Estimating a preference-based index for a menopause specific health quality of life questionnaire

BACKGROUND: The aim of the study was to develop a menopause-specific, preference-based healthrelated quality-of-life (HRQoL) index reflecting both menopausal symptoms and potential sideeffects of Hormone Replacement Therapy (HRT). METHODS: The study had three phases: the development of a health state classification, a prospective valuation survey and the estimation of a model to interpolate HRQoL indices for all remaining health states as defined by the classification. A menopausal health state classification was developed with seven dimensions: hot flushes, aching joints/muscles, anxious/frightened feelings, breast tenderness, bleeding, vaginal dryness and undesirable androgenic signs. Each dimension contains between three and five levels and defines a total of 6,075 health states. A sample of 96 health states was selected for the valuation survey. These states were valued by a sample of 229 women aged 45 to 60, randomly selected from 6 general practice lists in Sheffield, UK. Respondents were asked to complete a time trade-off (TTO) task for nine health states, resulting in an average of 16.5 values for each health state. RESULTS: Mean health states valued range from 0.48 to 0.98 (where 1.0 is full health and zero is for states regarded as equivalent to death). Symptoms, as described by the classification system, can be rank-ordered in terms of their impact (from high to low) on menopausal HRQoL as follows: aching joints and muscles, bleeding, breast tenderness, anxious or frightened feelings, vaginal dryness, androgenic signs. Hot flushes did not significantly contribute to model fit. The preferred model produced a mean absolute error of 0.053, but suffered from bias at both ends of the scale. CONCLUSION: This article presents an attempt to directly value a condition specific health state classification. The overall fit was disappointing, but the results demonstrate that menopausal symptoms are perceived by patients to have a significant impact on utility. The overall effect is modest compared to the more generic health state descriptions such as the EQ-5D. The resultant algorithm generates a preference-based index that can be used economic evaluation and that reflects the impact of this condition

Significance of soil organic phosphorus to plant growth

The first indication that soils contain organic phosphorus was obtained in 1844 by Mulder (20), in experiments wherein he could not obtain phosphorus-free preparations of certain soil organic matter fractions. Since the time of Mulder, a number of investigations have dealt specifically with the problem of soil organic phosphorus, and it is now generally recognized that a portion of the soil phosphorus occurs in organic forms. The distribution of organic phosphorus in different soil types and groups has been investigated in only a preliminary way, but it has become apparent that the quantities of organic phosphorus are correlated with the quantities of soil organic matter. In Iowa and other North Central states, there are extensive areas of soils that contain relatively large quantities of both substances

A health/media literacy intervention improves adults’ interpretations of sugar-sweetened beverage advertising

Although excessive sugar-sweetened beverages (SSB) intake is linked to numerous adverse health consequences, media literacy interventions rarely address the influences of food and beverage marketing with a specific focus on adults. This randomized controlled trial study investigated (1) whether media literacy education modifies adults’ perceptions of SSB advertising and (2) whether changes are moderated by health literacy. Results from the multilevel mixed-effects regression analyses with the intention-to-treat last-observation-carried-forward method showed that compared to MoveMore (a matched-contact comparison condition), SIPsmartER (an intervention condition) participants significantly enhanced their skillsets across media literacy domains (i.e., authors/audiences, messages/meanings, representation/reality) between baseline and 6-month follow-up. Baseline health literacy status did not moderate media literacy outcomes. Both low and high health literate participants improved their outcomes, suggesting that this media literacy intervention benefited adults regardless of their health literacy level. Results demonstrate the importance of cultivating critical analyses and strengthening adults’ resistance toward SSB advertising

A health/media literacy intervention improves adults’ interpretations of sugar-sweetened beverage advertising

Although excessive sugar-sweetened beverages (SSB) intake is linked to numerous adverse health consequences, media literacy interventions rarely address the influences of food and beverage marketing with a specific focus on adults. This randomized controlled trial study investigated (1) whether media literacy education modifies adults’ perceptions of SSB advertising and (2) whether changes are moderated by health literacy. Results from the multilevel mixed-effects regression analyses with the intention-to-treat last-observation-carried-forward method showed that compared to MoveMore (a matched-contact comparison condition), SIPsmartER (an intervention condition) participants significantly enhanced their skillsets across media literacy domains (i.e., authors/audiences, messages/meanings, representation/reality) between baseline and 6-month follow-up. Baseline health literacy status did not moderate media literacy outcomes. Both low and high health literate participants improved their outcomes, suggesting that this media literacy intervention benefited adults regardless of their health literacy level. Results demonstrate the importance of cultivating critical analyses and strengthening adults’ resistance toward SSB advertising

Simulated reductions in consumption of sugar-sweetened beverages improves diet quality in Lower Mississippi Delta adults

Although the effects of replacing sugar-sweetened beverages (SSBs) with water on energy intake and body weight have been reported, little is known about how these replacements affect diet quality.To simulate the effects of replacing SSBs with tap water on diet quality and total energy intake of Lower Mississippi Delta (LMD) adults.Retrospective analysis of cross-sectional dietary intake data using a representative sample of LMD adults (n=1,689). Diet quality was measured using the Healthy Eating Index-2005 (HEI-2005) scores that were computed using the population ratio method. The effects of substituting SSBs with water on diet quality were simulated by replacing the targeted items’ nutrient profile with tap water's profile.Simulating the replacement of SSBs with tap water at 25, 50, and 100% levels resulted in 1-, 2.3-, and 3.8-point increases, respectively, in the HEI-2005 total score. Based on a mean daily intake of 2,011 kcal, 100% substitution of SSBs with tap water would result in 11% reduction in energy intake.Replacing SSBs with water could substantially improve the diet quality of the LMD adult population and potentially lead to significant weight loss overtime. Prioritizing intervention efforts to focus on the replacement of SSBs with energy-free drinks may be the most efficacious approach for conveying potentially substantial health benefits in this and similar disadvantaged populations

Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: Findings from a randomized control trial

This work is licensed under a Creative Commons Attribution 4.0 International License.Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p < 0.05); yet the human-delivered behavior condition was not significantly different from either the IVR-behavior condition (27 SSB kcals/day, 95% CI = − 69, 125) or IVR control condition (− 70 SSB kcals/day, 95% CI = − 209, 64). Call completion rates were similar across maintenance conditions (4.2–4.6 out of 11 calls); however, loss to follow-up was greatest in the IVR control condition. Approximated costs of IVR and human-delivered calls were remarkably similar (i.e., $3.15/participant/month or$38/participant total for the 12-month maintenance phase), yet implications for scalability and sustainability differ. Conclusion Overall, SIPsmartER participants maintained improvements in SSB behaviors. Using IVR to support SSB behaviors is effective and may offer advantages as a scalable maintenance strategy for real-world systems in rural regions to address excessive SSB consumption.National Institutes of Health, National Cancer Institute (R01CA154364

Control of Electron-State Coupling in Asymmetric Ge/Si-Ge Quantum Wells

Theoretical predictions indicate that the n-type Ge/Si-Ge multi-quantum-well system is the most promising material for the realization of a Si-compatible THz quantum cascade laser operating at room temperature. To advance in this direction, we study, both experimentally and theoretically, asymmetric coupled multi-quantum-well samples based on this material system, that can be considered as the basic building block of a cascade architecture. Extensive structural characterization shows the high material quality of strain-symmetrized structures grown by chemical vapor deposition, down to the ultrathin barrier limit. Moreover, THz absorption spectroscopy measurements supported by theoretical modeling unambiguously demonstrate inter-well coupling and wavefunction tunneling. The agreement between experimental data and simulations allows us to characterize the tunneling barrier parameters and, in turn, achieve highly controlled engineering of the electronic structure in forthcoming unipolar cascade systems based on n-type Ge/Si-Ge multi-quantum-wells

Integrating the promotion of physical activity within a smoking cessation programme: Findings from collaborative action research in UK Stop Smoking Services

Background: Within the framework of collaborative action research, the aim was to explore the feasibility of developing and embedding physical activity promotion as a smoking cessation aid within UK 6/7-week National Health Service (NHS) Stop Smoking Services. Methods: In Phase 1 three initial cycles of collaborative action research (observation, reflection, planning, implementation and re-evaluation), in an urban Stop Smoking Service, led to the development of an integrated intervention in which physical activity was promoted as a cessation aid, with the support of a theoretically based self-help guide, and self monitoring using pedometers. In Phase 2 advisors underwent training and offered the intervention, and changes in physical activity promoting behaviour and beliefs were monitored. Also, changes in clients’ stage of readiness to use physical activity as a cessation aid, physical activity beliefs and behaviour and physical activity levels were assessed, among those who attended the clinic at 4-week post-quit. Qualitative data were collected, in the form of clinic observation, informal interviews with advisors and field notes. Results: The integrated intervention emerged through cycles of collaboration as something quite different to previous practice. Based on field notes, there were many positive elements associated with the integrated intervention in Phase 2. Self-reported advisors’ physical activity promoting behaviour increased as a result of training and adapting to the intervention. There was a significant advancement in clients’ stage of readiness to use physical activity as a smoking cessation aid. Conclusions: Collaboration with advisors was key in ensuring that a feasible intervention was developed as an aid to smoking cessation. There is scope to further develop tailored support to increasing physical activity and smoking cessation, mediated through changes in perceptions about the benefits of, and confidence to do physical activity

Control of electron-state coupling in asymmetric Ge/Si−Ge quantum wells

Theoretical predictions indicate that the n-type Ge / Si − Ge multi-quantum-well system is the most promising material for the realization of a Si -compatible THz quantum cascade laser operating at room temperature. To advance in this direction, we study, both experimentally and theoretically, asymmetric coupled multi-quantum-well samples based on this material system, that can be considered as the basic building block of a cascade architecture. Extensive structural characterization shows the high material quality of strain-symmetrized structures grown by chemical vapor deposition, down to the ultrathin barrier limit. Moreover, THz absorption spectroscopy measurements supported by theoretical modeling unambiguously demonstrate inter-well coupling and wavefunction tunneling. The agreement between experimental data and simulations allows us to characterize the tunneling barrier parameters and, in turn, achieve highly controlled engineering of the electronic structure in forthcoming unipolar cascade systems based on n-type Ge / Si − Ge multi-quantum-wells

High-Quality n-Type Ge/SiGe Multilayers for THz Quantum Cascade Lasers

The exploitation of intersubband transitions in Ge/SiGe quantum cascade devices could pave the way towards the integration of THz light emitters into the silicon-based technology. Aiming at the realization of a Ge/SiGe Quantum Cascade Laser (QCL), we investigate optical and structural properties of n-type Ge/SiGe coupled quantum well systems. The samples have been investigated by means of X-ray diffraction, scanning transmission electron microscopy, atom probe tomography and Fourier Transform Infrared absorption spectroscopy to assess the growth capability with respect to QCL design requirements, carefully identified by means of modelling based on the non-equilibrium Green function formalism