Communication Networks for Health Promotion in Industrial Settings
Authors: Heirich Max A. , Cameron Victoria , Erfurt John C. , Foote Andrea , Gregg Walt
Published: December 2011

Health educators, medical personnel, and managers interested in worksite efforts to change health behaviors often face problems in communicating effectively with rank and file members of the workforce. This article describes an effective strategy for getting health information flowing among an industrial workforce and changing health behaviors. Identifying effective communication routes at a worksite and creating new ones, establishing relationships with key information carriers, and making health information salient to potential communicators are keys to successful information flow. Wellness Committees can provide access to formal communication routes, which may or may not work for health information. One-to-one counseling and development of buddy systems, however, create short-link, health-oriented communication networks. If people whom large numbers of employees contact for plant business get recruited into these health networks, information spreads rapidly. Poster posting can generate interaction with people so that they read and talk about health messages. Unusual motion, sound, and messages can call attention to special events. Using these methods has increased participation in specific health activities from a handful to between fifty and one hundred people at a time.
The Total Life Concept Transplanted from AT&T to Sandia National Laboratories
Authors: Harris Susan L. , Ewing Judy W.
Published: December 2011

This study illustrates how the Total Life Concept (TLC) program originated by AT&T was successfully transplanted to another work site, Sandia National Laboratories. Demographics of the participants at AT&T and Sandia differ and make comparisons difficult, but it is possible to assess program impact in terms of participation rates for each program.

The original AT&T TLC pilot study had three major components: orientation, testing, and risk interpretation; lifestyle-improvement courses; and activities to promote health. Sandia kept the three major components of the AT&T TLC concept and made some modifications to meet Sandia's needs.

Sandia's experience of adopting a model program and tailoring it to local needs worked well, demonstrating that an existing model can be successfully altered to meet the needs of different companies in varied settings.
Initial Development of an Inventory to Assess Stress and Health Risk
Authors: Nowack Kenneth M.
Published: December 2011

In recent years, considerable attention has been given to the role of individual variables in the stress-illness relationship. Of particular value at this point are measurement tools and studies that evaluate the possible effects of two or more individual variables on health status. This study summarizes the initial development, psychometric properties, and validation of a brief, rationally derived, and reliable stress and health risk factor instrument. The 123-item instrument has shown criterion-related validity with both physical and psychological health outcomes in a study with 194 employees working in several large companies in the Los Angeles area. Implications for future development, application, and research are discussed.
A Health Promotion Program for Medical Students: Louisiana State University Medical Center
Authors: Wolf Thomas M. , Randall Howard M. , Faucett John M.
Published: December 2011

A health promotion program for medical students at Louisiana State University Medical Center (LSUMC) in New Orleans encourages students to take responsibility for their own physical and psychological health and well-being, enabling them to better cope with the stressors of medical education and those of later clinical practice.

Administrative support for developing the program was considerable, and a broad-based Health Promotion Committee, comprising faculty, administrators, and students, was established to oversee the program. The program's cost was minimal, inasmuch as most components were offered voluntarily by full-time faculty. The most consistent funding came from the LSUMC Student Health fee, although grants and pharmaceutical companies also provided support.

A full day of orientation was devoted to the program. The students completed a thorough lifestyle and nutrition assessment and used the results to help decide which component to sign up for: aerobics, relaxation/meditation, support groups, time management, and nutrition. Participation was voluntary, and aerobics and relaxation/meditation were the best attended. Overall, the students responded favorably to the orientation day and found the components valuable and useful. Students reported improvements on eight of 11 wellness dimensions and a composite score from a lifestyle assessment questionnaire over the one-year longitudinal study. These gains may in part be attributable to the program. The nutrition findings suggest entering medical students do not have better dietary practices than comparable young adults living in the United States. Students most often requested information on these topics: relaxation/stress reduction, exercise programs, time-management skills, nutrition, and learning skills.

Offering individualized and diverse programs to students is important. A major challenge has been to motivate students to participate, and means are recommended for improving participation. Program evaluation is essential; therefore, problems in this area are discussed. Also, including physical and biochemical measures is desirable.

We believe incorporating the principles of health promotion and disease prevention throughout the medical education curriculum is essential. Medical students taking responsibility for their own health are more likely to promote this self-responsibility with their patients in clinical practice.
A Review of Five Major Community-Based Cardiovascular Disease Prevention Programs. Part I: Rationale, Design, and Theoretical Framework
Authors: Shea Steven , Basch Charles E.
Published: December 2011

Major community-based cardiovascular disease prevention programs have been conducted in North Karelia, Finland; the state of Minnesota; Pawtucket, Rhode Island; and in three communities and more recently in five cities near Stanford, California. These primary prevention programs aim to reduce cardiovascular disease incidence by reducing risk factors in whole communities. These risk factors are smoking, high blood cholesterol, diet high in cholesterol and saturated fat, hypertension, sedentary lifestyle, and obesity. This strategy may be contrasted with secondary prevention programs directed at patients who already have symptomatic cardiovascular disease and “high risk” primary prevention programs directed at individuals found through screening to have one or more risk factors. The design of the five major programs is similar in that intervention communities are matched for purposes of evaluation with nearby comparision communities. Underlying these programs are theories of community health education, social learning, communication, social marketing, and community activation, as well as more traditional biomedical and public health disciplines. This is Part I of a two-part article.
The Accuracy of Substitution Rules for Health Risk Appraisals
Authors: Berlin Jesse A. , Thorington Bruce D. , McKinlay John B. , McKinlay Sonja M.
Published: December 2011

Health Risk Appraisals (HRAs) have been in increasingly wide use over the past 20 years as health education tools designed to encourage healthy behaviors. A major criticism of HRAs has been the error introduced by missing or incorrectly-specified responses by clients, especially regarding physiological measures such as blood pressure and cholesterol.

Four HRAs were randomly assigned to members of a random sample of Massachusetts residents as part of a trial to assess the reliability and validity of HRA instruments. Two rules for substituting unknown physiological measures were evaluated: the existing rule for an HRA and a new rule, which simply substitutes the age- and gender-specific mean physiological values. Ordinary least squares regression was used to compare risk scores generated from known physiological measures, taken in respondents' homes, with risk scores generated by substitution.

Regression slopes were mostly close to 1.0, most intercepts were relatively close to 0.0, and correlations were all extremely high, suggesting good performance of substitution rules on a group level. However, outliers from the regressions tended to be individuals at high risk whose risk was underestimated by the substitution rules. These results raise ethical questions about the use of substitution rules and reinforce the need for taking actual physiological measurements.
HIV Infection: Assessment of Sexual Risk, Knowledge, and Attitudes towards Prevention in 1,586 High School Students in the Toulouse Education Authority Area
Authors: Malavaud Sandra , Dumay Françoise , Malavaud Bernard
Published: December 2011

In view of the spread of the AIDS epidemic in France, knowledge of the disease and sexual behavior, particularly use of condoms, was examined in 1,586 high school pupils in the Toulouse area. Modes of HIV transmission were found to be well known. However, some misconceptions existed, including the possibility of contagion from drinking utensils or from being around someone with AIDS. One third of the pupils had had sexual intercourse with more than one partner, and of these, 42 percent had never used condoms. A total of 65 percent of those questioned were in favor of condom use, but nearly 25 percent of students who had already used condoms found them difficult to use. Use of condoms appeared more likely if students felt personally at risk.
Improving Participation in Worksite Wellness Programs: Comparing Health Education Classes, a Menu Approach, and Follow-up Counseling
Authors: Erfurt John C , Foote Andrea , Heirich Max A. , Gregg Walter
Published: December 2011

Findings are presented from a study to compare four types of worksite wellness programs to reduce cardiovascular risks. Using a quasi-experimental design, the study was implemented in four large manufacturing plants, similar in demographic characteristics. At the end of the three-year study period, the two sites that included individual outreach and counseling had engaged about 46 percent of identified smokers and 54 percent of the overweight into smoking cessation and weight loss activities, respectively. This compares with fewer than 10 percent at the site offering health education classes only, and less than one percent at the control site. In order to achieve these results, the outreach and follow-up counseling was coupled with a menu of interventions for smoking cessation and weight loss, to accommodate the needs of people who cannot or will not participate in classes. The menu includes guided self-help, one-to-one counseling, mini-groups, and full classes.
A Review of Five Major Community-Based Cardiovascular Disease Prevention Programs. Part II: Intervention Strategies, Evaluation Methods, and Results
Authors: Shea Steven , Basch Charles E.
Published: December 2011

Major community-based cardiovascular disease prevention programs have been conducted in North Karelia, Finland; the state of Minnesota; Pawtucket, Rhode Island; and in three communities and more recently in five cities near Stanford, California. The main hypothesis is that community intervention will reduce the prevalence of cardiovascular disease risk factors and consequently reduce cardiovascular disease incidence, morbidity, and mortality. Intervention strategies include community mobilization, social marketing, school-based health education, worksite health promotion, screening and referral of those at high risk, education of health professionals, direct education of adults, and modification of physical environments. Formative evaluation provides short-term feedback to program managers about immediate effects of intervention strategies. Outcome evaluation examines the effects of intervention on longitudinally sampled cohorts and compares cardiovascular risk status and morbidity and mortality in intervention and comparison communities. Results from North Karelia and the Stanford Three Community Study indicate that this model is efficacious and cost-effective. The National Heart, Lung, and Blood Institute biomedical research spectrum envisions research in knowledge transfer and innovation diffusion as the last link in the causal chain whereby research affects the health of the population, but research in this area remains undeveloped compared to other aspects of cardiovascular disease prevention. This is Part II of a two part article; Part I appeared in Volume 4, Number 3.
Rapid Assessment of Dietary Intake of Fat, Fiber, and Saturated Fat: Validity of an Instrument Suitable for Community Intervention Research and Nutritional Surveillance
Authors: Kristal Alan R. , Shattuck Ann L. , Henry Holly J. , Fowler Ann S.
Published: December 2011

Traditional methods to assess changes in dietary intake, for example food frequency questionnaires or 24-hour dietary recalls, are often not practical: they are lengthy, expensive, and unsuitable for telephone administration. This article describes the development and evaluation of an approach to the rapid assessment of the dietary intake of nutrients of most interest in health promotion research; total fat, saturated fat, dietary fiber, and percent of calories from fat. In this validation study on 97 women, short dietary questionnaires were compared to two criterion measures of usual dietary intake, a food frequency questionnaire and the mean of two four-day diet records. Correlations between self-administered short questionnaires and four-day diet records were 0.52, 0.53, 0.61, and 0.40 for total fat, percent of calories from fat, saturated fat, and dietary fiber, respectively. These correlations are similar to those observed between food frequency questionnaires and four-day diet records, which suggests that this approach to developing and administering short dietary questionnaires may be useful in situations where more expensive and time-consuming methods of dietary assessment are not practical.
Health Conception, Health Locus of Control, and Power as Predictors of Smoking Behavior Change
Authors: Segall Mary E. , Wynd Christine A.
Published: December 2011

The purpose for this study was to examine the value of health conception, health locus of control, and power as predictors of success or failure with smoking behavior change. Discriminant analysis was used to differentiate between subjects who successfully abstained from smoking and those who resumed smoking following participation in a smoking control program. Results indicated that an external locus of control, including expected outcomes attributed to chance and powerful others, a clinical-based conception of health, and a heightened sense of awareness, distinguished recidivists from successful abstainers. Study findings may have implications for identifying smokers who have a high probability of failing in initial attempts to quit smoking. Special instructions and interventions need to be designed to help these smokers develop a broader definition of health as more than the absence of disease, a greater sense of internal control over health practices, and an increased sense of power for participating in behavioral change.
Self-Selection in Responding to a Health Risk Appraisal: Are We Preaching to the Choir?
Authors: Nice D. Stephen , Woodruff Susan I.
Published: December 2011

The objectives of the present study were a) to examine behavioral and sociodemographic factors associated with voluntary response to a health risk appraisal (HRA), and b) to assess the effect of HRA feedback on subsequent preventive health behaviors and risk-taking behaviors. After collection of health behavior data from a larger sample participating in a Navy-wide health promotion evaluation, an HRA was mailed to a random subsample of 625 individuals. A total of 270 (43%) people responded to the HRA and received printed feedback. Follow-up health behavior data were collected one year later from 93 of the 270 HRA respondents. These 93 individuals were then matched with a control group who did not receive an HRA but had provided health behavior data both times. Analyses revealed that HRA respondents were older, better educated, had higher health status, smoked less, consumed less alcohol, and used seat belts more often than nonrespondents. Separate analyses of HRA respondents and matched controls indicated that HRA participation had no significant effect on subsequent preventive health behaviors or risk-taking behaviors. Results suggest limitations of the HRA as an effective cue to behavior change.
Health Risk Assessment: Suggested Directions for Research
Authors: DeFriese Gordon H.
Published: December 2011

Despite the widespread acceptance and importance of HRA as a method for health education and health promotion, research on the method is deficient in a number of respects. Most of the research has been preoccupied with the technical problems of risk estimation, not the educational impact of the method on those who respond to HRA instruments or participate in subsequent information feedback or behavior modification programs.20 If we are to better understand the implications of HRA-based techniques as educational instruments or as assessment devices for evaluating the effects of health programs, the underlying research base must expand. Rather than focusing exclusively on the methods by which risks are estimated within the structure of any particular instrument, research in the future needs to address a larger agenda which includes the potential educational implications of the method. Given the extent of use of HRA, research in this field should be a rewarding and valued enterprise for many years ahead.
Correlates of Internists' Practices in Caring for Patients with Elevated Serum Cholesterol
Authors: Shea Steven , Basch Charles E. , Zybert Patricia
Published: December 2011

This study examined the relationship between internists personal health practices, health beliefs, and demographic characteristics and their reported practices in caring for patients with elevated serum cholesterol. A questionnaire was mailed to 271 internists (181 respondents) on the medical staff of an urban university hospital. Perceived ability to provide dietary counseling was consistently associated with interventions offered by the internists themselves, including education, counseling, and use of lipid-lowering drugs and with defining elevation of serum cholesterol at a lower value. It was not associated with referral to the dietitian or the Lipid Clinic. There were only weak and inconsistent associations between physician personal health practices, including diet and having a personal cholesterol goal, and any of the physician-reported professional practices examined. These findings strengthen the hypothesis that there is a relationship between physicians' perceived competence and their use of diet counseling and lipid-lowering drugs.
Project LEAN: A National Campaign to Reduce Dietary Fat Consumption
Authors: Samuels Sarah E.
Published: December 2011

The Henry J. Kaiser Family Foundation initiated a social marketing campaign in 1987, to reduce the nation's risk for heart disease and some cancers. Project LEAN (Low-Fat Eating for America Now) encourages reduction in dietary fat consumption to 30 percent of total calories, by 1998, through public service advertising, publicity, and point-of-purchase programs in restaurants, supermarkets, and school and worksite cafeterias. The campaign has joined efforts with the Partners for Better Health, a coalition of over thirty national health and consumer organizations that are working towards a common goal of improved health through nutrition. Project LEAN has provided funds to states and communities to intitiate local campaigns and work with chefs, food professionals, and the food industry to change norms and customs in food preparation and manufacturing. The goal of the campaign is to accelerate the trend in fat reduction and to stimulate the greater availability of low-fat food choices in the marketplace.
Cost-Benefit and Cost-Effectiveness Analysis for Health Promotion Programs
Authors: Barry Patricia Z. , DeFriese Gordon H.
Published: December 2011

Health promotion programs have been hailed as having great potential to help solve the problem of rapidly increasing health care costs. In order to assess whether health promotion programs are “worth it,” some kind of cost-benefit or cost-effectiveness analysis must be included as part of program evaluation. This article provides a basic introduction to the concepts of cost-benefit and cost-effectiveness analysis, compares them, and presents a simple procedure for performing a basic cost-effectiveness analysis. The potential for health promotion programs to impact on the rising costs of medical care is discussed.
Systematic investigation of parameters affecting ozonation oxidation of emerging contaminants
Authors: Yue Chaoyang , Seth Rajesh , Tabe Shahram , Zhao Xiaoming , Yang Paul
Published: December 2011

The effect of five process variables‐pH, dissolved organic matter (DOM), ozone concentration, contact time, and temperature— on the removal efficiency of 14 selected pharmaceutically active compounds and bisphenol A was studied through fractional factorial‐ designed experiments. Results showed that DOM content and ozone dose had the most significant effect, accounting for 60–99% of the observed variability in oxidation efficiencies for compounds with both fast and slower reaction rates with ozone. Oxidation efficiency of > 90% is expected for the fast‐reacting compounds at ozone exposures > 1.3 mg/L × min, over the wide range of operating conditions used in the study. For compounds with a slower reaction rate with ozone, the oxidation efficiency is expected to be variable and strongly dependent on the characteristics of the raw water, particularly the concentration and nature of the DOM.