713 research outputs found
A philosophy of health: life as reality, health as a universal value
Emphases on biomarkers (e.g. when making diagnoses) and pharmaceutical/drug methods (e.g. when researching/disseminating population level interventions) in primary care evidence philosophies of health (and healthcare) that reduce health to the biological level. However, with chronic diseases being responsible for the majority of all cause deaths and being strongly linked to health behavior and lifestyle; predominantly biological views are becoming increasingly insufficient when discussing this health crisis. A philosophy that integrates biological, behavioral, and social determinants of health could benefit multidisciplinary discussions of healthy publics. This manuscript introduces a Philosophy of Health by presenting its first five principles of health. The philosophy creates parallels among biological immunity, health behavior change, social change by proposing that two general functions—precision and variation—impact population health at biological, behavioral, and social levels. This higher-level of abstraction is used to conclude that integrating functions, rather than separated (biological) structures drive healthy publics. A Philosophy of Health provides a framework that can integrate existing theories, models, concepts, and constructs
Methods of quantifying change in multiple risk factor interventions
Objective: Risky behaviors such as smoking, alcohol abuse, physical inactivity, and poor diet are detrimental to health, costly, and often co-occur. Greater efforts are being targeted at changing multiple risk behaviors to more comprehensively address the health needs of individuals and populations. With increased interest in multiple risk factor interventions, the field will need ways to conceptualize the issue of overall behavior change. Method: Analyzing data from over 8000 participants in four multibehavioral interventions, we present five different methods for quantifying and reporting changes in multiple risk behaviors.
Results: The methods are: (a) the traditional approach of reporting changes in individual risk behaviors; (b) creating a combined statistical index of overall behavior change, standardizing scores across behaviors on different metrics; (c) using a behavioral index; (d) calculating an overall impact factor; and (e) using overarching outcome measures such as quality of life, related biometrics, or cost outcomes. We discuss the methods\u27 interpretations, strengths, and limitations.
Conclusion: Given the lack of consensus in the field on how to examine change in multiple risk behaviors, we recommend researchers employ and compare multiple methods in their publications. A dialogue is needed to work toward developing a consensus for optimal ways of conceptualizing and reporting changes in multibehavioral interventions
An adaptive behavioral immune system: a model of population health behavior
The understanding that immunity could be strengthened in the general population (e.g., through vaccine interventions) supported global advances upon acute infectious disease epidemics in the eighteenth, nineteenth, and twentieth centuries. However, in the twenty-first century, global populations face chronic disease epidemics. Research demonstrates that diseases largely emerge from health risk behavior. The understanding of how health behavior, like the biological immune system, can be strengthened in the general population, could support advances in the twenty-first century. To consider how health behavior can be strengthened in the general population, the authors present a theoretical model of population health behavior. The model operationalizes health behavior as a system of functions that, like the biological immune system, exists in each member of the population. Constructs are presented that operationalize the specific decisions and habits that drive health behavior and behavior change in the general population. The constructs allow the authors to present parallels (1) among existing behavior change theories and (2) between the proposed system and the biological immune system. Through these parallels, the authors introduce a model and a logic of population-level health behavior change. The Adaptive Behavioral Immune System is an integrative model of population health behavior
The circumgalactic medium of massive galaxies at z~3: a test for stellar feedback, galactic outflows, and cold streams
We present new results on the kinematics, thermal and ionization state, and
spatial distribution of metal-enriched gas in the circumgalactic medium (CGM)
of massive galaxies at redshift 3, using the "Eris" suite of cosmological
"zoom-in" simulations. The reference run adopts a blastwave scheme for
supernova feedback that produces galactic outflows, a star formation recipe
based on a high gas density threshold, metal-dependent radiative cooling, and a
model for the diffusion of metals and thermal energy. Synthetic spectra through
the multiphase CGM produce interstellar absorption line strengths of Lya, CII,
CIV, SiII, and SiIV as a function of galactocentric impact parameter (scaled to
the virial radius) that are in broad agreement with those observed at
high-redshift by Steidel et al. (2010). Only about one third of all the gas
within R_vir is outflowing. The fraction of sightlines within one virial radius
that intercept optically thick material is 27%, in agreement with recent
observations by Rudie et al. (2012). Such optically thick absorption is shown
to trace inflowing "cold" streams that penetrate deep inside the virial radius.
The streams, enriched to metallicities above 0.01 solar, give origin to strong
(log N > 13) CII absorption with a covering factor of 22% within R_vir and 10%
within 2 R_vir. Galactic outflows do not cause any substantial suppression of
the cold accretion mode. The central galaxy is surrounded by a large OVI halo,
with a typical column density log N>14 and a near unity covering factor
maintained all the way out to 150 kpc. This matches the trends recently
observed in star-forming galaxies at low redshift by Tumlinson et al. (2011).
Our zoom-in simulations of this single system appear to reproduce
quantitatively the complex baryonic processes that determine the exchange of
matter, energy, and metals between galaxies and their surroundings. (Abridged)Comment: 16 pages, 13 figures, accepted for publication in The Astrophysical
Journa
The benefits and challenges of multiple health behavior change in research and in practice
Objective: The major chronic diseases are caused by multiple risks, yet the science of multiple health behavior change (MHBC) is at an early stage, and factors that facilitate or impede scientists\u27 involvement in MHBC research are unknown. Benefits and challenges of MHBC interventions were investigated to strengthen researchers\u27 commitment and prepare them for challenges.
Method: An online anonymous survey was e-mailed to listservs of the Society of Behavioral Medicine between May 2006 and 2007. Respondents (N = 69) were 83% female; 94% held a doctoral degree; 64% were psychologists, 24% were in public health; and 83% targeted MHBC in their work.
Results: A sample majority rated 23 of the 24 benefits, but only 1 of 31 challenge items, as very to extremely important. Those engaged in MHBC rated the total benefits significantly higher than respondents focused on single behaviors, F(1,69) = 4.21, p \u3c .05, and rated the benefits significantly higher than the challenges: paired t(57) = 7.50, p \u3c .001. The two groups did not differ in ratings of challenges.
Conclusion: It appears that individuals focused solely on single behaviors do not fully appreciate the benefits that impress MHBC researchers; it is not that substantial barriers are holding them back. Benefits of MHBC interventions need emphasizing more broadly to advance this research area
Contraceptive and Condom Use Adoption and Maintenance: A Stage Paradigm Approach
The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of constructs that act as sensitive intervening or outcome variables—the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior
Molecular hydrogen deficiency in HI-poor galaxies and its implications for star formation
We use a sample of 47 homogeneous and high sensitivity CO images taken from
the Nobeyama and BIMA surveys to demonstrate that, contrary to common belief, a
significant number (~40%) of HI-deficient nearby spiral galaxies are also
depleted in molecular hydrogen. While HI-deficiency by itself is not a
sufficient condition for molecular gas depletion, we find that H2 reduction is
associated with the removal of HI inside the galaxy optical disk. Those
HI-deficient galaxies with normal H2 content have lost HI mainly from outside
their optical disks, where the H2 content is low in all galaxies. This finding
is consistent with theoretical models in which the molecular fraction in a
galaxy is determined primarily by its gas column density. Our result is
supported by indirect evidence that molecular deficient galaxies form stars at
a lower rate or have dimmer far infrared fluxes than gas rich galaxies, as
expected if the star formation rate is determined by the molecular hydrogen
content. Our result is consistent with a scenario in which, when the atomic gas
column density is lowered inside the optical disk below the critical value
required to form molecular hydrogen and stars, spirals become quiescent and
passive evolving systems. We speculate that this process would act on the
time-scale set by the gas depletion rate and might be a first step for the
transition between the blue and red sequence observed in the color-magnitude
diagram.Comment: 12 pages, 9 figures, accepted for publication in Ap
Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion
Objective: This study was designed to compare the initial efficacy of Motivational Interviewing (MI), Online Transtheoretical Model (TTM)-tailored communications and a brief Health Risk Intervention (HRI) on four health risk factors (inactivity, BMI, stress and smoking) in a worksite sample.
Method: A randomized clinical trial assigned employees to one of three recruitment strategies and one of the three treatments. The treatment protocol included an HRI session for everyone and in addition either a recommended three TTM online sessions or three MI in person or telephone sessions over 6 months. At the initial post-treatment assessment at 6 months, groups were compared on the percentage who had progressed from at risk to taking effective action on each of the four risks.
Results: Compared to the HRI only group, the MI and TTM groups had significantly more participants in the Action stage for exercise and effective stress management and significantly fewer risk behaviors at 6 months. MI and TTM group outcomes were not different.
Conclusion: This was the first study to demonstrate that MI and online TTM could produce significant multiple behavior changes. Future research will examine the long-term impacts of each treatment, their cost effectiveness, effects on productivity and quality of life and process variables mediating outcomes
Transtheoretical principles and processes for quitting smoking: A 24-month comparison of a representative sample of quitters, relapsers, and non-quitters
This longitudinal study compared 14 principles and processes of change applied by successful quitters, relapsers and non-quitters over 24 months in a representative sample of 4144 smokers in intervention and control groups. The successful quitters showed a decrease in the use of experiential processes (cognitive, affective and effective) and an increase in behavioral processes (e.g., counter-conditioning and stimulus control). The non-quitters showed little change in their use of almost all of the processes. The relapsers\u27 use of the processes tended to initially parallel the successful quitters, but over time, their use ended up between the quitters and the non-quitters. In general, the relapsers ended up working harder but not smarter than the successful quitters. The pattern of use of change processes in the treatment and control groups were remarkably similar, suggesting common pathways to change
Predictors of relapse among smokers: Transtheoretical effort variables, demographics, and smoking severity
The present longitudinal study investigates baseline assessments of static and dynamic variables, including demographic characteristics, smoking severity, and Transtheoretical Model of Behavior Change (TTM) effort variables (Decisional Balance (i.e. Pros and Cons), Situational Temptations, and Processes of Change) of relapse among individuals who were abstinent at 12 months. The study sample (N = 521) was derived from an integrated dataset of four population-based smoking cessation interventions. Several key findings included: Participants who were aged 25–44 and 45–64 (OR = .43, p = .01 and OR = .40, p = .01, respectively) compared to being aged 18–24 were less likely to relapse at follow-up. Participants in the control group were more than twice as likely to relapse (OR = 2.17, p = .00) at follow-up compared to participants in the treatment group. Participants who reported higher Habit Strength scores were more likely to relapse (OR = 1.05, p = .02). Participants who had higher scores of Reinforcement Management (OR = 1.05, p = .04) and Self-Reevaluation (OR = 1.08, p = .01) were more likely to relapse. Findings add to one assumption that relapsers tend to relapse not solely due to smoking addiction severity, but due to immediate precursor factors such as emotional distress. One approach would be to provide additional expert guidance on how smokers can manage stress effectively when they enroll in treatment at any stage of change
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