bluuebunny/crossref_metadata_2025 huggingface dataset:
What Can U.S. Open Ocean Aquaculture Learn From Salmon Farming?
Authors: Forster John
Published: June 2010

AbstractGlobal production of farmed salmon and trout in saltwater was 1.82 million metric tons in 2007, three times more than any other farmed marine fish category. Development of this industry teaches that, for fish farming to succeed, containment systems must be easily
deployed and operated and governments must create space in their coastal waters where farms can be located. Neither of these circumstances exists presently in the United States and, until this changes, other lessons that salmon farming teaches can only provide research or policy guidance.
These include the importance of selecting a good fish to farm and making them “affordable” by being efficient. Salmon farmers achieved the latter through mechanization, industry scale, and a focus on good fish health and performance.Salmon farming also teaches that various
plant and animal ingredients can be used in salmon feed and that its future growth will not be limited because salmon is a carnivore, as some have suggested. In fact, carnivorous fish, such as salmon, may turn out to be some of the most ecologically efficient species to farm. It is noteworthy,
too, that it took 40 years to establish an industry with the capacity to produce 1.82 million metric tons of fish per year while the United States imported 2.36 million metric tons of seafood in 2008, 83% of its needs, much of it from foreign farms. If future international competition for
these same supplies leads to national seafood shortages, it will be hard to replace it quickly with products from domestic aquaculture.
The continuing conundrum of varicocele
Authors: Sathesan B , Goonewardena SAS
Published: June 2010

Varicocele is an abnormal dilatation and tortuosity of the pampiniform venous plexus of the spermatic cord, chiefly affecting the internal spermatic vein and less commonly the cremasteric (external spermatic) vein. There are two types of varicocele: 1. the primary or idiopathic - the most common type, and 2 the secondary, due to kidney or retroperitoneal tumour, lymphadenopathy and hepatic congestion. DOI: 10.4038/slju.v9i1.1955 Sri Lanka Journal of Urology, 2008, 9, 1-6
How scientific are we in treating symptomatic benign prostatic hyperplasia (BPH)?
Authors: Perera ND , Mallikaarachchi NA , Namaratne LDRM , Silva JSL
Published: June 2010

Key words: prostate symptom score; benign prostatic hyperplasia; urodynamic assessment of BPH. DOI: 10.4038/slju.v9i1.1956 Sri Lanka Journal of Urology, 2008, 9, 7-12
Association between renal stones and renal cell carcinoma
Authors: Abeygunasekera AM
Published: June 2010

DOI: 10.4038/slju.v9i1.1962 Sri Lanka Journal of Urology, 2008, 9, 29
Core Temperature and Metabolic Responses After Carbohydrate Intake During Exercise at 30°C
Authors: Horswill Craig A. , Stofan John R. , Lovett Shannon C. , Hannasch Chris
Published: June 2010

Context:

Carbohydrate ingestion has recently been associated with elevated core temperature during exercise in the heat when testing for ergogenic effects. Whether the association holds when metabolic rate is controlled is unclear. Such an effect would have undesirable consequences for the safety of the athlete.

Objective:

To examine whether ingesting fluids containing carbohydrate contributed to an accelerated rise in core temperature and greater overall body heat production during 1 hour of exercise at 30°C when the effort was maintained at steady state.

Design:

Crossover design (repeated measures) in randomized order of treatments of drinking fluids with carbohydrate and electrolytes (CHO) or flavored-water placebo with electrolytes (PLA). The beverages were identical except for the carbohydrate content: CHO  =  93.7 ± 11.2 g, PLA  =  0 g.

Setting:

Research laboratory.

Patients or Other Participants:

Nine physically fit, endurance-trained adult males.

Intervention(s):

Using rectal temperature sensors, we measured core temperature during 30 minutes of rest and 60 minutes of exercise at 65% of maximal oxygen uptake (V˙o2 max) in the heat (30.6°C, 51.8% relative humidity). Participants drank equal volumes (1.6 L) of 2 beverages in aliquots 30 minutes before and every 15 minutes during exercise. Volumes were fixed to approximate sweat rates and minimize dehydration.

Main Outcome Measure(s):

Rectal temperature and metabolic response (V˙o2, heart rate).

Results:

Peak temperature, rate of temperature increase, and metabolic responses did not differ between beverage treatments. Initial hydration status, sweat rate, and fluid replacement were also not different between trials, as planned.

Conclusions:

Ingestion of carbohydrate in fluid volumes that minimized dehydration during 1 hour of steady-state exercise at 30°C did not elicit an increase in metabolic rate or core temperature.
Research Methodology: Endocrinologic Measurements in Exercise Science and Sports Medicine
Authors: Hackney Anthony C. , Viru Atko
Published: June 2010

Objective:

To provide background information on methodologic factors that influence and add variance to endocrine outcome measurements. Our intent is to aid and improve the quality of exercise science and sports medicine research endeavors of investigators inexperienced in endocrinology.

Background:

Numerous methodologic factors influence human endocrine (hormonal) measurements and, consequently, can dramatically compromise the accuracy and validity of exercise and sports medicine research. These factors can be categorized into those that are biologic and those that are procedural-analytic in nature.

Recommendations:

Researchers should design their studies to monitor, control, and adjust for the biologic and procedural-analytic factors discussed within this paper. By doing so, they will find less variance in their hormonal outcomes and thereby will increase the validity of their physiologic data. These actions can assist the researcher in the interpretation and understanding of endocrine data and, in turn, make their research more scientifically sound.
Thermoregulatory Responses and Hydration Practices in Heat-Acclimatized Adolescents During Preseason High School Football
Authors: Yeargin Susan Walker , Casa Douglas J. , Judelson Daniel A. , McDermott Brendon P. , Ganio Matthew S. , Lee Elaine C. , Lopez Rebecca M. , Stearns Rebecca L. , Anderson Jeffrey M. , Armstrong Lawrence E. , Kraemer William J. , Maresh Carl M.
Published: June 2010

Context:

Previous researchers have not investigated the thermoregulatory responses to multiple consecutive days of American football in adolescents.

Objective:

To examine the thermoregulatory and hydration responses of high school players during formal preseason football practices.

Design:

Observational study.

Setting:

Players practiced outdoors in late August once per day on days 1 through 5, twice per day on days 6 and 7, and once per day on days 8 through 10. Maximum wet bulb globe temperature averaged 23 ± 4°C.

Patients or Other Participants:

Twenty-five heat-acclimatized adolescent boys (age  =  15 ± 1 years, height  =  180 ± 8 cm, mass  =  81.4 ± 15.8 kg, body fat  =  12 ± 5%, Tanner stage  =  4 ± 1).

Main Outcome Measure(s):

We observed participants within and across preseason practices of football. Measures included gastrointestinal temperature (TGI), urine osmolality, sweat rate, forearm sweat composition, fluid consumption, testosterone to cortisol ratio, perceptual measures of thirst, perceptual measures of thermal sensation, a modified Environmental Symptoms Questionnaire, and knowledge questionnaires assessing the participants' understanding of heat illnesses and hydration. Results were analyzed for differences across time and were compared between younger (14–15 years, n  =  13) and older (16–17 years, n  =  12) participants.

Results:

Maximum daily TGI values remained less than 40°C and were correlated with maximum wet bulb globe temperature (r  =  0.59, P  =  .009). Average urine osmolality indicated that participants generally experienced minimal to moderate hypohydration before (881 ± 285 mOsmol/kg) and after (856 ± 259 mOsmol/kg) each practice as a result of replacing approximately two-thirds of their sweat losses during exercise but inadequately rehydrating between practices. Age did not affect most variables; however, sweat rate was lower in younger participants (0.6 ± 0.2 L/h) than in older participants (0.8 ± 0.1 L/h) (F1,18  =  8.774, P  =  .008).

Conclusions:

Previously heat-acclimatized adolescent boys (TGI < 40°C) can safely complete the initial days of preseason football practice in moderate environmental conditions using well-designed practice guidelines. Adolescent boys replaced most sweat lost during practice but remained mildly hypohydrated throughout data collection, indicating inadequate hydration habits when they were not at practice.
Current Knowledge, Attitudes, and Practices of Certified Athletic Trainers Regarding Recognition and Treatment of Exertional Heat Stroke
Authors: Mazerolle Stephanie M. , Scruggs Ian C. , Casa Douglas J. , Burton Laura J. , McDermott Brendon P. , Armstrong Lawrence E. , Maresh Carl M.
Published: June 2010

Context:

Previous research has indicated that despite awareness of the current literature on the recommended prevention and care of exertional heat stroke (EHS), certified athletic trainers (ATs) acknowledge failure to follow those recommendations.

Objective:

To investigate the current knowledge, attitudes, and practices of ATs regarding the recognition and treatment of EHS.

Design:

Cross-sectional study.

Setting:

Online survey.

Patients or Other Participants:

We obtained a random sample of e-mail addresses for 1000 high school and collegiate ATs and contacted these individuals with invitations to participate. A total of 498 usable responses were received, for a 25% response rate.

Main Outcome Measure(s):

The survey instrument evaluated ATs' knowledge and actual practice regarding EHS and included 29 closed-ended Likert scale questions (1  =  strongly disagree, 7  =  strongly agree), 2 closed-ended questions rated on a Likert scale (1  =  lowest value, 9  =  greatest value), 8 open-ended questions, and 7 demographic questions. We focused on the open-ended and demographic questions.

Results:

Although most ATs (77.1%) have read the current National Athletic Trainers' Association position statement on heat illness, only 18.6% used rectal thermometers to assess core body temperature to recognize EHS, and 49.7% used cold-water immersion to treat EHS. Athletic trainers perceived rectal thermometers as the most valid temperature assessment device when compared with other assessment devices (P ≤ .05), but they used oral thermometers as the primary assessment tool (49.1%). They identified cold-water immersion as the best cooling method (P ≤ .05), even though they used other means to cool a majority of the time (50.3%).

Conclusions:

The ATs surveyed have sound knowledge of the correct means of EHS recognition and treatment. However, a significant portion of these ATs reported using temperature assessment devices that are invalid with athletes exercising in the heat. Furthermore, they reported using cooling treatment methods that have inferior cooling rates.
Epidemiological changes in oesophageal cancer at National Hospital, Bloemfontein: 1995, 2000 and 2005
Authors: Van der Merwe Tian , Van der Walt Ruan , Esterhuizen Jován , Botha Stephani , Goedhals Louis , Joubert Gina
Published: June 2010

Background: Oesophageal cancer is a common malignancy with a high mortality rate. The two main histological types are squamous cell and adenocarcinoma. An increase in oesophageal adenocarcinoma has been noted, especially in developed countries.Objectives: The aim of this retrospective study was to investigate the profile of oesophageal cancer by reviewing medical records of patients diagnosed with oesophageal cancer in 1995, 2000 and 2005.Method: The study sample consisted of 474 files of patients diagnosed, for the first time, with oesophageal cancer in 1995, 2000 and 2005, at the National Hospital in Bloemfontein and the outreach clinics in surrounding areas. Information reviewed from patient files included: age, race and gender of the patient, as well as topography, size, histological grade and type of the tumour.Results: The number of newly diagnosed cases of oesophageal carcinoma decreased over the 10-year period. The mean age of patients was > 57 years. The majority of cases were Black patients: 90.5% in 1995, 93.2% in 2000 and 87.7% in 2005. More male patients were seen (71.5% in 1995, 70.1% in 2000 and 64.2% in 2005), although the number of female patients diagnosed with this malignancy increased by 7.3% from 1995 to 2005. The mid- and lower third of the oesophagus were affected most commonly, most lesions were 6 cm – 10 cm in length and classified as Grade II, moderately differentiated tumours. Squamous cell carcinoma was diagnosed in 76.9% of patients in 1995, 90.5% in 2000 and 94.3% in 2005.Conclusion: The number of newly diagnosed cases of oesophageal carcinoma decreased over the 10-year period, but demographic and disease characteristics remained constant.
A Systematic Review of Interventions to Increase Awareness, Knowledge, and Folic Acid Consumption before and during Pregnancy
Authors: Chivu Corina Mihaela , Tulchinsky Theodore H. , Soares-Weiser Karla , Braunstein Rony , Brezis Mayer
Published: June 2010

Objective.

We conducted a systematic review of studies designed to increase awareness of, knowledge about, and consumption of folic acid before and during pregnancy.

Data sources.

Studies were identified from Cochrane Library, Medline, and the references of primary studies and reviews.

Study inclusion and exclusion criteria.

Studies included randomized controlled trials, quasi-experimental interrupted time series studies, follow-up studies, case-control studies, and before-and-after studies, all of which were conducted between 1992 and 2005 on women ages 15 to 49 years and/or health professionals, evaluating awareness and/or knowledge and/or consumption of folic acid both before and after intervention. Studies were excluded if data were not presented both before and after intervention or were other outcomes than those mentioned here.

Data extraction.

Data were extracted in relation to characteristics of studies, participants, interventions, and outcomes.

Data synthesis.

Because of heterogeneity, we performed a narrative synthesis describing the direction and the size of effects.

Results.

On average, women's awareness increased from 60% to 72%, knowledge from 21% to 45%, and consumption from 14% to 23%.

Conclusions.

Interventions had a positive effect on folic acid intakes before and during pregnancy, although the average usage reached less than 25%.

So what?

Further research is needed to design more effective interventions to increase periconceptional use of folic acid.
Evaluation of a “Nondieting” Stress Reduction Program for Overweight Women: A Randomized Trial
Authors: Katzer Lisa , Bradshaw Alison J. , Horwath Caroline C. , Gray Andrew R. , O'Brien Sue , Joyce Janine
Published: June 2010

Purpose.

Determine if a “nondieting” intervention focused on intensive training in eliciting the relaxation response enhances health outcomes compared with nondieting interventions without such training.

Design.

Randomized trial with follow-up at 10 weeks, 4 months, and 12 months.

Setting.

General community.

Subjects.

Total of 225 overweight and obese women with at least one other cardiovascular risk factor.

Interventions.

Three 10-week nondieting interventions: a group program (P1) focused on intensive training in techniques for eliciting the relaxation response (n = 60), a group program (P2) focused on healthy eating and physical activity (n = 61), and a self-guided, mail-delivered version of P2 (P3; n = 101).

Measures.

The Revised Symptom Checklist measured psychological distress, the Medical Symptoms Checklist measured the experience of medical symptoms, and the Health-Promoting Lifestyle Profile measured a range of lifestyle behaviors. Self-efficacy for low-fat eating, intuitive eating, and body mass index were also assessed.

Analysis.

An intention-to-treat analysis was used.

Results.

At 12 months, P1 produced statistically greater improvements in stress management behaviors and medical symptom discomfort and was the only program to significantly improve self-efficacy for low-fat eating. In P1, the effect sizes for reductions in depression (0.75) and interpersonal sensitivity (0.85) were large. At 12 months, mean weight was unchanged.

Conclusion.

Inclusion of intensive relaxation response training in a nondieting program for overweight women enhanced stress management and medical symptoms outcomes but not weight outcomes.
Predictors of Stage Transitions in the Precaution Adoption Process Model
Authors: De Vet Emely , De Nooijer Jascha , Oenema Anke , De Vries Nanne K. , Brug Johannes
Published: June 2010

Purpose.

To explore psychosocial correlates and predictors of stage transitions in the precaution adoption process model (PAPM) for fruit intake.

Design.

A cohort completed three electronic questionnaires, at baseline (time 0), 35 days later (time 1), and another 32 days later (time 2).

Setting.

Secured Internet Web site.

Subjects.

A cohort of 735 adults was formed from a random sample of an existing Internet panel. The mean age was 37.5 years, 51% were women, and 90% were of Dutch origin. Most respondents (48%) had a medium level of education.

Measures.

Precaution adoption process model stage, risk perception, perception of own fruit intake level, attitude, pros, cons, subjective norms, social support, modeling, self-efficacy, and fruit intake (assessed using a food frequency questionnaire).

Analysis.

Cross-sectional differences in psychosocial variables and fruit intake across PAPM stages at baseline were analyzed using analysis of variance with Tukey multiple comparisons tests. Predictors of PAPM stage transitions between time 0 and time 1 and between time 1 and time 2 were analyzed using logistic regression analysis.

Results.

Factors related to attitude and social influences may be important if one is to decide to act, whereas strong self-efficacy may also be required for acting on the decision to act.

Conclusion.

Although the results should be replicated in a larger and more representative sample, the PAPM seems a good framework for studying fruit intake.
Faith-Health Collaboration in the United States: Results from a Nationally Representative Study
Authors: Steinman Kenneth Jacob , Bambakidis Athe
Published: June 2010

Purpose.

Estimate the prevalence of and identify characteristics associated with religious congregations' collaboration with health agencies.

Design.

Cross-sectional analyses of self-report data from the National Congregations Study, a random sample of religious congregations generated from the 1998 General Social Survey.

Setting.

United States.

Subjects.

Key informants from 1236 congregations. Each respondent described a single congregation.

Measures.

Respondents provided open-ended descriptions of congregational programs. Researchers coded program descriptions by content (e.g., domestic violence) and whether the program involved collaboration with a secular agency. Other congregational characteristics (e.g., denomination) were measured by validated measures and linked census tract data.

Results.

Overall, 11.1% of congregations participated in faith-health collaboration (FHC). Logistic regression analyses found that FHC was more common among congregations with more members, with a small proportion of congregants under 35 years, and with a senior pastor with a graduate degree. Other effects were conditional; for instance, denominational differences varied depending on urban/suburban/rural location and the proportion of low-income members.

Conclusion.

This study provides the first national estimates of the prevalence of FHC. Such collaborative efforts may require different approaches in different areas. These results can help practitioners identify congregations that may be more willing to collaborate.
The Association between Medical Costs and Participation in the Vitality Health Promotion Program among 948,974 Members of a South African Health Insurance Company
Authors: Patel Deepak N. , Lambert Estelle V. , da Silva Roseanne , Greyling Mike , Nossel Craig , Noach Adam , Derman Wayne , Gaziano Thomas
Published: June 2010

Purpose.

Examine the association between the levels of participation in an incentive-based health promotion program (Vitality) and inpatient medical claims among members of a major health insurer.

Design.

A 1-year, cross-sectional, correlational analyses of engagement with a health promotion program and hospital claims experience (admissions costs, days in hospital, and admission rate) of members of a national private health insurer.

Setting.

Adult members of South Africa's largest national private health insurer, Discovery Health. Insured members were also eligible for voluntary membership in an insurance-linked incentivized health promotion program, Vitality.

Subjects.

The study sample included 948,974 adult members of the Discovery Health plan for the year 2006. Of these, 591,134 (62.3%) were also members of the Vitality health promotion program.

Measures.

The study sample was grouped based on registration and the level of engagement with the Vitality health promotion program into the following: not registered (37.5%), registered but not engaged with any health promotion activity (21.9%), low engagement (30.9%), and high engagement (9.5%). High engagement was defined a priori by the accumulation of an arbitrary number of points on the Vitality program, allocated against specific activities (knowledge, fitness-related activities, assessment and screening, and healthy choices). Hospital admission costs, the number of days in hospital, and hospital admission rates were compared among highly engaged members and those members who were not enrolled in the program, nonengaged, and lowly engaged. Data were normalized for age, gender, plan type, and chronic disease status.

Results.

Highly engaged members had lower costs per patient, shorter stays in hospital, and fewer admissions compared with other groups (p < .001). Low or no engagement was not associated with lower hospital costs. Admission rates were also 7.4% lower for cardiovascular disease, 13.2% lower for cancers, and 20.7% lower for endocrine and metabolic diseases in the highly engaged group compared with any of the other groups (p < .01).

Conclusions.

Engagement in an incentive-based wellness program, offered by a health insurer, was associated with lower health care costs.
Behavioral, Demographic, Psychosocial, and Sociocultural Concomitants of Stage of Change for Physical Activity Behavior in a Mixed-Culture Sample
Authors: Cardinal Bradley J. , Lee Jong-Young , Kim Young-Ho , Lee Hyo , Li Kin-Kit , Si Qi
Published: June 2010

Purpose.

Examine behavioral, demographic, psychosocial, and sociocultural concomitants of the stages of change for physical activity behavior among college students in South Korea (n = 221) and the United States (n = 166).

Methods.

Measures obtained in this cross-sectional study included age; body mass index; nationality; gender; exercise behavior; processes of change; decisional balance; self-efficacy; stage of change; and predisposing, reinforcing and enabling factors.

Results.

The amount of variance explained for stage of change by the transtheoretical model constructs (i.e., decisional balance, processes of change, self-efficacy) ranged from 11% to 29% (all p < .001), whereas the predisposing (2%; p = .052), reinforcing (3%; p = .06), and enabling (5%; p < .001) factors were not as important. In multivariate ordinal logistic regression analysis, gender (odds ratio [OR] = 3.3; p < .001), gender by nationality interaction (OR = .27; p < .01), weekly exercise behavior (OR = 1.04; p < .001), and behavioral processes of change (OR = 1.12; p < .001) were each significant concomitants of the stages of change.

Discussion.

In terms of physical activity behavior, South Korean women were more likely than South Korean men to be in the early stages, whereas American men were slightly more likely to be in the early stages than American women when all the concomitants were accounted for. Among the psychosocial stage of change concomitants, only the behavioral processes of change were found to be important.
Television Viewing: Moderator or Mediator of an Adolescent Physical Activity Intervention?
Authors: Graham Dan J. , Schneider Margaret , Cooper Dan M.
Published: June 2010

Purpose.

To determine whether the amount of television (TV) watched by participants enrolled in a physical activity intervention mediates or moderates program effectiveness.

Design.

Nine-month, controlled, school-based physical activity intervention.

Setting.

Public high school.

Participants.

One hundred twenty-two sedentary adolescent females (mean + standard deviation age = 15.04 + 0.79 years).

Intervention.

Supervised in-class exercise, health education, and internet-based self-monitoring.

Measures.

Physical activity by 3-day physical activity recall; TV viewing by self-reports; cardiovascular fitness by cycle ergometer.

Analysis.

T-tests were conducted to examine between-group differences. Linear regression equations tested the mediating or moderating role of TV watching relative to the intervention.

Results.

TV viewing moderated the intervention's effect on vigorous activity; the intervention significantly predicted change in physical activity among high (β = −.45; p < .001), but not among low (p > .05), TV watchers. TV viewing did not mediate the intervention effect.

Conclusions.

Consistent with displacement theory, adolescents who watched more TV prior to the intervention showed postintervention increases in vigorous physical activity and concomitant decreases in TV viewing, whereas those who watched less TV showed no change in physical activity or TV viewing.
Factors Which Influence Tobacco Use among Junior Enlisted Personnel in the United States Army and Air Force: A Formative Research Study
Authors: Haddock C. Keith , Taylor Jennifer E. , Hoffman Kevin M. , Poston Walker S. C. , Peterson Alan , Lando Harry A. , Shelton Suzanne
Published: June 2010

Background.

Despite the implementation of a host of tobacco control initiatives, tobacco use among active duty members of the U.S. Military remains high. It has been suggested that a positive culture of tobacco, which drives consumption, exists in the military. However, little is know about factors that impact tobacco use among military personnel.

Objective.

This study provides the first formative data on the culture of tobacco in the U.S. Military.

Methods.

A total of 15 focus groups on six military installations were conducted (n = 189). These military installations were located throughout the continental United States and were of average size for each service.

Results.

Participants suggested that the primary method the military uses to discourage use is tobacco bans. Unfortunately, they also believed that the military accommodates tobacco use so that smoking remains convenient despite the bans on tobacco use. Smoking was believed to be encouraged through liberal smoking breaks, social interaction within designated smoking areas, and cheap and convenient tobacco products sold on military installations. Additionally, smoking was seen as an effective method to combat the stress and boredom of military life and to avoid weight gain.

Conclusions.

Suggestions for addressing the culture of tobacco are suggested.
Associations of Cycling with Urban Sprawl and the Gasoline Price
Authors: Rashad Inas
Published: June 2010

Purpose.

Determine the relationships between cycling and urban sprawl and between cycling and the gasoline price.

Analysis.

Cross-sectional multivariate regression analyses using pooled data from two individual-level national surveys to analyze the effects of variations in levels of urban sprawl and the gasoline price on cycling as a form of physical activity.

Setting.

Metropolitan areas representative of the U.S. population, 1990 to 2001.

Subjects.

Behavioral Risk Factor Surveillance System: 146,730 individuals at least 18 years old in the United States; Nationwide Personal Transportation Survey: 73,903 individuals at least 18 years old in the United States.

Measures.

Self-reported information on bicycling served as the dependent variable. Urban sprawl and the gasoline price served as key independent variables.

Results.

Living in a metropolitan area with a lower degree of urban sprawl increased the probability of cycling in the past month by 3.4 to 4.4 percentage points and 1.6 to 2.1 percentage points from the means for men and women, respectively. Increasing the gasoline price by one dollar increased the probability of cycling by 4.3 to 4.7 percentage points and 2.9 to 3.5 percentage points for men and women, respectively.

Conclusion.

Results indicate that the prevalence of cycling is higher in less sprawling areas and areas with higher gasoline prices. More research is needed to refine results on how individuals respond to incentives and the roles that monetary and time costs play in improving public health.
Comparing Individualized Rehabilitation to a Group Wellness Intervention for Persons with Multiple Sclerosis
Authors: Plow Matthew A. , Mathiowetz Virgil , Lowe Dawn A.
Published: June 2010

Purpose.

Compare the efficacy of two interventions designed to promote health and physical activity (PA).

Design.

This study was a randomized clinical trial using a time series design. Subjects were randomized into individualized physical rehabilitation (IPR) and group wellness intervention (GWI). Primary questionnaires were administered twice preintervention and twice postintervention. Physical fitness and PA frequency were assessed preintervention and postintervention.

Setting.

Clinic based in a metropolitan area.

Subjects.

Fifty volunteers with multiple sclerosis.

Interventions.

IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions.

Measures.

Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency.

Analysis.

Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes.

Results.

Primary measures were stable between pretests. MANOVA showed nonsignificant differences between interventions. Eight weeks postintervention, both groups had improved PA, fatigue, resting heart rate, and strength. Effect sizes suggested that IPR had a greater effect on preventing decline of physical health, whereas GWI had a greater effect on improving mental health.

Conclusion.

Preliminary evidence indicated that health and PA improved in both groups. Effect sizes suggested that participants benefited more physically from IPR and more mentally from GWI. Future research should determine whether combining therapeutic exercise with group education improves both mental and physical health.
The Use of Exploratory Factor Analysis in Public Health: A Note on Parallel Analysis as a Factor Retention Criterion
Authors: Patil Vivek H. , McPherson Matthew Q. , Friesner Daniel
Published: June 2010

Purpose.

Exploratory factor analysis is used to identify latent factors for public health interventions. The most popular factor retention criterion, the eigenvalue greater than one (EVG1) rule, leads to the retention of more factors than warranted. The use of parallel analysis (PA) as a factor retention criterion is recommended.

Design.

Environmental factors that are likely to affect the propensity of individuals to walk are identified. Results from PA are compared with those obtained by using the EVG1 rule.

Setting.

Telephone survey data were collected from three communities (spanning 12 counties) in the Appalachian region.

Participants.

The sample was composed of adults between the ages of 40 and 65 years. There were 1019 completed surveys.

Measures.

The data on 14 variables, including measures of neighborhood safety, beauty, and access to walking facilities were collected.

Analysis.

A principal components analysis was performed. The factors retained after using the EVG1 rule were compared with the factors retained after using PA. Varimax rotation was used to aid factor interpretation.

Results.

The EVG1 rule led to the retention of nearly twice the number of latent factors as did the PA criterion.

Conclusion.

The use of the EVG1 rule in research may mislead policy makers to focus on trivial interventions. They are urged to use PA to obtain more parsimonious and externally valid interventions.
Sources of Human Immunodeficiency Virus and Sexually Transmitted Disease Information and Responses to Prevention Messages among Massachusetts Men Who Have Sex with Men
Authors: Mimiaga Matthew J. , Reisner Sari L. , Goldhammer Hilary , Tetu Ashley M. , Belanoff Candice , Mayer Kenneth H.
Published: June 2010

Purpose.

Sexually transmitted disease (STD) rates have continued to increase among men who have sex with men (MSM). The present study used qualitative methods to assess sources of human immunodeficiency virus (HIV)/STD information and responses to HIV/STD prevention messages among MSM. This was done to understand how to design more effective media campaigns on HIV/STD prevention and testing for this population.

Design.

One-on-one semistructured, qualitative interviews and a brief demographic written survey were conducted.

Setting.

A Massachusetts community-based organization specializing in HIV/AIDS healthcare.

Participants.

A novel, modified, respondent-driven sampling method was used to recruit a diverse sample of 50 Massachusetts MSM between January and April 2005; qualitative interviews were conducted until redundancy in responses was achieved.

Method.

Qualitative data were analyzed using content analysis. NVIVO software was used to organize transcripts, identify themes, and report frequency of responses.

Results.

Respondents reported having derived information on sexual health from multiple media sources. Direct outreach, gay- and HIV-centered organizations, print and broadcast media, public transportation ads, and the Internet held the greatest potential for dissemination. Primary care providers were also frequently seen as trusted sources of HIV/STD prevention information. Ideas for content often included having “people just like you” in ads.

Conclusion.

Health messages that focus on getting tested for HIV and STDs, practicing safe sex, and incorporating straightforward and accurate information on prevention may be the most acceptable to MSM. Providers should be proactive in disseminating information about HIV/STD prevention.
Socioeconomic Status and Tobacco Expenditures among Moroccans: Results of the “Maroc Tabagisme” Survey
Authors: Tachfouti Nabil , Berraho Mohammed , Elfakir Samira , Serhier Zineb , Elrhazi Karima , Slama Karen , Najjari Chakib
Published: June 2010

Purpose.

To investigate the relationship of sociodemographic and economic characteristics to tobacco expenses among Moroccan daily smokers.

Design.

Cross-sectional (“Maroc Tabagisme” Survey) study.

Setting.

Random sample of 9195 subjects representative of the Moroccan population.

Subjects.

Household subjects 15 years and older.

Measures.

Data were collected from selected households using a questionnaire about smoking, educational level, occupation, and household monthly income.

Analysis.

Associations between sociodemographic and economic characteristics, smoking status, and tobacco expenses were assessed by multivariate analysis in a sample of 5959 respondents who provided details about their family income.

Results.

Of 5959 participants, 28.5% of men and 2.8% of women were daily smokers. Compared with students, the odds of daily smoking were higher among blue-collar workers (odds ratio, 2.66). Tobacco expenses increased with higher family monthly income (p < .001). Moreover, smokers whose family monthly income was less than 1000 Moroccan dirham (MAD) spent 50.9% on tobacco, while those with family monthly income of 6000 MAD or higher spent 13.0% on tobacco.

Conclusions.

There was a strong association between tobacco expenses and sociodemographic and economic characteristics. Among households with low monthly income, up to half of the monthly income is spent on tobacco.
Health Insurers Promoting Employee Wellness: Strategies, Program Components and Results
Authors: Murphy Brigid M. , Schoenman Julie A. , Pirani Hafiza
Published: June 2010

Purpose.

To examine health insurance companies' role in employee wellness.

Approach.

Case studies of eight insurers.

Setting.

Wellness activities in work, clinical, online, and telephonic settings.

Participants.

Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization.

Methods.

Telephone interviews with 20 informants.

Results.

Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes.

Conclusion.

Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.
Impact of Obesity on Work Productivity and Role Disability in Individuals with and at Risk for Diabetes Mellitus
Authors: Rodbard Helena W. , Fox Kathleen M. , Grandy Susan
Published: June 2010

Purpose.

Evaluate work absence, work productivity, and disruption of work, social, and family life among individuals of varying body mass index (BMI) with or at risk for diabetes mellitus.

Design.

Cross-sectional analysis of survey data.

Setting.

Community-based U.S. population.

Subjects.

Respondents (n = 15,132; n = 7338 working adults) participating in the U.S. Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) study were stratified by combinations of BMI (i.e., ≥ 30 kg/m2 [obese], 25 to 29.9 kg/m2 [overweight], and < 25 kg/m2 [normal weight]) and diabetes (i.e., type 2 diabetes mellitus [T2DM], type 1 diabetes mellitus [T1DM], and high risk [HR] or low risk [LR] of T2DM).

Measures.

Work impairment was measured using the Work Productivity and Activity Impairment Questionnaire: General Health. Disruption in life was measured using the Sheehan Disability Scale. HR was defined as 3 to 5 of the following factors: abdominal obesity, BMI ≥ 28 kg/m2, reported diagnosis of “cholesterol problems,” reported diagnosis of “hypertension,” or history of coronary heart disease or stroke. LR was defined as ≤ 2 of these factors.

Results.

Percentage of work impairment and proportion with severe disruption of work, family, and social life increased systematically from normal weight to obese (p < .001). Obese individuals had the greatest impairment at work (11%-15% of work time), greatest impairment of daily activities (20%-34% of time), and greatest overall impairment (11%-15% of time) in the LR, HR, and T2DM groups. Obesity and T2DM were independent predictors of overall work impairment and life disruption (p < .001). Between 5% and 7% of total variance was explained in the regression models with BMI category, diabetes/risk group, age, gender, race, income, and household size as variables.

Conclusion.

Greatest impairment of work and daily activities was evident among obese individuals for all groups.
Characteristics of Smokers Calling a National Reactive Telephone Helpline
Authors: Sood Akshay , Andoh Jennifer , Rajoli Naveen , Hopkins-Price Patricia , Verhulst Steven J.
Published: June 2010

Purpose.

Although reactive telephone helplines for quitting smoking are increasingly popular in the United States, the characteristics of callers using this resource have not been adequately studied. The objective of this study was to describe the characteristics of the current smokers calling a national reactive telephone helpline (i.e., study population).

Design and Setting.

In this cross-sectional study, information was obtained from eligible participants telephonically.

Subjects.

The study included 890 adult current smokers who were new callers to a national reactive helpline.

Measures.

The information collected included selected demographic and smoking-related characteristics.

Analysis.

The proportions of the above characteristics were analyzed.

Results.

There was a significant overrepresentation of blacks, non-Hispanics, women, and urban residents, as well as poorer, older, less educated, and heavier smokers in the study population (p < .01 for all comparisons).

Conclusions.

Reactive telephone helplines may be preferentially used by population segments who are disadvantaged or smoke heavily and thus are in greatest need for assistance. These helplines may therefore fill a much-needed niche in the marketplace of smoking cessation strategies.
An Analysis of Cardiovascular Health Information in Popular Young Women's Magazines: What Messages are Women Receiving?
Authors: Turner Melanie B. , Vader Amanda M. , Walters Scott T.
Published: June 2010

Purpose.

This study evaluated the consistency of cardiovascular health information in popular women's magazines against the American Heart Association's (AHA) guidelines for nutrition, physical activity, weight management, and smoking.

Design.

Six issues of four publications, Cosmopolitan, Glamour, Vogue, and Shape (24 total) were reviewed for inclusion.

Setting.

Content analysis was performed by two independent raters on 162 articles (283 instances of priority-related information).

Measures.

Articles were rated using a questionnaire developed from the AHA-recommended priorities.

Analysis.

Results are presented primarily in qualitative form, supplemented by analyses of variance and correlation significance tests when appropriate.

Results.

Physical activity was the most common topic, followed by nutrition, weight management, and cigarette smoking. Information about weight management was less consistent than other areas. Although publications varied widely in the frequency of coverage, there was no significant difference among them in overall consistency of the information. No articles gave information directly contrary to the AHA recommendations. Limitations include the subjective nature of the content analysis and the limited number of publications and time period for review.

Conclusion.

Women are receiving information related to diet, exercise, weight management, and cigarette smoking in popular magazines. However, the information is variable to the extent that it is consistent with evidence-based prevention guidelines.
Best Practices in Implementing Lifestyle Interventions in the WISEWOMAN Program: Adaptable Strategies for Public Health Programs
Authors: Besculides Melanie , Zaveri Heather , Hanson Charlotte , Farris Rosanne , Gregory-Mercado Karen , Will Julie
Published: June 2010

Purpose.

Describe best practices for implementing a variety of lifestyle interventions targeting cardiovascular disease risk factors.

Approach.

A mixed-methods approach was used to collect and analyze data. The study was guided by the RE-AIM framework.

Setting.

Selected Well-Integrated Screening and Intervention for Women Across the Nation (WISEWOMAN) projects funded by the Centers for Disease Control and Prevention.

Participants.

Five of the 15 currently operating WISEWOMAN projects were selected for study. Selection was based on availability of quantitative performance data, which were used to identify two high-performing and one low-performing sites within each project.

Method.

Qualitative data collection included a review of program materials; telephone interviews with federal, project, and local staff and site visits. Site visits involved interviews with staff, observations of the lifestyle intervention, and discussions with focus groups of participants. Analysis involved writing site reports, developing theme tables, identifying practices of interest, and applying an algorithm to identify best practices.

Results.

Eighty-seven best practices were identified. We present a subset of 31 practices applicable to other public health programs and for which differences in how high- and low-performing sites used the practices were identified.

Discussion.

Many of the best practices identified are applicable to broader audiences. Practitioners interested in strategies to recruit, engage, and retain participants and to facilitate behavior change can learn from these practices.
The Causal Influence of Neighborhood Design on Physical Activity within the Neighborhood: Evidence from Northern California
Authors: Handy Susan L. , Cao Xinyu , Mokhtarian Patricia L.
Published: June 2010

Purpose.

Test for a causal relationship between neighborhood design and physical activity within the neighborhood by controlling for self-selection.

Design.

Cross-sectional and quasi-longitudinal analyses of residents of selected neighborhoods.

Setting.

Eight Northern California neighborhoods.

Subjects.

Random sample of 1682 adults stratified by movers (moved within 1 year) and nonmovers (moved > 1 year ago) responding to self-administered mail surveys (24.7% response rate).

Measures.

Self-reported number of days in last 7 days of moderate to vigorous physical activity somewhere in the neighborhood and self-reported change in physical activity in the neighborhood from prior to moving (for movers) or from 1 year ago (for nonmovers).

Analysis.

Zero-inflated Poisson regression for cross-sectional analysis (n = 1497); ordered probit model for quasi-longitudinal analysis (n = 1352).

Results.

After we controlled for physical activity attitudes and neighborhood preferences, selected neighborhood design characteristics were associated with physical activity within the neighborhood and changes in selected neighborhood design characteristics were associated with changes in physical activity within the neighborhood.

Conclusions.

Both cross-sectional and quasi-longitudinal analyses provided evidence of a causal impact of neighborhood design. Improving physical activity options, aesthetic qualities, and social environment may increase physical activity. Critical limitations included self-report measures of physical activity, lack of measures of duration and intensity of neighborhood physical activity, lack of measures of total physical activity, and limited measures of preferences related to physical activity.