How useful are the stages of change for targeting interventions? randomized test of a brief intervention to reduce smoking

Objectives. To see whether the stages of change are useful for targeting a brief intervention to reduce smoking based on implementation intentions. A second objective was to rule out demand characteristics as an alternative explanation for the findings of intervention studies based on the transtheoretical model and implementation intentions. Design. Participants (N = 350) were randomized to a passive control condition (questionnaire only), active control condition (questionnaire-plus-instruction to plan to quit) or experimental condition (questionnaire, plan to quit, form an implementation intention). Their behavior and psychosocial orientation to quit were measured at baseline and 2-month follow-up. Main Outcome Measures. Theory of planned behavior variables, nicotine dependence and quitting. Results. Significantly more people quit smoking in the experimental condition than in the control conditions, and the planning instructions changed intention to quit and perceived control over quitting, but not behavior. Stage of change moderated these effects such that implementation intentions worked best for individuals who were in the preparation stage at baseline. Conclusion. Harnessing both motivational and volitional processes seems to enhance the effectiveness of smoking cessation programs, although further work is required to clarify inconsistencies in the literature using the stages of change.</p

UTILIZING EXPECTED REVENUE IN SELECTING OPTIMAL MARKETING ALTERNATIVES FOR FIXED RESOURCE COW/CALF OPERATORS IN THE TEXAS PANHANDLE

Beef cattle enterprises for the 91% of Texas producers with less than 100 cows represent secondary or supplemental enterprises. In most cases the operator is depending on surplus or discretional labor and the alternate use of the physical resources is limited due to topography or environmental factors. These characteristics transform the decision making process from a variable resource allocation problem to a fixed resource problem. Monthly average prices for 300-900 lb stocker steers, divided into 50 lb intervals, are analyzed for three market locations for the period 1992-1999. Consistent price roll back is observed as the price per cwt decreases as the weight increases. However, as the reduction in price is more than offset by the increase in value due to additional weight, the expected revenue per animal increases as weight increases.Livestock Production/Industries,

Evaluating Dryland Crop/Livestock System Alternatives for Risk Management under Declining Irrigation in the Texas Panhandle

Production budgets for dryland crop and crop/livestock systems are developed to estimate yields, costs and returns for dryland wheat and sorghum and for alternative dryland crop/livestock systems. A crop simulation model aids yield estimation. The yield and return distributions are used to estimate risk and relative risk for included alternatives.Relative Risk, Ogallala Aquifer, Crop-Livestock Systems, Wheat, Sorghum, Crop Production/Industries, Farm Management, Livestock Production/Industries, Production Economics, Productivity Analysis,

Management of early pregnancy loss with mifepristone and misoprostol: clinical predictors of treatment success from a randomized trial.

BackgroundEarly pregnancy loss is a common event in the first trimester, occurring in 15%-20% of confirmed pregnancies. A common evidence-based medical regimen for early pregnancy loss uses misoprostol, a prostaglandin E1 analog, with a dosage of 800 μg, self-administered vaginally. The clinical utility of this regimen is limited by suboptimal effectiveness in patients with a closed cervical os, with 29% of patients experiencing early pregnancy loss requiring a second dose after 3 days and 16% of patients eventually requiring a uterine aspiration procedure.ObjectiveThis study aimed to evaluate clinical predictors associated with treatment success in patients receiving medical management with mifepristone-misoprostol or misoprostol alone for early pregnancy loss.Study designWe performed a planned secondary analysis of a randomized trial comparing mifepristone-misoprostol with misoprostol alone for management of early pregnancy loss. The published prediction model for treatment success of single-dose misoprostol administered vaginally included the following variables: active bleeding, type of early pregnancy loss (anembryonic pregnancy or embryonic and/or fetal demise), parity, gestational age, and treatment site; previous significant predictors were vaginal bleeding within the past 24 hours and parity of 0 or 1 vs &gt;1. To determine if these characteristics predicted differential proportions of patients with treatment success or failure, we performed bivariate analyses; given the small proportion of treatment failures in the combined treatment arm, both arms were combined for analysis. Thereafter, we performed a logistic regression analysis to assess the effect of these predictors collectively in each of the 2 treatment groups separately as well as in the full cohort as a proxy for the combined treatment arm. Finally, by using receiver operating characteristic curves, we tested the ability of these predictors in association with misoprostol treatment success to discriminate between treatment success and treatment failure. To quantify the ability of the score to discriminate between treatment success and treatment failure in each treatment arm as well as in the entire cohort, we calculated the area under the curve. Using multivariable logistic regression, we then assessed our study population for other predictors of treatment success in both treatment groups, with and without mifepristone pretreatment.ResultsOverall, 297 evaluable participants were included in the primary study, with 148 in the mifepristone-misoprostol combined treatment group and 149 in the misoprostol-alone treatment group. Among patients who had vaginal bleeding at the time of treatment, 15 of 17 (88%) in the mifepristone-misoprostol combined treatment group and 12 of 17 (71%) in the misoprostol-alone treatment group experienced expulsion of pregnancy tissue. Among patients with a parity of 0 or 1, 94 of 108 (87%) in the mifepristone-misoprostol treatment group and 66 of 95 (69%) in the misoprostol-alone treatment group experienced expulsion of pregnancy tissue. These clinical characteristics did not predict treatment success in the combined cohort alone (area under the curve=0.56; 95% confidence interval, 0.48-0.64). No other baseline clinical factors predicted treatment success in the misoprostol-alone treatment arm or mifepristone pretreatment arm. In the full cohort, the significant predictors of treatment success were pretreatment with mifepristone (adjusted odds ratio=2.51; 95% confidence interval, 1.43-4.43) and smoking (adjusted odds ratio=2.15; 95% confidence interval, 1.03-4.49).ConclusionNo baseline clinical factors predicted treatment success in women receiving medical management with misoprostol for early pregnancy loss. Adding mifepristone to the medical management regimen of early pregnancy loss improved treatment success; thus, mifepristone treatment should be considered for management of early pregnancy loss regardless of baseline clinical factors

The multifocal pattern electroretinogram in chloroquine retinopathy

Purpose: Optimal screening for ocular toxicity caused by chloroquine and hydroxychloroquine is still controversial. With the multifocal pattern electroretinogram (mfPERG), a new electrophysiological technique has recently become available to detect early changes of ganglion cells. In this study this new technique is applied to a series of 10 patients seen consecutively receiving long-term chloroquine medication. Methods: In 10 patients receiving chloroquine medication, clinical examination, Amsler visual field testing and computerized color vision testing were performed. If toxicity was suspected, automated perimetry was carried out. In addition, in all patients conventional pattern electroretinogram (PERG) and mfPERG testing were performed. Results: On clinical examination 8 patients showed no chloroquine-associated maculopathy, while 2 patients did. Of these 2, only 1 reported abnormalities when viewing the Amsler chart, while automated perimetry showed typical, ring-like paracentral scotomas in both affected patients and color vision was significantly abnormal. In the normal patients, 4 of 8 had a mild color vision disturbance, which correlated to age-related macular changes. The amplitudes of the PERG and the central (approximately 10degrees) responses of the mfPERG were markedly reduced in chloroquine maculopathy, while the latencies were unchanged. The peripheral rings of mfPERG (ranging to 48degrees) were not affected by chloroquine toxicity. Both PERG and mfPERG were less affected by age-related macular changes. Conclusions: The reduction of PERG and central mfPERG responses in chloroquine maculopathy may help with the early detection of toxicity. Copyright (C) 2004 S. Karger AG, Basel

Enhancing the Effectiveness of Alcohol Warning Labels With a Self-Affirming Implementation Intention

Objective. Excess alcohol consumption extorts significant social and economic costs that are increasing despite the presence of mandatory warning labels on packaged alcoholic beverages. We used a novel approach by adding a brief statement based on self-affirmation theory (Steele, 1988) to alcohol warning labels. Method. In two studies (N = 85; N = 58), we randomized regular wine drinkers recruited from University campuses to complete a wine pouring task with bottles that had standard labelling, or bottles that added a self-affirming implementation intention to the standard labeling. Alcohol consumption, behavioral intention and self-efficacy were measured pre-manipulation; message acceptance was measured post-manipulation; and alcohol consumption, behavioral intention and self-efficacy were measured again at follow-up. Results. In both studies, the self-affirming implementation intention significantly reduced subsequent alcohol consumption (ds = 0.70 and 0.91, respectively). However, message acceptance, behavioral intention, and self-efficacy did not significantly mediate the observed effects. Conclusions. Self-affirming implementation intentions augmented the effect of alcohol warning labels to reduce subsequent alcohol consumption, but – consistent with the broader self-affirmation literature – it was not clear what mediated the effects. Further research is required to examine whether self-affirming implementation intentions could augment the effects of other kinds of public health-related labelling

Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis.

Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of long-term gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2))

CGM2, a Member of the Carcinoembryonic Antigen Gene Family is Down- Regulated in Colorectal Carcinomas

We have determined the precise chromosomal location, the exon structure, and the expression pattern of CGM2, a member of the carcinoembryonic antigen (CEA) gene family. CGM2 cDNA was amplified by reverse transcription-polymerase chain reaction (RT/PCR) from the colon adenocarcinoma cell line, LS174T. A defective exon is missing from this cDNA clone, leading to a novel domain organization for the human CEA family with two immunoglobulin-like domains. The derived C-terminal domain predicts that the CGM2 protein is membrane-bound through a glycosyl phosphatidylinositol anchor. RT/PCR analyses identified CGM2 transcripts in mucinous ovarian and colonic adenocarcinomas as well as in adjacent colonic tissue, but not in other tumors including leukocytes from six chronic myeloid leukemia patients. Thus, unlike several other family members, CGM2 is not expressed in granulocytes but reveals a more CEA-like expression pattern. Northern blot analyses identified a 2.5-kilobase CGM2 mRNA that is strongly down-regulated in colonic adenocarcinomas compared with adjacent colonic mucosa, suggesting a possible tumor suppressor function. In addition, a 3.2- kilobase transcript was observed in a number of colon tumors that is not detectable in normal colonic tissue. This mRNA species could represent a tumor-specific CGM2 splice variant

National counter-terrorism (C-T) policies and challenges to human rights and civil liberties: Case study of United Kingdom

In the UK the rise post-2005 in “home-grown” terrorism, relying to a significant extent on strikes on soft targets by “self-starters,” means that the search for effective preventive measures remains a continuing concern. Below a number of the preventive counter-terror measures adopted post-9/11, and incrementally strengthened in response to the current threat, are found to fall into three categories and represent interventions at the stages in the path toward attacks. This chapter focuses on selected examples of these preventive measures. In terms of three key stages, firstly, there is the attempt to prevent radicalization, under the “Prevent” strategy. A second strategy relies on taking certain measures to control the activities of those considered likely – on the balance of probabilities – to engage in terrorist-related activity. A third preventive strategy relies on the special terrorism offences under the Terrorism Acts 2000 and 2006, as amended, intended to allow for intervention at a very early stage in terrorist plots and in preparing or instigating terrorist acts (“precursor” offences)