A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description

PubMed Central

Silva, Marlene N; Markland, David; Minderico, Cláudia S; Vieira, Paulo N; Castro, Margarida M; Coutinho, Sílvia R; Santos, Teresa C; Matos, Margarida G; Sardinha, Luís B; Teixeira, Pedro J

2008-01-01

Background Research on the motivational model proposed by Self-Determination Theory (SDT) provides theoretically sound insights into reasons why people adopt and maintain exercise and other health behaviors, and allows for a meaningful analysis of the motivational processes involved in behavioral self-regulation. Although obesity is notoriously difficult to reverse and its recidivism is high, adopting and maintaining a physically active lifestyle is arguably the most effective strategy to counteract it in the long-term. The purposes of this study are twofold: i) to describe a 3-year randomized controlled trial (RCT) aimed at testing a novel obesity treatment program based on SDT, and ii) to present the rationale behind SDT's utility in facilitating and explaining health behavior change, especially physical activity/exercise, during obesity treatment. Methods Study design, recruitment, inclusion criteria, measurements, and a detailed description of the intervention (general format, goals for the participants, intervention curriculum, and main SDT strategies) are presented. The intervention consists of a 1-year group behavioral program for overweight and moderately obese women, aged 25 to 50 (and pre-menopausal), recruited from the community at large through media advertisement. Participants in the intervention group meet weekly or bi-weekly with a multidisciplinary intervention team (30 2 h sessions in total), and go through a program covering most topics considered critical for successful weight control. These topics and especially their delivery were adapted to comply with SDT and Motivational Interviewing guidelines. Comparison group receive a general health education curriculum. After the program, all subjects are follow-up for a period of 2 years. Discussion Results from this RCT will contribute to a better understanding of how motivational characteristics, particularly those related to physical activity/exercise behavioral self-regulation, influence treatment success, while exploring the utility of Self-Determination Theory for promoting health behavior change in the context of obesity. Trial Registration Clinical Trials Gov. Identifier NCT00513084 PMID:18613959

Development of an Internet/Population-Based Weight Management Program for the U.S. Army

PubMed Central

Stewart, Tiffany; May, Sandra; Allen, H. Raymond; Bathalon, Col. Gaston P.; Lavergne, Guy; Sigrist, Lori; Ryan, Donna; Williamson, Donald A.

2008-01-01

A significant number of Army soldiers are sufficiently overweight to exceed the maximum weight allowances defined by the Army weight control program (AR600-9). Also, the body weights of a substantial number of soldiers approach the maximum weight allowances. These soldiers should not gain additional weight if they are to meet Army weight allowances. The conventional approach to this overweight problem is assigning soldiers to remedial physical training and mandatory referral for nutrition counseling by a health care provider. An alternative to this conventional approach is to target the entire population of soldiers (population-based intervention) to promote weight loss in overweight soldiers and weight gain prevention in soldiers who are approaching overweight status. To accomplish this objective, the Healthy Eating, Activity, and Lifestyle Training Headquarters (H.E.A.L.T.H.) program was developed. This article describes the rationale for developing the program, the components of the program, and the utilization promotion strategies of the program. The H.E.A.L.T.H. program includes two primary components: (1) a Web site tailored to the standards established in Field Manual 21-20, Physical Fitness Training, Army physical fitness test, and AR600-9, the army weight control program, and (2) a health promotion program designed to promote awareness of the H.E.A.L.T.H. Web site and to facilitate use of the Web site by soldiers and their family members. The Web site is equipped with personalized planning tools and progress tracking over time related to fitness, caloric intake, and lifestyle behavior change goals. The health promotion program includes media advertisements and “ground roots” efforts to facilitate use by soldiers. PMID:19885186

Study protocol for Log2Lose: A feasibility randomized controlled trial to evaluate financial incentives for dietary self-monitoring and interim weight loss in adults with obesity.

PubMed

Voils, Corrine I; Levine, Erica; Gierisch, Jennifer M; Pendergast, Jane; Hale, Sarah L; McVay, Megan A; Reed, Shelby D; Yancy, William S; Bennett, Gary; Strawbridge, Elizabeth M; White, Allison C; Shaw, Ryan J

2018-02-01

The obesity epidemic has negative physical, psychological, and financial consequences. Despite the existence of effective behavioral weight loss interventions, many individuals do not achieve adequate weight loss, and most regain lost weight in the year following intervention. We report the rationale and design for a 2×2 factorial study that involves financial incentives for dietary self-monitoring (yes vs. no) and/or interim weight loss (yes vs. no). Outpatients with obesity participate in a 24-week, group-based weight loss intervention. All participants are asked to record their daily dietary and liquid intake on a smartphone application (app) and to weigh themselves daily at home on a study-provided cellular scale. An innovative information technology (IT) solution collates dietary data from the app and weight from the scale. Using these data, an algorithm classifies participants weekly according to whether they met their group's criteria to receive a cash reward ranging from $0 to $30 for dietary self-monitoring and/or interim weight loss. Notice of the reward is provided via text message, and credit is uploaded to a gift card. This pilot study will provide information on the feasibility of using this novel IT solution to provide variable-ratio financial incentives in real time via its effects on recruitment, intervention adherence, retention, and cost. This study will provide the foundation for a comprehensive, adequately-powered, randomized controlled trial to promote short-term weight loss and long-term weight maintenance. If efficacious, this approach could reduce the prevalence, adverse outcomes, and costs of obesity for millions of Americans. Clinicaltrials.gov registration: NCT02691260. Published by Elsevier Inc.

The PPET Study: people and pets exercising together.

PubMed

Kushner, Robert F; Blatner, Dawn Jackson; Jewell, Dennis E; Rudloff, Kimberly

2006-10-01

Obesity is a significant public health problem that is affecting people and their pets. The human-companion animal bond and the role of pets in providing social support provides a rationale framework for studying the effectiveness of a combined people and pets (PP) exercising together (PPET) weight loss program. Thirty-six pairs of overweight or obese people with an obese pet (PP) and 56 overweight or obese people only (PO) participated in a 1-year prospective controlled weight loss study. In a group format, people received dietary and physical activity counseling, and dogs were fed a calorie-controlled prescription diet. Physical activity was recorded using the physical activity recall questionnaire. Completion rates at 1 year were 61% for the PP group and 58% for the PO group. Mean weight losses at 12 months using last observation carried forward were 4.7% (PP) and 5.2% (PO). Mean weight loss among the dogs was 15%. Time spent in physical activity increased in both groups to 3.9 (PP) and 3.5 (PO) h/wk. Two-thirds of total physical activity in the PP group was spent with the dogs. The PPET study is the first program to demonstrate the effectiveness of a combined PP weight loss program. This fresh approach to the dual obesity epidemic builds on the human-companion animal bond. Consideration of social support for weight loss of family members, friends, and coworkers should be extended to include pets.

Solid state power controllers

NASA Technical Reports Server (NTRS)

Gibbs, R. S.

1973-01-01

The rationale, analysis, design, breadboarding and testing of the incremental functional requirements are reported that led to the development of prototype 1 and 5 Amp dc and 1 Amp ac solid state power controllers (SSPC's). The SSPC's are to be considered for use as a replacement of electro-mechanical relays and circuit breakers in future spacecraft and aircraft. They satisfy the combined function of both the relay and circuit breaker and can be remotely controlled by small signals, typically 10 mA, 5 to 28 Vdc. They have the advantage over conventional relay/circuit breaker systems in that they can be located near utilization equipment and the primary ac or dc bus. The low level control, trip indication and status signals can be circuited by small guage wire for control, computer interface, logic, electrical multiplexing, unboard testing, and power management and distribution purposes. This results in increased system versatility at appreciable weight saving and increased reliability.

Design and Implementation of a Randomized Controlled Social and Mobile Weight Loss Trial for Young Adults (project SMART)

PubMed Central

Patrick, K; Marshall, SJ; Davila, EP; Kolodziejczyk, JK; Fowler, J; Calfas, KJ; Huang, J; Rock, CL; Griswold, W; Gupta, A; Merchant, G; Norman, GJ; Raab, F; Donohue, M; Fogg, BJ; Robinson, TN

2014-01-01

Purpose To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. Methods A total of 404 overweight or obese college students from three Southern California universities (Mage = 22(±4) years; MBMI=29(±2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, SMS, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, physical activity (PA), sedentary behavior (SED), diet, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Conclusion Theory-driven, evidence-based strategies for PA, SED, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. PMID:24215774

Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART).

PubMed

Patrick, K; Marshall, S J; Davila, E P; Kolodziejczyk, J K; Fowler, J H; Calfas, K J; Huang, J S; Rock, C L; Griswold, W G; Gupta, A; Merchant, G; Norman, G J; Raab, F; Donohue, M C; Fogg, B J; Robinson, T N

2014-01-01

To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. A total of 404 overweight or obese college students from three Southern California universities (M(age) = 22( ± 4) years; M(BMI) = 29( ± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. Copyright © 2013 Elsevier Inc. All rights reserved.

Meal-based enhancement of protein quality and quantity during weight loss in obese older adults with mobility limitations: rationale and design for the MEASUR-UP trial.

PubMed

McDonald, Shelley R; Porter Starr, Kathryn N; Mauceri, Luisa; Orenduff, Melissa; Granville, Esther; Ocampo, Christine; Payne, Martha E; Pieper, Carl F; Bales, Connie W

2015-01-01

Obese older adults with even modest functional limitations are at a disadvantage for maintaining their independence into late life. However, there is no established intervention for obesity in older individuals. The Measuring Eating, Activity, and Strength: Understanding the Response - Using Protein (MEASUR-UP) trial is a randomized controlled pilot study of obese women and men aged ≥60 years with mild to moderate functional impairments. Changes in body composition (lean and fat mass) and function (Short Physical Performance Battery) in an enhanced protein weight reduction (Protein) arm will be compared to those in a traditional weight loss (Control) arm. The Protein intervention is based on evidence that older adults achieve optimal rates of muscle protein synthesis when consuming about 25-30 g of high quality protein per meal; these participants will consume ~30 g of animal protein at each meal via a combination of provided protein (beef) servings and diet counseling. This trial will provide information on the feasibility and efficacy of enhancing protein quantity and quality in the context of a weight reduction regimen and determine the impact of this intervention on body weight, functional status, and lean muscle mass. We hypothesize that the enhancement of protein quantity and quality in the Protein arm will result in better outcomes for function and/or lean muscle mass than in the Control arm. Ultimately, we hope our findings will help identify a safe weight loss approach that can delay or prevent late life disability by changing the trajectory of age-associated functional impairment associated with obesity. Copyright © 2014 Elsevier Inc. All rights reserved.

Long-term effects of vitamin D supplementation in vitamin D deficient obese children participating in an integrated weight-loss programme (a double-blind placebo-controlled study) - rationale for the study design.

PubMed

Szlagatys-Sidorkiewicz, Agnieszka; Brzeziński, Michał; Jankowska, Agnieszka; Metelska, Paulina; Słomińska-Frączek, Magdalena; Socha, Piotr

2017-04-04

Obesity is associated not only with an array of metabolic disorders (e.g. insulin resistance, hiperinsulinemia, impaired tolerance of glucose, lipid disorders) but also skeletal and joint abnormalities. Recently, a pleiotropic role of vitamin D has been emphasized. Obese children frequently present with vitamin D deficiency, and greater fat mass is associated with lower serum concentration of this vitamin. Although some evidence suggests that weight loss may affect vitamin D status, this issue has not been studied extensively thus far. The aim of a double-blind placebo-controlled study is to assess long-term health effects of vitamin D supplementation in vitamin D deficient obese children participating in an integrated weight-loss programme. A randomized double-blind, placebo-controlled trial analysing the effects of vitamin D3 supplementation in overweight or obese vitamin D deficient (<30 ng/ml) children participating in an integrated weight-loss programme. Children are randomized to receive either vitamin D (1200 IU) or placebo for 26 weeks. Primary endpoints include changes in BMI (body mass index), body composition and bone mineral density at the end of the study period, and secondary endpoints - the changes in laboratory parameter reflecting liver and kidney function (transaminases, creatinine) and glucose homeostasis (glucose and insulin levels during oral glucose tolerance test). The effects of vitamin D supplementation in obese individuals, especially children, subjected to a weight-loss program are still poorly understood. Considering physiological processes associated with puberty and adolescent growth, we speculate that supplementation may enhance weight reduction and prevent bone loss in obese children deficient in this vitamin. NCT 02828228 ; Trial registration date: 8 Jun 2016; Registered in: ClinicalTrials.gov. The trial was registered retrospectively.

Enhancing physical and social environments to reduce obesity among public housing residents: rationale, trial design, and baseline data for the Healthy Families study.

PubMed

Quintiliani, Lisa M; DeBiasse, Michele A; Branco, Jamie M; Bhosrekar, Sarah Gees; Rorie, Jo-Anna L; Bowen, Deborah J

2014-11-01

Intervention programs that change environments have the potential for greater population impact on obesity compared to individual-level programs. We began a cluster randomized, multi-component multi-level intervention to improve weight, diet, and physical activity among low-socioeconomic status public housing residents. Here we describe the rationale, intervention design, and baseline survey data. After approaching 12 developments, ten were randomized to intervention (n=5) or assessment-only control (n=5). All residents in intervention developments are welcome to attend any intervention component: health screenings, mobile food bus, walking groups, cooking demonstrations, and a social media campaign; all of which are facilitated by community health workers who are residents trained in health outreach. To evaluate weight and behavioral outcomes, a subgroup of female residents and their daughters age 8-15 were recruited into an evaluation cohort. In total, 211 households completed the survey (RR=46.44%). Respondents were Latino (63%), Black (24%), and had ≤ high school education (64%). Respondents reported ≤2 servings of fruits & vegetables/day (62%), visiting fast food restaurants 1+ times/week (32%), and drinking soft drinks daily or more (27%). The only difference between randomized groups was race/ethnicity, with more Black residents in the intervention vs. control group (28% vs. 19%, p=0.0146). Among low-socioeconomic status urban public housing residents, we successfully recruited and randomized families into a multi-level intervention targeting obesity. If successful, this intervention model could be adopted in other public housing developments or entities that also employ community health workers, such as food assistance programs or hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.

Neuroimaging Studies of Factors Related to Exercise: Rationale and design of a 9 month trial

PubMed Central

Herrmann, Stephen D.; Martin, Laura E.; Breslin, Florence J.; Honas, Jeffery J.; Willis, Erik A.; Lepping, Rebecca J.; Gibson, Cheryl A.; Befort, Christie A.; Lambourne, Kate; Burns, Jeffrey M.; Smith, Bryan K.; Sullivan, Debra K.; Washburn, Richard A.; Yeh, Hung-Wen; Donnelly, Joseph E.; Savage, Cary R.

2014-01-01

The prevalence of obesity is high resulting from chronic imbalances between energy intake and expenditure. On the expenditure side, regular exercise is associated with health benefits, including enhanced brain function. The benefits of exercise are not immediate and require persistence to be realized. Brain regions associated with health-related decisions, such as whether or not to exercise or controlling the impulse to engage in immediately rewarding activities (e.g., sedentary behavior), include reward processing and cognitive control regions. A 9 month aerobic exercise study will be conducted in 180 sedentary adults (n = 90 healthy weight [BMI= 18.5 to 26.0 kg/m2]; n = 90 obese [BMI=29.0 to 41.0 kg/m2) to examine the brain processes underlying reward processing and impulse control that may affect adherence in a new exercise regimen. The primary aim is to use functional magnetic resonance imaging (fMRI) to examine reward processing and impulse control among participants that adhere (exercise >80% of sessions) and those that do not adhere to a nine-month exercise intervention with secondary analyses comparing sedentary obese and sedentary healthy weight participants. Our results will provide valuable information characterizing brain activation underlying reward processing and impulse control in sedentary obese and healthy weight individuals. In addition, our results may identify brain activation predictors of adherence and success in the exercise program along with measuring the effects of exercise and improved fitness on brain activation. PMID:24291150

Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study: rationale and design for a randomized controlled trial evaluating rheumatoid arthritis risk education to first-degree relatives.

PubMed

Sparks, Jeffrey A; Iversen, Maura D; Miller Kroouze, Rachel; Mahmoud, Taysir G; Triedman, Nellie A; Kalia, Sarah S; Atkinson, Michael L; Lu, Bing; Deane, Kevin D; Costenbader, Karen H; Green, Robert C; Karlson, Elizabeth W

2014-09-01

We present the rationale, design features, and protocol of the Personalized Risk Estimator for Rheumatoid Arthritis (PRE-RA) Family Study (ClinicalTrials.gov NCT02046005). The PRE-RA Family Study is an NIH-funded prospective, randomized controlled trial designed to compare the willingness to change behaviors in first-degree relatives of rheumatoid arthritis (RA) patients without RA after exposure to RA risk educational programs. Consented subjects are randomized to receive education concerning their personalized RA risk based on demographics, RA-associated behaviors, genetics, and biomarkers or to receive standard RA information. Four behavioral factors associated with RA risk were identified from prior studies for inclusion in the risk estimate: cigarette smoking, excess body weight, poor oral health, and low fish intake. Personalized RA risk information is presented through an online tool that collects data on an individual's specific age, gender, family history, and risk-related behaviors; presents genetic and biomarker results; displays relative and absolute risk of RA; and provides personalized feedback and education. The trial outcomes will be changes in willingness to alter behaviors from baseline to 6 weeks, 6 months, and 12 months in the three intervention groups. The design and the execution of this trial that targets a special population at risk for RA, while incorporating varied risk factors into a single risk tool, offer distinct challenges. We provide the theoretical rationale for the PRE-RA Family Study and highlight particular design features of this trial that utilize personalized risk education as an intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

Acarbose plus metformin fixed-dose combination in the management of type 2 diabetes.

PubMed

Joshi, Shashank R; Ramachandran, Ambady; Chadha, Manoj; Chatterjee, Sudip; Rathod, Rahul; Kalra, Sanjay

2014-08-01

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Concerns in the management of diabetes include drug-induced hypoglycemia, poor control of postprandial blood glucose level and weight gain. A carbohydrate-rich diet can cause more load on the intestinal cells producing α-glucosidase. Many patients need combination treatment based on their level of glycemic control and other associated parameters. In such cases, a therapy that provides effective glycemic control with minimal or no risk of adverse events like hypoglycemia or weight gain is highly desired. The chances of cardiovascular events are high in diabetes patients; hence, medicines providing benefits beyond glycemic control such as reduced cardiovascular risk factors may be ideal in such patients. Current available data are related to the rationale and clinical trials on the fixed-dose combination of acarbose plus metformin in management of type 2 diabetes. Combination therapy is routinely prescribed in the management of T2DM. Drugs with complimentary mechanisms should be used to maximize the efficacy of combination therapy. The combination of metformin and acarbose is a rational therapy because of their different and complimentary mechanisms of action, which provides effective glycemic control with additional cardiovascular benefits and minimizes adverse events.

Ketogenic diet in migraine: rationale, findings and perspectives.

PubMed

Barbanti, Piero; Fofi, Luisa; Aurilia, Cinzia; Egeo, Gabriella; Caprio, Massimiliano

2017-05-01

Ketogenic diet (KD) is an established treatment for refractory pediatric epilepsy and a promising therapy for diverse neurological diseases. Clinical data on KD in migraine-obtained from 150 patients investigated in case reports and prospective studies-suggest that KD may be a rapid onset effective prophylaxis for episodic and chronic migraine. KD would contribute to restore brain excitability and metabolism and to counteract neuroinflammation in migraine, although its precise mechanism is still unclear. Randomized controlled studies are needed to confirm the usefulness of KD in migraine and to investigate its optimal duration, repeatability, feasibility in normal weight subjects, efficacy in pediatric population and association to conventional migraine prophylaxis.

A Graphical User-Interface for Propulsion System Analysis

NASA Technical Reports Server (NTRS)

Curlett, Brian P.; Ryall, Kathleen

1992-01-01

NASA LeRC uses a series of computer codes to calculate installed propulsion system performance and weight. The need to evaluate more advanced engine concepts with a greater degree of accuracy has resulted in an increase in complexity of this analysis system. Therefore, a graphical user interface was developed to allow the analyst to more quickly and easily apply these codes. The development of this interface and the rationale for the approach taken are described. The interface consists of a method of pictorially representing and editing the propulsion system configuration, forms for entering numerical data, on-line help and documentation, post processing of data, and a menu system to control execution.

A graphical user-interface for propulsion system analysis

NASA Technical Reports Server (NTRS)

Curlett, Brian P.; Ryall, Kathleen

1993-01-01

NASA LeRC uses a series of computer codes to calculate installed propulsion system performance and weight. The need to evaluate more advanced engine concepts with a greater degree of accuracy has resulted in an increase in complexity of this analysis system. Therefore, a graphical user interface was developed to allow the analyst to more quickly and easily apply these codes. The development of this interface and the rationale for the approach taken are described. The interface consists of a method of pictorially representing and editing the propulsion system configuration, forms for entering numerical data, on-line help and documentation, post processing of data, and a menu system to control execution.

A feasibility study of developing toroidal tanks for a spinning spacecraft

NASA Technical Reports Server (NTRS)

Anderson, J. E.; Fester, D. A.

1973-01-01

A study was made to determine the feasibility of developing toroidal propellant tanks for a bipropellant (N204/MMH) propulsion system to be used in a proposed advanced Pioneer spin-stabilized vehicle intended for a Jupiter-orbiter and possibly a Saturn-orbiter mission. The rationale for considering the use of two toroidal tanks rather than the proposed use of four spherical tanks includes the belief that a more symmetrical distribution of propellant mass and a smaller variation in the position of the vehicle center-of-mass during propellant consumption would result, reducing requirements for attitude-control propellants, for balance weight, and for other weights associated with the dynamics of the spinning spacecraft. Results lead to the conclusion that a toroidal tank containing an effective, passive surface tension propellant acquisition device could be fabricated with available manufacturing methods and could be used interchangeably for either fuel or oxidizer.

Low-molecular-weight heparin to prevent recurrent venous thromboembolism in pregnancy: Rationale and design of the Highlow study, a randomised trial of two doses.

PubMed

Bleker, Suzanne M; Buchmüller, Andrea; Chauleur, Céline; Ní Áinle, Fionnuala; Donnelly, Jennifer; Verhamme, Peter; Jacobsen, Anne Flem; Ganzevoort, Wessel; Prins, Martin; Beyer-Westendorf, Jan; DeSancho, Maria; Konstantinides, Stavros; Pabinger, Ingrid; Rodger, Marc; Decousus, Hervé; Middeldorp, Saskia

2016-08-01

Women with a history of venous thromboembolism (VTE) have a 2% to 10% absolute risk of VTE recurrence during subsequent pregnancies. Therefore, current guidelines recommend that all pregnant women with a history of VTE receive pharmacologic thromboprophylaxis. The optimal dose of low-molecular-weight heparin (LMWH) for thromboprophylaxis is unknown. In the Highlow study (NCT 01828697; www.highlowstudy.org), we compare a fixed low dose of LMWH with an intermediate dose of LMWH for the prevention of pregnancy-associated recurrent VTE. We present the rationale and design features of this study. The Highlow study is an investigator-initiated, multicentre, international, open-label, randomised trial. Pregnant women with a history of VTE and an indication for ante- and postpartum pharmacologic thromboprophylaxis are included before 14weeks of gestation. The primary efficacy outcome is symptomatic recurrent VTE during pregnancy and 6weeks postpartum. The primary safety outcomes are clinically relevant bleeding, blood transfusions before 6weeks postpartum and mortality. Patients are closely monitored to detect cutaneous reactions to LMWH and are followed for 3months after delivery. A central independent adjudication committee adjudicates all suspected outcome events. The Highlow study is the first large randomised controlled trial in pregnancy that will provide high-quality evidence on the optimal dose of LWMH thromboprophylaxis for the prevention of recurrent VTE in pregnant women with a history of VTE. Copyright © 2016 Elsevier Ltd. All rights reserved.

Weight Science: Evaluating the Evidence for a Paradigm Shift

PubMed Central

2011-01-01

Current guidelines recommend that "overweight" and "obese" individuals lose weight through engaging in lifestyle modification involving diet, exercise and other behavior change. This approach reliably induces short term weight loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES. PMID:21261939

Healthcare tariffs for specialist inpatient neurorehabilitation services: rationale and development of a UK casemix and costing methodology.

PubMed

Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert

2012-03-01

To describe the rationale and development of a casemix model and costing methodology for tariff development for specialist neurorehabilitation services in the UK. Patients with complex needs incur higher treatment costs. Fair payment should be weighted in proportion to costs of providing treatment, and should allow for variation over time CASEMIX MODEL AND BAND-WEIGHTING: Case complexity is measured by the Rehabilitation Complexity Scale (RCS). Cases are divided into five bands of complexity, based on the total RCS score. The principal determinant of costs in rehabilitation is staff time. Total staff hours/week (estimated from the Northwick Park Nursing and Therapy Dependency Scales) are analysed within each complexity band, through cross-sectional analysis of parallel ratings. A 'band-weighting' factor is derived from the relative proportions of staff time within each of the five bands. Total unit treatment costs are obtained from retrospective analysis of provider hospitals' budget and accounting statements. Mean bed-day costs (total unit cost/occupied bed days) are divided broadly into 'variable' and 'non-variable' components. In the weighted costing model, the band-weighting factor is applied to the variable portion of the bed-day cost to derive a banded cost, and thence a set of cost-multipliers. Preliminary data from one unit are presented to illustrate how this weighted costing model will be applied to derive a multilevel banded payment model, based on serial complexity ratings, to allow for change over time.

Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics.

PubMed

Zenk, Shannon N; Tarlov, Elizabeth; Powell, Lisa M; Wing, Coady; Matthews, Stephen A; Slater, Sandy; Gordon, Howard S; Berbaum, Michael; Fitzgibbon, Marian L

2018-03-01

To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. Retrospective cohort. Continental United States. A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. The VA MOVE! weight management program, an evidence-based lifestyle intervention. Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. Descriptive statistics presented on cohort characteristics and environments where they live. Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.

Combination therapy with GLP-1 receptor agonists and basal insulin: a systematic review of the literature

PubMed Central

Balena, R; Hensley, I E; Miller, S; Barnett, A H

2013-01-01

Treatment algorithms for type 2 diabetes call for intensification of therapy over time as the disease progresses and glycaemic control worsens. If diet, exercise and oral antihyperglycaemic medications (OAMs) fail to maintain glycaemic control then basal insulin is added and ultimately prandial insulin may be required. However, such an intensification strategy carries risk of increased hypoglycaemia and weight gain, both of which are associated with worse long-term outcomes. An alternative strategy is to intensify therapy by the addition of a short-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) rather than prandial insulin. Short-acting GLP-1 RAs such as exenatide twice daily are particularly effective at reducing postprandial glucose while basal insulin has a greater effect on fasting glucose, providing a physiological rationale for this complementary approach. This review analyzes the latest randomized controlled clinical trials of insulin/GLP-1 RA combination therapy and examines results from ‘real-world’ use of the combinations as reported through observational and clinical practice studies. The most common finding across all types of studies was that combination therapy improved glycaemic control without weight gain or an increased risk of hypoglycaemia. Many studies reported weight loss and a reduction in insulin use when a GLP-1 RA was added to existing insulin therapy. Overall, the relative degree of benefit to glycaemic control and weight was influenced by the insulin titration employed in conjunction with the GLP-1 RA. The greatest glycaemic benefits were observed in studies with structured titration of insulin to glycaemic targets while the greatest weight benefits were observed in studies with a protocol-specified focus on insulin sparing. The adverse event profile of GLP-1 RAs in the reviewed trials was similar to that reported with GLP-1 RAs as monotherapy or in combination with OAMs with gastrointestinal events being the most commonly reported. PMID:23061470

Mixed-methods designs in mental health services research: a review.

PubMed

Palinkas, Lawrence A; Horwitz, Sarah M; Chamberlain, Patricia; Hurlburt, Michael S; Landsverk, John

2011-03-01

Despite increased calls for use of mixed-methods designs in mental health services research, how and why such methods are being used and whether there are any consistent patterns that might indicate a consensus about how such methods can and should be used are unclear. Use of mixed methods was examined in 50 peer-reviewed journal articles found by searching PubMed Central and 60 National Institutes of Health (NIH)-funded projects found by searching the CRISP database over five years (2005-2009). Studies were coded for aims and the rationale, structure, function, and process for using mixed methods. A notable increase was observed in articles published and grants funded over the study period. However, most did not provide an explicit rationale for using mixed methods, and 74% gave priority to use of quantitative methods. Mixed methods were used to accomplish five distinct types of study aims (assess needs for services, examine existing services, develop new or adapt existing services, evaluate services in randomized controlled trials, and examine service implementation), with three categories of rationale, seven structural arrangements based on timing and weighting of methods, five functions of mixed methods, and three ways of linking quantitative and qualitative data. Each study aim was associated with a specific pattern of use of mixed methods, and four common patterns were identified. These studies offer guidance for continued progress in integrating qualitative and quantitative methods in mental health services research consistent with efforts by NIH and other funding agencies to promote their use.

The 40-Something randomized controlled trial to prevent weight gain in mid-age women.

PubMed

Williams, Lauren T; Hollis, Jenna L; Collins, Clare E; Morgan, Philip J

2013-10-25

Obesity prevention is a major public health priority. Despite the health risks associated with weight gain, there has been a distinct lack of research into effective interventions to prevent, rather than treat, obesity particularly at high risk life stages such as menopause in women. This paper describes the rationale for and design of a 2-year randomized controlled trial (RCT) (the 40-Something Study) aimed at testing the feasibility and efficacy of a relatively low intensity intervention designed to achieve weight control in non-obese women about to enter the menopause transition. The study is a parallel-group RCT consisting of 12 months of intervention (Phase 1) and 12 months of monitoring (Phase 2). Non-obese pre-menopausal healthy females 44-50 years of age were screened, stratified according to Body Mass Index (BMI) category (18.5-24.9 and 25-29.9 kg/m²) and randomly assigned to one of two groups: motivational interviewing (MI) intervention (n = 28), or a self-directed intervention (SDI) (control) (n = 26). The MI intervention consisted of five consultations with health professionals (four with a Dietitian and one with an Exercise Physiologist) who applied components of MI counselling to consultations with the women over a 12 month period. The SDI was developed as a control and these participants received print materials only. Outcome measures were collected at baseline, three, 12, 18 and 24 months and included weight (primary outcome), waist circumference, body composition, blood pressure, plasma markers of metabolic syndrome risk, dietary intake, physical activity and quality of life. Analysis of covariance will be used to investigate outcomes according to intervention type and duration (comparing baseline, 12 and 24 months). The 40-Something study is the first RCT aimed at preventing menopausal weight gain in Australian women. Importantly, this paper describes the methods used to evaluate whether a relatively low intensity, health professional led intervention will achieve better weight control in pre-menopausal women than a self-directed intervention. The results will add to the scant body of literature on obesity prevention methods at an under-researched high-risk life stage, and inform the development of population-based interventions. ACTRN12611000064909.

Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study.

PubMed

Berry, Diane C; Neal, Madeline; Hall, Emily G; Schwartz, Todd A; Verbiest, Sarah; Bonuck, Karen; Goodnight, William; Brody, Seth; Dorman, Karen F; Menard, Mary K; Stuebe, Alison M

2013-10-10

Women who are diagnosed with gestational diabetes mellitus (GDM) are at increased risk for developing prediabetes and type 2 diabetes mellitus (T2DM). To date, there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM. This paper describes the rationale, design and methodology of a 2-year, randomized, controlled study being conducted in North Carolina. Using a two-group, repeated measures, experimental design, we will test a 14- week intensive intervention on the benefits of breastfeeding, understanding gestational diabetes and risk of progression to prediabetes and T2DM, nutrition and exercise education, coping skills training, physical activity (Phase I), educational and motivational text messaging and 3 months of continued monthly contact (Phase II). A total of 100 African American, non-Hispanic white, and bilingual Hispanic women between 22-36 weeks of pregnancy who are diagnosed with GDM and their infants will be randomized to either the experimental group or the wait-listed control group. The first aim of the study is to determine the feasibility of the intervention. The second aim of study is to test the effects of the intervention on maternal outcomes from baseline (22-36 weeks pregnant) to 10 months postpartum. Primary maternal outcomes will include fasting blood glucose and weight (BMI) from baseline to 10 months postpartum. Secondary maternal outcomes will include clinical, adiposity, health behaviors and self-efficacy outcomes from baseline to 10 months postpartum. The third aim of the study is to quantify the effects of the intervention on infant feeding and growth. Infant outcomes will include weight status and breastfeeding from birth through 10 months of age. Data analysis will include general linear mixed-effects models. Safety endpoints include adverse event reporting. Findings from this trial may lead to an effective intervention to assist women diagnosed with GDM to improve maternal glucose homeostasis and weight as well as stabilize infant growth trajectory, reducing the burden of metabolic disease across two generations. NCT01809431.

Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study

PubMed Central

2013-01-01

Background Women who are diagnosed with gestational diabetes mellitus (GDM) are at increased risk for developing prediabetes and type 2 diabetes mellitus (T2DM). To date, there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM. This paper describes the rationale, design and methodology of a 2-year, randomized, controlled study being conducted in North Carolina. Methods/Design Using a two-group, repeated measures, experimental design, we will test a 14- week intensive intervention on the benefits of breastfeeding, understanding gestational diabetes and risk of progression to prediabetes and T2DM, nutrition and exercise education, coping skills training, physical activity (Phase I), educational and motivational text messaging and 3 months of continued monthly contact (Phase II). A total of 100 African American, non-Hispanic white, and bilingual Hispanic women between 22–36 weeks of pregnancy who are diagnosed with GDM and their infants will be randomized to either the experimental group or the wait-listed control group. The first aim of the study is to determine the feasibility of the intervention. The second aim of study is to test the effects of the intervention on maternal outcomes from baseline (22–36 weeks pregnant) to 10 months postpartum. Primary maternal outcomes will include fasting blood glucose and weight (BMI) from baseline to 10 months postpartum. Secondary maternal outcomes will include clinical, adiposity, health behaviors and self-efficacy outcomes from baseline to 10 months postpartum. The third aim of the study is to quantify the effects of the intervention on infant feeding and growth. Infant outcomes will include weight status and breastfeeding from birth through 10 months of age. Data analysis will include general linear mixed-effects models. Safety endpoints include adverse event reporting. Discussion Findings from this trial may lead to an effective intervention to assist women diagnosed with GDM to improve maternal glucose homeostasis and weight as well as stabilize infant growth trajectory, reducing the burden of metabolic disease across two generations. Trial registration NCT01809431 PMID:24112417

Exercise in obese female rats has beneficial effects on maternal and male and female offspring metabolism

PubMed Central

Vega, Claudia C; Reyes-Castro, Luis A; Bautista, Claudia J; Larrea, Fernando; Nathanielsz, Peter W; Zambrano, Elena

2013-01-01

BACKGROUND Maternal obesity (MO) impairs maternal and offspring health. Mechanisms and interventions to prevent adverse maternal and offspring outcomes need to be determined. Human studies are confounded by socio-economic status providing the rationale for controlled animal data on effects of maternal exercise (MEx) intervention on maternal (F0) and offspring (F1) outcomes in MO. HYPOTHESIS MO produces metabolic and endocrine dysfunction, increases maternal and offspring glucocorticoid exposure, oxidative stress and adverse offspring outcomes by postnatal day (PND) 36. MEx prevents these outcomes. METHODS F0 female rats ate either control or obesogenic diet from weaning through lactation. Half of each group wheel ran (from day ninety of life through pregnancy beginning day 120) providing four groups (n=8/group) – i) controls, ii) obese, iii) exercised controls and iv) exercised obese. After weaning, PND 21, F1 offspring ate a control diet. Metabolic parameters of F0 prepregnancy and end of lactation and F1 offspring at PND 36 were analyzed. RESULTS Exercise did not change maternal weight. Before breeding, MO elevated F0 glucose, insulin, triglycerides, cholesterol, leptin, fat and oxidative stress. Exercise completely prevented the triglyceride rise and partially glucose, insulin, cholesterol and oxidative stress increases. MO decreased fertility, recovered by exercise. At the end of lactation, exercise returned all metabolic variables except leptin to control levels. Exercise partially prevented MO elevated corticosterone. F1 Offspring weights were similar at birth. At PND 36 MO increased F1 male but not female offspring leptin, triglycerides and fat mass. In controls exercise reduced male and female offspring glucose, prevented the offspring leptin increase and partially the triglyceride rise. CONCLUSIONS MEx before and during pregnancy has beneficial effects on maternal and offspring metabolism and endocrine function occurring with no weight change in mothers and offspring indicating the importance of body composition rather than weight in evaluations of metabolic status. PMID:23949616

Rationale, design, methodology and sample characteristics for the family partners for health study: a cluster randomized controlled study

PubMed Central

2012-01-01

Background Young children who are overweight are at increased risk of becoming obese and developing type 2 diabetes and cardiovascular disease later in life. Therefore, early intervention is critical. This paper describes the rationale, design, methodology, and sample characteristics of a 5-year cluster randomized controlled trial being conducted in eight elementary schools in rural North Carolina, United States. Methods/Design The first aim of the trial is to examine the effects of a two-phased intervention on weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy in overweight or obese 2nd, 3 rd, and 4th grade children and their overweight or obese parents. The primary outcome in children is stabilization of BMI percentile trajectory from baseline to 18 months. The primary outcome in parents is a decrease in BMI from baseline to 18 months. Secondary outcomes for both children and parents include adiposity, nutrition and exercise health behaviors, and self-efficacy from baseline to 18 months. A secondary aim of the trial is to examine in the experimental group, the relationships between parents and children's changes in weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy. An exploratory aim is to determine whether African American, Hispanic, and non-Hispanic white children and parents in the experimental group benefit differently from the intervention in weight status, adiposity, health behaviors, and self-efficacy. A total of 358 African American, non-Hispanic white, and bilingual Hispanic children with a BMI ≥ 85th percentile and 358 parents with a BMI ≥ 25 kg/m2 have been inducted over 3 1/2 years and randomized by cohort to either an experimental or a wait-listed control group. The experimental group receives a 12-week intensive intervention of nutrition and exercise education, coping skills training and exercise (Phase I), 9 months of continued monthly contact (Phase II) and then 6 months (follow-up) on their own. Safety endpoints include adverse event reporting. Intention-to-treat analysis will be applied to all data. Discussion Findings from this trial may lead to an effective intervention to assist children and parents to work together to improve nutrition and exercise patterns by making small lifestyle pattern changes. Trial registration NCT01378806. PMID:22463125

No global consensus: a cross-sectional survey of maternal weight policies

PubMed Central

2014-01-01

Background Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. Methods This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Results Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. Conclusions These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child. PMID:24884985

OFT-1 reference flight profile. Deorbit through landing

NASA Technical Reports Server (NTRS)

Heath, D.; Gonzales, L.; Montez, M.; Hiott, J. M.; Ruda, R.; Kyle, H.

1977-01-01

Changes made in the de-orbiting through landing reference flight profile because of increases in Orbiter weight during entry and in the circular orbital attitude prior to deorbit are discussed. The rationale for the shaping of each phase is also presented.

Integrating a family-focused approach into child obesity prevention: Rationale and design for the My Parenting SOS study randomized control trial

PubMed Central

2011-01-01

Background More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. Methods This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Discussion Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. Trial Registration ClinicalTrials.gov: NCT00998348 PMID:21639940

Integrating a family-focused approach into child obesity prevention: rationale and design for the My Parenting SOS study randomized control trial.

PubMed

Ward, Dianne S; Vaughn, Amber E; Bangdiwala, Kant I; Campbell, Marci; Jones, Deborah J; Panter, Abigail T; Stevens, June

2011-06-05

More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. ClinicalTrials.gov: NCT00998348.

On the MTD paradigm and optimal control for multi-drug cancer chemotherapy.

PubMed

Ledzewicz, Urszula; Schättler, Heinz; Gahrooi, Mostafa Reisi; Dehkordi, Siamak Mahmoudian

2013-06-01

In standard chemotherapy protocols, drugs are given at maximum tolerated doses (MTD) with rest periods in between. In this paper, we briey discuss the rationale behind this therapy approach and, using as example multidrug cancer chemotherapy with a cytotoxic and cytostatic agent, show that these types of protocols are optimal in the sense of minimizing a weighted average of the number of tumor cells (taken both at the end of therapy and at intermediate times) and the total dose given if it is assumed that the tumor consists of a homogeneous population of chemotherapeutically sensitive cells. A 2-compartment linear model is used to model the pharmacokinetic equations for the drugs.

Design considerations and rationale of a multi-center trial to sustain weight loss: the Weight Loss Maintenance Trial.

PubMed

Brantley, Phillip; Appel, Lawrence; Hollis, Jack; Stevens, Victor; Ard, Jamy; Champagne, Catherine; Elmer, Patricia; Harsha, David; Myers, Valerie; Proschan, Michael; William, Vollmer; Svetkey, Laura

2008-01-01

The Weight Loss Maintenance Trial (WLM) is a multi-center, randomized, controlled trial that compares the effects of two 30-month maintenance interventions, i.e., Personal Contact (PC) and Interactive Technology (IT) to a self-directed usual care control group (SD), in overweight or obese individuals who are at high risk for cardiovascular disease. This paper provides an overview of the design and methods, and design considerations and lessons learned from this trial. All participants received a 6-month behavioral weight loss program consisting of weekly group sessions. Participants who lost 4 kg were randomized to one of three conditions (PC, IT, or SD). The PC condition provided monthly contacts with an interventionist primarily via telephone and quarterly face-to-face visits. The IT condition provided frequent, individualized contact through a tailored, website system. Both the PC and IT maintenance programs encouraged the DASH dietary pattern and employed theory-based behavioral techniques to promote maintenance. Design considerations included choice of study population, frequency and type of intervention visits, and choice of primary outcome. Overweight or obese persons with CVD risk factors were studied. The pros and cons of studying this population while excluding others are presented. We studied intervention contact strategies that made fewer demands on participant time and travel, while providing frequent opportunities for interaction. The primary outcome variable for the trial was change in weight from randomization to end of follow-up (30 months). Limits to generalizability are discussed. Individuals in need of weight loss strategies may have been excluded due to barriers associated with internet use. Other participants may have been excluded secondary to a comorbid condition. This paper highlights the design and methods of WLM and informs readers of discussions of critical issues and lessons learned from the trial.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

PubMed

Donnelly, J E; Ptomey, L T; Goetz, J R; Sullivan, D K; Gibson, C A; Greene, J L; Lee, R H; Mayo, M S; Honas, J J; Washburn, R A

2016-11-01

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery. Copyright © 2016. Published by Elsevier Inc.

Factors associated with opioid dose increases: a chart review of patients’ first year on long-term opioids

PubMed Central

Bautista, Christopher A.; Iosif, Ana-Maria; Wilsey, Barth L.; Melnikow, Joy A.; Crichlow, Althea; Henry, Stephen G.

2016-01-01

OBJECTIVE To examine encounter-level factors associated with opioid dose increases during patients’ first year on opioid therapy for chronic pain. DESIGN Case-control study analyzing all opioid prescriptions for patients with chronic pain during their first year after opioid initiation. Cases were patients who experienced an overall dose escalation of ≥30 mg morphine equivalents over the 1-year period; controls did not experience overall dose escalation. Main measures were encounter type; opioid dose change; documented prescribing rationale; documentation of guideline-concordant opioid prescribing practices. Two coders reviewed all encounters associated with opioid prescriptions. Analysis of factors associated with dose increases and provider documentation of prescribing rationale was conducted using multiple logistic regression. RESULTS 674 encounters were coded for 66 patients (22 cases, 44 controls). Fifty-three percent of opioid prescriptions were associated with telephone encounters; 13% were associated with email encounters. No prescribing rationale was documented for 43% of all opioid prescriptions and 25% of dose increases. Likelihood of dose increase and documentation of prescribing rationale did not significantly differ for cases versus controls. Compared to face-to-face encounters, dose increases were significantly less likely for telephone (OR 0.18, 95%CI 0.11 – 0.28) and email (OR 0.23, 95%CI 0.12 – 0.47) encounters; documentation of prescribing rationale was significantly more likely for email (OR 5.06, 95%CI 1.87–13.72) and less likely for telephone (OR 0.30, 95%CI 0.18–0.51) encounters. CONCLUSION Most opioid prescriptions were written without face-to-face encounters. One quarter of dose increases contained no documented prescribing rationale. Documented encounter-level factors were not significantly associated with overall opioid dose escalation. PMID:27477581

Environmental effects on passive thermal control materials of the space station freedom

NASA Astrophysics Data System (ADS)

Jones, C. A.; David, K. E.; LeVesque, R. J.; Babel, H. W.

The long-life Space Station Freedom (SSF) has power and weight requirements that are not to be exceeded during the detailed design development. There are requirements for both minimum and maximum temperatures associated with allowable fluid temperature ranges as well as prevention of astronaut injury during extravehicular activity, such as frozen or burned skin. In selected areas, temperature gradients must be controlled to prevent distortion of the primary structure. SSF will fly in low Earth orbit, in which atomic oxygen, ultraviolet radiation, meteoroid/orbital debris impacts, and plasma coupling are considered some of the most damaging constituents. These, in conjunction with hardware-induced contamination, required McDonnell Douglas Aerospace to focus on thermal control coatings based on the more durable metals, oxides, and fluorinated polymers. This paper describes the approach and rationale that McDonnell Douglas Aerospace employed for SSF Work Package 2 to provide the required thermal control coatings and insulation to ensure that the operational temperatures remain within acceptable limits.

Behavioral Weight Loss Treatment in Antipsychotic Treated Youth.

PubMed

Nicol, Ginger E; Kolko, Rachel P; Mills, Monica; Gunnarsdottir, Thrudur; Yingling, Michael D; Schweiger, Julia A; Lenze, Eric J; Newcomer, John W; Wilfley, Denise

2016-05-01

Antipsychotic-treated youth have increased risk for the development of obesity and type 2 diabetes. Behavioral weight loss treatments show promise in reducing obesity and diabetes risk in antipsychotic treated adults, but have received no study in antipsychotic treated youth. We describe a rationale for behavioral weight loss interventions in high-weight antipsychotic treated youth, and report behavioral, anthropomorphic, and metabolic findings from a case series of obese antipsychotic-treated adolescents participating in a short-term, family-based behavioral weight loss intervention. We adapted the Traffic Light Plan, a 16-week family-based weight loss intervention that promotes healthy energy balance using the colors of the traffic light to categorize the nutritional value of foods and intensity of physical activity, adapting a social ecological framework to address health behavior change in multiple social contexts. The intervention was administered to three obese adolescents with long-term antipsychotic medication exposure. Efficacy of the intervention was evaluated with a battery of anthropomorphic and metabolic assessments including weight, body mass index percentile, whole body adiposity, liver fat content, and fasting plasma glucose and lipids. Participants and their parents also filled out a treatment satisfaction questionnaire upon study completion. Two males and 1 female (all aged 14 years) participated. All 3 participants attended all 16 sessions, and experienced beneficial changes in adiposity, fasting lipids and liver fat content associated with weight stabilization or weight loss. Adolescents and their parents all reported a high level of satisfaction with the treatment. Family-based behavioral weight loss treatment can be feasibly delivered and is acceptable to antipsychotic-treated youth and their families. Randomized controlled trials are needed to fully evaluate the effectiveness and acceptability of behavioral weight loss interventions in antipsychotic treated youth and their families.

HomeStyles, A Web-Based Childhood Obesity Prevention Program for Families With Preschool Children: Protocol for a Randomized Controlled Trial

PubMed Central

2017-01-01

Background The home environment is where young children spend most of their time, and is critically important to supporting behaviors that promote health and prevent obesity. However, the home environment and lifestyle patterns remain understudied, and few interventions have investigated parent-led makeovers designed to create home environments that are supportive of optimal child health and healthy child weights. Objective The aim of the HomeStyles randomized controlled trial (RCT) is to determine whether the Web-based HomeStyles intervention enables and motivates parents to shape the weight-related aspects of their home environments and lifestyle behavioral practices (diet, exercise, and sleep) to be more supportive of their preschool children’s optimal health and weight. Methods A rigorous RCT utilizing an experimental group and an attention control group, receiving a bona fide contemporaneous treatment equal in nonspecific treatment effects and differing only in subject matter content, will test the effect of HomeStyles on a diverse sample of families with preschool children. This intervention is based on social cognitive theory and uses a social ecological framework, and will assess: intrapersonal characteristics (dietary intake, physical activity level, and sleep) of parents and children; family interpersonal or social characteristics related to diet, physical activity, media use, and parental values and self-efficacy for obesity-preventive practices; and home environment food availability, physical activity space and supports in and near the home, and media availability and controls in the home. Results Enrollment for this study has been completed and statistical data analyses are currently underway. Conclusions This paper describes the HomeStyles intervention with regards to: rationale, the intervention’s logic model, sample eligibility criteria and recruitment, experimental group and attention control intervention content, study design, instruments, data management, and planned analyses. PMID:28442452

20 CFR 30.411 - What happens if the opinion of the physician selected by OWCP differs from the opinion of the...

Code of Federal Regulations, 2011 CFR

2011-04-01

... reports of virtually equal weight and rationale reach opposing conclusions. (b) If a conflict exists... the case. Also, a case file may be sent to a physician who conforms to the standards regarding...

The 40-Something randomized controlled trial to prevent weight gain in mid-age women

PubMed Central

2013-01-01

Background Obesity prevention is a major public health priority. Despite the health risks associated with weight gain, there has been a distinct lack of research into effective interventions to prevent, rather than treat, obesity particularly at high risk life stages such as menopause in women. This paper describes the rationale for and design of a 2-year randomized controlled trial (RCT) (the 40-Something Study) aimed at testing the feasibility and efficacy of a relatively low intensity intervention designed to achieve weight control in non-obese women about to enter the menopause transition. Methods and design The study is a parallel-group RCT consisting of 12 months of intervention (Phase 1) and 12 months of monitoring (Phase 2). Non-obese pre-menopausal healthy females 44–50 years of age were screened, stratified according to Body Mass Index (BMI) category (18.5-24.9 and 25–29.9 kg/m2) and randomly assigned to one of two groups: motivational interviewing (MI) intervention (n = 28), or a self-directed intervention (SDI) (control) (n = 26). The MI intervention consisted of five consultations with health professionals (four with a Dietitian and one with an Exercise Physiologist) who applied components of MI counselling to consultations with the women over a 12 month period. The SDI was developed as a control and these participants received print materials only. Outcome measures were collected at baseline, three, 12, 18 and 24 months and included weight (primary outcome), waist circumference, body composition, blood pressure, plasma markers of metabolic syndrome risk, dietary intake, physical activity and quality of life. Analysis of covariance will be used to investigate outcomes according to intervention type and duration (comparing baseline, 12 and 24 months). Discussion The 40-Something study is the first RCT aimed at preventing menopausal weight gain in Australian women. Importantly, this paper describes the methods used to evaluate whether a relatively low intensity, health professional led intervention will achieve better weight control in pre-menopausal women than a self-directed intervention. The results will add to the scant body of literature on obesity prevention methods at an under-researched high-risk life stage, and inform the development of population-based interventions. Trial registration ACTRN12611000064909 PMID:24156558

Laundering in space - A summary of recent developments.

NASA Technical Reports Server (NTRS)

Houck, O. K.; Symons, J. J.

1973-01-01

Clothing must be washed and reused on future long duration space missions to maintain personal hygiene without severe weight penalties of stored clothing. Laundering equipment that may operate in the absence of gravity is being developed. Weight savings expected from this equipment are illustrated in this paper that describes a six-man combined clothes washer/dryer engineering prototype. Also included in the paper is the rationale used in selecting the final prototype design as well as a discussion of major factors affecting design and performance.

A spatially constrained ecological classification: rationale, methodology and implementation

Treesearch

Franz Mora; Louis Iverson; Louis Iverson

2002-01-01

The theory, methodology and implementation for an ecological and spatially constrained classification are presented. Ecological and spatial relationships among several landscape variables are analyzed in order to define a new approach for a landscape classification. Using ecological and geostatistical analyses, several ecological and spatial weights are derived to...

Bupropion-SR plus naltrexone-SR for the treatment of mild-to-moderate obesity.

PubMed

Ali, Khawla F; Shukla, Alpana P; Aronne, Louis J

2016-01-01

Naltrexone-bupropion is a recently approved drug combination for chronic weight management. In this article, we discuss the rationale for its use as a combination followed by a comprehensive review of safety and efficacy data from major preclinical, phase II and III clinical trials.

Metrics Made Easy: A Classroom Guide - 1978.

ERIC Educational Resources Information Center

Blau, Sharon; And Others

This classroom guide for metric education included a brief rationale and history of metrics, a preliminary metric quiz, a symbol summary, and a list of recommended instructional materials. The guide is comprised primarily of four sections covering the topics of: weight, length, volume, and temperature. Each of these sections contains goals and…

A unique problem of muscle adaptation from weightlessness: The deceleration deficiency

NASA Technical Reports Server (NTRS)

Stauber, William T.

1989-01-01

Decelerator problems of the knee are emphasized since the lower leg musculature is known to atrophy in response to weightlessness. However, other important decelerator functions are served by the shoulder muscles, in particular the rotator cuff muscles. Problems in these muscles often result in tears and dislocations as seen in baseball pitchers. It is noteworthy that at least one device currently exists that can measure concentric and eccentric muscle loading including a submaximal simulated free weight exercise (i.e., force-controlled) and simultaneously record integrated EMG analysis appropriate for assessment of all muscle functional activities. Studies should be undertaken to provide information as to the performance of maximal and submaximal exercise in space travelers to define potential problems and provide rationale for prevention.

How might acupuncture work? A systematic review of physiologic rationales from clinical trials.

PubMed

Moffet, Howard H

2006-07-07

Scientific interest in acupuncture has led numerous investigators to conduct clinical trials to test the efficacy of acupuncture for various conditions, but the mechanisms underlying acupuncture are poorly understood. The author conducted a PubMed search to obtain a fair sample of acupuncture clinical trials published in English in 2005. Each article was reviewed for a physiologic rationale, as well as study objectives and outcomes, experimental and control interventions, country of origin, funding sources and journal type. Seventy-nine acupuncture clinical trials were identified. Twenty-six studies (33%) offered no physiologic rationale. Fifty-three studies (67%) posited a physiologic basis for acupuncture: 33 (62% of 53) proposed neurochemical mechanisms, 2 (4%) segmental nervous system effects, 6 (11%) autonomic nervous system regulation, 3 (6%) local effects, 5 (9%) effects on brain function and 5 (9%) other effects. No rationale was proposed for stroke; otherwise having a rationale was not associated with objective, positive or negative findings, means of intervention, country of origin, funding source or journal type. The dominant explanation for how acupuncture might work involves neurochemical responses and is not reported to be dependent on treatment objective, specific points, means or method of stimulation. Many acupuncture trials fail to offer a meaningful rationale, but proposing a rationale can help investigators to develop and test a causal hypothesis, choose an appropriate control and rule out placebo effects. Acupuncture may stimulate self-regulatory processes independent of the treatment objective, points, means or methods used; this would account for acupuncture's reported benefits in so many disparate pathologic conditions.

Dissemination of the Look AHEAD Lifestyle Intervention in the United States Air Force: Study Rationale, Design and Methods

PubMed Central

Krukowski, Rebecca A.; Hare, Marion E.; Talcott, Gerald W.; Johnson, Karen C.; Richey, Phyllis A.; Kocak, Mehmet; Balderas, Jennifer; Colvin, Lauren; Keller, Patrick L.; Waters, Teresa M.; Klesges, Robert C.

2014-01-01

Despite an increase in overweight and obesity similar to the civilian population, there have been few randomized controlled trials examining behavioral weight management interventions in the military settings. This paper describes the design, intervention development and analysis plan of the Fit Blue study, a randomized controlled behavioral weight loss trial taking place in the United States Air Force. This study compares two adapted versions of the efficacious Look AHEAD Intensive Lifestyle Intervention (ILI), a counselor-initiated condition and a self-paced condition. Also described are the unique steps required when conducting military-based health promotion research and adaptations made to the Look AHEAD intervention to accommodate the military environment. To our knowledge, this is the first translation of the Look AHEAD ILI in the military setting and one of the first translations of the ILI in general. If successful, this intervention could be disseminated to the entire U.S. Military as this project is designed to overcome the barriers and utilize the facilitators for weight loss that are unique to a military population. Programs validated in military populations can have a major public health impact given that with 1.4 million active duty personnel, the Department of Defense is the nation’s largest employer. However, while this intervention is designed for a military population and there are unique aspects of the military that may enhance weight loss interventions, the diversity of the study population should help inform obesity efforts in both civilian and military settings. PMID:25545025

Dissemination of the Look AHEAD intensive lifestyle intervention in the United States Air Force: study rationale, design and methods.

PubMed

Krukowski, Rebecca A; Hare, Marion E; Talcott, Gerald W; Johnson, Karen C; Richey, Phyllis A; Kocak, Mehmet; Balderas, Jennifer; Colvin, Lauren; Keller, Patrick L; Waters, Teresa M; Klesges, Robert C

2015-01-01

Despite an increase in overweight and obesity similar to the civilian population, there have been few randomized controlled trials examining behavioral weight management interventions in the military settings. This paper describes the design, intervention development and analysis plan of the Fit Blue study, a randomized controlled behavioral weight loss trial taking place in the United States Air Force. This study compares two adapted versions of the efficacious Look AHEAD Intensive Lifestyle Intervention (ILI), a counselor-initiated condition and a self-paced condition. Also described are the unique steps required when conducting military-based health promotion research and adaptations made to the Look AHEAD intervention to accommodate the military environment. To our knowledge, this is the first translation of the Look AHEAD ILI in the military setting and one of the first translations of the ILI in general. If successful, this intervention could be disseminated to the entire U.S. Military as this project is designed to overcome the barriers and utilize the facilitators for weight loss that are unique to a military population. Programs validated in military populations can have a major public health impact given that with 1.4 million active duty personnel, the Department of Defense is the nation's largest employer. However, while this intervention is designed for a military population and there are unique aspects of the military that may enhance weight loss interventions, the diversity of the study population should help inform obesity efforts in both civilian and military settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study.

PubMed

Williams, David M; Lee, Harold H; Connell, Lauren; Boyle, Holly; Emerson, Jessica; Strohacker, Kelley; Galárraga, Omar

2018-03-01

Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking). Copyright © 2018 Elsevier Inc. All rights reserved.

Fitness in the Elementary Schools. Second Edition. A Teacher's Manual.

ERIC Educational Resources Information Center

Pangrazi, Robert P.; Hastad, Douglas N.

The first chapter of this manual discusses the impact physical activity has on the growth and development of youngsters. It offers a rationale for including physical education in the school curriculum. Guidelines for exercising children safely are offered, including a section on weight training for children. Chapter 2 includes the Physical Best…

Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: the HIPP study.

PubMed

Skouteris, Helen; McCabe, Marita; Milgrom, Jeannette; Kent, Bridie; Bruce, Lauren J; Mihalopoulos, Cathrine; Herring, Sharon J; Barnett, Malcolm; Patterson, Denise; Teale, Glyn; Gale, Janette

2012-01-25

Pregnancy is a time of significant physiological and physical change for women. In particular, it is a time at which many women are at risk of gaining excessive weight. We describe the rationale and methods of the Health in Pregnancy and Post-birth (HIPP) Study, a study which aims primarily to determine the effectiveness of a specialized health coaching (HC) intervention during pregnancy, compared to education alone, in preventing excessive gestational weight gain and postpartum weight retention 12 months post birth. A secondary aim of this study is to evaluate the mechanisms by which our HC intervention impacts on weight management both during pregnancy and post birth. The randomized controlled trial will be conducted with 220 women who have a BMI > 18.5 (American IOM cut-off for normal weight), are 18 years of age or older, English speaking, no history of disordered eating or diabetes and are less than 18 weeks gestation at recruitment. Women will be randomly allocated to either a specialized HC intervention group or an Education Alone group. Our specialized HC intervention has two components: (1) one-on-one sessions with a Health Coach, and (2) two by two hour educational group sessions led by a Health Coach. Women in the Education Alone group will receive two by two hour educational group sessions with no HC components. Body Mass Index, waist circumference, and psychological factors including motivation, readiness to change, symptoms of depression and anxiety, and body dissatisfaction will be assessed at baseline (14-16 weeks gestation), and again at follow-up: 32 weeks gestation, 6 weeks, 6 months and 12 months postpartum. Our study responds to the urgent need to design effective interventions in pregnancy to prevent excessive gestational weight gain and postpartum weight retention. Our pregnancy HC intervention is novel and innovative and has been designed to be easily adopted by health professionals who work with pregnant women, such as obstetricians, midwives, allied health professionals and health psychologists. Australian New Zealand Clinical Trials Registry ACTRN12611000331932.

Healthy Moms, a randomized trial to promote and evaluate weight maintenance among obese pregnant women: study design and rationale

PubMed Central

Vesco, Kimberly K.; Karanja, Njeri; King, Janet C.; Gillman, Matthew W.; Perrin, Nancy; McEvoy, Cindy; Eckhardt, Cara; Smith, K. Sabina; Stevens, Victor J.

2012-01-01

Background Obesity and excessive weight gain during pregnancy are associated with adverse pregnancy outcomes. Observational studies suggest that minimal or no gestational weight gain (GWG) may minimize the risk of adverse pregnancy outcomes for obese women. Objective This report describes the design of Healthy Moms, a randomized trial testing a weekly, group-based, weight management intervention designed to help limit GWG to 3% of weight (measured at the time of randomization) among obese pregnant women (BMI ≥30 kg/m2). Participants are randomized at 10–20 weeks gestation to either the intervention or a single dietary advice control condition. Primary Outcomes The study is powered for the primary outcome of total GWG, yielding a target sample size of 160 women. Additional secondary outcomes include weight change between randomization and one-year postpartum and proportion of infants with birth weight > 90th percentile for gestational age. Statistical analyses will be based on intention-to-treat. Methods Following randomization, all participants receive a 45-minute dietary consultation. They are encouraged to follow the Dietary Approaches to Stop Hypertension diet without sodium restriction. Intervention group participants receive an individualized calorie intake goal, a second individual counseling session and attend weekly group meetings until they give birth. Research staff assess all participants at 34-weeks gestation and at 2-weeks and one-year postpartum with their infants. Summary The Healthy Moms study is testing weight management techniques that have been used with non-pregnant adults. We aim to help obese women limit GWG to improve their long-term health and the health of their offspring. PMID:22465256

Prenatal Polycyclic Aromatic Hydrocarbon, Adiposity, Peroxisome Proliferator-Activated Receptor (PPAR) γ Methylation in Offspring, Grand-Offspring Mice

PubMed Central

Yan, Zhonghai; Zhang, Hanjie; Maher, Christina; Arteaga-Solis, Emilio; Champagne, Frances A.; Wu, Licheng; McDonald, Jacob D.; Yan, Beizhan; Schwartz, Gary J.; Miller, Rachel L.

2014-01-01

Rationale Greater levels of prenatal exposure to polycyclic aromatic hydrocarbon (PAH) have been associated with childhood obesity in epidemiological studies. However, the underlying mechanisms are unclear. Objectives We hypothesized that prenatal PAH over-exposure during gestation would lead to weight gain and increased fat mass in offspring and grand-offspring mice. Further, we hypothesized that altered adipose gene expression and DNA methylation in genes important to adipocyte differentiation would be affected. Materials and Methods Pregnant dams were exposed to a nebulized PAH mixture versus negative control aerosol 5 days a week, for 3 weeks. Body weight was recorded from postnatal day (PND) 21 through PND60. Body composition, adipose cell size, gene expression of peroxisome proliferator-activated receptor (PPAR) γ, CCAAT/enhancer-binding proteins (C/EBP) α, cyclooxygenase (Cox)-2, fatty acid synthase (FAS) and adiponectin, and DNA methylation of PPAR γ, were assayed in both the offspring and grand-offspring adipose tissue. Findings Offspring of dams exposed to greater PAH during gestation had increased weight, fat mass, as well as higher gene expression of PPAR γ, C/EBP α, Cox2, FAS and adiponectin and lower DNA methylation of PPAR γ. Similar differences in phenotype and DNA methylation extended through the grand-offspring mice. Conclusions Greater prenatal PAH exposure was associated with increased weight, fat mass, adipose gene expression and epigenetic changes in progeny. PMID:25347678

Legitimizing Technical Communication in English Departments: Carolyn Miller's "Humanistic Rationale for Technical Writing"

ERIC Educational Resources Information Center

Moore, Patrick

2006-01-01

Carolyn Miller's oft-cited "Humanistic Rationale for Technical Writing," published in 1979, tries to give technical communication faculty more cultural capital in English departments controlled by literature professors. Miller replaces a positivistic emphasis in technical communication pedagogy with rhetoric. She shows how technical knowledge is…

Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes.

PubMed

Santilli, Francesca; Simeone, Paola G; Guagnano, Maria T; Leo, Marika; Maccarone, Marica T; Di Castelnuovo, Augusto; Sborgia, Cristina; Bonadonna, Riccardo C; Angelucci, Ermanno; Federico, Virginia; Cianfarani, Stefano; Manzoli, Lamberto; Davì, Giovanni; Tartaro, Armando; Consoli, Agostino

2017-11-01

Obesity is associated with an increased risk of type 2 diabetes and cardiovascular complications. The risk depends significantly on adipose tissue distribution. Liraglutide, a glucagon-like peptide 1 analog, is associated with weight loss, improved glycemic control, and reduced cardiovascular risk. We determined whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese subjects with prediabetes or early type 2 diabetes. Sixty-two metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes, were randomized to liraglutide (1.8 mg/day) or lifestyle counseling. Changes in SAT and VAT levels (determined by abdominal MRI), insulin sensitivity (according to the Matsuda index), and β-cell function (β-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight loss (7% of initial body weight). After comparable weight loss, achieved by 20 patients per arm, and superimposable glycemic control, as reflected by HbA 1c level ( P = 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm ( P = 0.028), in parallel with a greater improvement in β-index ( P = 0.021). No differences were observed in SAT reduction ( P = 0.64). IGF-II serum levels were significantly increased ( P = 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = -0.435, P = 0.056) and an increase in the β-index (ρ = 0.55, P = 0.012). Liraglutide effects on visceral obesity and β-cell function might provide a rationale for using this molecule in obese subjects in an early phase of glucose metabolism dysregulation natural history. © 2017 by the American Diabetes Association.

Rationale and design of REWARD (revving-up exercise for sustained weight loss by altering neurological reward and drive): a randomized trial in obese endometrial cancer survivors.

PubMed

Nock, Nora L; Dimitropoulos, Anastasia; Rao, Stephen M; Flask, Chris A; Schluchter, Mark; Zanotti, Kristine M; Rose, Peter G; Kirwan, John P; Alberts, Jay

2014-11-01

Obesity is a leading risk factor for endometrial cancer (EC), particularly Type I forms, which are increasing in the U.S. Although death rates from most cancers have been decreasing, overall mortality in EC is increasing in the U.S. EC survivors' poor fitness combined with their surgical treatments may make weight loss particularly challenging. High intensity exercise increases neurotrophins and neurological reward via altered striatal dopamine in animals, and, in humans, chronic high intensity exercise enhances meal-induced satiety and may reduce hedonic eating. "Assisted" exercise, a mode of exercise whereby a patient's voluntary exercise rate is augmented mechanically, may modulate brain dopamine levels in Parkinson's Disease patients but has not been previously evaluated as a treatment for obesity. We describe the rationale and design of the REWARD trial, which has the overarching goal of randomizing 120 obese EC survivors to "assisted" or voluntary rate cycling to evaluate the efficacy of "assisted" exercise in enhancing and sustaining weight loss. Patients in both arms will receive 3 days/week of supervised exercise and 1 day/week of a group dietary behavioral intervention for 16 weeks and, then, will be followed for 6 months. The primary outcome is weight loss. Secondary outcomes include measures for body composition, fitness, eating behavior, exercise motivation and, quality of life as well as cognition and food reward and motivation as assessed by functional magnetic resonance imaging (fMRI) tasks. If successful, the REWARD program could be extended to help sustain weight loss in obese cancer and non-cancer patients. Copyright © 2014 Elsevier Inc. All rights reserved.

A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults123

PubMed Central

Stote, Kim S; Baer, David J; Spears, Karen; Paul, David R; Harris, G Keith; Rumpler, William V; Strycula, Pilar; Najjar, Samer S; Ferrucci, Luigi; Ingram, Donald K; Longo, Dan L; Mattson, Mark P

2009-01-01

Background Although consumption of 3 meals/d is the most common pattern of eating in industrialized countries, a scientific rationale for this meal frequency with respect to optimal health is lacking. A diet with less meal frequency can improve the health and extend the lifespan of laboratory animals, but its effect on humans has never been tested. Objective A pilot study was conducted to establish the effects of a reduced-meal-frequency diet on health indicators in healthy, normal-weight adults. Design The study was a randomized crossover design with two 8-wk treatment periods. During the treatment periods, subjects consumed all of the calories needed for weight maintenance in either 3 meals/d or 1 meal/d. Results Subjects who completed the study maintained their body weight within 2 kg of their initial weight throughout the 6-mo period. There were no significant effects of meal frequency on heart rate, body temperature, or most of the blood variables measured. However, when consuming 1 meal/d, subjects had a significant increase in hunger; a significant modification of body composition, including reductions in fat mass; significant increases in blood pressure and in total, LDL-, and HDL-cholesterol concentrations; and a significant decrease in concentrations of cortisol. Conclusions Normal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes. PMID:17413096

A randomized pilot study of a community-based weight loss intervention for African-American women: Rationale and study design of Doing Me! Sisters Standing Together for a Healthy Mind and Body.

PubMed

Springfield, Sparkle; Buscemi, Joanna; Fitzgibbon, Marian L; Stolley, Melinda R; Zenk, Shannon N; Schiffer, Linda; Sampson, Jameika; Jones, Quiana; Murdock, Tanine; Davis, Iona; Holland, Loys; Watkins, April; Odoms-Young, Angela

2015-07-01

Despite the high prevalence of obesity among African-American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach have been limited. Doing Me!: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African-American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n = 30) or waitlist control (n = 30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45 min of instruction on diet, physical activity, and/or weight management plus 45 min of physical activity. Data will be collected at baseline and post-intervention (16 weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African-American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial.

PubMed

Messier, Stephen P; Callahan, Leigh F; Beavers, Daniel P; Queen, Kate; Mihalko, Shannon L; Miller, Gary D; Losina, Elena; Katz, Jeffrey N; Loeser, Richard F; Quandt, Sara A; DeVita, Paul; Hunter, David J; Lyles, Mary F; Newman, Jovita; Hackney, Betsy; Jordan, Joanne M

2017-02-22

Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m 2 ) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA. clinicaltrials.gov Identifier: NCT02577549 October 12, 2015.

Large Deployable Reflector (LDR) feasibility study update

NASA Technical Reports Server (NTRS)

Alff, W. H.; Banderman, L. W.

1983-01-01

In 1982 a workshop was held to refine the science rationale for large deployable reflectors (LDR) and develop technology requirements that support the science rationale. At the end of the workshop, a set of LDR consensus systems requirements was established. The subject study was undertaken to update the initial LDR study using the new systems requirements. The study included mirror materials selection and configuration, thermal analysis, structural concept definition and analysis, dynamic control analysis and recommendations for further study. The primary emphasis was on the dynamic controls requirements and the sophistication of the controls system needed to meet LDR performance goals.

Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized controlled trial.

PubMed

Ockene, Judith K; Ashe, Karen M; Hayes, Rashelle B; Churchill, Linda C; Crawford, Sybil L; Geller, Alan C; Jolicoeur, Denise; Olendzki, Barbara C; Basco, Maria Theresa; Pendharkar, Jyothi A; Ferguson, Kristi J; Guck, Thomas P; Margo, Katherine L; Okuliar, Catherine A; Shaw, Monica A; Soleymani, Taraneh; Stadler, Diane D; Warrier, Sarita S; Pbert, Lori

2018-01-01

Physicians have an important role addressing the obesity epidemic. Lack of adequate teaching to provide weight management counseling (WMC) is cited as a reason for limited treatment. National guidelines have not been translated into an evidence-supported, competency-based curriculum in medical schools. Weight Management Counseling in Medical Schools: A Randomized Controlled Trial (MSWeight) is designed to determine if a multi-modal theoretically-guided WMC educational intervention improves observed counseling skills and secondarily improve perceived skills and self-efficacy among medical students compared to traditional education (TE). Eight U.S. medical schools were pair-matched and randomized in a group randomized controlled trial to evaluate whether a multi-modal education (MME) intervention compared to traditional education (TE) improves observed WMC skills. The MME intervention includes innovative components in years 1-3: a structured web-course; a role play exercise, WebPatientEncounter, and an enhanced outpatient internal medicine or family medicine clerkship. This evidence-supported curriculum uses the 5As framework to guide treatment and incorporates patient-centered counseling to engage the patient. The primary outcome is a comparison of scores on an Objective Structured Clinical Examination (OSCE) WMC case among third year medical students. The secondary outcome compares changes in scores of medical students from their first to third year on an assessment of perceived WMC skills and self-efficacy. MSWeight is the first RCT in medical schools to evaluate whether interventions integrated into the curriculum improve medical students' WMC skills. If this educational approach for teaching WMC is effective, feasible and acceptable it can affect how medical schools integrate WMC teaching into their curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

Beliefs about weight and breast cancer: an interview study with high risk women following a 12 month weight loss intervention.

PubMed

Wright, Claire E; Harvie, Michelle; Howell, Anthony; Evans, D Gareth; Hulbert-Williams, Nick; Donnelly, Louise S

2015-01-01

Breast cancer is the most common cancer in the UK. Lifestyle factors including excess weight contribute to risk of developing the disease. Whilst the exact links between weight and breast cancer are still emerging, it is imperative to explore how women understand these links and if these beliefs impact on successful behaviour change. Overweight/obese premenopausal women (aged 35-45) with a family history of breast cancer (lifetime risk 17-40%) were invited to a semi-structured interview following their participation in a 12 month weight loss intervention aimed at reducing their risk of breast cancer. Interviews were carried out with 9 women who successfully achieved ≥5% weight loss and 11 who were unsuccessful. Data were transcribed verbatim and analysed using thematic analysis. Three themes were developed from the analysis. The first theme how women construct and understand links between weight and breast cancer risk is composed of two subthemes, the construction of weight and breast cancer risk and making sense of weight and breast cancer risk. This theme explores women's understanding of what contributes to breast cancer risk and whether they believe that weight loss could reduce their breast cancer risk. The second theme motivation and adherence to weight loss interventions explains that breast cancer risk can be a motivating factor for adherence to a weight loss intervention. The final theme, acceptance of personal responsibility for health is composed of two subthemes responsibility for one's own health and responsibility for family health through making sensible lifestyle choices. Beliefs about weight and breast cancer risk were informed by social networks, media reports and personal experiences of significant others diagnosed with breast cancer. Our study has highlighted common doubts, anxieties and questions and the importance of providing a credible rationale for weight control and weight loss which addresses individual concerns. Counselling and health education material should be tailored to facilitate understanding of both genetic and modifiable risk factors and should do more help individuals to visualise the weight and breast cancer link.

Active video games as a tool to prevent excessive weight gain in adolescents: rationale, design and methods of a randomized controlled trial.

PubMed

Simons, Monique; Chinapaw, Mai J M; van de Bovenkamp, Maaike; de Boer, Michiel R; Seidell, Jacob C; Brug, Johannes; de Vet, Emely

2014-03-24

Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games--i.e. active games--may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents. The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12-16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents' measured BMI-SDS (SDS=adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents' self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games. This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in adolescents. Dutch Trial register NTR3228.

Active video games as a tool to prevent excessive weight gain in adolescents: rationale, design and methods of a randomized controlled trial

PubMed Central

2014-01-01

Background Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games –i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents. Methods/Design The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12 – 16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents’ measured BMI-SDS (SDS = adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents’ self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games. Discussion This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in adolescents. Trial registration Dutch Trial register NTR3228. PMID:24661535

HomeStyles, A Web-Based Childhood Obesity Prevention Program for Families With Preschool Children: Protocol for a Randomized Controlled Trial.

PubMed

Byrd-Bredbenner, Carol; Martin-Biggers, Jennifer; Koenings, Mallory; Quick, Virginia; Hongu, Nobuko; Worobey, John

2017-04-25

The home environment is where young children spend most of their time, and is critically important to supporting behaviors that promote health and prevent obesity. However, the home environment and lifestyle patterns remain understudied, and few interventions have investigated parent-led makeovers designed to create home environments that are supportive of optimal child health and healthy child weights. The aim of the HomeStyles randomized controlled trial (RCT) is to determine whether the Web-based HomeStyles intervention enables and motivates parents to shape the weight-related aspects of their home environments and lifestyle behavioral practices (diet, exercise, and sleep) to be more supportive of their preschool children's optimal health and weight. A rigorous RCT utilizing an experimental group and an attention control group, receiving a bona fide contemporaneous treatment equal in nonspecific treatment effects and differing only in subject matter content, will test the effect of HomeStyles on a diverse sample of families with preschool children. This intervention is based on social cognitive theory and uses a social ecological framework, and will assess: intrapersonal characteristics (dietary intake, physical activity level, and sleep) of parents and children; family interpersonal or social characteristics related to diet, physical activity, media use, and parental values and self-efficacy for obesity-preventive practices; and home environment food availability, physical activity space and supports in and near the home, and media availability and controls in the home. Enrollment for this study has been completed and statistical data analyses are currently underway. This paper describes the HomeStyles intervention with regards to: rationale, the intervention's logic model, sample eligibility criteria and recruitment, experimental group and attention control intervention content, study design, instruments, data management, and planned analyses. ©Carol Byrd-Bredbenner, Jennifer Martin-Biggers, Mallory Koenings, Virginia Quick, Nobuko Hongu, John Worobey. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.04.2017.

Targeting Body Image Schema for Smoking Cessation among College Females: Rationale, Program Description, and Pilot Study Results

ERIC Educational Resources Information Center

Napolitano, Melissa A.; Lloyd-Richardson, Elizabeth E.; Fava, Joseph L.; Marcus, Bess H.

2011-01-01

Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue smoking is important for designing smoking cessation interventions. The aim of the current article is to outline…

A systematic review of the effects of neuromodulation on eating and body weight: evidence from human and animal studies.

PubMed

McClelland, Jessica; Bozhilova, Natali; Campbell, Iain; Schmidt, Ulrike

2013-11-01

Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). Emerging neural models of ED provide a rationale for more targeted, brain-directed interventions. This systematic review has examined the effects of neuromodulation techniques on eating behaviours and body weight and assessed their potential for therapeutic use in ED. All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models. Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss. Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain 'brainless'. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Adaptive Distributed Environment for Procedure Training (ADEPT)

NASA Technical Reports Server (NTRS)

Domeshek, Eric; Ong, James; Mohammed, John

2013-01-01

ADEPT (Adaptive Distributed Environment for Procedure Training) is designed to provide more effective, flexible, and portable training for NASA systems controllers. When creating a training scenario, an exercise author can specify a representative rationale structure using the graphical user interface, annotating the results with instructional texts where needed. The author's structure may distinguish between essential and optional parts of the rationale, and may also include "red herrings" - hypotheses that are essential to consider, until evidence and reasoning allow them to be ruled out. The system is built from pre-existing components, including Stottler Henke's SimVentive? instructional simulation authoring tool and runtime. To that, a capability was added to author and exploit explicit control decision rationale representations. ADEPT uses SimVentive's Scalable Vector Graphics (SVG)- based interactive graphic display capability as the basis of the tool for quickly noting aspects of decision rationale in graph form. The ADEPT prototype is built in Java, and will run on any computer using Windows, MacOS, or Linux. No special peripheral equipment is required. The software enables a style of student/ tutor interaction focused on the reasoning behind systems control behavior that better mimics proven Socratic human tutoring behaviors for highly cognitive skills. It supports fast, easy, and convenient authoring of such tutoring behaviors, allowing specification of detailed scenario-specific, but content-sensitive, high-quality tutor hints and feedback. The system places relatively light data-entry demands on the student to enable its rationale-centered discussions, and provides a support mechanism for fostering coherence in the student/ tutor dialog by including focusing, sequencing, and utterance tuning mechanisms intended to better fit tutor hints and feedback into the ongoing context.

Enhancing inhibitory learning to reduce overeating: Design and rationale of a cue exposure therapy trial in overweight and obese women.

PubMed

van den Akker, Karolien; Schyns, Ghislaine; Jansen, Anita

2016-07-01

The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effectiveness of this 8-session cue exposure intervention relative to a control intervention in 45 overweight adult (aged 18-60) females at post-treatment and 3-month follow-up, of which 39 participants completed the study. Weight loss, eating psychopathology, food cue reactivity, and snacking behaviour were studied as main treatment outcomes, and mediators and moderators of treatment effects were studied. The presented study design represents an innovative effort to provide valuable clinical recommendations for the treatment of overeating and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Cargo Movement Operations System (CMOS). Software User’s Manual

DTIC Science & Technology

1990-06-27

RATIONALE: N/A CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: ACCEPT [ ] REJECT [ ] COMMENT STATUS...NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ 3 ORIGINATOR CONTROL NUMBER: SUM-0003 PROGRAM...3.1.11. RATIONALE: Clarity. CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN

BCI Control of Heuristic Search Algorithms

PubMed Central

Cavazza, Marc; Aranyi, Gabor; Charles, Fred

2017-01-01

The ability to develop Brain-Computer Interfaces (BCI) to Intelligent Systems would offer new perspectives in terms of human supervision of complex Artificial Intelligence (AI) systems, as well as supporting new types of applications. In this article, we introduce a basic mechanism for the control of heuristic search through fNIRS-based BCI. The rationale is that heuristic search is not only a basic AI mechanism but also one still at the heart of many different AI systems. We investigate how users’ mental disposition can be harnessed to influence the performance of heuristic search algorithm through a mechanism of precision-complexity exchange. From a system perspective, we use weighted variants of the A* algorithm which have an ability to provide faster, albeit suboptimal solutions. We use recent results in affective BCI to capture a BCI signal, which is indicative of a compatible mental disposition in the user. It has been established that Prefrontal Cortex (PFC) asymmetry is strongly correlated to motivational dispositions and results anticipation, such as approach or even risk-taking, and that this asymmetry is amenable to Neurofeedback (NF) control. Since PFC asymmetry is accessible through fNIRS, we designed a BCI paradigm in which users vary their PFC asymmetry through NF during heuristic search tasks, resulting in faster solutions. This is achieved through mapping the PFC asymmetry value onto the dynamic weighting parameter of the weighted A* (WA*) algorithm. We illustrate this approach through two different experiments, one based on solving 8-puzzle configurations, and the other on path planning. In both experiments, subjects were able to speed up the computation of a solution through a reduction of search space in WA*. Our results establish the ability of subjects to intervene in heuristic search progression, with effects which are commensurate to their control of PFC asymmetry: this opens the way to new mechanisms for the implementation of hybrid cognitive systems. PMID:28197092

BCI Control of Heuristic Search Algorithms.

PubMed

Cavazza, Marc; Aranyi, Gabor; Charles, Fred

2017-01-01

The ability to develop Brain-Computer Interfaces (BCI) to Intelligent Systems would offer new perspectives in terms of human supervision of complex Artificial Intelligence (AI) systems, as well as supporting new types of applications. In this article, we introduce a basic mechanism for the control of heuristic search through fNIRS-based BCI. The rationale is that heuristic search is not only a basic AI mechanism but also one still at the heart of many different AI systems. We investigate how users' mental disposition can be harnessed to influence the performance of heuristic search algorithm through a mechanism of precision-complexity exchange. From a system perspective, we use weighted variants of the A* algorithm which have an ability to provide faster, albeit suboptimal solutions. We use recent results in affective BCI to capture a BCI signal, which is indicative of a compatible mental disposition in the user. It has been established that Prefrontal Cortex (PFC) asymmetry is strongly correlated to motivational dispositions and results anticipation, such as approach or even risk-taking, and that this asymmetry is amenable to Neurofeedback (NF) control. Since PFC asymmetry is accessible through fNIRS, we designed a BCI paradigm in which users vary their PFC asymmetry through NF during heuristic search tasks, resulting in faster solutions. This is achieved through mapping the PFC asymmetry value onto the dynamic weighting parameter of the weighted A* (WA*) algorithm. We illustrate this approach through two different experiments, one based on solving 8-puzzle configurations, and the other on path planning. In both experiments, subjects were able to speed up the computation of a solution through a reduction of search space in WA*. Our results establish the ability of subjects to intervene in heuristic search progression, with effects which are commensurate to their control of PFC asymmetry: this opens the way to new mechanisms for the implementation of hybrid cognitive systems.

20 CFR 10.321 - What happens if the opinion of the physician selected by OWCP differs from the opinion of the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... two reports of virtually equal weight and rationale reach opposing conclusions (see James P. Roberts... has had no prior connection with the case. The employee is not entitled to have anyone present at the... employee needs an interpreter, the presence of an interpreter would be allowed. Also, a case file may be...

20 CFR 10.321 - What happens if the opinion of the physician selected by OWCP differs from the opinion of the...

Code of Federal Regulations, 2011 CFR

2011-04-01

... two reports of virtually equal weight and rationale reach opposing conclusions (see James P. Roberts... has had no prior connection with the case. The employee is not entitled to have anyone present at the... employee needs an interpreter, the presence of an interpreter would be allowed. Also, a case file may be...

EMPOWER: a randomized trial using community health workers to deliver a lifestyle intervention program in African American women with Type 2 diabetes: design, rationale, and baseline characteristics.

PubMed

Cummings, Doyle M; Lutes, Lesley D; Littlewood, Kerry; Dinatale, Emily; Hambidge, Bertha; Schulman, Kathleen

2013-09-01

African American (AA) women with Type 2 diabetes mellitus (T2DM) in the rural south experience less weight loss and poorer glycemic control in traditional diabetes management programs compared to Caucasians. This paper describes the design, rationale, and baseline characteristics from an innovative community health worker (CHW) delivered intervention program in this population. This prospective trial randomized rural AA women with uncontrolled T2DM (HbA1c ≥ 7.0) to receive a behaviorally-centered, culturally-tailored lifestyle intervention during 16 contacts from a trained AA CHW or 16 approved diabetes educational mailings. Changes from baseline in glycosylated hemoglobin levels (HbA1c), blood pressure (BP), weight, body mass index (BMI), self-reported dietary and physical activity patterns, and psychosocial measures including diabetes distress, empowerment, depression, self-care, medication adherence, and life satisfaction will be assessed at 6- and 12-months. Two hundred AA women (mean age = 53.09 ± 10.89 years) with T2DM from impoverished rural communities were enrolled. Baseline data demonstrated profoundly uncontrolled diabetes of long term duration (mean HbA1c = 9.11 ± 1.82; mean BMI = 37.68 ± 8.20; mean BP = 134.51 ± 20.39/84.19 ± 11.68; 10.5 ± 0.7 years). Self-care behavior assessment revealed poor dietary and medication adherence and sedentary lifestyle. Most psychosocial measures ranged within normal limits. The present sample of AA women from impoverished rural communities exhibited significantly uncontrolled T2DM of long duration with associated obesity and poor lifestyle behaviors. An innovative CHW led lifestyle intervention may lead to more effective strategies for T2DM management in this population. Copyright © 2013 Elsevier Inc. All rights reserved.

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods.

PubMed

Williams, Allison N; Konopken, Yolanda P; Keller, Colleen S; Castro, Felipe Gonzalez; Arcoleo, Kimberly J; Barraza, Estela; Patrick, Donald L; Olson, Micah L; Shaibi, Gabriel Q

2017-03-01

Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods

PubMed Central

Williams, AN; Konopken, YP; Keller, CS; Castro, FG; Arcoleo, K; Barraza, E; Patrick, DL; Olson, ML; Shaibi, GQ

2017-01-01

Background Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. Objectives To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14–16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. Conclusions The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. PMID:28104469

Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities.

PubMed

Smith, Jordan J; Morgan, Philip J; Plotnikoff, Ronald C; Dally, Kerry A; Salmon, Jo; Okely, Anthony D; Finn, Tara L; Babic, Mark J; Skinner, Geoff; Lubans, David R

2014-01-01

The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are 'at risk' of obesity. The aim of this paper is to report the rationale and study protocol for the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. Copyright © 2013 Elsevier Inc. All rights reserved.

Nutrigenomics of Body Weight Regulation: A Rationale for Careful Dissection of Individual Contributors

PubMed Central

Keijer, Jaap; Hoevenaars, Femke P. M.; Nieuwenhuizen, Arie; van Schothorst, Evert M.

2014-01-01

Body weight stability may imply active regulation towards a certain physiological condition, a body weight setpoint. This interpretation is ill at odds with the world-wide increase in overweight and obesity. Until now, a body weight setpoint has remained elusive and the setpoint theory did not provide practical clues for body weight reduction interventions. For this an alternative theoretical model is necessary, which is available as the settling point model. The settling point model postulates that there is little active regulation towards a predefined body weight, but that body weight settles based on the resultant of a number of contributors, represented by the individual’s genetic predisposition, in interaction with environmental and socioeconomic factors, such as diet and lifestyle. This review refines the settling point model and argues that by taking body weight regulation from a settling point perspective, the road will be opened to careful dissection of the various contributors to establishment of body weight and its regulation. This is both necessary and useful. Nutrigenomic technologies may help to delineate contributors to body weight settling. Understanding how and to which extent the different contributors influence body weight will allow the design of weight loss and weight maintenance interventions, which hopefully are more successful than those that are currently available. PMID:25338273

Nutrigenomics of body weight regulation: a rationale for careful dissection of individual contributors.

PubMed

Keijer, Jaap; Hoevenaars, Femke P M; Nieuwenhuizen, Arie; van Schothorst, Evert M

2014-10-21

Body weight stability may imply active regulation towards a certain physiological condition, a body weight setpoint. This interpretation is ill at odds with the world-wide increase in overweight and obesity. Until now, a body weight setpoint has remained elusive and the setpoint theory did not provide practical clues for body weight reduction interventions. For this an alternative theoretical model is necessary, which is available as the settling point model. The settling point model postulates that there is little active regulation towards a predefined body weight, but that body weight settles based on the resultant of a number of contributors, represented by the individual's genetic predisposition, in interaction with environmental and socioeconomic factors, such as diet and lifestyle. This review refines the settling point model and argues that by taking body weight regulation from a settling point perspective, the road will be opened to careful dissection of the various contributors to establishment of body weight and its regulation. This is both necessary and useful. Nutrigenomic technologies may help to delineate contributors to body weight settling. Understanding how and to which extent the different contributors influence body weight will allow the design of weight loss and weight maintenance interventions, which hopefully are more successful than those that are currently available.

Combinations of Drugs in the Treatment of Obesity

PubMed Central

Halpern, Bruno; Oliveira, Eduardo S. L.; Faria, André M.; Halpern, Alfredo; de Melo, Maria Edna; Cercato, Cintia; Mancini, Marcio C.

2010-01-01

Obesity is a chronic disease associated with excess morbidity and mortality. Clinical treatment, however, currently offers disappointing results, with very high rates of weight loss failure or weight regain cycles, and only two drugs (orlistat and sibutramine) approved for long-term use. Drugs combinations can be an option for its treatment but, although widely used in clinical practice, very few data are available in literature for its validation. Our review focuses on the rationale for their use, with advantages and disadvantages; on combinations often used, with or without studies; and on new perspectives of combinations being studied mainly by the pharmaceutical industry. PMID:27713360

A Brief Motivational Intervention for Preventing Medication-Associated Weight Gain Among Youth with Bipolar Disorder: Treatment Development and Case Report

PubMed Central

Goldstein, Benjamin I.; Mantz, Michael B.; Bailey, Bridget; Douaihy, Antoine

2011-01-01

Abstract Bipolar disorder (BP) in youth is an impairing psychiatric disorder associated with high rates of relapse and recurrence. High rates of psychiatric and medical co-morbidities account for additional illness burden in pediatric BP. The elevated risk of overweight and obesity in this population is of particular concern. One of the likely etiologies for weight gain in youth with BP is use of mood-stabilizing medications. Although these medications can be effective for mood stabilization, excessive weight gain is a common side effect. Obesity is associated with a host of medical problems and is also correlated with worse psychiatric outcomes in BP, rendering the prevention of weight gain in this population particularly clinically relevant. In this article, we describe the rationale and development of a brief motivational intervention for preventing weight gain among youth with BP initiating mood-stabilizing pharmacological treatment and then present a case example illustrating the principles of the intervention. PMID:21663430

A rationale for human operator pulsive control behavior

NASA Technical Reports Server (NTRS)

Hess, R. A.

1979-01-01

When performing tracking tasks which involve demanding controlled elements such as those with K/s-squared dynamics, the human operator often develops discrete or pulsive control outputs. A dual-loop model of the human operator is discussed, the dominant adaptive feature of which is the explicit appearance of an internal model of the manipulator-controlled element dynamics in an inner feedback loop. Using this model, a rationale for pulsive control behavior is offered which is based upon the assumption that the human attempts to reduce the computational burden associated with time integration of sensory inputs. It is shown that such time integration is a natural consequence of having an internal representation of the K/s-squared-controlled element dynamics in the dual-loop model. A digital simulation is discussed in which a modified form of the dual-loop model is shown to be capable of producing pulsive control behavior qualitively comparable to that obtained in experiment.

Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

PubMed Central

Frank, Guido K.W.; Shott, Megan E.

2016-01-01

Anorexia nervosa is a severe psychiatric disorder without approved medication intervention. Every class of psychoactive medication has been tried to improve treatment outcome; however, randomized controlled trials have been ambiguous at best and across studies have not shown robust improvements in weight gain and recovery. Here we review the available literature on pharmacological interventions since anorexia nervosa came to greater public recognition in the 1960s. This will include a critical review of why those trials may not have been successful. We further provide a neurobiological background for the disorder and discuss how cognition, learning and emotion-regulating circuits could become treatment targets in the future. Making every effort to develop effective pharmacological treatment options for anorexia nervosa is imperative, as it continues to be a complex psychiatric disorder with high disease burden and mortality. PMID:27106297

Does Armodafinil Improve Driving Task Performance and Weight Loss in Sleep Apnea? A Randomized Trial.

PubMed

Chapman, Julia Louise; Cayanan, Elizabeth Anne; Hoyos, Camilla Miranda; Serinel, Yasmina; Comas, Maria; Yee, Brendon John; Wong, Keith Keat Huat; Grunstein, Ronald Robert; Marshall, Nathaniel Stuart

2018-05-18

RATIONALE Obstructive sleep apnea (OSA) patients unable to tolerate standard treatments have few alternatives. They may benefit from weight loss, but the major symptom of daytime performance impairment may remain during weight loss programs. OBJECTIVES We hypothesized that wakefulness-promoter armodafinil would improve driving task performance over placebo in patients undergoing weight loss. METHODS Placebo-controlled, double-blind, randomized trial of Armodafinil vs Placebo daily for 6 months in patients who were also randomized to one of two diets for six months with follow-up at one year in overweight, adult, OSA patients who had rejected standard treatment and suffered daytime sleepiness. MEASUREMENTS Primary outcome: change in steering deviation in the final 30 minutes of a 90 minute afternoon driving task (AusED) at six months. Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, fat mass measured by dual-emission X-ray absorptiometry (DXA). MAIN RESULTS Armodafinil improved driving task performance over placebo at three months (12.9cm, 95%CI 4.1 to 21.7, p=0.004), but not the primary timepoint of six months (5.5cm, 95%CI -3.3 to 14.3, p=0.223). Patients on armodafinil lost 2.4kg more fat than those on placebo at six months (95%CI 0.9 to 4.0, p=0.002). Other secondary outcomes were not significantly improved. CONCLUSIONS Armodafinil did not improve driving task performance at the primary endpoint of six months. Armodafinil might be a useful adjunctive to weight loss in OSA patients rejecting conventional treatments but this needs to be directly tested in a specifically designed, properly powered clinical trial. Clinical trial registration available at www.anzctr.org.au, ID ACTRN12611000847910.

40 CFR 798.5200 - Mouse visible specific locus test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... control groups. (4) Control groups—(i) Concurrent controls. The use of positive or spontaneous controls is... control groups. (ii) Test chemical vehicle, doses used and rationale for dose selection, toxicity data... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5200 Mouse...

40 CFR 798.5200 - Mouse visible specific locus test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... control groups. (4) Control groups—(i) Concurrent controls. The use of positive or spontaneous controls is... control groups. (ii) Test chemical vehicle, doses used and rationale for dose selection, toxicity data... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5200 Mouse...

40 CFR 798.5200 - Mouse visible specific locus test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... control groups. (4) Control groups—(i) Concurrent controls. The use of positive or spontaneous controls is... control groups. (ii) Test chemical vehicle, doses used and rationale for dose selection, toxicity data... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5200 Mouse...

40 CFR 798.5200 - Mouse visible specific locus test.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control groups. (4) Control groups—(i) Concurrent controls. The use of positive or spontaneous controls is... control groups. (ii) Test chemical vehicle, doses used and rationale for dose selection, toxicity data... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5200 Mouse...

40 CFR 798.5200 - Mouse visible specific locus test.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control groups. (4) Control groups—(i) Concurrent controls. The use of positive or spontaneous controls is... control groups. (ii) Test chemical vehicle, doses used and rationale for dose selection, toxicity data... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5200 Mouse...

For Researchers on Obesity: Historical Review of Extra Body Weight Definitions.

PubMed

Komaroff, Marina

2016-01-01

Rationale. The concept of obesity has been known since ancient world; however, the current standard definition of obesity was endorsed only about a decade ago. There is a need for researches to understand multiple approaches to defining obesity and how and why the standard definition was developed. The review will help to grasp the complexity of the problem and can lead to novel hypotheses in obesity research. Objective. This paper focuses on the objective to understand historical background on the development of "reference and standard tables" of weight as a platform for normal versus abnormal body weight definition. Methods. A systematic literature review was performed to chronologically summarize the definition of body weight from time of Hippocrates till the year of 2010. Conclusion. This paper presents the historical background on the development of "reference and standard tables" of weight as a platform for normal versus abnormal body weight definition. Knowledge of historical approaches to the concept of obesity can motivate researchers to find new hypotheses and utilize the appropriate obesity assessments to address their objectives.

Madres para la Salud: design of a theory-based intervention for postpartum Latinas.

PubMed

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-05-01

Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. This report describes the theoretical rationale, design considerations, and cultural relevance for "Madres para la Salud" [Mothers for Health]. Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using "bouts" of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. Copyright © 2011 Elsevier Inc. All rights reserved.

Madres para la Salud: Design of a Theory-based Intervention for Postpartum Latinas

PubMed Central

Keller, Colleen; Records, Kathie; Ainsworth, Barbara; Belyea, Michael; Permana, Paska; Coonrod, Dean; Vega-López, Sonia; Nagle-Williams, Allison

2011-01-01

Background Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained. Objectives This report describes the theoretical rationale, design considerations, and cultural relevance for “Madres para la Salud” [Mothers for Health]. Design and Methods Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using “bouts” of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas. Summary The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas. PMID:21238614

Solar array study for solar electric propulsion spacecraft for the Encke rendezvous mission

NASA Technical Reports Server (NTRS)

Sequeira, E. A.; Patterson, R. E.

1974-01-01

The work is described which was performed on the design, analysis and performance of a 20 kW rollup solar array capable of meeting the design requirements of a solar electric spacecraft for the 1980 Encke rendezvous mission. To meet the high power requirements of the proposed electric propulsion mission, solar arrays on the order of 186.6 sq m were defined. Because of the large weights involved with arrays of this size, consideration of array configurations is limited to lightweight, large area concepts with maximum power-to-weight ratios. Items covered include solar array requirements and constraints, array concept selection and rationale, structural and electrical design considerations, and reliability considerations.

Teaching Applied Chemistry in a Pollution Control Context.

ERIC Educational Resources Information Center

Sell, Nancy J.

1982-01-01

Discusses rationale behind and content of a course (Industrial Pollution Control Techniques) combining knowledge from fields of industrial chemistry and chemical engineering and utilizing this knowledge in the context of understanding pollution problems and potential methods of pollution control. (Author/SK)

Does Prolonged Enteral Feeding With Supplemental Omega-3 Fatty Acids Impact on Recovery Post-esophagectomy: Results of a Randomized Double-Blind Trial.

PubMed

Healy, Laura A; Ryan, Aoife; Doyle, Suzanne L; Ní Bhuachalla, Éadaoin Bríd; Cushen, Samantha; Segurado, Ricardo; Murphy, Thomas; Ravi, Narayanasamy; Donohoe, Claire L; Reynolds, John V

2017-11-01

This randomized controlled trial (RCT) hypothesized that prolonged enteral nutrition (EN) with supplemental eicosapentanoic acid (EPA), an omega-3 fatty acid with immune and anabolic properties, may impact on clinical and nutritional outcomes. Esophagectomy is associated with significant weight loss and catabolism, and negatively impacts quality of life (QL). Strategies to counter sustained catabolism have therapeutic rationale. This multicenter, double-blind, placebo-controlled RCT was powered on a 5% difference in lean body mass (LBM) at 1 month. Patients were randomly assigned to receive either EN-EPA (2.2 g EPA/day) (n = 97) or isocaloric isonitrogenous standard EN (EN-S) (n = 94), preoperatively (5 days orally), and postoperatively via a jejunostomy until 1 month postdischarge. Assessments perioperatively, and at 1, 3, and 6 months included weight, body mass index (BMI), body composition, muscle strength, cytokines, complications, and QL. The median (range) nutrition support was for 51 (36 to 78) days, and overall compliance was 96%. For the entire cohort, a significant (P < 0.005) decrease in weight (-7.4 ± 6.6 kg), BMI (-2.6 ± 2.2 kg/m), LBM (-2.5 ± 8.7 kg), and fat mass (-3.4 ± 5.8 kg) was evident from preoperatively to 6 months. The mean (±SD) loss of LBM (kg) at 1 month was -3.7 ± 8.7 in the EN-S group, compared with -5.6 ± 12.1 in the EN-EPA group (P = 0.355). Per-protocol analysis revealed no difference between the EN-EPA and EN-S in any clinical, nutritional, functional, QL or immune parameter at any time point. The thesis that EPA impacts on anabolism, immune function, and clinical outcomes post-esophagectomy was not supported. Compliance with home EN was excellent, but weight, muscle, and fat loss was significant in 30% of patients, highlighting the complexity of postoperative weight loss.

The Role of Pulses in the Dietary Management of Diabetes.

PubMed

Ramdath, Dan; Renwick, Simone; Duncan, Alison M

2016-08-01

Pulses are highly nutritious foods that are included as part of Canada's Food Guide to promote healthful eating, and they have established health benefits that can contribute to the dietary management of diabetes. A review of studies that have examined the effects of pulse consumption on health outcomes, integral to the management of diabetes, provides credible evidence for improvements in glycemic control, reduction of blood lipids and regulation of body weight. Results from acute feeding trials suggest that postprandial blood glucose response is significantly attenuated by a single pulse serving of between three-quarters and 1 cup. At lower doses, pulses attenuate postprandial blood glucose response more than similar amounts of starchy foods. Long-term pulse consumption of 5 cups per week appears to result consistently in improvements in glycemic control. There is high-quality evidence that supports a role for pulse consumption in the reduction of risk for cardiovascular disease; this provides a sound rationale for the regular incorporation of pulses at about two-thirds of a cup daily in the management of hyperlipidemia in persons with type 2 diabetes. Pulse consumption can contribute to improving satiety, reducing food intake and regulating body weight, which can reduce obesity risk and, in turn, improve diabetes management. Collectively, available evidence provides very good support for a role of regular pulse consumption in the prevention and management of diabetes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Study protocol and rationale for a randomized double-blinded crossover trial of phentermine-topiramate ER versus placebo to treat binge eating disorder and bulimia nervosa.

PubMed

Dalai, Shebani Sethi; Adler, Sarah; Najarian, Thomas; Safer, Debra Lynn

2018-01-01

Bulimia nervosa (BN) and binge eating disorder (BED) are associated with severe psychological and medical consequences. Current therapies are limited, leaving up to 50% of patients symptomatic despite treatment, underscoring the need for additional treatment options. Qsymia, an FDA-approved medication for obesity, combines phentermine and topiramate ER. Topiramate has demonstrated efficacy for both BED and BN, but limited tolerability. Phentermine is FDA-approved for weight loss. A rationale for combined phentermine/topiramate for BED and BN is improved tolerability and efficacy. While a prior case series exploring Qsymia for BED showed promise, randomized studies are needed to evaluate Qsymia's safety and efficacy when re-purposed in eating disorders. We present a study protocol for a Phase I/IIa single-center, prospective, double-blinded, randomized, crossover trial examining safety and preliminary efficacy of Qsymia for BED and BN. Adults with BED (n=15) or BN (n=15) are randomized 1:1 to receive 12weeks Qsymia (phentermine/topiramate ER, 3.75mg/23mg-15mg/92mg) or placebo, followed by 2-weeks washout and 12-weeks crossover, where those on Qsymia receive placebo and vice versa. Subsequently participants receive 8weeks follow-up off study medications. The primary outcome is the number of binge days/week measured by EDE. Secondary outcomes include average number of binge episodes, percentage abstinence from binge eating, and changes in weight/vitals, eating psychopathology, and mood. To our knowledge this is the first randomized, double-blind protocol investigating the safety and efficacy of phentermine/topiramate in BED and BN. We highlight the background and rationale for this study, including the advantages of a crossover design. Clinicaltrials.gov identifier NCT02553824 registered on 9/17/2015. https://clinicaltrials.gov/ct2/show/NCT02553824. Copyright © 2017 Elsevier Inc. All rights reserved.

Vasopressin for Hemorrhagic Shock Management: Revisiting the Potential Value in Civilian and Combat Casualty Care

DTIC Science & Technology

2010-07-01

get rid of weight relevant infusion bags . The rationale behind vasopressor drugs for cardiocirculatory stabilization in hemorrhage is based on our...Ringer’s and hydroxyethyl starch solu- tions were applied at this point in time, hepatic blood loss rapidly increased. These animals died of protracted...norepinephrine (20 g/kg followed by 1 g/kg/min) was combined with hypertonic starch solution, CPP and cerebral oxygenation were significantly increased and

40 CFR 68.39 - Documentation.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., and the rationale for selection; assumptions shall include use of any administrative controls and any... include the anticipated effect of the controls and mitigation on the release quantity and rate. (b) For... administrative controls and any mitigation that were assumed to limit the quantity that could be released...

40 CFR 68.39 - Documentation.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., and the rationale for selection; assumptions shall include use of any administrative controls and any... include the anticipated effect of the controls and mitigation on the release quantity and rate. (b) For... administrative controls and any mitigation that were assumed to limit the quantity that could be released...

40 CFR 68.39 - Documentation.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., and the rationale for selection; assumptions shall include use of any administrative controls and any... include the anticipated effect of the controls and mitigation on the release quantity and rate. (b) For... administrative controls and any mitigation that were assumed to limit the quantity that could be released...

40 CFR 68.39 - Documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and the rationale for selection; assumptions shall include use of any administrative controls and any... include the anticipated effect of the controls and mitigation on the release quantity and rate. (b) For... administrative controls and any mitigation that were assumed to limit the quantity that could be released...

40 CFR 68.39 - Documentation.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and the rationale for selection; assumptions shall include use of any administrative controls and any... include the anticipated effect of the controls and mitigation on the release quantity and rate. (b) For... administrative controls and any mitigation that were assumed to limit the quantity that could be released...

USA’S PRACTICES FOR CONTROLLING PATHOGENS IN BIOSOLIDS

EPA Science Inventory

The U.S.A. initially established regulations for the management of sewage sludge in 1979 and updated them in 1993. They are briefly discussed with emphasis on the rationale for the procedures chosen to disinfect sludge and control its vector attractiveness. By controlling pathoge...

A computer program for calculation of doses and prices of injectable medications based on body weight or body surface area

PubMed Central

2004-01-01

Abstract A computer program (CalcAnesth) was developed with Visual Basic for the purpose of calculating the doses and prices of injectable medications on the basis of body weight or body surface area. The drug names, concentrations, and prices are loaded from a drug database. This database is a simple text file, that the user can easily create or modify. The animal names and body weights can be loaded from a similar database. After typing the dose and the units into the user interface, the results will be automatically displayed. The program is able to open and save anesthetic protocols, and export or print the results. This CalcAnesth program can be useful in clinical veterinary anesthesiology and research. The rationale for dosing on the basis of body surface area is also discussed in this article. PMID:14979437

Molecular physiology of weight regulation in mice and humans

PubMed Central

Leibel, RL

2009-01-01

Evolutionary considerations relating to efficiency in reproduction, and survival in hostile environments, suggest that body energy stores are sensed and actively regulated, with stronger physiological and behavioral responses to loss than gain of stored energy. Many physiological studies support this inference, and suggest that a critical axis runs between body fat and the hypothalamus. The molecular cloning of leptin and its receptor—projects based explicitly on the search for elements in this axis—confirmed the existence of this axis and provided important tools with which to understand its molecular physiology. Demonstration of the importance of this soma-brain reciprocal connection in body weight regulation in humans has been pursued using both classical genetic approaches and studies of physiological responses to experimental weight perturbation. This paper reviews the history of the rationale and methodology of the cloning of leptin (Lep) and the leptin receptor (Lepr), and describes some of the clinical investigation characterizing this axis. PMID:19136999

Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights.

PubMed

Willey, Karen A; Singh, Maria A Fiatarone

2003-05-01

Exercise improves insulin resistance and has beneficial effects in preventing and treating type 2 diabetes. However, aerobic exercise is hindered in many type 2 diabetic patients because of advancing age, obesity, and other comorbid conditions. Weight lifting or progressive resistance training (PRT) offers a safe and effective exercise alternative for these people. PRT promotes favorable energy balance and reduced visceral fat deposition through enhanced basal metabolism and activity levels while counteracting age- and disease-related muscle wasting. PRT improves insulin sensitivity and glycemic control; increases muscle mass, strength, and endurance; and has positive effects on bone density, osteoarthritic symptoms, mobility impairment, self-efficacy, hypertension, and lipid profiles. PRT also alleviates symptoms of anxiety, depression, and insomnia in individuals with clinical depression and improves exercise tolerance in individuals with cardiac ischemic disease and congestive heart failure; all of these aspects are relevant to the care of diabetic elders. Moreover, PRT is safe and well accepted in many complex patient populations, including very frail elderly individuals and those with cardiovascular disease. The greater feasibility of using PRT over aerobic exercise in elderly obese type 2 diabetic individuals because of concomitant cardiovascular, arthritic, and other disease provides a solid rationale for investigating the global benefits of PRT in the management of diabetes.

Antenatal exercise in overweight and obese women and its effects on offspring and maternal health: design and rationale of the IMPROVE (Improving Maternal and Progeny Obesity Via Exercise) randomised controlled trial.

PubMed

Seneviratne, Sumudu N; Parry, Graham K; McCowan, Lesley Me; Ekeroma, Alec; Jiang, Yannan; Gusso, Silmara; Peres, Geovana; Rodrigues, Raquel O; Craigie, Susan; Cutfield, Wayne S; Hofman, Paul L

2014-04-26

Obesity during pregnancy is associated with adverse outcomes for the offspring and mother. Lifestyle interventions in pregnancy such as antenatal exercise, are proposed to improve both short- and long-term health of mother and child. We hypothesise that regular moderate-intensity exercise during the second half of pregnancy will result in improved maternal and offspring outcomes, including a reduction in birth weight and adiposity in the offspring, which may be protective against obesity in later life. The IMPROVE (Improving Maternal and Progeny Risks of Obesity Via Exercise) study is a two-arm parallel randomised controlled clinical trial being conducted in Auckland, New Zealand. Overweight and obese women (BMI ≥25 kg/m2) aged 18-40 years, with a singleton pregnancy of <20 weeks of gestation, from the Auckland region, are eligible for the trial. Exclusion criteria are ongoing smoking or medical contra-indications to antenatal exercise.Participants are randomised with 1:1 allocation ratio to either intervention or control group, using computer-generated randomisation sequences in variable block sizes, stratified on ethnicity and parity, after completion of baseline assessments. The intervention consists of a 16-week structured home-based moderate-intensity exercise programme utilising stationary cycles and heart rate monitors, commencing at 20 weeks of gestation. The control group do not receive any exercise intervention. Both groups undergo regular fetal ultrasonography and receive standard antenatal care. Due to the nature of the intervention, participants are un-blinded to group assignment during the trial.The primary outcome is offspring birth weight. Secondary offspring outcomes include fetal and neonatal body composition and anthropometry, neonatal complications and cord blood metabolic markers. Maternal outcomes include weight gain, pregnancy and delivery complications, aerobic fitness, quality of life, metabolic markers and post-partum body composition. The results of this trial will provide valuable insights on the effects of antenatal exercise on health outcomes in overweight and obese mothers and their offspring. Australian New Zealand Clinical Trials Registry ACTRN12612000932864.

Pro-HEART - a randomized clinical trial to test the effectiveness of a high protein diet targeting obese individuals with heart failure: rationale, design and baseline characteristics.

PubMed

Motie, Marjan; Evangelista, Lorraine S; Horwich, Tamara; Hamilton, Michele; Lombardo, Dawn; Cooper, Dan M; Galassetti, Pietro R; Fonarow, Gregg C

2013-11-01

There is ample research to support the potential benefits of a high protein diet on clinical outcomes in overweight/obese, diabetic subjects. However, nutritional management of overweight/obese individuals with heart failure (HF) and type 2 diabetes mellitus (DM) or metabolic syndrome (MS) is poorly understood and few clinical guidelines related to nutritional approaches exist for this subgroup. This article describes the design, methods, and baseline characteristics of study participants enrolled in Pro-HEART, a randomized clinical trial to determine the short term and long term effects of a high protein diet (30% protein [~110 g/day], 40% carbohydrates [150 g/day], 30% fat [~50 g/day]) versus a standard protein diet (15% protein [~55 g/day], 55% carbohydrates [~200 g/day], 30% fat [~50 g/day]) on body weight and adiposity, cardiac structure and function, functional status, lipid profile, glycemic control, and quality of life. Between August, 2009 and May, 2013, 61 individuals agreed to participate in the study; 52 (85%) - mean age 58.2 ± 9.8 years; 15.4% Blacks; 57.7% Whites; 19.2% Hispanics; 7.7% Asians; 73.1% male; weight 112.0 ± 22.6 kg - were randomized to a 3-month intensive weight management program of either a high protein or standard protein diet; data were collected at baseline, 3 months, and 15 months. This study has the potential to reveal significant details about the role of macronutrients in weight management of overweight/obese individuals with HF and DM or MS. © 2013 Elsevier Inc. All rights reserved.

40 CFR 799.9110 - TSCA acute oral toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... number. A system to assign animals to test groups and control groups randomly is required. (E) Housing... randomization in assigning animals to test and control groups. (3) Rationale for selection of species, if other... CONTROL ACT (CONTINUED) IDENTIFICATION OF SPECIFIC CHEMICAL SUBSTANCE AND MIXTURE TESTING REQUIREMENTS...

40 CFR 799.9110 - TSCA acute oral toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... number. A system to assign animals to test groups and control groups randomly is required. (E) Housing... randomization in assigning animals to test and control groups. (3) Rationale for selection of species, if other... CONTROL ACT (CONTINUED) IDENTIFICATION OF SPECIFIC CHEMICAL SUBSTANCE AND MIXTURE TESTING REQUIREMENTS...

40 CFR 799.9110 - TSCA acute oral toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... number. A system to assign animals to test groups and control groups randomly is required. (E) Housing... randomization in assigning animals to test and control groups. (3) Rationale for selection of species, if other... CONTROL ACT (CONTINUED) IDENTIFICATION OF SPECIFIC CHEMICAL SUBSTANCE AND MIXTURE TESTING REQUIREMENTS...

40 CFR 799.9110 - TSCA acute oral toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... number. A system to assign animals to test groups and control groups randomly is required. (E) Housing... randomization in assigning animals to test and control groups. (3) Rationale for selection of species, if other... CONTROL ACT (CONTINUED) IDENTIFICATION OF SPECIFIC CHEMICAL SUBSTANCE AND MIXTURE TESTING REQUIREMENTS...

40 CFR 799.9110 - TSCA acute oral toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... number. A system to assign animals to test groups and control groups randomly is required. (E) Housing... randomization in assigning animals to test and control groups. (3) Rationale for selection of species, if other... CONTROL ACT (CONTINUED) IDENTIFICATION OF SPECIFIC CHEMICAL SUBSTANCE AND MIXTURE TESTING REQUIREMENTS...

Contemporary multilevel analysis of the effectiveness of water fluoridation in Australia.

PubMed

Do, Loc; Spencer, A John

2015-02-01

Water fluoridation was extended in Queensland, Australia, across 2009-2011. A research program was commenced to inform the rationale for and the outcome of this program, to estimate the effectiveness of water fluoridation in preventing caries and to predict changes in caries experience as a result of the extension of fluoridation. Queensland children were selected through a stratified random sample selection in 2010-2012. Oral epidemiological examinations provided individual-level outcomes for decayed, missing or filled primary or permanent tooth surfaces: dmfs (among 5-8-year-olds) and DMFS (9-14-year-olds). Explanatory factors at the individual-level, school-level and area-level fluoridation status were derived. Data were weighted to represent the population. Three-level multilevel multivariable models were sequentially specified for negative binomial distribution of dmfs/DMFS to estimate rate ratios (RR). The effectiveness of area-level water fluoridation was evaluated in the full models controlling for other factors. Data from 2,214 5-8 year-olds and 3,186 9-14 year-olds from 207 schools in 16 areas were analysed. Queensland's average dmfs was 4.23 and DMFS 1.47. The lowest levels of dental caries were observed in long-term fluoridated Townsville. In the full models, Townsville children had significantly lower caries experience (RR for dmfs: 0.61 (95%CI: 0.44-0.82); RR for DMFS 0.60 (95%CI: 0.42-0.88)) compared with children in non-fluoridated areas. Comparison of caries experience of children at the time of the extension of water fluoridation supported the rationale for this population health measure. © 2014 Public Health Association of Australia.

RESEARCH IN A REGULATORY ENVIRONMENT

EPA Science Inventory

The paper discusses the rationale and motivation for integrated environmental control as it relates to EPA research, particularly as it involves risk management. EPA research, whether in support of integrated environmental control or not, must be responsive to the Agency's regula...

The background and rationale for a new fixed-dose combination for first-line treatment of tuberculosis in children.

PubMed

Graham, S M; Grzemska, M; Gie, R P

2015-12-01

In 2010, the World Health Organization revised the recommendations for the treatment of tuberculosis (TB) in children. The major revision was to increase isoniazid, rifampicin and pyrazinamide dosages according to body weight in children. The recommendations for higher dosages are based on consistent evidence from 1) pharmacokinetic studies suggesting that young children require higher dosages than adolescents and adults to achieve desired serum concentrations; and 2) observational studies reporting that the higher dosages would not be associated with increased risk of toxicity in children. However, national tuberculosis programmes faced unforeseen challenges in implementing the revised recommendations. The main difficulty was to adapt the revised dosages for the treatment of children with drug-susceptible TB using available fixed-dose combinations (FDCs). A more suitable FDC for the intensive and continuation phases of treatment has now been developed for planned implementation in 2015. This paper explains the background and rationale for the development of a new FDC tablet for children with drug-susceptible TB.

A virtual reality intervention (Second Life) to improve weight maintenance: Rationale and design for an 18-month randomized trial.

PubMed

Sullivan, D K; Goetz, J R; Gibson, C A; Mayo, M S; Washburn, R A; Lee, Y; Ptomey, L T; Donnelly, J E

2016-01-01

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI≥25kg/m(2)) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance are clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without real-life repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25-44.9kg/m(2)). Participants who achieve ≥5% weight loss following a 6month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed. Copyright © 2015 Elsevier Inc. All rights reserved.

A virtual reality intervention (second life) to improve weight maintenance: Rationale and design for an 18 month randomized trial

PubMed Central

Sullivan, DK; Goetz, JR; Gibson, CA; Mayo, MS; Washburn, RA; Lee, Y; Ptomey, LT; Donnelly, JE

2015-01-01

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance is clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without reallife repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25–44.9 kg/m2). Participants who achieve ≥ 5% weight loss following a 6 month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed. PMID:26616535

Rationale for classical biological control of cattle fever ticks and proposed methods for field collection of natural enemies

USDA-ARS?s Scientific Manuscript database

Classical biological control using specialist parasitoids, predators and/or nematodes from the native ranges of cattle fever ticks Rhipicephalus microplus and Rhipicephalus annulatus could complement existing control strategies for this livestock pest in the transboundary region between Mexico and T...

The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results.

PubMed

Lubans, David R; Morgan, Philip J; Dewar, Deborah; Collins, Clare E; Plotnikoff, Ronald C; Okely, Anthony D; Batterham, Marijka J; Finn, Tara; Callister, Robin

2010-10-28

Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases. Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years, this has not been the case among youth from low socioeconomic backgrounds. The purpose of this paper is to report the rationale, study design and baseline findings of a school-based obesity prevention program for low-active adolescent girls from disadvantaged secondary schools. The Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) intervention will be evaluated using a group randomized controlled trial. NEAT Girls is a 12-month multi-component school-based intervention developed in reference to Social Cognitive Theory and includes enhanced school sport sessions, interactive seminars, nutrition workshops, lunch-time physical activity (PA) sessions, PA and nutrition handbooks, parent newsletters, pedometers for self-monitoring and text messaging for social support. The following variables were assessed at baseline and will be completed again at 12- and 24-months: adiposity, objectively measured PA, muscular fitness, time spent in sedentary behaviors, dietary intake, PA and nutrition social-cognitive mediators, physical self-perception and global self-esteem. Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA and nutrition behavior change will be explored. NEAT Girls is an innovative intervention targeting low-active girls using evidence-based behavior change strategies and nutrition and PA messages and has the potential to prevent unhealthy weight gain and reduce the decline in physical activity and poor dietary habits associated with low socio-economic status. Few studies have reported the long-term effects of school-based obesity prevention programs and the current study has the potential to make an important contribution to the field. Australian New Zealand Clinical Trials Registry No: ACTRN12610000330044.

Dipeptidyl peptidase-4 inhibition with linagliptin and effects on hyperglycaemia and albuminuria in patients with type 2 diabetes and renal dysfunction: Rationale and design of the MARLINA-T2D™ trial.

PubMed

Groop, Per-Henrik; Cooper, Mark E; Perkovic, Vlado; Sharma, Kumar; Schernthaner, Guntram; Haneda, Masakazu; Hocher, Berthold; Gordat, Maud; Cescutti, Jessica; Woerle, Hans-Juergen; von Eynatten, Maximilian

2015-11-01

Efficacy, Safety & Modification of Albuminuria in Type 2 Diabetes Subjects with Renal Disease with LINAgliptin (MARLINA-T2D™), a multicentre, multinational, randomized, double-blind, placebo-controlled, parallel-group, phase 3b clinical trial, aims to further define the potential renal effects of dipeptidyl peptidase-4 inhibition beyond glycaemic control. A total of 350 eligible individuals with inadequately controlled type 2 diabetes and evidence of renal disease are planned to be randomized in a 1:1 ratio to receive either linagliptin 5 mg or placebo in addition to their stable glucose-lowering background therapy for 24 weeks. Two predefined main endpoints will be tested in a hierarchical manner: (1) change from baseline in glycated haemoglobin and (2) time-weighted average of percentage change from baseline in urinary albumin-to-creatinine ratio. Both endpoints are sufficiently powered to test for superiority versus placebo after 24 weeks with α = 0.05. MARLINA-T2D™ is the first of its class to prospectively explore both the glucose- and albuminuria-lowering potential of a dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes and evidence of renal disease. © The Author(s) 2015.

Antitumour Effects of Isocurcumenol Isolated from Curcuma zedoaria Rhizomes on Human and Murine Cancer Cells

PubMed Central

Lakshmi, S.; Padmaja, G.; Remani, P.

2011-01-01

Curcuma zedoaria belonging to the family Zingiberaceae has been used in the traditional system of medicine in India and Southwest Asia in treating many human ailments and is found to possess many biological activities. The rationale of the present study was to isolate, identify, and characterize antitumour principles from the rhizomes of Curcuma zedoaria, to assess its cytotoxic effects on human and murine cancer cells, to determine its apoptosis inducing capacity in cancer cells, and to evaluate its tumour reducing properties in in vivo mice models. Isocurcumenol was characterized as the active compound by spectroscopy and was found to inhibit the proliferation of cancer cells without inducing significant toxicity to the normal cells. Fluorescent staining exhibited the morphological features of apoptosis in the compound-treated cancer cells. In vivo tumour reduction studies revealed that a dose of 35.7 mg/kg body weight significantly reduced the ascitic tumour in DLA-challenged mice and increased the lifespan with respect to untreated control mice. PMID:27429805

SGLT2 inhibitor/DPP-4 inhibitor combination therapy - complementary mechanisms of action for management of type 2 diabetes mellitus.

PubMed

Dey, Jayant

2017-05-01

Type 2 diabetes mellitus is a progressive disease with multiple underlying pathophysiologic defects. Monotherapy alone cannot maintain glycemic control and leads to treatment failure. Ideally, a combination of glucose-lowering agents should have complementary mechanisms of action that address multiple pathophysiologic pathways, can be used at all stages of the disease, and be generally well tolerated with no increased risk of hypoglycemia, cardiovascular events, or weight gain. The combination should also provide conveniences for patients, such as oral dosing, single-pill formulations, and once-daily administration, potentially translating to improved adherence. Two classes of glucose-lowering agents that meet these criteria are the sodium glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors. This article reviews the rationale for combination therapy with these agents, and evidence from clinical trials with empagliflozin and linagliptin or dapagliflozin and saxagliptin in the management of type 2 diabetes mellitus. Both combinations have been approved as single-pill formulations.

Perioperative ketorolac in high risk breast cancer patients. Rationale, feasibility and methodology of a prospective randomized placebo-controlled trial.

PubMed

Forget, Patrice; Berlière, Martine; van Maanen, Aline; Duhoux, Francois P; Machiels, Jean-Pascal; Coulie, Pierre G; Bouche, Gauthier; De Kock, Marc

2013-10-01

Ketorolac, a NSAID routinely used during surgery proposed to have anticancer effects, is a promising way to improve postoperative oncological outcome. This effect may be particularly prominent in patients with elevated preoperative inflammatory scores, like the neutrophil:lymphocyte ratio. In this paper, we describe the rationale, the preliminary analyses in our patients, the feasibility and the methodology of a prospective randomized trial called "Ketorolac in Breast Cancer trial" (KBCt) (NCT01806259). Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of Role and Assignment Rationale on Attitudes Formed During Peer Tutoring

PubMed Central

Bierman, Karen Linn; Furman, Wyndol

2012-01-01

This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors’ and tutees’ attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs. PMID:23946549

Effects of Role and Assignment Rationale on Attitudes Formed During Peer Tutoring.

PubMed

Bierman, Karen Linn; Furman, Wyndol

1981-02-01

This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors' and tutees' attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs.

Effects of Metformin, Buformin, and Phenformin on the Post Initiation Stage of Chemically-Induced Mammary Carcinogenesis in the Rat

PubMed Central

Zhu, Zongjian; Jiang, Weiqin; Thompson, Matthew D.; Echeverria, Dimas; McGinley, John N.; Thompson, Henry J.

2015-01-01

Metformin is a widely prescribed drug for the treatment of type-2 diabetes. Although epidemiological data have provided a strong rationale for investigating the potential of this biguanide for use in cancer prevention and control, uncertainty exists whether metformin should be expected to have an impact in non-diabetic patients. Furthermore, little attention has been given to the possibility that other biguanides may have anticancer activity. In this study, the effects of clinically relevant doses of metformin (9.3mmol/kg diet), buformin (7.6 mmol/kg diet), and phenformin (5.0 mmol/kg diet) were compared to rats fed control diet (AIN93-G) during the post initiation stage of 1-methyl-1-nitrosourea-induced (50 mg/kg body weight) mammary carcinogenesis (n = 30/group). Plasma, liver, skeletal muscle, visceral fat, mammary gland, and mammary carcinoma concentrations of the biguanides were determined. In comparison to the control group, buformin decreased cancer incidence, multiplicity, and burden; whereas, metformin and phenformin had no statistically significant effect on the carcinogenic process relative to the control group. Buformin did not alter fasting plasma glucose or insulin. Within mammary carcinomas, evidence was obtained that buformin treatment perturbed signaling pathways related to energy sensing. However, further investigation is needed to determine the relative contributions of host systemic and cell autonomous mechanisms to the anticancer activity of biguanides such as buformin. PMID:25804611

Distance learning strategies for weight management utilizing social media: A comparison of phone conference call versus social media platform. Rationale and design for a randomized study.

PubMed

Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Al-Hihi, Eyad M; Lee, Robert; Vansaghi, Lisa; Washburn, Richard A; Donnelly, Joseph E

2016-03-01

Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0-45.0 kg/m(2)) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed. Copyright © 2016 Elsevier Inc. All rights reserved.

Rationale and Methods for Archival Sampling and Analysis of Atmospheric Trace Chemical Contaminants On Board Mir and Recommendations for the International Space Station

NASA Technical Reports Server (NTRS)

Perry, J. L.; James, J. T.; Cole, H. E.; Limero, T. F.; Beck, S. W.

1997-01-01

Collection and analysis of spacecraft cabin air samples are necessary to assess the cabin air quality with respect to crew health. Both toxicology and engineering disciplines work together to achieve an acceptably clean cabin atmosphere. Toxicology is concerned with limiting the risk to crew health from chemical sources, setting exposure limits, and analyzing air samples to determine how well these limits are met. Engineering provides the means for minimizing the contribution of the various contaminant generating sources by providing active contamination control equipment on board spacecraft and adhering to a rigorous material selection and control program during the design and construction of the spacecraft. A review of the rationale and objectives for sampling spacecraft cabin atmospheres is provided. The presently-available sampling equipment and methods are reviewed along with the analytical chemistry methods employed to determine trace contaminant concentrations. These methods are compared and assessed with respect to actual cabin air quality monitoring needs. Recommendations are presented with respect to the basic sampling program necessary to ensure an acceptably clean spacecraft cabin atmosphere. Also, rationale and recommendations for expanding the scope of the basic monitoring program are discussed.

Rheological and molecular weight comparisons of approved hyaluronic acid products - preliminary standards for establishing class III medical device equivalence.

PubMed

Braithwaite, Gavin J C; Daley, Michael J; Toledo-Velasquez, David

2016-01-01

Hyaluronic acid of various molecular weights has been in use for the treatment of osteoarthritis knee pain for decades. Worldwide, these products are regulated as either as drugs or devices and in some countries as both. In the US, this class of products is regulated as Class III medical devices, which places specific regulatory requirements on developers of these materials under a Pre-Market Approval process, typically requiring data from prospective randomized controlled clinical studies. In 1984 pharmaceutical manufacturers became able to file an Abbreviated New Drug Application for approval of a generic drug, thus establishing standards for demonstrating equivalence to an existing chemical entity. Recently, the first biosimilar, or 'generic biologic', was approved. Biosimilars are biological products that are approved by the FDA because they are 'highly similar' to a reference product, and have been shown to have no clinically meaningful differences from the reference product. For devices, Class II medical devices have a pathway for declaring equivalence to an existing product by filing a 510 k application for FDA clearance. However, until recently no equivalent regulatory pathway was available to Class III devices. In this paper, we consider the critical mechanical performance parameters for intra-articular hyaluronic products to demonstrate indistinguishable characteristics. Analogous to the aforementioned pathways that allow for a demonstration of equivalence, we examine these parameters for an existing, marketed device and compare molecular weight and rheological properties of multiple batches of a similar product. We propose that this establishes a scientific rationale for establishing Class III medical device equivalence.

Cognitive defusion versus thought distraction: a clinical rationale, training, and experiential exercise in altering psychological impacts of negative self-referential thoughts.

PubMed

Masuda, Akihiko; Feinstein, Amanda B; Wendell, Johanna W; Sheehan, Shawn T

2010-11-01

Using two modes of intervention delivery, the present study compared the effects of a cognitive defusion strategy with a thought distraction strategy on the emotional discomfort and believability of negative self-referential thoughts. One mode of intervention delivery consisted of a clinical rationale and training (i.e., Partial condition). The other mode contained a condition-specific experiential exercise with the negative self-referential thought in addition to the clinical rationale and training (i.e., Full condition). Nonclinical undergraduates were randomly assigned to one of five protocols: Partial-Defusion, Full-Defusion, Partial-Distraction, Full-Distraction, and a distraction-based experimental control task. The Full-Defusion condition reduced the emotional discomfort and believability of negative self-referential thoughts significantly more than other comparison conditions. The positive results of the Full-Defusion condition were also found among participants with elevated depressive symptoms.

Self-rated health appraisal as cultural and identity process: African American elders' health and evaluative rationales.

PubMed

McMullen, Carmit K; Luborsky, Mark R

2006-08-01

We explored self-rated health by using a meaning-centered theoretical foundation. Self-appraisals, such as self-rated health, reflect a cultural process of identity formation, whereby identities are multiple, simultaneously individual and collective, and produced by specific historical formations. Anthropological research in Philadelphia determined (a) how African American elders appraise their health, and (b) how health evaluations reflect cultural and historical experiences within a community. We interviewed and observed 35 adults aged 65 to 80, stratified by gender and self-rated health. We validated theme analysis of focused interview questions against the larger data set of field notes and transcripts. Health appraisal reflected a complex process of adaptation and identity. Criteria for health included: independent functioning, physical condition, control and responsibility for health, and overall feeling. Evaluative rationales that shaped health appraisals were comparisons, restricted possibilities for self-evaluation, and ways of handling adversity. Evaluative rationales mitigated undesirable health identities (including low self-reported health) and provided mechanisms for claiming desired health identities despite adversity. Describing the criteria and evaluative rationales underlying self-appraisals of health extends current understandings of self-rated health and illustrates the sociohistorical context of individual assessments of well-being.

Weight management by phone conference call: A comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial

PubMed Central

Lambourne, Kate; Washburn, Richard A.; Gibson, Cheryl; Sullivan, Debra K.; Goetz, Jeannine; Lee, Robert; Smith, Bryan K.; Mayo, Matthew S.; Donnelly, Joseph E.

2012-01-01

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25–39.9 kg/m2) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed. PMID:22664647

Weight management by phone conference call: a comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial.

PubMed

Lambourne, Kate; Washburn, Richard A; Gibson, Cheryl; Sullivan, Debra K; Goetz, Jeannine; Lee, Robert; Smith, Bryan K; Mayo, Matthew S; Donnelly, Joseph E

2012-09-01

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25-39.9 kg/m(2)) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed. Copyright © 2012 Elsevier Inc. All rights reserved.

‘…I've Found Once the Weight Had Gone Off, I've Had a Few Twinges, But Nothing Like Before’. Exploring Weight and Self-Management of Knee Pain

PubMed Central

Morden, Andrew; Jinks, Clare; Ong, Bie Nio

2014-01-01

Objectives Being overweight or obese is a key risk factor for the onset and exacerbation of knee pain. Policy and clinical guidelines encourage lifestyle changes as part of prevention or supported self-management. The present study explores how people who have not consulted for knee pain understand weight in relation to joint pain, if and how they self-manage and potential barriers to doing so. Methods A qualitative investigation was undertaken using repeat in-depth semi-structured interviews and diary study. Thirteen participants who self-reported moderate to severe pain and had not recently consulted their general practitioner for knee pain were recruited to the study. Thematic analysis of data was conducted. Results Participants did not recognize the association between being overweight and the onset of joint pain. The findings illuminate understandings of the effect of weight on joint pain, rationales and strategies for losing weight, and how participants’ position responsibility for weight gain and loss. Discussion The present study suggests that clinicians need to account for existing understandings and actions of individuals in relation to weight and joint pain. Supported self-management and public health interventions need to be individually tailored accordingly. © 2013 The Authors. Musculoskeletal Care published by John Wiley & Sons, Ltd. PMID:23861332

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial.

PubMed

2012-08-28

Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method. ClinicalTrials.gov Identifier: NCT01374022.

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method. Trial registration ClinicalTrials.gov Identifier: NCT01374022 PMID:22929542

A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale.

PubMed

Chang, Mei-Wei; Nitzke, Susan; Brown, Roger; Resnicow, Ken

2014-03-25

Over 45% of American women 20-39 years old are at risk for type 2 diabetes, cardiovascular disease, and other health conditions because they are overweight or obese. The prevalence of overweight and obesity is disproportionately high among low-income women. This paper describes the study design and rationale of a community based intervention (Mothers In Motion, MIM) aimed to prevent weight gain among low-income overweight and obese mothers 18-39 years old by promoting stress management, healthy eating, and physical activity. Peer recruiters approach participants from 5 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Michigan. The MIM delivers theory-based, culturally-sensitive intervention messages via a combination of DVDs and peer support group teleconferences (PSGTs). The DVD features African American and white overweight and obese WIC mothers who participated in a healthy lifestyle intervention patterned after MIM. The PSGTs are led by paraprofessionals from Michigan State University Extension and WIC providers in Michigan who are trained in motivational interviewing and group facilitation skills. Participants are randomly assigned to an intervention (n=350) or comparison group (n=175). The intervention group receives a 16-week intervention on a weekly or bi-weekly basis. Participants are asked to watch 10 MIM DVD chapters at home and join 10 PSGT sessions by phone. The comparison group receives printed educational materials. The primary outcome is body weight. Secondary outcomes include dietary fat, fruit, and vegetable intake; physical activity; stress, and affect. Mediators are self-efficacy, emotional coping response, social support, and autonomous motivation. Telephone interviews and in-person data collection at WIC offices occur at 3 time points: baseline, immediately, and 3 months after the 16-week intervention. If MIM shows effectiveness, it could have a favorable impact on public health and community programs. The DVDs and PSGTs will be disseminated in WIC, Extension, clinical practice that promote healthy lifestyles for similar target audiences to make a broad contribution to the prevention of weight gain in low-income mothers. Also, our methodology can be adapted by researchers and community stakeholders to help other low-income populations prevent weight gain. Clinical Trials Number: NCT01839708.

Pilot Aircraft Interface Objectives/Rationale

NASA Technical Reports Server (NTRS)

Shively, Jay

2010-01-01

Objective: Database and proof of concept for guidelines for GCS compliance a) Rationale: 1) Provide research test-bed to develop guidelines. 2) Modify GCS for NAS Compliance to provide proof of concept. b) Approach: 1) Assess current state of GCS technology. 2) Information Requirements Definition. 3) SME Workshop. 4) Modify an Existing GCS for NAS Compliance. 5) Define exemplar UAS (choose system to develop prototype). 6) Define Candidate Displays & Controls. 7) Evaluate/ refine in Simulations. 8) Demonstrate in flight. c) Deliverables: 1) Information Requirements Report. 2) Workshop Proceedings. 3) Technical Reports/ papers on Simulations & Flight Demo. 4) Database for guidelines.

Media independent interface

NASA Technical Reports Server (NTRS)

1987-01-01

The work done on the Media Independent Interface (MII) Interface Control Document (ICD) program is described and recommendations based on it were made. Explanations and rationale for the content of the ICD itself are presented.

A Microprocessor Project for Non-Electrical Engineering Students.

ERIC Educational Resources Information Center

Swingler, D. N.

1981-01-01

Offers rationale for and a description of a microprocessor-based control system project for mechanical engineering students. Includes reasons for selecting a Texas Instruments TM990/189 microprocessor system. (SK)

Pharmacological management of binge eating disorder: current and emerging treatment options

PubMed Central

McElroy, Susan L; Guerdjikova, Anna I; Mori, Nicole; O’Melia, Anne M

2012-01-01

Growing evidence suggests that pharmacotherapy may be beneficial for some patients with binge eating disorder (BED), an eating disorder characterized by repetitive episodes of uncontrollable consumption of abnormally large amounts of food without inappropriate weight loss behaviors. In this paper, we provide a brief overview of BED and review the rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED. We conclude by summarizing these data, discussing the role of pharmacotherapy in the BED treatment armamentarium, and suggesting future areas for research. PMID:22654518

Rationale for Further Medical and Health Research on High-Potency Sweeteners

PubMed Central

2012-01-01

High-potency or artificial sweeteners have historically been considered inert compounds without physiological consequences other than taste sensations. However, recent data suggest that some of these sweeteners have biological effects that may impact human health. Furthermore, there are significant gaps in our current knowledge of the pharmacokinetics of these sweeteners, their potential for “sweetener–drug interactions” and their impact on appetite and body weight regulation. Nine research needs are described that address some of the major unknown issues associated with ingestion of high-potency sweeteners. PMID:22539626

The rationale for preventing cancer cachexia: targeting excessive fatty acid oxidation.

PubMed

Qian, Chao-Nan

2016-07-21

Cachexia commonly occurs at the terminal stage of cancer and has largely unclear molecular mechanisms. A recent study published in Nature Medicine, entitled "Excessive fatty acid oxidation induces muscle atrophy in cancer cachexia," reveals that cachectic cancer cells can secrete multiple cytokines that induce excessive fatty acid oxidation, which is responsible for muscle loss in cancer cachexia. Inhibition of fatty acid oxidation using etomoxir can increase muscle mass and body weight in cancer cachexia animal models. The usage of stable cachexia animal models is also discussed in this research highlight.

Rationale for further medical and health research on high-potency sweeteners.

PubMed

Schiffman, Susan S

2012-10-01

High-potency or artificial sweeteners have historically been considered inert compounds without physiological consequences other than taste sensations. However, recent data suggest that some of these sweeteners have biological effects that may impact human health. Furthermore, there are significant gaps in our current knowledge of the pharmacokinetics of these sweeteners, their potential for "sweetener-drug interactions" and their impact on appetite and body weight regulation. Nine research needs are described that address some of the major unknown issues associated with ingestion of high-potency sweeteners.

40 CFR 1051.125 - What maintenance instructions must I give to buyers?

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintenance steps to address engine operation that is not atypical, or that the maintenance is unlikely to... (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM RECREATIONAL ENGINES AND VEHICLES Emission... maintenance step, recommend the maximum feasible interval for this maintenance, include your rationale with...

Public Information for Water Pollution Control.

ERIC Educational Resources Information Center

Water Pollution Control Federation, Washington, DC.

This publication is a handbook for water pollution control personnel to guide them towards a successful public relations program. This handbook was written to incorporate the latest methods of teaching basic public information techniques to the non-professional in this area. Contents include: (1) a rationale for a public information program; (2)…

Chemical Sensing in Process Analysis.

ERIC Educational Resources Information Center

Hirschfeld, T.; And Others

1984-01-01

Discusses: (1) rationale for chemical sensors in process analysis; (2) existing types of process chemical sensors; (3) sensor limitations, considering lessons of chemometrics; (4) trends in process control sensors; and (5) future prospects. (JN)

Treatment of Obesity: Weight Loss and Bariatric Surgery

PubMed Central

Wolfe, Bruce M.; Kvach, Elizaveta; Eckel, Robert H.

2016-01-01

This review focuses on the mechanisms underlying, and indications for, bariatric surgery in the reduction of cardiovascular disease (CVD) as well as other expected benefits of this intervention. The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by non-surgical means. An explanation of possible indications for weight loss surgery as well as specific bariatric surgical procedures is presented, along with review of the safety literature of such procedures. Procedures that are less invasive or those that involve less gastrointestinal rearrangement accomplish considerably less weight loss but have substantially lower perioperative and longer-term risk. The ultimate benefit of weight reduction relates to the reduction of the co-morbidities, quality of life and all-cause mortality. With weight loss being the underlying justification for bariatric surgery in ameliorating CVD risk, current evidence-based research is discussed concerning body fat distribution, dyslipidemia, hypertension, diabetes, inflammation, obstructive sleep apnea and others. The rationale for bariatric surgery reducing CVD events is discussed and juxtaposed with impacts on all-cause mortalities. Given the improvement of established obesity-related CVD risk factors following weight loss, it is reasonable to expect a reduction of CVD events and related mortality following weight loss in populations with obesity. The quality of the current evidence is reviewed and future research opportunities and summaries are stated. PMID:27230645

Children, parents, and pets exercising together (CPET) randomised controlled trial: study rationale, design, and methods.

PubMed

Yam, Philippa S; Morrison, Ryan; Penpraze, Viki; Westgarth, Carri; Ward, Dianne S; Mutrie, Nanette; Hutchison, Pippa; Young, David; Reilly, John J

2012-03-19

Objectively measured physical activity is low in British children, and declines as childhood progresses. Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults, but there are no published public health interventions based on dog-walking with children. The Children, Parents, and Pets Exercising Together Study aims to develop and evaluate a theory driven, generalisable, family-based, dog walking intervention for 9-11 year olds. The Children, Parents, and Pets Exercising Together Study is an exploratory, assessor-blinded, randomised controlled trial as defined in the UK MRC Framework on the development and evaluation of complex interventions in public health. The trial will follow CONSORT guidance. Approximately 40 dog-owning families will be allocated randomly in a ratio of 1.5:1 to receive a simple behavioural intervention lasting for 10 weeks or to a 'waiting list' control group. The primary outcome is change in objectively measured child physical activity using Actigraph accelerometry. Secondary outcomes in the child, included in part to shape a future more definitive randomised controlled trial, are: total time spent sedentary and patterning of sedentary behaviour (Actigraph accelerometry); body composition and bone health from dual energy x-ray absorptiometry; body weight, height and BMI; and finally, health-related quality of life using the PedsQL. Secondary outcomes in parents and dogs are: changes in body weight; changes in Actigraph accelerometry measured physical activity and sedentary behaviour. Process evaluation will consist of assessment of simultaneous child, parent, and dog accelerometry data and brief interviews with participating families. The Children, Parents, and Pets Exercising Together trial should be the first randomised controlled study to establish and evaluate an intervention aimed at dog-based physical activity promotion in families. It should advance our understanding of whether and how to use pet dogs to promote physical activity and/or to reduce sedentary behaviour in children and adults. The trial is intended to lead to a subsequent more definitive randomised controlled trial, and the work should inform future dog-based public health interventions such as secondary prevention interventions in children or adults. ISRCTN85939423.

Children, parents, and pets exercising together (CPET) randomised controlled trial: study rationale, design, and methods

PubMed Central

2012-01-01

Background Objectively measured physical activity is low in British children, and declines as childhood progresses. Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults, but there are no published public health interventions based on dog-walking with children. The Children, Parents, and Pets Exercising Together Study aims to develop and evaluate a theory driven, generalisable, family-based, dog walking intervention for 9-11 year olds. Methods/design The Children, Parents, and Pets Exercising Together Study is an exploratory, assessor-blinded, randomised controlled trial as defined in the UK MRC Framework on the development and evaluation of complex interventions in public health. The trial will follow CONSORT guidance. Approximately 40 dog-owning families will be allocated randomly in a ratio of 1.5:1 to receive a simple behavioural intervention lasting for 10 weeks or to a 'waiting list' control group. The primary outcome is change in objectively measured child physical activity using Actigraph accelerometry. Secondary outcomes in the child, included in part to shape a future more definitive randomised controlled trial, are: total time spent sedentary and patterning of sedentary behaviour (Actigraph accelerometry); body composition and bone health from dual energy x-ray absorptiometry; body weight, height and BMI; and finally, health-related quality of life using the PedsQL. Secondary outcomes in parents and dogs are: changes in body weight; changes in Actigraph accelerometry measured physical activity and sedentary behaviour. Process evaluation will consist of assessment of simultaneous child, parent, and dog accelerometry data and brief interviews with participating families. Discussion The Children, Parents, and Pets Exercising Together trial should be the first randomised controlled study to establish and evaluate an intervention aimed at dog-based physical activity promotion in families. It should advance our understanding of whether and how to use pet dogs to promote physical activity and/or to reduce sedentary behaviour in children and adults. The trial is intended to lead to a subsequent more definitive randomised controlled trial, and the work should inform future dog-based public health interventions such as secondary prevention interventions in children or adults. Trial registration number ISRCTN85939423 PMID:22429665

Climate Model Ensemble Methodology: Rationale and Challenges

NASA Astrophysics Data System (ADS)

Vezer, M. A.; Myrvold, W.

2012-12-01

A tractable model of the Earth's atmosphere, or, indeed, any large, complex system, is inevitably unrealistic in a variety of ways. This will have an effect on the model's output. Nonetheless, we want to be able to rely on certain features of the model's output in studies aiming to detect, attribute, and project climate change. For this, we need assurance that these features reflect the target system, and are not artifacts of the unrealistic assumptions that go into the model. One technique for overcoming these limitations is to study ensembles of models which employ different simplifying assumptions and different methods of modelling. One then either takes as reliable certain outputs on which models in the ensemble agree, or takes the average of these outputs as the best estimate. Since the Intergovernmental Panel on Climate Change's Fourth Assessment Report (IPCC AR4) modellers have aimed to improve ensemble analysis by developing techniques to account for dependencies among models, and to ascribe unequal weights to models according to their performance. The goal of this paper is to present as clearly and cogently as possible the rationale for climate model ensemble methodology, the motivation of modellers to account for model dependencies, and their efforts to ascribe unequal weights to models. The method of our analysis is as follows. We will consider a simpler, well-understood case of taking the mean of a number of measurements of some quantity. Contrary to what is sometimes said, it is not a requirement of this practice that the errors of the component measurements be independent; one must, however, compensate for any lack of independence. We will also extend the usual accounts to include cases of unknown systematic error. We draw parallels between this simpler illustration and the more complex example of climate model ensembles, detailing how ensembles can provide more useful information than any of their constituent models. This account emphasizes the epistemic importance of considering degrees of model dependence, and the practice of ascribing unequal weights to models of unequal skill.

Factor investing based on Musharakah principle

NASA Astrophysics Data System (ADS)

Simon, Shahril; Omar, Mohd; Lazam, Norazliani Md; Amin, Mohd Nazrul Mohd

2015-10-01

Shariah stock investing has become a widely discussed topic in financial industry as part of today's investment strategy. The strategy primarily applies market capitalization allocations. However, some researchers have argued that market capitalization weighting is inherently flawed and have advocated replacing market capitalization allocations with factor allocations. In this paper, we discuss the rationale for factor investing based on Musharakah principle. The essential elements or factors of Musharakah principle such as business sector, management capability, profitability growth and capital efficiency are embedded in the Shariah-compliant stock. We then transform these factors into indexation for better analysis and performance measurement. Investment universe for this research covers Malaysian stocks for the period of January 2009 to December 2013. We found out that these factor indexes have historically earned excess returns over market capitalization weighted indexes and experienced higher Sharpe Ratios.

Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics.

PubMed

Dandanell, Sune; Elbe, Anne-Marie; Pfister, Gertrud; Elsborg, Peter; W Helge, Jørn

2017-05-01

To investigate the relationship between volition, physical activity and weight loss maintenance. We recruited 84 sedentary (maximal oxygen uptake: 25 ± 5 ml/min), overweight and obese (Body mass index (BMI) 38 ± 7 m/h 2 , fat 44 ± 7 %) women ( n = 55) and men ( n = 29) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1-3 hours/day), a healthy hypo-caloric diet (-500 to -700 kCal/day) and education in healthy lifestyle in classes/groups. The participants' body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer/questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after, and 3 and 12 months after the intervention. At the 12-month follow-up, three different groups will be established: Clinical weight loss maintenance (> 10% weight loss from baseline), moderate weight loss maintenance (1-10% weight loss) and no weight loss (or weight regain). A linear mixed model analysis will be used to compare levels of volitional skills, physical activity and maximal oxygen uptake over time, between the three groups. Correlational analyses will be used to investigate possible associations between volition, maximal oxygen uptake, physical activity level and weight loss maintenance. If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate.

A Cluster-Randomized Trial of Restorative Practices: An Illustration to Spur High-Quality Research and Evaluation.

PubMed

Acosta, Joie D; Chinman, Matthew; Ebener, Patricia; Phillips, Andrea; Xenakis, Lea; Malone, Patrick S

2016-01-01

Restorative Practices in schools lack rigorous evaluation studies. As an example of rigorous school-based research, this paper describes the first randomized control trial of restorative practices to date, the Study of Restorative Practices. It is a 5-year, cluster-randomized controlled trial (RCT) of the Restorative Practices Intervention (RPI) in 14 middle schools in Maine to assess whether RPI impacts both positive developmental outcomes and problem behaviors and whether the effects persist during the transition from middle to high school. The two-year RPI intervention began in the 2014-2015 school year. The study's rationale and theoretical concerns are discussed along with methodological concerns including teacher professional development. The theoretical rationale and description of the methods from this study may be useful to others conducting rigorous research and evaluation in this area.

Acupressure in Controlling Nausea in Young Patients Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

Cancer.gov

RATIONALE: Acupressure wristbands may prevent or reduce nausea and caused by chemotherapy. It is not yet known whether standard care is more effective with or without acupressure wristbands in controlling acute and delayed nausea. PURPOSE: This randomized phase III trial is studying how well acupressure wristbands work with or without standard care in controlling nausea in

Thermal Control of the Scientific Instrument Package in the Large Space Telescope

NASA Technical Reports Server (NTRS)

Hawks, K. H.

1972-01-01

The general thermal control system philosophy was to utilize passive control where feasible and to utilize active methods only where required for more accurate thermal control of the SIP components with narrow temperature tolerances. A thermal model of the SIP and a concept for cooling the SIP cameras are presented. The model and cooling concept have established a rationale for determining a Phase A baseline for SIP thermal control.

Gene Expression Correlated with Severe Asthma Characteristics Reveals Heterogeneous Mechanisms of Severe Disease

PubMed Central

Modena, Brian D.; Bleecker, Eugene R.; Busse, William W.; Erzurum, Serpil C.; Gaston, Benjamin M.; Jarjour, Nizar N.; Meyers, Deborah A.; Milosevic, Jadranka; Tedrow, John R.; Wu, Wei; Kaminski, Naftali

2017-01-01

Rationale: Severe asthma (SA) is a heterogeneous disease with multiple molecular mechanisms. Gene expression studies of bronchial epithelial cells in individuals with asthma have provided biological insight and underscored possible mechanistic differences between individuals. Objectives: Identify networks of genes reflective of underlying biological processes that define SA. Methods: Airway epithelial cell gene expression from 155 subjects with asthma and healthy control subjects in the Severe Asthma Research Program was analyzed by weighted gene coexpression network analysis to identify gene networks and profiles associated with SA and its specific characteristics (i.e., pulmonary function tests, quality of life scores, urgent healthcare use, and steroid use), which potentially identified underlying biological processes. A linear model analysis confirmed these findings while adjusting for potential confounders. Measurements and Main Results: Weighted gene coexpression network analysis constructed 64 gene network modules, including modules corresponding to T1 and T2 inflammation, neuronal function, cilia, epithelial growth, and repair mechanisms. Although no network selectively identified SA, genes in modules linked to epithelial growth and repair and neuronal function were markedly decreased in SA. Several hub genes of the epithelial growth and repair module were found located at the 17q12–21 locus, near a well-known asthma susceptibility locus. T2 genes increased with severity in those treated with corticosteroids but were also elevated in untreated, mild-to-moderate disease compared with healthy control subjects. T1 inflammation, especially when associated with increased T2 gene expression, was elevated in a subgroup of younger patients with SA. Conclusions: In this hypothesis-generating analysis, gene expression networks in relation to asthma severity provided potentially new insight into biological mechanisms associated with the development of SA and its phenotypes. PMID:27984699

Personality Correlates of Continuation and Outcome in Meditation and Erect Sitting Control Treatments.

ERIC Educational Resources Information Center

Smith, Jonathan C.

1978-01-01

Anxious college students were assigned to transcendental meditation (TM) and a control treatment. Demographic and pretest personality variables were correlated with continuation in treatment. The TM dropout was more disturbed and less self-critical than the person who continued. Differing treatment rationales rendered the treatments effective for…

Real-time support for high performance aircraft operation

NASA Technical Reports Server (NTRS)

Vidal, Jacques J.

1989-01-01

The feasibility of real-time processing schemes using artificial neural networks (ANNs) is investigated. A rationale for digital neural nets is presented and a general processor architecture for control applications is illustrated. Research results on ANN structures for real-time applications are given. Research results on ANN algorithms for real-time control are also shown.

Determining volume sensitive waters in Beaufort County, SC tidal creeks

Treesearch

Andrew Tweel; Denise Sanger; Anne Blair; John Leffler

2016-01-01

Non-point source pollution from stormwater runoff associated with large-scale land use changes threatens the integrity of ecologically and economically valuable estuarine ecosystems. Beaufort County, SC implemented volume-based stormwater regulations on the rationale that if volume discharge is controlled, contaminant loading will also be controlled.

A Tutorial on Multiple Testing: False Discovery Control

NASA Astrophysics Data System (ADS)

Chatelain, F.

2016-09-01

This paper presents an overview of criteria and methods in multiple testing, with an emphasis on the false discovery rate control. The popular Benjamini and Hochberg procedure is described. The rationale for this approach is explained through a simple Bayesian interpretation. Some state-of-the-art variations and extensions are also presented.

75 FR 34726 - Energy Conservation Program for Consumer Products: Notice of Petition for Waiver of LG...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... relative humidity sensors and adaptive control anti-sweat heaters. The rationale for granting these waivers is equally applicable to LG, which has products containing similar relative humidity sensors and anti... humidity sensors and adaptive control anti-sweat heaters. Therefore, it is ordered that: The application...

Vitamin D and Cancer Prevention

MedlinePlus

... D and OmegA-3 TriaL (VITAL): rationale and design of a large randomized controlled trial of vitamin ... the National Cancer Institute.” Please note that blog posts that are written by individuals from outside the ...

Internet-based intervention programme for obese adolescents and their families (Next.Step): research protocol of a controlled trial.

PubMed

Sousa, Pedro; Fonseca, Helena; Gaspar, Pedro; Gaspar, Filomena

2014-04-01

This paper describes the design and rationale of a controlled trial that aims to determine the effectiveness of an intervention programme in which the internet is used. Adolescent obesity is a major health problem, there being urgency to find effective interventions that induce behavioural change. The inclusion of the internet in the intervention may improve adolescents' adherence to the weight management programme and lead to adoption of healthier lifestyles. A clinical trial with a control group (non-randomized). Participants are adolescents with appointments at a paediatric obesity clinic (Portugal). Sample size was calculated according to the power analysis. The experimental group will follow the standard treatment protocol and receive free access to the e-therapeutic platform. The control group will follow the standard treatment protocol and join a waiting list. Intervention length will be 36 weeks (24 weeks of direct intervention with a follow-up for 12 weeks). This study was approved by the Ethical Committee for Health (Lisbon, Portugal) in January 2012 and funded by the Foundation for Science and Technology (Portugal) in December 2012. The results of this research will promote reflection on new approaches directed to treat adolescent obesity and on the promotion of healthy behaviours. We expect to gather empirical evidence of the intervention programme effectiveness. The expectations lie on the population health gains, empowerment in decision-making and adoption of healthier lifestyles. © 2013 John Wiley & Sons Ltd.

Effects of metformin, buformin, and phenformin on the post-initiation stage of chemically induced mammary carcinogenesis in the rat.

PubMed

Zhu, Zongjian; Jiang, Weiqin; Thompson, Matthew D; Echeverria, Dimas; McGinley, John N; Thompson, Henry J

2015-06-01

Metformin is a widely prescribed drug for the treatment of type II diabetes. Although epidemiologic data have provided a strong rationale for investigating the potential of this biguanide for use in cancer prevention and control, uncertainty exists whether metformin should be expected to have an impact in nondiabetic patients. Furthermore, little attention has been given to the possibility that other biguanides may have anticancer activity. In this study, the effects of clinically relevant doses of metformin (9.3 mmol/kg diet), buformin (7.6 mmol/kg diet), and phenformin (5.0 mmol/kg diet) were compared with rats fed control diet (AIN93-G) during the post-initiation stage of 1-methyl-1-nitrosourea-induced (50 mg/kg body weight) mammary carcinogenesis (n = 30/group). Plasma, liver, skeletal muscle, visceral fat, mammary gland, and mammary carcinoma concentrations of the biguanides were determined. In comparison with the control group, buformin decreased cancer incidence, multiplicity, and burden, whereas metformin and phenformin had no statistically significant effect on the carcinogenic process relative to the control group. Buformin did not alter fasting plasma glucose or insulin. Within mammary carcinomas, evidence was obtained that buformin treatment perturbed signaling pathways related to energy sensing. However, further investigation is needed to determine the relative contributions of host systemic and cell autonomous mechanisms to the anticancer activity of biguanides such as buformin. ©2015 American Association for Cancer Research.

Extracorporeal blood purification therapy for sepsis and systemic inflammation: its biological rationale.

PubMed

Bellomo, R; Baldwin, I; Ronco, C

2001-01-01

EBPTs represent a promising new approach to the adjuvant treatment of severe sepsis, septic shock and MODS. Their technology is rapidly evolving and pilot animal and human studies are now taking place to prepare the territory for the first large randomized controlled trial. The rationale for EBPT is reasonable and the initial data are encouraging. The correct technology and molecular targeting, however, are still being explored. Once the best technology has been determined, it is likely that phase II and phase III trials will be performed to test the hypothesis that these therapies can indeed alter mortality in severe inflammatory multiorgan dysfunction.

The Colorado LEAP study: rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program

PubMed Central

2013-01-01

Background The preschool years are a critical window for obesity prevention efforts; representing a time when children establish healthy eating habits and physical activity patterns. Understanding the context in which these behaviors develop is critical to formulating a model to address childhood obesity. The Colorado LEAP Study, an intervention study designed to prevent early childhood obesity, utilizes a social ecological approach to explore individual, family and environmental factors and their relationship to child weight status over a 3 year timeframe. Methods The study is located in 5 rural Colorado preschool centers and elementary schools (2 treatment and 3 control). Treatment sites receive The Food Friends® nutrition (12 weeks) and physical activity (18 weeks) interventions during preschool. Observational measures assess 3 layers of the social ecological model including individual, family and organizational inputs. Children’s food preferences, food intake, gross motor skills, physical activity (pedometers/accelerometers), cognitive, physical and social self-competence and height/weight are collected. Parents provide information on feeding and activity practices, child’s diet, oral sensory characteristics, food neophobia, home food and activity environment, height/weight and physical activity (pedometers). School personnel complete a school environment and policy assessment. Measurements are conducted with 3 cohorts at 4 time points – baseline, post-intervention, 1- and 2-year follow-up. Discussion The design of this study allows for longitudinal exploration of relationships among eating habits, physical activity patterns, and weight status within and across spheres of the social ecological model. These methods advance traditional study designs by allowing not only for interaction among spheres but predictively across time. Further, the recruitment strategy includes both boys and girls from ethnic minority populations in rural areas and will provide insights into obesity prevention effects on these at risk populations. Trial registration ClinicalTrials.gov: NCT01937481. PMID:24321701

Iontophoresis: A Potential Emergence of a Transdermal Drug Delivery System

PubMed Central

Dhote, Vinod; Bhatnagar, Punit; Mishra, Pradyumna K.; Mahajan, Suresh C.; Mishra, Dinesh K.

2012-01-01

The delivery of drugs into systemic circulation via skin has generated much attention during the last decade. Transdermal therapeutic systems propound controlled release of active ingredients through the skin and into the systemic circulation in a predictive manner. Drugs administered through these systems escape first-pass metabolism and maintain a steady state scenario similar to a continuous intravenous infusion for up to several days. However, the excellent impervious nature of the skin offers the greatest challenge for successful delivery of drug molecules by utilizing the concepts of iontophoresis. The present review deals with the principles and the recent innovations in the field of iontophoretic drug delivery system together with factors affecting the system. This delivery system utilizes electric current as a driving force for permeation of ionic and non-ionic medications. The rationale behind using this technique is to reversibly alter the barrier properties of skin, which could possibly improve the penetration of drugs such as proteins, peptides and other macromolecules to increase the systemic delivery of high molecular weight compounds with controlled input kinetics and minimum inter-subject variability. Although iontophoresis seems to be an ideal candidate to overcome the limitations associated with the delivery of ionic drugs, further extrapolation of this technique is imperative for translational utility and mass human application. PMID:22396901

Joint HVAC transmission EMF environmental study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stormshak, F.; Thompson, J.

1992-05-01

This document describes the rationale, procedures, and results of a carefully controlled study conducted to establish whether chronic exposure of female (ewe) Suffolk lambs to the environment of a 500-kV 60-Hz transmission line would affect various characteristics of growth, endocrine function, and reproductive development. This experiment used identical housing and management schemes for control and line-exposed ewes, thus minimizing these factors as contributors to between-group experimental error. Further, throughout the 10-month duration of this study, changes in electric and magnetic fields, audible noise, and weather conditions were monitored continuously by a computerized system. Such measurements provided the opportunity to identifymore » any relationship between environmental factors and biological responses. Because of reports in the literature that electric and magnetic fields alter concentrations of melatonin in laboratory animals, the primary objective of this study was to ascertain whether a similar effect occurs in lambs exposed to a 500-kV a-c line in a natural setting. In addition, onset of puberty, changes in body weight, wool growth, and behavior were monitored. To determine whether the environment of a 500-kV line caused stress in the study animals, serum levels of cortisol were measured. The study was conducted at Bonneville Power Administration's Ostrander Substation near Estacada, Oregon.« less

Joint HVAC Transmission EMF Environmental Study : Final Report on Experiment 1.

DOE Office of Scientific and Technical Information (OSTI.GOV)

United States. Bonneville Power Administration; Oregon Regional Primate Research Center

1992-05-01

This document describes the rationale, procedures, and results of a carefully controlled study conducted to establish whether chronic exposure of female (ewe) Suffolk lambs to the environment of a 500-kV 60-Hz transmission line would affect various characteristics of growth, endocrine function, and reproductive development. This experiment used identical housing and management schemes for control and line-exposed ewes, thus minimizing these factors as contributors to between-group experimental error. Further, throughout the 10-month duration of this study, changes in electric and magnetic fields, audible noise, and weather conditions were monitored continuously by a computerized system. Such measurements provided the opportunity to identifymore » any relationship between environmental factors and biological responses. Because of reports in the literature that electric and magnetic fields alter concentrations of melatonin in laboratory animals, the primary objective of this study was to ascertain whether a similar effect occurs in lambs exposed to a 500-kV a-c line in a natural setting. In addition, onset of puberty, changes in body weight, wool growth, and behavior were monitored. To determine whether the environment of a 500-kV line caused stress in the study animals, serum levels of cortisol were measured. The study was conducted at Bonneville Power Administration`s Ostrander Substation near Estacada, Oregon.« less

Cargo Movement Operations System (CMOS) Final Software Design Document, Change 01, Increment I

DTIC Science & Technology

1991-03-22

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SDDl-0002 PROGRAM OFFICE...COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SDDl-0003 PROGRAM OFFICE CONTROL NUMBER: DATA...CARMODE and SURRTG. RATIONALE: Request clarification of these deletions. CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [

Cargo Movement Operations System (CMOS) Computer System Operator’s Manual. Draft

DTIC Science & Technology

1990-06-27

are arranged in page number order. RATIONALE: N/A CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION...ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMEN7 STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: CSOM-0003 PROGRAM OFFICE CONTROL...ACCEPTS COMMENT: YES [ ] NO ( 3 ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ 3 ORIGINATOR CONTROL NUMBER

Pragmatic cluster randomised trial of a free telephone-based health coaching program to support women in managing weight gain during pregnancy: the Get Healthy in Pregnancy Trial.

PubMed

Clements, Vanessa; Leung, Kit; Khanal, Santosh; Raymond, Jane; Maxwell, Michelle; Rissel, Chris

2016-08-30

Excessive gestational weight gain can result in poor maternal and child health outcomes. Estimates from single studies indicate the prevalence of excessive gestational weight gain in Australia could lie between 38 and 67 %. The risk of excessive weight gain can be reduced through healthy eating and exercise. We describe the rationale and methods of the Get Healthy in Pregnancy Service, a trial service which aims to support women in achieving appropriate gestational weight gain through an existing telephone-based health coaching service. This study aims to compare the effectiveness of a telephone-based health coaching program versus provision of information only in supporting pregnant women to achieve appropriate gestational weight gain. A pragmatic stratified clustered randomised controlled trial will be conducted with 710 women who present to 5 hospitals for their first antenatal appointment during the recruitment period (6-8 months), have a pre-pregnancy body mass index (BMI) ≥ 18.50 (healthy weight or above), are 18 years and over, singleton gestation, English speaking, have no pre-existing medical conditions that may limit their ability to exercise or require a restricted diet and are 18 weeks or less gestation. Hospitals will be randomised into one of two intervention models: a) information only; or b) information plus 10 telephone-based health coaching sessions with a university qualified coach. Both interventions will set a weight-range target with pregnant women. The women attending antenatal clinics at participating hospitals will be screened at their initial hospital appointment to assess their eligibility. Women recruited to the trial will have a number of measures recorded including anthropometrics (self-reported height and weight) and dietary and physical activity scores during and following pregnancy. These measurements will be collected at baseline (prior to 18 weeks gestation), 36 weeks gestation and 12 months post-birth. This study responds to a need for an effective intervention that targets excessive gestational weight gain at a population level. This study investigates the potential for an innovative intervention combining two existing services; a free state-wide telephone-based health coaching service and hospital-based antenatal care to support pregnant women to achieve healthy weight gain during pregnancy. The use of existing services provides the potential for immediate post-study implementation. While the impacts of telephone-based lifestyle programmes have been tested in a number of settings, there are few studies which evaluate the effectiveness and acceptability of telephone support in achieving healthy gestational weight gain in association with routine antenatal care. ACTRN12615000397516 (Registration date: 26 June 2014, retrospectively registered).

Does the addition of visceral manipulation improve outcomes for patients with low back pain? Rationale and study protocol.

PubMed

Panagopoulos, John; Hancock, Mark; Ferreira, Paulo

2013-07-01

There has been no randomised controlled trial conducted to investigate the effectiveness of visceral manipulation (VM) for the treatment of low back pain (LBP). The primary aim of this study would be to investigate whether the addition of VM, to a standard physiotherapy treatment regimen, improves pain 6 weeks post treatment commencement in people with LBP. Secondary aims would be to examine the effect of VM on disability and functional outcomes at 2, 6 and 52 weeks post-treatment commencement and pain at 2 and 52 weeks. This paper describes the rationale and design of a randomised controlled trial investigating the addition of VM to a standard physiotherapy treatment algorithm which includes manual therapy, specific exercise and functional exercise prescription. Analysis of data would be carried out by a statistician blinded to group allocation and by intention-to-treat. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Cluster-Randomized Trial of Restorative Practices: An Illustration to Spur High-Quality Research and Evaluation

PubMed Central

Acosta, Joie D.; Chinman, Matthew; Ebener, Patricia; Phillips, Andrea; Xenakis, Lea; Malone, Patrick S.

2017-01-01

Restorative Practices in schools lack rigorous evaluation studies. As an example of rigorous school-based research, this paper describes the first randomized control trial of restorative practices to date, the Study of Restorative Practices. It is a 5-year, cluster-randomized controlled trial (RCT) of the Restorative Practices Intervention (RPI) in 14 middle schools in Maine to assess whether RPI impacts both positive developmental outcomes and problem behaviors and whether the effects persist during the transition from middle to high school. The two-year RPI intervention began in the 2014–2015 school year. The study’s rationale and theoretical concerns are discussed along with methodological concerns including teacher professional development. The theoretical rationale and description of the methods from this study may be useful to others conducting rigorous research and evaluation in this area. PMID:28936104

Effectiveness and implementation of an obesity prevention intervention: the HeLP-her Rural cluster randomised controlled trial.

PubMed

Lombard, Catherine B; Harrison, Cheryce L; Kozica, Samantha L; Zoungas, Sophia; Keating, Catherine; Teede, Helena J

2014-06-16

To impact on the obesity epidemic, interventions that prevent weight gain across populations are urgently needed. However, even the most efficacious interventions will have little impact on obesity prevention unless they are successfully implemented in diverse populations and settings. Implementation research takes isolated efficacy studies into practice and policy and is particularly important in obesity prevention where there is an urgent need to accelerate the evidence to practice cycle. Despite the recognised need, few obesity prevention interventions have been implemented in real life settings and to our knowledge rarely target rural communities. Here we describe the rationale, design and implementation of a Healthy Lifestyle Program for women living in small rural communities (HeLP-her Rural). The primary goal of HeLP-her Rural is to prevent weight gain using a low intensity, self-management intervention. Six hundred women from 42 small rural communities in Australia will be randomised as clusters (n-21 control towns and n = 21 intervention towns). A pragmatic randomised controlled trial methodology will test efficacy and a comprehensive mixed methods community evaluation and cost analysis will inform effectiveness and implementation of this novel prevention program. Implementing population interventions to prevent obesity is complex, costly and challenging. To address these barriers, evidence based interventions need to move beyond isolated efficacy trials and report outcomes related to effectiveness and implementation. Large pragmatic trials provide an opportunity to inform both effectiveness and implementation leading to potential for greater impact at the population level. Pragmatic trials should incorporate both effectiveness and implementation outcomes and a multidimensional methodology to inform scale-up to population level. The learnings from this trial will impact on the design and implementation of population obesity prevention strategies nationally and internationally. ANZ clinical trial registry ACTRN12612000115831. Date of registration 24/01/2012.

Endothelial Dysfunction in the Microcirculation of Patients with Obstructive Sleep Apnea

PubMed Central

Patt, Brian T.; Jarjoura, David; Haddad, Diane N.; Sen, Chandan K.; Roy, Sashwati; Flavahan, Nicholas A.; Khayat, Rami N.

2010-01-01

Rationale: Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease. We hypothesized that patients with OSA and no cardiovascular disease have oxidant-related microcirculatory endothelial dysfunction. Objectives: To evaluate the microcirculation in OSA. Methods: This study included seven patients with OSA and seven age- and weight-matched control subjects (mean age, 38 yr; mean body mass index, 32.5 kg/m2). All participants were free of cardiovascular risk factors. Participants received measurement of brachial artery flow-mediated dilation and forearm subcutaneous biopsy. Patients underwent repeated tests 12 weeks after treatment. Microcirculatory endothelial cells were isolated, and immunohistochemistry staining for peroxynitrite in the microcirculation was performed. Measurements and Main Results: Flow-mediated dilation was lower in patients than in control subjects at baseline (mean ± SEM: 5.7 ± 0.5 vs. 9.5 ± 0.6; P = 0.02) and increased after treatment (5.7–7.3; change, 1.7 ± 0.6; P = 0.04). Microcirculatory peroxynitrite deposit was higher in patients compared with control subjects (44.0 ± 1.6 vs. 21.8 ± 1.9 stain density units; P < 0.001) and decreased after treatment from 44.0 to 30.5 stain density units (change, −13.5 ± 2.9; P = 0.009). In patients, transcription of endothelial nitric oxide synthase decreased from 5.2 to −1.3 after treatment (change, 6.5 ± 2.5; P = 0.05), and transcription of superoxide dismutase1 decreased from −4.0 to −12.3 after treatment (change, −8.3 ± 2.1; P = 0.01). These changes persisted after adjustment for weight and underlying severity of OSA. Conclusions: This is the first direct evaluation of the microcirculation in OSA. Patients with OSA with low cardiovascular risk status had increased oxidant production in the microcirculation and endothelial dysfunction, both of which improved with treatment. Endothelial nitric oxide synthase transcription decreased with treatment. PMID:20656942

Aqueous calyxes extract of Roselle or Hibiscus sabdariffa Linn supplementation improves liver morphology in streptozotocin induced diabetic rats.

PubMed

Nazratun Nafizah, Akhtar Husin; Budin, Siti Balkis; Zaryantey, Abd Hamid; Mariati, Abd Rahman; Santhana, Raj Louis; Osman, Mohamad; Muhd Hanis, Md Idris; Jamaludin, Mohamed

2017-03-01

The complex series of deleterious events among diabetes patients leads to multiple organ failure. Therefore, a holistic approach of treatment is urgently required to prevent worsening of complications. The present investigation was carried out to study the possible protective effects of Roselle or Hibiscus sabdariffa Linn (HSL) calyxes aqueous extract, as an antidiabetic and antioxidant agent against oxidative liver injury in streptozotocin-induced diabetic rats. A single dose of streptozotocin (45mg/kg body weight, iv) was used to induced diabetes in male Sprague Dawley rats which were then divided into two groups: Diabetic control (DC) and HSL-treated diabetic (DR) group. Normal rats were divided into normal control (NC), HSL-treated control (NR). Aqueous calyxes extract of HSL (100mg/kg/day, orally) was given for 28 consecutive days in the treated group. Weight, biochemical and histopathological (light and electron microscopic) parameters were compared in all groups. Supplementation of HSL significantly lowered the level of fasting blood glucose and increased plasma insulin level in DR group compared to DC group (p<0.05). Alanine aminotransaminases and aspartate aminotransferase enzymes level were found to be significantly reduced in DR compared to DC. Microscopic examination demonstrated destruction of the liver architecture, cytoplasmic vacuolation of the hepatocytes and signs of necrosis in diabetic rats. Moreover, dilatation and congestion of blood vessels with leucocytes adherence were detected. Ultrastructural study using electron microscope showed homogeneous substance accumulation in nuclear chromatin, a decrease of organelles and mitochondrial degeneration in the diabetic rats. Administration of HSL in diabetic rats causes significant decrease in hepatocyte destruction and prevented the changes associated with the diabetic condition. Thus, our findings provide a scientific rationale for the use of HSL as promising agent in preventing liver injury in diabetes. Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Nutritional risk in allogeneic stem cell transplantation: rationale for a tailored nutritional pathway.

PubMed

Aoyama, Takashi; Imataki, Osamu; Mori, Keita; Yoshitsugu, Kanako; Fukaya, Masafumi; Okamura, Ikue; Enami, Terukazu; Tatara, Raine; Ikeda, Takashi

2017-04-01

Hematopoietic stem cell transplantation carries nutrition-related risks. Therefore, nutritional therapy needs to be initiated before transplantation even takes place. We assessed nutritional risk among patients who underwent allogeneic stem cell transplantation. We assessed nutrient supply (calorie supply and protein supply) by chart review. Assessments were made from the pretreatment phase of transplantation to after the end of parenteral nutrition in 51 patients who underwent allogeneic stem cell transplantation at Shizuoka Cancer Center between 2007 and 2012. We compared nutrition-related adverse events and parameters between two groups: those in whom % loss of body weight was ≥7.5 and those in whom % loss of body weight was <7.5. A correlation was observed between changes in weight and skeletal muscle mass (r = 0.89; P < 0.0001). A weak correlation was observed between % loss of body weight and nutrient supply of calories (r = 0.517; P = 0.0001). There were significant differences between the % loss of body weight ≥7.5 group and the % loss of body weight <7.5 group in the following variables: % loss of body weight, nutrient supply from calories and protein; orally ingested nutrient supply from calories and protein; start day of oral intake; and acute graft-versus-host disease. Orally ingested calories were negatively correlated with nutrition-related adverse events in both groups. Early and customized nutritional intervention may be optimal for all patients who undergo allogeneic stem cell transplantation to ameliorate body weight loss associated with nutrition-related adverse events.

Discrimination and Excessive Weight Gain During Pregnancy Among Black and Latina Young Women

PubMed Central

Reid, Allecia E.; Rosenthal, Lisa; Earnshaw, Valerie A.; Lewis, Tené T.; Lewis, Jessica B.; Stasko, Emily C.; Tobin, Jonathan N.; Ickovics, Jeannette R.

2016-01-01

Rationale Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women. PMID:27038321

78 FR 21172 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... design Subscriber Entitlement Controls to produce an audit report and make each audit report available to... manages its own non-display infrastructure and controls the access to and permissioning of the market data... proposed non-display fees); (3) the rationale for creating a new non- display usage fee structure; (4) the...

Multiple Memory Stores and Operant Conditioning: A Rationale for Memory's Complexity

ERIC Educational Resources Information Center

Meeter, Martijn; Veldkamp, Rob; Jin, Yaochu

2009-01-01

Why does the brain contain more than one memory system? Genetic algorithms can play a role in elucidating this question. Here, model animals were constructed containing a dorsal striatal layer that controlled actions, and a ventral striatal layer that controlled a dopaminergic learning signal. Both layers could gain access to three modeled memory…

Ultimate intrinsic-coercivity samarium-cobalt magnet: An Earth-based feasibility study for space-shuttle missions. [containerless melts

NASA Technical Reports Server (NTRS)

Das, D. K.; Kumar, K.; Frost, R. T.; Chang, C. W.

1980-01-01

Techniques for containerless melting and solidification of the samarium-cobalt alloy without excessive oxidation were developed. The rationale for extending these experiments in a weightless environment is also discussed. The effect of oxygen content from 0.15 to 0.63 weight percent and grain size in the range of 2 to 10 micrometers has been examined on arc-plasma-sprayed SmCo5 magnets. Contrary to expectations, the larger grain sizes tended to improve the coercivities. This was attributed to an increase in homogeneity resulting from higher temperature treatments used to produce larger grain size. No significant differences in coercivity were observed on the basis of oxygen content in the range examined. It is expected that more meaningful data on the relationship between oxygen content and coercivity will be seen when the oxygen content can be lowered to less than 0.1 weight percent.

The design and synthesis of new synthetic low molecular weight heparins

PubMed Central

Chandarajoti, K.; Liu, J.; Pawlinski, R.

2016-01-01

Low molecular weight heparins (LMWH) have remained the most favorable form of heparin in clinics since 1990s’ owing to its predictable pharmacokinetic properties. However, LMWH is mainly eliminated through kidney, thus limits its use in renal-impaired patients. In addition, the anticoagulant activity of LMWH is only partially neutralized by protamine. LMWH is obtained from a full-length, highly sulfated polysaccharide harvested from porcine mucosal tissue. The depolymerization involved in LMWH production generates a broad size distribution of LMWH fragments (6-22 sugar residues). This, combined with the various methods used to produce commercial LMWHs, result in variable pharmacological and pharmacokinetic properties. An alternative, chemoenzymatic approach offers a method for the synthesis of LMWH that has the potential to overcome the limitations of current LMWHs. This review summarizes the application of a chemoenzymatic approach to generate LMWH and the rationale for development of a synthetic LMWH. PMID:26990516

The design and synthesis of new synthetic low-molecular-weight heparins.

PubMed

Chandarajoti, K; Liu, J; Pawlinski, R

2016-06-01

Low-molecular-weight heparin (LMWH) has remained the most favorable form of heparin in clinics since the 1990s owing to its predictable pharmacokinetic properties. However, LMWH is mainly eliminated through the kidney, which limits its use in renal-impaired patients. In addition, the anticoagulant activity of LMWH is only partially neutralized by protamine. LMWH is obtained from a full-length, highly sulfated polysaccharide harvested from porcine mucosal tissue. The depolymerization involved in LMWH production generates a broad distribution of LMWH fragments (6-22 sugar residues). This, combined with the various methods used to produce commercial LMWHs, results in variable pharmacological and pharmacokinetic properties. An alternative chemoenzymatic approach offers a method for the synthesis of LMWH that has the potential to overcome the limitations of current LMWHs. This review summarizes the application of a chemoenzymatic approach to generate LMWH and the rationale for development of a synthetic LMWH. © 2016 International Society on Thrombosis and Haemostasis.

Can the use of creatine supplementation attenuate muscle loss in cachexia and wasting?

PubMed

Sakkas, Giorgos K; Schambelan, Morris; Mulligan, Kathleen

2009-11-01

Weight loss and low BMI due to an underlying illness have been associated with increased mortality, reduced functional capacity, and diminished quality of life. There is a need for well tolerated, long-term approaches to maintain body weight in patients with cachexia or wasting. The purpose of this review is to highlight the scientific and clinical evidence derived from the recent literature investigating the rationale for and potential medical use of creatine supplementation in patients with cachexia or wasting. Some studies have demonstrated that supplementation with creatine can increase creatine reserves in skeletal muscle and increase muscle mass and performance in various disease states that affect muscle size and function. The mechanisms underlying these effects are not clear. It has been suggested that creatine supplementation may increase intramuscular phosphocreatine stores and promote more rapid recovery of adenosine triphosphate levels following exercise, thus allowing users to exercise for longer periods or at higher intensity levels. Other hypothesized mechanisms include attenuation of proinflammatory cytokines, stimulation of satellite cell proliferation and upregulation of genes that promote protein synthesis and cell repair. Creatine is a generally well tolerated, low-cost, over-the-counter nutritional supplement that shows potential in improving lean body mass and functionality in patients with wasting diseases. However, placebo-controlled studies have shown variable effects, with improvements in some and not in others. Additional studies with longer follow-up are required to identify the populations that might benefit most from creatine supplementation.

Illinois Manufacturing Technology Curriculum.

ERIC Educational Resources Information Center

Cliffe, Roger; And Others

This manufacturing technology curriculum involves students in learning problem-solving, communication, team building, quality control, safety, math, science, and technical skills. The document begins with a section on implementation, which gives background information on the purposes and development of the curriculum, explains its rationale,…

ATRAZINE AND REPRODUCTIVE FUNCTION: MODE AND MECHANISM OF ACTION STUDIES

EPA Science Inventory

Atrazine, a chlorotriazine herbicide, is used to control annual grasses and broadleaf weeds. In this review, we summarize our laboratory's work evaluating the neuroendocrine toxicity of atrazine (and related chlorotriazines) from an historic perspective. We provide the rationale ...

Rationale and design of a comparative effectiveness trial to prevent type 2 diabetes in mothers and children: the ENCOURAGE healthy families study.

PubMed

Hannon, Tamara S; Carroll, Aaron E; Palmer, Kelly N; Saha, Chandan; Childers, Wendy K; Marrero, David G

2015-01-01

The number of youth with type 2 diabetes (T2D) is expected to quadruple over 4 decades. Gestational diabetes mellitus (GDM) is also increasing and is linked with development of T2D in women, and greater risk for T2D in adolescents exposed to GDM. Despite the increasing prevalence of T2D, approaches to prevent diabetes in high-risk youth and families are rare. To address this, we are conducting the Encourage Health Families Study (ENCOURAGE). This is a randomized trial evaluating the comparative effectiveness and costs of an adaptation of the Diabetes Prevention Program (DPP) directed at mothers who had GDM or prediabetes and their children. The intervention is a group-based lifestyle program which we developed and implemented in partnership with the YMCA. We are comparing the ENCOURAGE intervention targeted to 1) mothers who have had GDM or prediabetes, and 2) mothers who have had GDM or prediabetes along with their school-aged children. This manuscript provides 1) the rationale for a targeted approach to preventing T2D and the interventions, 2) description of the translation of the DPP curriculum, and 3) the study design and methodology. The primary aims are to determine if participation leads to 1) weight loss in high-risk mothers, and 2) youth having healthier weights and lifestyle habits. We will also evaluate costs associated with each approach. These data are essential to build a translation model of T2D prevention that is both realistic and feasible to address this growing problem in both youth and adults. Copyright © 2014 Elsevier Inc. All rights reserved.

Investigating methotrexate toxicity within a randomized double-blinded, placebo-controlled trial: rationale and design of the Cardiovascular Inflammation Reduction Trial-Adverse Events (CIRT-AE) Study

USDA-ARS?s Scientific Manuscript database

Background: The role of low dose methotrexate (LDM) in potential serious toxicities remains unclear despite its common use. Prior observational studies investigating LDM toxicity compared LDM to other active drugs. Prior placebo-controlled clinical trials of LDM in inflammatory conditions were not l...

Cargo Movement Operations System (CMOS). Software Design Document

DTIC Science & Technology

1990-04-29

order. RATIONALE: N/A CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: ACCEPT [ ] REJECT [ ] COMMENT...inadvertently omitted from the table. CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN...YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SDDI-0005 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM

Rationales for Commonly "Challenged" Taught Books.

ERIC Educational Resources Information Center

Shugert, Diane P., Ed.; And Others

1983-01-01

Intended for teachers, this focused journal issue contains separate rationales for teaching books that have been challenged as appropriate instructional materials. Following a discussion of the purpose for rationales and suggestions for using them, the journal presents rationales for teaching the following books: "To Kill a Mockingbird,""The Diary…

Understanding the Anatomic Basis for Obstructive Sleep Apnea Syndrome in Adolescents

PubMed Central

Kim, Christopher; Bagchi, Sheila; Keenan, Brendan T.; Comyn, François-Louis; Wang, Stephen; Tapia, Ignacio E.; Huang, Shirley; Traylor, Joel; Torigian, Drew A.; Bradford, Ruth M.; Marcus, Carole L.

2015-01-01

Rationale: Structural risk factors for obstructive sleep apnea syndrome (OSAS) in adolescents have not been well characterized. Because many adolescents with OSAS are obese, we hypothesized that the anatomic OSAS risk factors would be more similar to those in adults than those in children. Objectives: To investigate the anatomic risk factors in adolescents with OSAS compared with obese and lean control subjects using magnetic resonance imaging (MRI). Methods: Three groups of adolescents (age range: 12–16 yr) underwent MRI: obese individuals with OSAS (n = 49), obese control subjects (n = 38), and lean control subjects (n = 50). Measurements and Main Results: We studied 137 subjects and found that (1) obese adolescents with OSAS had increased adenotonsillar tissue compared with obese and lean control subjects; (2) obese OSAS adolescents had a smaller nasopharyngeal airway than control subjects; (3) the size of other upper airway soft tissue structures (volume of the tongue, parapharyngeal fat pads, lateral walls, and soft palate) was similar between subjects with OSAS and obese control subjects; (4) although there were no major craniofacial abnormalities in most of the adolescents with OSAS, the ratio of soft tissue to craniofacial space surrounding the airway was increased; and (5) there were sex differences in the pattern of lymphoid proliferation. Conclusions: Increased size of the pharyngeal lymphoid tissue, rather than enlargement of the upper airway soft tissue structures, is the primary anatomic risk factor for OSAS in obese adolescents. These results are important for clinical decision making and suggest that adenotonsillectomy should be considered as the initial treatment for OSAS in obese adolescents, a group that has poor continuous positive airway pressure adherence and difficulty in achieving weight loss. PMID:25835282

A shuttle and space station manipulator system for assembly, docking, maintenance, cargo handling and spacecraft retrieval (preliminary design). Volume 2: Concept development and selection

NASA Technical Reports Server (NTRS)

1972-01-01

The overall program background, the various system concepts considered, and the rationale for the selected design are described. The concepts for each subsystem are also described and compared. Details are given for the requirements, boom configuration and dynamics, actuators, man/machine interface and control, visual system, control system, environmental control and life support, data processing, and materials.

Dynamic Energy Balance: An Integrated Framework for Discussing Diet and Physical Activity in Obesity Prevention—Is it More than Eating Less and Exercising More?

PubMed Central

Manore, Melinda M.; Larson-Meyer, D. Enette; Lindsay, Anne R.; Hongu, Nobuko; Houtkooper, Linda

2017-01-01

Understanding the dynamic nature of energy balance, and the interrelated and synergistic roles of diet and physical activity (PA) on body weight, will enable nutrition educators to be more effective in implementing obesity prevention education. Although most educators recognize that diet and PA are important for weight management, they may not fully understand their impact on energy flux and how diet alters energy expenditure and energy expenditure alters diet. Many nutrition educators have little training in exercise science; thus, they may not have the knowledge essential to understanding the benefits of PA for health or weight management beyond burning calories. This paper highlights the importance of advancing nutrition educators’ understanding about PA, and its synergistic role with diet, and the value of incorporating a dynamic energy balance approach into obesity-prevention programs. Five key points are highlighted: (1) the concept of dynamic vs. static energy balance; (2) the role of PA in weight management; (3) the role of PA in appetite regulation; (4) the concept of energy flux; and (5) the integration of dynamic energy balance into obesity prevention programs. The rationale for the importance of understanding the physiological relationship between PA and diet for effective obesity prevention programming is also reviewed. PMID:28825615

Dynamic Energy Balance: An Integrated Framework for Discussing Diet and Physical Activity in Obesity Prevention-Is it More than Eating Less and Exercising More?

PubMed

Manore, Melinda M; Larson-Meyer, D Enette; Lindsay, Anne R; Hongu, Nobuko; Houtkooper, Linda

2017-08-19

Understanding the dynamic nature of energy balance, and the interrelated and synergistic roles of diet and physical activity (PA) on body weight, will enable nutrition educators to be more effective in implementing obesity prevention education. Although most educators recognize that diet and PA are important for weight management, they may not fully understand their impact on energy flux and how diet alters energy expenditure and energy expenditure alters diet. Many nutrition educators have little training in exercise science; thus, they may not have the knowledge essential to understanding the benefits of PA for health or weight management beyond burning calories. This paper highlights the importance of advancing nutrition educators' understanding about PA, and its synergistic role with diet, and the value of incorporating a dynamic energy balance approach into obesity-prevention programs. Five key points are highlighted: (1) the concept of dynamic vs. static energy balance; (2) the role of PA in weight management; (3) the role of PA in appetite regulation; (4) the concept of energy flux; and (5) the integration of dynamic energy balance into obesity prevention programs. The rationale for the importance of understanding the physiological relationship between PA and diet for effective obesity prevention programming is also reviewed.

Rationale for selection of a flight control system for lift cruise fan V/STOL aircraft

NASA Technical Reports Server (NTRS)

Konsewicz, R. K.

1977-01-01

Various features of the lift cruise fan V/STOL concept are briefly reviewed. The ability to operate from small ships in adverse weather, low visibility, and rough sea conditions is emphasized as is the need for a highly capable, flexible, and reliabile flight control system. A three channel control by wire, digital flight control system is suggested. The requirement for automatic flight control, the advantage of control by wire implementation, the preference for a digital computer, and the need for three channel redundancy are among the factors discussed.

Rationale and design of a study using a standardized locally procured macronutrient supplement as adjunctive therapy to HIV treatment in Kenya.

PubMed

Sztam, Kevin A; Ndirangu, Murugi; Sheriff, Muhsin; Arpadi, Stephen M; Hawken, Mark; Rashid, Juma; Deckelbaum, Richard J; El Sadr, Wafaa M

2013-01-01

Poor nutritional status at initiation of antiretroviral therapy (ART) is predictive of mortality. Decreased dietary intake is a major determinant of weight loss in HIV. Despite a biological rationale to treat undernutrition in adults receiving ART, few studies have provided data on feasibility, safety, effectiveness, and sustainability of specific macronutrient supplements with HIV treatment in adults, especially supplements such as a food basket, a supplement approach seldom evaluated in spite of its wide use. We present the rationale and design for a study of a locally procured macronutrient supplement given to HIV-infected patients initiating ART with a body mass index (BMI) ≤20.0 kg/m(2). The objective was to determine feasibility of procurement, distribution, safety and to obtain preliminary effectiveness data for a locally procured supplement. The design was a comparative study for 200 adult participants at two Kenya government-supported clinics. The primary outcome was BMI at 24 weeks. Supplement duration was 24 weeks, total follow-up was 48 weeks, and the study included a comparison site. Novel aspects of this study include use of a standardized macronutrient supplement to protect the participant against household food sharing, and a complementary micronutrient supplement. Comprehensive data collected included dietary intake, HIV-related quality-of-life, food security, neuropsychiatric assessments, laboratory studies, and household geomapping. Assessments were made at baseline, at 24 weeks, and at 48 weeks post-ART initiation. Challenges included establishing a partnership with local millers, distribution from the HIV clinic, food safety, and tracking of participants. These findings will help inform nutrition support programming in Kenya and similar settings, and provide needed data regarding use of macronutrient supplements as an adjunctive intervention with ART.

Development document for proposed effluent-limitations guidelines and standards for shipbuilding and repair. Point-source category

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1979-12-01

The document contains a discussion of the technical rationale for effluent limitations guidelines for the Shipbuilding and Repair Point Source Category, and the control and treatment technologies which form the basis for these guidelines.

Campus Housing: Beware!

ERIC Educational Resources Information Center

Campbell, Margaret; Bassett, Bill

1973-01-01

As a result of a survey to discover the rationale for student preference for off-campus living the following factors were indicated most often as reasons given for moving from the residence hall: (1) better study conditions; (2) expense; (3) freedom from control; and (4) new experiences. (JC)

NICKEL PLATING: INDUSTRY PRACTICES, CONTROL TECHNOLOGIES, AND ENVIRONMENTAL MANAGEMENT

EPA Science Inventory

This report was prepared under the direction of EPA's ORD to assist the metal finishing community with the management of nickel plating environmental issues. This report provides the rationale for developing the document, identifies the intended user audience, and presents the fr...

Personality Traits and Body Weight: Evidence Using Sibling Comparisons

PubMed Central

Kim, Jinho

2016-01-01

Rationale Past research has shown that personality traits relate to body weight, but this relationship may be confounded by unobserved family-level characteristics such as genetic endowments. Objective The purpose of this study was to investigate whether the association between personality traits, as measured by the Big Five taxonomy, and body weight among young adults is spurious owing to shared family background. Methods Participants were drawn from the full (n = 14,366) and family (n = 2,813) samples of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study employed family-fixed effects to eliminate shared family background factors that might affect personality traits and body weight simultaneously. Results Among the Big Five personality traits, only conscientiousness showed a robust association with body weight, including body mass index (BMI) and obesity risk. These results were robust to adjustments for family-fixed effects, which indicates that the association between conscientiousness and body weight is generally not confounded by unobserved family-level characteristics shared by siblings. A one-standard-deviation increase in conscientiousness was associated with a decrease in BMI by 0.89 (equivalent to a 2.5 kg decrease in weight for an individual with an average height of the sample) and a 12% reduction in the probability of being obese. This study also found some suggestive evidence of gender and racial/ethnic differences. The association between conscientiousness and obesity was larger and statistically significant only for women, and conscientiousness was most strongly associated with obesity among Hispanic people. Conclusion Conscientiousness is associated with decreased body weight net of unobserved background characteristics that are shared by siblings. The results suggest that interventions that develop personality traits may have “spillover effects”; in other words, they may also help reduce obesity. PMID:27394194

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

PubMed

Voils, Corrine I; Gierisch, Jennifer M; Olsen, Maren K; Maciejewski, Matthew L; Grubber, Janet; McVay, Megan A; Strauss, Jennifer L; Bolton, Jamiyla; Gaillard, Leslie; Strawbridge, Elizabeth; Yancy, William S

2014-09-01

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein. Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective. If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs. NCT01357551. Published by Elsevier Inc.

Teaching Economics to Young Adolescents: A Research-Based Rationale.

ERIC Educational Resources Information Center

Davis, James E.

This booklet presents a research-based rationale for teaching economics at the middle/junior high school level in the United States. Chapter 1, "Introduction," describes the project in which the rationale was developed and outlines the remainder of the document. Chapter 2, "Elements of a Rationale for Middle School Economic Education," presents…

The credibility of exposure therapy: Does the theoretical rationale matter?

PubMed

Arch, Joanna J; Twohig, Michael P; Deacon, Brett J; Landy, Lauren N; Bluett, Ellen J

2015-09-01

Little is understood about how the public perceives exposure-based therapy (ET) for treating anxiety and trauma-related disorders or how ET rationales affect treatment credibility. Distinct approaches to framing ET are practiced, including those emphasized in traditional cognitive behavioral therapy, acceptance and commitment therapy, and the more recent inhibitory learning model. However, their relative effect on ET's credibility remains unknown. A final sample of 964 U.S. adults provided baseline views of ET. Participants rated ET treatment credibility following a simple ET definition (pre-rationale) and following randomization to rationale modules addressing ET goals, fear, and cognitive strategies from distinct theoretical perspectives (post-rationale). Baseline ET views, symptoms, and sociodemographic characteristics were examined as putative moderators and predictors. At baseline, the majority had never heard of ET. From pre- to post-rationale, ET treatment credibility significantly increased but the rationales' theoretical perspective had little impact. More negative baseline ET views, specific ethnic/racial minority group status, and lower education moderated or predicted greater increases in treatment credibility following the rationale. ET remains relatively unknown as a treatment for anxiety or trauma, supporting the need for direct-to-consumer marketing. Diverse theory-driven rationales similarly increased ET credibility, particularly among those less likely to use ET. Copyright © 2015 Elsevier Ltd. All rights reserved.

Main braking phase for a soft moon landing as a form of trajectory correction

NASA Astrophysics Data System (ADS)

Likhachev, V. N.; Sikharulidze, Yu. G.; Fedotov, V. P.

2013-12-01

Rationale is given for the braking profile of a spacecraft making a soft landing on the Moon's surface, including the following four phases: main braking, free fall, repeated braking, and descent at a constant speed. Due to the large altitude differential over the braking path in near-polar regions of the Moon, main braking is proposed as a type of trajectory correction impulse using no altimeter. The boundary problem solution and statistical calculations are used to give the potential energy costs and characteristics of the dispersion characteristics for this phase and choose an optimal thrust-to-weight ratio for the phase.

A nuclear electric propulsion vehicle for planetary exploration

NASA Technical Reports Server (NTRS)

Pawlik, E. V.; Phillips, W. M.

1976-01-01

A study is currently underway at JPL to design a nuclear electric-propulsion vehicle capable of performing detailed exploration of the outer planets. Evaluation of the design indicates that it is also applicable to orbit raising. Primary emphasis is on the power subsystem. Work on the design of the power system, the mission rationale, and preliminary spacecraft design are summarized. A propulsion system at a 400-kWe power level with a specific weight goal of no more than 25-kg/kW was selected for this study. The results indicate that this goal can be realized along with compatibility with the shuttle launch-vehicle constraints.

Process development and fabrication of space station type aluminum-clad graphite epoxy struts

NASA Technical Reports Server (NTRS)

Ring, L. R.

1990-01-01

The manufacture of aluminum-clad graphite epoxy struts, designed for application to the Space Station truss structure, is described. The strut requirements are identified, and the strut material selection rationale is discussed. The manufacturing procedure is described, and shop documents describing the details are included. Dry graphite fiber, Pitch-75, is pulled between two concentric aluminum tubes. Epoxy resin is then injected and cured. After reduction of the aluminum wall thickness by chemical milling the end fittings are bonded on the tubes. A discussion of the characteristics of the manufactured struts, i.e., geometry, weight, and any anomalies of the individual struts is included.

The Impact of Numerical Control Technology and Computer Aided Manufacturing on Curriculum Development in Industrial Education and Technology. A Final Report.

ERIC Educational Resources Information Center

Bauch, Klaus Dieter

The study was designed to investigate the effects of Numerical Control Technology and Computer-Aided Manufacturing (NC/CAM) in American industry on industrial education and engineering technology education. The specific purpose was to identify a data base and rationale for curriculum development in NC/CAM through a comparison of views by…

The Development of a Technical Conceptual Structure for the Concepts Possessed by Selected Quality Control Specialists. Report of a Research Project.

ERIC Educational Resources Information Center

Nee, John G.

This project had as its specific objective the development and field testing of a procedure for identifying the structure of technical concepts possessed by a group of selected quality control specialists. The associative theory of verbal behavior served as the rationale by which conceptual structures depicted by graphical maps of technical…

Effects of Providing a Rationale for Learning a Lesson on Students' Motivation and Learning in Online Learning Environments

ERIC Educational Resources Information Center

Shin, Tae Seob

2010-01-01

This study examined whether providing a rationale for learning a particular lesson influences students' motivation and learning in online learning environments. A mixed-method design was used to investigate the effects of two types of rationales (former student vs. instructor rationales) presented in an online introductory educational psychology…

Why Do Higher Education Institutions Internationalize? An Investigation of the Multilevel Determinants of Internationalization Rationales

ERIC Educational Resources Information Center

Seeber, Marco; Cattaneo, Mattia; Huisman, Jeroen; Paleari, Stefano

2016-01-01

In recent decades internationalization has risen to prominence in higher education institutions (HEIs). Scholars have identified several rationales for internationalization. There is however a lack of conceptual understanding and empirical evidence for which rationale(s) for internationalization are chosen by a given HEI and why. The goal of this…

Client Resistance in Counseling: Its Theoretical Rationale and Taxonomic Classification.

ERIC Educational Resources Information Center

Otani, Akira

1989-01-01

Reviews 3 theoretical models of client resistance in counseling: anxiety control, noncompliance, and negative social influence. Describes 22 commonly observed client resistance behaviors in 4 separate categories: response quantity resistance, response content resistance, response style resistance, and logistic management resistance. (Author/ABL)

Rapid microRNA changes in airways of human volunteers after controlled exposure to air pollutants

EPA Science Inventory

Introduction/Rationale: Exposure to air pollutants, including ozone and diesel exhaust (DE) are known to cause acute cardiopulmonary dysfunction; however, the molecular mechanisms underlying these changes remain elusive. One mechanism for rapid regulation of multiple genes is a...

Holonic Rationale and Bio-inspiration on Design of Complex Emergent and Evolvable Systems

NASA Astrophysics Data System (ADS)

Leitao, Paulo

Traditional centralized and rigid control structures are becoming inflexible to face the requirements of reconfigurability, responsiveness and robustness, imposed by customer demands in the current global economy. The Holonic Manufacturing Systems (HMS) paradigm, which was pointed out as a suitable solution to face these requirements, translates the concepts inherited from social organizations and biology to the manufacturing world. It offers an alternative way of designing adaptive systems where the traditional centralized control is replaced by decentralization over distributed and autonomous entities organized in hierarchical structures formed by intermediate stable forms. In spite of its enormous potential, methods regarding the self-adaptation and self-organization of complex systems are still missing. This paper discusses how the insights from biology in connection with new fields of computer science can be useful to enhance the holonic design aiming to achieve more self-adaptive and evolvable systems. Special attention is devoted to the discussion of emergent behavior and self-organization concepts, and the way they can be combined with the holonic rationale.

Multicenter Trial of Rivaroxaban for Early Discharge of Pulmonary Embolism From the Emergency Department (MERCURY PE): Rationale and Design.

PubMed

Singer, Adam J; Xiang, Jim; Kabrhel, Christopher; Merli, Gino J; Pollack, Charles; Tapson, Victor F; Wildgoose, Peter; Peacock, W Frank

2016-11-01

Traditionally, patients with pulmonary embolism (PE) are admitted from the emergency department and treated with low-molecular-weight heparin followed by warfarin. Several studies now demonstrate that it is possible to identify low-risk PE patients that can safely be treated as outpatients. The advent of the direct-acting oral anticoagulants such as rivaroxaban has made it easier than ever to manage patients outside of the hospital. This article describes the design of a randomized controlled trial aimed at testing the hypothesis that low-risk PE patients can be safely and effectively managed at home using rivaroxaban, resulting in fewer days of hospitalization than standard-of-care treatment. We have initiated a multicenter, open-label, randomized clinical trial in which low-risk adult PE patients (identified by the Hestia criteria) are randomized to outpatient management with oral rivaroxaban 15 mg twice daily for 21 days followed by 20 mg once daily for 90 days versus standard care, determined by the treating physician and based on local practices. The primary clinical endpoint will be the total number of inpatient hospital days (including the index admission) for venous thromboembolic or bleeding-related events during the first 30 days after randomization. A total of 150 subjects per group will provide 82% power to detect a difference of 1 day or greater in the primary outcome. Patient enrollment is ongoing at present in 45 of 60 planned sites. No interim analysis is planned and the study is being monitored by a data safety management board. The MERCURY PE study is designed to test the hypothesis that outpatient management of low-risk PE patients with rivaroxaban reduces the number of hospitalization days from venous thromboembolism and bleeding compared with standard care. This article describes the rationale and methodology for this study. © 2016 by the Society for Academic Emergency Medicine.

Design and implementation of a physical activity intervention to enhance children's use of the built environment (the CUBE study).

PubMed

Oreskovic, Nicolas M; Goodman, Elizabeth; Park, Elyse R; Robinson, Alyssa I; Winickoff, Jonathan P

2015-01-01

Adequate physical activity promotes physical and mental health and decreases obesity risk. However, most adolescents do not attain recommended physical activity levels and effective interventions are lacking. Physical activity trials rarely incorporate built environment use patterns. This paper describes the design and rationale of the Children's Use of the Built Environment (CUBE) Study, an office-based intervention designed to teach youth how to use their surrounding built environment to increase physical activity. CUBE is a 6-month intervention trial among 60 overweight and obese 10-16 year old adolescents from a community health center in Massachusetts. The study began in the winter of 2013. Patients are sequentially assigned to either the intervention or control group. Baseline physical activity by accelerometry and location by GPS, along with measured height, weight, and blood pressure are collected. Control subjects receive standard of care lifestyle counseling. Intervention subjects receive tailored recommendations on how to increase their physical activity based on their accelerometer and GPS data. Data collections are repeated at end-of-treatment, and again 3 months later. The findings from this study should help guide future efforts to design interventions aimed at increasing adolescent physical activity as well as to inform design professionals and government officials charged with creating outdoor spaces where adolescents spend time. Copyright © 2014 Elsevier Inc. All rights reserved.

Client cognitive responses to counselor paradoxical and nonparadoxical directives.

PubMed

Lee, D Y; Rossiter, B; Martin, J; Uhlemann, M R

1990-09-01

Client cognitive responses to counselor paradoxical and nonparadoxical directives were examined. It was predicted (a) that clients who received paradoxical symptom prescriptions would display a greater negativity toward the counselor and counseling than those who received nonparadoxical directives; and (b) that clients who received no rationale for the paradoxical directives would display a greater negativity than those who received a rationale. Thirty clients who had reported performance anxiety received one 45-minute counseling interview. Ten clients received paradoxical directives with a rationale, 10 received paradoxical directives with no rationale, and 10 received nonparadoxical directives. Results showed no significant differences in either client in-session negativity or out-of-session implementation of directives between the paradoxical and nonparadoxical conditions and between the rationale and no rationale paradoxical conditions. Possible implications of the findings are discussed.

Rationale, design and methods of the HEALTHY study behavior intervention component

USDA-ARS?s Scientific Manuscript database

HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physic...

48 CFR 252.215-7002 - Cost estimating system requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... costs and other data included in proposals submitted to customers in the expectation of receiving... lines of authority, duties, and responsibilities; (3) Internal controls and managerial reviews; (4) Flow... Contractor shall, within 30 days, state its rationale for disagreeing. (2) The ACO will evaluate the...

EEG Biofeedback: A Critical Evaluation of the Results and Underlying Rationale.

DTIC Science & Technology

1977-01-31

workers (Nowlia & Kamiya, 1970), improved delayed recall have published a series of studies evaluating the (Cannon 6 Sternbach , 1971), extrasensory ... perception role of the visuomotor system in the control of (Ifonorton , Davidson, 6 Bindier, 1971) , and decreased alpha activity (Mulholland 6 Runnals, 1962

Civilising Recalcitrant Boys' Bodies: Pursuing Social Fitness through the Anti-Obesity Offensive

ERIC Educational Resources Information Center

Monaghan, Lee F.

2014-01-01

Obesity discourse provides a commonly recycled rationale for multiple, ostensibly well-intended, interventions. Formal educational settings sometimes operate as sites for these biopedagogies which putatively promote "good health" among young people as they transition to "responsible" adulthood. Yet, regulation and control, or…

48 CFR 1816.405-274 - Award fee evaluation factors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... factor, if used, must include consideration of risk management (including mission success, safety... above the contracting officer, with the concurrence of the project manager. The rationale for any waiver shall be documented in the contract file. When safety, export control, or security are considered under...

Adherence to balance tolerance limits at the Upper Mississippi Science Center, La Crosse, Wisconsin.

USGS Publications Warehouse

Myers, C.T.; Kennedy, D.M.

1998-01-01

Verification of balance accuracy entails applying a series of standard masses to a balance prior to use and recording the measured values. The recorded values for each standard should have lower and upper weight limits or tolerances that are accepted as verification of balance accuracy under normal operating conditions. Balance logbooks for seven analytical balances at the Upper Mississippi Science Center were checked over a 3.5-year period to determine if the recorded weights were within the established tolerance limits. A total of 9435 measurements were checked. There were 14 instances in which the balance malfunctioned and operators recorded a rationale in the balance logbook. Sixty-three recording errors were found. Twenty-eight operators were responsible for two types of recording errors: Measurements of weights were recorded outside of the tolerance limit but not acknowledged as an error by the operator (n = 40); and measurements were recorded with the wrong number of decimal places (n = 23). The adherence rate for following tolerance limits was 99.3%. To ensure the continued adherence to tolerance limits, the quality-assurance unit revised standard operating procedures to require more frequent review of balance logbooks.

Urgent Bypass Surgery Following Failed Endovascular Treatment in Acute Symptomatic Stroke Patient With MCA Occlusion.

PubMed

Lee, Chang Yeob; Kim, Chang Hyun; Lee, Chang-Young; Sohn, Sung-Il; Hong, Jeong-Ho

2017-01-01

Although the benefits of extracranial-intracranial bypass surgery remain controversial, there is some surgical rationale for the augmentation of cerebral blood flow in cases of acute ischemic stroke with hemodynamic instability. We report a case of a 62-year-old woman who suddenly developed right hemiplegia and global aphasia. Initial magnetic resonance imaging and magnetic resonance angiography revealed a small acute ischemic lesion in left parietal lobe with occlusion at the left middle cerebral artery. We performed an endovascular thrombectomy, which failed. Her neurological deficits remained unchanged. On the basis of immediate postendovascular magnetic resonance perfusion, diffusion-weighted imaging (DWI), and neurological examination, an obvious clinical-DWI and a DWI-perfusion-weighted imaging mismatch were detected. We decided to perform emergency superficial temporal artery to middle cerebral artery bypass to prevent further progression of cerebral ischemia. On a 3-month follow-up, neurological deficits remained minimal motor aphasia and dysarthria. Following failed endovascular treatment in patients with acute symptoms attributed to major cerebral artery occlusion, we recommend immediate multimodal neuroimaging. If there are clinical-DWI and DWI-perfusion-weighted imaging mismatch indications, surgical revascularization could be considered as the next salvageable strategy.

Drug safety evaluation of naltrexone/bupropion for the treatment of obesity.

PubMed

Verpeut, Jessica L; Bello, Nicholas T

2014-06-01

Obesity is a known health risk for the development of several preventable diseases. Obesity-related metabolic alterations negatively impact different physiological mechanisms, which supports the rationale for the use of combined drug therapy. Naltrexone is an opioid antagonist for the treatment of opioid and alcohol dependency, whereas bupropion is a norepinephrine/dopamine reuptake inhibitor used to treat depression and smoking cessation. Although not effective as individual monotherapies for obesity, naltrexone and bupropion in combination produce weight loss and a metabolic profile beneficial for the potential treatment of obesity. This review examines the safety and antiobesity effects of naltrexone and bupropion alone and in combination. It reviews the results of four Phase III clinical trials of a novel fixed dose of sustained-released naltrexone/bupropion. Naltrexone/bupropion has a greater weight loss efficacy than two FDA-approved medications, orlistat and lorcaserin. Although the weight loss produced by phentermine/topiramate is superior to naltrexone/bupropion, the safety profile of naltrexone/bupropion has less severe adverse effects. In addition, naltrexone/bupropion is well tolerated, with nausea being the most reported adverse event. Unlike other centrally acting medications, lorcaserin and phentermine/topiramate, naltrexone/bupropion has no abuse potential.

Evaluating a small change approach to preventing long term weight gain in overweight and obese adults--Study rationale, design, and methods.

PubMed

Ross, Robert; Hill, James O; Latimer, Amy; Day, Andrew G

2016-03-01

Despite the rapid rise in obesity worldwide, few strategies have been effective in treating this epidemic. An emerging strategy is to focus on preventing excessive weight gain rather than weight reduction. The proposed intervention, small change approach (SCA), is an innovative weight gain prevention strategy in which individuals monitor their usual nutrition and physical activity patterns and then make modest but sustainable alterations through behavioral intervention techniques (self-regulation, goal setting) enough to reduce overall energy balance by 100 to 200 kcal per day (e.g., reduce caloric intake by 100 kcal per day and/or increase daily step count by ~2000 steps (~100 kcal) per day). The primary aim of the trial is to determine whether small changes in energy expenditure and/or energy intake prevent weight gain in overweight and obese men and women long-term. The pre-specified primary and secondary assessments are at 2 and 3 years post-randomization respectively. The primary outcome is change in body weight. Secondary outcomes include body composition variables (adipose tissue distribution and lean mass distribution) and cardiorespiratory fitness (VO2peak). We randomized 320 primarily White (n=305) overweight and obese men and women to one of 2 conditions: 1) usual care (UC), 2) small change approach (SCA). Participant involvement in the study is 3 years; 2 year intervention with a 1 year follow-up. Our study findings will indicate whether there is value in clinicians adopting a SCA to lifestyle counseling for their patients who are overweight and obese. Copyright © 2016 Elsevier Inc. All rights reserved.

Postangioplasty restenosis followed with magnetic resonance imaging in an atherosclerotic rabbit model.

PubMed

Hänni, Mari; Leppänen, Olli; Smedby, Orjan

2012-01-01

Rationale and Objectives. Testing a quantitative, noninvasive method to assess postangioplasty vessel wall changes in an animal model. Material and Methods. Six New Zealand white rabbits were subjected to atherosclerotic injury, including cholesterol-enriched diet, deendothelialization, and percutaneous transluminal angioplasty (PTA) in the distal part of abdominal aorta (four weeks after deendothelialization). The animals were examined with a 1.5T MRI scanner at three times as follows: baseline (six weeks after diet start and two days after PTA) and four weeks and 10 weeks after-PTA. Inflow angiosequence (M2DI) and proton-density-weighted sequence (PDW) were performed to examine the aorta with axial slices. To identify the inner and outer vessel wall boundaries, a dynamic contour algorithm (Gradient Vector Flow Snakes) was applied to the images, followed by calculation of the vessel wall dimensions. The results were compared with histopathological analysis. Results. The wall thickness in the lesion was significantly higher than in the control region at 4 and 10 weeks, reflecting induction of experimentally created after-angioplasty lesion. At baseline, no significant difference between the two regions was present. Conclusions. It is possible to follow the development of vessel wall changes after-PTA with MRI in this rabbit model.

Internal Medicine Physicians’ Perceptions Regarding Rate versus Rhythm Control for Atrial Fibrillation

PubMed Central

McCabe, James M.; Johnson, Colleen J; Marcus, Gregory M

2011-01-01

Atrial fibrillation (AF) is often managed by general internal medicine physicians. Available data suggest that guidelines regarding AF management are often not followed, but the reasons for this remain unknown. We sought to assess the knowledge and beliefs of internists regarding strategies to treat AF. We conducted a national electronic survey of internal medicine physicians regarding their perceptions of optimal AF management, with an emphasis on the rationale for choosing a rhythm or rate control strategy. One hundred and forty-eight physicians from 36 different states responded (representing at least 19% of unique e-mails opened). Half of the respondents reported managing their AF patients independently without referral to a cardiologist. Seventy-three percent of participants believe a rhythm control strategy conveys a decreased stroke risk, 64% believe there is a mortality benefit to rhythm control, and 55% think that it would help avoid long term anticoagulation. Comparing those who prefer a rhythm control strategy to everyone else, those who favor rhythm control statistically significantly more often believe that rhythm control reduces the risk for stroke (96% versus 67%, p=0.009) and that rhythm control allows for the discontinuation of anticoagulation therapy (76% versus 49%, p=0.045). In conclusion, contrary to available data in clinical trials and recent guidelines regarding the rationale for choosing a rhythm control strategy in treating AF, the majority of study participants believe that rhythm control decreases stroke risk, decreases mortality, and allows for discontinuation of anticoagulation therapy. These prevalent misconceptions may substantially contribute to guideline non-adherence. PMID:19195516

Influence of body weight and type of chow on the sensitivity of rats to the behavioral effects of the direct-acting dopamine receptor agonist quinpirole

PubMed Central

Baladi, Michelle G; Newman, Amy H; France, Charles P

2013-01-01

Rationale Amount and type of food can alter dopamine systems and sensitivity to drugs acting on those systems. Objectives This study examined whether changes in body weight, food type, or both body weight and food type contribute to these effects. Methods Rats had free or restricted access (increasing, decreasing, or maintaining body weight) to standard (5.7% fat) or high fat (34.3%) chow. Results In rats gaining weight with restricted or free access to high fat chow, both limbs of the quinpirole yawning dose-response curve (0.0032–0.32 mg/kg) shifted leftward compared with rats eating standard chow. Restricting access to standard or high fat chow (maintaining or decreasing body weight) decreased or eliminated quinpirole-induced yawning; within one week of resuming free feeding, sensitivity to quinpirole was restored, although the descending limb of the dose-response curve was shifted leftward in rats eating high fat chow. These are not likely pharmacokinetic differences because quinpirole-induced hypothermia was not different among groups. PG01037 and L-741,626 antagonized the ascending and descending limbs of the quinpirole dose-response curve in rats eating high fat chow, indicating D3 and D2 receptor mediation, respectively. Rats eating high fat chow also developed insulin resistance. Conclusions These results show that amount and type of chow alter sensitivity to a direct-acting dopamine receptor agonist with the impact of each factor depending on whether body weight increases, decreases, or is maintained. These data demonstrate that feeding conditions, perhaps related to insulin and insulin sensitivity, profoundly impact the actions of drugs acting on dopamine systems. PMID:21544521

Industrial noise control: Some case histories, volume 1

NASA Technical Reports Server (NTRS)

Hart, F. D.; Neal, C. L.; Smetana, F. O.

1974-01-01

A collection of solutions to industrial noise problems is presented. Each problem is described in simple terms, with noise measurements where available, and the solution is given, often with explanatory figures. Where the solution rationale is not obvious, an explanatory paragraph is usually appended. As a preface to these solutions, a short exposition is provided of some of the guiding concepts used by noise control engineers in devising their solutions.

Are two penicillins better than one? A systematic review of oral flucloxacillin and penicillin V versus oral flucloxacillin alone for the emergency department treatment of cellulitis.

PubMed

Quirke, Michael; O'Sullivan, Ronan; McCabe, Aileen; Ahmed, Jameel; Wakai, Abel

2014-06-01

Flucloxacillin either alone or combined with penicillin V is still the first-line antibiotic drug of choice for the treatment of cellulitis in emergency departments (EDs) in Ireland. The rationale for this antibiotic regimen is their anti-staphylococcal and anti-streptococcal activity. To determine the clinical efficacy, tolerability and safety of oral flucloxacillin alone (monotherapy) compared with a combination of flucloxacillin with penicillin V (dual therapy) in the ED-directed outpatient treatment of cellulitis. We searched the following electronic databases: MEDLINE (1950 to August 2011), EMBASE (1980 to August 2011), Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library 2011, Issue), OpenGrey, Current Controlled Trials metaRegister of Clinical Trials (August 2011) and reference lists and websites of potential trials. We performed cross-referencing from the reference lists of major articles on the subject. We imposed no language restriction. Despite a comprehensive literature search to identify relevant studies, no randomized-controlled trials that fulfilled the inclusion criteria were found. Despite its common use, there are no published randomized-controlled trials comparing flucloxacillin monotherapy with a combination of flucloxacillin and penicillin V in the ED management of cellulitis. We discuss existing European and North American prescribing rationale and current guidelines.

Rationale and Roadmap for Moon Exploration

NASA Astrophysics Data System (ADS)

Foing, B. H.; ILEWG Team

We discuss the different rationale for Moon exploration. This starts with areas of scientific investigations: clues on the formation and evolution of rocky planets, accretion and bombardment in the inner solar system, comparative planetology processes (tectonic, volcanic, impact cratering, volatile delivery), records astrobiology, survival of organics; past, present and future life. The rationale includes also the advancement of instrumentation: Remote sensing miniaturised instruments; Surface geophysical and geochemistry package; Instrument deployment and robotic arm, nano-rover, sampling, drilling; Sample finder and collector. There are technologies in robotic and human exploration that are a drive for the creativity and economical competitivity of our industries: Mecha-electronics-sensors; Tele control, telepresence, virtual reality; Regional mobility rover; Autonomy and Navigation; Artificially intelligent robots, Complex systems, Man-Machine interface and performances. Moon-Mars Exploration can inspire solutions to global Earth sustained development: In-Situ Utilisation of resources; Establishment of permanent robotic infrastructures, Environmental protection aspects; Life sciences laboratories; Support to human exploration. We also report on the IAA Cosmic Study on Next Steps In Exploring Deep Space, and ongoing IAA Cosmic Studies, ILEWG/IMEWG ongoing activities, and we finally discuss possible roadmaps for robotic and human exploration, starting with the Moon-Mars missions for the coming decade, and building effectively on joint technology developments.

Relief for the Tuition Migraine.

ERIC Educational Resources Information Center

Settel, John F.

1990-01-01

No matter what the rationale for high tuition, unless it is controlled, the average American family will not be able to afford a private college or university education. What is needed is a flexible tuition prepayment plan built on cooperation between private institutions, the federal government, and investment firms. Requirements of a successful…

Using the Game Paddle in the Laboratory and Classroom.

ERIC Educational Resources Information Center

De Gilio, John F.

1983-01-01

Offers a rationale and method for using the hand controllers (game paddles) in the design of computer programs for student use. Methods for their use in entering data as well as in conducting pendulum and acceleration experiments are provided. Complete program listings (for Apple) are included. (JN)

Military Medical Revolution: Deployed Hospital and En Route Care

DTIC Science & Technology

2012-01-01

Coagulopathy, hypothermia and acidosis in trauma patients: the rationale for damage control surgery. Acta Chir Belg. 2002;102:313 316. 5...casualties. J Trauma. 2008;64(Suppl 2):S136 S144; discus- sion S144 135. 81. Higgins RA. MEDEVAC critical care transport from the battlefield. AACN Adv Crit

Maximizing Patient Thermoregulation in US Army Forward Surgical Teams

DTIC Science & Technology

2008-01-01

Vermassen FE. Coagulopathy, hypothermia and acidosis in trauma patients: the rationale for damage control surgery. Acta Chir Belg. 2002;102(5):313-316...bypass. J Cardiothorac Vasc Anesth. 2000;14(5):501- 505. 41. Janicki PK, Higgins MS, Janssen J, Johnson RF, Beattie C. Comparison of two different

Saving Money Through Energy Conservation.

ERIC Educational Resources Information Center

Presley, Michael H.; And Others

This publication is an introduction to personal energy conservation. The first chapter presents a rationale for conserving energy and points out that private citizens control about one third of this country's energy consumption. Chapters two and three show how to save money by saving energy. Chapter two discusses energy conservation methods in the…

The Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project: Rationale and Approach.

PubMed

MacLean, Paul S; Rothman, Alexander J; Nicastro, Holly L; Czajkowski, Susan M; Agurs-Collins, Tanya; Rice, Elise L; Courcoulas, Anita P; Ryan, Donna H; Bessesen, Daniel H; Loria, Catherine M

2018-04-01

Individual variability in response to multiple modalities of obesity treatment is well documented, yet our understanding of why some individuals respond while others do not is limited. The etiology of this variability is multifactorial; however, at present, we lack a comprehensive evidence base to identify which factors or combination of factors influence treatment response. This paper provides an overview and rationale of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, which aims to advance the understanding of individual variability in response to adult obesity treatment. This project provides an integrated model for how factors in the behavioral, biological, environmental, and psychosocial domains may influence obesity treatment responses and identify a core set of measures to be used consistently across adult weight-loss trials. This paper provides the foundation for four companion papers that describe the core measures in detail. The accumulation of data on factors across the four ADOPT domains can inform the design and delivery of effective, tailored obesity treatments. ADOPT provides a framework for how obesity researchers can collectively generate this evidence base and is a first step in an ongoing process that can be refined as the science advances. © 2018 The Obesity Society.

Cultural Variables Underlying Obesity in Latino Men: Design, Rationale and Participant Characteristics from the Latino Men's Health Initiative.

PubMed

Sanchez-Johnsen, Lisa; Craven, Meredith; Nava, Magdalena; Alonso, Angelica; Dykema-Engblade, Amanda; Rademaker, Alfred; Xie, Hui

2017-08-01

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans (p < .0001) and there were significant differences in marital status (p < .05), country of birth (p < .05), smoking (p < .05) and work status (p < .001). There were no significant differences in religion, education, health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men.

An anthology: Rationale for a US ballistic missile defense (1969 - 1984)

NASA Astrophysics Data System (ADS)

Tircuit, E. C.

1985-04-01

This anthology is a selection and short synopsis of representative articles on the rationale for a US ballistic missile defense (BMD). Unclassified articles and documents were reviewed and analyzed to identify and include nine representative articles in the anthology. The anthology reduces the search for quality material on the subject and documents the fundamental rationale for a BMD. The author concluded that the fundamental rationale for a US BMD is to deter nuclear war. In addition, specific rationale for a US BMD is provided in the anthology. Finally, an extensive bibliography is included in the anthology to enhance further research on the subject.

Magical beliefs and discriminating science from pseudoscience in undergraduate professional students.

PubMed

Garrett, Bernard M; Cutting, Roger L

2017-11-01

Paranormal beliefs and magical thinking exist in the public, and amongst university students. Researchers have found that media can influence such beliefs. A 2012 study suggested pseudoscientific rationales can influence acceptance of reported paranormal phenomena. Using a paranormal belief survey and controlled experiment this work explores the paranormal beliefs and test the effects of three versions of a supernatural news story on undergraduate professional students. One version of the story presented a simple news article, another the same with a pseudoscientific rationale, and another gave a discrediting scientific critique. Results confirmed that many students do hold magical beliefs but discriminated between scientific and pseudoscientific narratives. However, pre-existing paranormal beliefs were associated with an increased likelihood of students finding paranormal reports scientific, believable and credible.

Changes in self-efficacy for exercise and improved nutrition fostered by increased self-regulation among adults with obesity.

PubMed

Annesi, James J; Johnson, Ping H; McEwen, Kristin L

2015-10-01

Behavioral theory suggests that treatments that increase participants' use of self-regulatory skills and/or their feelings of ability (self-efficacy) will improve exercise and nutrition behaviors. In addition, psychosocial factors associated with increased exercise may carry over to improved eating. Self-regulation might enhance self-efficacy through feelings of ability to manage barriers to maintaining weight-loss behaviors. Sedentary adults with severe or morbid obesity (M age = 43 years; M BMI = 40.1 kg/m(2)) participated in a 6-month study within a community-based YMCA center. We randomly assigned participants to one of the two groups that incorporated the same cognitive-behavioral support of exercise paired with methods for controlled, healthy eating emphasizing either (a) self-efficacy (n = 138), or (b) self-regulation (n = 136) methods. Mixed model repeated measures ANOVAs indicated significant improvements in exercise- and eating-related self-regulation over 3 months, and exercise- and eating-related self-efficacy over 6 months. The Self-Regulation Treatment Group demonstrated greater improvements in self-regulation for eating and fruit and vegetable intake than the Self-Efficacy Group. Regression analyses indicated that for both exercise and eating, self-regulation change significantly predicted self-efficacy change. In separate equations, changes in exercise and fruit and vegetable intake mediated those relationships, and change in self-efficacy and the corresponding behavioral changes demonstrated reciprocal, mutually reinforcing, relationships. There was evidence of carry-over, or generalization, of both self-regulation and self-efficacy changes from an exercise context to an eating context. We discussed findings in terms of leveraging self-regulation to improve self-efficacy, and provide a rationale for why exercise is the strongest predictor of success with weight loss. Results may be used to inform future behavioral weight-management treatments through improved knowledge of relationships among theoretically derived psychosocial factors.

Adhesives: Test Method, Group Assignment, and Categorization Guide for High-Loading Rate Applications - History and Rationale

DTIC Science & Technology

2017-04-20

Categorization Guide for High -Loading- Rate Applications – History and Rationale by Robert Jensen, David Flanagan, Daniel DeSchepper, and Charles...Adhesives: Test Method, Group Assignment, and Categorization Guide for High -Loading- Rate Applications – History and Rationale by Robert Jensen...Categorization Guide for High - Loading-Rate Applications – History and Rationale 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

Summary of NDE of Additive Manufacturing Efforts in NASA

NASA Technical Reports Server (NTRS)

Waller, Jess; Saulsberry, Regor; Parker, Bradford; Hodges, Kenneth; Burke, Eric; Taminger, Karen

2014-01-01

(1) General Rationale for Additive Manufacturing (AM): (a) Operate under a 'design-to-constraint' paradigm, make parts too complicated to fabricate otherwise, (b) Reduce weight by 20 percent with monolithic parts, (c) Reduce waste (green manufacturing), (e) Eliminate reliance on Original Equipment Manufacturers for critical spares, and (f) Extend life of in-service parts by innovative repair methods; (2) NASA OSMA NDE of AM State-of-the-Discipline Report; (3) Overview of NASA AM Efforts at Various Centers: (a) Analytical Tools, (b) Ground-Based Fabrication (c) Space-Based Fabrication; and (d) Center Activity Summaries; (4) Overview of NASA NDE data to date on AM parts; and (5) Gap Analysis/Recommendations for NDE of AM.

Comprehensive approach for hypertension control in low-income populations: rationale and study design for the hypertension control program in Argentina.

PubMed

Mills, Katherine T; Rubinstein, Adolfo; Irazola, Vilma; Chen, Jing; Beratarrechea, Andrea; Poggio, Rosana; Dolan, Jacquelyn; Augustovski, Federico; Shi, Lizheng; Krousel-Wood, Marie; Bazzano, Lydia A; He, Jiang

2014-08-01

Although the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials, this scientific knowledge has not been fully applied in the general population, especially in low-income communities. This article summarizes interventions to improve hypertension management and describes the rationale and study design for a cluster randomized trial testing whether a comprehensive intervention program within a national public primary care system will improve hypertension control among uninsured hypertensive men and women and their families. We will recruit 1,890 adults from 18 clinics within a public primary care network in Argentina. Clinic patients with uncontrolled hypertension, their spouses and hypertensive family members will be enrolled. The comprehensive intervention program targets the primary care system through health care provider education, a home-based intervention among patients and their families (home delivery of antihypertensive medication, self-monitoring of blood pressure [BP], health education for medication adherence and lifestyle modification) conducted by community health workers and a mobile health intervention. The primary outcome is net change in systolic BP from baseline to month 18 between intervention and control groups among hypertensive study participants. The secondary outcomes are net change in diastolic BP, BP control and cost-effectiveness of the intervention. This study will generate urgently needed data on effective, practical and sustainable intervention programs aimed at controlling hypertension and concomitant cardiovascular disease in underserved populations in low- and middle-income countries.

Comprehensive Approach for Hypertension Control in Low-income Populations: Rationale and Study Design for the Hypertension Control Program in Argentina (HCPIA)

PubMed Central

Mills, Katherine T.; Rubinstein, Adolfo; Irazola, Vilma; Chen, Jing; Beratarrechea, Andrea; Poggio, Rosana; Dolan, Jacquelyn; Augustovski, Federico; Shi, Lizheng; Krousel-Wood, Marie; Bazzano, Lydia A.; He, Jiang

2014-01-01

Although the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials, this scientific knowledge has not been fully applied in the general population, especially in low-income communities. This paper summarizes interventions to improve hypertension management and describes the rationale and study design for a cluster randomized trial testing whether a comprehensive intervention program within a national public primary care system will improve hypertension control among uninsured hypertensive men and women and their families. We will recruit 1,890 adults from 18 clinics within a public primary care network in Argentina. Clinic patients with uncontrolled hypertension, their spouses and hypertensive family members will be enrolled. The comprehensive intervention program targets the primary care system through health care provider education, a home-based intervention among patients and their families (home delivery of antihypertensive medication, self-monitoring of blood pressure, health education for medication adherence and lifestyle modification) conducted by community health workers, and a mobile health intervention. The primary outcome is net change in systolic blood pressure from baseline to month 18 between intervention and control groups among hypertensive study participants. The secondary outcomes are net change in diastolic blood pressure, blood pressure control, and cost-effectiveness of the intervention. This study will generate urgently needed data on effective, practical, and sustainable intervention programs aimed at controlling hypertension and concomitant cardiovascular disease in underserved populations in low- and middle-income countries. PMID:24978148

A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): rationale, design and methodology of a randomized controlled trial in Nanjing city, China.

PubMed

Xu, Fei; Ware, Robert S; Tse, Lap Ah; Wang, Zhiyong; Hong, Xin; Song, Aiju; Li, Jiequan; Wang, Youfa

2012-06-15

The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group). Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a) classroom curriculum, (including physical education and healthy diet education), b) school environment support, c) family involvement, and d) fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools' regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. ChiCTR-ERC-11001819.

Compared with what? An analysis of control-group types in Cochrane and Campbell reviews of psychosocial treatment efficacy with substance use disorders.

PubMed

Karlsson, Patrik; Bergmark, Anders

2015-03-01

A crucial, but under-appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control-group designs have been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders. We assessed Cochrane and Campbell reviews (n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn. The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head-to-head comparisons versus untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions. Cochrane and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that the use of different control-group types yields different effect estimates. Most reviews have not distinguished between different control-group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control-group designs in research reviews is necessary for meaningful estimates of treatment efficacy. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Temporal Profile of Gene Expression Alterations in Primary Human Bronchial Epithelial Cells Following In Vivo Exposure to Ozone

EPA Science Inventory

RATIONALE: Ozone (Os) isa ubiquitous air pollutant that has been shown to have a detrimental effect on human health. Controlled exposure studies in humans have demonstrated that acute exposure to 03 results in reversible reduction in lung function immediately post-exposure, incre...

A randomized controlled trial to prevent childhood obesity through early childhood feeding and parenting guidance: Rationale and design of study

USDA-ARS?s Scientific Manuscript database

Early and rapid growth in infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social ...

76 FR 10852 - Magnuson-Stevens Act Provisions; Fisheries of the Northeastern United States; Northeast...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

..., permitting restrictions, gear restrictions designed to minimize habitat impacts, and reporting requirements... requirement was previously approved for FY 2010 based upon the rationale that this measure was designed to... gillnet gear. This exemption was previously approved for FY 2010 because it is designed to control fishing...

Developing a Process Model for Student Reformation of Curriculum and Instruction.

ERIC Educational Resources Information Center

Grimaldi, Ettore P.; Garrett, Philip R.

This paper presents a working framework for a controlled change of instructional practices within a community college. A methodology for the training of students and faculty in the evaluation of curriculum and instruction is presented: (1) establish a positive rationale for evaluation within a context of meaningful philosophy; (2) determine a…

From Rationale to Results: Implementing Performance Indicators in a Public Library.

ERIC Educational Resources Information Center

Alston, Ruth

This paper describes the theoretical design and practical implementation of a set of performance indicators in a public library system in London (England). Bromley Libraries has 15 branch libraries and serves 300,000 people. The need for improved management control by assessing performance and monitoring progress, library restructuring, and…

Message Control Intensity: Rationale and Preliminary Findings.

ERIC Educational Resources Information Center

Rogers, L. Edna; And Others

The discussions of four family-related topics by 85 married couples were recorded and analyzed to test the validity of an expanded version of the relational communication coding system developed by L. Edna Rogers and Richard V. Farace. The expanded version of the system is based on the implicit intensity continuum that underlies the communication…

Challenging the Politics of the "Model Minority" Stereotype: A Case for Educational Equality

ERIC Educational Resources Information Center

Yu, Tianlong

2006-01-01

This article examines the political rationale of the "model minority" stereotype about Asian Americans and its ramifications on education. Created by white elites in the 1960s as a device of political control, the model minority stereotype continues to serve the larger conservative restoration in American society today. By…

A Conceptual Framework for Examining School Finance Reform Options for the State of Ohio.

ERIC Educational Resources Information Center

Monk, David H.; Theobald, Neil D.

2001-01-01

Interviews involving 58 Ohio stakeholders focused on detailing state K-12 education goals, identifying the current system's strengths and weaknesses, and discussing the financial/political viability of potential school funding strategies. Consensus emerged regarding the role of property taxes, local control, the foundation formula rationale, and…

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

A Rationale for System-Dependent Advantages and Disadvantages of Solution Crystal Growth at Low Gravity

NASA Technical Reports Server (NTRS)

Rosenberger, Franz; Vekilov, Peter G.; Lin, Hong; Alexander, J. Iwan D.

1997-01-01

Protein crystallization experiments at reduced gravity have yielded crystals that, depending on the specific material, are either superior or inferior in their structural perfection compared to counterparts grown at normal gravity. A reduction of the crystals' quality due to their growth at low gravity cannot be understood from existing models. Our experimental investigations of the ground-based crystallization of the protein lysozyme have revealed pronounced unsteady growth layer dynamics and associated defect formation under steady external conditions. Through scaling analysis and numerical simulations we show that the observed fluctuations originate from the coupling of bulk transport with non-linear interface kinetics under mixed kinetics-transport control of the growth rate. The amplitude of the fluctuations is smallest when either transport or interfacial kinetics dominate the control of the crystallization process. Thus, depending on the specific system, crystal quality may be improved by either enhancing or suppressing the transport in the solution. These considerations provide, for the first time, a material-dependent rationale for the advantages, as well as the disadvantages, of reduced gravity for (protein) crystallization.

Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care.

PubMed

Roos-Blom, Marie-José; Gude, Wouter T; de Jonge, Evert; Spijkstra, Jan Jaap; van der Veer, Sabine N; Dongelmans, Dave A; de Keizer, Nicolette F

2017-01-01

Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is delivered in both verbal and written formats, and it includes specific targets and an action plan. However, there is little information to guide operationalization of these factors. Researchers have consequently called for A&F interventions featuring well-described and carefully justified components, with their theoretical rationale made explicit. This paper describes the rationale and development of a quality dashboard including an improvement toolbox for four previous developed pain indicators, guided by Control Theory.

The evaluation of a number of prototypes for the free-tip rotor constant-moment controller

NASA Technical Reports Server (NTRS)

Young, L. A.

1986-01-01

The development of several prototypes of a constant moment controller, a critical component of the free-tip rotor (FTR) concept, is described. Also presented are the experimental results of a whirl test designed to select a final controller configuration to be included in a future wind-tunnel test of this innovative rotor system. A brief explanation of the FTR concept and its history are included. The paper documents the controller design constraints, each prototype's operating principle, the evaluation test, and the individual prototype test results. A recommended design is identified, along with the selection rationale.

Long-term effects of an inpatient weight-loss program in obese children and the role of genetic predisposition-rationale and design of the LOGIC-trial.

PubMed

Rank, Melanie; Siegrist, Monika; Wilks, Désirée C; Haller, Bernhard; Wolfarth, Bernd; Langhof, Helmut; Halle, Martin

2012-03-19

The prevalence of childhood obesity has increased worldwide, which is a serious concern as obesity is associated with many negative immediate and long-term health consequences. Therefore, the treatment of overweight and obesity in children and adolescents is strongly recommended. Inpatient weight-loss programs have shown to be effective particularly regarding short-term weight-loss, whilst little is known both on the long-term effects of this treatment and the determinants of successful weight-loss and subsequent weight maintenance.The purpose of this study is to evaluate the short, middle and long-term effects of an inpatient weight-loss program for children and adolescents and to investigate the likely determinants of weight changes, whereby the primary focus lies on the potential role of differences in polymorphisms of adiposity-relevant genes. The study involves overweight and obese children and adolescents aged 6 to 19 years, who participate in an inpatient weight-loss program for 4 to 6 weeks. It started in 2006 and it is planned to include 1,500 participants by 2013. The intervention focuses on diet, physical activity and behavior therapy. Measurements are taken at the start and the end of the intervention and comprise blood analyses (DNA, lipid and glucose metabolism, adipokines and inflammatory markers), anthropometry (body weight, height and waist circumference), blood pressure, pubertal stage, and exercise capacity. Physical activity, dietary habits, quality of life, and family background are assessed by questionnaires. Follow-up assessments are performed 6 months, 1, 2, 5 and 10 years after the intervention: Children will complete the same questionnaires at all time points and visit their general practitioner for examination of anthropometric parameters, blood pressure and assessment of pubertal stage. At the 5 and 10 year follow-ups, blood parameters and exercise capacity will be additionally measured. Apart from illustrating the short, middle and long-term effects of an inpatient weight-loss program, this study will contribute to a better understanding of inter-individual differences in the regulation of body weight, taking into account the role of genetic predisposition and lifestyle factors. NCT01067157.

Examining the relative effectiveness of different message framing strategies for child passenger safety: recommendations for increased comprehension and compliance.

PubMed

Will, Kelli England; Decina, Lawrence E; Maple, Erin L; Perkins, Amy M

2015-06-01

Age-appropriate child restraints and rear seating dramatically reduce injury in vehicle crashes. Yet parents and caregivers struggle to comply with child passenger safety (CPS) recommendations, and frequently make mistakes when choosing and installing restraints. The purpose of this research was to evaluate various methods of framing CPS recommendations, and to examine the relative effectiveness on parents' knowledge, attitudes, and behavioral intentions related to best practices and proper use of child restraints. Emphasis framing is a persuasion technique that involves placing focus on specific aspects of the content in order to encourage or discourage certain interpretations of the content. A 5 (flyer group) X 2 (time) randomized experiment was conducted in which 300 parent participants answered a pre-survey, viewed one of four flyer versions or a no-education control version, and completed a post-survey. Surveys measured CPS knowledge, attitudes, perceptions of efficacy and risk, and behavioral intentions. The four flyers compared in this study all communicated the same CPS recommendations, but several versions were tested which each employed a different emphasis frame: (1) recommendations organized by the natural progression of seat types; (2) recommendations which focused on avoiding premature graduation; (3) recommendations which explained the risk-reduction rationale behind the information given; or (4) recommendations which were organized by age. In a fifth no-education (control) condition, participants viewed marketing materials. Analyses of covariance and pairwise comparisons indicated the risk-reduction rationale flyer outperformed other flyers for many subscales, and significantly differed from no-education control for the most subscales, including restraint selection, back seat knowledge, rear-facing knowledge and attitudes, total efficacy, overall attitudes, and stated intentions. This research provides insight for increasing caregiver understanding and compliance with CPS information. Recommendations for the field include communicating the rationale behind the information given, using behavior-based directives in headers, avoiding age-based headers, and incorporating back-seat positioning directives throughout. Copyright © 2015 Elsevier Ltd. All rights reserved.

A historical perspective on ventilator management.

PubMed

Shapiro, B A

1994-02-01

Paralysis via neuromuscular blockade in ICU patients requires mechanical ventilation. This review historically addresses the technological advances and scientific information upon which ventilatory management concepts are based, with special emphasis on the influence such concepts have had on the use of neuromuscular blocking agents. Specific reference is made to the scientific information and technological advances leading to the newer concepts of ventilatory management. Information from > 100 major studies in the peer-reviewed medical literature, along with the author's 25 yrs of clinical experience and academic involvement in acute respiratory care is presented. Nomenclature related to ventilatory management is specifically defined and consistently utilized to present and interpret the data. Pre-1970 ventilatory management is traced from the clinically unacceptable pressure-limited devices to the reliable performance of volume-limited ventilators. The scientific data and rationale that led to the concept of relatively large tidal volume delivery are reviewed in the light of today's concerns regarding alveolar overdistention, control-mode dyssynchrony, and auto-positive end-expiratory pressure. Also presented are the post-1970 scientific rationales for continuous positive airway pressure/positive end-expiratory pressure therapy, avoidance of alveolar hyperxia, and partial ventilatory support techniques (intermittent mandatory ventilation/synchronized intermittent mandatory ventilation). The development of pressure-support devices is discussed and the capability of pressure-control techniques is presented. The rationale for more recent concepts of total ventilatory support to avoid ventilator-induced lung injury is presented. The traditional techniques utilizing volume-preset ventilators with relatively large tidal volumes remain valid and desirable for the vast majority of patients requiring mechanical ventilation. Neuromuscular blockade is best avoided in these patients. However, adequate analgesia, amnesia, and sedation are required. For patients with severe lung disease, alveolar overdistention and hyperoxia should be avoided and may be best accomplished by total ventilatory support techniques, such as pressure control. Total ventilatory support requires neuromuscular blockade and may not provide eucapnic ventilation.

Associations of body weight perception and weight control behaviors with problematic internet use among Korean adolescents.

PubMed

Park, Subin; Lee, Yeeun

2017-05-01

We examined the association of body mass index (BMI), body weight perception, and weight control behaviors with problematic Internet use in a nationwide sample of Korean adolescents. Cross-sectional data from the 2010 Korean Youth Risk Behavior Web-based Survey collected from 37,041 boys and 33,655 girls in middle- and high- schools (grades 7-12) were analyzed. Participants were classified into groups based on BMI (underweight, normal weight, overweight, and obese), body weight perception (underweight, normal weight, and overweight), and weight control behavior (no weight control behavior, appropriate weight control behavior, inappropriate weight control behavior). The risk of problematic Internet use was assessed with the Korean Internet Addiction Proneness Scale for Youth-Short Form. Both boys and girls with inappropriate weight control behavior were more likely to have problematic Internet use. Underweight, overweight, and obese boys and girls were more likely to have problematic Internet use. For both boys and girls, subjective perception of underweight and overweight were positively associated with problematic Internet use. Given the negative effect of inappropriate weight control behavior, special attention needs to be given to adolescents' inappropriate weight control behavior, and an educational intervention for adolescents to control their weight in healthy ways is needed. Copyright © 2017. Published by Elsevier B.V.

Small Changes and Lasting Effects (SCALE) Trial: The Formation of a Weight Loss Behavioral Intervention Using EVOLVE

PubMed Central

Phillips-Caesar, Erica G.; Winston, Ginger; Peterson, Janey C.; Wansink, Brian; Devine, Carol M.; Kanna, Balavanketsh; Michelin, Walid; Wethington, Elaine; Wells, Martin; Hollenberg, James; Charlson, Mary E.

2015-01-01

Background Obesity is a major health problem that disproportionately affects Black and Hispanic adults. This paper presents the rationale and innovative design of a small change eating and physical activity intervention (SC) combined with a positive affect and self-affirmation (PA/SA) intervention versus the SC intervention alone for weight loss. Methods Using a mixed methods translational model (EVOLVE), we designed and tested a SC approach intervention in overweight and/ or obese African American and Hispanic adults. In Phase I, we explored participant’s values and beliefs about the small change approach. In Phase II, we tested and refined the intervention and then, in Phase III we conducted a RCT. Participants were randomized to the SC approach with PA/SA intervention vs. a SC approach alone for 12 months. The primary outcome was clinically significant weight loss at 12 months. Results Over 4.5 years a total of 574 participants (67 in Phase I, 102 in Phase II and 405 in Phase III) were enrolled. Phase I findings were used to create a workbook based on real life experiences about weight loss and to refine the small change eating strategies. Phase II results shaped the recruitment and retention strategy for the RCT, as well as the final intervention. The RCT results are currently under analysis. Conclusion The present study seeks to determine if a SC approach combined with a PA/SA intervention will result in greater weight loss at 12 months in Black and Hispanic adults compared to a SC approach alone. PMID:25633208

Tailored weight loss intervention in obese adults within primary care practice: rationale, design, and methods of Choose to Lose.

PubMed

Hartman, Sheri J; Risica, Patricia M; Gans, Kim M; Marcus, Bess H; Eaton, Charles B

2014-07-01

Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or standard intervention. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Standard intervention participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Intermittent fasting: A “new” historical strategy for controlling seizures?

PubMed Central

Hartman, Adam L.; Rubenstein, James E.; Kossoff, Eric H.

2013-01-01

Summary In antiquity, fasting was a treatment for epilepsy and a rationale for the ketogenic diet (KD). Preclinical data indicate the KD and intermittent fasting do not share identical anticonvulsant mechanisms. We implemented an intermittent fasting regimen in six children with an incomplete response to a KD. Three patients adhered to the combined intermittent fasting/KD regimen for 2 months and four had transient improvement in seizure control, albeit with some hunger-related adverse reactions. PMID:23206889

The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT)

PubMed Central

2010-01-01

Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU) has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum) till one year (maximum) will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy), also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE) and functional status (Neck Disability Index (NDI-DV)). Secondary outcomes are neck pain (Numeric Rating Scale (NRS)), Eurocol, costs and quality of life (SF36). Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843 PMID:20096136

Study rationale and design of OPTIMISE, a randomised controlled trial on the effect of benchmarking on quality of care in type 2 diabetes mellitus.

PubMed

Nobels, Frank; Debacker, Noëmi; Brotons, Carlos; Elisaf, Moses; Hermans, Michel P; Michel, Georges; Muls, Erik

2011-09-22

To investigate the effect of physician- and patient-specific feedback with benchmarking on the quality of care in adults with type 2 diabetes mellitus (T2DM). Study centres in six European countries were randomised to either a benchmarking or control group. Physicians in both groups received feedback on modifiable outcome indicators (glycated haemoglobin [HbA1c], glycaemia, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein [LDL]-cholesterol and triglycerides) for each patient at 0, 4, 8 and 12 months, based on the four times yearly control visits recommended by international guidelines. The benchmarking group also received comparative results on three critical quality indicators of vascular risk (HbA1c, LDL-cholesterol and systolic blood pressure [SBP]), checked against the results of their colleagues from the same country, and versus pre-set targets. After 12 months of follow up, the percentage of patients achieving the pre-determined targets for the three critical quality indicators will be assessed in the two groups. Recruitment was completed in December 2008 with 3994 evaluable patients. This paper discusses the study rationale and design of OPTIMISE, a randomised controlled study, that will help assess whether benchmarking is a useful clinical tool for improving outcomes in T2DM in primary care. NCT00681850.

Study rationale and design of OPTIMISE, a randomised controlled trial on the effect of benchmarking on quality of care in type 2 diabetes mellitus

PubMed Central

2011-01-01

Background To investigate the effect of physician- and patient-specific feedback with benchmarking on the quality of care in adults with type 2 diabetes mellitus (T2DM). Methods Study centres in six European countries were randomised to either a benchmarking or control group. Physicians in both groups received feedback on modifiable outcome indicators (glycated haemoglobin [HbA1c], glycaemia, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein [LDL]-cholesterol and triglycerides) for each patient at 0, 4, 8 and 12 months, based on the four times yearly control visits recommended by international guidelines. The benchmarking group also received comparative results on three critical quality indicators of vascular risk (HbA1c, LDL-cholesterol and systolic blood pressure [SBP]), checked against the results of their colleagues from the same country, and versus pre-set targets. After 12 months of follow up, the percentage of patients achieving the pre-determined targets for the three critical quality indicators will be assessed in the two groups. Results Recruitment was completed in December 2008 with 3994 evaluable patients. Conclusions This paper discusses the study rationale and design of OPTIMISE, a randomised controlled study, that will help assess whether benchmarking is a useful clinical tool for improving outcomes in T2DM in primary care. Trial registration NCT00681850 PMID:21939502

Apoptotic impact on Brugia malayi by sulphonamido-quinoxaline: search for a novel therapeutic rationale.

PubMed

Bhoj, Priyanka S; Ingle, Rahul G; Goswami, Kalyan; Jena, Lingaraj; Wadher, Shailesh

2018-05-01

Human lymphatic filariasis although not fatal but poses serious socioeconomic burden due to associated disability. This is reflected by the huge magnitude of the estimated disability-adjusted life years of about 5.09 million. Therefore, following WHO mandate, our earlier studies on antifilarial drug development revealed the significance of apoptosis. Apoptotic impact has been implicated in anticancer rationale of several drugs. In this study, we explored the antifilarial potential of sulphonamido-quinoxaline compounds, shown to be specific inhibitor for c-Met kinase in human cancer cells. Out of studied compounds, Q4, showing favorable drug-likeness and medicinal chemistry properties on bioinformatics platform along with subsequently recorded lowest IC 100 value, was considered as a suitable antifilarial candidate. Significant apoptosis due to mitochondrial involvement was recorded in drug-treated parasite unlike untreated control. In spite of homology between human c-Met kinase and Brugia malayi counterpart, comparative docking result of this compound showed more favorable binding parameters with the parasitic target. The wide gap between IC 100 and LD 50 values further confirmed the therapeutic safety. We propose sulphonamido-quinoxaline derivative as a lead candidate for antifilarial drug development. Further study is warranted to authenticate parasitic c-Met kinase as a novel therapeutic target reminiscent of anticancer rationale implicating inhibition of proliferation.

Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice.

PubMed

McCarty, Lynn S; Borgert, Christopher J; Mihaich, Ellen M

2012-07-01

There is an ongoing discussion on the provenance of toxicity testing data regarding how best to ensure its validity and credibility. A central argument is whether journal peer-review procedures are superior to Good Laboratory Practice (GLP) standards employed for compliance with regulatory mandates. We sought to evaluate the rationale for regulatory decision making based on peer-review procedures versus GLP standards. We examined pertinent published literature regarding how scientific data quality and validity are evaluated for peer review, GLP compliance, and development of regulations. Some contend that peer review is a coherent, consistent evaluative procedure providing quality control for experimental data generation, analysis, and reporting sufficient to reliably establish relative merit, whereas GLP is seen as merely a tracking process designed to thwart investigator corruption. This view is not supported by published analyses pointing to subjectivity and variability in peer-review processes. Although GLP is not designed to establish relative merit, it is an internationally accepted quality assurance, quality control method for documenting experimental conduct and data. Neither process is completely sufficient for establishing relative scientific soundness. However, changes occurring both in peer-review processes and in regulatory guidance resulting in clearer, more transparent communication of scientific information point to an emerging convergence in ensuring information quality. The solution to determining relative merit lies in developing a well-documented, generally accepted weight-of-evidence scheme to evaluate both peer-reviewed and GLP information used in regulatory decision making where both merit and specific relevance inform the process.

Weight-control behaviour and weight-concerns in young elite athletes – a systematic review

PubMed Central

2013-01-01

Weight-control behaviour is commonly observed in a wide range of elite sports, especially leanness sports, where control over body weight is crucial for high peak performance. Nonetheless, there is only a fine line between purely functional behaviour and clinically relevant eating disorders. Especially the rapid form of weight manipulation seems to foster later eating disorders. So far, most studies have focussed on adult athletes and concentrated on manifest eating disorders. In contrast, our review concentrates on young athletes and weight-control behaviour as a risk factor for eating disorders. An electronic search according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement was performed using Pubmed, PsychInfo and Spolit. The following search terms were used: weight-control, weight-control behaviour, weight gain, weight loss, pathogenic weight-control behaviour and weight-concerns, each of them combined with elite athlete, young elite athlete, adolescent elite athlete and elite sports. Overall, data are inconsistent. In general, athletes do not seem to be at a higher risk for pathogenic weight concerns and weight-control behaviour. It does seem to be more prevalent in leanness sports, though. There is evidence for pathogenic weight-control behaviour in both genders; male athletes mostly trying to gain weight whereas females emphasise weight reduction. There is not enough data to make predictions about connections with age of onset. Young elite athletes do show weight-control behaviour with varying degrees of frequency and severity. In particular, leanness sports seem to be a risk factor for weight manipulation. Further research is needed for more details and possible connections. PMID:24999399

Overcoming Fear of Eating: A Case Study of a Novel Use of Exposure and Response Prevention

PubMed Central

Glasofer, Deborah R.; Albano, Anne Marie; Simpson, H. Blair; Steinglass, Joanna E.

2016-01-01

Even after successful weight restoration, many patients with anorexia nervosa (AN) continue to exhibit maladaptive eating including repetitive behaviors (i.e., food rituals) used to decrease anxiety about food, and to describe fears related to food content its effect on shape and weight. While there are important differences between eating disorders and anxiety disorders, the shared clinical phenomena suggest potentially useful overlap in treatment strategies. This case study will describe treatment of a woman with AN using Exposure and Response Prevention for Anorexia Nervosa (AN-EXRP) as an adjunct to concurrent inpatient treatment. This is a novel use of a treatment approach with established efficacy in the treatment of anxiety disorders. AN-EXRP specifically targets eating-related anxiety with the intent to improve the restrictive eating patterns that persist after acute weight restoration. The case study described includes descriptions of (1) the treatment rationale and its phases of implementation, (2) illustrative sample dialogue between the patient and therapist, (3) pre- and post-treatment data on outcome measures of interest (e.g., food intake at a laboratory meal, self-report anxiety ratings, self-report eating-related rituals and preoccupations), and (4) therapist considerations (e.g., maintaining alliance, adhering to treatment frame). PMID:27267508

Weighting factors for radiation quality: how to unite the two current concepts.

PubMed

Kellerer, Albrecht M

2004-01-01

The quality factor, Q(L), used to be the universal weighting factor to account for radiation quality, until--in its 1991 Recommendations--the ICRP established a dichotomy between 'computable' and 'measurable' quantities. The new concept of the radiation weighting factor, w(R), was introduced for use with the 'computable' quantities, such as the effective dose, E. At the same time, the application of Q(L) was restricted to 'measurable' quantities, such as the operational quantities ambient dose equivalent or personal dose equivalent. The result has been a dual system of incoherent dosimetric quantities. The most conspicuous inconsistency resulted for neutrons, for which the new concept of wR had been primarily designed. While its definition requires an accounting for the gamma rays produced by neutron capture in the human body, this effect is not adequately reflected in the numerical values of wR, which are now suitable for mice, but are--at energies of the incident neutrons below 1 MeV--conspicuously too large for man. A recent Report 92 to ICRP has developed a proposal to correct the current imbalance and to define a linkage between the concepts Q(L) and wR. The proposal is here considered within a broader assessment of the rationale that led to the current dual system of dosimetric quantities.

Overcoming fear of eating: A case study of a novel use of exposure and response prevention.

PubMed

Glasofer, Deborah R; Albano, Anne Marie; Simpson, H Blair; Steinglass, Joanna E

2016-06-01

Even after successful weight restoration, many patients with anorexia nervosa (AN) continue to exhibit maladaptive eating including repetitive behaviors (i.e., food rituals) used to decrease anxiety about food, and to describe fears related to food content, including its effect on shape and weight. Although there are important differences between eating disorders and anxiety disorders, the shared clinical phenomena suggest potentially useful overlap in treatment strategies. This case study will describe treatment of a woman with AN using Exposure and Response Prevention for Anorexia Nervosa (AN-EXRP) as an adjunct to concurrent inpatient treatment. This is a novel use of a treatment approach with established efficacy in the treatment of anxiety disorders. AN-EXRP specifically targets eating-related anxiety with the intent to improve the restrictive eating patterns that persist after acute weight restoration. The case study described includes descriptions of (a) the treatment rationale and its phases of implementation, (b) illustrative sample dialogue between the patient and therapist, (c) pre- and posttreatment data on outcome measures of interest (e.g., food intake at a laboratory meal, self-report anxiety ratings, self-report eating-related rituals, and preoccupations), and (d) therapist considerations (e.g., maintaining alliance, adhering to treatment frame). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management.

PubMed

Bryan, Angela D; Jakicic, John M; Hunter, Christine M; Evans, Mary E; Yanovski, Susan Z; Epstein, Leonard H

2017-10-01

Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity. © 2017 The Obesity Society.

Forum: The Rise of International Large-Scale Assessments and Rationales for Participation

ERIC Educational Resources Information Center

Addey, Camilla; Sellar, Sam; Steiner-Khamsi, Gita; Lingard, Bob; Verger, Antoni

2017-01-01

This Forum discusses the significant growth of international large-scale assessments (ILSAs) since the mid-1990s. Addey and Sellar's contribution ("A Framework for Analysing the Multiple Rationales for Participating in International Large-Scale Assessments") outlines a framework of rationales for participating in ILSAs and examines the…

The Social Benefits of Higher Education: Implications for Regional Finance.

ERIC Educational Resources Information Center

Winkler, Donald R.

This paper evaluates the nature, size, and distribution of public benefits generated by institutions of higher education and assesses the rationale for regional subsidies. Following introductory material, part two discusses the rationale for general public support of higher education and assesses the legitimacy of extending this rationale to…

"Socialized Music": Historical Formations of Community Music through Social Rationales

ERIC Educational Resources Information Center

Yerichuk, Deanna

2014-01-01

This article traces the formation of community music through professional and scholarly articles over the last century in North America, and argues that community music has been discursively formed through social rationales, although the specific rationales have shifted. The author employs an archaeological framework inspired by Michel Foucault to…

Rationale for Student Dress Codes: A Review of School Handbooks

ERIC Educational Resources Information Center

Freeburg, Elizabeth W.; Workman, Jane E.; Lentz-Hees, Elizabeth S.

2004-01-01

Through dress codes, schools establish rules governing student appearance. This study examined stated rationales for dress and appearance codes in secondary school handbooks; 182 handbooks were received. Of 150 handbooks containing a rationale, 117 related dress and appearance regulations to students' right to a non-disruptive educational…

Efficacy and Safety of Ivacaftor in Patients Aged 6 to 11 Years with Cystic Fibrosis with a G551D Mutation

PubMed Central

Wainwright, Claire E.; Canny, Gerard J.; Chilvers, Mark A.; Howenstine, Michelle S.; Munck, Anne; Mainz, Jochen G.; Rodriguez, Sally; Li, Haihong; Yen, Karl; Ordoñez, Claudia L.; Ahrens, Richard

2013-01-01

Rationale: Ivacaftor (VX-770), a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator, has been shown to improve lung function, pulmonary exacerbation rate, respiratory symptoms, and weight gain compared with placebo in patients with cystic fibrosis aged 12 years or older with a G551D-CFTR mutation. Objectives: This randomized, double-blind, placebo-controlled trial evaluated ivacaftor in patients with cystic fibrosis aged 6–11 years with a G551D-CFTR mutation on at least one allele. Methods: Patients were randomly assigned to receive ivacaftor administered orally at 150 mg (n = 26) or placebo (n = 26) every 12 hours for 48 weeks in addition to existing prescribed cystic fibrosis therapies. Measurements and Main Results: Despite near-normal mean baseline values in FEV1, patients receiving ivacaftor had a significant increase in percent predicted FEV1 from baseline through Week 24 versus placebo group (treatment effect, 12.5 percentage points; P < 0.001). Effects on pulmonary function were evident by 2 weeks, and a significant treatment effect was maintained through Week 48. Patients treated with ivacaftor gained, on average, 2.8 kg more than those receiving placebo at Week 48 (P < 0.001). The change from baseline through Week 48 in the concentration of sweat chloride, a measure of CFTR activity, with ivacaftor was −53.5 mmol/L (P < 0.001) versus placebo. The incidence of adverse events was similar in the two groups. Conclusions: In patients who are younger and healthier than those in previously studied populations, ivacaftor demonstrated a significant improvement in pulmonary function, weight, and CFTR activity compared with placebo. Clinical trial registered with www.clinicaltrials.gov (NCT00909727). PMID:23590265

The Dilemma of Time: Student-Centered Teaching in the Rural Classroom in China

ERIC Educational Resources Information Center

Wang, Dan

2011-01-01

China has been promoting student-centered education under the current curriculum reform. However, teachers in rural schools continue to exercise tight control of the classroom, with lecturing taking up most of the class time. Drawing on ethnographic observation and interviews in a rural elementary school, this study analyzes the rationale of rural…

77 FR 42833 - Approval, Disapproval and Promulgation of Air Quality Implementation Plans; Arizona; Regional...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... the problem of visibility impairment in Class I areas, states, or the EPA when implementing a FIP... explanation and rationale for its determinations. While we find these problems in all of ADEQ's BART analyses... problems resulted in control determinations that are inconsistent with the RHR and the BART Guidelines. We...

The Savannah River Site's groundwater monitoring program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program's activities and rationale, and serves as an official document of the analytical results.

From a contractors perspective: what is needed to recover used CCA treated lumber?

Treesearch

Delton R. Alderman; Robert L. Smith; Philip A. Araman

2003-01-01

The rationale of this research was to discern the factors that currently are preventing contractors from recovering and recycling spent chromated copper arsenate (CCA) lumber. This study examines the effects of evaluations and beliefs, subjective norms, perceived behavioral control, and awareness of the contractor's decision intention to recover used CCA lumber....

Literate Specification: Using Design Rationale To Support Formal Methods in the Development of Human-Machine Interfaces.

ERIC Educational Resources Information Center

Johnson, Christopher W.

1996-01-01

The development of safety-critical systems (aircraft cockpits and reactor control rooms) is qualitatively different from that of other interactive systems. These differences impose burdens on design teams that must ensure the development of human-machine interfaces. Analyzes strengths and weaknesses of formal methods for the design of user…

Attitudes towards Affirmative Action: Effects of Procedural Rationale and Candidates' Qualifications.

ERIC Educational Resources Information Center

Mann, Jeffrey A.; Fasolo, Peter M.

This study examined whether individuals in higher education who are exposed to a hiring rationale based on a diversity value (minority group differences are valuable and should be relevant criteria for employment decisions in higher education) will rate affirmative action as fairer than those exposed to a compensation rationale (minority status is…

Moral and Instrumental Rationales for Affirmative Action in Five National Contexts

ERIC Educational Resources Information Center

Moses, Michele S.

2010-01-01

The author's primary aims are to clarify the differing rationales for affirmative action that have emerged in five nations--France, India, South Africa, the United States, and Brazil--and to make the case for the most compelling rationales, whether instrumentally or morally based. She examines the different social contexts surrounding the…

Structure, Citizenship, and Professionalism: Exploring Rationale Development as Part of Graduate Education in Social Studies

ERIC Educational Resources Information Center

Hawley, Todd S.; Pifel, A. Robert; Jordan, Adam W.

2012-01-01

This article details an interpretive, qualitative interview study that explored rationales developed by seven social studies graduate students, all experienced teachers, at a large Midwestern university. Interviews revealed three common themes regarding the influence of the rationale development process. The three themes were: providing structure,…

Rationales for Challenged Books. [CD-ROM].

ERIC Educational Resources Information Center

National Council of Teachers of English, Urbana, IL.

This CD-ROM presents a collection of over 200 rationales for over 170 works (mainly novels but a few films) for use by teachers combating censorship. Some rationales on the disc are from published sources; others are student papers. Although the materials in the collection range from kindergarten through grade 12, the emphasis is on the middle…

Uncertainty plus prior equals rational bias: an intuitive Bayesian probability weighting function.

PubMed

Fennell, John; Baddeley, Roland

2012-10-01

Empirical research has shown that when making choices based on probabilistic options, people behave as if they overestimate small probabilities, underestimate large probabilities, and treat positive and negative outcomes differently. These distortions have been modeled using a nonlinear probability weighting function, which is found in several nonexpected utility theories, including rank-dependent models and prospect theory; here, we propose a Bayesian approach to the probability weighting function and, with it, a psychological rationale. In the real world, uncertainty is ubiquitous and, accordingly, the optimal strategy is to combine probability statements with prior information using Bayes' rule. First, we show that any reasonable prior on probabilities leads to 2 of the observed effects; overweighting of low probabilities and underweighting of high probabilities. We then investigate 2 plausible kinds of priors: informative priors based on previous experience and uninformative priors of ignorance. Individually, these priors potentially lead to large problems of bias and inefficiency, respectively; however, when combined using Bayesian model comparison methods, both forms of prior can be applied adaptively, gaining the efficiency of empirical priors and the robustness of ignorance priors. We illustrate this for the simple case of generic good and bad options, using Internet blogs to estimate the relevant priors of inference. Given this combined ignorant/informative prior, the Bayesian probability weighting function is not only robust and efficient but also matches all of the major characteristics of the distortions found in empirical research. PsycINFO Database Record (c) 2012 APA, all rights reserved.

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014

PubMed Central

Sim, Won Yong; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Background Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. Methods This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ Results The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Conclusion Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors. PMID:28197330

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014.

PubMed

Sim, Won Yong; Cho, Young Gyu; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. 'Unhealthy weight control behaviors' were subcategorized into 'extreme weight control behaviors' and 'less extreme weight control behaviors.' The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

Supplement use in sport: is there a potentially dangerous incongruence between rationale and practice?

PubMed Central

Petróczi, Andrea; Naughton, Declan P

2007-01-01

Background Supplement use by athletes is complex and research supports the alarming notion of misinformed decisions regarding supplements. Hypothesis A frequent divergence between the type of supplements chosen by athletes and the rationale dictating the supplement use is hypothesized. Thus, a potentially dangerous incongruence may exist between rationale and practice. Testing the hypothesis In the continued absence of reliable data on supplement use, an alternative approach of studying the reasons underlying supplement use in athletes is proposed to determine whether there is an incongruence between rationale and practice. Existing data from large scale national surveys can be used to investigate this incongruence. Implications of the hypothesis In this report, analyses of distinctive patterns between the use and rationale for use of supplements among athletes are recommended to explore this potentially dangerous phenomenon. PMID:17535442

Future Astronomical Observatories on the Moon

NASA Technical Reports Server (NTRS)

Burns, Jack O. (Editor); Mendell, Wendell W. (Editor)

1988-01-01

Papers at a workshop which consider the topic astronomical observations from a lunar base are presented. In part 1, the rationale for performing astronomy on the Moon is established and economic factors are considered. Part 2 includes concepts for individual lunar based telescopes at the shortest X-ray and gamma ray wavelengths, for high energy cosmic rays, and at optical and infrared wavelengths. Lunar radio frequency telescopes are considered in part 3, and engineering considerations for lunar base observatories are discussed in part 4. Throughout, advantages and disadvantages of lunar basing compared to terrestrial and orbital basing of observatories are weighted. The participants concluded that the Moon is very possibly the best location within the inner solar system from which to perform front-line astronomical research.

Development of a solar-powered residential air conditioner: Economic analysis

NASA Technical Reports Server (NTRS)

1975-01-01

The results of investigations aimed at the development of cost models to be used in the economic assessment of Rankine-powered air conditioning systems for residential application are summarized. The rationale used in the development of the cost model was to: (1) collect cost data on complete systems and on the major equipment used in these systems; (2) reduce these data and establish relationships between cost and other engineering parameters such as weight, size, power level, etc; and (3) derive simple correlations from which cost-to-the-user can be calculated from performance requirements. The equipment considered in the survey included heat exchangers, fans, motors, and turbocompressors. This kind of hardware represents more than 2/3 of the total cost of conventional air conditioners.

Composite Dry Structure Cost Improvement Approach

NASA Technical Reports Server (NTRS)

Nettles, Alan; Nettles, Mindy

2015-01-01

This effort demonstrates that by focusing only on properties of relevance, composite interstage and shroud structures can be placed on the Space Launch System vehicle that simultaneously reduces cost, improves reliability, and maximizes performance, thus providing the Advanced Development Group with a new methodology of how to utilize composites to reduce weight for composite structures on launch vehicles. Interstage and shroud structures were chosen since both of these structures are simple in configuration and do not experience extreme environments (such as cryogenic or hot gas temperatures) and should represent a good starting point for flying composites on a 'man-rated' vehicle. They are used as an example only. The project involves using polymer matrix composites for launch vehicle structures, and the logic and rationale behind the proposed new methodology.

Intermittent fasting: a "new" historical strategy for controlling seizures?

PubMed

Hartman, Adam L; Rubenstein, James E; Kossoff, Eric H

2013-05-01

In antiquity, fasting was a treatment for epilepsy and a rationale for the ketogenic diet (KD). Preclinical data indicate the KD and intermittent fasting do not share identical anticonvulsant mechanisms. We implemented an intermittent fasting regimen in six children with an incomplete response to a KD. Three patients adhered to the combined intermittent fasting/KD regimen for 2 months and four had transient improvement in seizure control, albeit with some hunger-related adverse reactions. Copyright © 2012 Elsevier B.V. All rights reserved.

Selection of combined water electrolysis and resistojet propulsion for Space Station Freedom

NASA Technical Reports Server (NTRS)

Schmidt, George R.

1988-01-01

An analytical rationale is presented for the configuration of the NASA Space Station's two-element propulsion system, and attention is given to the cost benefits accruing to this system over the Space Station's service life. The principal system element uses gaseous oxygen and hydrogen obtained through water electrolysis to furnish attitude control, backup attitude control, and contingency maneuvering. The secondary element uses resistojets to augment Space Station reboost through the acceleration of waste gases in the direction opposite the Station's flight path.

Cargo Movement Operations System (CMOS). Increment II System Design Document, Final

DTIC Science & Technology

1990-08-02

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SSDD-0002 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A002-06 DATE: 08/02/90 ORIGINATOR NAME: John J. Brassil OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: 35 PARA NUMBER: 4.2.1.3.1 COMMENT OR RECOMMENDED CHANGE: Add subordinate paragraphs to describe the 3-digit System Capabilities that are listed under System Administration in Appendix G. RATIONALE: Both Process Outbound Cargo

Cargo Movement Operations System (CMOS): Final Software Design Document, Forms 3.0 Conversion Project, Increment III.

DTIC Science & Technology

1991-09-05

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ 3 ... ... .. . ....... ... .. ............ ... . . . . . . . u m ORIGINATOR CONTROL NUMBER: SDD-0002 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: DCO0-0005d DATE: 09/05/91 ORIGINATOR NAME: Vivian L. Martin OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 271-2999 SUBSTANTIVE: x EDITORIAL: PAGE NUMBER: CUlAO025-3 PARA NUMBER: c. COMMENT OR RECOMMENDED CHANGE: Provide the input, output, and local data elements for this CSU. RATIONALE: Paragraph c. states that data

Cargo Movement Operations System (CMOS) System Segment Specification

DTIC Science & Technology

1990-04-19

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED ( ] 0 ORIGINATOR CONTROL NUMBER: SSS-0003 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A004-25 DATE: 04/06/90 ORIGINATOR NAME: Patrick Combs OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: 44 PARA NUMBER: 3.2.1.2.4.2.11 COMMENT OR RECOMMENDED CHANGE: Change the fifth sentence to read, "The system shall require the operator to input status into the remarks section to clear the management notice." RATIONALE:

Controlled Ecological Life Support System. Design, Development, and Use of a Ground-Based Plant Growth Module

NASA Technical Reports Server (NTRS)

Macelroy, Robert D.; Smernoff, David T.; Rummel, John D.

1987-01-01

Problems of food production by higher plants are addressed. Experimentation requirements and necessary equipment for designing an experimental Controlled Ecological Life Support System (CELSS) Plant Growth Module are defined. A framework is provided for the design of laboratory sized plant growth chambers. The rationale for the development of an informal collaborative effort between investigators from universities and industry and those at Ames is evaluated. Specific research problems appropriate for collaborative efforts are identified.

A study on body weight perception and weight control behaviours among adolescents in Hong Kong.

PubMed

Cheung, Patrick C H; Ip, Patricia L S; Lam, S T; Bibby, Helen

2007-02-01

To examine the relationships between body weight perceptions, estimated body mass index, gender, and weight control behaviours. Cross-sectional survey. Three secondary schools in Hong Kong. A total of 1132 secondary school forms 1 and 3 students. The strength of agreement between perceived weight and estimated body mass index, and the association between perceived weight, estimated body mass index, and weight control behaviours. A total of 14% of students were estimated to be overweight or obese. The agreement between actual (estimated) body mass index and perceived weight was poor in females and fair in males (Kappa 0.137 and 0.225, respectively). In females, there was no evidence of a relationship between body mass index and weight control behaviours. However, there was a relationship between perceived weight and weight control behaviours such that females who perceived themselves as overweight were more likely to exercise, restrict caloric intake, self medicate with diet pills, purge, or use laxatives. In males, there was evidence of a relationship between perceived weight, body mass index, and weight control behaviours. Males who perceived themselves as overweight or were overweight, were more likely to exercise or restrict caloric intake. Body weight perceptions are not in agreement with actual weight in adolescents. This discrepancy is more marked in females who use a variety of weight control behaviours. These behaviours are motivated by perceived weight rather than actual (estimated) body mass index. Overweight adolescents should be encouraged to adopt appropriate weight control behaviours for their health needs.

Multivitamin/mineral supplements: Rationale and safety - A systematic review.

PubMed

Biesalski, Hans K; Tinz, Jana

2017-01-01

Multivitamin/mineral supplements (MVM) are widely used in many populations. In particular, in pregnant women, MVM together with iron and folic acid are recommended to improve birth outcome and reduce low birth weight and rates of miscarriage. However, MVM use is common in the general population. This raises questions regarding the safety of long-term use of these supplements. To estimate the safety of MVM use, we performed a literature search for randomized, controlled studies for supplements with a combination of at least nine vitamins and three minerals at a maximum concentration of 100% of the recommended dietary allowance. We found nine studies evaluating the use and efficacy of MVM in pregnant women and healthy adults and six studies in the elderly where adverse effects were explicitly addressed. Only minor adverse effects (e.g., unspecific gastrointestinal symptoms) were reported in all studies. In particular, there were no significant differences between treatment and placebo groups. MVM use within the range of the dietary reference intake will not result in excess intake, even when including the impact of food and fortified food, and does not increase mortality. Taken together, these findings indicate that MVM can be safe for long-term use (more than 10 y). Copyright © 2016 Elsevier Inc. All rights reserved.

IL-33 induces protective effects in adipose tissue inflammation during obesity in mice

PubMed Central

Miller, Ashley M.; Asquith, Darren L.; Hueber, Axel J.; Anderson, Lesley A.; Holmes, William M.; McKenzie, Andrew N.; Xu, Damo; Sattar, Naveed; McInnes, Iain B.; Liew, Foo Y.

2014-01-01

Rationale Chronic low-grade inflammation involving adipose tissue likely contributes to the metabolic consequences of obesity. The cytokine IL-33 and its receptor ST2 are expressed in adipose tissue but their role in adipose tissue inflammation during obesity is unclear. Objective To examine the functional role of IL-33 in adipose tissues, and investigate the effects on adipose tissue inflammation and obesity in vivo. Methods and Results We demonstrate that treatment of adipose tissue cultures in vitro with IL-33 induced production of Th2 cytokines (IL-5, IL-13, IL-10), and reduced expression of adipogenic and metabolic genes. Administration of recombinant IL-33 to genetically obese diabetic (ob/ob) mice led to reduced adiposity, reduced fasting glucose and improved glucose and insulin tolerance. IL-33 also induced accumulation of Th2 cells in adipose tissue and polarization of adipose tissue macrophages towards an M2 alternatively activated phenotype (CD206+), a lineage associated with protection against obesity-related metabolic events. Furthermore, mice lacking endogenous ST2 fed HFD had increased body weight and fat mass, impaired insulin secretion and glucose regulation compared to WT controls fed HFD. Conclusions In conclusion, IL-33 may play a protective role in the development of adipose tissue inflammation during obesity. PMID:20634488

The Role of the Pediatrician in Primary Prevention of Obesity.

PubMed

Daniels, Stephen R; Hassink, Sandra G

2015-07-01

The adoption of healthful lifestyles by individuals and families can result in a reduction in many chronic diseases and conditions of which obesity is the most prevalent. Obesity prevention, in addition to treatment, is an important public health priority. This clinical report describes the rationale for pediatricians to be an integral part of the obesity-prevention effort. In addition, the 2012 Institute of Medicine report "Accelerating Progress in Obesity Prevention" includes health care providers as a crucial component of successful weight control. Research on obesity prevention in the pediatric care setting as well as evidence-informed practical approaches and targets for prevention are reviewed. Pediatricians should use a longitudinal, developmentally appropriate life-course approach to help identify children early on the path to obesity and base prevention efforts on family dynamics and reduction in high-risk dietary and activity behaviors. They should promote a diet free of sugar-sweetened beverages, of fewer foods with high caloric density, and of increased intake of fruits and vegetables. It is also important to promote a lifestyle with reduced sedentary behavior and with 60 minutes of daily moderate to vigorous physical activity. This report also identifies important gaps in evidence that need to be filled by future research. Copyright © 2015 by the American Academy of Pediatrics.

Implantation in assisted reproduction: a look at endometrial receptivity.

PubMed

Fatemi, H M; Popovic-Todorovic, B

2013-11-01

Implantation failure in assisted reproduction is thought to be mainly due to impaired uterine receptivity. With normal uterine anatomy, changes in endocrine profile during ovarian stimulation and medical conditions of the mother (i.e. thrombophilia and abnormal immunological response) could result in a non-receptive endometrium. High oestradiol concentrations during ovarian stimulation lead to premature progesterone elevation, causing endometrial advancement and hampering implantation, which can be overcome by a freeze-all approach and embryo transfer in natural cycles or by milder stimulation protocols. Patients with recurrent implantation failure (RIF) should be tested for inherited and acquired thrombophilias. Each patient should be individually assessed and counselled regarding therapy with low-molecular-weight heparin (LMWH). Empirical treatment with LMWH, aspirin or corticosteroids is not effective for women with RIF who have negative thrombophilic tests. If thrombophilic tests are normal, patients should be tested for immunological causes. If human leukocyte antigen dissimilarity is proven, treatment with intravenous immunoglobulin might be beneficial. Preliminary observational studies using intralipid infusion in the presence of increased natural killer cytotoxic activity are interesting but the proposed rationale is controversial and randomized controlled trials are needed. Hysteroscopy and/or endometrial scratching in the cycle preceding ovarian stimulation should become standard for patients with RIF. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Postangioplasty Restenosis Followed with Magnetic Resonance Imaging in an Atherosclerotic Rabbit Model

PubMed Central

Hänni, Mari; Leppänen, Olli; Smedby, Örjan

2012-01-01

Rationale and Objectives. Testing a quantitative, noninvasive method to assess postangioplasty vessel wall changes in an animal model. Material and Methods. Six New Zealand white rabbits were subjected to atherosclerotic injury, including cholesterol-enriched diet, deendothelialization, and percutaneous transluminal angioplasty (PTA) in the distal part of abdominal aorta (four weeks after deendothelialization). The animals were examined with a 1.5T MRI scanner at three times as follows: baseline (six weeks after diet start and two days after PTA) and four weeks and 10 weeks after-PTA. Inflow angiosequence (M2DI) and proton-density-weighted sequence (PDW) were performed to examine the aorta with axial slices. To identify the inner and outer vessel wall boundaries, a dynamic contour algorithm (Gradient Vector Flow Snakes) was applied to the images, followed by calculation of the vessel wall dimensions. The results were compared with histopathological analysis. Results. The wall thickness in the lesion was significantly higher than in the control region at 4 and 10 weeks, reflecting induction of experimentally created after-angioplasty lesion. At baseline, no significant difference between the two regions was present. Conclusions. It is possible to follow the development of vessel wall changes after-PTA with MRI in this rabbit model. PMID:23316216

gLExec: gluing grid computing to the Unix world

NASA Astrophysics Data System (ADS)

Groep, D.; Koeroo, O.; Venekamp, G.

2008-07-01

The majority of compute resources in todays scientific grids are based on Unix and Unix-like operating systems. In this world, user and user-group management are based around the concepts of a numeric 'user ID' and 'group ID' that are local to the resource. In contrast, grid concepts of user and group management are centered around globally assigned identifiers and VO membership, structures that are independent of any specific resource. At the fabric boundary, these 'grid identities' have to be translated to Unix user IDs. New job submission methodologies, such as job-execution web services, community-deployed local schedulers, and the late binding of user jobs in a grid-wide overlay network of 'pilot jobs', push this fabric boundary ever further down into the resource. gLExec, a light-weight (and thereby auditable) credential mapping and authorization system, addresses these issues. It can be run both on fabric boundary, as part of an execution web service, and on the worker node in a late-binding scenario. In this contribution we describe the rationale for gLExec, how it interacts with the site authorization and credential mapping frameworks such as LCAS, LCMAPS and GUMS, and how it can be used to improve site control and traceability in a pilot-job system.

Psychological Treatments for Binge Eating Disorder

PubMed Central

Gredysa, Dana M.; Altman, Myra; Wilfley, Denise E.

2012-01-01

Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models. PMID:22707016

Young adults' responses to alternative messages describing a sugar-sweetened beverage price increase.

PubMed

Gollust, Sarah E; Tang, Xuyang; White, James M; French, Simone A; Runge, Carlisle Ford; Rothman, Alexander J

2017-01-01

Many jurisdictions in the USA and globally are considering raising the prices of sugar-sweetened beverages (SSB) through taxes as a strategy to reduce their consumption. The objective of the present study was to identify whether the rationale provided for an SSB price increase affects young adults' behavioural intentions and attitudes towards SSB. Participants were randomly assigned to receive one of eight SSB price increase rationales. Intentions to purchase SSB and attitudes about the product and policy were measured. A forty-six-item cross-sectional Internet survey. Undergraduate students (n 494) at a large US Midwestern university. Rationale type was significantly associated with differences in participants' purchasing intentions for the full sample (F 7,485=2·53, P=0·014). Presenting the rationale for an SSB price increase as a user fee, an effort to reduce obesity, a strategy to offset health-care costs or to protect children led to lower SSB purchasing intentions compared with a message with no rationale. Rationale type was also significantly associated with differences in perceptions of soda companies (F 7,485=2·10, P=0·043); among low consumers of SSB, messages describing the price increase as a user fee or tax led to more negative perceptions of soda companies. The rationale attached to an SSB price increase could influence consumers. However, these message effects may depend on individuals' level of SSB consumption.

A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation in patients with systolic heart failure: rationale, design, and baseline patient characteristics.

PubMed

Abraham, William T; Burkhoff, Daniel; Nademanee, Koonlawee; Carson, Peter; Bourge, Robert; Ellenbogen, Kenneth A; Parides, Michael; Kadish, Alan

2008-10-01

Cardiac contractility modulation (CCM) signals are nonexcitatory electrical signals delivered during the cardiac absolute refractory period that enhance the strength of cardiac muscular contraction. Prior research in experimental and human heart failure has shown that CCM signals normalize phosphorylation of key proteins and expression of genes coding for proteins involved in regulation of calcium cycling and contraction. The results of prior clinical studies of CCM have supported its safety and efficacy. A large-scale clinical study, the FIX-HF-5 study, is currently underway to test the safety and efficacy of this treatment. In this article, we provide an overview of the system used to deliver CCM signals, the implant procedure, and the details and rationale of the FIX-HF-5 study design. Baseline characteristics for patients randomized in this trial are also presented.

Rationale and Development of a Security Assurance Index with Application toward the Development of a World Risk Index

DOE Office of Scientific and Technical Information (OSTI.GOV)

M. M. Plum; G. A. Beitel, PhD

Assurance categories were previously developed to support the Department of Homeland Security’s efforts in the mitigation of Cyber Control System events. Defined according to the risk of life and economic loss, the minimum range is designated by policy, whereas the maximum limit seems to be constrained only by limits and interdependencies of the event. Use of this life / assets scale has proven to be helpful in managing risk due to the scale's ease of use, communication, and understanding. Suggestions have been made that this scale could be applied to all events of terror, disaster, and calamity of an internationalmore » scale, with equally good results. This paper presents the history of some existing scales of disaster and assurance, the rationale behind the development of the original Security Assurance Index, and our proposed scale of disaster and calamity as a World Risk Index.« less

Public Risk Criteria and Rationale for Commercial Launch and Reentry

NASA Astrophysics Data System (ADS)

Wilde, P. D.

2012-01-01

This paper summarizes the rationale for risk criteria intended to protect the public during commercial spaceflight, including launch, reentry, and suborbital missions. The recommended approach includes: (1) safety goals to guide periodic updates of the quantitative collective risk limits if warranted based on the quantity of launch and reentry missions; the demonstrated safety record and benefits provided; technological capabilities and maturity of the industry; and contemporary attitudes about the risks from commercial space transportation; (2) separate limits on the risks from each type of mission with explicit definitions of the extent of launch and reentry missions; and (3) quantitative risk limits consistent with the safety goals. For current conditions, the author's recommends (a) maximum of 1E-6 probability of casualty per-mission (b) a maximum of 100E-6 expected casualties per-mission, and (c) equal per-mission risk limits for orbital and suborbital launches, as well as controlled and uncontrolled reentries.

NITRIC OXIDE FOR THE ADJUNCTIVE TREATMENT OF SEVERE MALARIA: HYPOTHESIS AND RATIONALE

PubMed Central

Hawkes, Michael; Opoka, Robert Opika; Namasopo, Sophie; Miller, Christopher; Conroy, Andrea L.; Serghides, Lena; Kim, Hani; Thampi, Nisha; Liles, W. Conrad; John, Chandy C.; Kain, Kevin C.

2011-01-01

We hypothesize that supplemental inhaled nitric oxide (iNO) will improve outcomes in children with severe malaria receiving standard antimalarial therapy. The rationale for the hypothesized efficacy of iNO rests on: (1) biological plausibility, based on known actions of NO in modulating endothelial activation; (2) pre-clinical efficacy data from animal models of experimental cerebral malaria; and (3) a human trial of the NO precursor L-arginine, which improved endothelial function in adults with severe malaria. iNO is an attractive new candidate for the adjunctive treatment of severe malaria, given its proven therapeutic efficacy in animal studies, track record of safety in clinical practice and numerous clinical trials, inexpensive manufacturing costs, and ease of administration in settings with limited healthcare infrastructure. We plan to test this hypothesis in a randomized controlled trial (ClinicalTrials.gov Identifier: NCT01255215). PMID:21745716

A Rationale for Building a Comprehensive Science Program for Inner-City Education.

ERIC Educational Resources Information Center

Martin, Charles Arthur

The intent of this dissertation was to develop a science curriculum from an inner-city perspective. Five units and a rationale for inner-city education are included. The units include both physical and biological science topics. The units are as follows: (1) Rationale for Building a Comprehensive Science Program for Inner-City Education; (2) With…

Soft Power as a Policy Rationale for International Education in the UK: A Critical Analysis

ERIC Educational Resources Information Center

Lomer, Sylvie

2017-01-01

This article presents the results of a textual analysis conducted on policy discourses on international students in the UK between 1999 and 2013. A number of rationales for and against increasing their numbers have been made, which have largely remained consistent over changing political administrations. One key rationale is that international…

Rationales Shaping International Linkages in Higher Education: A Qualitative Case Study of the ASU-ITESM Strategic Alliance

ERIC Educational Resources Information Center

Camacho Lizarraga, Monica Irene

2011-01-01

This qualitative case study examines the rationales of the relationship between Arizona State University (ASU)--an American public research university--and Tecnologico de Monterrey (ITESM), a Mexican private not for profit research university. The focus of the study is to document the different meanings participants attached to the rationales of…

The Effects of Rationales, Differential Reinforcement, and a Guided Compliance Procedure to Increase Compliance among Preschool Children

ERIC Educational Resources Information Center

Wilder, David A.; Myers, Kristin; Nicholson, Katie; Allison, Janelle; Fischetti, Anthony T.

2012-01-01

Previous research suggests that rationales, or statements describing why a child should comply with a caregiver-delivered instruction, are ineffective at increasing compliance. In the current study, we compared the effects of rationales to a differential reinforcement procedure and a guided compliance procedure. The results indicated that…

A comparison of methods for calculating population exposure estimates of daily weather for health research.

PubMed

Hanigan, Ivan; Hall, Gillian; Dear, Keith B G

2006-09-13

To explain the possible effects of exposure to weather conditions on population health outcomes, weather data need to be calculated at a level in space and time that is appropriate for the health data. There are various ways of estimating exposure values from raw data collected at weather stations but the rationale for using one technique rather than another; the significance of the difference in the values obtained; and the effect these have on a research question are factors often not explicitly considered. In this study we compare different techniques for allocating weather data observations to small geographical areas and different options for weighting averages of these observations when calculating estimates of daily precipitation and temperature for Australian Postal Areas. Options that weight observations based on distance from population centroids and population size are more computationally intensive but give estimates that conceptually are more closely related to the experience of the population. Options based on values derived from sites internal to postal areas, or from nearest neighbour sites--that is, using proximity polygons around weather stations intersected with postal areas--tended to include fewer stations' observations in their estimates, and missing values were common. Options based on observations from stations within 50 kilometres radius of centroids and weighting of data by distance from centroids gave more complete estimates. Using the geographic centroid of the postal area gave estimates that differed slightly from the population weighted centroids and the population weighted average of sub-unit estimates. To calculate daily weather exposure values for analysis of health outcome data for small areas, the use of data from weather stations internal to the area only, or from neighbouring weather stations (allocated by the use of proximity polygons), is too limited. The most appropriate method conceptually is the use of weather data from sites within 50 kilometres radius of the area weighted to population centres, but a simpler acceptable option is to weight to the geographic centroid.

Talking Health, A pragmatic randomized-controlled health literacy trial targeting sugar-sweetened beverage consumption among adults: Rationale, design & methods

PubMed Central

Zoellner, Jamie; Chen, Yvonnes; Davy, Brenda; You, Wen; Hedrick, Valisa; Corsi, Terri; Estabrooks, Paul

2014-01-01

High consumption of sugar-sweetened beverages (SSB) contributes to a wide range of poor health outcomes. Further, few US adults drink less than the recommended ≤8 ounces per day; and individuals with low socioeconomic, low health literacy status, and in rural areas are even less likely to meet recommendations. Unfortunately, few SSB behavioral interventions exist targeting adults, and none focus on low health literacy in rural areas. Talking Health, a type 1 effectiveness-implementation hybrid trial targeting adults in rural southwest Virginia, was developed using the RE-AIM planning and evaluation framework (reach, effectiveness, adoption, implementation, maintenance). The primary aim of this pragmatic randomized-controlled trial was to determine the effectiveness of a scalable 6-month intervention aimed at decreasing SSB consumption (SIPsmartER) when compared to a matched contact physical activity promotion control group (MoveMore). SIPsmartER was developed based upon the Theory of Planned Behavior and uses health literacy strategies to improve comprehension of the intervention content among participants. MoveMore is based on a research-tested intervention that was adapted to address all theory of planned behavior constructs and health literacy principles. Secondary aims include additional health outcomes (e.g., physical activity, weight) and reach, adoption, implementation, and maintenance indicators. This paper highlights the opportunities and considerations for developing health behavior trials that aim to determine intervention effectiveness, provide all study participants an opportunity to benefit from research participation, and collect key information on reach and the potential for organizational adoption, implementation, and maintenance with the longer-term goal of speeding translation into practice settings. PMID:24246819

Introducing iron isomaltoside 1000 (Monofer®)-development rationale and clinical experience.

PubMed

Kalra, Philip A

2011-06-01

Patients with chronic kidney disease (CKD) often suffer from iron deficiency anaemia necessitating treatment with intravenous (IV) iron. Several studies demonstrate that oral iron is insufficient in these patients and that IV supplementation is a more effective treatment. Until now, use of available parenteral iron preparations has been limited by dosing schedules and the need, in some cases, for a test dose, and despite the availability of a range of different IV iron compounds, there is still a need for improved compounds. The new IV iron, iron isomaltoside 1000 Monofer®, is composed of iron and chemically modified isomalto-oligosaccharides which have a mean molecular weight of 1000 Da and consist predominantly of 3-5 glucose units. In contrast to dextrans, the carbohydrate isomaltoside 1000 is a linear and unbranched structure with theoretically a low immunological potential. Hence, a test dose is not necessary. Iron isomaltoside 1000 contains strongly bound iron within the iron-isomaltoside formulation, which enables a controlled slow release of bioavailable iron to the iron-binding proteins, with potentially a reduced risk of free iron toxicity. This allows flexible dosing including high and rapid dosing securing convenient iron therapy for a wide range of patients. The development of Monofer® has been enthusiastically acknowledged by clinicians, and in 2009, there has been fast approval by European authorities via a decentralized registration procedure. This new IV iron is currently being marketed in several European countries. This article describes the development rationale and summarizes the clinical data assessing the use of iron isomaltoside 1000 administered without a test dose by either repeated bolus injections or fast high single iron infusions [defined as total dose infusion (TDI)] to patients suffering from CKD. Since CKD is associated with a high prevalence of cardiovascular disease, data from a small trial applying high single doses of iron isomatoside 1000 in patients with chronic heart failure (CHF) are also reviewed. Collectively, the available data demonstrate adequate efficacy and a good safety profile of iron isomaltoside 1000 in CKD and CHF patients even when administered without a test dose and as single rapid high-dose infusions.

Automation of closed environments in space for human comfort and safety

NASA Technical Reports Server (NTRS)

1990-01-01

The results are presented of the first year of a three year project on the automation of the Environmental Control and Life Support System (ECLSS) of the Space Station Freedom (SSF). The results are applicable to other future space mission. The work was done by the Kansas State University NASA/USRA interdisciplinary student design team. The six ECLSS subsystems and how they interact are discussed. Proposed control schemes and their rationale are discussed for the Atmosphere Revitalization (AR) subsystem. Finally, a description of the mathematical models for many components of the ECLSS control system is given.

Weight-Control Methods, 3-Year Weight Change, and Eating Behaviors: A Prospective Nationwide Study of Middle-Aged New Zealand Women.

PubMed

Leong, Sook Ling; Gray, Andrew; Haszard, Jillian; Horwath, Caroline

2016-08-01

The effectiveness of women's weight-control methods and the influences of dieting on eating behaviors remain unclear. Our aim was to determine the association of various weight-control methods at baseline with weight change to 3 years, and examine the association between baseline weight-control status (trying to lose weight, trying to prevent weight gain or no weight-control attempts) and changes in intuitive eating and binge eating at 3 years. A nationally representative sample of 1,601 New Zealand women (40 to 50 years) was recruited and completed a self-administered questionnaire at baseline regarding use of variety of weight-control methods. Information on demographic characteristics, weight, height, food habits, binge eating, and intuitive eating were collected at baseline and 3 years. Linear and logistic regression models examined associations between both weight status and weight-control methods at baseline and weight change to 3 years; and baseline weight-control status and change in intuitive eating from baseline to 3 years and binge eating at 3 years. χ(2) tests were used to cross-sectionally compare food habits across the weight status categories at both baseline and 3 years. Trying to lose weight and the use of weight-control methods at baseline were not associated with change in body weight to 3 years. There were a few differences in the frequency of consumption of high-energy-density foods between those trying to lose or maintain weight and those not attempting weight control. Trying to lose weight at baseline was associated with a 2.0-unit (95% CI 0.7 to 3.4, P=0.003) reduction in intuitive eating scores by 3 years (potential range=21 to 105), and 224% (odds ratio=3.24; 95% CI 1.69 to 6.20; P<0.001) higher odds of binge eating at 3 years. The apparent ineffectiveness of dieting and weight-control behaviors may reflect misconceptions about what constitutes healthy eating or energy-dense foods. Dieting may reduce women's ability to recognize hunger and satiety cues and place women at increased risk of binge eating. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Declines with Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations

ERIC Educational Resources Information Center

Ko, Yi-An; Song, Peter X. K.; Clark, Noreen M.

2014-01-01

Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline…

New legislation on palliative care and pain in Mexico.

PubMed

Bistre, Sara

2009-01-01

International policy initiatives have called for recognition of pain management and palliative care as basic humans rights. This paper describes the rationale for and realization of major changes in Mexican health law to help assure availability of such services to the citizenry of that nation. The necessity for appropriate symptom control and safeguards against inappropriate initiation or cessation of care are defined.

Mental Set Shifting in Childhood: The Role of Working Memory and Inhibitory Control

ERIC Educational Resources Information Center

Brocki, Karin C.; Tillman, Carin

2014-01-01

The role of working memory (WM) and inhibition in mental set shifting was examined from an individual difference perspective in children aged 5-14?years (N?=?117). Using the Hearts and Flowers task the rationale of the present study was to directly test the theoretical assumption that mental set shifiting in childhood primarily builds on WM and…

A Randomized Controlled Trial of Acceptance-Based Behavior Therapy and Cognitive Therapy for Test Anxiety: A Pilot Study

ERIC Educational Resources Information Center

Brown, Lily A.; Forman, Evan M.; Herbert, James D.; Hoffman, Kimberly L.; Yuen, Erica K.; Goetter, Elizabeth M.

2011-01-01

Many university students suffer from test anxiety that is severe enough to impair performance. Given mixed efficacy results of previous cognitive-behavior therapy (CBT) trials and a theoretically driven rationale, an acceptance-based behavior therapy (ABBT) approach was compared to traditional CBT (i.e., Beckian cognitive therapy; CT) for the…

The Savannah River Site`s groundwater monitoring program. First quarter 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program`s activities and rationale, and serves as an official document of the analytical results.

Multimedia Language Learning Courseware: A Design Solution to the Production of a Series of CD-ROMs.

ERIC Educational Resources Information Center

Brett, P. A.; Nash, M.

1999-01-01

Discusses multimedia software and describes the production and the learning rationale of a series of six multimedia CD-ROMs that develop the listening skills of learners of Business English. Describes problems of cost, time, and quality in producing multiple courseware and explains the programming solution which gives control to subject experts.…

ADA Integrated Environment I. Design Rationale.

DTIC Science & Technology

1981-12-01

integration and integrated communications are evidenced across data, control and development concepts. STONEMAN [STONEMAN] and the S.O.W. suggest a layered...their managers, but others as well. During development , ongoing communication must be maintained with system specifiers and designers, hardware engineers...reorganization as a result of organizational change or of technology insertion. Consequently, current MAPSE development must be viewed in the context of

Reassessing policy paradigms: A comparison of the global tobacco and alcohol industries.

PubMed

Hawkins, Benjamin; Holden, Chris; Eckhardt, Jappe; Lee, Kelley

2018-01-01

Tobacco is widely considered to be a uniquely harmful product for human health. Since the mid-1990s, the strategies of transnational tobacco corporations to undermine effective tobacco control policy has been extensively documented through internal industry documents. Consequently, the sale, use and marketing of tobacco products are subject to extensive regulation and formal measures to exclude the industry from policy-making have been adopted in the Framework Convention on Tobacco Control. In contrast to tobacco, alcohol is subject to less stringent forms of regulation, and the alcohol industry continues to play a central role in policy-making in many countries and at the global level. This article examines whether there is a sufficient rationale for such different regulatory approaches, through a comparative analysis of the political economy of the tobacco and alcohol industries including the structure of the industries, and the market and political strategies they pursue. Despite some important differences, the extensive similarities which exist between the tobacco and alcohol industries in terms of market structure and strategy, and political strategy, call into question the rationale for both the relatively weak regulatory approach taken towards alcohol, and the continued participation of alcohol corporations in policy-making processes.

Evaluation of indigenous grains from the Peruvian Andean region for antidiabetes and antihypertension potential using in vitro methods.

PubMed

Ranilla, Lena Galvez; Apostolidis, Emmanouil; Genovese, Maria Ines; Lajolo, Franco Maria; Shetty, Kalidas

2009-08-01

The health-relevant functionality of 10 thermally processed Peruvian Andean grains (five cereals, three pseudocereals, and two legumes) was evaluated for potential type 2 diabetes-relevant antihyperglycemia and antihypertension activity using in vitro enzyme assays. Inhibition of enzymes relevant for managing early stages of type 2 diabetes such as hyperglycemia-relevant alpha-glucosidase and alpha-amylase and hypertension-relevant angiotensin I-converting enzyme (ACE) were assayed along with the total phenolic content, phenolic profiles, and antioxidant activity based on the 1,1-diphenyl-2-picrylhydrazyl radical assay. Purple corn (Zea mays L.) (cereal) exhibited high free radical scavenging-linked antioxidant activity (77%) and had the highest total phenolic content (8 +/- 1 mg of gallic acid equivalents/g of sample weight) and alpha-glucosidase inhibitory activity (51% at 5 mg of sample weight). The major phenolic compound in this cereal was protocatechuic acid (287 +/- 15 microg/g of sample weight). Pseudocereals such as Quinoa (Chenopodium quinoa Willd) and Kañiwa (Chenopodium pallidicaule Aellen) were rich in quercetin derivatives (1,131 +/- 56 and 943 +/- 35 microg [expressed as quercetin aglycone]/g of sample weight, respectively) and had the highest antioxidant activity (86% and 75%, respectively). Andean legumes (Lupinus mutabilis cultivars SLP-1 and H-6) inhibited significantly the hypertension-relevant ACE (52% at 5 mg of sample weight). No alpha-amylase inhibitory activity was found in any of the evaluated Andean grains. This in vitro study indicates the potential of combination of Andean whole grain cereals, pseudocereals, and legumes to develop effective dietary strategies for managing type 2 diabetes and associated hypertension and provides the rationale for animal and clinical studies.

Analysis of weight control in Korean adolescents using the transtheoretical model.

PubMed

Chae, Sun-Mi; Kwon, Insook; Kim, Chun-Ja; Jang, Jaecheol

2010-06-01

The purpose of this study was to identify the stages of change, the processes of change, and the decisional balance for weight control, self-efficacy, and other weight control-related variables and to determine the significant factors explaining movements between the stages of change in Korean adolescents. A total of 475 adolescents completed questionnaires and anthropometric measures. The majority of the adolescents were in the precontemplation (42.1%) and contemplation (43.0%) stages. The benefits of weight control (pros), desire for weight change, perceived body shape, and past experience with weight control increased the odds ratio of movement from precontemplation to contemplation. Stimulus control, self-reevaluation, regular exercise, and past experience of weight control significantly influenced the movement to action and maintenance from contemplation. The study results suggest that weight control programs should emphasize significant factors to help adolescents move through the stages of change.

An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.

PubMed

Jepson, Marcus; Elliott, Daisy; Conefrey, Carmel; Wade, Julia; Rooshenas, Leila; Wilson, Caroline; Beard, David; Blazeby, Jane M; Birtle, Alison; Halliday, Alison; Stein, Rob; Donovan, Jenny L

2018-07-01

To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. Qualitative analysis of 73 audio recordings of recruitment consultations from five, multicenter, UK-based RCTs with identified or anticipated recruitment difficulties. One in 10 appointments did not include any mention of randomization. Most included a description of the method or process of allocation. Descriptions often made reference to gambling-related metaphors or similes, or referred to allocation by a computer. Where reference was made to a computer, some patients assumed that they would receive the treatment that was "best for them". Descriptions of the rationale for randomization were rarely present and often only came about as a consequence of patients questioning the reason for a random allocation. The methods and processes of randomization were usually described by recruiters, but often without clarity, which could lead to patient misunderstanding. The rationale for randomization was rarely mentioned. Recruiters should avoid problematic gambling metaphors and illusions of agency in their explanations and instead focus on clearer descriptions of the rationale and method of randomization to ensure patients are better informed about randomization and RCT participation. Copyright © 2018 University of Bristol. Published by Elsevier Inc. All rights reserved.

Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol.

PubMed

Fine, Naomi B; Achituv, Michal; Etkin, Amit; Merin, Ofer; Shalev, Arieh Y

2018-01-01

Background : The immediate aftermath of traumatic events is a period of enhanced neural plasticity, following which some survivors remain with post-traumatic stress disorder (PTSD) whereas others recover. Evidence points to impairments in emotional reactivity, emotion regulation, and broader executive functions as critically contributing to PTSD. Emerging evidence further suggests that the neural mechanisms underlying these functions remain plastic in adulthood and that targeted retraining of these systems may enhance their efficiency and could reduce the likelihood of developing PTSD. Administering targeted neurocognitive training shortly after trauma exposure is a daunting challenge. This work describes a study design addressing that challenge. The study evaluated the direct effects of cognitive remediation training on neurocognitive mechanisms that hypothetically underlay PTSD, and the indirect effect of this intervention on emerging PTSD symptoms. Method : We describe a study rationale, design, and methodological choices involving: (a) participants' enrolment; (b) implementation and management of a daily self-administered, web-based intervention; (c) reliable, timely screening and assessment of treatment of eligible survivors; and (d) defining control conditions and outcome measures. We outline the rationale of choices made regarding study sample, timing of intervention, measurements, monitoring participants' adherence, and ways to harmonize and retain interviewers' fidelity and mitigate eventual burnout by repeated contacts with recently traumatized survivors. Conclusion : Early web-based interventions targeting causative mechanisms of PTSD can be informed by the model presented in this paper.

Instrument Selection for Randomized Controlled Trials Why This and Not That?

PubMed Central

Records, Kathie; Keller, Colleen; Ainsworth, Barbara; Permana, Paska

2011-01-01

A fundamental linchpin for obtaining rigorous findings in quantitative research involves the selection of survey instruments. Psychometric recommendations are available for the processes for scale development and testing and guidance for selection of established scales. These processes are necessary to address the validity link between the phenomena under investigation, the empirical measures and, ultimately, the theoretical ties between these and the world views of the participants. Detailed information is most often provided about study design and protocols, but far less frequently is a detailed theoretical explanation provided for why specific instruments are chosen. Guidance to inform choices is often difficult to find when scales are needed for specific cultural, ethnic, or racial groups. This paper details the rationale underlying instrument selection for measurement of the major processes (intervention, mediator and moderator variables, outcome variables) in an ongoing study of postpartum Latinas, Madres para la Salud [Mothers for Health]. The rationale underpinning our choices includes a discussion of alternatives, when appropriate. These exemplars may provide direction for other intervention researchers who are working with specific cultural, racial, or ethnic groups or for other investigators who are seeking to select the ‘best’ instrument. Thoughtful consideration of measurement and articulation of the rationale underlying our choices facilitates the maintenance of rigor within the study design and improves our ability to assess study outcomes. PMID:21986392

Weight-control behaviors and subsequent weight change among adolescents and young adult females123

PubMed Central

Haines, Jess; Rosner, Bernard; Willett, Walter C

2010-01-01

Background: Little is known about the effectiveness of behavioral strategies to prevent long-term weight gain among adolescents and young adults. Objective: The objective was to assess the relation of dietary and physical activity weight-control strategies, alone and together, with subsequent weight change. Design: This was a prospective study of 4456 female adolescents and young adults aged 14–22 y in the ongoing Growing Up Today Study. Weight-control behaviors, including dietary approaches and physical activity, were self-reported in 2001 and were used to predict weight change from 2001 to 2005. Results: In 2001–2002, 23.7% of female adolescents and young adults were trying to maintain their weight and another 54.4% were trying to lose weight. Approximately 25% used each of the following weight-control strategies: not eating snacks, following low-calorie or low-fat diets, and limiting portion sizes. In addition, 47.7% reported exercising at least occasionally for weight control. During 4 y of follow-up, participants gained an average of 3.3 kg. None of the dietary approaches to weight control predicted less weight change; however, females who exercised ≥5 d/wk gained significantly less weight than did their peers (−0.9 kg; 95% CI: −1.4, −0.4). The most successful strategy for weight-gain prevention among the females was to limit portion sizes (−1.9 kg; 95% CI: −2.6, −1.1) combined with frequent exercise. Conclusions: Our results suggest that physical activity is a necessary strategy for long-term weight control among adolescents and young adult females. Combining dietary weight-control approaches with physical activity is the most effective method for reducing weight gain. PMID:19889827

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study

PubMed Central

2012-01-01

Background Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Methods Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. Results 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. Conclusions There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis. PMID:22873682

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study.

PubMed

Waters, Lauren; George, Alexis S; Chey, Tien; Bauman, Adrian

2012-08-08

Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis.

Assessing the Rationales for Educational Reforms: A Test of the Professional Development, Comprehensive Reform, and Direct Instruction Hypotheses. Policy Research Report.

ERIC Educational Resources Information Center

St. John, Edward P.; Manset, Genevieve; Chung, Choong-Geun; Worthington, Kimberly

Educational reforms are advocated based on rationales that emerge from the research literature. However, evaluation studies seldom examine whether the rationales used to argue for a reform actually hold up when empirical evidence is examined after the reform has been implemented. This paper examines survey data from 3 years of analyses of early…

Weight Control: Attitudes of Dieters and Change Agents.

ERIC Educational Resources Information Center

Parham, Ellen S.; And Others

1991-01-01

Survey explores attitudes toward weight loss/weight control among 2 groups of change agents--40 dietitians and 42 fitness instructors--and among 96 people trying to lose weight. Significant differences were found in terms of importance in weight control of diet, drugs, exercise, religion, and will power; in importance of being of normal weight;…

Examination of print and telephone channels for physical activity promotion: Rationale, design, and baseline data from Project STRIDE.

PubMed

Marcus, Bess H; Napolitano, Melissa A; King, Abby C; Lewis, Beth A; Whiteley, Jessica A; Albrecht, Anna E; Parisi, Alfred F; Bock, Beth C; Pinto, Bernardine M; Sciamanna, Christopher A; Jakicic, John M; Papandonatos, George D

2007-01-01

Project STRIDE is a 4-year randomized controlled trial comparing two computer-based expert system guided intervention delivery channels (phone vs. print) for physical activity adoption and short-term maintenance among previously sedentary adults. Sedentary adults (n=239) were randomized to one of the following (1) telephone-based, individualized motivationally-tailored feedback; (2) print-based, individualized motivationally-tailored feedback; (3) contact-control delayed treatment group (received intervention after 12 months as control). This paper: (1) outlines the study design, rationale, and participant sample; and (2) describes relationships between baseline variables to better understand their influence on the efficacy of the intervention. Participants averaged 19.8+/-25.0 min of physical activity/week that was at least of moderate intensity, with no group differences. The average estimated VO(2) at 85% of maximum heart rate was 25.6 ml/kg/min. Body fat was 34.1% for women and 23.2% for men and the BMI of the sample averaged 28.5 kg/m(2). Project STRIDE examines non face-to-face approaches for promoting physical activity behavior. It has unique features including a direct comparison of an expert system guided intervention delivered via phone or print. Future analyses will examine the cost-effectiveness of the interventions and this will likely yield important information for policy-makers.

Weight-related Teasing in the School Environment: Associations with Psychosocial Health and Weight Control Practices among Adolescent Boys and Girls

PubMed Central

Lampard, Amy M.; Maclehose, Richard F.; Eisenberg, Marla E.; Neumark-Sztainer, Dianne; Davison, Kirsten K.

2014-01-01

Weight-related teasing has been found to be associated with low self-esteem, depressive symptoms, body dissatisfaction, and weight control behaviors in adolescents. While research has typically examined weight-related teasing directed towards the individual, little is known about weight-related teasing at the school level. This study aimed to determine the association between the school-level prevalence of weight-related teasing and psychosocial factors, body dissatisfaction and weight control behaviors in adolescents. Adolescents (N = 2,793; 53.2% female) attending 20 US public middle and high schools were surveyed as part of the Eating and Activity in Teens (EAT) 2010 study. Generalized estimating equations were used to estimate the association between school-level weight-related teasing and health variables, controlling for individual-level weight-related teasing, clustering of individuals within schools, and relevant covariates. A greater school-level prevalence of weight-related teasing was associated with lower self-esteem and greater body fat dissatisfaction in girls, and greater depressive symptoms in boys, over and above individual-level weight-related teasing. Dieting was associated with the school-level prevalence of weight-related teasing in analysis adjusted for covariates in girls, but not following adjustment for individual-level weight-related teasing. Unhealthy weight control behaviors, extreme weight control behaviors, and muscle-enhancing behaviors were not associated with the school-level prevalence of weight-related teasing in girls or boys. Findings from the current study, in conjunction with previous findings showing associations between weight-related teasing, psychological concerns, and weight control behaviors, highlight the importance of implementing strategies to decrease weight-related teasing in schools. PMID:24395152

Commercial portion-controlled foods in research studies: how accurate are label weights?

PubMed

Conway, Joan M; Rhodes, Donna G; Rumpler, William V

2004-09-01

The purpose of this study was to evaluate the reliability of label weights as surrogates for actual weights in commercial portion-controlled foods used in a research setting. Actual weights of replicate samples of 82 portion-controlled food items and 17 discrete units of food from larger packaging were determined over time. Comparison was made to the package label weights for the portion-controlled food items and the per-serving weights for the discrete units. The study was conducted at the US Department of Agriculture's Beltsville Human Nutrition Research Center's Human Study Facility, which houses a metabolic kitchen and human nutrition research facility. The primary outcome measures were the actual and label weights of 99 food items consumed by human volunteers during controlled feeding studies. Statistical analyses performed The difference between label and actual weights was tested by the paired t test for those data that complied with the assumptions of normality. The Wilcoxon signed rank test was used for the remainder of the data. Compliance with federal guidelines for packaged weights was also assessed. There was no statistical difference between actual and label weights for only 37 food items. The actual weights of 15 portion-controlled food items were 1% or more less than label weights, making them potentially out of compliance with federal guidelines. With advance planning and continuous monitoring, well-controlled feeding studies could incorporate portion-controlled food items and discrete units, especially beverages and confectionery products. Dietetics professionals should encourage individuals with diabetes and others on strict dietary regimens to check actual weights of portion-controlled products carefully against package weights.

Psychosocial and behavioural factors in the regulation of weight: Self-regulation, self-efficacy and locus control.

PubMed

Menéndez-González, Lara; Orts-Cortés, María Isabel

To identify the relationship and behaviour of the variables of self-control, self-efficacy and locus control in weight regulation of obese, overweight and normal weight adults. Transversal study undertaken in the Health Centre of El Coto (Gijón) from 1st April to 30th July 2015. Subjects between 18-65 years of age with a body mass index recording within the last two years. serious medical illness, eating disorders or pregnant women. Behavioural variables: self-regulation of body weight (Inventory of self-control of body weight), perceived self-efficacy in weight regulation (Inventory of perceived self-efficacy in weight regulation) and locus control in weight regulation (Inventory of locus control in weight regulation). Anthropometric variables: weight (kg) and height (m), body mass index. One hundred and six participants were included: 32 were obese, 28 overweight and 46 normal weight. Significant differences were found between the 3 study groups for total scale of self-efficacy (F=61.77; p<.01), total scale of self-regulation (F=45.97; p<.01), internal locus control (F=13.92; p=.019), other weighty influences of locus control (F=9.21; p<.01) and random locus control (F=3.50; p=.011). The relationship between body mass index and behavioural variables of self-efficacy, self-regulation and locus control, suggests the need for healthcare professionals to include psychological factors of behaviour in any preventive action and intervention directed at weight control. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol

PubMed Central

2011-01-01

Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. Methods/design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. Discussion We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. Trial Registration http://www.clinicaltrials.gov NCT00302718 PMID:21967830

Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol.

PubMed

Petersen, Laura A; Urech, Tracy; Simpson, Kate; Pietz, Kenneth; Hysong, Sylvia J; Profit, Jochen; Conrad, Douglas; Dudley, R Adams; Lutschg, Meghan Z; Petzel, Robert; Woodard, Lechauncy D

2011-10-03

Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. http://www.clinicaltrials.govNCT00302718.

Body Weight Perception and Weight Control Practices among Teenagers

PubMed Central

Jeewon, Rajesh

2013-01-01

Background. Weight-loss behaviours are highly prevalent among adolescents, and body weight perception motivates weight control practices. However, little is known about the association of body weight perception, and weight control practices among teenagers in Mauritius. The aim of this study is to investigate the relationships between actual body weight, body weight perception, and weight control practices among teenagers. Methods. A questionnaire-based survey was used to collect data on anthropometric measurements, weight perception and weight control practices from a sample of 180 male and female students (90 boys and 90 girls) aged between 13 and 18 years old. Results. Based on BMI, 11.7% of students were overweight. Overall, 43.3% of respondents reported trying to lose weight (61.1% girls and 25.6% boys). Weight-loss behaviours were more prevalent among girls. Among the weight-loss teens, 88.5% students perceived themselves as overweight even though only 19.2% were overweight. Reducing fat intake (84.6%), exercising (80.8%), and increasing intake of fruits and vegetables (73.1%) and decreasing intake of sugar (66.7%) were the most commonly reported methods to lose weight. Conclusion. Body weight perception was poorly associated with actual weight status. Gender difference was observed in body weight perception. PMID:24967256

Rationales for the Lightning Launch Commit Criteria

NASA Technical Reports Server (NTRS)

Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

2016-01-01

Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

Mother-child conversations about safety: implications for socializing safety values in children.

PubMed

O'Neal, Elizabeth E; Plumert, Jodie M

2014-05-01

This study examined how mothers socialize their children about safety through conversations about potentially unsafe activities. Mothers and their 8- and 10-year-old children discussed and rated the safety of 12 photographs depicting another same-gender child engaged in potentially dangerous activities. Conversations usually unfolded with children giving the first rating or rationale, followed by additional discussion between the mother and child. Mothers and children relied on 2 main types of rationales to justify their ratings: potential outcomes of the activity and specific features of the situation (dangerous and nondangerous). Mothers (but not children) used dangerous feature rationales more often than dangerous outcome rationales. When disagreements arose, mothers typically guided children to adopt their own rating rather than the child's rating. Additionally, children who used more nondangerous feature and outcome rationales had experienced more injuries requiring medical attention. Mothers' focus on dangerous features appears to reflect their efforts to help children make causal connections between dangerous elements of the situation and adverse outcomes that might result.

Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices.

PubMed

Williams, L; Germov, J; Young, A

2007-06-01

To examine women's weight control practices and their effectiveness in preventing weight gain. Retrospective cohort study of weight control practices and 2-year weight change among mid-age women participating in the Australian Longitudinal Study on Women's Health (ALSWH). 11,589 Australian women (aged 47-52 years). The prevalence and types of self-reported weight control practices used were assessed by a nine-item instrument. Two-year weight change was self-reported and adjusted for baseline body mass index (BMI) and other potential confounders. Seventy-four per cent of the cohort (N=8556) reported actively trying to control their weight. Dietary modification was used more frequently than exercise. Two-thirds of the weight-controlling women used a combination of practices, the two most common being 'decreased food quantity, cut down on fats/sugars and exercise' (32%, baseline BMI 25.87(0.10)), and 'decreased food quantity and cut down on fats/sugars without exercise' (15.6%, baseline BMI 27.04(0.14)). Potentially health-damaging practices (smoking, laxatives, fasting) were relatively uncommon, at 7.9%. Only one combination of practices (decreased food quantity, cut down on fats/sugars, use of a commercial weight loss programme and exercise) prevented mean weight gain (-0.03 kg), whereas the mean (s.d.) weight of the cohort increased (+1.19(4.78)) over the 2-year period. The majority of mid-age women attempting weight control used practices consistent with public health messages. Despite their efforts, the group was mostly unsuccessful in preventing weight gain. Public health authorities and health practitioners may need to make more quantitative recommendations and emphasize the importance of balancing physical activity with dietary intake to achieve successful weight control for women at this life stage.

Women's Perspectives of Personal Trainers: A Qualitative Study.

PubMed

Melton, Deana; Dail, Teresa K; Katula, Jeffrey A; Mustian, Karen M

2011-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers.

Women's Perspectives of Personal Trainers: A Qualitative Study

PubMed Central

Melton, Deana; Dail, Teresa K.; Katula, Jeffrey A.; Mustian, Karen M.

2015-01-01

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients' attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client's decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients' reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers' affective qualities and that clients' would benefit from information about the credentials of personal trainers. PMID:26005398

A Systematic Review and Meta-Analysis of Practices Exposing Humans to Avian Influenza Viruses, Their Prevalence, and Rationale

PubMed Central

Fournié, Guillaume; Høg, Erling; Barnett, Tony; Pfeiffer, Dirk U.; Mangtani, Punam

2017-01-01

Abstract. Almost all human infections by avian influenza viruses (AIVs) are transmitted from poultry. A systematic review was conducted to identify practices associated with human infections, their prevalence, and rationale. Observational studies were identified through database searches. Meta-analysis produced combined odds ratio estimates. The prevalence of practices and rationales for their adoptions were reported. Of the 48,217 records initially identified, 65 articles were included. Direct and indirect exposures to poultry were associated with infection for all investigated viral subtypes and settings. For the most frequently reported practices, association with infection seemed stronger in markets than households, for sick and dead than healthy poultry, and for H7N9 than H5N1. Practices were often described in general terms and their frequency and intensity of contact were not provided. The prevalence of practices was highly variable across studies, and no studies comprehensively explored reasons behind the adoption of practices. Combining epidemiological and targeted anthropological studies would increase the spectrum and detail of practices that could be investigated and should aim to provide insights into the rationale(s) for their existence. A better understanding of these rationales may help to design more realistic and acceptable preventive public health measures and messages. PMID:28749769

Cargo Movement Operations System (CMOS). Final Software Design Document

DTIC Science & Technology

1990-09-27

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SDDI-0002 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A006-03 DATE: 09/27/90 ORIGINATOR NAME: Patrick L. Combs OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: iv PARA NUMBER: 4.18.2 COMMENT OR RECOMMENDED CHANGE: Delete Ř.18.2". RATIONALE: The paragraph number is incorrect and was called forward to be placed in the Table of Contents. The number should read Ř.18.1.2" and

Cargo Movement Operations System (CMOS). Final Software Product Specification Increment 1

DTIC Science & Technology

1991-02-17

NO ( ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SPSl-0002 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRI NUMBER: A014-02 DATE: 02/17/91 ORIGINATOR NAME: Vivian L. Martin OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: E-1 PARA NUMBER: 10. COMMENT OR RECOMMENDED CHANGE: Footnote the AUTOEXEC.BAT entry to indicate that it is identified as CUlAO001 in the SDD (20 Dec 90). RATIONALE: This will synchronize the SPS with the SDD. CMOS PMO ACCEPTS

Cargo Movement Operations System (CMOS) Software Test Plan. Final

DTIC Science & Technology

1990-07-26

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: STP-0002 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A007-03 DATE: 07/26/90 ORIGINATOR NAME: John J.Brassil OFFICE SYMBOL: SAIC TELEPHONE NU4BER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: 63 PARA NUMBER: Table 4.2.1.2 COMMENT OR RECOMMENDED CHANGE: Replace the reference to the Source and Destination STP paragraphs with a reference to the paragraph of the STP which tests the interface itself. RATIONALE: Each internal

Cargo Movement Operations System (CMOS). Final Software Design Document Increment III, (PC UNIX - Navy Configuration)

DTIC Science & Technology

1991-07-03

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED ( ] ORIGINATOR CONTROL NUMBER: SDD-0003 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A006-02 DATE: 07/03/91 ORIGINATOR NAME: Vivian L. Martin OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: L-1 PARA NUMBER: 10 COMMENT OR RECOMMENDED CHANGE: Explain the effect of "no longer required" or "replaced" CSUs on the Navy configuration Menu hierarchy. RATIONALE: Paragraph 10 states that the CMOS menu heirarchy is

Cargo Movement Operations System (CMOS) Requirements Traceability Matrix, ECP. Version 2

DTIC Science & Technology

1990-06-07

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN ( ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: RTM2-0003 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A018-02A DATE: 06/07/90 ORIGINATOR NAME: Patrick L. Combs OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: E-25 PARA NUMBER: SC122 COMMENT OR RECOMMENDED CHANGE: Delete SS0850 and SS0851 from SC122. RATIONALE: These requirements are not present in all the subordinate system capabilities and, therefore, should not be allocated to

Drug-Free Macromolecular Therapeutics – A New Paradigm in Polymeric Nanomedicines

PubMed Central

Chu, Te-Wei; Kopeček, Jindřich

2015-01-01

This review highlights a unique research area in polymer-based nanomedicine designs. Drug-free macromolecular therapeutics induce apoptosis of malignant cells by the crosslinking of surface non-internalizing receptors. The receptor crosslinking is mediated by the biorecognition of high-fidelity natural binding motifs (such as antiparallel coiled-coil peptides or complementary oligonucleotides) that are grafted to the side chains of polymers or attached to targeting moieties against cell receptors. This approach features the absence of low-molecular-weight cytotoxic compounds. Here, we summarize the rationales, different designs, and advantages of drug-free macromolecular therapeutics. Recent developments of novel therapeutic systems for B-cell lymphomas are discussed, as well as relevant approaches for other diseases. We conclude by pointing out various potential future directions in this exciting new field. PMID:26191406

A quantitative method for evaluating alternatives. [aid to decision making

NASA Technical Reports Server (NTRS)

Forthofer, M. J.

1981-01-01

When faced with choosing between alternatives, people tend to use a number of criteria (often subjective, rather than objective) to decide which is the best alternative for them given their unique situation. The subjectivity inherent in the decision-making process can be reduced by the definition and use of a quantitative method for evaluating alternatives. This type of method can help decision makers achieve degree of uniformity and completeness in the evaluation process, as well as an increased sensitivity to the factors involved. Additional side-effects are better documentation and visibility of the rationale behind the resulting decisions. General guidelines for defining a quantitative method are presented and a particular method (called 'hierarchical weighted average') is defined and applied to the evaluation of design alternatives for a hypothetical computer system capability.

Space Shuttle food galley design concept

NASA Technical Reports Server (NTRS)

Heidelbaugh, N. D.; Smith, M. C.; Fischer, R.; Cooper, B.

1974-01-01

A food galley has been designed for the crew compartment of the NASA Space Shuttle Orbiter. The rationale for the definition of this design was based upon assignment of priorities to each functional element of the total food system. Principle priority categories were assigned in the following order: food quality, nutrition, food packaging, menu acceptance, meal preparation efficiency, total system weight, total system volume, and total power requirements. Hence, the galley was designed using an 'inside-out' approach which first considered the food and related biological functions and subsequently proceeded 'outward' from the food to encompass supporting hardware. The resulting galley is an optimal design incorporating appropriate priorities for trade-offs between biological and engineering constraints. This design approach is offered as a model for the design of life support systems.

A knowledge-based approach to configuration layout, justification, and documentation

NASA Technical Reports Server (NTRS)

Craig, F. G.; Cutts, D. E.; Fennel, T. R.; Case, C.; Palmer, J. R.

1990-01-01

The design, development, and implementation is described of a prototype expert system which could aid designers and system engineers in the placement of racks aboard modules on Space Station Freedom. This type of problem is relevant to any program with multiple constraints and requirements demanding solutions which minimize usage of limited resources. This process is generally performed by a single, highly experienced engineer who integrates all the diverse mission requirements and limitations, and develops an overall technical solution which meets program and system requirements with minimal cost, weight, volume, power, etc. This system architect performs an intellectual integration process in which the underlying design rationale is often not fully documented. This is a situation which lends itself to an expert system solution for enhanced consistency, thoroughness, documentation, and change assessment capabilities.

A Knowledge-Based Approach to Configuration Layout, Justification, and Documentation

NASA Technical Reports Server (NTRS)

Craig, F. G.; Cutts, D. E.; Fennel, T. R.; Case, C. M.; Palmer, J. R.

1991-01-01

The design, development, and implementation of a prototype expert system which could aid designers and system engineers in the placement of racks aboard modules on the Space Station Freedom are described. This type of problem is relevant to any program with multiple constraints and requirements demanding solutions which minimize usage of limited resources. This process is generally performed by a single, highly experienced engineer who integrates all the diverse mission requirements and limitations, and develops an overall technical solution which meets program and system requirements with minimal cost, weight, volume, power, etc. This system architect performs an intellectual integration process in which the underlying design rationale is often not fully documented. This is a situation which lends itself to an expert system solution for enhanced consistency, thoroughness, documentation, and change assessment capabilities.

Effects of aqueous extract of Musa paradisiaca root on testicular function parameters of male rats.

PubMed

Yakubu, Musa Toyin; Oyeyipo, Theo Oyetayo; Quadri, Ayodeji Luqman; Akanji, Musbau Adewumi

2013-01-01

There is an age-long claim that the Musa paradisiaca root is used to manage reproductive dysfunction, most especially sexual dysfunction (as an aphrodisiac), but there are no data in the open scientific literature that have refuted or supported this claim and the effects of M. paradisiaca root on the testes. Therefore, this study was aimed at investigating the effect of oral administration of the aqueous extract of M. paradisiaca root on the testicular function parameters of male rat testes. Sexually matured male albino rats (138.67±5.29 g) were randomly assigned into four groups, A, B, C, and D, that respectively received 0.5 mL (3.6 mL/kg body weight) of distilled water and 25, 50, and 100 mg/kg body weight of the extract, orally, once daily, for 14 days. The extract significantly increased (p<0.05) the testes-body weight ratio, total protein, sialic acid, glycogen, cholesterol, activities of alkaline phosphatase, γ-glutamyltransferase, acid phosphatase, and the concentration of testicular testosterone. In contrast, the extract decreased the concentrations of both luteinizing and follicle-stimulating hormones in the serum of the animals. The results revealed that oral administration of M. paradisiaca root extract at doses of 25, 50, and 100 mg/kg body weight enhanced the testosterone-dependent normal functioning of the testes. Overall, the aqueous extract of M. paradisiaca stimulated the normal functioning of the testes and exhibited both androgenic and anabolic properties. The results may explain the rationale behind the folkloric beneficial effect of the plant in the management of reproductive dysfunction.

Interagency Collaborative Arrangements and Activities: Types, Rationales, Considerations (Interagency Paper, Number 5, June 2011)

DTIC Science & Technology

2011-06-01

much of the 20th century and into the current day, controlling U.S. borders— primarily to halt illegal immigration and smuggling of contraband...this lengthy period—include the Coast Guard; Customs Service; Immigration and Naturalization Service; Immigration and Customs Enforcement Bureau...that] a true network starts with robust communications collectivity, but also leverages physical and cultural proximity, shared purpose, established

Cargo Movement Operations System (CMOS) System Segment Design Document (Draft) Increment II

DTIC Science & Technology

1990-05-02

and are arranged in page number order. RATIONALE: N/A CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION...NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ ] ORIGINATOR CONTROL NUMBER: SSDD-0003 PROGRAM...CMOS. CMOS PMO ACCEPTS COMMENT: YES [ ] NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ 3 ORIGINATOR

Preliminary design data package, appendix C. [hybrid electric vehicles

NASA Technical Reports Server (NTRS)

1979-01-01

The data and documentation required to define the preliminary design of a near term hybrid vehicle and to quantify its operational characteristics are presented together with the assumptions and rationale behind the design decisions. Aspects discussed include development requirements for the propulsion system, the chassis system, the body, and the vehicle systems. Particular emphasis is given to the controls, the heat engine, and the batteries.

Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design.

PubMed

Jolly, Kate; Duda, Joan L; Daley, Amanda; Eves, Frank F; Mutrie, Nanette; Ntoumanis, Nikos; Rouse, Peter C; Lodhia, Rekha; Williams, Geoffrey C

2009-06-08

The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation. An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT) exercise on prescription intervention. 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7) or to the SDT-based intervention (n = 6).Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise. This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes) via structural equation modelling. The trial is registered as Current Controlled trials ISRCTN07682833.

Rationale and design of the STAR randomized controlled trial to accelerate adoption of childhood obesity comparative effectiveness research.

PubMed

Taveras, Elsie M; Marshall, Richard; Horan, Christine M; Gillman, Matthew W; Hacker, Karen; Kleinman, Ken P; Koziol, Renata; Price, Sarah; Simon, Steven R

2013-01-01

Comparative effectiveness research (CER) evidence on childhood obesity provides the basis for effective screening and management strategies in pediatric primary care. The uses of health information technology including decision support tools in the electronic health records (EHRs), as well as remote and mobile support to families, offer the potential to accelerate the adoption of childhood obesity CER evidence. The Study of Technology to Accelerate Research (STAR) is a three-arm, cluster-randomized controlled trial being conducted in 14 pediatric offices in Massachusetts designed to enroll 800, 6 to 12 year old children with a body mass index (BMI)≥ 95th percentile seen in primary care at those practices. We will examine the extent to which computerized decision support tools in the EHR delivered to primary care providers at the point of care, with or without direct-to-parent support and coaching, will increase adoption of CER evidence for management of obese children. Direct-to-parent intervention components include telephone coaching and twice-weekly text messages. Point-of-care outcomes include obesity diagnosis, nutrition and physical activity counseling, and referral to weight management. One-year child-level outcomes include changes in BMI and improvements in diet, physical activity, screen time, and sleep behaviors, as well as cost and cost-effectiveness. STAR will determine the extent to which decision support tools in EHRs with or without direct-to-parent support will increase adoption of evidence-based obesity management strategies in pediatric practice and improve childhood obesity-related outcomes. Copyright © 2012 Elsevier Inc. All rights reserved.

Promotion of healthy weight-control practices in young athletes.

PubMed

2005-12-01

Children and adolescents are often involved in sports in which weight loss or weight gain is perceived as an advantage. This policy statement describes unhealthy weight-control practices that may be harmful to the health and/or performance of athletes. Healthy methods of weight loss and weight gain are discussed, and physicians are given resources and recommendations that can be used to counsel athletes, parents, coaches, and school administrators in discouraging inappropriate weight-control behaviors and encouraging healthy methods of weight gain or loss, when needed.

Understanding Water Storage Practices of Urban Residents of an Endemic Dengue Area in Colombia: Perceptions, Rationale and Socio-Demographic Characteristics.

PubMed

García-Betancourt, Tatiana; Higuera-Mendieta, Diana Rocío; González-Uribe, Catalina; Cortés, Sebastian; Quintero, Juliana

2015-01-01

The main preventive measure against dengue virus transmission is often based on actions to control Ae. Aegypti reproduction by targeting water containers of clean and stagnant water. Household water storage has received special attention in prevention strategies but the evidence about the rationale of this human practice is limited. The objective was to identify and describe water storage practices among residents of an urban area in Colombia (Girardot) and its association with reported perceptions, rationales and socio-demographic characteristics with a mixed methods approach. Knowledge, attitudes and practices and entomological surveys from 1,721 households and 26 semi-structured interviews were conducted among residents of Girardot and technicians of the local vector borne disease program. A multivariate analysis was performed to identify associations between a water storage practice and socio-demographic characteristics, and knowledge, attitudes and practices about dengue and immature forms of the vector, which were then triangulated with qualitative information. Water storage is a cultural practice in Girardot. There are two main reasons for storage: The scarcity concern based on a long history of shortages of water in the region and the perception of high prices in water rates, contrary to what was reported by the local water company. The practice of water storage was associated with being a housewife (Inverse OR: 2.6, 95% CI 1.5 -4.3). The use of stored water depends on the type of container used, while water stored in alberca (Intra household cement basins) is mainly used for domestic cleaning chores, water in plastic containers is used for cooking. It is essential to understand social practices that can increase or reduce the number of breeding sites of Ae. Aegypti. Identification of individuals who store water and the rationale of such storage allow a better understanding of the social dynamics that lead to water accumulation.

Understanding Water Storage Practices of Urban Residents of an Endemic Dengue Area in Colombia: Perceptions, Rationale and Socio-Demographic Characteristics

PubMed Central

González-Uribe, Catalina; Cortés, Sebastian; Quintero, Juliana

2015-01-01

Introduction The main preventive measure against dengue virus transmission is often based on actions to control Ae. Aegypti reproduction by targeting water containers of clean and stagnant water. Household water storage has received special attention in prevention strategies but the evidence about the rationale of this human practice is limited. The objective was to identify and describe water storage practices among residents of an urban area in Colombia (Girardot) and its association with reported perceptions, rationales and socio-demographic characteristics with a mixed methods approach. Methods Knowledge, attitudes and practices and entomological surveys from 1,721 households and 26 semi-structured interviews were conducted among residents of Girardot and technicians of the local vector borne disease program. A multivariate analysis was performed to identify associations between a water storage practice and socio-demographic characteristics, and knowledge, attitudes and practices about dengue and immature forms of the vector, which were then triangulated with qualitative information. Results Water storage is a cultural practice in Girardot. There are two main reasons for storage: The scarcity concern based on a long history of shortages of water in the region and the perception of high prices in water rates, contrary to what was reported by the local water company. The practice of water storage was associated with being a housewife (Inverse OR: 2.6, 95% CI 1.5 -4.3). The use of stored water depends on the type of container used, while water stored in alberca (Intra household cement basins) is mainly used for domestic cleaning chores, water in plastic containers is used for cooking. Conclusions It is essential to understand social practices that can increase or reduce the number of breeding sites of Ae. Aegypti. Identification of individuals who store water and the rationale of such storage allow a better understanding of the social dynamics that lead to water accumulation. PMID:26061628

Effects of polymer molecular weight on relative oral bioavailability of curcumin.

PubMed

Tsai, Yin-Meng; Chang-Liao, Wan-Ling; Chien, Chao-Feng; Lin, Lie-Chwen; Tsai, Tung-Hu

2012-01-01

Polylactic-co-glycolic acid (PLGA) nanoparticles have been used to increase the relative oral bioavailability of hydrophobic compounds and polyphenols in recent years, but the effects of the molecular weight of PLGA on bioavailability are still unknown. This study investigated the influence of polymer molecular weight on the relative oral bioavailability of curcumin, and explored the possible mechanism accounting for the outcome. Curcumin encapsulated in low (5000-15,000) and high (40,000-75,000) molecular weight PLGA (LMw-NPC and HMw-NPC, respectively) were prepared using an emulsification-solvent evaporation method. Curcumin alone and in the nanoformulations was administered orally to freely mobile rats, and blood samples were collected to evaluate the bioavailability of curcumin, LMw-NPC, and HMw-NPC. An ex vivo experimental gut absorption model was used to investigate the effects of different molecular weights of PLGA formulation on absorption of curcumin. High-performance liquid chromatography with diode array detection was used for quantification of curcumin in biosamples. There were no significant differences in particle properties between LMw-NPC and HMw-NPC, but the relative bioavailability of HMw-NPC was 1.67-fold and 40-fold higher than that of LMw-NPC and conventional curcumin, respectively. In addition, the mean peak concentration (C(max)) of conventional curcumin, LMw-NPC, and HMw-NPC was 0.028, 0.042, and 0.057 μg/mL, respectively. The gut absorption study further revealed that the HMw-PLGA formulation markedly increased the absorption rate of curcumin in the duodenum and resulted in excellent bioavailability compared with conventional curcumin and LMw-NPC. Our findings demonstrate that different molecular weights of PLGA have varying bioavailability, contributing to changes in the absorption rate at the duodenum. The results of this study provide the rationale for design of a nanomedicine delivery system to enhance the bioavailability of water-insoluble pharmaceutical compounds and functional foods.

Effects of polymer molecular weight on relative oral bioavailability of curcumin

PubMed Central

Tsai, Yin-Meng; Chang-Liao, Wan-Ling; Chien, Chao-Feng; Lin, Lie-Chwen; Tsai, Tung-Hu

2012-01-01

Background Polylactic-co-glycolic acid (PLGA) nanoparticles have been used to increase the relative oral bioavailability of hydrophobic compounds and polyphenols in recent years, but the effects of the molecular weight of PLGA on bioavailability are still unknown. This study investigated the influence of polymer molecular weight on the relative oral bioavailability of curcumin, and explored the possible mechanism accounting for the outcome. Methods Curcumin encapsulated in low (5000–15,000) and high (40,000–75,000) molecular weight PLGA (LMw-NPC and HMw-NPC, respectively) were prepared using an emulsification-solvent evaporation method. Curcumin alone and in the nanoformulations was administered orally to freely mobile rats, and blood samples were collected to evaluate the bioavailability of curcumin, LMw-NPC, and HMw-NPC. An ex vivo experimental gut absorption model was used to investigate the effects of different molecular weights of PLGA formulation on absorption of curcumin. High-performance liquid chromatography with diode array detection was used for quantification of curcumin in biosamples. Results There were no significant differences in particle properties between LMw-NPC and HMw-NPC, but the relative bioavailability of HMw-NPC was 1.67-fold and 40-fold higher than that of LMw-NPC and conventional curcumin, respectively. In addition, the mean peak concentration (Cmax) of conventional curcumin, LMw-NPC, and HMw-NPC was 0.028, 0.042, and 0.057 μg/mL, respectively. The gut absorption study further revealed that the HMw-PLGA formulation markedly increased the absorption rate of curcumin in the duodenum and resulted in excellent bioavailability compared with conventional curcumin and LMw-NPC. Conclusion Our findings demonstrate that different molecular weights of PLGA have varying bioavailability, contributing to changes in the absorption rate at the duodenum. The results of this study provide the rationale for design of a nanomedicine delivery system to enhance the bioavailability of water-insoluble pharmaceutical compounds and functional foods. PMID:22745556

Gender and socioeconomic status in relation to weight perception and weight control behavior in Korean adults.

PubMed

Joh, Hee-Kyung; Oh, Juhwan; Lee, Hae-Jeung; Kawachi, Ichiro

2013-01-01

In Korea, obesity is more prevalent among men and lower socioeconomic groups. To explain this obesity disparity, we compared weight perception and weight control behavior across gender and socioeconomic status (SES). We analyzed data from 16,260 participants aged 20 years or older in a nationally representative cross-sectional survey. SES indicators included education and income levels. Weight under-perception was defined when participants considered themselves lighter than their measured BMI status. Either no active or inappropriate weight control (i.e., trying to gain weight in obese individuals) was considered to be unhealthy patterns. Multivariate prevalence ratios were calculated using log-binomial regressions. Men had a higher prevalence of weight under-perception (24.5 vs. 11.9%) and unhealthy patterns of weight control behavior (57 vs. 40%) than women. Low education level was associated with weight under-perception (ptrend = 0.022 in men, ptrend < 0.001 in women). Both education and income levels were significantly associated with patterns of weight control behavior (for education: ptrend < 0.001 in men and women; for income: ptrend = 0.047 in men, ptrend < 0.001 in women). Weight perception and weight control behavior significantly varied by gender and SES. Public actions should be directed toward improving perception and behavior of high-risk populations.

A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr.

PubMed

Fitzgibbon, Marian L; Stolley, Melinda R; Dyer, Alan R; VanHorn, Linda; KauferChristoffel, Katherine

2002-02-01

BACKGROUND; The increasing prevalence of overweight among children in the United States presents a national health priority. Higher rates of overweight/obesity among minority women place their children at increased risk. Although increased rates of overweight are observed in 4- to 5-year-old children, they are not observed in 2- to 3-year-old children. Therefore, early prevention efforts incorporating families are critical. The primary aim of Hip-Hop to Health Jr. is to alter the trajectory toward overweight/obesity among preschool African-American and Latino children. This 5-year randomized intervention is conducted in 24 Head Start programs, where each site is randomized to either a 14-week dietary/physical activity intervention or a general health intervention. This paper presents the rationale and design of the study. Efficacy of the intervention will be determined by weight change for the children and parent/caretaker. Secondary measures include reductions in dietary fat and increases in fiber, fruit/vegetable intake, and physical activity. Baseline data will be presented in future papers. The problem of overweight/obesity is epidemic in the United States. Behaviors related to diet and physical activity are established early in life and modeled by family members. Early intervention efforts addressing the child and family are needed to prevent obesity later in life. This paper describes a comprehensive, family-oriented obesity prevention program for minority preschool children. Copyright 2002 American Health Foundation and Elsevier Science (USA).

Using Positive Deviance for Determining Successful Weight-Control Practices

PubMed Central

Stuckey, Heather L.; Boan, Jarol; Kraschnewski, Jennifer L.; Miller-Day, Michelle; Lehman, Erik B.; Sciamanna, Christopher N.

2013-01-01

Based on positive deviance (examining the practices of successful individuals), we identified five primary themes from 36 strategies that help to maintain long-term weight loss (weight control) in 61 people. We conducted in-depth interviews to determine what successful individuals did and/or thought about regularly to control their weight. The themes included weight-control practices related to (a) nutrition: increase water, fruit, and vegetable intake, and consistent meal timing and content; (b) physical activity: follow and track an exercise routine at least 3×/week; (c) restraint: practice restraint by limiting and/or avoiding unhealthy foods; (d) self-monitor: plan meals, and track calories/weight progress; and (e) motivation: participate in motivational programs and cognitive processes that affect weight-control behavior. Using the extensive data involving both the practices and practice implementation, we used positive deviance to create a comprehensive list of practices to develop interventions for individuals to control their weight. PMID:20956609

Automatic weight determination in nonlinear model predictive control of wind turbines using swarm optimization technique

NASA Astrophysics Data System (ADS)

Tofighi, Elham; Mahdizadeh, Amin

2016-09-01

This paper addresses the problem of automatic tuning of weighting coefficients for the nonlinear model predictive control (NMPC) of wind turbines. The choice of weighting coefficients in NMPC is critical due to their explicit impact on efficiency of the wind turbine control. Classically, these weights are selected based on intuitive understanding of the system dynamics and control objectives. The empirical methods, however, may not yield optimal solutions especially when the number of parameters to be tuned and the nonlinearity of the system increase. In this paper, the problem of determining weighting coefficients for the cost function of the NMPC controller is formulated as a two-level optimization process in which the upper- level PSO-based optimization computes the weighting coefficients for the lower-level NMPC controller which generates control signals for the wind turbine. The proposed method is implemented to tune the weighting coefficients of a NMPC controller which drives the NREL 5-MW wind turbine. The results are compared with similar simulations for a manually tuned NMPC controller. Comparison verify the improved performance of the controller for weights computed with the PSO-based technique.

Weight Gain after Lung Reduction Surgery Is Related to Improved Lung Function and Ventilatory Efficiency

PubMed Central

Kretschman, Dana M.; Sternberg, Alice L.; DeCamp, Malcolm M.; Criner, Gerard J.

2012-01-01

Rationale: Lung volume reduction surgery (LVRS) is associated with weight gain in some patients, but the group that gains weight after LVRS and the mechanisms underlying this phenomenon have not been well characterized. Objectives: To describe the weight change profiles of LVRS patients enrolled in the National Emphysema Treatment Trial (NETT) and to correlate alterations in lung physiological parameters with changes in weight. Methods: We divided 1,077 non–high-risk patients in the NETT into groups according to baseline body mass index (BMI): underweight (<21 kg/m2), normal weight (21–25 kg/m2), overweight (25–30 kg/m2), and obese (>30 kg/m2). We compared BMI groups and LVRS and medical groups within each BMI stratum with respect to baseline characteristics and percent change in BMI (%ΔBMI) from baseline. We examined patients with (ΔBMI ≥ 5%) and without (ΔBMI < 5%) significant weight gain at 6 months and assessed changes in lung function and ventilatory efficiency (V̇e/V̇co2). Measurements and Main Results: The percent change in BMI was greater in the LVRS arm than in the medical arm in the underweight and normal weight groups at all follow-up time points, and at 12 and 24 months in the overweight group. In the LVRS group, patients with ΔBMI ≥ 5% at 6 months had greater improvements in FEV1 (11.53 ± 9.31 vs. 6.58 ± 8.68%; P < 0.0001), FVC (17.51 ± 15.20 vs. 7.55 ± 14.88%; P < 0.0001), residual volume (–66.20 ± 40.26 vs. –47.06 ± 39.87%; P < 0.0001), 6-minute walk distance (38.70 ± 69.57 vs. 7.57 ± 73.37 m; P < 0.0001), maximal expiratory pressures (12.73 ± 49.08 vs. 3.54 ± 32.22; P = 0.0205), and V̇e/V̇co2 (–1.58 ± 6.20 vs. 0.22 ± 8.20; P = 0.0306) at 6 months than patients with ΔBMI < 5% at 6 months. Conclusions: LVRS leads to weight gain in nonobese patients, which is associated with improvement in lung function, exercise capacity, respiratory muscle strength, and ventilatory efficiency. These physiological changes may be partially responsible for weight gain in patients who undergo LVRS. PMID:22878279

How to lose weight bias fast! Evaluating a brief anti-weight bias intervention.

PubMed

Diedrichs, Phillippa C; Barlow, Fiona Kate

2011-11-01

Although experiencing weight bias is associated with poor physical and psychological health, health professionals often stigmatize overweight and obese clients. The objective of this study was to evaluate a brief educational intervention that aimed to reduce weight bias among Australian pre-service health students by challenging beliefs about the controllability of weight. Non-equivalent group comparison trial. Undergraduate psychology students were assigned to an intervention (n= 30), control (n= 35), or comparison (n= 20) condition. The intervention condition received a lecture on obesity, weight bias, and the multiple determinants of weight; the comparison condition received a lecture on obesity and the behavioural determinants of weight; and the control condition received no lecture. Beliefs about the controllability of weight and attitudes towards overweight and obese people were assessed 1 week pre-intervention, immediately post-intervention, and 3 weeks post-intervention. After receiving the lecture, participants in the intervention group were less likely to believe that weight is solely within individual control and were also less likely to hold negative attitudes towards overweight and obese people and rate them as unattractive. These changes were maintained 3 weeks post-intervention. There were no such changes in the control or comparison groups. Disparagement of overweight and obese peoples' social character increased over time for participants in the control condition but did not change in the comparison or intervention groups. This study provides evidence that brief, education-based anti-weight bias interventions show success in challenging weight controllability beliefs and reducing weight bias among pre-service health students. ©2011 The British Psychological Society.

Effects of a 10-week weight control program on obese patients with schizophrenia or schizoaffective disorder: a 12-month follow up.

PubMed

Chen, Chih-Ken; Chen, Yi-Chih; Huang, Yu-Shu

2009-02-01

Weight gain secondary to antipsychotic medication is associated with many serious conditions, including type II diabetes mellitus, hypertension, and coronary heart disease, and also with poor medication compliance. Weight control programs may be of benefit to outpatients with schizophrenia, but also raise an issue of cost-effectiveness. We aimed to evaluate the effectiveness of a 10-week weight control program for outpatients taking atypical antipsychotics for treatment of schizophrenia, and to follow up the effects of this weight control program in controlling weight gain after termination of the program. A total of 33 patients with schizophrenia and antipsychotic-related obesity were enrolled in a 10-week multimodal weight control program. The patients' weights were recorded at baseline, week 4, week 8, week 10 (end of the intervention), week 12, week 24, and week 48. Secondary measures included blood sugar levels, cholesterol levels, triglyceride levels, quality of life and mental health. For those who completed the weight control program, there was a mean weight loss of 2.1 kg by the end of the intervention, 3.7 kg over 6 months, and 2.7 kg over 12 months. The mean body mass index decreased by 0.8, 1.5 and 1.1 at week 10, week 24 and week 48, respectively, all with statistical significance. The 10-week weight control program was effective in terms of weight reduction among obese patients with schizophrenia or schizoaffective disorder, and the weight reduction effect lasted for up to 6 months, and up to 12 months in some cases.

UltraSail CubeSat Solar Sail Flight Experiment

NASA Technical Reports Server (NTRS)

Carroll, David; Burton, Rodney; Coverstone, Victoria; Swenson, Gary

2013-01-01

UltraSail is a next-generation, highrisk, high-payoff sail system for the launch, deployment, stabilization, and control of very large (km2 class) solar sails enabling high payload mass fractions for interplanetary and deep space spacecraft. UltraSail is a non-traditional approach to propulsion technology achieved by combining propulsion and control systems developed for formation- flying microsatellites with an innovative solar sail architecture to achieve controllable sail areas approaching 1 km2, sail subsystem area densities approaching 1 g/m2, and thrust levels many times those of ion thrusters used for comparable deep space missions. UltraSail can achieve outer planetary rendezvous, a deep-space capability now reserved for high-mass nuclear and chemical systems. There is a twofold rationale behind the UltraSail concept for advanced solar sail systems. The first is that sail-andboom systems are inherently size-limited. The boom mass must be kept small, and column buckling limits the boom length to a few hundred meters. By eliminating the boom, UltraSail not only offers larger sail area, but also lower areal density, allowing larger payloads and shorter mission transit times. The second rationale for UltraSail is that sail films present deployment handling difficulties as the film thickness approaches one micrometer. The square sail requires that the film be folded in two directions for launch, and similarly unfolded for deployment. The film is stressed at the intersection of two folds, and this stress varies inversely with the film thickness. This stress can cause the film to yield, forming a permanent crease, or worse, to perforate. By rolling the film as UltraSail does, creases are prevented. Because the film is so thin, the roll thickness is small. Dynamic structural analysis of UltraSail coupled with dynamic control analysis shows that the system can be designed to eliminate longitudinal torsional waves created while controlling the pitch of the blades, while using solar photon pressure to slew the spin axis. Vacuum tests have also verified that electrostatic and molecular adhesion forces can substantially be eliminated by making the film electrically conductive, reducing the peel force of the film off the storage roll to levels of 100s of micro-N. The innovation demonstrated the capability of deploying a six-micron aluminum- coated film from a reel through a slit in vacuum. The innovation also demonstrated a spin-stabilized method for deploying a long reel of solar sail film using solar pressure to spin-up and orbit raise the satellite, and also a gravity gradient method for deploying a long reel of solar sail film using solar pressure to orbit raise the satellite. The solar sail mass fraction of 25% is consistent with high specific impulse ion systems, but without the added weight and cost of a power source and processing unit. The large sail area, coupled with low film density, is giving UltraSail a high payload fraction. The UltraSail deployment scheme unrolls a micrometerscale reflection-coated polyimide film from a storage mandrel to a maximum length of several kilometers with the aid of a blade tip satellite.

The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity.

PubMed

Daniels, Lynne A; Magarey, Anthea; Battistutta, Diana; Nicholson, Jan M; Farrell, Ann; Davidson, Geoffrey; Cleghorn, Geoffrey

2009-10-14

Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency) and include responses (eg coercion) to infant feeding behaviour (eg. food refusal). There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. This randomised controlled trial (RCT) aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods), food preferences, feeding behaviour and growth and self-reported maternal feeding practices and parenting practices and efficacy. Covariates will include sociodemographics, infant feeding mode and temperament, maternal weight status and weight concern and child care exposure. Despite the strong rationale to focus on parents' early feeding practices as a key determinant of child food preferences, intake and self-regulatory capacity, prospective longitudinal and intervention studies are rare. This trial will be amongst to provide Level II evidence regarding the impact of an intervention (commencing prior to age 12 months) on children's eating patterns and behaviours. ACTRN12608000056392.

Evaluation of the Hepato and Nephron-Protective Effect of a Polyherbal Mixture using Wistar Albino Rats

PubMed Central

Adebesin, Olumide Adedapo; Okpuzor, Joy

2014-01-01

Aim: A polyherbal formulation prepared from a mixture of leaves of Gongronema latifolia, Ocimum gratissimum and Vernonia amygdalina (GOV) was evaluated for hepato-nephro protective properties against acetaminophen-induced toxicity in Wistar albino rats. Materials and Methods: Normal Wistar albino rats were orally treated with different doses of GOV extract (2, 4 and 8 g/kg b. wt), distilled water and some standard hepatoprotective drugs such as Liv 52 and silymarin for 14 days. However, a day prior to the 14th day, 3 g/kg body weight dose of Acetaminophen (APAP) was administered p.o. 1h before GOV and the standard drugs to induce hepatic and renal damage. The normal control was setup which received only distilled water. The serum levels of liver marker enzymes, biochemical analytes, antioxidant enzymes and hematological parameters were monitored. Results: The results showed that pretreatment of experimental animals with a different doses of the polyherbal formulation dose dependently caused a significant (p≤0.05) increase in the levels of most of the measured hematological parameters but significantly (p≤0.05) reduced the levels of MCV and monocytes when compared to the APAP induced toxin control group. Rats pretreated with GOV exhibited significant (p < 0.05) increase in serum levels of ALP, ALT, AST, GGT, LDH, Cholesterol, Triglycerides, Urea and a subsequent decrease in Albumin, Creatine and Total protein when compared to the normal rats. This trend in enzyme and biochemical analytes levels were significantly (p < 0.05) reversed when compared to toxin control group. GOV significantly (p < 0.05) and dose dependently increased the serum, kidney and hepatic CAT, GPx, GSH, GST, SOD and total protein activity in APAP induced damage in rats compared to the toxin control groups. Conclusion: The data from this study suggest that the polyherbal formulation possess hepato and nephron-protective potential against acetaminophen induced hepatotoxicity in rats, thus providing scientific rationale for its use in traditional medicine for the treatment of liver diseases. PMID:25121002

COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

PubMed Central

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-01-01

Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

COACH trial: a randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: rationale and design.

PubMed

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-05-01

Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. Copyright © 2011 Elsevier Inc. All rights reserved.

How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study

ERIC Educational Resources Information Center

Senkowski, Valerie; Branscum, Paul

2015-01-01

Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight…

Gender orientation and alcohol-related weight control behavior among male and female college students.

PubMed

Peralta, Robert L; Barr, Peter B

2017-01-01

We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. Participants completed an online survey (N = 651; 59.9% women; 40.1% men). Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.

Social factors, weight perception, and weight control practices among adolescents in Mexico.

PubMed

Bojorquez, Ietza; Villatoro, Jorge; Delgadillo, Marlene; Fleiz, Clara; Fregoso, Diana; Unikel, Claudia

2018-06-01

We evaluated the association of social factors and weight control practices in adolescents, and the mediation of this association by weight perception, in a national survey of students in Mexico ( n = 28,266). We employed multinomial and Poisson regression models and Sobel's test to assess mediation. Students whose mothers had a higher level of education were more likely to perceive themselves as overweight and also to engage in weight control practices. After adjusting for body weight perception, the effect of maternal education on weight control practices remained significant. Mediation tests were significant for boys and non-significant for girls.

Overcoming limitations in previous research on exercise as a smoking cessation treatment: rationale and design of the "Quit for Health" trial.

PubMed

Williams, David M; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J; Monti, Peter M; Emerson, Jessica

2014-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)--an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments. Copyright © 2013 Elsevier Inc. All rights reserved.

Overcoming Limitations in Previous Research on Exercise as a Smoking Cessation Treatment: Rationale and Design of the “Quit for Health” Trial

PubMed Central

Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica

2013-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818

The Definition, Rationale, and Effects of Thresholding in OCT Angiography.

PubMed

Cole, Emily D; Moult, Eric M; Dang, Sabin; Choi, WooJhon; Ploner, Stefan B; Lee, ByungKun; Louzada, Ricardo; Novais, Eduardo; Schottenhamml, Julia; Husvogt, Lennart; Maier, Andreas; Fujimoto, James G; Waheed, Nadia K; Duker, Jay S

2017-01-01

To examine the definition, rationale, and effects of thresholding in OCT angiography (OCTA). A theoretical description of OCTA thresholding in combination with qualitative and quantitative analysis of the effects of OCTA thresholding in eyes from a retrospective case series. Four eyes were qualitatively examined: 1 from a 27-year-old control, 1 from a 78-year-old exudative age-related macular degeneration (AMD) patient, 1 from a 58-year-old myopic patient, and 1 from a 77-year-old nonexudative AMD patient with geographic atrophy (GA). One eye from a 75-year-old nonexudative AMD patient with GA was quantitatively analyzed. A theoretical thresholding model and a qualitative and quantitative description of the dependency of OCTA on thresholding level. Due to the presence of system noise, OCTA thresholding is a necessary step in forming OCTA images; however, thresholding can complicate the relationship between blood flow and OCTA signal. Thresholding in OCTA can cause significant artifacts, which should be considered when interpreting and quantifying OCTA images.

Gender and Socioeconomic Status in Relation to Weight Perception and Weight Control Behavior in Korean Adults

PubMed Central

Joh, Hee-Kyung; Oh, Juhwan; Lee, Hae-Jeung; Kawachi, Ichiro

2013-01-01

Aim In Korea, obesity is more prevalent among men and lower socioeconomic groups. To explain this obesity disparity, we compared weight perception and weight control behavior across gender and socioeconomic status (SES). Methods We analyzed data from 16,260 participants aged 20 years or older in a nationally representative cross-sectional survey. SES indicators included education and income levels. Weight under-perception was defined when participants considered themselves lighter than their measured BMI status. Either no active or inappropriate weight control (i.e., trying to gain weight in obese individuals) was considered to be unhealthy patterns. Multivariate prevalence ratios were calculated using log-binomial regressions. Results Men had a higher prevalence of weight under-perception (24.5 vs. 11.9%) and unhealthy patterns of weight control behavior (57 vs. 40%) than women. Low education level was associated with weight under-perception (ptrend = 0.022 in men, ptrend ℋ 0.001 in women). Both education and income levels were significantly associated with patterns of weight control behavior (for education: ptrend ℋ 0.001 in men and women; for income: ptrend = 0.047 in men, ptrend ℋ 0.001 in women). Conclusion Weight perception and weight control behavior significantly varied by gender and SES. Public actions should be directed toward improving perception and behavior of high-risk populations. PMID:23429009

One-dimensional zinc oxide nanomaterials synthesis and photovoltaic applications

NASA Astrophysics Data System (ADS)

Weintraub, Benjamin A.

As humanly engineered materials systems approach the atomic scale, top-down manufacturing approaches breakdown and following nature's example, bottom-up or self-assembly methods have the potential to emerge as the dominant paradigm. Synthesis of one-dimensional nanomaterials takes advantage of such self-assembly manufacturing techniques, but until now most efforts have relied on high temperature vapor phase schemes which are limited in scalability and compatibility with organic materials. The solution-phase approach is an attractive low temperature alternative to overcome these shortcomings. To this end, this thesis is a study of the rationale solution-phase synthesis of ZnO nanowires and applications in photovoltaics. The following thesis goals have been achieved: rationale synthesis of a single ZnO nanowire on a polymer substrate without seeding, design of a wafer-scale technique to control ZnO nanowire array density using layer-by-layer polymers, determination of optimal nanowire field emitter density to maximize the field enhancement factor, design of bridged nanowires across metal electrodes to order to circumvent post-synthesis manipulation steps, electrical characterization of bridged nanowires, rationale solution-phase synthesis of long ZnO nanowires on optical fibers, fabrication of ZnO nanowire dye-sensitized solar cells on optical fibers, electrical and optical characterization of solar cell devices, comparison studies of 2-D versus 3-D nanowire dye-sensitized solar cell devices, and achievement of 6-fold solar cell power conversion efficiency enhancement using a 3-D approach. The thesis results have implications in nanomanufacturing scale-up and next generation photovoltaics.

Novelty, coherence, and Mendeleev's periodic table.

PubMed

Schindler, Samuel

2014-03-01

Predictivism is the view that successful predictions of "novel" evidence carry more confirmational weight than accommodations of already known evidence. Novelty, in this context, has traditionally been conceived of as temporal novelty. However temporal predictivism has been criticized for lacking a rationale: why should the time order of theory and evidence matter? Instead, it has been proposed, novelty should be construed in terms of use-novelty, according to which evidence is novel if it was not used in the construction of a theory. Only if evidence is use-novel can it fully support the theory entailing it. As I point out in this paper, the writings of the most influential proponent of use-novelty contain a weaker and a stronger version of use-novelty. However both versions, I argue, are problematic. With regard to the appraisal of Mendeleev' periodic table, the most contentious historical case in the predictivism debate, I argue that temporal predictivism is indeed supported, although in ways not previously appreciated. On the basis of this case, I argue for a form of so-called symptomatic predictivism according to which temporally novel predictions carry more confirmational weight only insofar as they reveal the theory's presumed coherence of facts as real.

Optimizing separations in online comprehensive two‐dimensional liquid chromatography

PubMed Central

Gargano, Andrea F.G.; Schoenmakers, Peter J.

2017-01-01

Abstract Online comprehensive two‐dimensional liquid chromatography has become an attractive option for the analysis of complex nonvolatile samples found in various fields (e.g. environmental studies, food, life, and polymer sciences). Two‐dimensional liquid chromatography complements the highly popular hyphenated systems that combine liquid chromatography with mass spectrometry. Two‐dimensional liquid chromatography is also applied to the analysis of samples that are not compatible with mass spectrometry (e.g. high‐molecular‐weight polymers), providing important information on the distribution of the sample components along chemical dimensions (molecular weight, charge, lipophilicity, stereochemistry, etc.). Also, in comparison with conventional one‐dimensional liquid chromatography, two‐dimensional liquid chromatography provides a greater separation power (peak capacity). Because of the additional selectivity and higher peak capacity, the combination of two‐dimensional liquid chromatography with mass spectrometry allows for simpler mixtures of compounds to be introduced in the ion source at any given time, improving quantitative analysis by reducing matrix effects. In this review, we summarize the rationale and principles of two‐dimensional liquid chromatography experiments, describe advantages and disadvantages of combining different selectivities and discuss strategies to improve the quality of two‐dimensional liquid chromatography separations. PMID:29027363

Congressional Control of Navy Budget Execution: Acquisition of the A-6F Aircraft

DTIC Science & Technology

1988-06-01

understandable to Congress, and explaining the rationale may employ tricks of storytelling . Promotional efforts serve the purpose of 64 0 winning...Circumstances That Gain Congressional Empathy The second sub-category of financial manipulation is a tactic that gains understanding for the mutability...defeat at the polls. Similarly, the bid for empathy in coping with uncertainty creates an atmosphere of friendliness, trust and benevolence in which

Near-term hybrid vehicle program, phase 1. Appendix C: Preliminary design data package

NASA Technical Reports Server (NTRS)

1979-01-01

The design methodology, the design decision rationale, the vehicle preliminary design summary, and the advanced technology developments are presented. The detailed vehicle design, the vehicle ride and handling and front structural crashworthiness analysis, the microcomputer control of the propulsion system, the design study of the battery switching circuit, the field chopper, and the battery charger, and the recent program refinements and computer results are presented.

Job-Grading System Manual for Nonappropriated Fund Instrumentalities

DTIC Science & Technology

1981-10-01

rationale for use and forwarded through designated channels to the office of DoD NAF Personnel Policy. E. USE OF OPM POSITION CLASSIFICATION AND JOB...marking, building and control of campfires, and identification of hazardous plants and animals. Schedules day or longer "camp-outs," publicizes the...Merchandisers PS-5 decorate designated areas, including showcases, ledges, and fixtures. Incumbents set up focal displays near entrances to attract cus

Telotristat ethyl: proof of principle and the first oral agent in the management of well-differentiated metastatic neuroendocrine tumor and carcinoid syndrome diarrhea.

PubMed

Masab, Muhammad; Saif, Muhammad Wasif

2017-12-01

Metastatic neuroendocrine tumors (NETs) are associated with carcinoid syndrome that is typically characterized by diarrhea, cutaneous flushing and bronchospasm. Treatment with somatostatin analogues (SSA) improves the symptom burden but a significant proportion of patients stop responding to SSA therapy eventually. Novel agents with the potential to effectively control the symptoms are urgently needed. This article reviews an in-depth analysis of the phase I-III clinical trials determining the clinical rationale for the use of tryptophan hydroxylase inhibitor, telotristat ethyl in patients with well-differentiated metastatic NETs and uncontrolled carcinoid syndrome. Telotristat ethyl has already been approved for the treatment of inadequately controlled carcinoid syndrome symptoms in metastatic NET patients on SSA therapy. Results from multiple phase I-III clinical studies of telotristat ethyl therapy have reported a significant decrease in the daily bowel movement frequency, increase in quality of life and the subsequent decrease in annual health costs related to carcinoid syndrome symptoms in NET patients. The associated decrease in urinary 5-hydroxyindoleacetic acid (u5-HIAA) provides evidence that telotristat ethyl effectively decreases serotonin production, and therefore, offers a rationale to investigate this agent to mitigate serotonin-mediated complications in this patient population, especially cardiac valvular disease or mesenteric fibrosis.

Neoliberal Long-Term Care: From Community to Corporate Control.

PubMed

Polivka, Larry; Luo, Baozhen

2017-09-23

Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS programs have been largely administered by the state and local level nonprofit aging networks (ANs) consisting of Area Agencies on Aging and thousands of service providers. Over the last decade, however, for-profit HMOs administered primarily by large insurance companies have begun to displace AN organizations. State policymakers have embraced for-profit privatizations under the rationale that this approach will generate greater savings, efficiencies, and higher quality outcomes than the traditional public or private nonprofit models of program administration. As we show here, there is very little evidence for this rationale; yet, this lack of evidence has not prevented the continuing growth of for-profit managed LTC programs supported more by an ideology of market fundamentalism than empirical evidence. We also describe six possible consequences of the trend toward corporate control of public LTC services in the years ahead. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of self-reported height and weight with controlled height and weight in women and men.

PubMed

Schlichting, P; Høilund-Carlsen, P F; Quaade, F

1981-01-01

Self-reported height and weight were compared with directly-measured controlled height and weight in 158 women with a median age of 34 years (16-62 years) and in 594 men with a median age of 37 (16-66 years). A model of two one-dimensional linear regressions with two independent variables was used in order to describe the combined influence of both controlled height and controlled weight on self-reported height and on self-reported weight. For both sexes there was a systematic tendency for tall and heavy persons to underestimate their height and weight and conversely for small and thin persons to overestimate these measurements. The influence of controlled weight on self-reported height was statistically significant (women: P less than 0.05; men: P approximately 0.05,) and so was the influence of controlled height on self-reported weight (women: P less than 0.002; men: P less than 0.001). The reported heights and weights of women and men converged towards a pair of desired measures for each sex, ie the values of height and weight for which the reported and the controlled values were identical. For women the desired measures were 159.6 cm and 45.2 kg, for men 176.7 cm and 68.9 kg. The demonstrated differences between self-reported and controlled body measures may invalidate data and conclusions of insurance studies and population surveys based on self-reported measures.

Assessment of executive functioning in binge-eating disorder independent of weight status.

PubMed

Eneva, Kalina T; Arlt, Jean M; Yiu, Angelina; Murray, Susan M; Chen, Eunice Y

2017-08-01

Executive functioning (EF) problems may serve as vulnerability or maintenance factors for Binge-Eating Disorder (BED). However, it is unclear if EF problems observed in BED are related to overweight status or BED status. The current study extends this literature by examining EF in overweight and normal-weight BED compared to weight-matched controls. Participants were normal-weight women with BED (n = 23), overweight BED (n = 32), overweight healthy controls (n = 48), and normal-weight healthy controls (n = 29). The EF battery utilized tests from the National Institutes of Health (NIH) Toolbox and Delis-Kaplan Executive Function System (D-KEFS). After controlling for years of education and minority status, overweight individuals performed more poorly than normal-weight individuals on a task of cognitive flexibility requiring generativity (p < .01), and speed on psychomotor performance tasks (p = .01). Normal-weight and overweight BED performed worse on working memory tasks compared to controls (p = .04). Unexpectedly, normal-weight BED individuals out-performed all other groups on an inhibitory control task (p < .01). No significant differences were found between the four groups on tasks of planning. Regardless of weight status, BED is associated with working memory problems. Replication of the finding that normal-weight BED is associated with enhanced inhibitory control is needed. © 2017 Wiley Periodicals, Inc.

Behavioral intervention to promote smoking cessation and prevent weight gain: A systematic review and meta-analysis

PubMed Central

Spring, Bonnie; Howe, Dorothea; Berendsen, Mark; McFadden, H. Gene; Hitchcock, Kristin; Rademaker, Alfred W.; Hitsman, Brian

2009-01-01

Aims The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain. Methods We identified randomized controlled trials that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met criteria and were included in the meta-analysis. Results Patients who received both smoking treatment and weight treatment showed increased abstinence (OR=1.29, 95% CI=1.01,1.64) and reduced weight gain (g = -0.30, 95% CI=-0.63, -0.04) in the short term (<3 months) compared with patients who received smoking treatment alone. Differences in abstinence (OR=1.23, 95% CI=0.85, 1.79) and weight control (g= -0.17, 95% CI=-0.42, 0.07) were no longer significant in the long term (>6 months). Conclusions Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking. PMID:19549058

Motivation, self-determination, and long-term weight control

PubMed Central

2012-01-01

This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation - not only considering the level but also type of motivation - in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change. PMID:22385818

Motivation, self-determination, and long-term weight control.

PubMed

Teixeira, Pedro J; Silva, Marlene N; Mata, Jutta; Palmeira, António L; Markland, David

2012-03-02

This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation--not only considering the level but also type of motivation--in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change.

Comprehensive genetic assessment of the ESR1 locus identifies a risk region for endometrial cancer.

PubMed

O'Mara, Tracy A; Glubb, Dylan M; Painter, Jodie N; Cheng, Timothy; Dennis, Joe; Attia, John; Holliday, Elizabeth G; McEvoy, Mark; Scott, Rodney J; Ashton, Katie; Proietto, Tony; Otton, Geoffrey; Shah, Mitul; Ahmed, Shahana; Healey, Catherine S; Gorman, Maggie; Martin, Lynn; Hodgson, Shirley; Fasching, Peter A; Hein, Alexander; Beckmann, Matthias W; Ekici, Arif B; Hall, Per; Czene, Kamila; Darabi, Hatef; Li, Jingmei; Dürst, Matthias; Runnebaum, Ingo; Hillemanns, Peter; Dörk, Thilo; Lambrechts, Diether; Depreeuw, Jeroen; Annibali, Daniela; Amant, Frederic; Zhao, Hui; Goode, Ellen L; Dowdy, Sean C; Fridley, Brooke L; Winham, Stacey J; Salvesen, Helga B; Njølstad, Tormund S; Trovik, Jone; Werner, Henrica M J; Tham, Emma; Liu, Tao; Mints, Miriam; Bolla, Manjeet K; Michailidou, Kyriaki; Tyrer, Jonathan P; Wang, Qin; Hopper, John L; Peto, Julian; Swerdlow, Anthony J; Burwinkel, Barbara; Brenner, Hermann; Meindl, Alfons; Brauch, Hiltrud; Lindblom, Annika; Chang-Claude, Jenny; Couch, Fergus J; Giles, Graham G; Kristensen, Vessela N; Cox, Angela; Pharoah, Paul D P; Dunning, Alison M; Tomlinson, Ian; Easton, Douglas F; Thompson, Deborah J; Spurdle, Amanda B

2015-10-01

Excessive exposure to estrogen is a well-established risk factor for endometrial cancer (EC), particularly for cancers of endometrioid histology. The physiological function of estrogen is primarily mediated by estrogen receptor alpha, encoded by ESR1. Consequently, several studies have investigated whether variation at the ESR1 locus is associated with risk of EC, with conflicting results. We performed comprehensive fine-mapping analyses of 3633 genotyped and imputed single nucleotide polymorphisms (SNPs) in 6607 EC cases and 37 925 controls. There was evidence of an EC risk signal located at a potential alternative promoter of the ESR1 gene (lead SNP rs79575945, P=1.86×10(-5)), which was stronger for cancers of endometrioid subtype (P=3.76×10(-6)). Bioinformatic analysis suggests that this risk signal is in a functionally important region targeting ESR1, and eQTL analysis found that rs79575945 was associated with expression of SYNE1, a neighbouring gene. In summary, we have identified a single EC risk signal located at ESR1, at study-wide significance. Given SNPs located at this locus have been associated with risk for breast cancer, also a hormonally driven cancer, this study adds weight to the rationale for performing informed candidate fine-scale genetic studies across cancer types. © 2015 Society for Endocrinology.

Tocilizumab for uncontrollable systemic inflammatory response syndrome complicating adult-onset Still disease

PubMed Central

Masui-Ito, Asami; Okamoto, Ryuji; Ikejiri, Kaoru; Fujimoto, Mika; Tanimura, Muneyoshi; Nakamori, Shiro; Murata, Tomohiro; Ishikawa, Eiji; Yamada, Norikazu; Imai, Hiroshi; Ito, Masaaki

2017-01-01

Abstract Rationale: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, fever spikes, arthralgia, and lymphadenopathy. AOSD usually has a good prognosis, but it can sometimes be fatal, especially when it is complicated by systemic inflammatory response syndrome (SIRS) and multiple organ failure. Patient concerns: A previously healthy 26-year-old woman was referred to our hospital for persistent high fever and mild systemic edema. Five days later, the patient presented with dyspnea, hypotension, and anuria. Anasarca developed with massive pleural effusion, ascites, and systemic edema, resulting in an increase of 47 kg in body weight. Diagnoses: The patient was diagnosed as AOSD after infection, malignancy, hematologic disorders, and other autoimmune diseases were excluded. Interventions: We administered tocilizumab, an IL-6 receptor inhibitor, intravenously in addition to cyclosporine, prednisolone, plasma exchange, and continuous hemodiafiltration. Outcomes: The patient's systemic condition improved. After stabilization by all medications, the patient was managed and responded to tocilizumab alone. To the best of our knowledge, this was the first case of severe SIRS complicating AOSD that was successfully treated with an anti- IL-6 receptor antibody. Lessons: SIRS should not be overlooked in a patient with steroid-resistant AOSD and edema. Inhibitors of the IL-6 receptor can be used safely and effectively to control AOSD complicated with severe SIRS. PMID:28723802

The keys to healthy family child care homes intervention: study design and rationale.

PubMed

Østbye, Truls; Mann, Courtney M; Vaughn, Amber E; Namenek Brouwer, Rebecca J; Benjamin Neelon, Sara E; Hales, Derek; Bangdiwala, Shrikant I; Ward, Dianne S

2015-01-01

Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children's development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider's own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children's health-related behaviors. Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. Copyright © 2014. Published by Elsevier Inc.

The Keys to Healthy Family Child Care Homes intervention: Study design and rationale

PubMed Central

Østbye, Truls; Mann, Courtney M.; Vaughn, Amber E.; Namenek Brouwer, Rebecca J.; Benjamin Neelon, Sara E.; Hales, Derek; Bangdiwala, Shrikant I.; Ward, Dianne S.

2014-01-01

Background Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children’s development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider’s own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children’s health-related behaviors. Methods Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Conclusion Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. PMID:25460337

Bioethics: A Rationale and a Model

ERIC Educational Resources Information Center

Barman, Charles R.; Rusch, John J.

1978-01-01

Discusses the rationale for and development of an undergraduate bioethics course. Based on experiences with the course, general suggestions are offered to instructors planning to add bioethics to existing curricula. (MA)

Vaping to lose weight: Predictors of adult e-cigarette use for weight loss or control.

PubMed

Morean, Meghan E; Wedel, Amelia V

2017-03-01

Some traditional cigarette smokers are motivated to smoke to lose weight or control their weight. The current study evaluated whether a subset of adult e-cigarette users reported vaping to lose or control their weight and examined potential predictors of vaping for weight management. Adult e-cigarette users (n=459) who reported wanting to lose weight or maintain their weight completed an anonymous online survey. Participants reported on demographics, vaping frequency, e-cigarette nicotine content, cigarette smoking status, preferred e-cigarette/e-liquid flavors, current weight status (i.e., overweight, underweight), use of dieting strategies associated with anorexia and bulimia, lifetime history of binge eating, self-discipline, and impulse control. Binary logistic regression was used to examine whether vaping for weight loss/control was associated with the aforementioned variables. Participants who reported vaping for weight loss/control (13.5%) were more likely to vape frequently (adjOR=1.15; 95% CI [1.00, 1.31]); be overweight (adjOR=2.80; [1.33, 5.90]); restrict calories (adjOR=2.23; [1.13, 4.42]); have poor impulse control (adjOR=0.59; [0.41, 0.86]); and prefer coffee- (adjOR=2.92; [1.47, 5.80]) or vanilla-flavored e-liquid (adjOR=7.44; [1.56, 36.08]). A subset of adult e-cigarette users reported vaping for weight loss/control, raising concerns about expanded, scientifically unsubstantiated uses of e-cigarettes. Identifying where individuals obtain information about vaping for weight loss (e.g., e-cigarette ads, Internet) and whether weight-related motives promote e-cigarette initiation among e-cigarette naïve individuals is important to informing regulatory efforts. Further research also is needed to better understand the link between e-liquid flavors and weight loss motivations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Changes in weight control behaviors and hedonic hunger during a 12-week commercial weight loss program.

PubMed

O'Neil, Patrick M; Theim, Kelly R; Boeka, Abbe; Johnson, Gail; Miller-Kovach, Karen

2012-12-01

Greater use of key self-regulatory behaviors (e.g., self-monitoring of food intake and weight) is associated with greater weight loss within behavioral weight loss treatments, although this association is less established within widely-available commercial weight loss programs. Further, high hedonic hunger (i.e., susceptibility to environmental food cues) may present a barrier to successful behavior change and weight loss, although this has not yet been examined. Adult men and women (N=111, body mass index M±SD=31.5±2.7kg/m(2)) were assessed before and after participating in a 12-week commercial weight loss program. From pre- to post-treatment, reported usage of weight control behaviors improved and hedonic hunger decreased, and these changes were inversely associated. A decrease in hedonic hunger was associated with better weight loss. An improvement in reported weight control behaviors (e.g., self-regulatory behaviors) was associated with better weight loss, and this association was even stronger among individuals with high baseline hedonic hunger. Findings highlight the importance of specific self-regulatory behaviors within weight loss treatment, including a commercial weight loss program developed for widespread community implementation. Assessment of weight control behavioral skills usage and hedonic hunger may be useful to further identify mediators of weight loss within commercial weight loss programs. Future interventions might specifically target high hedonic hunger and prospectively examine changes in hedonic hunger during other types of weight loss treatment to inform its potential impact on sustained behavior change and weight control. Copyright © 2012 Elsevier Ltd. All rights reserved.

Rationale and Design of the Feeding Dynamic Intervention (FDI) Study for Self-Regulation of Energy Intake in Preschoolers

PubMed Central

Eneli, Ihuoma U.; Tylka, Tracy L.; Hummel, Jessica; Watowicz, Rosanna P.; Perez, Susana A.; Kaciroti, Niko; Lumeng, Julie C.

2015-01-01

In 2011, the Institute of Medicine Early Childhood Prevention Policies Report identified feeding dynamics as an important focus area for childhood obesity prevention and treatment. Feeding dynamics include two central components: (1) caregiver feeding practices (i.e., determining how, when, where, and what they feed their children) and (2) child eating behaviors (i.e., determining how much and what to eat from what food caregivers have provided). Although there has been great interest in overweight and obesity prevention and treatment in young children, they have not focused comprehensively on feeding dynamics. Interventions on feeding dynamics that reduce caregivers’ excessive controlling and restrictive feeding practices and encourage the development of children’s self-regulation of energy intake may hold promise for tackling childhood obesity especially in the young child but currently lack an evidence base. This manuscript describes the rationale and design for a randomized controlled trial designed to compare a group of mothers and their 3-to 5-year old children who received an intervention focused primarily on feeding dynamics called the Feeding Dynamic Intervention (FDI) with a Wait-list Control Group (WLC). The primary aim of the study will be to investigate the efficacy of the FDI for decreasing Eating in the Absence of Hunger (EAH) and improving energy compensation (COMPX). The secondary aim will be to examine the effect of the FDI in comparison to the WLC on maternal self-reported feeding practices and child satiety responsiveness. PMID:25616192

STARPROBE: Scientific rationale

NASA Technical Reports Server (NTRS)

Underwood, J. H. (Editor); Randolph, J. E. (Editor)

1982-01-01

The scientific rationale and instrumentation problems in the areas of solar internal dynamics and relativity, solar plasma and particle dynamics, and solar atmosphere structure were studied. Current STARPROBE mission and system design concepts are summarized.

Weighing every day matters: daily weighing improves weight loss and adoption of weight control behaviors.

PubMed

Steinberg, Dori M; Bennett, Gary G; Askew, Sandy; Tate, Deborah F

2015-04-01

Daily weighing is emerging as the recommended self-weighing frequency for weight loss. This is likely because it improves adoption of weight control behaviors. To examine whether weighing every day is associated with greater adoption of weight control behaviors compared with less frequent weighing. Longitudinal analysis of a previously conducted 6-month randomized controlled trial. Overweight men and women in Chapel Hill, NC, participated in the intervention arm (N=47). The intervention focused on daily weighing for weight loss using an e-scale that transmitted weights to a study website, along with weekly e-mailed lessons and tailored feedback on daily weighing adherence and weight loss progress. We gathered objective data on self-weighing frequency from the e-scales. At baseline and 6 months, weight change was measured in the clinic and weight control behaviors (total items=37), dietary strategies, and calorie expenditure from physical activity were assessed via questionnaires. Calorie intake was assessed using an online 24-hour recall tool. We used χ(2) tests to examine variation in discrete weight control behaviors and linear regression models to examine differences in weight, dietary strategies, and calorie intake and expenditure by self-weighing frequency. Fifty-one percent of participants weighed every day (n=24) over 6 months. The average self-weighing frequency among those weighing less than daily (n=23) was 5.4±1.2 days per week. Daily weighers lost significantly more weight compared with those weighing less than daily (mean difference=-6.1 kg; 95% CI -10.2 to -2.1; P=0.004). The total number of weight control behaviors adopted was greater among daily weighers (17.6±7.6 vs 11.2±6.4; P=0.004). There were no differences by self-weighing frequency in dietary strategies, calorie intake, or calorie expenditure. Weighing every day led to greater adoption of weight control behaviors and produced greater weight loss compared with weighing most days of the week. This further implicates daily weighing as an effective weight loss tool. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Weight Control

MedlinePlus

... obesity. Achieving a healthy weight can help you control your cholesterol, blood pressure and blood sugar. It ... use more calories than you eat. A weight-control strategy might include Choosing low-fat, low-calorie ...

Associations between body mass index, weight control concerns and behaviors, and eating disorder symptoms among non-clinical Chinese adolescents

PubMed Central

2010-01-01

Background Previous research with adolescents has shown associations of body weight, weight control concerns and behaviors with eating disorder symptoms, but it is unclear whether these associations are direct or whether a mediating effect exists. This study was conducted to investigate the prevalence of overweight and obesity, weight control concerns and behaviors, and eating disorder symptoms and to examine the mediating function of weight control concerns and behaviors on the relationship between body mass index (BMI) and eating disorder symptoms among non-clinical adolescents in China. Methods A cross-sectional survey among 2019 adolescent girls and 1525 adolescent boys in the 7th, 8th, 10th and 11th grades from seven cities in China was conducted. Information on weight control concerns and behaviors, and eating disorder symptoms (Eating Disorder Inventory-3) were collected from the adolescents using a self-administrated questionnaire. Results Weight control concerns and behaviors, and eating disorder symptoms were prevalent among the study population. A high proportion of adolescents scored at or above the threshold on the eating disorder inventory (EDI) subscale such as bulimia, interoceptive deficits, perfectionism, and maturity fears, which indicated eating disorder symptoms. High BMI was significantly associated with high score of drive for thinness, body dissatisfaction, bulimia, low self-esteem, interceptive deficits and maturity fears, so do perceived body weight status. Almost all weight control concerns and behaviors we investigated were significantly associated with high EDI subscale scores. When weight control concerns were added to the model, as shown in the model, the association between BMI and tendency of drive to thinness and bulimia was attenuated but still kept significant. The association between BMI and body dissatisfaction were no further significant. The association of BMI and drive for thinness, body dissatisfaction and bulimia was considerably weaker than when weight control behaviors were not included. Conclusions Weight control concerns and behaviors may be mediators of the association between BMI and eating disorder symptoms. Interpretation of these weight control problems is crucial to develop culturally appropriate educational and intervention programs for adolescents. PMID:20525394

Weight Control Beliefs, Body Shape Attitudes, and Physical Activity among Adolescents

ERIC Educational Resources Information Center

Martin, Scott B.; Rhea, Deborah J.; Greenleaf, Christy A.; Judd, Doryce E.; Chambliss, Heather O.

2011-01-01

Background: Relatively little is known about how perceived weight controllability influences important psychological health factors among adolescents. Thus, the purpose of this study is to explore adolescents' weight controllability beliefs and how those beliefs influence weight-related attitudes and behaviors. Methods: Adolescents (N = 369, mean…

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

PubMed

Befort, C A; Stewart, E E; Smith, B K; Gibson, C A; Sullivan, D K; Donnelly, J E

2008-03-01

To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Patients with rib fractures: use of incentive spirometry volumes to guide care.

PubMed

Brown, Sheree D; Walters, Madonna R

2012-01-01

Rib fractures pose significant risk to trauma patients. Effective pain control and the ability to take deep breaths are crucial for optimal recovery, and these are key elements in current clinical guidelines. These guidelines use incentive spirometry volumes along with other assessment values to guide patient care. However, despite current guidelines, nurses do not routinely document inspired respiratory volumes. This article provides trauma nurses with the rationale for documenting and tracking incentive spirometry volumes to improve outcomes for patients with rib fractures. This promotes early detection of respiratory decline and early interventions to improve pain control and pulmonary function.

Mesalazine in treating diverticular disease of the colon.

PubMed

Tursi, Antonio

2013-07-01

Evaluation of: Kruis W, Meier E, Schumacher M, Mickisch O, Greinwald R, Mueller R; German SAG-20 Study Group. Randomised clinical trial: mesalazine (Salofalk granules) for uncomplicated diverticular disease of the colon - a placebo-controlled study. Aliment. Pharmacol. Ther. 37(7), 680-690 (2013). Although diverticular disease (DD) is one of the commonest diseases in the western world, robust evidences about its treatment are lack so far. A recent, placebo-controlled study found mesalazine effective in obtaining pain relief in patients suffering from DD. A brief comment is provided herein in order to assess the rationale of this drug in treating DD.

ISFM guidelines on population management and welfare of unowned domestic cats (Felis catus).

PubMed

Sparkes, Andrew H; Bessant, Claire; Cope, Kevin; Ellis, Sarah L H; Finka, Lauren; Halls, Vicky; Hiestand, Karen; Horsford, Kim; Laurence, Christopher; MacFarlaine, Ian; Neville, Peter F; Stavisky, Jenny; Yeates, James

2013-09-01

GUIDELINES RATIONALE: Cats are among the most commonly kept domestic pets, and coexist with humans in a variety of different circumstances. Cats are sentient beings and, as such, humans have a responsibility for cat welfare where humans and cats coexist. Because cats reproduce efficiently, measures to control populations are frequently needed, but these should be based on ethical and humane approaches. These consensus guidelines from the International Society of Feline Medicine's Welfare Advisory Panel provide a framework for the approach to welfare and population control measures, primarily among unowned cats and those going through a homing programme.

Cargo Movement Operations System (CMOS) Interface Requirements Specification (Draft). Increment II

DTIC Science & Technology

1990-05-17

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ 3 CLOSED [ ] ORIGINATOR CONTROL NUMBER: IRS1-0003 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A004-05 DATE: 05/17/90 ORIGINATOR NAME: Ronald J. Lacour OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: 9 PARA NUMBER: 3.2 c. COMMENT OR RECOMMENDED CHANGE: Change line 2 to read, "CMOS IRD/SBSS-01 and SBSS-03." Move "CMOS IRD/SBSS-02" to paragraph 3.3 c. RATIONALE: The CMOS IRD/SBSS-02 covers the Shipment Suspense

Cargo Movement Operations System (CMOS). Draft Software Design Document for the PC UNIX Prototype (Navy Configuration), Increment III.

DTIC Science & Technology

1991-04-21

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED ( ] ORIGINATOR CONTROL NUMBER: SDDN-0003 PROGRAM OFFICE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: C006-02 DATE: 04/21/91 ORIGINATOR NAME: Ronald J. Lacour OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: CUBA0065-1 PARA NUMBER: N/A COMMENT OR RECOMMENDED CHANGE: Change CUVA0065 in Table 6 to CUBA0065 to match the name in Attachment 1. RATIONALE: It appears that this CSU was improperly named in Table 6. CMOS PMO ACCEPTS COMMENT:

Cargo Movement Operations System (CMOS). Final Software Design Document for the Applications CSCI, Increment II

DTIC Science & Technology

1991-10-03

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ CLOSED [] ORIGINATOR CONTROL NUMBER: SDDl-0002 PROGRAM OFFiCE CONTROL NUMBER: DATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A006-0250L DATE: 10/03/11 ORIGINATOR NAME: Ronald J. Lacour OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: CU2A5040-19 PARA NUMBER: N/A COMMENT OR RECOMMENDED CHANGE: Add "STANDBY PAX" on the last page of this screen. RATIONALE: This redesigned page is for handling standby passengers. However, no mention of that is present.

Cargo Movement Operations System (CMOS) Revised Draft Software Simulator Utilization Handbook

DTIC Science & Technology

1990-12-17

NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [] CLOSED [1 I ORIGINATOR CONTROL NUMBER: SSUH-0002I PROGRAM OFFICE CONTROL NUMBER: IDATA ITEM DISCREPANCY WORKSHEET CDRL NUMBER: A022-02 DATE: 12/17/90 ORIGINATOR NAME: Patrick L. Combs OFFICE SYMBOL: SAIC TELEPHONE NUMBER: 272-2999 SUBSTANTIVE: X EDITORIAL: PAGE NUMBER: E-3 PARA NUMBER: M1521 COMMENT OR RECOMMENDED CHANGE: I Add "DILOGHIS, SNLOGHIS, and SN503000" to M1521. RATIONALE: These short names are located under M1521 in the SUM dated 30 Nov 90, but are not in the SSUH. I CMOS

PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting.

PubMed

Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

2017-04-01

Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization prior to recruitment feasible with 100% participation of facilities randomized to the intervention arm. Critical regulatory issues included minimal risk determination, waiver of informed consent, and determination that nursing home providers were not engaged in human subjects research. Intervention training and implementation were initiated on 5 January 2016 using corporate infrastructures for new program roll-out guided by standardized training elements designed by the research team. Video Status Reports in facilities' electronic medical records permitted "real-time" adherence monitoring and corrective actions. The Centers for Medicare and Medicaid Services Virtual Research Data Center allowed for rapid outcomes ascertainment. Conclusion We must rigorously evaluate interventions to deliver more patient-focused care to an increasingly frail nursing home population. Video decision support is a practical approach to improve advance care planning. PRagmatic trial Of Video Education in Nursing homes has the potential to promote goal-directed care among millions of older Americans in nursing homes and establish a methodology for future pragmatic randomized controlled trials in this complex healthcare setting.

Fragment-based screening by protein crystallography: successes and pitfalls.

PubMed

Chilingaryan, Zorik; Yin, Zhou; Oakley, Aaron J

2012-10-08

Fragment-based drug discovery (FBDD) concerns the screening of low-molecular weight compounds against macromolecular targets of clinical relevance. These compounds act as starting points for the development of drugs. FBDD has evolved and grown in popularity over the past 15 years. In this paper, the rationale and technology behind the use of X-ray crystallography in fragment based screening (FBS) will be described, including fragment library design and use of synchrotron radiation and robotics for high-throughput X-ray data collection. Some recent uses of crystallography in FBS will be described in detail, including interrogation of the drug targets β-secretase, phenylethanolamine N-methyltransferase, phosphodiesterase 4A and Hsp90. These examples provide illustrations of projects where crystallography is straightforward or difficult, and where other screening methods can help overcome the limitations of crystallography necessitated by diffraction quality.

Fragment-Based Screening by Protein Crystallography: Successes and Pitfalls

PubMed Central

Chilingaryan, Zorik; Yin, Zhou; Oakley, Aaron J.

2012-01-01

Fragment-based drug discovery (FBDD) concerns the screening of low-molecular weight compounds against macromolecular targets of clinical relevance. These compounds act as starting points for the development of drugs. FBDD has evolved and grown in popularity over the past 15 years. In this paper, the rationale and technology behind the use of X-ray crystallography in fragment based screening (FBS) will be described, including fragment library design and use of synchrotron radiation and robotics for high-throughput X-ray data collection. Some recent uses of crystallography in FBS will be described in detail, including interrogation of the drug targets β-secretase, phenylethanolamine N-methyltransferase, phosphodiesterase 4A and Hsp90. These examples provide illustrations of projects where crystallography is straightforward or difficult, and where other screening methods can help overcome the limitations of crystallography necessitated by diffraction quality. PMID:23202926

Can Attention to the Intestinal Microbiota Improve Understanding and Treatment of Anorexia Nervosa?

PubMed Central

Carr, Jacquelyn; Kleiman, Susan C.; Bulik, Cynthia M.; Bulik-Sullivan, Emily C.; Carroll, Ian M.

2016-01-01

Summary Anorexia nervosa (AN) is characterized by severe dietary restriction or other weight loss behaviors and exhibits the highest mortality rate of any psychiatric disorder. Therapeutic renourishment in AN is founded primarily on clinical opinion and guidelines, with a weak evidence base. Genetic factors do not fully account for the etiology of AN, and non-genetic factors that contribute to the onset and persistence of this disease warrant investigation. Compelling evidence that the intestinal microbiota regulates adiposity and metabolism, and more recently, anxiety behavior, provides a strong rationale for exploring the role of this complex microbial community in the onset, maintenance of, and recovery from AN. This review explores the relationship between the intestinal microbiota and AN and a potential role for this enteric microbial community as a therapy for this severe illness. PMID:27003627

Weight Control Belief and Its Impact on the Effectiveness of Tobacco Control Policies on Quit Attempts: Findings from the ITC 4 Country

PubMed Central

Shang, Ce; Chaloupka, Frank J.; Fong, Geoffrey T.; Thompson, Mary; Siahpush, Mohammad; Ridgeway, William

2015-01-01

Background Weight concerns are widely documented as one of the major barriers for girls and young adult women to quit smoking. Therefore, it is important to investigate whether smokers who have weight concerns respond to tobacco control policies differently than smokers who do not in terms of quit attempts, and how this difference varies by gender and country. Objective This study aims to investigate, by gender and country, whether smokers who believe that smoking helps control weight are less responsive to tobacco control policies with regards to quit attempts than those who do not. Methods We use longitudinal data from the International Tobacco Control Policy (ITC) Evaluation Project in the US, Canada, the UK, and Australia to conduct the analysis. We first constructed a dichotomous indicator for smokers who have the weight control belief and then the disparity in policy responsiveness in terms of quit attempts by directly estimating the interaction terms of policies and the weight control belief indicator using generalized estimating equations. Findings We find that weight control belief significantly attenuates the policy impact of tobacco control measures on quit attempts among US female smokers and among UK smokers. This pattern was not found among smokers in Canada and Australia. Conclusions Although our results vary by gender and country, the findings suggest that weight concerns do alter policy responsiveness in quit attempts in certain populations. Policy makers should take this into account and alleviate weight concerns to enhance the effectiveness of existing tobacco control policies on promoting quitting smoking. PMID:25646173

Nutritional status, weight perception and weight control practices among office employees in Sokoto, Nigeria.

PubMed

Awosan, Kehinde Joseph; Adeniyi, Semiyu Adetunji; Bello, Hamza; Bello-Ibrahim, Zarau

2017-01-01

Overweight and obesity have become the fifth leading risk for global deaths. Office employees have been identified as a high risk group due to the sedentary nature of their work, and accurate weight perception is believed to be critical to acceptance of weight control interventions. This study was conducted to assess the nutritional status, weight perception and weight control practices of office employees in Sokoto, Nigeria. A cross sectional study was conducted among 285 randomly selected office employees in private establishments in Sokoto, Nigeria, in February and March 2013. Anthropometry was done for the participants in addition to questionnaire administration. The mean age of the participants was 33.08 ± 7.23 years, they were predominantly males (56.5%) and married (57.5%). None was underweight, 111 (38.9%) had normal weight, 105 (36.8%) were overweight and 69 (24.2%) were obese. Among the participants with normal weight, overweight and obesity, 71.2%, 35.2% and 58.0% respectively accurately perceived their weight; while 28.8%, 50.5% and 30.4% respectively underestimated their weight. There was poor agreement between actual and perceived weight (k statistics = 0.341, p < 0.001). Only 67 (23.5%) of the 285 participants were engaged in weight control practices. This study showed high prevalence of overweight and obesity, weight misperceptions, and poor uptake of weight control practices among office employees in Sokoto, Nigeria. These findings underscore the need for a holistic approach to obesity control interventions that encompasses both body image perception and nutritional assessment.

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls.

PubMed

Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

2018-04-01

To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model. Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership. Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity. Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Unhealthy and healthy weight control behaviours among bus operators.

PubMed

Escoto, K H; French, S A

2012-03-01

Urban bus operators are an occupational group with high rates of overweight and obesity. Understanding methods bus operators use for weight control may be important; there may be increased risk for these workers to engage in less healthy weight management behaviours due to stressful working conditions. To examine the prevalence of unhealthy and healthy weight control behaviours used by bus operators and examine associations between use of unhealthy weight control behaviours and work-related and sociodemographic variables. Bus operators from four different transit garages were invited to complete a self-administered survey; height and weight were measured by research staff. Unhealthy and healthy weight control behaviours, work hours, work schedule and social support were measured with self-report items on the employee survey. Logistic regression analysis was conducted to estimate associations. Nearly 60% of bus operators endorsed at least one unhealthy method; over 50% reported skipping meals, 30% fasted and 10% reported taking diet pills in the past year. Bus operator gender, race, body mass index status and hours worked per week showed significant associations with using at least one unhealthy weight control behaviour. Worksite interventions should emphasize the benefit of healthy eating and physical activity but should also address the use of less healthy methods for weight control for individuals employed in transportation occupations.

Physical activity intensity and weight control status among U.S. Adults with diabetes.

PubMed

Loprinzi, Paul D; Pariser, Gina

2014-01-01

We have a limited understanding of the objectively determined physical activity levels by weight control status (i.e., trying to lose weight, trying to maintain weight, and neither trying to lose or maintain weight) among U.S. adults with diabetes. Therefore, this study assessed the association between physical activity and weight control status among U.S. adults with diabetes. Cross-sectional survey. The 2003-2006 National Health and Nutrition Examination Survey (NHANES) was used, which is representative of the U.S. population. Subjects were 733 adults (≥20 years) with diabetes. Participants wore an accelerometer to assess physical activity, and questionnaires were used to assess weight control status and covariates. Multivariate negative binomial regressions were used. After adjustments, and compared to those not trying to lose or maintain their weight, women trying to lose weight engaged in 74% more physical activity (rate ratio = 1.74; 95% confidence interval [CI]: 1.14 to 2.65). Although findings were not significant for men, men were more likely than women to meet physical activity recommendations. Diabetic women trying to lose weight engaged in more physical activity than did their female counterparts not trying to lose or maintain their weight. Although men were more active than women, no differences in activity estimates occurred across weight control status for men.

Therapeutic drug monitoring of eculizumab: Rationale for an individualized dosing schedule.

PubMed

Gatault, Philippe; Brachet, Guillaume; Ternant, David; Degenne, Danielle; Récipon, Guillaume; Barbet, Christelle; Gyan, Emmanuel; Gouilleux-Gruart, Valérie; Bordes, Cécile; Farrell, Alexandra; Halimi, Jean Michel; Watier, Hervé

2015-01-01

The annual cost of eculizumab maintenance therapy in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic-uremic syndrome (aHUS) exceeds $300,000 per patient. A better understanding of eculizumab pharmacokinetics and subsequent individual dose adjustment could reduce this cost. We measured the trough eculizumab concentration in 9 patients with maintenance therapy (aHUS, n = 7; PNH, n = 2) and determined: 1) the intra- and inter-individual variability; 2) the influence of weight on eculizumab pharmacokinetics; and 3) the rate of elimination of eculizumab following discontinuation. A one-compartment model was developed to describe the pharmacokinetics of eculizumab and predicted complement activity by body weight. Trough eculizumab concentrations were >50 µg/mL in 9/9, >100 µg/mL in 8/9, and >300 µg/mL in 5/9 of patients. Intra-individual variability was low but eculizumab concentrations, closely correlated with patient weight (R(2) = 0.66, p = 0.034), varied broadly (55 ± 12 to 733 ± 164 µg/mL). Pharmacokinetic modeling showed that the elimination half-life varied greatly, with an increase from 7.8 d in a patient weighing 100 kg to 19.5 d in a 40 kg patient. We predicted that infusions of 1200 mg could be spaced every 4 or 6 weeks in patients weighing <90 and <70 kg, respectively. In this pilot study, the current recommended use of a fixed eculizumab dose for maintenance therapy is associated with excessively high trough concentrations in many patients. Further prospective larger studies are now required to support an individualized schedule adjusted for patient weight and based on the observed trough serum eculizumab concentration.

Therapeutic drug monitoring of eculizumab: Rationale for an individualized dosing schedule

PubMed Central

Gatault, Philippe; Brachet, Guillaume; Ternant, David; Degenne, Danielle; Récipon, Guillaume; Barbet, Christelle; Gyan, Emmanuel; Gouilleux-Gruart, Valérie; Bordes, Cécile; Farrell, Alexandra; Halimi, Jean Michel; Watier, Hervé

2015-01-01

The annual cost of eculizumab maintenance therapy in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic–uremic syndrome (aHUS) exceeds $300,000 per patient. A better understanding of eculizumab pharmacokinetics and subsequent individual dose adjustment could reduce this cost. We measured the trough eculizumab concentration in 9 patients with maintenance therapy (aHUS, n = 7; PNH, n = 2) and determined: 1) the intra- and inter-individual variability; 2) the influence of weight on eculizumab pharmacokinetics; and 3) the rate of elimination of eculizumab following discontinuation. A one-compartment model was developed to describe the pharmacokinetics of eculizumab and predicted complement activity by body weight. Trough eculizumab concentrations were >50 µg/mL in 9/9, >100 µg/mL in 8/9, and >300 µg/mL in 5/9 of patients. Intra-individual variability was low but eculizumab concentrations, closely correlated with patient weight (R2 = 0.66, p = 0.034), varied broadly (55 ± 12 to 733 ± 164 µg/mL). Pharmacokinetic modeling showed that the elimination half-life varied greatly, with an increase from 7.8 d in a patient weighing 100 kg to 19.5 d in a 40 kg patient. We predicted that infusions of 1200 mg could be spaced every 4 or 6 weeks in patients weighing <90 and <70 kg, respectively. In this pilot study, the current recommended use of a fixed eculizumab dose for maintenance therapy is associated with excessively high trough concentrations in many patients. Further prospective larger studies are now required to support an individualized schedule adjusted for patient weight and based on the observed trough serum eculizumab concentration. PMID:26337866

American Society of Clinical Oncology Obesity Initiative: Rationale, Progress, and Future Directions.

PubMed

Ligibel, Jennifer A; Wollins, Dana

2016-12-10

Obesity is increasingly being linked to the risk of developing and dying from cancer. In recognition of the growing contribution of obesity to cancer risk and outcomes, ASCO made obesity and cancer one of its core initiatives in 2014. The goals of this initiative included raising awareness of the relationship between obesity and cancer, providing tools and resources to oncology providers and patients to help encourage conversations regarding weight management in cancer survivors, fostering a robust research agenda, and advocating for access to evidence-based weight management programs for cancer survivors. Efforts to date have included developing patient and provider toolkits focused on weight management and physical activity, publishing a policy statement outlining ASCO's initiatives in this area, and hosting a summit focused on obesity research in cancer populations. As ASCO has defined its priorities in the area of obesity and cancer, it has become increasingly clear that obesity is a problem that extends far beyond its impact on cancer risk and outcomes. Many groups, including those focused on heart disease, diabetes, and endocrinology, have been developing, testing, and implementing obesity prevention and treatment strategies for years. As ASCO moves forward with its obesity initiative, the next steps will focus on forging collaboration with groups working on obesity-related initiatives both within and outside of the field of cancer to learn from their efforts and to partner with them on efforts to increase the education of medical professionals; raising awareness in lay populations regarding the negative health consequences of obesity and effective strategies to foster weight loss; developing collaborative research initiatives; and working together to advocate for the societal changes that will be needed to combat the obesity epidemic in the United States and beyond.

The Fit Study: Design and rationale for a cluster randomized trial of school-based BMI screening and reporting.

PubMed

Madsen, Kristine A; Linchey, Jennifer; Ritchie, Lorrene; Thompson, Hannah R

2017-07-01

In the U.S., 25 states conduct body mass index (BMI) screening in schools, just under half of which report results to parents. While some experts recommend the practice, evidence demonstrating its efficacy to reduce obesity is lacking, and concerns about weight-related stigma have been raised. The Fit Study is a 3-arm cluster-randomized trial assessing the effectiveness of school-based BMI screening and reporting in reducing pediatric obesity and identifying unintended consequences. Seventy-nine elementary and middle schools across California were randomized to 1 of 3 Arms: 1) BMI screening and reporting; 2) BMI screening only; or 3) no BMI screening or reporting. In Arm 1 schools, students were further randomized to receive reports with BMI results alone or both BMI and fitness test results. Over 3 consecutive years, staff in schools in Arms 1 and 2 will measure students' BMI (grades 3-8) and additional aspects of fitness (grades 5-8), and students in grades 4-8 in all Arms will complete surveys to assess weight-based stigmatization. Change in BMI z-score will be compared between Arm 1 and Arm 2 to determine the impact of BMI reporting on weight status, with sub-analyses stratified by report type (BMI results alone versus BMI plus fitness results) and by race/ethnicity. The potential for BMI reports to lead to weight-based stigma will be assessed by comparing student survey results among the 3 study Arms. This study will provide evidence on both the benefit and potential unintended harms of school-based BMI screening and reporting. Copyright © 2017. Published by Elsevier Inc.

Is there evidence for a set point that regulates human body weight?

PubMed

Müller, Manfred J; Bosy-Westphal, Anja; Heymsfield, Steven B

2010-08-09

There is evidence for the idea that there is biological (active) control of body weight at a given set point. Body weight is the product of genetic effects (DNA), epigenetic effects (heritable traits that do not involve changes in DNA), and the environment. Regulation of body weight is asymmetric, being more effective in response to weight loss than to weight gain. However, regulation may be lost or camouflaged by Western diets, suggesting that the failure of biological control is due mainly to external factors. In this situation, the body's 'set point' (i.e., a constant 'body-inherent' weight regulated by a proportional feedback control system) is replaced by various 'settling points' that are influenced by energy and macronutrient intake in order for the body to achieve a zero energy balance. In a world of abundance, a prudent lifestyle and thus cognitive control are preconditions of effective biological control and a stable body weight. This idea also impacts future genetic research on body weight regulation. Searching for the genetic background of excess weight gain in a world of abundance is misleading since the possible biological control is widely overshadowed by the effect of the environment. In regard to clinical practice, dietary approaches to both weight loss and weight gain have to be reconsidered. In underweight patients (e.g., patients with anorexia nervosa), weight gain is supported by biological mechanisms that may or may not be suppressed by hyperalimentation. To overcome weight loss-induced counter-regulation in the overweight, biological signals have to be taken into account. Computational modeling of weight changes based on metabolic flux and its regulation will provide future strategies for clinical nutrition.

The role of a personalized dietary intervention in managing gestational weight gain: a prospective, controlled study in a low-risk antenatal population.

PubMed

Di Carlo, Costantino; Iannotti, Giuseppina; Sparice, Stefania; Chiacchio, Maria Pia; Greco, Elena; Tommaselli, Giovanni Antonio; Nappi, Carmine

2014-04-01

To compare the efficacy of a personal dietary intervention on gestational weight gain control with a general intervention promoting healthy eating. Prospective, controlled study including 154 low-risk pregnant women randomly allocated to two groups: 77 receiving a personalized diet plan and a close follow-up by a dietician (intervention group), 77 receiving standard dietary care by means of a brochure on healthy eating during pregnancy (control group). Pre-pregnancy weight, gestational age, height, weight and BMI at baseline, weight at term, gestational age at delivery and newborn weight were recorded for all participants. The primary end-point was the difference in body weight between baseline and term. Secondary end-points were the difference in body weight between pre-pregnancy and term and in newborn weights. Maternal weight gain at term was significantly lower both as compared to pre-pregnancy weight (8.2 ± 4.0 vs. 13.4 ± 4.2 kg; p < 0.001) and to weight at baseline (7.7 ± 3.8 vs. 13.7 ± 4.3 kg; p < 0.001) in the intervention group as compared to controls. A positive, significant correlation between the delta weight between baseline and term and newborn weight was observed in both groups, but stronger in patients from the intervention group (intervention group R = 0.76, p < 0.001; control group R = 0.35, p = 0.01). This study suggests that a personalized nutritional intervention, in which the dietician plays an active role within the obstetric team, may represent a successful approach in limiting weight gain in pregnant women.

Neural and Molecular Mechanisms Involved in Controlling the Quality of Feeding Behavior: Diet Selection and Feeding Patterns

PubMed Central

2017-01-01

We are what we eat. There are three aspects of feeding: what, when, and how much. These aspects represent the quantity (how much) and quality (what and when) of feeding. The quantitative aspect of feeding has been studied extensively, because weight is primarily determined by the balance between caloric intake and expenditure. In contrast, less is known about the mechanisms that regulate the qualitative aspects of feeding, although they also significantly impact the control of weight and health. However, two aspects of feeding quality relevant to weight loss and weight regain are discussed in this review: macronutrient-based diet selection (what) and feeding pattern (when). This review covers the importance of these two factors in controlling weight and health, and the central mechanisms that regulate them. The relatively limited and fragmented knowledge on these topics indicates that we lack an integrated understanding of the qualitative aspects of feeding behavior. To promote better understanding of weight control, research efforts must focus more on the mechanisms that control the quality and quantity of feeding behavior. This understanding will contribute to improving dietary interventions for achieving weight control and for preventing weight regain following weight loss. PMID:29053636

An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

PubMed

Cawley, John

2015-09-01

This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity. Copyright © 2015. Published by Elsevier B.V.

[The rationale for the combined application of cryomassage and silvinite speleotherapy for the rehabilitative treatment of the patients with bronchial asthma].

PubMed

Aĭrapetova, N S; Rassulova, M A; Antonovich, I V; Stiazhkina, E M; Ksenofontova, I V; Nikoda, N V; Derevnina, N A

2011-01-01

The present study is devoted to the estimation of therapeutic and prophylactic effects of cryomassage and silvinite speleotherapy in the patients with partially controlled asthma. Advantages of the combined application of rehabilitative technologies are illustrated by their well-expressed anti-inflammatory and immunocorrecive actions, reduced obstruction and hyper-reactivity of the bronchi, improved pulmonary cardiohemodynamics, enhanced physical tolerance and better psychological adaptation.

A system safety model for developmental aircraft programs

NASA Technical Reports Server (NTRS)

Amberboy, E. J.; Stokeld, R. L.

1982-01-01

Basic tenets of safety as applied to developmental aircraft programs are presented. The integration of safety into the project management aspects of planning, organizing, directing and controlling is illustrated by examples. The basis for project management use of safety and the relationship of these management functions to 'real-world' situations is presented. The rationale which led to the safety-related project decision and the lessons learned as they may apply to future projects are presented.

Managing professional work: three models of control for health organizations.

PubMed Central

Scott, W R

1982-01-01

Three arrangements for structuring the work of professional participants in professional organizations are described, contrasted and evaluated. Arguments are illustrated by application to the organization of physicians within hospitals. The primary rationale, the support structures that have fostered its development, the key structural features and the advantages and disadvantages of each arrangement are described. The effect on these arrangements of structures and forces external to any particular professional organization is emphasized. PMID:6749761

Rationale for the Coadministration of Albendazole and Ivermectin to Humans for Malaria Parasite Transmission Control

DTIC Science & Technology

2014-07-28

programs and supported by global public health funding agencies. Albendazole belongs to the class of benzimidazole anthel- mintics that are active against...blood-stage P. falciparum in vitro83,84 and P. berghei in vivo85,86 but not at human-relevant concentrations. The benzimidazoles are microtubule...cycles at which benzimidazoles may inhibit microtubule assem- bly, including micro- and macrogametocytogenisis, microga- mete exflaggelation, and the

Natural enemies of Saperda spp. (Col.: Cerambycidae, Lamiinae) in Europe, envisioned as potential agents in biological control of Anoplophora spp. in Europe and the U.S.A.

Treesearch

Franck Herard; Christian Cocquempot; Olivier Simonot

2003-01-01

Project Objectives/Approach. Our rationale is founded on the evaluation of possible new associations between the Asian longhorned beetle (ALB) and natural enemies of European cerambycids that have similarities with ALB in terms of taxonomy, host-plants, and behavior. Our first objective is to search, among the biocoenoses associated with selected European cerambycids,...

Identification and selection of cases and controls in the Pneumonia Etiology Research for Child Health project.

PubMed

Deloria-Knoll, Maria; Feikin, Daniel R; Scott, J Anthony G; O'Brien, Katherine L; DeLuca, Andrea N; Driscoll, Amanda J; Levine, Orin S

2012-04-01

Methods for the identification and selection of patients (cases) with severe or very severe pneumonia and controls for the Pneumonia Etiology Research for Child Health (PERCH) project were needed. Issues considered include eligibility criteria and sampling strategies, whether to enroll hospital or community controls, whether to exclude controls with upper respiratory tract infection (URTI) or nonsevere pneumonia, and matching criteria, among others. PERCH ultimately decided to enroll community controls and an additional human immunodeficiency virus (HIV)-infected control group at high HIV-prevalence sites matched on age and enrollment date of cases; controls with symptoms of URTI or nonsevere pneumonia will not be excluded. Systematic sampling of cases (when necessary) and random sampling of controls will be implemented. For each issue, we present the options that were considered, the advantages and disadvantages of each, the rationale for the methods selected for PERCH, and remaining implications and limitations.

Randomized Controlled Trial for Behavioral Smoking and Weight Control Treatment: Effect of Concurrent versus Sequential Intervention

PubMed Central

Spring, Bonnie; Doran, Neal; Pagoto, Sherry; Schneider, Kristin; Pingitore, Regina; Hedeker, Don

2014-01-01

Prospects for changing multiple health behaviors conjointly remain controversial. We compared effects on tobacco abstinence and weight gain of adding diet and exercise concurrently or after smoking treatment. Female regular smokers (n=315) randomized to 3 conditions received 16 weeks of behavioral smoking treatment, quit at week 5, and were followed for 9 months after the quit date. Weight management was added to the first 8 weeks for Early Diet (ED), the final 8 weeks for Late Diet (LD), and omitted for Control. Both Diet groups tended to show greater bio-verified abstinence than Control although differences were nonsignificant. Compared to Control, ED initially suppressed weight gain but lost that effect over time, whereas LD initially lacked but gradually acquired a weight suppression effect that stabilized [p = .004]. Behavioral weight control did not undermine smoking cessation and slowed the rate of weight gain when initiated after the smoking quit date, supporting a sequential approach to multiple behavior change. PMID:15482037

Development of weight and cost estimates for lifting surfaces with active controls

NASA Technical Reports Server (NTRS)

Anderson, R. D.; Flora, C. C.; Nelson, R. M.; Raymond, E. T.; Vincent, J. H.

1976-01-01

Equations and methodology were developed for estimating the weight and cost incrementals due to active controls added to the wing and horizontal tail of a subsonic transport airplane. The methods are sufficiently generalized to be suitable for preliminary design. Supporting methodology and input specifications for the weight and cost equations are provided. The weight and cost equations are structured to be flexible in terms of the active control technology (ACT) flight control system specification. In order to present a self-contained package, methodology is also presented for generating ACT flight control system characteristics for the weight and cost equations. Use of the methodology is illustrated.

The Tracking Study: Description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program

PubMed Central

Linde, Jennifer A.; Jeffery, Robert W.; Crow, Scott J.; Brelje, Kerrin L.; Pacanowski, Carly R.; Gavin, Kara L.; Smolenski, Derek J.

2014-01-01

Observational evidence from behavioral weight control trials and community studies suggests that greater frequency of weighing oneself, or tracking weight, is associated with better weight outcomes. Conversely, it has also been suggested that frequent weight tracking may have a negative impact on mental health and outcomes during weight loss, but there are minimal experimental data that address this concern in the context of an active weight loss program. To achieve the long-term goal of strengthening behavioral weight loss programs, the purpose of this randomized controlled trial (the Tracking Study) is to test variations on frequency of self-weighing during a behavioral weight loss program, and to examine psychosocial and mental health correlates of weight tracking and weight loss outcomes. Three hundred thirty-nine overweight and obese adults were recruited and randomized to one of three variations on weight tracking frequency during a 12-month weight loss program with a 12-month follow-up: daily weight tracking, weekly weight tracking, or no weight tracking. The primary outcome is weight in kilograms at 24 months. The weight loss program integrates each weight tracking instruction with standard behavioral weight loss techniques (goal setting, self-monitoring, stimulus control, dietary and physical activity enhancements, lifestyle modifications); participants in weight tracking conditions were provided with wireless Internet technology (Wi-Fi-enabled digital scales and touchscreen personal devices) to facilitate weight tracking during the study. This paper describes the study design, intervention features, recruitment, and baseline characteristics of participants enrolled in the Tracking Study. PMID:25533727

Accuracy of body image perception and preferred weight loss strategies in schizophrenia: a controlled pilot study.

PubMed

Loh, C; Meyer, J M; Leckband, S G

2008-02-01

Obesity in severely mentally ill (SMI) populations is an increasing problem, but there is no controlled data regarding the relationship between SMI and weight perception. Fifty patients with schizophrenia and 50 demographically matched control participants were recruited. Weight, height, and body image accuracy were assessed for all participants, and assessments of mood, psychotic symptom severity and anxiety, and preferred modes of weight loss were assessed for the schizophrenia sample. Patients with schizophrenia were significantly more likely to be obese than controls (46% vs. 18%, P < 0.005), and most patients expressed an interest in losing weight. Obese participants with schizophrenia underestimated their body size (11.0%) more than controls (4.9%) (P < 0.05). Patients with schizophrenia are more likely to underestimate their body size, independent of the effects of obesity. However, they also express concern about weight issues and willingness to participate in psychoeducational groups targeted at weight loss.

Systems and Methods for Derivative-Free Adaptive Control

NASA Technical Reports Server (NTRS)

Calise, Anthony J. (Inventor); Yucelen, Tansel (Inventor); Kim, Kilsoo (Inventor)

2015-01-01

An adaptive control system is disclosed. The control system can control uncertain dynamic systems. The control system can employ one or more derivative-free adaptive control architectures. The control system can further employ one or more derivative-free weight update laws. The derivative-free weight update laws can comprise a time-varying estimate of an ideal vector of weights. The control system of the present invention can therefore quickly stabilize systems that undergo sudden changes in dynamics, caused by, for example, sudden changes in weight. Embodiments of the present invention can also provide a less complex control system than existing adaptive control systems. The control system can control aircraft and other dynamic systems, such as, for example, those with non-minimum phase dynamics.

Health literacy and parent attitudes about weight control for children.

PubMed

Liechty, Janet M; Saltzman, Jaclyn A; Musaad, Salma M

2015-08-01

The purpose of this study was to examine associations between parental health literacy and parent attitudes about weight control strategies for young children. Parental low health literacy has been associated with poor child health outcomes, yet little is known about its relationship to child weight control and weight-related health information-seeking preferences. Data were drawn from the STRONG Kids Study, a Midwest panel survey among parents of preschool aged children (n = 497). Parents endorsed an average of 4.3 (SD =2.8) weight loss strategies, 53% endorsed all three recommended weight loss strategies for children, and fewer than 1% of parents endorsed any unsafe strategies. Parents were most likely to seek child weight loss information from healthcare professionals but those with low (vs. adequate) health literacy were significantly less likely to use the Internet or books and more likely to use minister/clergy as sources. Poisson and logistic regressions showed that higher health literacy was associated with endorsement of more strategies overall, more recommended strategies, and greater odds of endorsing each specific recommended strategy for child weight control, after adjusting for parent age, education, race/ethnicity, income, marital status, weight concern, and child BMI percentile. Findings suggest that health literacy impacts parental views about child weight loss strategies and health information-seeking preferences. Pediatric weight loss advice to parents should include assessment of parent attitudes and prior knowledge about child weight control and facilitate parent access to reliable sources of evidence-informed child weight control information. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relationship of weight-related attitudes with suicidal behaviors in Korean adolescents.

PubMed

Kim, Jun-Su; Lee, Kayoung

2010-11-01

The objective of this study was to assess the relationship between weight-related attitudes and suicidal behavior after consideration of depressive mood in Korean adolescents. The study population consisted of a nationally representative sample of 74,698 adolescents (n = 39,466 boys, 35,232 girls) in middle and high school who completed the Korea Youth Risk Behavior Web-based Survey (KYRBWS) in 2007. Logistic regression models were used to examine the relationships between measures of weight-related and self-reported suicidal behavior, controlling for demographics, depressive mood, stress perception, level of school achievement, and substance use. Suicide attempts were surveyed among those reported to have suicidal ideation (n = 7,579 boys, 10,204 girls). Significantly more girls than boys reported suicidal ideation (29 vs. 19%) and suicide attempts (7.7 vs. 4.5%). Factors significantly associated with suicidal ideation were overestimation of weight (vs. correct estimation) and behaviors to lose or gain weight (vs. no weight control) among boys and overestimation of weight and attempting to lose weight among girls. In contrast, the odds of suicide attempts were significantly higher among boys who tried to lose, gain, or maintain their weight (vs. no weight control) and girls who underestimated their weight (vs. correct estimation) and tried to lose weight (vs. no weight control). Boys and girls classified as overweight or at risk for overweight were significantly less likely to report suicide attempts compared to those classified as underweight. Weight-related attitudes, such as incorrect weight perception and weight control behaviors, seem to be useful indicators for identifying Korean adolescents who are at risk for suicidal behaviors.

Weight misperception and disordered weight control behaviors among U.S. high school students with overweight and obesity: Associations and trends, 1999-2013.

PubMed

Hazzard, Vivienne M; Hahn, Samantha L; Sonneville, Kendrin R

2017-08-01

To examine prevalence of weight misperception (incongruence between one's perceived weight status and one's actual weight status) and disordered weight control behaviors (DWCBs; unhealthy behaviors aiming to control or modify weight), associations between weight misperception and DWCBs, and temporal trends in prevalence and associations among adolescents with overweight and obesity from 1999 to 2013. Self-reported data from eight biennial cycles (1999-2013) of the cross-sectional national Youth Risk Behavior Survey were used in analyses restricted to respondents with overweight/obesity. Data on weight status perception, use of fasting, purging, and diet pills to control weight, sex, race/ethnicity, and grade in school were used in multivariate logistic regression models. Among U.S. high school students with overweight and obesity, no linear temporal trends were detected for prevalence of weight misperception, fasting, or purging between 1999 and 2013, while a significant linear decrease was observed for prevalence of diet pill use between 1999 and 2013 (b=-0.81, p<0.01). Using data pooled across 1999-2013, weight misperception predicted lower use of all DWCBs examined in this study among females and lower use of fasting to control weight among males. No significant changes over time in associations of weight misperception with fasting or purging were observed, though the association between weight misperception and diet pill use weakened somewhat across 1999-2013. In the context of increasing prevalence of overweight and obesity, weight misperception appears to be a robust protective factor for DWCBs. Copyright © 2017. Published by Elsevier Ltd.

Public policy versus individual rights and responsibility: an economist's perspective.

PubMed

Chaloupka, Frank J

2011-09-01

Interventions to reduce childhood obesity entail ethical considerations. Although a rationale exists for government to intervene in a way that limits individual rights while protecting the public's health, a clear economic rationale also exists. The markets for goods and services that contribute to obesity are characterized by multiple failures that create an economic rationale for government to intervene (eg, consumers' lack of accurate information regarding obesogenic foods and beverages). If effective public policies for reducing obesity and its consequences are to be developed and implemented, individual rights and government interests must be balanced.

Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial.

PubMed

Yancy, William S; Shaw, Pamela A; Wesby, Lisa; Hilbert, Victoria; Yang, Lin; Zhu, Jingsan; Troxel, Andrea; Huffman, David; Foster, Gary D; Wojtanowski, Alexis C; Volpp, Kevin G

2018-05-25

Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. Participants aged 30-80 years who lost at least 5 kg during the first 4-6 months in a nationally available commercial weight loss program were recruited via the internet into a three-arm randomized trial of two types of financial incentives versus active control during months 1-6 (Phase I) followed by passive monitoring during months 7-12 (Phase II). Interventions were daily self-weighing and text messaging feedback alone (control) or combined with a lottery-based incentive or a direct incentive. The primary outcome was weight change 6 months after initial weight loss. Secondary outcomes included weight change 12 months after initial weight loss (6 months after cessation of maintenance intervention), and self-reported physical activity and eating behaviors. Of 191 participants randomized, the mean age was 49.0 (SD = 10.5) years and weight loss prior to randomization was 11.4 (4.7) kg; 92% were women and 89% were White. Mean weight changes during the next 6 months (Phase I) were: lottery -3.0 (5.8) kg; direct -2.8 (5.8) kg; and control -1.4 (5.8) kg (all pairwise comparisons p > 0.1). Weight changes through the end of 12 months post-weight loss (Phase II) were: lottery -1.8 (10.5) kg; direct -0.7 (10.7) kg; and control -0.3 (9.4) kg (all pairwise comparisons p > 0.1). The percentages of participants who maintained their weight loss (defined as gaining ≤1.36 kg) were: lottery 79%, direct 76%, and control 67% at 6 months and lottery 66%, direct 62%, and control 59% at 12 months (all pairwise comparisons p > 0.1). At 6 and 12 months after initial weight loss, changes in self-reported physical activity or eating behaviors did not differ across arms. Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance.

HEALTHY study rationale, design and methods

PubMed Central

2009-01-01

The HEALTHY primary prevention trial was designed and implemented in response to the growing numbers of children and adolescents being diagnosed with type 2 diabetes. The objective was to moderate risk factors for type 2 diabetes. Modifiable risk factors measured were indicators of adiposity and glycemic dysregulation: body mass index ≥85th percentile, fasting glucose ≥5.55 mmol l-1 (100 mg per 100 ml) and fasting insulin ≥180 pmol l-1 (30 μU ml-1). A series of pilot studies established the feasibility of performing data collection procedures and tested the development of an intervention consisting of four integrated components: (1) changes in the quantity and nutritional quality of food and beverage offerings throughout the total school food environment; (2) physical education class lesson plans and accompanying equipment to increase both participation and number of minutes spent in moderate-to-vigorous physical activity; (3) brief classroom activities and family outreach vehicles to increase knowledge, enhance decision-making skills and support and reinforce youth in accomplishing goals; and (4) communications and social marketing strategies to enhance and promote changes through messages, images, events and activities. Expert study staff provided training, assistance, materials and guidance for school faculty and staff to implement the intervention components. A cohort of students were enrolled in sixth grade and followed to end of eighth grade. They attended a health screening data collection at baseline and end of study that involved measurement of height, weight, blood pressure, waist circumference and a fasting blood draw. Height and weight were also collected at the end of the seventh grade. The study was conducted in 42 middle schools, six at each of seven locations across the country, with 21 schools randomized to receive the intervention and 21 to act as controls (data collection activities only). Middle school was the unit of sample size and power computation, randomization, intervention and primary analysis. PMID:19623188

HEALTHY study rationale, design and methods: moderating risk of type 2 diabetes in multi-ethnic middle school students.

PubMed

Hirst, Kathryn; Baranowski, Tom; DeBar, Lynn; Foster, Gary D; Kaufman, Francine; Kennel, Phyllis; Linder, Barbara; Schneider, Margaret; Venditti, Elizabeth M; Yin, Zenong

2009-08-01

The HEALTHY primary prevention trial was designed and implemented in response to the growing numbers of children and adolescents being diagnosed with type 2 diabetes. The objective was to moderate risk factors for type 2 diabetes. Modifiable risk factors measured were indicators of adiposity and glycemic dysregulation: body mass index > or =85th percentile, fasting glucose > or =5.55 mmol l(-1) (100 mg per 100 ml) and fasting insulin > or =180 pmol l(-1) (30 microU ml(-1)). A series of pilot studies established the feasibility of performing data collection procedures and tested the development of an intervention consisting of four integrated components: (1) changes in the quantity and nutritional quality of food and beverage offerings throughout the total school food environment; (2) physical education class lesson plans and accompanying equipment to increase both participation and number of minutes spent in moderate-to-vigorous physical activity; (3) brief classroom activities and family outreach vehicles to increase knowledge, enhance decision-making skills and support and reinforce youth in accomplishing goals; and (4) communications and social marketing strategies to enhance and promote changes through messages, images, events and activities. Expert study staff provided training, assistance, materials and guidance for school faculty and staff to implement the intervention components. A cohort of students were enrolled in sixth grade and followed to end of eighth grade. They attended a health screening data collection at baseline and end of study that involved measurement of height, weight, blood pressure, waist circumference and a fasting blood draw. Height and weight were also collected at the end of the seventh grade. The study was conducted in 42 middle schools, six at each of seven locations across the country, with 21 schools randomized to receive the intervention and 21 to act as controls (data collection activities only). Middle school was the unit of sample size and power computation, randomization, intervention and primary analysis.

An in vivo and in vitro investigation of the effect of Aloe vera gel ethanolic extract using animal model with diabetic foot ulcer

PubMed Central

Daburkar, Mohan; Lohar, Vikram; Rathore, Arvind Singh; Bhutada, Pravin; Tangadpaliwar, Shrikant

2014-01-01

Aim: To examine the preventive effect of Aloe vera gel ethanolic extract using diabetic foot ulcer (DFUs) protocol in Wistar rats. Materials and Methods: Male Wistar rats were divided into untreated control (Group I), untreated DFUs (Group II), DFUs treated with A. vera gel ethanolic extract (Group III), DFUs treated with topical A. vera gel (Group IV), DFUs treated with A. vera gel ethanolic extract and topical A. vera gel (Group V). The rats in the treatment groups were daily administered the A. vera gel and ethanolic extract for 9 days. Fasting blood glucose levels and percentage of wound ulcer contraction were measured on day 3, 6, and 9. Statistical Analysis used: The results are expressed as a mean ± Standard Error Mean (SEM). Data were analyzed using one-way analysis of variance (ANOVA) after Newman–Keuls test. P < 0.05 were considered statistically significant in all cases. Results: Oral administration of A. vera gel ethanolic extract at a dose of 300 mg/kg body weight per day to diabetic rats for a period of 9 days resulted in a significant reduction in fasting blood glucose and a significant improvement in plasma insulin. Topical application of A. vera gel at a dose 30 mg/kg body weight per day to streptozotocin (STZ)-induced diabetic rats for a period of 9 days resulted in no change in blood glucose and plasma insulin. Oral administration as well as topical application of A. vera gel ethanolic extract and gel significantly reduced the blood glucose, improved the plasma insulin, and significantly increased DNA and glycosaminoglycans (GAGs) to improve the wound ulcer healing as well as the breaking strength on day 9. Conclusions: Present findings provide a scientific rationale for the use of A. vera gel ethanolic extract, and showed that the gel attenuated the diabetic foot wound in rats. PMID:25035641

Fundamental movement skills in children and adolescents: review of associated health benefits.

PubMed

Lubans, David R; Morgan, Philip J; Cliff, Dylan P; Barnett, Lisa M; Okely, Anthony D

2010-12-01

The mastery of fundamental movement skills (FMS) has been purported as contributing to children's physical, cognitive and social development and is thought to provide the foundation for an active lifestyle. Commonly developed in childhood and subsequently refined into context- and sport-specific skills, they include locomotor (e.g. running and hopping), manipulative or object control (e.g. catching and throwing) and stability (e.g. balancing and twisting) skills. The rationale for promoting the development of FMS in childhood relies on the existence of evidence on the current or future benefits associated with the acquisition of FMS proficiency. The objective of this systematic review was to examine the relationship between FMS competency and potential health benefits in children and adolescents. Benefits were defined in terms of psychological, physiological and behavioural outcomes that can impact public health. A systematic search of six electronic databases (EMBASE, OVID MEDLINE, PsycINFO, PubMed, Scopus and SportDiscus®) was conducted on 22 June 2009. Included studies were cross-sectional, longitudinal or experimental studies involving healthy children or adolescents (aged 3-18 years) that quantitatively analysed the relationship between FMS competency and potential benefits. The search identified 21 articles examining the relationship between FMS competency and eight potential benefits (i.e. global self-concept, perceived physical competence, cardio-respiratory fitness [CRF], muscular fitness, weight status, flexibility, physical activity and reduced sedentary behaviour). We found strong evidence for a positive association between FMS competency and physical activity in children and adolescents. There was also a positive relationship between FMS competency and CRF and an inverse association between FMS competency and weight status. Due to an inadequate number of studies, the relationship between FMS competency and the remaining benefits was classified as uncertain. More longitudinal and intervention research examining the relationship between FMS competency and potential psychological, physiological and behavioural outcomes in children and adolescents is recommended.

Maternal and adolescent report of mothers' weight-related concerns and behaviors: longitudinal associations with adolescent body dissatisfaction and weight control practices.

PubMed

van den Berg, Patricia A; Keery, Helene; Eisenberg, Marla; Neumark-Sztainer, Dianne

2010-11-01

This population-based study examined mothers' weight-related concerns and behaviors (weight status, weight dissatisfaction, dieting, and encouraging child to diet) at baseline, as assessed by both mothers and adolescents, and associations with adolescents' body dissatisfaction and weight control practices 5 years later. Adolescents and their mothers (n = 443 pairs) were surveyed in 1998-1999; adolescents were resurveyed in 2003-2004. Baseline maternal report of higher levels of her weight-related concerns/behaviors was associated with greater body dissatisfaction in girls 5 years later, controlling for adolescent weight status and other covariates. Baseline maternal report of weight-related concerns/behaviors was also associated with greater prevalence of trying to lose weight in both boys and girls 5 years later. Baseline adolescent report of higher maternal weight-related concerns/behaviors was associated with a higher prevalence of trying to lose weight 5 years later in girls. These findings highlight the importance of mothers' weight-related concerns and behaviors for adolescents' weight-related outcomes.

Efficacy of lifestyle modification for long-term weight control.

PubMed

Wadden, Thomas A; Butryn, Meghan L; Byrne, Kirstin J

2004-12-01

A comprehensive program of lifestyle modification induces loss of approximately 10% of initial weight in 16 to 26 weeks, as revealed by a review of recent randomized controlled trials, including the Diabetes Prevention Program. Long-term weight control is facilitated by continued patient-therapist contact, whether provided in person or by telephone, mail, or e-mail. High levels of physical activity and the consumption of low-calorie, portion-controlled meals, including liquid meal replacements, can also help maintain weight loss. Additional studies are needed of the effects of macronutrient content (e.g., low-fat vs. low-carbohydrate diets) on long-term changes in weight and health. Research also is needed on effective methods of providing comprehensive weight loss control to the millions of Americans who need it.

Socioeconomic status and weight control practices in British adults

PubMed Central

Wardle, J; Griffith, J

2001-01-01

STUDY OBJECTIVE—Attitudes and practices concerning weight control in British adults were examined to test the hypothesis that variation in concern about weight and deliberate weight control might partly explain the socioeconomic status (SES) gradient in obesity. Higher SES groups were hypothesised to show more weight concern and higher levels of dieting.
SETTING—Data were collected as part of the monthly Omnibus Survey of the Office of National Statistics in March 1999.
PARTICIPANTS—A stratified, probability sample of 2690 households was selected by random sampling of addresses in Britain. One randomly selected person in each household was interviewed at their home.
MAIN RESULTS—As predicted, higher SES men and women had higher levels of perceived overweight, monitored their weight more closely, and were more likely to be trying to lose weight. Higher SES groups also reported more restrictive dietary practices and more vigorous physical activity.
CONCLUSIONS—The results are consistent with the idea that part of the protection against weight gain in higher SES groups could be a higher frequency of weight monitoring, a lower threshold for defining themselves as overweight, and a greater likelihood of deliberate efforts at weight control.


Keywords: socioeconomic status; weight control; obesity PMID:11160173