Implementing a Multi-Component School-based Obesity Prevention Intervention: A Qualitative Study

Objective: To explore barriers and facilitators to implementing and sustaining Healthy Choices, a three-year multi-component obesity prevention intervention implemented in middle schools in Massachusetts. Methods: Using purposive sampling, 56 in-depth interviews were conducted with middleschool employees representing different positions (administrators, teachers, food service personnel, and employees serving as intervention coordinators). Interviews were recorded and transcribed. Emergent themes were identified using thematic analyses. Results: State-mandated testing, budget limitations, and time constraints were viewed as implementation barriers while staff buy-in and technical assistance were seen as facilitating implementation. Respondents felt that intervention sustainability was dependent on external funding and expert assistance. Conclusions and Implications: Results confirm the importance of gaining faculty and staff support. Schools implementing large scale interventions should consider developing sustainable partnerships with organizations that can provide resources and ongoing training. Sustainability of complex interventions may depend on state-level strategies that provide resources for implementation and technical assistance

Early-stage breast cancer is not associated with the risk of marital dissolution in a large prospective study of women

Background: As breast cancer and its treatment are likely to interfere with traditional expectations of womanhood, it may affect marital stability. Methods: The risk of marital dissolution was analysed with respect to diagnosis of early-stage (T1-4N0-3M0) breast cancer in a cohort of 134 435 married Finnish women followed for a median of 17.0 married years. Age, socioeconomic status, education, number of children, duration of marriage and earlier marriages were taken into account and the effects of surgery, chemotherapy, radiotherapy and endocrine therapy were analysed separately. Results: Women with a diagnosis of early-stage breast cancer did not show increase in marital dissolution (hazard ratio -0.96, 95% confidence interval = 0.79-1.17). Neither the type of surgical procedure nor any of the oncologic treatments was associated with an increase in the risk of divorce. Conclusions: Any evidence of excess risk of marital breakdown after the diagnosis of early-stage breast cancer and its treatment was not demonstrated.Peer reviewe

Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

BACKGROUND: Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. METHODS: A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. RESULTS: As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. CONCLUSION: The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses

Understanding the association between negative symptoms and performance on effort-based decision-making tasks: The importance of defeatist performance beliefs

Effort-based decision-making paradigms are increasingly utilized to gain insight into the nature of motivation deficits. Research has shown associations between effort-based decision making and experiential negative symptoms; however, the associations are not consistent. The current study had two primary goals. First, we aimed to replicate previous findings of a deficit in effort-based decision making among individuals with schizophrenia on a test of cognitive effort. Second, in a large sample combined from the current and a previous study, we sought to examine the association between negative symptoms and effort by including the related construct of defeatist beliefs. The results replicated previous findings of impaired cognitive effort-based decision making in schizophrenia. Defeatist beliefs significantly moderated the association between negative symptoms and effort-based decision making such that there was a strong association between high negative symptoms and deficits in effort-based decision making, but only among participants with high levels of defeatist beliefs. Thus, our findings suggest the relationship between negative symptoms and effort performance may be understood by taking into account the role of defeatist beliefs, and finding that might explain discrepancies in previous studies

Clcn7F318L/+ as a new mouse model of Albers-Schönberg disease

Dominant negative mutations in CLCN7, which encodes a homodimeric chloride channel needed for matrix acidification by osteoclasts, cause Albers-Schönberg disease (also known as autosomal dominant osteopetrosis type 2). More than 25 different CLCN7 mutations have been identified in patients affected with Albers-Schönberg disease, but only one mutation (Clcn7G213R) has been introduced in mice to create an animal model of this disease. Here we describe a mouse with a different osteopetrosis-causing mutation (Clcn7F318L). Compared to Clcn7+/+ mice, 12-week-old Clcn7F318L/+ mice have significantly increased trabecular bone volume, consistent with Clcn7F318L acting as a dominant negative mutation. Clcn7F318L/F318L and Clcn7F318L/G213R mice die by 1 month of age and resemble Clcn7 knockout mice, which indicate that p.F318L mutant protein is non-functional and p.F318L and p.G213R mutant proteins do not complement one another. Since it has been reported that treatment with interferon gamma (IFN-G) improves bone properties in Clcn7G213R/+ mice, we treated Clcn7F318L/+ mice with IFN-G and observed a decrease in osteoclast number and mineral apposition rate, but no overall improvement in bone properties. Our results suggest that the benefits of IFN-G therapy in patients with Albers-Schönberg disease may be mutation-specific

Charges in Gauge Theories

In this article we investigate charged particles in gauge theories. After reviewing the physical and theoretical problems, a method to construct charged particles is presented. Explicit solutions are found in the Abelian theory and a physical interpretation is given. These solutions and our interpretation of these variables as the true degrees of freedom for charged particles, are then tested in the perturbative domain and are demonstrated to yield infra-red finite, on-shell Green's functions at all orders of perturbation theory. The extension to collinear divergences is studied and it is shown that this method applies to the case of massless charged particles. The application of these constructions to the charged sectors of the standard model is reviewed and we conclude with a discussion of the successes achieved so far in this programme and a list of open questions.Comment: 47 pages, LaTeX, 14 figures, uses feynmp, necessary Metapost files included. Review to appear in Pramana, Journal of Physics. Minor LaTeX change to make page numbers visible on "Letter" paper forma

Detection of the BL Lac Object H1426+428 at TeV Gamma Ray Energies

A very high energy (VHE) gamma-ray signal has been detected at the 5.4 sigma level from H1426+428, an x-ray selected BL Lacertae object at a redshift of 0.129. The object was monitored from 1995 - 1998 with the Whipple 10m imaging atmospheric Cherenkov telescope as part of a general blazar survey; the results of these observations, although not statistically significant, were consistently positive. X-ray observations of H1426+428 during 1999 with the BeppoSAX instrument revealed that the peak of its synchrotron spectrum occurs at > 100 keV, leading to the prediction of observable TeV emission from this object. H1426+428 was monitored extensively at the Whipple Observatory during the 1999, 2000, and 2001 observing seasons. The strongest TeV signals were detected in 2000 and 2001. During 2001, an integral flux of 2.04 +/- 0.35 x10e-11 cm-2 s-1 above 280 GeV was recorded from H1426+428. The detection of H1426+428 supports the idea that, as also seen in Markarian 501 and 1ES2344+514, BL Lacertae objects with extremely high synchrotron peak frequencies produce gamma rays in the TeV range.Comment: 35 pages, 7 figures, accepted by ApJ Two upper limits in Table 3 (upper limits for 1995 and 1997) are different from the ApJ versio

VERITAS Observations of the gamma-Ray Binary LS I +61 303

LS I +61 303 is one of only a few high-mass X-ray binaries currently detected at high significance in very high energy gamma-rays. The system was observed over several orbital cycles (between September 2006 and February 2007) with the VERITAS array of imaging air-Cherenkov telescopes. A signal of gamma-rays with energies above 300 GeV is found with a statistical significance of 8.4 standard deviations. The detected flux is measured to be strongly variable; the maximum flux is found during most orbital cycles at apastron. The energy spectrum for the period of maximum emission can be characterized by a power law with a photon index of Gamma=2.40+-0.16_stat+-0.2_sys and a flux above 300 GeV corresponding to 15-20% of the flux from the Crab Nebula.Comment: accepted for publication in The Astrophysical Journa

A Search for Dark Matter Annihilation with the Whipple 10m Telescope

We present observations of the dwarf galaxies Draco and Ursa Minor, the local group galaxies M32 and M33, and the globular cluster M15 conducted with the Whipple 10m gamma-ray telescope to search for the gamma-ray signature of self-annihilating weakly interacting massive particles (WIMPs) which may constitute astrophysical dark matter (DM). We review the motivations for selecting these sources based on their unique astrophysical environments and report the results of the data analysis which produced upper limits on excess rate of gamma rays for each source. We consider models for the DM distribution in each source based on the available observational constraints and discuss possible scenarios for the enhancement of the gamma-ray luminosity. Limits on the thermally averaged product of the total self-annihilation cross section and velocity of the WIMP, , are derived using conservative estimates for the magnitude of the astrophysical contribution to the gamma-ray flux. Although these limits do not constrain predictions from the currently favored theoretical models of supersymmetry (SUSY), future observations with VERITAS will probe a larger region of the WIMP parameter phase space, and WIMP particle mass (m_\chi).Comment: 33 pages, 12 figures, accepted for publication in the Astrophysical Journa