bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Variation in Treatment Costs: A Cost Function for Outpatient Methadone Treatment Programs
Authors: Dunlap Laura J. , Zarkin Gary A. , Cowell Alexander J.
Published: October 2007

Objectives. To estimate a hybrid cost function of the relationship between total annual cost for outpatient methadone treatment and output (annual patient days and selected services), input prices (wages and building space costs), and selected program and patient case‐mix characteristics.

Data Sources. Data are from a multistate study of 159 methadone treatment programs that participated in the Center for Substance Abuse Treatment's Evaluation of the Methadone/LAAM Treatment Program Accreditation Project between 1998 and 2000.

Study Design. Using least squares regression for weighted data, we estimate the relationship between total annual costs and selected output measures, wages, building space costs, and selected program and patient case‐mix characteristics.

Principal Findings. Findings indicate that total annual cost is positively associated with program's annual patient days, with a 10 percent increase in patient days associated with an 8.2 percent increase in total cost. Total annual cost also increases with counselor wages (p<.01), but no significant association is found for nurse wages or monthly building costs. Surprisingly, program characteristics and patient case mix variables do not appear to explain variations in methadone treatment costs. Similar results are found for a model with services as outputs.

Conclusions. This study provides important new insights into the determinants of methadone treatment costs. Our findings concur with economic theory in that total annual cost is positively related to counselor wages. However, among our factor inputs, counselor wages are the only significant driver of these costs. Furthermore, our findings suggest that methadone programs may realize economies of scale; however, other important factors, such as patient access, should be considered.
Gender Differences in Friends’ Influences on Adolescent Drinking: A Genetic Epidemiological Study
Authors: Dick Danielle M. , Pagan Jason L. , Holliday Candice , Viken Richard , Pulkkinen Lea , Kaprio Jaakko , Rose Richard J.
Published: October 2007

Background:  We use data from a population‐based twin study to examine the association between characteristics of the friendship group and adolescents’ own alcohol use at age 14, with focus on gender differences, both with respect to the adolescent’s own gender and the gender composition of his/her friendship group.

Methods:  (1) We conducted analyses on the full epidemiological sample of individuals to determine the magnitude of association between friendship characteristics and alcohol use, and to test for interaction with gender and gender of friends. (2) We used the twin structure of the dataset to study the extent to which similarity in drinking behaviors between adolescents and their friends was due to shared genetic and/or environmental pathways.

Results:  Friends’ drinking, smoking, and delinquency were more strongly related to alcohol use in girls, compared to boys, and in adolescents with opposite‐sex friends, compared to adolescents with only same‐sex friends. Friends’ alcohol use showed modest evidence of genetic influence in girls, suggesting peer selection; however, there was no evidence of genetic influence on friends’ alcohol use in boys. The correlation between adolescent and friend drinking was largely attributable to shared environmental effects across genders.

Conclusions:  Gender and gender of friends moderate the associations between friends’ behavior and adolescents’ alcohol use, with evidence that girls, and those with opposite‐sex friends, may be more susceptible to friends’ influence. Genetically informative analyses suggest that similarity in alcohol use between adolescents and their friends is mediated, at least partially, through environmental pathways.
Concurrent Dietary Administration of D‐SAL and Ethanol Diminishes Ethanol’s Teratogenesis
Authors: Parnell Scott E. , Chen Shao‐yu , Charness Michael E. , Hodge Clyde W. , Dehart Deborah B. , Sulik Kathleen K.
Published: October 2007

Background: SAL (SALLRSIPA) is a peptide fragment of activity‐dependent neurotrophic factor. Both L‐ and D‐SAL diminish ethanol’s pathogenesis, however, the D‐peptide is protease resistant, and can therefore be effectively administered in a diet. The present study tested the hypothesis that D‐SAL provided in a liquid diet containing ethanol will prevent ethanol‐induced teratogenicity in mice.

Methods: Following an ethanol acclimation period, female C57Bl/6J mice were withdrawn from the ethanol, bred, and then returned during gestational days (GD) 7 and 8 to a control liquid diet or one containing 4.8% ethanol alone or in combination with 5.6 μg/ml D‐SAL. At these doses, the mice received approximately 75 μg of D‐SAL on each day and achieved peak blood‐alcohol concentrations on GD 8 that ranged from 148–162 mg/dl. On GD 14, the fetuses were examined for the presence of ocular abnormalities including microphthalmia and irregularly shaped pupils, teratogenic effects known to result from this ethanol exposure paradigm.

Results: Dietary D‐SAL reduced the incidence of ocular defects in ethanol‐exposed fetuses from 29 to 10% in the right eyes and from 21 to 7.5% in the left eyes; levels similar to those observed in pair‐fed controls. In addition to decreasing their incidence, D‐SAL also reduced the severity of the ocular defects.

Conclusions: These results demonstrate that oral D‐SAL can prevent ethanol‐induced ocular defects. Because ocular defects are commonly associated with CNS damage, oral D‐SAL may also prove valuable in preventing ethanol‐induced brain defects.
Alcohol Exposure During Development: Analysis of Effects on Female Sexual Behavior
Authors: Gass Justin T. , Jenkins William J. , Marino Melissa D. , Lugo Joaquin N. , Kelly Sandra J.
Published: October 2007

Background: Alcohol exposure during development has been shown to alter a variety of social behaviors in both humans and rodents. Sexual behavior in rodents has been well characterized and lends itself to a detailed investigation of the manner in which ethanol impacts this particular social behavior.

Methods: Rats were exposed to ethanol during both the prenatal and early postnatal period (ET). Control groups included rats exposed to the administration procedures alone (intubated‐control) and nontreated controls (NC). Sexual behavior of intact naïve female rats in estrus was assessed in adulthood (approximately postnatal day 90) and activity was measured by the number of crossings between chambers in the 3‐chamber test apparatus. A separate study examined the olfactory preferences for 4 odors by intact naïve female rats in all 3 groups. The 4 odors were the odors resulting from 1 hour of occupation of the test chamber by an intact male, 1 hour of occupation of the test chamber by a gonadectomized male, 0.5 ml of urine from an intact male, and 0.5 ml of urine from a gonadectomized male.

Results: ET female rats showed a reduced return latency after ejaculation compared to both control groups. There was a trend toward a reduction in percent exits after all forms of male behavior in the ET animals compared to the control groups. No significant differences across groups were seen in the lordosis quotient, activity, or the behavior of the nonexperimental male. ET female rats showed a reduced preference for the odor from the intact male compared to both control groups and a reduced preference for the odor from the gonadectomized male compared to NC females only.

Conclusions: These data suggest that ethanol exposure during the prenatal and postnatal period in females alters sexual motivation and changes the processing of olfactory cues and possibly coital cues from male rats.
Nicotine’s Effects on Attentional Efficiency in Alcoholics
Authors: Jo Nixon Sara , Lawton‐Craddock Andrea , Tivis Rick , Ceballos Natalie
Published: October 2007

Background: Historically, the concomitant use of nicotine among alcoholics has not been methodologically accounted for. Given the observed cognitive enhancing effects of acute nicotine on attentional processes, it is important that the potentially positive effects of nicotine be disentangled from the negative effects of chronic alcohol dependence. The current study was conducted to address this question and to test the hypothesis that alcoholics who are regular smokers are more sensitive to the effects of nicotine on cognition as compared to regular smoking community controls.

Methods: A 2 [drug group; alcoholics (n = 28), community controls (n = 27)] X 2 nicotine dose level [low (7 mg dose) vs. high (14 or 21 mg dose)] double‐blind design was used to assess the differential effects of nicotine dose on a battery of neurocognitive tests focusing on attentional efficiency.

Results: As expected, the alcoholic group performed more poorly than did the control group. However, of greater interest to the current study was the finding that alcoholic participants differentially benefited from nicotine administration, as demonstrated in the differential dose effect.

Conclusion: The concomitant use of nicotine may serve to “mask” or “overcome” some of the negative effects of chronic alcohol dependence in newly recovering alcoholics. This potential effect has significant implications for treatment development and further understanding of the process of recovery of function in chronic alcoholics.
Gender Differences for Ghrelin Levels in Alcohol‐Dependent Patients and Differences Between Alcoholics and Healthy Controls
Authors: Wurst Friedrich M. , Graf Iris , Ehrenthal Hans D. , Klein Silvia , Backhaus Jutta , Blank Sebastian , Graf Marc , Pridzun Lutz , Wiesbeck Gerhard A. , Junghanns Klaus
Published: October 2007

Background:  Ghrelin is a 28‐amino acid gut‐brain peptide, mainly secreted by the gastric mucosa. Its effects are linked to energy homeostasis and particularly seem to increase hunger and food intake. In recent years, studies suggested that appetite‐regulating peptides, such as ghrelin play a relevant role in alcoholism. Since data published to date on the potential role of ghrelin as state and/or trait marker in alcoholism and the association with craving are controversial, we aimed at further elucidating these aspects.

Patients and Methods:  One‐hundred nine alcohol‐dependent abstinent patients after withdrawal (27 f, 82 m), (ICD 10 F 10.25) and 45 healthy volunteers (12 f, 33 m) were included. Laboratory testing (Ghrelin RIA 90, Mediagnost Inc., Germany) was performed and several craving scales [Obsessive Compulsive Drinking Scale, Alcohol Urge Questionnaire and Visual Analogue Scale (VAS)] were applied at the beginning and at the end of the 3‐week rehabilitation program.

Results:  (1) Ghrelin levels are significantly higher in female alcohol‐dependent patients as compared to controls, not, however, in men alcoholics. (2) In several statistical subanalyses, an association of craving and ghrelin was found. The results, however, remain heterogeneous.

Conclusion:  The data suggest gender‐dependent ghrelin levels in alcohol‐dependent patients. We therefore conclude, that it might be useful to perform statistical analyses gender‐specific. With regard to a potential correlation of ghrelin and craving the results seem to depend on gender, duration of the abstinence period and the instrument used.
Underserved and Unprepared: Postsecondary Learning Disabilities
Authors: Gregg Noel
Published: October 2007

The adolescent and adult population with learning disabilities (LD) continues to be underserved and underprepared to meet the demands of postsecondary education. Evidence pertaining to postsecondary education outcomes for the population with LD is extremely bleak. One purpose of this article is to situate thinking about adolescents and adults with LD across the spectrum of ability and socioeconomic status within the current world context. The second objective is to heighten awareness of the changing needs of this population based on social, educational, economic, and political directives. Several academic options are presented as alternative pathways available to individuals in the transition from secondary to postsecondary environments.
Determining Appropriate Accommodations for Postsecondary Students with Reading and Written Expression Disorders
Authors: Lindstrom Jennifer H.
Published: October 2007

One of the most significant barriers facing postsecondary students with reading and written expression disorders who are eligible to receive specific accommodations is the lack of professional knowledge pertaining to issues surrounding accommodations. Though guided by Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act, the process by which accommodation decisions are made varies considerably across institutions of higher education. Given the recent rise in litigation surrounding the practice of how accommodations are determined as well as the increasing number of postsecondary students with reading and writing disabilities who are requesting accommodations, it is imperative that accommodation decisions be defensible and supported by empirical research. The purpose of this article is to provide an overview of current research on the effectiveness of accommodations for postsecondary students with language‐based learning disabilities, discuss important considerations in the accommodation selection process, and offer recommendations for future research.
Math, Science, and Foreign Language: Evidence‐Based Accommodation Decision Making at the Postsecondary Level
Authors: Ofiesh Nicole S.
Published: October 2007

Accommodations in postsecondary settings have become commonplace for many students with learning disabilities (LD) who have documented needs. Many of the accommodations professionals recommend for students with LD are based on an analysis of the course demands, the student's functional limitations, and a basic understanding of how the accommodation can facilitate the demonstration or acquisition of knowledge. However, little is known about which accommodations are recommended for math, science, and foreign language courses as well as the effectiveness of those accommodations. Because these content areas pose substantial hurdles for secondary students with LD who may transition to postsecondary settings, a review of the literature was conducted to evaluate current practices in the provision of accommodations to postsecondary students with LD in math, science, and foreign language courses. Findings indicate strong empirical evidence for extended test time for algebra exams and emerging research in changes to foreign language instruction. Recommendations for further research are provided.
Misconceptions Regarding Accommodations on High‐Stakes Tests: Recommendations for Preparing Disability Documentation for Test Takers with Learning Disabilities
Authors: Brinckerhoff Loring C. , Banerjee Manju
Published: October 2007

The process of submitting documentation to testing agencies as proof of a disability can be time consuming, expensive, and even intimidating to test takers with learning disabilities. Misconceptions about the accommodations review process employed by testing agencies add to the anxiety that many test takers feel around obtaining approval for high‐stakes test accommodations. The objective of this article is to clarify some of these misconceptions as well as shed more light on the accommodation decision‐making process employed by testing agencies.
Who are Most, Average, or High‐Functioning Adults?
Authors: Gregg Noel , Coleman Chris , Lindstrom Jennifer , Lee Christopher
Published: October 2007

The growing number of high‐functioning adults seeking accommodations from testing agencies and postsecondary institutions presents an urgent need to ensure reliable and valid diagnostic decision making. The potential for this population to make significant contributions to society will be greater if we provide the learning and testing accommodations to allow them access to knowledge, as well as the means to demonstrate their extraordinary abilities. The criteria and decision making used to identify high‐functioning adults with learning disabilities (LD) must be robust yet flexible enough to account for individual differences, measurement fallibility, and examiner expertise. The purpose of this article is to explore legal, measurement, and clinical issues surrounding the provision of accommodations to high‐functioning individuals with LD.
Remarkable Strontium B‐Site Occupancy in Ferroelectric Pb(Zr1−xTix)O3 Solid Solutions Doped With Cryolite‐Type Strontium Niobate
Authors: Feltz Adalbert , Schmidt‐Winkel Patrick , Schossmann Michael , Booth Corwin H. , Albering Jörg H.
Published: October 2007

New high‐performance ferroelectric solid solutions based on Pb(Zr1−xTix)O3 (PZT), which are doped with cryolite‐type strontium niobate (SNO, Sr4(Sr2−2y/3Nb2+2y/3)O11+yVO;1−y with 0≤y≤1) and hence denoted PZT:SNO, and their microscopic structure and defect chemistry are described. Extended X‐ray absorption fine‐structure (EXAFS) analyses of PZT:SNO samples revealed that ∼10% of Sr2+ occupy the nominal B‐sites of the perovskite‐type PZT host lattice. This result is supported by EXAFS analyses of both a canonical SrTiO3 perovskite and two SNO model and reference compounds. Fit models that do not account for Sr2+ on B‐sites are ruled out. A clear Sr–Pb peak in Fourier‐transformed EXAFS data visually confirms this structural model. The generation of temporary oxygen vacancies and the intricate defect chemistry induced by SNO‐doping of PZT are crucial for the exceptional material properties of PZT:SNO. As a result, ferroelectric PZT:SNO solid solutions are very attractive for use in new and innovative piezoelectric actuator and transducer applications.
Effect of Anisotropic Microstructure on the Viscous Properties of an LTCC Material
Authors: Ollagnier Jean‐Baptiste , Guillon Olivier , Rödel Jürgen
Published: October 2007

The sintering behavior of a glass–ceramic (commercial material Ceramtape GC) was characterized using the discontinuous sinter‐forging technique. The uniaxial viscosity Ep and the viscous Poisson's ratio np of the composite body were determined as a function of density. Particular attention was paid to microstructural changes in order to quantify the anisotropy induced by load application. Pores and alumina particles were found to be both oriented perpendicular to the applied load direction. Finally, the experimental results were used to predict the value of the hydrostatic sintering stress.
Microhabitat use, movements and abundance of gilt darters (Percina evides) in southern Appalachian (USA) streams
Authors: Skyfield J. P. , Grossman G. D.
Published: October 2007

Abstract –  We examined microhabitat use by gilt darters (Percina evides) in two streams in the south‐eastern USA. Darters were over‐represented in erosional microhabitats with higher average velocities and more cobble. Male darters tended to show stronger selection than females. Size‐based analyses showed that larger (≥60 mm) gilt darters tended to use microhabitats with more heterogeneous substrata and more boulder than smaller (≤59 mm) darters. We also conducted a short‐term movement study and calculated population estimates based on mark–recapture data in autumn 2005. Darters moved both long and short distances with 40% of all recaptures occurring within 5 m of the initial capture point. Using Program mark and model‐averaged parameter estimates gilt darter density was 0.31 darters·m−2 (225 darters/730 m2). Conservation of this species will require the preservation of erosional habitats in streams.
Osteogenic effect of interleukin‐11 and synergism with ascorbic acid in human periodontal ligament cells
Authors: Leon E. R. , Iwasaki K. , Komaki M. , Kojima T. , Ishikawa I.
Published: October 2007

Background and Objective:  Human periodontal ligament cells are considered to be a key cell type in the regeneration of periodontal tissues because of their unique localization and stem cell‐like properties. Interleukin‐11 is a multifunctional cytokine known to participate actively in bone metabolism. The purpose of this study was to examine the effect of interleukin‐11 on the osteoblastic differentiation of periodontal ligament cells.

Material and Methods:  Cultured periodontal ligament cells were stimulated with interleukin‐11 and/or ascorbic acid, with or without inhibitors for type 1 collagen, janus kinase/signal transducers and activator of transcription, and mitogen‐activated protein kinase (MAPK). Osteoblastic differentiation was investigated by examining the alkaline phosphatase activity and gene expression of Runx2, osteocalcin and bone sialoprotein using reverse transcription‐polymerase chain reaction. Type 1 collagen and tissue inhibitor of metalloproteinase‐1 production were measured using enzyme‐linked immunosorbent assays.

Results:  Interleukin‐11 enhanced alkaline phosphatase activity and Runx2, osteocalcin and bone sialoprotein gene expression in the presence of ascorbic acid. Interleukin‐11 induced type 1 collagen and tissue inhibitor of metalloproteinase‐1 production in periodontal ligament cells. Type 1 collagen inhibitor completely inhibited the alkaline phosphatase activity enhanced by interleukin‐11 and ascorbic acid. Furthermore, janus kinase/signal transducers and activator of transcription and MAPK signaling inhibitors reduced interleukin‐11/ascorbic acid‐induced alkaline phosphatase activity in periodontal ligament cells.

Conclusion:  Interleukin‐11/ascorbic acid induced the osteoblastic differentiation of periodontal ligament cells through type 1 collagen production and janus kinase/signal transducers and activator of transcription, and MAPK signaling pathways were involved in this process. These findings suggest that interleukin‐11 may function as an osteopromotive cytokine, stimulating the osteoblastic differentiation of periodontal ligament cells mainly through the synthesis of type 1 collagen and possibly by the induction of tissue inhibitor of metalloproteinase‐1.
Cosubstrate‐induced dynamics of D‐3‐hydroxybutyrate dehydrogenase from Pseudomonas putida
Authors: Paithankar Karthik S. , Feller Claudia , Kuettner E. Bartholomeus , Keim Antje , Grunow Marlis , Sträter Norbert
Published: October 2007

D‐3‐Hydroxybutyrate dehydrogenase from Pseudomonas putida belongs to the family of short‐chain dehydrogenases/reductases. We have determined X‐ray structures of the D‐3‐hydroxybutyrate dehydrogenase from Pseudomonas putida, which was recombinantly expressed in Escherichia coli, in three different crystal forms to resolutions between 1.9 and 2.1 Å. The so‐called substrate‐binding loop (residues 187–210) was partially disordered in several subunits, in both the presence and absence of NAD+. However, in two subunits, this loop was completely defined in an open conformation in the apoenzyme and in a closed conformation in the complex structure with NAD+. Structural comparisons indicated that the loop moves as a rigid body by about 46°. However, the two small α‐helices (αFG1 and αFG2) of the loop also re‐orientated slightly during the conformational change. Probably, the interactions of Val185, Thr187 and Leu189 with the cosubstrate induced the conformational change. A model of the binding mode of the substrate D‐3‐hydroxybutyrate indicated that the loop in the closed conformation, as a result of NAD+ binding, is positioned competent for catalysis. Gln193 is the only residue of the substrate‐binding loop that interacts directly with the substrate. A translation, libration and screw (TLS) analysis of the rigid body movement of the loop in the crystal showed significant librational displacements, describing the coordinated movement of the substrate‐binding loop in the crystal. NAD+ binding increased the flexibility of the substrate‐binding loop and shifted the equilibrium between the open and closed forms towards the closed form. The finding that all NAD+‐bound subunits are present in the closed form and all NAD+‐free subunits in the open form indicates that the loop closure is induced by cosubstrate binding alone. This mechanism may contribute to the sequential binding of cosubstrate followed by substrate.
G protein‐coupled receptor‐induced Akt activity in cellular proliferation and apoptosis
Authors: New David C. , Wu Kelvin , Kwok Alice W. S. , Wong Yung H.
Published: October 2007

Akt (also known as protein kinase B) plays an integral role in many intracellular signaling pathways activated by a diverse array of extracellular signals that target several different classes of membrane‐bound receptors. Akt plays a particularly prominent part in signaling networks that result in the modulation of cellular proliferation, apoptosis and survival. Thus, the overexpression of Akt subtypes has been measured in a number of cancer types, and dominant‐negative forms of Akt can trigger apoptosis and reduce the survival of cancer cells. G protein‐coupled receptors act as cell‐surface detectors for a diverse spectrum of biological signals and are able to activate or inhibit Akt via several direct and indirect means. In this review, we shall document how G protein‐coupled receptors are able to control Akt activity and examine the resulting biochemical and physiological changes, with particular emphasis on cellular proliferation, apoptosis and survival.
Glycation damage targets glutamate dehydrogenase in the rat liver mitochondrial matrix during aging
Authors: Hamelin Maud , Mary Jean , Vostry Michal , Friguet Bertrand , Bakala Hilaire
Published: October 2007

Aging is accompanied by gradual cellular dysfunction associated with an accumulation of damaged proteins, particularly via oxidative processes. This cellular dysfunction has been attributed, at least in part, to impairment of mitochondrial function as this organelle is both a major source of oxidants and a target for their damaging effects, which can result in a reduction of energy production, thereby compromising cell function. In the present study, we observed a significant decrease in the respiratory activity of rat liver mitochondria with aging, and an increase in the advanced glycation endproduct‐modified protein level in the mitochondrial matrix. Western blot analysis of the glycated protein pattern after 2D electrophoresis revealed that only a restricted set of proteins was modified. Within this set, we identified, by mass spectrometry, proteins connected with the urea cycle, and especially glutamate dehydrogenase, which is markedly modified in older animals. Moreover, mitochondrial matrix extracts exhibited a significant decrease in glutamate dehydrogenase activity and altered allosteric regulation with age. Therefore, the effect of the glycating agent methylglyoxal on glutamate dehydrogenase activity and its allosteric regulation was analyzed. The treated enzyme showed inactivation with time by altering both catalytic properties and allosteric regulation. Altogether, these results showed that advanced glycation endproduct modifications selectively affect mitochondrial matrix proteins, particularly glutamate dehydrogenase, a crucial enzyme at the interface between tricarboxylic acid and urea cycles. Thus, it is proposed that glycated glutamate dehydrogenase could be used as a biomarker of cellular aging. Furthermore, these results suggest a role for such intracellular glycation in age‐related dysfunction of mitochondria.
Effects on protease inhibition by modifying of helicase residues in hepatitis C virus nonstructural protein 3
Authors: Dahl Göran , Sandström Anja , Åkerblom Eva , Danielson U. Helena
Published: October 2007

This study of the full‐length bifunctional nonstructural protein 3 from hepatitis C virus (HCV) has revealed that residues in the helicase domain affect the inhibition of the protease. Two residues (Q526 and H528), apparently located in the interface between the S2 and S4 binding pockets of the substrate binding site of the protease, were selected for modification, and three enzyme variants (Q526A, H528A and H528S) were expressed, purified and characterized. The substitutions resulted in indistinguishable Km values and slightly lower kcat values compared to the wild‐type. The Ki values for a series of structurally diverse protease inhibitors were affected by the substitutions, with increases or decreases up to 10‐fold. The inhibition profiles for H528A and H528S were different, confirming that not only did the removal of the imidazole side chain have an effect, but also that minor differences in the nature of the introduced side chain influenced the characteristics of the enzyme. These results indicate that residues in the helicase domain of nonstructural protein 3 can influence the protease, supporting our hypothesis that full‐length hepatitis C virus nonstructural protein 3 should be used for protease inhibitor optimization and characterization. Furthermore, the data suggest that inhibitors can be designed to interact with residues in the helicase domain, potentially leading to more potent and selective compounds.
Overview and Summary: School Health Policies and Programs Study 2006
Authors: Kann Laura , Brener Nancy D. , Wechsler Howell
Published: October 2007

Background:  The School Health Policies and Programs Study (SHPPS) 2006 is the largest, most comprehensive assessment of school health programs in the United States ever conducted.

Methods:  The Centers for Disease Control and Prevention conducts SHPPS every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n = 538). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1103) and with a nationally representative sample of teachers of classes covering required health instruction in elementary schools and required health education courses in middle and high schools (n = 912) and teachers of required physical education classes and courses (n = 1194).

Results:  SHPPS 2006 describes key school health policies and programs across all 8 school health program components: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. SHPPS 2006 also provides data to monitor 6 Healthy People 2010 objectives.

Conclusions:  SHPPS 2006 is a new and important resource for school and public health practitioners, scientists, advocates, policymakers, and all those who care about the health and safety of youth and their ability to succeed academically and socially.
Methods: School Health Policies and Programs Study 2006
Authors: Kyle Tonja M. , Brener Nancy D. , Kann Laura , Ross James G. , Roberts Alice M. , Iachan Ronaldo , Robb William H. , McManus Tim
Published: October 2007

Background:  The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community involvement. All 8 components were assessed at the state, district, and school levels. Two components, health education and physical education and activity, also were assessed at the classroom level.

Methods:  Computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 538). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1103), with a nationally representative sample of teachers of required health education classes or courses (n = 912), and with a nationally representative sample of teachers of required physical education classes or courses (n = 1194).

Results:  This article provides a detailed description of the development of the questionnaires; sampling; data collection; and data cleaning, weighting, and analysis.

Conclusions:  SHPPS 2006 is the largest and most comprehensive study of school health programs ever conducted. Fielding a study of this magnitude provides many challenges, and several recommendations for future studies emerged from the experience.
Health Education: Results From the School Health Policies and Programs Study 2006
Authors: Kann Laura , Telljohann Susan K. , Wooley Susan F.
Published: October 2007

Background:  School health education can effectively help reduce the prevalence of health‐risk behaviors among students and have a positive influence on students’ academic performance. This article describes the characteristics of school health education policies and programs in the United States at the state, district, school, and classroom levels.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n = 459). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 920) and with a nationally representative sample of teachers of classes covering required health instruction in elementary schools and required health education courses in middle and high schools (n = 912).

Results:  Most states and districts had adopted a policy stating that schools will teach at least 1 of the 14 health topics, and nearly all schools required students to receive instruction on at least 1 of these topics. However, only 6.4% of elementary schools, 20.6% of middle schools, and 35.8% of high schools required instruction on all 14 topics. In support of schools, most states and districts offered staff development for those who teach health education, although the percentage of teachers of required health instruction receiving staff development was low.

Conclusions:  Health education has the potential to help students maintain and improve their health, prevent disease, and reduce health‐related risk behaviors. However, despite signs of progress, this potential is not being fully realized, particularly at the school level.
Physical Education and Physical Activity: Results From the School Health Policies and Programs Study 2006
Authors: Lee Sarah M. , Burgeson Charlene R. , Fulton Janet E. , Spain Christine G.
Published: October 2007

Background:  Comprehensive school‐based physical activity programs consist of physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, interscholastic sports, and walk and bike to school initiatives. This article describes the characteristics of school physical education and physical activity policies and programs in the United States at the state, district, school, and classroom levels.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n = 453). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 988) and with a nationally representative sample of teachers of required physical education classes and courses (n = 1194).

Results:  Most states and districts had adopted a policy stating that schools will teach physical education; however, few schools provided daily physical education. Additionally, many states, districts, and schools allowed students to be exempt from participating in physical education. Most schools provided some opportunities for students to be physically active outside physical education. Staff development for physical education was offered by states and districts, but physical education teachers generally did not receive staff development on a variety of important topics.

Conclusions:  To enhance physical education and physical activity in schools, a comprehensive approach at the state, district, school, and classroom levels is necessary. Policies, practices, and comprehensive staff development at the state and district levels might enable schools to improve opportunities for students to become physically active adults.
Health Services: Results From the School Health Policies and Programs Study 2006
Authors: Brener Nancy D. , Wheeler Lani , Wolfe Linda C. , Vernon‐Smiley Mary , Caldart‐Olson Linda
Published: October 2007

Background:  The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state‐ and district‐level policies and school practices.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 449). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 1029).

Results:  Most US schools provided basic health services to students, but relatively few provided prevention services or more specialized health services. Although state‐ and district‐level policies requiring school nurses or specifying maximum nurse‐to‐student ratios were relatively rare, 86.3% of schools had at least a part‐time school nurse, and 52.4% of these schools, or 45.1% of all schools, had a nurse‐to‐student ratio of at least 1:750.

Conclusions:  SHPPS 2006 suggests that the breadth of school health services can and should be improved, but school districts need policy, legislative, and fiscal support to make this happen. Increasing the percentage of schools with sufficient school nurses is a critical step toward enabling schools to provide more services, but schools also need to enhance collaboration and linkages with community resources if schools are to be able to meet both the health and academic needs of students.
Mental Health and Social Services: Results From the School Health Policies and Programs Study 2006
Authors: Brener Nancy D. , Weist Mark , Adelman Howard , Taylor Linda , Vernon‐Smiley Mary
Published: October 2007

Background:  Schools are in a unique position not only to identify mental health problems among children and adolescents but also to provide links to appropriate services. This article describes the characteristics of school mental health and social services in the United States, including state‐ and district‐level policies and school practices.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states and the District of Columbia and among a nationally representative sample of school districts (n = 445). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 873).

Results:  Although states and districts generally had not adopted policies stating that schools will have mental health and social services staff, 77.9% of schools had at least a part‐time counselor who provided services to students. Fewer schools had school psychologists or social workers. Consequently, counseling services were more common in schools than were psychological or social services. Few schools delivered mental health and social services through school‐based health centers. Arrangements with providers not located on school property were more common.

Conclusions:  SHPPS 2006 reveals that linkages with the community need to continue and grow to meet the mental health needs of students. Efforts must be made to build systematic state agendas for school‐based mental health, emphasizing a shared responsibility among families, schools, and other community systems.
Nutrition Services and Foods and Beverages Available at School: Results From the School Health Policies and Programs Study 2006
Authors: O’Toole Terrence P. , Anderson Susan , Miller Clare , Guthrie Joanne
Published: October 2007

Background:  Schools are in a unique position to promote healthy dietary behaviors and help ensure appropriate nutrient intake. This article describes the characteristics of both school nutrition services and the foods and beverages sold outside of the school meals program in the United States, including state‐ and district‐level policies and school practices.

Methods:  The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer‐assisted telephone interviews or self‐administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n = 445). Computer‐assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 944).

Results:  Few states required schools to restrict the availability of deep‐fried foods, to prohibit the sale of foods that have low nutrient density in certain venues, or to make healthful beverages available when beverages were offered. While many schools sold healthful foods and beverages outside of the school nutrition services program, many also sold items high in fat, sodium, and added sugars.

Conclusions:  Nutrition services program practices in many schools continue to need improvement. Districts and schools should implement more food preparation practices that reduce the total fat, saturated fat, sodium, and added sugar content of school meals. In addition, opportunities to eat and drink at school should be used to encourage greater daily consumption of fruits, vegetables, whole grains, and nonfat or low‐fat dairy products.
Robustness of a 3 min all‐out cycling test to manipulations of power profile and cadence in humans
Authors: Vanhatalo Anni , Doust Jonathan H. , Burnley Mark
Published: October 2007

The purpose of this study was to assess whether end‐test power output (EP, synonymous with ‘critical power’) and the work done above EP (WEP) during a 3 min all‐out cycling test against a fixed resistance were affected by the manipulation of cadence or pacing. Nine subjects performed a ramp test followed, in random order, by three cadence trials (in which flywheel resistance was manipulated to achieve end‐test cadences which varied by ∼20 r.p.m.) and two pacing trials (30 s at 100 or 130% of maximal ramp test power, followed by 2.5 min all‐out effort against standard resistance). End‐test power output was calculated as the mean power output over the final 30 s and the WEP as the power–time integral over 180 s for each trial. End‐test power output was unaffected by reducing cadence below that of the ‘standard test’ but was reduced by ∼10 W on the adoption of a higher cadence [244 ± 41 W for high cadence (at an end‐test cadence of 95 ± 7 r.p.m.), 254 ± 40 W for the standard test (at 88 ± 6 r.p.m.) and 251 ± 38 W for low cadence (at 77 ± 5 r.p.m.)]. Pacing over the initial 30 s of the test had no effect on the EP or WEP estimates in comparison with the standard trial. The WEP was significantly higher in the low cadence trial (16.2 ± 4.4 kJ) and lower in the high cadence trial (12.9 ± 3.6 kJ) than in the standard test (14.2 ± 3.7 kJ). Thus, EP is robust to the manipulation of power profile but is reduced by adopting cadences higher than ‘standard’. While the WEP is robust to initial pacing applied, it is sensitive to even relatively minor changes in cadence.
Detection of simultaneous movement at two human arm joints
Authors: Sturnieks Daina L. , Wright Julie R. , Fitzpatrick Richard C.
Published: October 2007

To detect joint movement, the brain relies on sensory signals from muscle spindles that sense the lengthening and shortening of the muscles. For single‐joint muscles, the unique relationship between joint angle and muscle length makes this relatively straightforward. However, many muscles cross more than one joint, making their spindle signals potentially ambiguous, particularly when these joints move in opposite directions. We show here that simultaneous movement at adjacent joints sharing biarticular muscles affects the threshold for detecting movements at either joint whereas it has no effect for non‐adjacent joints. The angular displacements required for 70% correct detection were determined in 12 subjects for movements imposed on the shoulder, elbow and wrist at angular velocities of 0.25–2 deg s−1. When moved in isolation, detection thresholds at each joint were similar to those reported previously. When movements were imposed on the shoulder and wrist simultaneously, there were no changes in the thresholds for detecting movement at either joint. In contrast, when movements in opposite directions at velocities greater than 0.5 deg s−1 were imposed on the elbow and wrist simultaneously, thresholds increased. At 2 deg s−1, the displacement threshold was approximately doubled. Thresholds decreased when these adjacent joints moved in the same direction. When these joints moved in opposite directions, subjects more frequently perceived incorrect movements in the opposite direction to the actual. We conclude that the brain uses potentially ambiguous signals from biarticular muscles for kinaesthesia and that this limits acuity for detecting joint movement when adjacent joints are moved simultaneously.