Underestimation of Standard Errors in Multi-Site Time Series Studies

Multi-site time series studies of air pollution and mortality and morbidity have figured prominently in the literature as comprehensive approaches for estimating acute effects of air pollution on health. Hierarchical models are generally used to combine site-specific information and estimate pooled air pollution effects taking into account both within-site statistical uncertainty, and across-site heterogeneity. Within a site, characteristics of time series data of air pollution and health (small pollution effects, missing data, highly correlated predictors, non linear confounding etc.) make modelling all sources of uncertainty challenging. One potential consequence is underestimation of the statistical variance of the site-specific effects to be combined. In this paper we investigate the impact of variance underestimation on the pooled relative rate estimate. We focus on two-stage normal-normal hierarchical models and on under- estimation of the statistical variance at the first stage. By mathematical considerations and simulation studies, we found that variance underestimation does not affect the pooled estimate substantially. However, some sensitivity of the pooled estimate to variance underestimation is observed when the number of sites is small and underestimation is severe. These simulation results are applicable to any two-stage normal-normal hierarchical model for combining information of site-specific results, and they can be easily extended to more general hierarchical formulations. We also examined the impact of variance underestimation on the national average relative rate estimate from the National Morbidity Mortality Air Pollution Study and we found that variance underestimation as much as 40% has little effect on the national average.

Analyzing the effects of vertical acceleration and deceleration in multi-phase, debris-flow sediment-column experiments / by Christine Marie Williams.

Water-saturated debris flows are among some of the most destructive mass movements. Their complex nature presents a challenge for quantitative description and modeling. In order to improve understanding of the dynamics of these flows, it is important to seek a simplified dynamic system underlying their behavior. Models currently in use to describe the motion of debris flows employ depth-averaged equations of motion, typically assuming negligible effects from vertical acceleration. However, in many cases debris flows experience significant vertical acceleration as they move across irregular surfaces, and it has been proposed that friction associated with vertical forces and liquefaction merit inclusion in any comprehensive mechanical model. The intent of this work is to determine the effect of vertical acceleration through a series of laboratory experiments designed to simulate debris flows, testing a recent model for debris flows experimentally. In the experiments, a mass of water-saturated sediment is released suddenly from a holding container, and parameters including rate of collapse, pore-fluid pressure, and bed load are monitored. Experiments are simplified to axial geometry so that variables act solely in the vertical dimension. Steady state equations to infer motion of the moving sediment mass are not sufficient to model accurately the independent solid and fluid constituents in these experiments. The model developed in this work more accurately predicts the bed-normal stress of a saturated sediment mass in motion and illustrates the importance of acceleration and deceleration.

Social control and smoking: Examining the moderating effects of different dimensions of relationship quality

A common form of social regulation of an individual’s health behavior is social control. The contextual model of social control assumes that higher relationship quality goes along with more beneficial effects of social control on health behavior. This study examined potential differential moderating effects of different dimensions of relationship quality on the associations between positive and negative social control and smoking behavior and hiding smoking. The sample consisted of 144 smokers (n = 72 women; mean age = 31.78, SD = 10.04) with a nonsmoking partner. Positive and negative social control, dimensions of relationship quality consensus, cohesion and satisfaction, numbers of cigarettes smoked (NCS), hiding smoking (HS), and control variables were assessed at baseline. Four weeks later NCS and HS were assessed again. Only for smokers with high consensus, but not cohesion and satisfaction, a negative association between positive control and NCS emerged. Moreover, smokers with high consensus tended to report more HS when being positively and negatively socially controlled. This also emerged for cohesion and positive control. Satisfaction with the relationship did not display any interaction effects. This study’s results emphasize the importance of differentiating not only between positive and negative social control but also between different dimensions of relationship quality in order to gain a comprehensive understanding of the dynamics in romantic dyads with regard to social regulation of behavioral change.

Predicting daily smoking around a quit date : Volitional processes at the inter- and intraindividual level

Background: The health action process approach (hapa) is a well-established model in predicting health behavior and assumes that volitional processes are important for effective behavioral change. however, only few studies have so far tested associations on the intraindividual level. thus, this study examined the inter- and intraindividual associations between volitional predictors and daily smoking around a quit attempt. method: overall, 105 smokers completed daily electronic questionnaires 10 days before and 21 days after a self-set quit date, including measures of intentions, self-efficacy, planning, action control and numbers of cigarettes smoked. multilevel analysis was applied. findings: at the interindividual level, higher mean levels of volitional predictors across the 32 days were associated with less numbers of cigarettes smoked. negative associations emerged also at the intraindividual level, indicating that on days with higher intentions, self-efficacy, planning and action control than usual, less cigarettes were smoked. moreover, these effects were stronger after the quit date than before the quit date. intentions and action control emerged as most powerful predictors at the intraindividual level. discussion: findings confirm assumptions of the hapa and emphasize the importance of volitional processes at the inter- and intraindividual level in the context of quitting smoking.

Food Fury: Online Casual Game Development for Nutrition Education

Introduction: The United States is currently experiencing increased prevalence of obesity. This is a particular problem amongst children who require dietary and activity behavioral change to mitigate this problem. The use of computer games as channels to motivate health behavior in children is increasing. Casual games are a subset of computer games that are simple in design, easy to access and play, popular with children, and have the potential to be effective for drill and practice learning. [See PDF for complete abstract]

Dyadic action control in overweight and obese couples: Effectiveness of a randomized controlled trial to promote physical activity.

BACKGROUND: Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population. The Health Action Process Approach (HAPA), which was the theoretical framework of this study, focuses on individual self-regulation variables for successful health behavior change. One key self-regulation variable of this model is action control with its three subfacets awareness of intentions, self-monitoring and regulatory effort. The social context of individuals, however, is usually neglected in common health behavior change theories. In order to integrate social influences into the HAPA, this randomized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity. METHODS/DESIGN: This protocol describes the design of a single-blind randomized controlled trial, which comprises four experimental groups: a dyadic action control group, an individual action control group and two control groups. Participants of this study are overweight or obese, heterosexual adult couples who intend to increase their physical activity. Blocking as means of a gender-balanced randomization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition. The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention. Follow-ups are one month and six months later. Subsequent to the six-months follow-up another 14 days diary phase takes place.The main outcome measures are self-reported and accelerometer-assessed physical activity. Secondary outcome measures are Body Mass Index (BMI), aerobic fitness and habitual physical activity. DISCUSSION: This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind randomized control trial. Challenges with running couples studies as well as advantages and disadvantages of certain design-related decisions are discussed. This RCT was funded by the Swiss National Science Foundation (PP00P1_133632/1) and was registered on 27/04/2012 at http://www.isrctn.com/ISRCTN15705531.

A Dyadic Action Control Trial in Overweight and Obese Couples (DYACTIC)

BACKGROUND: Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population. The Health Action Process Approach (HAPA), which was the theoretical framework of this study, focuses on individual self-regulation variables for successful health behavior change. One key self-regulation variable of this model is action control with its three subfacets awareness of intentions, self-monitoring and regulatory effort. The social context of individuals, however, is usually neglected in common health behavior change theories. In order to integrate social influences into the HAPA, this randomized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity. METHODS/DESIGN: This protocol describes the design of a single-blind randomized controlled trial, which comprises four experimental groups: a dyadic action control group, an individual action control group and two control groups. Participants of this study are overweight or obese, heterosexual adult couples who intend to increase their physical activity. Blocking as means of a gender-balanced randomization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition. The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention. Follow-ups are one month and six months later. Subsequent to the six-months follow-up another 14 days diary phase takes place.The main outcome measures are self-reported and accelerometer-assessed physical activity. Secondary outcome measures are Body Mass Index (BMI), aerobic fitness and habitual physical activity. DISCUSSION: This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind randomized control trial. Challenges with running couples studies as well as advantages and disadvantages of certain design-related decisions are discussed. This RCT was funded by the Swiss National Science Foundation (PP00P1_133632/1) and was registered on 27/04/2012 at http://www.isrctn.com/ISRCTN15705531.

Examining invisible social control as predictor of daily smoking and negative affect after a self-set quit date

Objectives: The dual-effects model of social control proposes that social control leads to better health practices, but also arouses psychological distress. However, findings are inconsistent in relation to health behavior and psychological distress. Recent research suggests that the most effective control is unnoticed by the receiver (i.e., invisible). There is some evidence that invisible social control is beneficial for positive and negative affective reactions. Yet, investigations of the influence of invisible social control on daily smoking and distress have been limited. In daily diaries, we investigated how invisible social control is associated with number of cigarettes smoked and negative affect on a daily basis. Methods: Overall, 99 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date for 22 consecutive days within the hour before going to bed, reporting received and provided social control, daily number of cigarettes smoked, and negative affect. Results: Multilevel analyses indicated that between-person levels of invisible social control were associated with lower negative affect, whereas they were unrelated to number of cigarettes smoked. On days with higher-than-average invisible social control, smokers reported less cigarettes smoked and more negative affect. Conclusions: Between-person level findings indicate that invisible social control can be beneficial for negative affect. However, findings on the within-person level are in line with the assumptions of the dual-effects model of social control: Invisible social control reduced daily smoking and simultaneously increased daily negative affect within person.

Salivary cortisol, psychological stress and depressive symptoms among patients undergoing colon cancer screenings

As the second leading cause of cancer-related deaths in the United States, colon cancer has a high cure rate if detected early by a colonoscopy (U.S. Cancer Statistics Working Group, 2007). However, more than 41 million at-risk Americans are not properly receiving colonoscopy screenings according to the recommendations of the Center for Disease Control. This study provides insight into the physiological and psychological benefits of the colonoscopy procedure over and above cancer detection and prevention. Thirty-six patients receiving colonoscopic screening at the University of Connecticut Health Center participated in this study. A questionnaire battery that assessed perceived stress, depressive symptoms, colon cancer related worry, and social support, and optional saliva sampling was completed 2 weeks prior to and post colonoscopy. It was hypothesized that salivary cortisol concentrations, perceived stress, and self-reported depressive symptoms would show significant decreases from pre to post colonoscopy, and that these variables would all be positively correlated with one another. Results showed significant, positive correlations between depressive symptoms and both salivary cortisol (r (34)= .348, p< .05) and perceived stress (r (34)= .635, p< .01). Morning salivary cortisol levels decreased significantly from pre to post colonoscopy to levels below the population mean (t (16)=-3.711, p<. 01). No such differences were observed in either perceived stress or depressive symptoms. These results indicate that by decreasing cortisol concentrations to levels below that of the population mean, the colonoscopy provided physiological health benefits to patients beyond cancer screening. From a health psychology standpoint, this may encourage some of the 41 million Americans not receiving proper colon cancer screenings to adopt this potentially life-saving health behavior.

The effectiveness of a promotora-led intervention for Mexican Americans with type 2 diabetes

Purpose. The purpose of this randomized control repeated measures trial was to determine the effectiveness of a self-management intervention led by community lay workers called promotoras on the health outcomes of Mexican Americans with type 2 diabetes living in a major city on the Texas - Mexico border. The specific aims of this study, in relation to the intervention group participants, were to: (1) decrease the glycosylated hemoglobin (A1c) blood levels at the six-month assessment, (2) increase diabetes knowledge at the three and six-month assessments, and (3) strengthen the participants' beliefs in their ability to manage diabetes at the three and six-month assessments.^ Methods. One hundred and fifty Mexican American participants were recruited at a Catholic faith-based clinic and randomized into an intervention group and a usual-care control group. Personal characteristics, acculturation and baseline A1c, diabetes knowledge and diabetes health beliefs were measured. The six-month, two-phase intervention was culturally specific and it was delivered entirely by promotoras. Phase One of the intervention consisted of sixteen hours of participative group education and bi-weekly telephone contact follow-up. Phase Two consisted of bi-weekly follow-up using inspirational faith-based health behavior change postcards. The A1c levels, diabetes knowledge and diabetes health beliefs were measured at baseline, and three and six months post-baseline. The mean changes between the groups were analyzed using analysis of covariance. ^ Results. The 80% female sample, with a mean age of 58 years, demonstrated very low: acculturation, income, education, health insurance coverage, and strong Catholicism. No significant changes were noted at the three-month assessment, but the mean change of the A1c levels (F (1, 148 = 10.28, p < .001) and the diabetes knowledge scores (F (1, 148 = 9.0, p < .002) of the intervention group improved significantly at six months, adjusting for health insurance coverage. The diabetes health belief scores decreased in both groups.^ Conclusions. This study demonstrated that an intervention led by promotoras could result in decreased A1c levels and increased diabetes knowledge in spite of the very low acculturation, educational level and insurance coverage of the intervention group participants. Clinical implications and recommendations for future research are suggested. ^

Development and preliminary validation of the cancer family impact scale for colorectal cancer

This study aimed to develop and validate The Cancer Family Impact Scale (CFIS), an instrument for use in studies investigating relationships among family factors and colorectal cancer (CRC) screening when family history is a risk factor. We used existing data to develop the measure from 1,285 participants (637 families) across the United States who were in the Johns Hopkins Colon Cancer Genetic Testing study. Participants were 94% white with an average age of 50.1 years, and 60% were women. None had a personal CRC history, and eighty percent had 1 FDR with CRC and 20% had more than one FDR with CRC. The study had three aims: (1) to identify the latent factors underlying the CFIS via exploratory factor analysis (EFA); (2) to confirm the findings of the EFA via confirmatory factor analysis (CFA); and (3) to assess the reliability of the scale via Cronbach's alpha. Exploratory analyses were performed on a split half of the sample, and the final model was confirmed on the other half. The EFA suggested the CFIS was an 18-item measure with 5 latent constructs: (1) NEGATIVE: negative effects of cancer on the family; (2) POSITIVE: positive effects of cancer on the family; (3) COMMUNICATE: how families communicate about cancer; (4) FLOW: how information about cancer is conveyed in families; and (5) NORM: how individuals react to family norms about cancer. CFA on the holdout sample showed the CFIS to have a reasonably good fit (Chi-square = 389.977, df = 122, RMSEA= 0.058 (.052-.065), CFI=.902, TLI=.877, GF1=.939). The overall reliability of the scale was α=0.65. The reliability of the subscales was: (1) NEGATIVE α = 0.682; (2) POSITIVE α = 0.686; (3) COMMUNICATE α = 0.723; (4) FLOW α = 0.467; and (5) NORM α = 0.732. ^ We concluded the CFIS to be a good measure with most fit levels over 0.90. The CFIS could be used to compare theoretically driven hypotheses about the pathways through which family factors could influence health behavior among unaffected individuals at risk due to family history, and also aid in the development and evaluation of cancer prevention interventions including a family component. ^

DETERMINING THE GENOTYPE-PHENOTYPE CONNECTION IN SYNTHETIC INDUCIBLE GENE EXPRESSION SYSTEMS

Introduction Gene expression is an important process whereby the genotype controls an individual cell’s phenotype. However, even genetically identical cells display a variety of phenotypes, which may be attributed to differences in their environment. Yet, even after controlling for these two factors, individual phenotypes still diverge due to noisy gene expression. Synthetic gene expression systems allow investigators to isolate, control, and measure the effects of noise on cell phenotypes. I used mathematical and computational methods to design, study, and predict the behavior of synthetic gene expression systems in S. cerevisiae, which were affected by noise. Methods I created probabilistic biochemical reaction models from known behaviors of the tetR and rtTA genes, gene products, and their gene architectures. I then simplified these models to account for essential behaviors of gene expression systems. Finally, I used these models to predict behaviors of modified gene expression systems, which were experimentally verified. Results Cell growth, which is often ignored when formulating chemical kinetics models, was essential for understanding gene expression behavior. Models incorporating growth effects were used to explain unexpected reductions in gene expression noise, design a set of gene expression systems with “linear” dose-responses, and quantify the speed with which cells explored their fitness landscapes due to noisy gene expression. Conclusions Models incorporating noisy gene expression and cell division were necessary to design, understand, and predict the behaviors of synthetic gene expression systems. The methods and models developed here will allow investigators to more efficiently design new gene expression systems, and infer gene expression properties of TetR based systems.

Innovative self management system for guided cardiac rehabilitation

This paper describes the design and development of a system for cardio rehabilitation of patients that suffered a myocardial infarction. The proposed solution focuses on exercise prescriptions and the encouragement of healthy behaviors. The innovative strategy of the design takes into account health promotion models to provide safe, assistive exercise training sessions, personalized feedbacks, and educational contents.

Auscultación de presas de hormigón con láser escáner terrestre y modelización de las deformaciones del paramento

Se está produciendo en la geodesia un cambio de paradigma en la concepción de los modelos digitales del terreno, pasando de diseñar el modelo con el menor número de puntos posibles a hacerlo con cientos de miles o millones de puntos. Este cambio ha sido consecuencia de la introducción de nuevas tecnologías como el escáner láser, la interferometría radar y el tratamiento de imágenes. La rápida aceptación de estas nuevas tecnologías se debe principalmente a la gran velocidad en la toma de datos, a la accesibilidad por no precisar de prisma y al alto grado de detalle de los modelos. Los métodos topográficos clásicos se basan en medidas discretas de puntos que considerados en su conjunto forman un modelo; su precisión se deriva de la precisión en la toma singular de estos puntos. La tecnología láser escáner terrestre (TLS) supone una aproximación diferente para la generación del modelo del objeto observado. Las nubes de puntos, producto del escaneo con TLS, pasan a ser tratadas en su conjunto mediante análisis de áreas, de forma que ahora el modelo final no es el resultado de una agregación de puntos sino la de la mejor superficie que se adapta a las nubes de puntos. Al comparar precisiones en la captura de puntos singulares realizados con métodos taquimétricos y equipos TLS la inferioridad de estos últimos es clara; sin embargo es en el tratamiento de las nubes de puntos, con los métodos de análisis basados en áreas, se han obtenido precisiones aceptables y se ha podido considerar plenamente la incorporación de esta tecnología en estudios de deformaciones y movimientos de estructuras. Entre las aplicaciones del TLS destacan las de registro del patrimonio, registro de las fases en la construcción de plantas industriales y estructuras, atestados de accidentes y monitorización de movimientos del terreno y deformaciones de estructuras. En la auscultación de presas, comparado con la monitorización de puntos concretos dentro, en coronación o en el paramento de la presa, disponer de un modelo continuo del paramento aguas abajo de la presa abre la posibilidad de introducir los métodos de análisis de deformaciones de superficies y la creación de modelos de comportamiento que mejoren la comprensión y previsión de sus movimientos. No obstante, la aplicación de la tecnología TLS en la auscultación de presas debe considerarse como un método complementario a los existentes. Mientras que los péndulos y la reciente técnica basada en el sistema de posicionamiento global diferencial (DGPS) dan una información continua de los movimientos de determinados puntos de la presa, el TLS permite ver la evolución estacional y detectar posibles zonas problemáticas en todo el paramento. En este trabajo se analizan las características de la tecnología TLS y los parámetros que intervienen en la precisión final de los escaneos. Se constata la necesidad de utilizar equipos basados en la medida directa del tiempo de vuelo, también llamados pulsados, para distancias entre 100 m y 300 m Se estudia la aplicación del TLS a la modelización de estructuras y paramentos verticales. Se analizan los factores que influyen en la precisión final, como el registro de nubes, tipo de dianas y el efecto conjunto del ángulo y la distancia de escaneo. Finalmente, se hace una comparación de los movimientos dados por los péndulos directos de una presa con los obtenidos del análisis de las nubes de puntos correspondientes a varias campañas de escaneos de la misma presa. Se propone y valida el empleo de gráficos patrón para relacionar las variables precisión o exactitud con los factores distancia y ángulo de escaneo en el diseño de trabajos de campo. Se expone su aplicación en la preparación del trabajo de campo para la realización de una campaña de escaneos dirigida al control de movimientos de una presa y se realizan recomendaciones para la aplicación de la técnica TLS a grandes estructuras. Se ha elaborado el gráfico patrón de un equipo TLS concreto de alcance medio. Para ello se hicieron dos ensayos de campo en condiciones reales de trabajo, realizando escaneos en todo el rango de distancias y ángulos de escaneo del equipo. Se analizan dos métodos para obtener la precisión en la modelización de paramentos y la detección de movimientos de estos: el método del “plano de mejor ajuste” y el método de la “deformación simulada”. Por último, se presentan los resultados de la comparación de los movimientos estacionales de una presa arco-gravedad entre los registrados con los péndulos directos y los obtenidos a partir de los escaneos realizados con un TLS. Los resultados muestran diferencias de milímetros, siendo el mejor de ellos del orden de un milímetro. Se explica la metodología utilizada y se hacen consideraciones respecto a la densidad de puntos de las nubes y al tamaño de las mallas de triángulos. A shift of paradigm in the conception of the survey digital models is taking place in geodesy, moving from designing a model with the fewer possible number of points to models of hundreds of thousand or million points. This change has happened because of the introduction of new technologies like the laser scanner, the interferometry radar and the processing of images. The fast acceptance of these new technologies has been due mainly to the great speed getting the data, to the accessibility as reflectorless technique, and to the high degree of detail of the models. Classic survey methods are based on discreet measures of points that, considered them as a whole, form a model; the precision of the model is then derived from the precision measuring the single points. The terrestrial laser scanner (TLS) technology supposes a different approach to the model generation of the observed object. Point cloud, the result of a TLS scan, must be treated as a whole, by means of area-based analysis; so, the final model is not an aggregation of points but the one resulting from the best surface that fits with the point cloud. Comparing precisions between the one resulting from the capture of singular points made with tachometric measurement methods and with TLS equipment, the inferiority of this last one is clear; but it is in the treatment of the point clouds, using area-based analysis methods, when acceptable precisions have been obtained and it has been possible to consider the incorporation of this technology for monitoring structures deformations. Among TLS applications it have to be emphasized those of registry of the cultural heritage, stages registry during construction of industrial plants and structures, police statement of accidents and monitorization of land movements and structures deformations. Compared with the classical dam monitoring, approach based on the registry of a set of points, the fact having a continuous model of the downstream face allows the possibility of introducing deformation analysis methods and behavior models that would improve the understanding and forecast of dam movements. However, the application of TLS technology for dam monitoring must be considered like a complementary method with the existing ones. Pendulums and recently the differential global positioning system (DGPS) give a continuous information of the movements of certain points of the dam, whereas TLS allows following its seasonal evolution and to detect damaged zones of the dam. A review of the TLS technology characteristics and the factors affecting the final precision of the scanning data is done. It is stated the need of selecting TLS based on the direct time of flight method, also called pulsed, for scanning distances between 100m and 300m. Modelling of structures and vertical walls is studied. Factors that influence in the final precision, like the registry of point clouds, target types, and the combined effect of scanning distance and angle of incidence are analyzed. Finally, a comparison among the movements given by the direct pendulums of a dam and the ones obtained from the analysis of point clouds is done. A new approach to obtain a complete map-type plot of the precisions of TLS equipment based on the direct measurement of time of flight method at midrange distances is presented. Test were developed in field-like conditions, similar to dam monitoring and other civil engineering works. Taking advantage of graphic semiological techniques, a “distance - angle of incidence” map based was designed and evaluated for field-like conditions. A map-type plot was designed combining isolines with sized and grey scale points, proportional to the precision values they represent. Precisions under different field conditions were compared with specifications. For this purpose, point clouds were evaluated under two approaches: the standar "plane-of-best-fit" and the proposed "simulated deformation”, that showed improved performance. These results lead to a discussion and recommendations about optimal TLS operation in civil engineering works. Finally, results of the comparison of seasonal movements of an arc-gravity dam between the registered by the direct pendulums ant the obtained from the TLS scans, are shown. The results show differences of millimeters, being the best around one millimeter. The used methodology is explained and considerations with respect to the point cloud density and to the size of triangular meshes are done.

Comportamiento y salud en la vejez

Determinados comportamientos pueden ser factores protectores y promotores de salud, o actuar como variables de riesgo de mortalidad prematura, de morbilidad y de discapacidad funcional. Frente a las enfermedades ligadas a la cronología, el comportamiento pasaría a constituir una variable crucial de las enfermedades de biografía. En este artículo se presenta una sucinta revisión de trabajos epidemiológicos que han analizado la relación comportamiento y salud en gerontología. Se presenta también una breve síntesis en relación al estado actual de algunos comportamientos de elección personal implicados en la salud del anciano o de interés para un envejecimiento satisfactorio: fumar, alcohol, ejercicio físico, comportamiento alimentario, hábitos de sueño, y sexo seguro. Finalmente, se sugieren algunas implicaciones prácticas de la revisión, destacando la necesidad de incorporar a las personas de edad en los programas de promoción de comportamientos de salud y de prevención de enfermedad, y de valorar la evidencia científica disponible ala hora de aconsejar cambios en determinados comportamientos de riesgo, sobre todo en aquellos ancianos sin problemas de salud para los que ciertos comportamientos se asocian a un hedonismo ponderado y a disfrute de la vida.