Peer support for physical activity adoption among breast cancer survivors: Do the helped resemble the helpers?

Interventions offering peer mentoring programmes promoting moderate-to-vigorous physical activity (MVPA) have shown improvements in MVPA and well-being from baseline; however, research is limited. The purpose of this study was to compare the physical activity (PA) levels and psychosocial well-being of coaches and participants at baseline and following a 12-week intervention. Breast cancer survivors (<5 years) were recruited and randomised into either exercise (Reach-to-Recovery (RTR) + PA) or control (RTR Control). Participants in both groups were individually assigned one of the 18 available coaches who delivered either the MVPA intervention or the control condition via telephone. PA (7-Day PA Recall), psychosocial well-being, fatigue and mood were assessed at baseline and intervention completion. Seventy-six breast cancer survivors (average age = 55.62 (±9.55)) were randomised. At baseline, all participants showed significantly lower MVPA (p = .001) and well-being (p < .05) as compared to coaches. However, post-intervention showed significant improvement in PA and well-being in RTR + PA, so that they were no longer significantly different from the coaches. Post-intervention, MVPA (p < .01), quality of life (p < .05) and fatigue (p < .05) remained significantly lower in RTR Controls compared to coaches. Future interventions should consider the behavioural patterns not only of the participants, but also of those who deliver the interventions.

Lifetime characteristics of participants and non-participants in a smoking cessation trial: implications for external validity and public health impact.

BACKGROUND: Detailed information about the characteristics of smokers who do and do not participate in smoking cessation treatment is needed to improve efforts to reach, motivate, and treat smokers. PURPOSE: The aim of this study is to explore a broad range of characteristics related to participation in a smoking cessation trial. METHODS: Eligible smokers were recruited from a longitudinal birth cohort. Participants and non-participants were compared on a broad range of sociodemographics, smoking, psychiatric and substance abuse disorders, personality, and prospective measures from early childhood. Eligible smokers were compared to a matched regional subsample of the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS: Few differences were observed, most of which were statistically significant but not clinically meaningful. Compared to non-participants, participants were more likely to be single, have lower income, be more nicotine-dependent, be more motivated to quit, and have higher levels of depressed mood and stress even after covariance of gender, income, and marital status. Sociodemographic differences between participants and the BRFSS sample reflect the skew toward lower socioeconomic status in the original birth cohort. CONCLUSIONS: The encouraging conclusion is that smokers who enroll in cessation trials may not differ much from non-participants. Information about treatment participants can inform the development of recruitment strategies, improve the tailoring of treatment to individual smoker profiles, help to estimate potential selection bias, and improve estimates of population impact.

Structure and dynamics of oligosaccharides: NMR and modeling studies.

Recent advances in the conformational analysis of oligosaccharides have focused on protein-bound oligosaccharides, glycopeptides, and glycoproteins, as well as on the conformational dynamics about glycosidic linkages. Significant progress has been made possible by dramatic improvements in NMR techniques and advances in computational chemistry and technology. Transferred nuclear Overhauser effects have been used to infer the conformations of carbohydrate ligands bound to protein receptors such as antibodies, lectins and enzymes. The increased use of combined NMR spectroscopic and computational protocols has resulted in insights into the dynamics of glycan chains.

Inhibition of recombinant human maltase glucoamylase by salacinol and derivatives.

Inhibitors targeting pancreatic alpha-amylase and intestinal alpha-glucosidases delay glucose production following digestion and are currently used in the treatment of Type II diabetes. Maltase-glucoamylase (MGA), a family 31 glycoside hydrolase, is an alpha-glucosidase anchored in the membrane of small intestinal epithelial cells responsible for the final step of mammalian starch digestion leading to the release of glucose. This paper reports the production and purification of active human recombinant MGA amino terminal catalytic domain (MGAnt) from two different eukaryotic cell culture systems. MGAnt overexpressed in Drosophila cells was of quality and quantity suitable for kinetic and inhibition studies as well as future structural studies. Inhibition of MGAnt was tested with a group of prospective alpha-glucosidase inhibitors modeled after salacinol, a naturally occurring alpha-glucosidase inhibitor, and acarbose, a currently prescribed antidiabetic agent. Four synthetic inhibitors that bind and inhibit MGAnt activity better than acarbose, and at comparable levels to salacinol, were found. The inhibitors are derivatives of salacinol that contain either a selenium atom in place of sulfur in the five-membered ring, or a longer polyhydroxylated, sulfated chain than salacinol. Six-membered ring derivatives of salacinol and compounds modeled after miglitol were much less effective as MGAnt inhibitors. These results provide information on the inhibitory profile of MGAnt that will guide the development of new compounds having antidiabetic activity.

Preliminary crystallographic analysis of a Fab specific for the O-antigen of Shigella flexneri cell surface lipopolysaccharide with and without bound saccharides.

The Fab of a monoclonal anti-carbohydrate antibody, SYA/J6 (IgG3, kappa, murine), raised against the O-polysaccharide antigen of the cell surface lipopolysaccharide of variant Y Shigella flexneri, a Gram negative bacterium, has been crystallized in the unliganded form and in complex with tri- and pentasaccharide antigens. The three crystal forms belong to the tetragonal space group P4(3)2(1)2, or P4(1)2(1)2, with very similar unit cell dimensions and an asymmetric unit that contains one molecule of about 50,000 Daltons, and a fourth crystal form belongs to monoclinic space group P2(1) that contains four molecules of Fab in an asymmetric unit. Whereas diffractions of these crystals on an area detector-rotating anode system extend to only about 3.5 A resolution, those measured using an imaging plate and synchrotron radiation at the Photon Factory facility extend to 2.5 A.

The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial.

BACKGROUND: Smoking prevalence rates among women are declining at a slower rate than among men. OBJECTIVE: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation. METHODS: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group-based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively). RESULTS: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P=.03) and 12 months (11.9% vs 5.4%, P=.05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25+/-6 to 28+/-6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P = .03). CONCLUSIONS: Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.

Training and maintenance of breast self-examination skills.

Maintenance of breast self-examination (BSE) skills is crucial to the effectiveness of self-exams in early detection of breast tumors. Although researchers have developed an effective technology for training in these skills, the actual maintenance of such skills remains questionable. The objective of this study was to evaluate the effects of reassessment (and retraining) on maintenance of BSE skills. Twenty-nine women (ages 25-64 years) were trained to complete BSE using the MammaCare training program. Experimental subjects were required to demonstrate their skills at a two-month reassessment and received retraining if their skills had declined below set standards. Measures of proficiency were obtained by requiring all subjects to examine breast models at pretraining, posttraining, and two follow-ups (four months and one year). Lump detection rates were significantly higher in the experimental group at both follow-ups. The control group showed a significant decrease in lump detection rates between posttraining and each follow-up. Results suggest that, after training, periodic reassessment (and retraining) could prevent significant deterioration of BSE skills.

Promoting physical activity in women: the new challenges.

INTRODUCTION: Participation in physical activity has important implications for the physical and psychological well-being of women. Although researchers and educators have previously focused chiefly on the promotion of vigorous activity, exercise experts have focused recently on recommendations promoting moderate activity in American adults that may have important ramifications for women. OBJECTIVES: We discuss the prevalence of activity levels among women, the barriers women encounter in becoming active, and implications for the adoption and maintenance of moderate activity. INTERVENTIONS: We present the lessons learned from theory-based intervention studies, for these findings could serve as a basis to accomplish the new objectives. CONCLUSIONS: Finally, we outline the research and policy issues that should be addressed for researchers and health educators interested in preventive health care in women.

Acceptability and feasibility of physician-based activity counseling. The PAL project.

BACKGROUND: The continued prevalence of sedentary behavior in older adults underscores the need for physical activity promotion. Physician-delivered activity counseling may be an important avenue of promoting physical activity for these individuals. The Physically Active for Life (PAL) project was a randomized study of the effects of brief physician counseling plus follow-up on physical activity behaviors in older adults. METHOD: Twelve practices were randomized to the intervention group and 12 to standard care. Physicians in the intervention group participated in a 1-hour training session and received support materials for exercise counseling. Pre-assessment and post-assessment of self-reported exercise counseling behaviors and confidence in providing exercise counseling were obtained from physicians in the study. Patient evaluations of the exercise counseling and support materials were also obtained. RESULTS: Results showed that physicians favorably endorsed the training and the support materials, and reported adherence to delivery of the intervention protocol. Comparisons between the two groups showed significant improvements in confidence for intervention-group physicians, but no significant changes in physician reports of exercise counseling provided to all patients. Patients reported satisfaction with the exercise counseling and support materials. CONCLUSIONS: Physicians and patients indicated the PAL project offered an acceptable and feasible approach to promote physical activity in older adults.

Physician-based physical activity counseling for middle-aged and older adults: a randomized trial.

Sedentary behavior among older adults increases risk for chronic diseases. Physicians in a primary care setting can play an important role in promoting physical activity adoption among their older patients. The Physically Active for Life (PAL) project was a randomized, controlled trial comparing the efficacy of brief physician-delivered physical activity counseling to usual care on self-reported physical activity levels. The physical activity counseling was based on the Transtheoretical Model of Change and social learning theory. Twenty-four community-based primary care medical practices were recruited into the study; 12 were randomized to the Intervention condition and 12 to the Control condition. Physicians in the Intervention practices received training in the delivery of brief physical activity counseling. Subjects in the Intervention practices (n=181) received brief activity counseling matched to their stage of motivational readiness for physical activity, a patient manual, a follow-up appointment with their physician to discuss activity counseling, and newsletter mailings. Subjects in the Control practices (n=174) received standard care. Measures of motivational readiness for physical activity and the Physical Activity Scale for the Elderly (PASE) were administered to subjects in both conditions at baseline, 6 weeks following their initial appointment, and at 8 months. Results showed that at the 6-week follow-up, subjects in the Intervention condition were more likely to be in more advanced stages of motivational readiness for physical activity than subjects in the Control condition. This effect was not maintained at the 8 month follow-up and the intervention did not produce significant changes in PASE scores. Results suggest that more intensive, sustained interventions may be necessary to promote the adoption of physical activity among sedentary, middle-aged, and older adults in primary care medical practices.

Novel structures in galactoglucomannans of the lichens Cladonia substellata and Cladonia ibitipocae: significance as chemotypes.

The galactoglucomannans of two species of the lichen genus Cladonia, C. substellata and C. ibitipocae, were compared. They were homogeneous on gel-filtration chromatography and structurally related, having (1-->6)-linked alpha-D-mannopyranosyl main-chains, but were substituted in different patterns by alpha- and beta-D-galacto-, beta-D-gluco- and alpha-D-mannopyranosyl groups. The C-1 portions of their 13C-NMR spectra are typical of the lichen species and indicate differences between the two polysaccharides. Partial acetolysis of the galactoglucomannan from C. substellata gave rise to oligosaccharides and three were identified, namely alpha-D-Manp-(1-->3)-alpha beta-D-Galp, alpha-D-Manp-(1-->2)-alpha beta-D-Manp and alpha-D-Manp-(1-->2)-[beta-D-Glcp-(1-->4)]-alpha beta-D-Manp, whereas only the latter two were obtained from that of C ibitipocae. Methylation and Smith degradation data confirmed these results. Whereas the mannobiose represents a common structure in lichen heteropolysaccharides, it is the first time that the other oligosaccharides have been isolated from those of lichens.

Theories and techniques for promoting physical activity behaviours.

The primary goal of this article is to review theoretical models utilised in designing physical activity interventions for healthy adults. Physical activity offers numerous benefits for improved physical and psychological health. However, the majority of the population is sedentary and therefore at increased risk for morbidity and mortality. Many techniques have been developed for intervening with physical activity behaviours, some of which are based on theoretical models. While some of these models show more promise than others, no model is sufficient to thoroughly explain exercise behaviours or how to best intervene. In the final section, recommendations for future research are presented, and promising areas of development in physical activity interventions are discussed. This is not an exhaustive review of theoretical models but rather focuses on models most commonly applied to physical activity.

Stress, coping, and well-being among third-year medical students.

BACKGROUND: Medical school is recognized as a stressful environment that often exerts a negative effect on the academic performance, physical health, and psychological well-being of the student. METHOD: Stress, coping, depression, and somatic distress were examined among 69 third-year students completing a psychiatry clerkship in 1992-93 at the University of Mississippi School of Medicine. Stress was assessed using the Medical Education Hassles Scale-R. Coping was assessed using the Coping Strategies Inventory. Depression was assessed using the Center for Epidemiologic Studies-Depression Scale, and somatic distress was assessed using the Wahler Physical Symptoms Inventory. Statistical methods included correlational analysis and hierarchical regression. RESULTS: Clinical levels of depression were found in 16 (23%) of the students, and 39 (57%) endorsed high levels of somatic distress. Stress accounted for a large percentage of the distress variance (i.e., 29% to 50%). Coping efforts contributed significant variance to the prediction of distress above and beyond that accounted for by stress alone, especially in relation to depression. Coping efforts classified by Engagement strategies were associated with fever depressive symptoms, while coping efforts classified by Disengagement strategies were associated with higher levels of depressive symptoms. CONCLUSIONS: Because students who employed coping efforts characterized by Engagement strategies suffered from fewer depressive symptoms, the results suggest that training in these types of strategies may be a useful intervention to lessen the negative consequences of stress among medical students.

Longitudinal shifts in employees' stages and processes of exercise behavior change.

PURPOSE: This study examines the usefulness of using the stages and processes of change model to explore exercise adoption and maintenance over time. DESIGN: Data for this study were collected as part of the baseline and follow-up survey of participants in a worksite health promotion project. SUBJECTS: Three hundred fourteen employees completed exercise questionnaires. The average age was 41 years, mean body mass index was 26, average years of education were 13, and 66% were women. SETTING: The study was conducted in two worksites, a retail outlet and a manufacturing company. MEASURES: Previously validated questionnaires to determine stages and processes of exercise adoption were administered at baseline and 6-month follow-up, along with questions about demographic variables. RESULTS: Four patterns of stage change emerged: subjects who became more active (adopters, 26%), those who became less active (relapsers, 15%), and those who did not change over time (stable sedentary, 32%; stable active, 27%). Adopters displayed increases in use of the processes of change, whereas relapsers displayed decreases in process use. Stable profiles were associated with no change in process use. CONCLUSIONS: These findings have important implications for research on exercise adoption and maintenance. Interventions tailored specifically to subjects' stage of readiness to be active and using specific processes to help in the change process are warranted at this time.

Application of theoretical models to exercise behavior among employed women.

PURPOSE: This study examines the utility of three theoretical models--the stages of change model, self-efficacy theory, and the decisional balance model--in understanding exercise behavior among employed women. DESIGN: Data for this cross-sectional study were collected as part of a routine follow-up of a worksite-based smoking and health risk appraisal study. SETTING: The study was conducted in three Rhode Island worksites, including one manufacturing company, one medical center, and one retail outlet. SUBJECTS: Of a sample of 431 women who completed exercise questionnaires, 293 reported participation in a physical activity over the previous week. The average age of the sample was 41.1 years, and mean years of education was 12.8. MEASURES: Previously validated measures to determine stage of exercise behavior, exercise self-efficacy, exercise decisional balance, and physical activity participation were administered. Additional demographic information was also obtained. RESULTS: Frequency counts revealed that 39% of the population was sedentary, 34% were participating in irregular activity, and 27% were active. MANOVAs followed by one way ANOVAs revealed that women in Precontemplation scored the lowest and those in Maintenance scored the highest on the self-efficacy, pro, and decisional-balance indices, with the trend reversed on the con scale. A chi-square test revealed that women with one or more young children in the home were more likely to be in a lower stage of exercise adoption. CONCLUSIONS: Most of the women in this cross-sectional study did not engage in regular activity. Presence of young children in the home was significantly related to decreased activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Randomized trial of a "talking computer" to improve adults' eating habits.

PURPOSE: To assess efficacy of an intervention delivered by an interactive, computer-controlled telephone system to improve individuals' diets. DESIGN: Randomized controlled trial. SETTING: Large multispecialty group practice. SUBJECTS: Two hundred ninety-eight adults who were both sedentary and had suboptimal diet quality. INTERVENTION: Weekly communication for 6 months via a totally automated, computer-based voice system. Among intervention group subjects, the system monitored dietary habits and provided educational feedback, advice, and behavioral counseling. Control group subjects received physical activity promotion counseling. MEASURES: Daily intake of fruits, vegetables, red and processed meats, whole fat dairy foods, and whole grain foods estimated from a food frequency questionnaire. RESULTS: Mean age 45.9 years, 72% women, 45% white, and 45% African-American. Among participants who completed diet assessments, compared with the control group, the intervention raised fruit intake a mean of 1.1 servings per day (95% confidence interval [CI] .4, 1.7). On a 0 to 100 global diet quality score combining all five food groups, intervention participants improved their mean score 9 (95% CI 4, 13) points more than in the control group. The intervention also raised dietary fiber intake 4.0 g/d (95% CI .1, 7.8) and decreased saturated fat, as a proportion of energy intake, by 1.7% (95% CI -2.7, -.7). CONCLUSIONS: This computer-based telecommunications dietary behavior intervention helped improve participants' overall diet.

Synthesis of a thio analogue of n-propyl kojibioside, a potential glucosidase inhibitor.

The disaccharide alpha-D-Glc p-(1-S-2)-beta-D-Glc p-(1-OPr) 1, a thio analogue of alpha-D-Glc p-(1 --> 2)-alpha-D-Glc p-(1-OPr)(n-propyl kojibioside) in which the inter-glycosidic oxygen atom is replaced by sulfur, has been synthesized for evaluation as a potential glucosidase inhibitor. Glycosylation of the 2-thiol glucopyranosyl acceptor 4 with the trichloroacetimidate of 2,3,4,6-tetra-O-benzyl-alpha-D-glucopyranose 5 gave the alpha-linked disaccharide 6 stereoselectively. Deprotection was performed by hydrogenolysis in the presence of Pd/C to give 1 as the beta-n-propyl glycoside. Glycosylation of the thiol 4 with the trichloroacetimidate of 2,3,4,6-tetra-O-acetyl-alpha-D-glucopyranose 8 gave a 1:2.3 mixture if the alpha and beta disaccharides (9 and 10); evidence is presented for the occurrence of the orthoester 11, as an intermediate in the formation of the beta-disaccharide.

Conformational analysis of oligosaccharides corresponding to the cell-wall polysaccharide of the Streptococcus group A by Metropolis Monte Carlo simulations.

Metropolis Monte Carlo simulations have been performed on four substructures from the cell-wall polysaccharide antigen of Streptococcus group A to explore the conformational behaviour of these compounds. The compounds examined are the trisaccharide, propyl 3-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)-2-O-(alpha-L-rhamnopyranosyl)- alpha-L-rhamnopyranoside, 1, the tetrasaccharide, propyl 3-O-(3-O-(2-acetamido-2-deoxy-beta-D- glucopyranosyl)-2-O-(alpha-L-rhamnopyranosyl)-alpha-L-rhamnopyranosyl)-alpha-L- rhamnopyranoside, 2, the hexasaccharide, propyl 3-O-(2-O-(3-O-(3-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)-alpha-L- rhamnopyranosyl)-alpha-L-rhamnopyranosyl)-3-O-(2-acetamido-2-deoxy-beta-D- glucopyranosyl)-alpha-L-rhamnopyranosyl)-alpha-L-rhamnopyranoside, 3, and the hexasaccharide, propyl 3-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)-2-O-(3-O-(3-O-(2-acetamido-2- deoxy-beta-D-glucopyranosyl)-2-O-(alpha-L-rhamnopyranosyl)-alpha-L- rhamnopyranosyl)-alpha-L-rhamnopyranosyl)-alpha-L-rhamnopyranoside, 4. In general, the conformational flexibility of similar glycosidic linkages in different compounds is comparable. However, in a few cases, small differences in the conformations available to these linkages in different structural environments could be detected. Interestingly, a second conformation found for the beta-D-GlcNAc-(1-->3)-alpha-L-Rha linkage in three of the compounds was not populated in the hexasaccharide 4. Furthermore, a conformational locale of the alpha-L-Rha-(1-->3)-alpha-L-Rha linkage found to be populated in the trisaccharide 1, tetrasaccharide 2, and hexasaccharide 4 is negligibly populated in the hexasaccharide 3. Ensemble averaged proton-proton distances compare favourably with experimental average distances obtained from NMR spectroscopy. The trisaccharide branch point in the hexasaccharides is shown to be a highly defined conformational feature. The same unit has been found to be one of the crucial elements recognized by anti-Group A Streptococcus antibodies, a result that has implications for the design of improved immunodiagnostics and vaccines.

Use of a phenyl 1-selenogalactofuranoside as a glycosyl donor for the synthesis of galactofuranosyl-containing disaccharides.

The use of acetylated phenyl 1-seleno-beta-D-galactofuranoside as a glycosyl donor for the synthesis of protected D-Galf-beta-(1-->3)-alpha-D-Manp as its methyl or ethylthio glycoside has been demonstrated. Activation of the selenoglycoside over a thioglycoside acceptor by NIS/TfOH is extremely selective and gives the ethylthio disaccharide in 91% yield. The parent disaccharide is found as a terminal and branched unit in the lipopeptidophosphoglycan oligosaccharides of the protozoan Trypanosoma cruzi, the causative agent of Chagas' disease.

Use of a phenyl 1-selenogalactofuranoside as a glycosyl donor for the synthesis of galactofuranosyl-containing disaccharides.

The use of acetylated phenyl 1-seleno-beta-D-galactofuranoside as a glycosyl donor for the synthesis of protected D-Galf-beta-(1-->3)-alpha-D-Manp as its methyl or ethylthio glycoside has been demonstrated. Activation of the selenoglycoside over a thioglycoside acceptor by NIS/TfOH is extremely selective and gives the ethylthio disaccharide in 91% yield. The parent disaccharide is found as a terminal and branched unit in the lipopeptidophosphoglycan oligosaccharides of the protozoan Trypanosoma cruzi, the causative agent of Chagas' disease.