A Review and Case Exemplifications of Health Enhancement Lifestyle Profile (HELP) and Its Screener (HELP–Screener) for Older Adults

Growing interest in promoting healthy lifestyles as a way to enhance successful aging has led to the necessity of screening and monitoring lifestyle behaviors among older adults. The 56-item Health Enhancement Lifestyle Profile (HELP) and its screening version, the 15-item HELP-Screener are a set of instruments designed for assessing various health-related lifestyle behaviors in older adults, including exercise, diet, social and productive activities, leisure, activities of daily living, stress management and spiritual participation, and other health promotion and risk behaviors. This article depicts the critical features (e.g., administration and scoring) and clinical usefulness of the two instruments and reviews the literature that supports the instruments\u27 psychometric properties (e.g., reliability and validity). Two case studies are also provided for exemplifying the clinical application of the tools. Occupational therapists can use the brief HELP-Screener for determining clients\u27 need for further evaluation with the 56-item HELP wherein scrutiny of diverse lifestyle behaviors and consultation of possible health-promoting strategies can take place

Single electron control in n-type semiconductor quantum dots using non-Abelian holonomies generated by spin orbit coupling

We propose that n-type semiconductor quantum dots with the Rashba and Dresselhaus spin orbit interactions may be used for single electron manipulation through adiabatic transformations between degenerate states. All the energy levels are discrete in quantum dots and possess a double degeneracy due to time reversal symmetryin the presence of the Rashba and/or Dresselhaus spin orbit coupling terms. We find that the presence of double degeneracy does not necessarily give rise to a finite non-Abelian (matrix) Berry phase. We show that a distorted two-dimensional harmonic potential may give rise to non-Abelian Berry phases. The presence of the non-Abelian Berry phase may be tested experimentally by measuring the optical dipole transitions.Comment: accepted in Phys. Rev.

State Transportation Improvement Program for Federal Fiscal Years 2011-2014

OBJECTIVES:To develop and validate a Taiwanese version of the Health Enhancement Lifestyle Profile (HELP-T) for community-dwelling older Taiwanese adults (≥ 55 years). METHODS:The original Health Enhancement Lifestyle Profile (HELP) is a 56-item self-report questionnaire measuring various aspects of health-related lifestyles in older adults. The standard cultural-adaptation procedure was used for questionnaire translation and modification. A field test was conducted for culturally specific item selection, rating-scale analysis, and psychometric validation of the HELP-T in a sample of 274 community-dwelling older adults via classical test theory. RESULTS:The 59-item HELP-T is culturally adapted from the original 56-item HELP. The original 6-point rating scale was modified to a 3-point scale for easy use by Taiwanese older adults. The HELP-T had good internal consistency (Cronbach's alpha = 0.82). The test-retest reliability for the total score was high (0.92), and moderate to high (range: 0.57-0.92) for subscales. The construct validity was supported by the significant correlations between each subscale and the total score (Spearman's rho = 0.41-0.67, p < 0.0001) and by the ability of the scores to significantly discriminate between participants with different levels of self-rated health (p = 0.0001). CONCLUSIONS:The HELP-T is a suitable clinical tool for assessing and monitoring lifestyle risk factors, establishing client-centered lifestyle intervention goals, and determining the outcomes of lifestyle interventions

Coulomb Blockade and Kondo Effect in a Quantum Hall Antidot

We propose a general capacitive model for an antidot, which has two localized edge states with different spins in the quantum Hall regime. The capacitive coupling of localized excess charges, which are generated around the antidot due to magnetic flux quantization, and their effective spin fluctuation can result in Coulomb blockade, h/(2e) Aharonov-Bohm oscillations, and the Kondo effect. The resultant conductance is in qualitative agreement with recent experimental data.Comment: 3 figures, to appear in Physical Review Letter

High thymidylate synthase gene expression predicts poor outcome after resection of hepatocellular carcinoma.

IntroductionPrognosis after resection of hepatocellular carcinoma (HCC) is highly variable. Compared to clinicopathologic factors, the use of molecular markers to predict outcome has not been well studied. We investigated the prognostic importance of thymidylate synthase (TS) gene expression and polymorphisms in patients after resection of HCC.MethodsPatients who underwent complete resection of HCC for whom tissue was available were identified. TS gene expression level and polymorphisms were determined in HCC specimens. Prognostic factors were evaluated using Kaplan-Meier curves and Cox proportional hazard models.ResultsThe study included 67 patients. In univariate analysis, variables that negatively influenced survival included TNM stage, microvascular invasion, and high TS expression. For the high TS expression group, median survival was 54 months and 5-year actuarial survival was 47%. For the low TS expression group, median survival was not reached and the 5-year actuarial survival was 91%. In multivariate analysis, only high TS expression remained an independent predictor of poor survival (HR = 10.77, 95% CI 1.36-84.91; P = 0.02). TS gene polymorphisms were not associated with TS expression or overall survival.ConclusionsHigh TS expression predicts poor outcome after resection of HCC. Molecular markers might be robust predictors of patient outcome after resection of HCC

Quality of weight loss advice on internet forums.

BACKGROUND: Adults use the Internet for weight loss information, sometimes by participating in discussion forums. Our purpose was to analyze the quality of advice exchanged on these forums. METHODS: This was a retrospective analysis of messages posted to 18 Internet weight loss forums during 1 month in 2006. Advice was evaluated for congruence with clinical guidelines; potential for causing harm; and subsequent correction when it was contradictory to guidelines (erroneous) or potentially harmful. Message- and forum-specific characteristics were evaluated as predictors of advice quality and self-correction. RESULTS: Of 3368 initial messages, 266 (7.9%) were requests for advice. Of 654 provisions of advice, 56 (8.6%) were erroneous and 19 of these 56 (34%) were subsequently corrected. Forty-three (6.6%) provisions of advice were harmful, and 12 of these 43 (28%) were subsequently corrected. Messages from low-activity forums (fewer messages) were more likely than those from high-activity forums to be erroneous (10.6% vs 2.4%, P \u3c .001) or harmful (8.4% vs 1.2%, P \u3c .001). In high-activity forums, 2 of 4 (50%) erroneous provisions of advice and 2 of 2 (100%) potentially harmful provisions of advice were corrected by subsequent postings. Compared with general weight loss advice, medication-related advice was more likely to be erroneous (P = .02) or harmful (P = .01). CONCLUSIONS: Most advice posted on highly active Internet weight loss forums is not erroneous or harmful. However, clinical and research strategies are needed to address the quality of medication-related advice

Screening for obstructive sleep apnea on the internet: randomized trial.

BACKGROUND: Obstructive sleep apnea is underdiagnosed. We conducted a pilot randomized controlled trial of an online intervention to promote obstructive sleep apnea screening among members of an Internet weight-loss community. METHODS: Members of an Internet weight-loss community who have never been diagnosed with obstructive sleep apnea or discussed the condition with their healthcare provider were randomized to intervention (online risk assessment+feedback) or control. The primary outcome was discussing obstructive sleep apnea with a healthcare provider at 12 weeks. RESULTS: Of 4700 members who were sent e-mail study announcements, 168 (97% were female, age 39.5 years [standard deviation 11.7], body mass index 30.3 [standard deviation 7.8]) were randomized to intervention (n=84) or control (n=84). Of 82 intervention subjects who completed the risk assessment, 50 (61%) were low risk and 32 (39%) were high risk for obstructive sleep apnea. Intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider within 12 weeks (11% [9/84] vs 2% [2/84]; P=.02; relative risk=4.50; 95% confidence interval, 1.002-20.21). The number needed to treat was 12. High-risk intervention subjects were more likely than control subjects to discuss obstructive sleep apnea with their healthcare provider (19% [6/32] vs 2% [2/84]; P=.004; relative risk=7.88; 95% confidence interval, 1.68-37.02). One high-risk intervention subject started treatment for obstructive sleep apnea. CONCLUSION: An online screening intervention is feasible and likely effective in encouraging members of an Internet weight-loss community to discuss obstructive sleep apnea with their healthcare provider

Toxicity in combination immune checkpoint inhibitor and radiation therapy: a systematic review and meta-analysis

BACKGROUND AND PURPOSE: Immune checkpoint inhibitor with radiation therapy (ICI + RT) is under investigation for improved patient outcome, so we performed a systematic review/meta-analysis of toxicities for ICI + RT compared to immune checkpoint inhibitor (ICI) therapy alone. MATERIALS AND METHODS: A PRISMA-compliant systematic review of studies in MEDLINE (PubMed) and in the National Comprehensive Cancer Network guidelines was conducted, with primary outcome grade 3+ toxicity. Criteria for ICI alone were: phase III/IV trials that compared immunotherapy to placebo, chemotherapy, or alternative immunotherapy; and for ICI + RT: prospective/retrospective studies with an arm treated with ICI + RT. Meta-analysis was performed by random effects models using the DerSimonian and Laird method. The I(2) statistic and Cochran\u27s Q test were used to assess heterogeneity, while funnel plots and Egger\u27s test assessed publication bias. RESULTS: This meta-analysis included 51 studies (n=15,398), with 35 ICI alone (n=13,956) and 16 ICI + RT studies (n=1,442). Our models showed comparable grade 3-4 toxicities in ICI + RT (17.8%; 95% CI, 12.0-24.5%) and ICI alone (22.3%; 95% CI, 18.1-26.9%). Stratification by timing of radiation and irradiated site showed no significant differences, but anti-CTLA4 therapy and melanoma showed increased toxicity. The grade 5 toxicities were 1.1% and 1.9% for ICI alone and ICI + RT respectively. There was significant heterogeneity, but not publication bias. CONCLUSIONS: The random effects model showed comparable grade 3-4 toxicity in using ICI + RT compared to ICI alone in CNS melanoma metastases, NSCLC, and prostate cancer. ICI + RT is safe for future clinical trials in these cancers

Non-Drude Optical Conductivity of (III,Mn)V Ferromagnetic Semiconductors

We present a numerical model study of the zero-temperature infrared optical properties of (III,Mn)V diluted magnetic semiconductors. Our calculations demonstrate the importance of treating disorder and interaction effects simultaneously in modelling these materials. We find that the conductivity has no clear Drude peak, that it has a broadened inter-band peak near 220 meV, and that oscillator weight is shifted to higher frequencies by stronger disorder. These results are in good qualitative agreement with recent thin film absorption measurements. We use our numerical findings to discuss the use of f-sum rules evaluated by integrating optical absorption data for accurate carrier-density estimates.Comment: 7 pages, 3 figure

Adjusting magnetic nanostructures for high-performance magnetic sensors

The magnetic properties of the soft ferromagnetic layer in magnetic tunnel junctions are one of key factors to determine the performance of magnetoresistance sensors. We use a three-step orthogonal annealing procedure to modify the nanostructures of the free layer in the magnetic tunnel junction to control features such as magnetization reversal, coercivity, exchange field, and tunnel magnetoresistance ratio. We present a sensor with an improved sensitivity as high as 3944%/mT. This magnetic sensor only dissipates 200 lW of power while operating under an applied voltage of 1V