Development and formative evaluation of an obesity prevention intervention for the pediatric primary care setting: Helping HAND (Healthy Activity and Nutrition Directions)

As the obesity epidemic continues to increase, the pediatric primary care office setting remains a relatively unexplored arena to offer obesity prevention interventions for children. The increased risk for adult obesity among 10 to 14 year-old children who are overweight, suggests obesity prevention programs should be introduced just before this age or early in this age period. Research is also accumulating on the importance of targeting parents along with children, since parents are in charge of the home environment for children. Therefore, the aim of this project was to develop an obesity prevention program called Helping HAND (Healthy Activity and Nutrition Directions) based on Social Cognitive Theory and authoritative parenting techniques for the pediatric primary care setting and conduct one-on-one interviews with parents as the initial formative evaluation of the intervention material for the obesity prevention intervention. A secondary aim of the project was to determine the feasibility of identifying appropriate subjects for the intervention, and conducting qualitative evaluations of the materials through recruitment through pediatric primary care settings. ^

SABR for early-stage lung cancer: Early-adoption and future directions

Early-stage lung cancer incidence among older adults is expected to increase due to demographic trends and CT-based screening, yet optimal treatment of lung cancer in the elderly remains controversial. There are several accepted strategies for treating lung cancer including surgery, conventional radiation, and stereotactic ablative body radiotherapy (SABR). However, there are currently no randomized controlled trials to help distinguish the comparative effectiveness of these various strategies. This is an unfortunate omission as lung cancer causes the most deaths among all cancers in the United States (as well as the entire world). SABR holds particular promise as it is a completely non-invasive, ambulatory technique for achieving cure without an operation, thus avoiding the risks of surgery and the associated pre-operative and post-operative costs. To provide fair view of the potential effect on SABR on controlling lung cancer in the United States, a systematic review of SABR with a focus on its achieved outcomes, toxicities, and comparison to conventional radiation and surgical options is presented. ^

Observations from the Balcony: Directions for Pediatric Health Disparities Research and Policy

In 2002, the Institute of Medicine released Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, a landmark monograph documenting health disparities in the U.S. health care system. Since the publication of Unequal Treatment, the field of pediatric health disparities research has advanced significantly with a proliferation of studies examining a wide array of topics concerning inequities in child health. Advances in health care policy and legislation have also added to a heightened discourse on pediatric health disparities. While there has been substantial activity in efforts to address pediatric health disparities, questions remain regarding whether these efforts have changed the trajectory of health equity among children. The aim of this paper is to examine the practical challenges of addressing pediatric health disparities in the dynamic context of global changes in health care research, policy, and legislation relevant to children. Using the Adaptive Leadership framework, this paper outlines a conceptual model for assessing the scope of progress made in addressing pediatric health disparities, diagnoses the continued adaptive challenges of pediatric health disparities, and provides an agenda for further work and future investment.

Essential elements of postabortion care: origins, evolution and future directions

In this comment, we chronicle the development and expansion of a postabortion care model designed to promote interventions that address abortion-related public health concerns even when abortion laws and policies are restrictive. We review years of program experience with the original model, which led to the development of an expanded and updated model, Essential Elements of Postabortion Care (PAC). Implementing the model challenges global public health leaders, donors, technical assistance agencies and ministries of health to work with communities to ensure that all women who want to prevent or space pregnancies can obtain contraceptive services; that all women have access to services to manage complications from abortion, whether induced or spontaneous; and that all women receiving treatment also receive counseling and the reproductive and other health services they need at the treatment visit, as well as follow-up care and contraceptive resupply

Characteristic directions and polarity ratings and polarity chron assignments of ODP Leg 171B sites

The full suite of magnetic polarity chrons from Subchron M''-2r'' (early Albian) through Chron C13r (latest Eocene) were resolved at one or more Ocean Drilling Program sites on the Blake Nose salient of the Florida continental margin. These sediments preserve diverse assemblages of calcareous and siliceous microfossils; therefore, the composite suite provides a reference section for high-resolution correlation of biostratigraphic datums to magnetic polarity chrons of the Late Cretaceous and Paleogene. Relative condensation or absence of polarity zones at different sites along the transect enhance the recognition and dating of depositional sequences and unconformities within the margin succession. A stable paleolatitude of ~25°N was maintained from the late Aptian through Eocene.

Average dip directions from intervals of dipmeter log in drill hole CRP-2A

Bedding dips in the CRP-2A drillhole were determined in two ways (1) analysis of a dipmeter log, and (2) identification of bed boundaries on digital images of the outer core surface. The two methods document the downhole increase in structural dip, to a maximum of 15° in the lowest 150 m of the hole. Dipmeter data, which are azimuthally oriented, indicate a 75° azimuth for structural tilting, in agreement with seismic reflection profiles. Core and log dips indicate that structural dip increases by 5-7° between 325 and 480 mbsf. Both, however, also exhibit high dip inhomogeneity because of depositional (e.g., cross bedding) and post-depositional (e.g., softsediment deformation) processes. This variability adds ambiguity to the search for angular unconformities within the CRP-2A drillhole. Dip directions of different lithologies are generally similar, as are dip directions for the four kinds of systems tracts. Downdip azimuths of sands and muds are slightly different from those of diamicts, possibly reflecting the divergence between ENE offshore dip and ESE glacial advance.

Wet and dry resistivities along three orthogonal directions of ODP Holes 185-801C and 185-1149B

The results of shore-based three-axis resistivity and X-ray computed tomography (CT) measurements on cube-shaped samples recovered during Leg 185 are presented along with moisture and density, P-wave velocity, resistivity, and X-ray CT measurements on whole-round samples of representative lithologies from Site 1149. These measurements augment the standard suite of physical properties obtained during Leg 185 from the cube samples and samples obtained adjacent to the cut cubes. Both shipboard and shore-based measurements of physical properties provide information that assists in characterizing lithologic units, correlating cored material with downhole logging data, understanding the nature of consolidation, and interpreting seismic reflection profiles.

Structural description and paleomagnetic directions of ODP Hole 152-917A

During Ocean Drilling Program Legs 152 and 163, we recovered core from the offshore East Greenland volcanic province. The basaltic core recovered included a set of structural elements reflecting the history of extrusion, cooling, postdeposition alteration, and minor tectonism. Brittle features in the basaltic core include faults and several generations of veins. Several minicore samples from the lower sections of core from Hole 917A were taken for paleomagnetic analysis, primarily to test whether there were any significant postdepositional tectonic rotations or whether the core could be reoriented using paleomagnetic techniques. The characteristic magnetization direction was used to estimate the in situ orientation of measured structural features within the core. Although significant uncertainty is associated with the analysis, the corrected attitudes of veins in basalt at Site 917 dip moderately west, with a smaller, conjugate group of veins dipping moderately east-southeast, parallel to other seaward-dipping faults in the area, which were interpreted from seismic lines.