Multiple Health Behavior Changes and Co-variation in a Telephone Counseling Trial

Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive telephone counseling or usual care. Results Those receiving telephone counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, telephone counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.

Predictors of physical activity in colorectal cancer survivors after participation in a telephone-delivered multiple health behavior change intervention

Purpose: Physical activity improves the health outcomes of colorectal cancer (CRC) survivors, yet few are exercising at levels known to yield health benefits. Baseline demographic, clinical, behavioral, and psychosocial predictors of physical activity at 12 months were investigated in CRC survivors. Methods: Participants were CRC survivors (n = 410) who completed a 12-month multiple health behavior change intervention trial (CanChange). The outcome variable was 12 month sufficient physical activity (≥150 min of moderate–vigorous physical activity/week). Baseline predictors included demographics and clinical variables, health behaviors, and psychosocial variables. Results: Multivariate linear regression revealed that baseline sufficient physical activity (p < 0.001), unemployment (p = 0.004), private health insurance (p = 0.040), higher cancer-specific quality of life (p = 0.031) and higher post-traumatic growth (p = 0.008) were independent predictors of sufficient physical activity at 12 months. The model explained 28.6 % of the variance. Conclusions: Assessment of demographics, health behaviors, and psychosocial functioning following a diagnosis of CRC may help to develop effective physical activity programs.

A randomized controlled trial of a multiple health behavior change intervention delivered to colorectal cancer survivors: Effects on sedentary behavior

BACKGROUND Sedentary behavior may independently contribute to morbidity and mortality among survivors of colorectal cancer. In the current study, the authors assessed whether a telephone-delivered multiple health behavior change intervention had an effect on the sedentary behavior of recently diagnosed colorectal cancer survivors. METHODS A total of 410 participants were recruited through the Queensland Cancer Registry and randomized to the health coaching (intervention) or usual-care (control) group. Eleven health coaching sessions addressing multiple health behaviors, including sedentary behavior, were delivered over a period of 6 months. Data were collected at baseline (before randomization), at 6 months, and at 12 months via a telephone interview. RESULTS At 12 months, there was a significant decrease noted in the hours per day of sedentary time in both the health coaching (−1.21; 95% confidence interval [95% CI], −1.71 to −0.70) and usual-care groups (−0.55; 95% CI, −1.06 to −0.05), but the between-group difference was not found to be statistically significant (−0.65; 95% CI, −1.37 to 0.06 [P = .07]). In stratified subgroup analyses, the multiple health behavior change intervention was found to have a significant effect on total sedentary time (hours/day) at 12 months in survivors of colorectal cancer who were aged > 60 years (−0.90; 95% CI, −1.80 to −0.01 [P = .05]), male (−1.33; 95% CI, −2.44 to −0.21 [P = .02]), and nonobese (−1.10; 95% CI, −1.96 to −0.25; [P = .01]). CONCLUSIONS Incorporating simple messages about limiting sedentary behaviors into a multiple health behavior change intervention was found to have modest effects on sedentary behavior. A sedentary behavior-specific intervention strategy may be required to achieve substantial changes in sedentary behavior among colorectal cancer survivors

Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: A randomized controlled trial

Background Multiple health behavior change can ameliorate adverse effects of cancer. Purpose The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life. Methods A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months. Results Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p < 0.001) and 12 months (4.1, p = 0.033), spirituality at 6 months (1.8, p = 0.011), acceptance at 6 months (0.2, p = 0.005), and quality of life at 6 (0.8, p = 0.049) and 12 months (0.9, p = 0.037). Conclusions The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. (Trial Registration Number: ACTRN12608000399392).

Multiple melting behavior of isotactic polypropylene and poly(propylene-co-ethylene) after stepwise isothermal crystallization

The multiple melting behavior of several commercial resins of isotactic polypropylene (iPP) and random copolymer, poly(propylene-co-ethylene) (PPE), after stepwise isothermal crystallization (SIC) were studied by differential scanning calorimeter and wide-angle X-ray diffraction (WAXD). For iPP samples, three typical melting endotherms appeared after SIC process when heating rate was lower than 10 degreesC/min. The WAXD experiments proved that only alpha-form crystal was formed during SIC process and no transition from alpha1- to alpha2-form occurred during heating process. Heating rate dependence for each endotherm was discussed and it was concluded that there were only,two major crystals with different thermal stability. For the PPE sample, more melting endotherms appeared after stepwise isothermal crystallization. The introduction of ethylene comonomer in isotactic propylene backbone further decreased the regularity of molecular chain, and the short isotactic propylene sequences could crystallize into gamma-form crystal having a low melting temperature whereas the long sequences crystallized into alpha-form crystal having high melting temperature.

The influence of hard-segments on two-phase structure and shape memory properties of PCL-based segmented polyurethanes

Poly(epsilon-caprolactone)-based segmented polyurethanes (PCLUs) were prepared from poly(epsilon-caprolactone) diol, diisocyanates (DI), and 1,4-butanediol. The DIs used were 4,4'-diphenylmethane diisocyanate (MDI), 2,4-toluenediisocyanate (TDI), iso-phorone diisocyanate (IPDI), and hexamethylene diisocyanate (HDI). Differential scanning calorimetry, small-angle X-ray scattering, and dynamic mechanical analysis were employed to characterize the two-phase structures of all PCLUs. It was found that HDI- and MDI-based PCLUs had higher degree of microphase separation than did IPDI- and TDI-based PCLUs, which was primarily due to the crystallization of HDI- and MDI-based hard-segments. As a result, the HDI-based PCLU exhibited the highest recovery force up to 6 MPa and slowest stress relaxation with increasing temperature. Besides, it was found that the partial damage in hard-segment domains during the sample deformation was responsible for the incomplete shape-recovery of PCLUs after the first deformation, but the damage did not develop during the subsequent deformation.

Effect of the average soft-segment length on the morphology and properties of segmented polyurethane nanocomposites

Two organically modified layered silicates (with small and large diameters) were incorporated into three segmented polyurethanes with various degrees of microphase separation. Microphase separation increased with the molecular weight of the poly(hexamethylene oxide) soft segment. The molecular weight of the soft segment did not influence the amount of polyurethane intercalating the interlayer spacing. Small-angle neutron scattering and differential scanning calorimetry data indicated that the layered silicates did not affect the microphase morphology of any host polymer, regardless of the particle diameter. The stiffness enhancement on filler addition increased as the microphase separation of the polyurethane decreased, presumably because a greater number of urethane linkages were available to interact with the filler. For comparison, the small nanofiller was introduced into a polyurethane with a poly(tetramethylene oxide) soft segment, and a significant increase in the tensile strength and a sharper upturn in the stress-strain curve resulted. No such improvement occurred in the host polymers with poly(hexamethylene oxide) soft segments. It is proposed that the nanocomposite containing the more hydrophilic and mobile poly(tetramethylene oxide) soft segment is capable of greater secondary bonding between the polyurethane chains and the organosilicate surface, resulting in improved stress transfer to the filler and reduced molecular slippage. (c) 2006 Wiley Periodicals, Inc.

Crystallization and melting behavior of amorphous poly(iminosebacoyl iminodecamethylene)

Multiple melting behavior was observed in the differential scanning calorimetry (DSC) scans for the isothermally crystallized poly(iminosebacoyl iminodecamethylene) (PA1010) samples. Coexistence of crystal populations with different lamellar thickness in PA1010 was discussed by means of DSC, wide-angle X-ray diffraction (WAXD), and small-angle X-ray scattering techniques. During crystallization of the polymer, a major lamellar crystal population developed first, which possessed a higher melting temperature. However, a small fraction of the polymer formed minor crystal population with thinner lamellae, which was metastable and, upon post-annealing, could grow into more stable and thicker lamellae through melting and recrystallization process. Lamellae insertion or stacks would develop during the post-annealing at a lower temperature for the isothermally crystallized samples; thus, multiple crystal populations with different thickness could be produced. It is the multiple distribution of lamella thickness that gives rise to multiple melting behavior of crystalline polymers. (C) 2000 John Wiley & Sons, Inc.

New insight into melting and crystallization behavior in semicrystalline poly(ethylene terephthalate)

After isothermal crystallization, poly(ethylene terephthalate) (PET) showed double endothermic behavior in the differential scanning calorimetry (DSC) heating scan. During the heating scans of semicrystalline PET, a metastable melt which comes from melting thinner lamellar crystal populations formed between the low and the upper endothermic temperatures. The metastable melt can recrystallize immediately just above the low melting temperature and form thicker lamellae than the original ones. The thickness and perfection depends on the crystallization time and crystallization temperature. The crystallization kinetics of this metastable melt can be determined by means of DSC. The kinetics analysis showed that the isothermal crystallization of the metastable PET melt proceeds with an Avrami exponent of n = 1.0 similar to 1.2, probably reflecting one-dimensional or irregular line growth of the crystal occurring between the existing main lamellae with heterogeneous nucleation. This is in agreement with the hypothesis that the melting peaks are associated with two distinct crystal populations with different thicknesses. (C) 2000 John Wiley & Sons, Inc.

Heritability of multiple mating by female field crickets, Gryllus integer (Orthoptera: Gryllidae)

The heritability of multiple mating in female Gryllus integer crickets was studied. Two preliminary experiments were conducted to determine when females first mate following the post-imaginal moult and to ascertain whether constant exposure to males affects female mating rate. Female Q. integer first mated at an average age of 3.6 days (S.D. = 2.3, Range = 0-8 days) . Exposing female crickets to courting males 24 hr daily did not significantly alter mating rates from those females in contact with males for only 5 hr per day. A heritability value of 0.690 ± 0.283 was calculated for multiple mating behavior in female Q. integer using a parent-offspring regression approach. Parental females mated between land 30 times (x 9.8, S . D. = 6. 6 ) and offspring matings ranged from 0 to 26 times (x 7 .3, S.D. = 3.4). Multiple mating is probably a sexually selected trait which functions as a mechanism of female choice and increases reproductive success through increased offspring production. Classical theory suggests that traits intimately related with fitness should exhibit negligible heritable variation. However, this study has shown that multiple mating, a trait closely linked with reproductive fitness, exhibits substantial heritability. These results are in concordance with a growing body of empirical evidence suggesting many fitness traits in natural populations demonstrate heritabilities far removed from zero. Various mechanisms which may maintain heritable variation for female multiple mating in wild, outbred Q. integer populations are discussed.

Poly(ethylene glycol-co-propylene glycol) as a Macromolecular Plasticizing Agent for Polylactide: Thermomechanical Properties and Aging

Finding a Suitable plasticizer for polylactide (PLA) is necessary to overcome its brittleness and enlarge its range of applications. In this study, commercial PLA was melt-blended with a new plasticizer, an ethylene glycol/propylene glycol random copolymer [poly(ethylene glycol-co-propylene glycol) (PEPG)] with a typical number-average molecular weight of 1.2 kDa and an ethylene glycol content of 78.7 mol %. The thermal properties, crystallization behavior, and mechanical properties of the quenched blends and the properties of the blends after storage for 2 months under the ambient conditions were investigated in detail. The advantage of using PEPG is that it does not crystallize at room temperature and has good compatibility with PLA. The quenched PLA/PEPG blends were homogeneous and amorphous systems. With an increase in the PEPG content (5-20%), the glass-transition temperature, tensile strength, and modulus of the blends decreased, whereas the elongation at break and crystallizability increased dramatically. The cold crystallization of PLA resulted in phase separation of the PLA/PEPG blends by annealing of the blends at the crystallization temperature.

Molecular heterogeneity and crystal morphology in metallocene short chain branch polyethylene (SCBPE)

Metallocene, a newer generation of commercial polymerization catalysts for polyolefins, is best known for its "single sitednss", and the intermolecular structural homogeneity of metallocene polyethylene copolymer is a very interesting research issue. The molecular segregation effects on the crystallization, melting and crystal morphologies of metallocene SCBPE have been investigated with DSC and TEM. The multiple endothermic peaks were observed in the DSC thermograms during heating experiments. The heterogeneity increases as branching content increases, the lamellae becomes thinner, and lamellae distribution becomes broader. Both macroscopic segregation (between two crystal aggregates) and microscopic segreation (between two lamellae) have been observed when SCBPE crystallized from phase separated melt.

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

Multiple-choice versus short-response items: Differences in omit behavior

The overall rate of omission of items for 28,331 17 year old Australian students on a high stakes test of achievement in the common elements or cognitive skills of the senior school curriculum is reported for a subtest in multiple choice format and a subtest in short response format. For the former, the omit rates were minuscule and there was no significant difference by gender or by type of school attended. For the latter, where an item can be 'worth' up to five times that of a single multiple choice item, the omit rates were between 10 and 20 times that for multiple choice and the difference between male and female omit rate was significant as was the difference between students from government and non-government schools. For both formats, females from single sex schools omitted significantly fewer items than did females from co-educational schools. Some possible explanations of omit behaviour are alluded to.

Induction of multiple reinstatements of ethanol- and sucrose-seeking behavior in Long–Evans rats by the α-2 adrenoreceptor antagonist yohimbine

Rationale Developing models to efficiently explore the mechanisms by which stress can mediate reinstatement of drug-seeking behavior is crucial to the development of new pharmacotherapies for alcohol use disorders. Objectives We examined the effects of multiple reinstatement sessions using the pharmacological stressor, yohimbine, in ethanol- and sucrose-seeking rats in order to develop a more efficient model of stress-induced reinstatement. Methods Long–Evans rats were trained to self-administer 10% ethanol with a sucrose-fading procedure, 20% ethanol without a sucrose-fading procedure, or 5% sucrose in 30-min operant self-administration sessions, followed by extinction training. After reaching extinction criteria, the animals were tested once per week with yohimbine vehicle and yohimbine (2 mg/kg), respectively, 30 min prior to the reinstatement sessions or blood collection. Levels of reinstatement and plasma corticosterone (CORT) were determined each week for four consecutive weeks. Results Yohimbine induced reinstatement of ethanol- and sucrose-seeking in each of the 4 weeks. Interestingly, the magnitude of the reinstatement decreased for the 10% ethanol group after the first reinstatement session but remained stable for the 20% ethanol group trained without sucrose. Plasma CORT levels in response to injection of both vehicle and yohimbine were significantly higher in the ethanol-trained animals compared to sucrose controls. Conclusions The stable reinstatement in the 20% ethanol group supports the use of this training procedure in studies using within-subject designs with multiple yohimbine reinstatement test sessions. Additionally, these results indicate that the hormonal response to stressors can be altered following extinction from self-administration of relatively modest amounts of ethanol.