A case of genetic polyandry in the shortfin mako Isurus oxyrinchus.

This article documents a case of genetic polyandry in the oceanic and pelagic shortfin mako Isurus oxyrinchus and briefly comments on the implications of this finding.

Stress management intervention for primary prevention of hypertension: detailed results from Phase I of Trials of Hypertension Prevention (TOHP-I).

PURPOSE: Stress Management Intervention (SMI) was one of seven nonpharmacologic approaches evaluated in Phase I Trials of Hypertension Prevention (TOHP-I) for efficacy in lowering diastolic blood pressure (BP) in healthy men and women aged 30 to 54 years with diastolic BP 80-89 mm Hg. METHODS: A total of 242 and 320 participants were randomized to SMI or an "assessment only" SMI Control, respectively, at four clinical centers. The SMI consisted of 37 contact hours in 21 group and two individual meetings over 18 months and included: training in four relaxation methods, techniques to reduce stress reactions, cognitive approaches, communication skills, time management, and anger management within a general problem-solving format. Standardized protocols detailed methods and timing for collecting BP, psychosocial measures, and urinary samples from both SMI and SMI Control participants. RESULTS: In intention-to-treat analyses, although significant baseline to termination BP reductions were observed in both groups, net differences between the SMI and SMI Control groups' BP changes (mean (95% CI)) were not significant: -0.82 (-1.86, 0.22) for diastolic BP, and -0.47 (-1.96, 1.01) for systolic BP. Extensive adherence sub-group analyses found one effect: a significant 1.36 mm Hg (p = 0.01) reduction in diastolic BP relative to SMI Controls at the end of the trial for SMI participants who completed 61% or more of intervention sessions. CONCLUSIONS: While the TOHP-I SMI was acceptable to participants as evident from high levels of session completion, the absence of demonstrated BP lowering efficacy in intention-to-treat analyses suggests that the TOHP-I SMI is an unlikely candidate for primary prevention of hypertension in a general population sample similar to study participants. The isolated finding of significant diastolic BP lowering in SMI participants with higher adherence provides very weak evidence of SMI BP lowering efficacy and may be a chance finding. Whether similar or other stress management interventions can produce significant BP lowering in populations selected for higher levels of BP, stress, or intervention adherence remains to be demonstrated.

Participants' evaluation of a weight-loss program.

OBJECTIVE: The purpose of this study was to evaluate participants' perceptions of the weight-loss intervention used in a hypertension prevention clinical trial. DESIGN: A total of 308 overweight and moderately obese subjects participated in the weight-management intervention. After the 18-month program, 281 participants completed a questionnaire designed to evaluate their perceptions of the program's effectiveness. SUBJECTS/SETTING: Adult participants (224 men and 84 women) in the weight-loss modality of the Trials of Hypertension Prevention Phase I, surveyed in 1991. STATISTICAL ANALYSES PERFORMED: chi 2 Analyses were used to test for statistical significance of group differences. RESULTS: Intervention components that were most useful are presented. Older participants (older than 50 years) were most likely to attend sessions and women were most likely to identify stress and frustration because of disappointing results. Successful participants were more likely to incorporate exercise into their daily activities, exercise regularly, and use self-monitoring strategies. Few participants found group exercise to be useful. CONCLUSION: These findings suggest that interventionists in weight-loss programs need to find flexible and creative ways to maintain contact with participants, continue to develop better methods of self-monitoring, obtain the skills needed to recognize frustration and provide timely support, continue to couple the message of diet and exercise, and emphasize helping participants develop their problem-solving skills. This may require training outside the traditional field of dietetics.

Psychologic profiles as predictors of success in a cardiovascular risk factors life-style intervention program.

The risk for cardiovascular events can be reduced by modifications in life-style. However, only a small percentage of subjects are able to adopt such changes. We determined whether psychologic profiles measured on entry into a life-style intervention program correlated with objective measurements of success after 1 year of enrollment. When compared with patients who had dropped out, patients still enrolled in the program after 1 year differed statistically on scales 1 and 6 of the Minnesota Multiphasic Personality Inventory, showing a lower level of paranoia and more concern about health issues. Among patients remaining in the program, psychologic profiles differed between those who met an objective measure of success (responders) and those who did not. In addition, profiles differed among responders as a function of the aspect of life-style that they successfully changed. These findings suggest that psychologic profiles can be used to identify which life-style changes an individual can easily adopt.

Energy regulation over the menstrual cycle.

To investigate the influence of ovarian hormones on energy regulation, twenty-six normal weight, noneating disordered women recorded their food consumption, exercise, and eating patterns over one menstrual cycle. Serum levels of ovarian hormones were measured to determine three menstrual cycle phases, namely perimenstrual, follicular/ovulatory, and luteal. Energy intake increased 685.9 kJ/day (p < 0.05) from the follicular/ovulatory to the luteal phase. The percent of energy intake as protein and carbohydrate was relatively constant over the three menstrual cycle phases, but the intake from fat increased 2% (p < 0.05) during the luteal phase, representing a 9.2 g/day increment. Variations in energy and fat intake over the menstrual cycle were not attributable to differences in energy expenditure through exercise or dietary restraint, and appear to be related to changes in the estrogen/progesterone ratio.

Outcome of psychoeducation for HIV risk reduction.

Our objectives were to assess the effects of a psychoeducational (PE) program designed to reduce HIV risk behaviors in recovering drug abusers and to evaluate mediating variables associated with risk reduction as described by the AIDS Risk Reduction Model (ARRM). Consecutive admissions to a Department of Veterans Affairs drug dependence inpatient treatment program (n = 152) were randomly assigned to PE or a standard information (INFO) condition. PE involved a 6-hour small group intervention designed to enhance knowledge and attitudes regarding HIV prevention, improve skills in condom use and needle sterilization, and modify high-risk sex- and drug-related behaviors. The INFO condition involved presentation of audiovisual and printed HIV prevention material with similar content. Following intervention, PE subjects showed significantly enhanced self-efficacy, condom use skills, and sexual communication skills relative to the INFO group. At 3-month follow-up, the PE group showed significantly greater reductions on some measures of sexual HIV risk behaviors relative to the INFO group. Hypotheses derived from the ARRM regarding presumed relationships between positive changes in mediating variables (e.g., self-efficacy and sexual communication) and ultimate outcome variables (e.g., condom use) were supported.

PIP: The objectives were to assess the effects of a psychoeducational (PE) program designed to reduce HIV risk behaviors in recovering drug abusers and to evaluate mediating variables associated with risk reduction as described by the AIDS Risk Reduction Model (ARRM). African-American male participants with no evidence of HIV seropositivity were recruited over a 10-month period from among 235 consecutive admissions to the Department of Veteran's Affair Drug Dependence Treatment Program (DDTP). 176 subjects fulfilled eligibility criteria. 152 consecutive admissions to DDTP were randomly assigned to either or standard information (INFO) groups of equal size. PE involved a 6-hour small group intervention to enhance knowledge regarding HIV prevention, improve condom use and needle sterilization skills, and modify high-risk sex- and drug-related behaviors. The INFO condition involved presentation of HIV prevention materials with similar content. Subjects were an average of 35.5 years old with 13.06 years old with 13.06 years of education, and an estimated IQ of 105.4 Overall, subjects reported a significant reduction in high-risk behaviors at 3 months compared to preintervention levels (p .0001). 75% of the subjects in the PE group reported higher sexual risk behaviors before the intervention vs. 32% at 3 months (p .0001). Also, 75% of INFO subjects were at higher risk pretreatment, which decreased to 48% at 3 months (p .01). There was a trend toward greater risk reduction in the PE group. 25 (62.5%) of the 40 PE subjects at higher risk prior to the intervention were at lower risk at the 3-month follow-up. In the INFO group, 51.2% of the preintervention higher risk subjects were at lower risk 3 months postintervention. Among the 107 subjects completing the 3-month follow-up, significantly fewer reported more than one partner, from 75.5% preintervention to 50.5% at 3 months (p = .0001). 75.5% of PE subjects reported more than one sexual partner preintervention vs. 47.5% at 3 months (binomial p = .0001). In the INFO group, this declined from 75.9% to 59.3%, which was without statistical significance.

Weight loss intervention in phase 1 of the Trials of Hypertension Prevention. The TOHP Collaborative Research Group.

BACKGROUND: Phase 1 of the Trials of Hypertension Prevention was a collaborative, randomized controlled clinical trial designed to determine the feasibility and efficacy of selected nonpharmacologic interventions in reducing or preventing an increase in diastolic blood pressure. METHODS: Participants aged 30 to 54 years who had a high-normal diastolic blood pressure (80 to 89 mm Hg), and were between 115% and 165% of their desirable body weight, were randomly assigned to either an 18-month weight loss intervention (n = 308) or a usual-care control condition (N = 256). Intervention consisted of 14 weekly group meetings followed by monthly maintenance sessions. Intervention participants received training in behavioral self-management technique and were asked to make life-style changes aimed at achieving a moderate reduction in energy intake and an increase in physical activity. RESULTS: The average weight losses in the intervention group at 6, 12, and 18 months of follow-up were 6.5, 5.6, and 4.7 kg for men and 3.7, 2.7, and 1.6 kg for women. The mean (+/- SE) change in diastolic blood pressure for intervention participants compared with controls at termination was -2.8 +/- 0.6 mm Hg for men and -1.1 +/- 0.9 mm Hg for women. For systolic blood pressure, the corresponding change was -3.1 +/- 0.7 mm Hg for men and -2.0 +/- 1.3 mm Hg for women. Blood pressure reductions were greater for those who lost larger amounts of weight. Sex-related differences in blood pressure response were largely due to the smaller amount of weight lost by women, and sex differences in weight loss could be accounted for by differences in baseline body weight. CONCLUSIONS: During an 18-month follow-up period, this weight reduction program was shown to be an effective nonpharmacologic intervention for reducing blood pressure in overweight adults with high-normal blood pressure.

Psychosocial factors associated with condom use among African-American drug abusers in treatment.

Although strategies for decreasing injection drug use have met with moderate success, efforts to decrease high-risk sexual behaviors have been less successful. Because condom use reduces HIV transmission, it is critically important to identify the attitudinal, emotional, and behavioral factors associated with using condoms. This study evaluated the relationship between condom use and various psychological and behavioral variables among heterosexual, African-American, cocaine-dependent men within the context of the AIDS Risk Reduction Model (ARRM). Subjects who used condoms (n = 52) reported significantly higher levels of self-efficacy, condom use skills, and sexual communication with partners than non-users (n = 84). However, the groups did not differ in perceived susceptibility, anxiety concerning HIV transmission, response efficacy, or knowledge regarding HIV. These findings suggest that future interventions focus on enhancing self-efficacy and condom use skills, as well as eroticizing condom use.

PIP: While strategies to decrease the prevalence and frequency of injection drug use have proved to be moderately successful, only minimal success has been achieved in getting IV drug users to reduce the amount of high-risk sex they have. It is common among heavy drug users, however, to be promiscuous and exchange sex for drugs and money. Injecting drug users rarely use condoms to reduce their risk of HIV transmission, even though it has been found that more than 70% of AIDS cases among heterosexuals may be attributed to sexual contact with drug users. Since consistent condom use can reduce the risk of HIV transmission, it is extremely important to identify the attitudinal, emotional, and behavioral factors associated with their use. This study was therefore conducted to evaluate the relationship between condom use and various psychological and behavioral variables among heterosexual, African-American, cocaine-dependent men within the context of the AIDS Risk Reduction Model. 136 subjects of mean age 35.5 years and an average education of 13.1 years were studied. 112 subjects smoked cocaine and 24 injected it. The 52 subjects who used condoms reported significantly higher levels of self-efficacy, condom use skills, and sexual communication with partners than the 84 non-users. The groups did not, however, differ in perceived susceptibility, anxiety concerning HIV transmission, response efficacy, or knowledge regarding HIV. Study findings suggest that future interventions focus on enhancing self-efficacy and condom use skills, as well as eroticizing condom use.

Cocaine and speedball users: differences in psychopathology.

Affective distress and related symptoms associated with co-injected cocaine and opioid ("speedball") use are incompletely explored, and the extent to which they diverge from problems shown by cocaine abusers who do not prefer opioids is unknown. This investigation compared groups of speedball and non-speedball cocaine users on global measures of depression and anxiety and modal groupings of personality characteristics measured by the MMPI. Compared to men who use cocaine without opioids, compulsive speedball users evidenced significantly greater problems with depression, trait anxiety, and related symptomatology, and were more uniformly characterized by modal profiles reflecting severe psychopathology and maladjustment. These results agree with descriptions of severe pathology associated with speedball use.

Demographic, knowledge, physiological, and behavioral variables as predictors of compliance with dietary treatment goals in hypertension.

The Hypertension Prevention Trial (HPT) was a multicenter, randomized trial testing calorie control, sodium restriction, and potassium increases in the prevention of hypertension in 841 men and women. Thirty four variables that were potentially related to changes in urine sodium, urine potassium, and weight were examined individually and together across 3 years of treatment and maintenance sessions. Univariate and multivariate analysis did not reveal a consistent pattern of variables associated with successful attainment of treatment goals or failure to do so. Baseline levels of urine sodium, urine potassium, and weight were the variables most consistently associated with compliance. Household composition, such as number of people living in the house or marital status and control over selection and preparation of foods, was associated with compliance in sodium reduction treatments. Number of complaints about the diets were positively associated with noncompliance. Attendance at treatment sessions was generally associated with compliance especially for weight loss. Practical implications of these results are discussed.

Weight reduction in the prevention and treatment of hypertension: a review of representative clinical trials.

Elevated blood pressure is a risk factor for cardiovascular disease, and weight reduction is currently advocated as a nonpharmacologic approach for the management of hypertension. Results of clinical trials indicate weight reduction is effective in preventing and treating hypertension. Knowledge of the results of clinical trials is extremely important for health educators since: 1) these findings provide a scientific basis for educating other health professionals about the beneficial effects of dietary approaches to the management of hypertension; 2) discussion of these results with patients may provide a means for altering patients' expectations and achieving improved treatment compliance; and 3) the processes by which clinical trials have achieved their dietary goals can provide health educators with extensive clinical experience upon which to draw in working with nonstudy patients. The content and general results of clinical trial programs are reviewed as well as features associated with health promotion in clinical trial and behavioral weight loss research.

Conditioning arbitrary stimuli to cigarette smoke intake: a preliminary study.

This study represents an attempt to classically condition arbitrary stimuli to cigarette smoke intake. A smoker either smoked or mock-smoked a cigarette in two discriminative contexts for 20 sessions. The contingencies were reversed during an additional last two sessions. Measures of heart rate, skin temperature, and puff duration were monitored during all sessions. Results suggested that both manipulations of smoke delivery and context cues were related to puff duration. The pattern of psychophysiological reactivity was mixed and not easily interpreted. This experimental paradigm may be useful in the investigation of conditioning factors underlying addictive behaviors.

Dietary restraint and eating behavior in the natural environment.

The influence of caloric labeling on meal selection with subjects differing in dietary restraint was investigated in a cafeteria restaurant. The three lowest calorie food selections within three food categories (i.e., salads, vegetables, entrees) were identified by labels. Within a multiple-baseline design, each food category was labeled for three evenings in a randomly determined order. Three hundred thirty-six male and female customers completed the Restraint Scale and were categorized as overweight or normal weight. Females and customers with high restraint scores chose and estimated that they chose lower calorie foods with neither effect for labeling nor a labeling-by-restraint interaction evident. Customers high in restraint also underestimated the caloric values of their selections.

Perceived barriers to exercise and weight control practices in community women.

A sample of community women was surveyed to determine exercise habits, weight control methods, and perceived barriers to sustaining and initiating exercise and weight management programs. Lack of time was reported to be the most significant factor limiting exercise, while lack of willpower and time constraints were the most frequently reported obstacles to weight management. Suggestions to aid adherence to exercise and weight control programs among women are outlined.

Prevalence of bulimia among patients in a chemical dependency treatment program.

The present study sought to determine the prevalence of bulimia in a chemically dependent population and to examine the patterns of psychopathology and eating attitudes among chemically dependent patients. Seventy-six male and 62 female consecutive admissions to an impatient treatment facility for chemical dependency were administered the BULIT. Restraint Scale, MMPI and the Marlowe-Crowne Social Desirability Scale. There was no evidence for an increased prevalence of bulimia in this sample. Five of the women (8%) achieved a cutoff score on the BULIT indicative of bulimia. The similarity between mean MMPI profiles of female patients in this sample and those previously obtained for bulimic patients was greater than the similarity between MMPI profiles for the male and female chemically dependent patients in this sample. Findings are discussed within the context of previous research.

A double-blind, randomized, sham-controlled trial of the gastric bubble for obesity.

We investigated the effect of an endoscopically placed gastric balloon, the Garren-Edwards gastric bubble (GEGB), on weight loss in obese patients. Fifty-nine obese patients were entered into a prospective double-blind study and randomized into two groups. In one group (34 patients) the GEGB was inserted, and in the other group (25 patients) a sham insertion was done. All patients participated in a standard weight loss program consisting of dietary therapy, behavior modification, and physical exercise. The bubble was removed endoscopically after 3 months from both groups. Patients were followed for an additional 9 months after bubble removal and weight loss was monitored. Weight loss was the same in both groups at 3 months (18.7 lb vs. 17.2 lb). This was true whether determined by change in pounds, percentage of body weight, or body mass index. We concluded that the GEGB was of no added benefit as compared with sham insertion, when combined with a standard weight loss program. Because of the lack of proven efficacy and the relatively high cost, we recommend that such devices be restricted to controlled studies until significant benefits are proven.

Influence of dietary soybean and egg lecithins on lipid responses in cholesterol-fed guinea pigs.

The comparative influence on plasma and tissue lipids of dietary soybean and egg lecithins, which have contrasting fatty acid compositions, was studied in the hypercholesterolemic guinea pig. The polyunsaturated to saturated fatty acid (P/S) ratios of the soybean and egg lecithins were 3.4 and 0.38, respectively. Hypercholesterolemia was induced by feeding guinea pigs a purified diet that contained 15% lard enriched with 0.5% cholesterol. Subsequently, guinea pigs were fed for six wk the same diet supplemented with either soybean or egg lecithin as 7.5% of the diet. A control group continued to be fed the lecithin-free diet. Parameters measured included body weight and relative liver weight; in plasma, total cholesterol, high density lipoprotein cholesterol (HDLC), phospholipid, and nonesterified cholesterol; in liver, total fat, cholesterol, and the specific activity of the catabolic enzyme cholesterol 7 alpha-hydroxylase; (EC 1.14.13.17); and in the aorta, cholesterol. Among the most noteworthy observations were the 49% decrease in total plasma cholesterol of the soybean lecithin group without decreasing HDLC and the 177% increase in HDLC of the egg lecithin group without a significant increase in total cholesterol compared with those values in the control group. These data suggest that dietary lecithin is particularly effective in increasing the HDLC/total cholesterol ratio in plasma. However, the absolute concentrations of those plasma lipids seem to depend upon the fatty acid composition of the lecithin.