Comparing thin slices of verbal communication behavior of varying number and duration.

OBJECTIVE: The aim of this study was to assess the accuracy of thin slices to characterize the verbal communication behavior of counselors and patients engaged in Motivational Interviewing sessions relative to fully coded sessions. METHODS: Four thin slice samples that varied in number (four versus six slices) and duration (one- versus two-minutes) were extracted from a previously coded dataset. In the parent study, an observational code scheme was used to characterize specific counselor and patient verbal communication behaviors. For the current study, we compared the frequency of communication codes and the correlations among the full dataset and each thin slice sample. RESULTS: Both the proportion of communication codes and strength of the correlation demonstrated the highest degree of accuracy when a greater number (i.e., six versus four) and duration (i.e., two- versus one-minute) of slices were extracted. CONCLUSION: These results suggest that thin slice sampling may be a useful and accurate strategy to reduce coding burden when coding specific verbal communication behaviors within clinical encounters. PRACTICE IMPLICATIONS: We suggest researchers interested in using thin slice sampling in their own work conduct preliminary research to determine the number and duration of thin slices required to accurately characterize the behaviors of interest.

Cardiovascular disease risk factors are elevated in urban minority children enrolled in head start.

BACKGROUND: The prevalence of obesity and overweight persists in the preschool population, despite some prevention and treatment advances, particularly in minorities. Investigating the prevalence of dyslipidemia and the effect of family health may also guide the focus of intervention efforts. METHODS: Anthropometric data were collected from urban minority preschool children (n=161; 42% female) enrolled in USDA Head Start. Blood was collected by finger prick and analyzed with the Cholestech LDX Analyzer (Cholestech Corporation, Hayward, CA). Caregivers provided a self-reported family health history for cardiovascular diseases (CVDs). RESULTS: By BMI percentile, 8% of the children were underweight (UW), 54% healthy weight (HW), 10% overweight (OW), and 28% obese (OB). One of every 5 children had borderline or high-risk levels for total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides based on the National Cholesterol Education Program categories. In OW/OB children only, BMI was positively correlated with TC (r(61)=0.428; p=0.001) and LDL (r(58)=0.395; p=0.005). Child BMI was also associated with family comorbid diseases (r(159)=0.177; p=0.025). UW/HW children with a family history of CVD had significantly higher LDL than UW/HW children without a family history of CVD (p=0.001). Step-wise regression analysis revealed that BMI (p=0.005) plus family history of heart attack (p=0.018) were significant predictors of blood TC levels. CONCLUSION: Continued efforts to treat and prevent elevated weight are urgently needed for minority preschoolers. Attention to CVD screening may be an important target in school, community, and healthcare arenas for minority populations regardless of weight status.

Provider communication behaviors that predict motivation to change in black adolescents with obesity.

OBJECTIVE: The goal of this research was to identify communication behaviors used by weight loss counselors that mostly strongly predicted black adolescents' motivational statements. Three types of motivational statements were of interest: change talk (CT; statements describing their own desires, abilities, reasons, and need for adhering to weight loss recommendations), commitment language (CML; statements about their intentions or plans for adhering), and counterchange talk (CCT; amotivational statements against change and commitment). METHODS: Thirty-seven black adolescents with obesity received a single motivational interviewing session targeting weight-related behaviors. The video-recorded transcribed sessions were coded using the Minority Youth Sequential Coding for Observing Process Exchanges generating a sequential chain of communication. Data were then subjected to sequential analysis to determine causal relationships between counselor and adolescent communication. RESULTS: Asking open-ended questions to elicit adolescent CT and emphasizing adolescents' autonomy most often led to CT. Open-ended questions to elicit CML, reflecting adolescent CML, and emphasizing autonomy most often led to CML. In contrast, open-ended questions to elicit CCT, reflecting CCT, reflecting ambivalence, and neutral open-ended questions about the target behavior led to CCT. CONCLUSIONS: This study provides clinicians with insight into the most effective way to communicate with black adolescents with obesity about weight loss. Specifically, reflective statements and open questions focusing on their own desires, abilities, reasons, need, and commitment to weight loss recommendations are more likely to increase motivational statements, whereas other types of reflections and questions may be counterproductive. Finally, because adolescents have a strong need for autonomous decision making, emphasizing their autonomy may be particularly effective in evoking motivational statements.

African American preschool children's physical activity levels in Head Start.

The purpose of this study was to describe the physical activity levels of urban inner city preschoolers while attending Head Start, the federally funded preschool program for children from low-income families. Participants were 158 African American children. Their physical activity during Head Start days was measured using programmed RT-3 accelerometers. Results revealed that the children spent the most time in sedentary and light physical activity, while their participation in moderate-to-vigorous physical activities was low. Given the sedentary class format and limited physical space for the Head Start programs observed, we suggest adding a structured physical activity component to Head Start schools to fight the overweight and obesity crisis.

Factors associated with weight resilience in obesogenic environments in female African-American adolescents.

This study used a descriptive, cross-sectional analysis to examine a social ecological model of obesity among African-American female adolescents residing in obesogenic environments. The goal was to identify factors that promote weight resilience, defined as maintaining a healthy body weight despite living in an environment that encourages inactivity and undermines healthy weight behaviors. During 2005 to 2008, weight-resilient (n=32) and obese (n=35) African-American female adolescents (12 to 17 years) living in Detroit, MI, and their caregivers completed measures of individual, family, and extrafamilial weight-resilience factors. Variables related to weight resilience in bivariate analyses were subjected to multivariate analysis using logistic regression to test the hypothesis that these factors independently predicted adolescent membership into the weight-resilient or obese group. As hypothesized, the odds of an adolescent being weight resilient were predicted by lower caregiver body mass index (calculated as kg/m(2)) (odds ratio [OR]=0.790; 95% confidence interval [CI]: 0.642 to 0.973), lower caregiver distress (OR=0.796; 95% CI: 0.635 to 0.998), higher caregiver monitoring and supervision of exercise (OR=5.746; 95% CI: 1.435 to 23.004), more frequent full-service grocery store shopping (OR=5.147; 95% CI: 1.137 to 23.298), and more peer support for eating (OR=0.656; 95% CI: 0.445 to 0.969). Contrary to prediction, lower eating self-efficacy (OR=0.597; 95% CI: 0.369 to 0.965) also predicted weight resilience. The model correctly classified 92.5% of all cases. Findings suggest that increasing psychosocial weight-resilience factors across multiple systems might be an important intervention strategy for obese African-American female adolescents residing in obesogenic environments.

A pilot study of motivational interviewing targeting weight-related behaviors in overweight or obese African American adolescents.

PURPOSE: To pilot motivational interviewing (MI) targeting weight-related behaviors in African American adolescents with body mass index ≥85th percentile. METHODS: A total of 44 adolescents were randomly assigned to MI or nutrition counseling with baseline and 3-month assessment. RESULTS: MI group reported improved eating behaviors and activity motivation. CONCLUSION: Brief clinic-based MI interventions merit further study in this population.

Developmental trajectories of overweight and obesity of US youth through the life course of adolescence to young adulthood.

OBJECTIVE: To detect subgroups with different risks at different ages to develop overweight and obese during the adolescence-young adulthood period. DESIGN: Accelerated longitudinal design and developmental trajectory analysis were used. The likelihoods to become overweight (body mass index [BMI] >25 kg/m(2)) and obese (BMI >30 kg/m(2)) were assessed across the life course from the ages of 12 to 28 years. SUBJECTS: Adolescent participants aged 12-17 years (n = 4119) identified in the National Longitudinal Survey of Youth 1997 at baseline were followed up to 2008. RESULTS: SEVEN OVERWEIGHT RISK GROUPS (WG) WERE DETECTED FOR MALE AND FEMALE SAMPLES RESPECTIVELY, OF WHICH FIVE WERE CLOSELY RELATED TO EACH OF THE FOLLOWING FIVE PERIODS: (a) middle-school ages (19.7% and 12.6% for male and female, respectively), (b) high-school ages (11.4% and 13.6%, respectively), (c) college ages (12.6% and 9.1%, respectively), (d) post-college ages (11.8% and 10.0%, respectively), and (e) work-family-formation ages (11.0% and 12.9%, respectively); two were nonperiod-specific groups: a permanent low-risk group for both sexes (27.3% for male, 36.4% for female), a growing-risk group for males (6.2%), and a self-limiting risk group for females (5.4%, with the likelihood increasing with age, which peaked at the age of 21 years, and then declined). Likewise, six obesity risk groups (OG) were detected, of which four corresponded to the first four high-risk WG groups. The risk groups were relatively independent of race and educational attainment. CONCLUSIONS: Findings of this study imply that five risk groups for weight gain like five consecutive "tests" exist from middle-school period to work-and-family formation. Failure to pass any of these tests in the life course could lead to overweight or obese status. Further research needs to study life-course-specific factors and mechanisms for more effective weight control.

Dietary vitamin D intake among high-risk adolescents with insulin dependent diabetes.

PURPOSE: The purpose of the present study was to describe the dietary intake of vitamin D in an urban, low income, predominantly African American sample of adolescents with insulin dependent diabetes. METHODS: Participants were 99 adolescents diagnosed with insulin dependent diabetes. Vitamin D intake was estimated from dietary recall data. Blood glucose levels were also assessed. RESULTS: The average daily vitamin D intake estimated from dietary recall data was 102 IUs (SD = 64.4) with 70% of adolescents consuming less than 50 IUs of vitamin D in their day. Level of vitamin D intake was a significant predictor of HbA1c levels in the current sample. CONCLUSIONS: Results indicate a need for the assessment of vitamin D levels in this at-risk population, as supplementation may be indicated.

A randomized pilot study of multisystemic therapy targeting obesity in African-American adolescents.

Adolescents with obesity (N = 48) and their caregivers were randomized to Multisystemic Therapy (MST) or a group weight-loss intervention. MST adolescents significantly reduced percents overweight and body fat, while control adolescents did not. Treatments such as MST that can intervene in the multiple systems that influence weight are worthy of further study.

Poor nutrient intake and high obese rate in an urban African American population with hypertension.

OBJECTIVE: To describe the nutrient intake patterns and general health conditions in an African American (AA) hypertensive population living in Detroit, MI. METHODS: Demographic, anthropometric, general health condition and 3-day dietary recalls were collected from 387 AAs in community-based settings. Only data from 342 participants who met the inclusion criteria were reported. RESULTS: The obesity and type 2 diabetes prevalence in this minority population were significantly higher, and both energy and nutrient intakes were significantly lower than the RDAs or those reported in NHANES. Female participants reported their highest weight at an earlier age but their body weight reduced in the older group. No such trend was observed in male participants. Both males and females consumed significantly fewer servings of fruit, vegetable and grains as recommended by USDA. As household income increased, the consumption of fruits and vegetables were also increased. CONCLUSION: In order to reduce the incidence of obesity and hypertension in this minority population, dietary intervention should begin at adolescence or even earlier. DASH diet would be beneficial for this population.

The effects of a new soluble dietary fiber on weight gain and selected blood parameters in rats.

This study was designed to investigate a new dietary fiber, alpha-cyclodextrin, marketed under the trade name FBCx (Wacker Biochem, Adrian, MI), for beneficial effects on weight reduction and the improvement of certain blood parameters in rats. Male Wistar rats were divided into 4 groups and fed ad libitum for a period of 6 weeks: (1) a normal low-fat diet (LF; 4% fat wt/wt); (2) an LF diet with FBCx added; (3) a high-fat diet (HF, 40% fat wt/wt); and (4) an HF diet with FBCx. The FBCx was added at the rate of 10% (wt/wt) of the fat in the diet. Body weight and food intake were recorded 3 times per week. Plasma constituent levels and liver and fecal lipid contents, as well as body composition were determined at sacrifice. Adding FBCx to the diet significantly reduced weight gain in rats fed with an HF diet relative to rats fed with the HF control diet (P < .05). FBCx also elicited a reduction in plasma triglyceride levels of 30%, total cholesterol of 9%, and increased the fat content of the feces in the rats fed with the HF diet with FBCx. In addition, the serum leptin levels were normalized, and the calculated insulin sensitivity was improved. No adverse effects were observed in the rats consuming FBCx. It would appear that FBCx might be effective in reducing body weight gain and improving metabolic syndrome.

Optical fiber-based sensors: application to chemical biology.

Optical fibers have been used to develop sensors based on nucleic acids and cells. Sensors employing DNA probes have been developed for various genomics applications and microbial pathogen detection. Live cell-based sensors have enabled the monitoring of environmental toxins, and have been used for fundamental studies on populations of individual cells. Both single-core optical fiber sensors and optical fiber sensor arrays have been used for sensing based on nucleic acids and live cells.

Influence of antibody immobilization strategy on molecular recognition force microscopy measurements.

A systematic evaluation of the effects of antibody immobilization strategy on the binding efficiency and selectivity (e.g., ability to distinguish between specific and nonspecific interactions) of immunosurfaces prepared with F(ab') antibody fragments of rabbit Immunoglobulin G (IgG) is described. F(ab') was attached to gold surfaces either (1) directly via the formation of a gold-thiolate bond or (2) indirectly through a series of a bifunctional linkers containing an alkane chain or ethylene glycol spacer. Immobilization of F(ab') via the sulfhydryl reactive group located opposite the antigen binding site ensured optimum orientation of the antigen binding site. X-ray photoelectron spectroscopy (XPS) and surface plasmon resonance (SPR) were used to confirm surface modification with the bifunctional linkers and antibody immobilization, respectively. Binding efficiency assays performed with SPR indicated that increasing the length of the linker increased the antigen binding efficiency. Atomic force microscopy (AFM) adhesion force measurements indicated that AFM probes functionalized with directly immobilized F(ab') more effectively discriminated between specific and nonspecific surface-bound proteins than probes modified indirectly via linker-immobilized F(ab'). In addition, a greater number of antibody-antigen binding events were observed with directly immobilized F(ab')-functionalized probes.

Influence of surfactants and antibody immobilization strategy on reducing nonspecific protein interactions for molecular recognition force microscopy.

Specific and nonspecific interactions between antibody-modified probes and substrate-immobilized proteins were monitored by atomic force microscopy (AFM). Probes were modified with anti-ovalbumin IgG antibodies immobilized in either an oriented or a random manner. The oriented immobilization of whole IgG was accomplished through the use of Protein A, and random immobilization was carried out with glutaraldehyde. Nonspecific interactions may lead to false detection of antibody-antigen binding events even when the antigen binding sites are properly positioned by an oriented immobilization strategy. Thus, nonionic and zwitterionic surfactants, including Tween 20, Tween 80, Triton X-100, and CHAPS, were evaluated to determine if nonspecific binding events could be reduced without compromising the desired specific antibody-antigen binding. Enzyme-linked immunosorbent assay and surface plasmon resonance assays were also employed to study antibody-antigen binding as a function of immobilization strategy and surfactant concentration. The data from these studies indicate that Protein A can be used to immobilize whole IgG onto AFM probes for force measurement experiments and that a surfactant is useful for improving the selectivity for such measurements.