Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with type 2 diabetes: results from the Look AHEAD trial.

Purpose: We determined the effect of an intensive lifestyle intervention on the prevalence, incidence and resolution of bothersome nocturia, increased daytime urinary voiding and urinary incontinence in overweight/obese men with type 2 diabetes after 1 year in the Look AHEAD trial.

Materials And Methods: A subset of male Look AHEAD participants was selected for this secondary data analysis. Overall 1,910 men with an average (mean ± SD) age of 59.

Building an Evidence Base Using Qualitative Data for mHealth Development.

To be successful mHealth applications must be consistent with the way individuals use technology. Using qualitative methods and an iterative approach that blends consumer-driven and investigator-driven aims can produce paradigm-shifting, novel intervention applications that maximize the likelihood of use by the target audience and their potential impact on health behaviors. In behavioral health the development of mHealth applications often takes a top-down approach driven by the investigators and programmers, with relatively little input from the targeted population.

Preventing weight gain in young adults: a randomized controlled pilot study.

Context: Weight gain in young adults is an important public health problem and few interventions have been successful.

Background: This pilot study evaluated the preliminary efficacy of two self-regulation approaches to weight-gain prevention: Small Changes (changes in energy balance of roughly 200 kcal/day) and Large Changes (initial weight loss of 5-10 lbs to buffer against future weight gains).

Intervention: Participants were enrolled in 8-week programs teaching Small or Large Changes (SC; LC).

Are standard behavioral weight loss programs effective for young adults?

Objective: To compare the enrollment, attendance, retention and weight losses of young adults in behavioral weight loss (BWL) programs with older participants in the same trials.

Methods: Data were pooled from three NIH-funded adult BWL trials from two clinical centers in different regions of the country (total N=298); young adults were defined as those aged 18-35 years. Both young adults and adults were compared on session attendance, retention at the 6-month assessment, weight loss and physical activity at 6 months.

Gene X environment interaction of vigorous exercise and body mass index among male Vietnam-era twins.

Background: Secular trends over the past several decades suggest an environmental influence on body mass index (BMI). However, twin models that incorporate a gene-environment correlation and gene x environment interaction have not been applied to elucidate specific environmental factors that affect the heritability of BMI.

Objective: Our aim was to determine whether one putative environmental predictor of obesity, vigorous exercise, shows evidence of a gene-environment correlation or gene x environment interaction with BMI among twins.

Stress response and the adolescent transition: performance versus peer rejection stressors.

Little is known about normative variation in stress response over the adolescent transition. This study examined neuroendocrine and cardiovascular responses to performance and peer rejection stressors over the adolescent transition in a normative sample. Participants were 82 healthy children (ages 7-12 years, n = 39, 22 females) and adolescents (ages 13-17, n = 43, 20 females) recruited through community postings.

Interventions to increase walking behavior.

Walking is the most prevalent and preferred method of physical activity for both work and leisure purposes, thus making it a prime target for physical activity promotion interventions. We identified 14 randomized controlled trials, which tested interventions specifically targeting and assessing walking behavior. Results show that among self-selected samples, intensive interventions can increase walking behavior relative to controls.

Ambulatory blood pressure and the metabolic syndrome in normotensive and untreated hypertensive men.

Background: Components of the metabolic syndrome are typically intercorrelated in epidemiologic studies and, when combined, predict type 2 diabetes and cardiovascular diseases. However, it remains unclear whether a single construct underlies the various components and which of the components are most closely associated with the underlying syndrome. Here, we use our confirmatory factor analytic model of the metabolic syndrome to examine the extent to which measures of ambulatory blood pressure, reflecting blood pressure variability throughout the day and night, may strengthen the association between blood pressure and the other components of the syndrome.

Educational attainment, smoking initiation and lifetime nicotine dependence among male Vietnam-era twins.

Background: Smoking initiation and persistence are clearly associated with factors commonly thought to be environmental in origin, including socio-economic status. However, twin models that incorporate gene-environment correlation and gene x environment interaction have not been applied to elucidate the genetic or environmental role that socio-economic status plays in smoking initiation and nicotine dependence.

Method: Twin structural equation modelling was used to examine gene-environment correlation and gene x environment interaction of one index of socio-economic status, educational attainment, with smoking initiation and nicotine dependence among 5119 monozygotic and 4295 dizygotic male-male Vietnam-era twins from the Vietnam Era Twin Registry, a national registry of twin pairs who served in the military during the Vietnam era.

Brief motivational interviewing as a clinical strategy to promote asthma medication adherence.

Patient-centered approaches are associated with better patient retention and treatment outcomes, without increased time and cost. Motivational interviewing (MI) is a patient-centered counseling approach that can be briefly integrated into patient encounters and is specifically designed to enhance motivation to change among patients not ready to change. Existing asthma management approaches (eg, education and self-management) increase resistance among patients not ready or willing to follow medical recommendations.

Nurses' knowledge about the risk of light cigarettes and other tobacco "harm reduction" strategies.

Light and ultra-light cigarettes are associated with little or no risk reduction versus regular cigarettes, but the majority of smokers believe they are safer. We evaluated whether nurses believe that certain products (light and ultra-light cigarettes, reduced-tar cigarettes, nicotine replacement), cigarette design features (filters, no additives), and smoking behaviors (smoking reduction) reduce health risks among their patients. Nurses (N = 178; 93% female, 10% smokers) completed questionnaires before mandatory training in smoking cessation counseling.

Genetics in psychosomatic medicine: research designs and statistical approaches.

It has become increasingly clear that genetic factors influence many of the behaviors and disease endpoints of interest to psychosomatic medicine researchers. There has been increasing interest in incorporating genetic variation markers into psychosomatic research. In this Statistical Corner article, we build on the valuable experiences gained during two workshops for "starters in the field" at the American Psychosomatic Society and the Society for Psychophysiological Research to review two common genetically informative research designs for human studies: twin and genetic association studies.

Long-term stability of maternal prenatal steroid hormones from the National Collaborative Perinatal Project: still valid after all these years.

Large epidemiological samples, including the National Collaborative Perinatal Project (NCPP), in which blood/serum was collected during pregnancy and offspring followed longitudinally, offer the unique opportunity to examine neuroendocrine mechanisms underlying prenatal "programming" of adult health and disease. However, in order to conduct longitudinal analyses, it is critical to determine the validity of maternal prenatal samples stored over long periods. We investigated the validity of cortisol, testosterone, and their binding globulins (corticosteroid-binding globulin (CBG) and sex hormone-binding globulin (SHBG)) in maternal prenatal serum from the NCPP after over 40 years of storage.

Worksite and communications-based promotion of a local walking path.

Current research has shown relationships between the environment (eg, parks and trails) and levels of physical activity participation. This study was designed to implement and evaluate a communications based worksite campaign to promote awareness of an existing local walking path and to increase walking. Promotional materials were distributed for 1 month via flyers, email, website postings, and during bi-weekly information booths.

The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: a randomized controlled trial.

Evidence suggests that vigorous-intensity exercise interventions may be effective for smoking cessation among women; however, few studies have examined the efficacy of a moderate-intensity exercise program. The present study examined the efficacy of moderate-intensity exercise for smoking cessation among female smokers. Healthy, sedentary female smokers (N = 217) were randomly assigned to an 8-week cognitive-behavioral smoking cessation program plus moderate-intensity exercise (CBT+EX) or to the same cessation program plus equal contact (CBT).

Efficacy and effectiveness approaches in behavioral treatment trials.

The objective is to clarify the distinction between efficacy and effectiveness approaches and to discuss how these approaches can be used in a complementary way in the development, evaluation, and implementation of behavioral treatments for primary headache in various settings. Efficacy studies, with an emphasis on internal validity, are experiments that evaluate treatment response in an ideal, highly controlled research environment. Despite their methodological strengths, efficacy studies are limited in their ability to estimate the treatment effects that can be expected in clinical practice settings.

Effects of acute tryptophan depletion on negative symptoms and smoking topography in nicotine-dependent schizophrenics and nonpsychiatric controls.

We studied the effect of acute tryptophan depletion (ATD), which transiently reduces brain serotonin, on negative symptoms and cigarette smoking topography in schizophrenic smokers. Nicotine-dependent schizophrenics (n=11) and nonpsychiatric controls (n=8) were examined after ingesting comparable mixtures that do and do not deplete plasma tryptophan. Tryptophan-depleting and placebo mixtures were administered double-blind and in counterbalanced order.

Older, medically ill smokers are concerned about weight gain after quitting smoking.

Concern about postcessation weight gain has been shown to be a barrier to quitting for healthy smokers, but no study has examined these concerns among medically ill smokers. We examined whether medically ill smokers (N=271; 54% female, mean age=57 years) receiving nurse-delivered home health care report postcessation weight concern as a barrier to quitting smoking. Higher levels of weight concern were associated with younger age, longer duration of home care service, greater motivation to quit smoking, lower self-efficacy to quit smoking, more favorable views of smoking, and lower levels of social support; collectively accounting for over 20% of the variance.

Conceptualization of disease timeline predicts posttreatment distress in breast cancer patients.

A sample of 69 breast cancer patients was assessed before and after cessation of treatment to determine the predictors of posttreatment distress. Patients were assessed approximately 6 weeks before completing chemotherapy treatment, 1 month after completing treatment, and 3 months after completing treatment. Results indicate that timeline beliefs are related to distress: Patients who conceptualize their cancer as a chronic or cyclic illness are more anxious, depressed, and worried about a recurrence than patients who conceptualize their cancer as an acute illness.

Cognitive-behavioral group treatment for disabling headache.

Objectives: Severe, disabling headache is costly to individual sufferers, through pain and reduced functioning, and to society, through decreased work productivity and increased health care use. First-line prophylactic agents combined with triptans do not adequately benefit many disabled headache sufferers. We sought to investigate whether a cognitive-behavioral treatment targeting the psychological and behavioral factors that contribute to disabling headache may provide additional benefit and whether using a group format may provide a more intensive clinic-based treatment without increasing the cost of service delivery.

Smoking cessation treatment on the Internet: content, quality, and usability.

The explosive growth in access to the Internet suggests that the Internet may be a viable channel through which we can reach and treat the large population of smokers who are unlikely to use other modes of intervention. We applied national guidelines from the U.S.

HIV, STD and hepatitis prevention among women in methadone maintenance: a qualitative and quantitative needs assessment.

In the USA, as well as internationally, rates of HIV infection among women continue to grow. In addition, women who inject drugs are at further increased risk for hepatitis C co-infection. The purpose of this study was to conduct qualitative and quantitative needs assessments for HIV/STD/hepatitis prevention among women in methadone maintenance programmes.

Training the transdisciplinary scientist: a general framework applied to tobacco use behavior.

The complexity of public health problems, including the problem of tobacco use behaviors, calls for formal efforts to train transdisciplinary scientists. These scientists can approach problems by using new conceptual frameworks and methodological tools that integrate different disciplinary perspectives. Transdisciplinary training focuses on developing strong scientists with superb core skills while protecting against creating scientists who are "jack of all trades, master of none.

Psychologic and behavioral management of tension-type headache: treatment procedures.

Used as an adjunct or alternative to medication treatment, psychologic and behavioral approaches to tension-type headache decrease headache frequency, affective distress, and headache-related disability. These approaches directly address the psychologic and behavioral factors that contribute to the disorder and to the individual headache episodes. There is well-established evidence of efficacy for the three broad approaches: relaxation training, electromyographic biofeedback training, and cognitive-behavioral stress management.