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Health promotion in physician organizations: results from a national study.

BACKGROUND: Health promotion programs can be effective in improving the delivery of clinical preventive services and in improving population health; however, the availability of health promotion programs offered through physician organizations, such as medical groups and independent practice associations, are largely unknown. METHODS: This research uses data from the National Study of Physician Organizations and the Management of Chronic Illness, conducted by the University of California, Berkeley, to document the extent to which physician organizations offer health promotion programs. Of 1587 physician organizations nationally with 20 or more physicians, 1104 participated, for a response rate of 70%. RESULTS: Overall, 60% of physician organizations offer at least one health promotion program targeting one or more of eight areas: prenatal education (42%), smoking cessation (39%), nutrition (39%), weight loss (34%), health risk assessments (25%), stress management (25%), substance abuse (20%), and sexually transmitted disease prevention (16%). Factors positively associated with offering health promotion programs include the following: outside reporting of quality measures, public recognition for quality measures, clinical information technology systems, being a medical group, and ownership by a hospital or health plan. CONCLUSIONS: Physician organizations in the United States have a long way to go in offering these important programs to their patients. However, our findings also suggest that health plans, purchasers, and policymakers can play a positive role in increasing the use of these programs. By offering recognition and incentives for quality improvement, and by funding the expansion of information technology, the healthcare community can encourage and enable physician organizations to increase the availability of health promotion programs nationally.

Data Interpretation, Statistical↗

BNCT dose distribution in liver with epithermal D-D and D-T fusion-based neutron beams.

Recently, a new application of boron neutron capture therapy (BNCT) treatment has been introduced. Results have indicated that liver tumors can be treated by BNCT after removal of the liver from the body. At Lawrence Berkeley National Laboratory, compact neutron generators based on (2)H(d,n)(3)He (D-D) or (3)H(t,n)(4)He (D-T) fusion reactions are being developed. Preliminary simulations of the applicability of 2.45 MeV D-D fusion and 14.1 MeV D-T fusion neutrons for in vivo liver tumor BNCT, without removing the liver from the body, have been carried out. MCNP simulations were performed in order to find a moderator configuration for creating a neutron beam of optimal neutron energy and to create a source model for dose calculations with the simulation environment for radiotherapy applications (SERA) treatment planning program. SERA dose calculations were performed in a patient model based on CT scans of the body. The BNCT dose distribution in liver and surrounding healthy organs was calculated with rectangular beam aperture sizes of 20 cm x 20 cm and 25 cm x 25 cm. Collimator thicknesses of 10 and 15 cm were used. The beam strength to obtain a practical treatment time was studied. In this paper, the beam shaping assemblies for D-D and D-T neutron generators and dose calculation results are presented.

Boron Neutron Capture Therapy↗

D-D neutron generator development at LBNL.

The plasma and ion source technology group in Lawrence Berkeley National Laboratory is developing advanced, next generation D-D neutron generators. There are three distinctive developments, which are discussed in this presentation, namely, multi-stage, accelerator-based axial neutron generator, high-output co-axial neutron generator and point source neutron generator. These generators employ RF-induction discharge to produce deuterium ions. The distinctive feature of RF-discharge is its capability to generate high atomic hydrogen species, high current densities and stable and long-life operation. The axial neutron generator is designed for applications that require fast pulsing together with medium to high D-D neutron output. The co-axial neutron generator is aimed for high neutron output with cw or pulsed operation, using either the D-D or D-T fusion reaction. The point source neutron generator is a new concept, utilizing a toroidal-shaped plasma generator. The beam is extracted from multiple apertures and focus to the target tube, which is located at the middle of the generator. This will generate a point source of D-D, T-T or D-T neutrons with high output flux. The latest development together with measured data will be discussed in this article.

Journal Article↗

Functional explanation and the function of explanation.

Teleological explanations (TEs) account for the existence or properties of an entity in terms of a function: we have hearts because they pump blood, and telephones for communication. While many teleological explanations seem appropriate, others are clearly not warranted--for example, that rain exists for plants to grow. Five experiments explore the theoretical commitments that underlie teleological explanations. With the analysis of [Wright, L. (1976). Teleological Explanations. Berkeley, CA: University of California Press] from philosophy as a point of departure, we examine in Experiment 1 whether teleological explanations are interpreted causally, and confirm that TEs are only accepted when the function invoked in the explanation played a causal role in bringing about what is being explained. However, we also find that playing a causal role is not sufficient for all participants to accept TEs. Experiment 2 shows that this is not because participants fail to appreciate the causal structure of the scenarios used as stimuli. In Experiments 3-5 we show that the additional requirement for TE acceptance is that the process by which the function played a causal role must be general in the sense of conforming to a predictable pattern. These findings motivate a proposal, Explanation for Export, which suggests that a psychological function of explanation is to highlight information likely to subserve future prediction and intervention. We relate our proposal to normative accounts of explanation from philosophy of science, as well as to claims from psychology and artificial intelligence.

Adult↗

Studies on membrane permeability of zebrafish (Danio rerio) oocytes in the presence of different cryoprotectants.

Investigation into fish oocyte membrane permeability is essential for developing successful protocols for their cryopreservation. The aim of the present work was to study the permeability of the zebrafish (Danio rerio) oocyte membrane to water and cryoprotectants before cryopreservation protocol design. The study was conducted on stage III and stage V zebrafish oocytes. Volumetric changes of stage III oocytes in different concentrations of sucrose were measured after 20 min exposure at 22 degrees C and the osmotically inactive volume of the oocytes (Vb) was determined using the Boyle-van't Hoff relationship. Volumetric changes of oocytes during exposure to different cryoprotectant solutions were also measured. Oocytes were exposed to 2 M dimethyl sulphoxide (DMSO), propylene glycol (PG), and methanol for 40 min at 22 degrees C. Stage III oocytes were also exposed to 2 M DMSO at 0 degrees C. Oocyte images were captured on an Olympus BX51 cryomicroscope using Linkham software for image recording. Scion Image was used for image analysis and diameter measurement. The experimental data were fitted to a two-parameter model using Berkeley Madonna 8.0.1 software. Hydraulic conductivity (L(p)) and solute (cryoprotectant) permeability (Ps) were estimated using the model. The osmotically inactive volume of stage III zebrafish oocytes was found to be 69.5%. The mean values+/-SE of Lp were found to be 0.169+/-0.02 and 0.196+/-0.01 microm/min/atm in the presence of DMSO and PG, respectively, at 22 degrees C, assuming an internal isosmotic value for the oocyte of 272 mOsm. The Ps values were 0.000948+/-0.00015 and 0.000933+/-0.00005 cm/min for DMSO and PG, respectively. It was also shown that the membrane permeability of stage III oocytes decreased significantly with temperature. No significant changes in cell volume during methanol treatment were observed. Fish oocyte membrane permeability parameters are reported here for the first time. The Lp and Ps values obtained for stage III zebrafish oocytes are generally lower than those obtained from successfully cryopreserved mammalian oocytes and higher than those obtained with fish embryos and sea urchin eggs. It was not possible to estimate membrane permeability parameters for stage V oocytes using the methods employed in this study because stage V oocytes experienced the separation of outer oolemma membrane from inner vitelline during exposure to cryoprotectants.

Animals↗

Modeling transport and deposition of contaminants to ecosystems of concern: a case study for the Laurentian Great Lakes.

Transfer efficiency (TE) is introduced as a model output that can be used to characterize the relative ability of chemicals to be transported in the environment and deposited to specific target ecosystems. We illustrate this concept by applying the Berkeley-Trent North American contaminant fate model (BETR North America) to identify organic chemicals with properties that result in efficient atmospheric transport and deposition to the Laurentian Great Lakes. By systematically applying the model to hypothetical organic chemicals that span a wide range of environmental partitioning properties, we identify combinations of properties that favor efficient transport and deposition to the Lakes. Five classes of chemicals are identified based on dominant transport and deposition pathways, and specific examples of chemicals in each class are identified and discussed. The role of vegetation in scavenging chemicals from the atmosphere is assessed, and found to have a negligible influence on transfer efficiency to the Great Lakes. Results indicate chemicals with octanol-water (K(ow)) and air-water (K(aw)) partition coefficients in the range of 10(5)-10(7) and 10(-4)-10(-1) combine efficient transport and deposition to the Great Lakes with potential for biaccumulation in the aquatic food web once they are deposited. A method of estimating the time scale for atmospheric transport and deposition process is suggested, and the effects of degrading reactions in the atmosphere and meteorological conditions on transport efficiency of different classes of chemicals are discussed. In total, this approach provides a method of identifying chemicals that are subject to long-range transport and deposition to specific target ecosystems as a result of their partitioning and persistence characteristics. Supported by an appropriate contaminant fate model, the approach can be applied to any target ecosystem of concern.

Air Pollutants↗

BETR-World: a geographically explicit model of chemical fate: application to transport of alpha-HCH to the Arctic.

The Berkeley-Trent (BETR)-World model, a 25 compartment, geographically explicit fugacity-based model is described and applied to evaluate the transport of chemicals from temperate source regions to receptor regions (such as the Arctic). The model was parameterized using GIS and an array of digital data on weather, oceans, freshwater, vegetation and geo-political boundaries. This version of the BETR model framework includes modification of atmospheric degradation rates by seasonally variable hydroxyl radical concentrations and temperature. Degradation rates in all other compartments vary with seasonally changing temperature. Deposition to the deep ocean has been included as a loss mechanism. A case study was undertaken for alpha-HCH. Dynamic emission scenarios were estimated for each of the 25 regions. Predicted environmental concentrations showed good agreement with measured values for the northern regions in air, and fresh and oceanic water and with the results from a previous model of global chemical fate. Potential for long-range transport and deposition to the Arctic region was assessed using a Transfer Efficiency combined with estimated emissions. European regions and the Orient including China have a high potential to contribute alpha-HCH contamination in the Arctic due to high rates of emission in these regions despite low Transfer Efficiencies. Sensitivity analyses reveal that the performance and reliability of the model is strongly influenced by parameters controlling degradation rates.

Air Pollutants↗

The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients. DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas. MAIN OUTCOME MEASURES: Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc. STATISTICAL ANALYSES: Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables. RESULTS: Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI. CONCLUSIONS: Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.

Adolescent↗

Glare sensitivity and optical side effects 1 year after photorefractive keratectomy and laser in situ keratomileusis.

PURPOSE: To compare the outcome of low-contrast visual acuity and glare sensitivity after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). SETTING: Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland. METHODS: In this prospective study, patients selected PRK or LASIK after the advantages and disadvantages of both had been described. Snellen visual acuity and disability glare were measured with the Berkeley glare test preoperatively and 1 year postoperatively. At the 1-year follow-up, haze was graded and patients had to assess their quality of vision subjectively. RESULTS: One-year follow-up of 58 patients in the PRK group and 64 patients in the LASIK group was achieved. In both groups, the mean uncorrected visual acuity was 20/32 (P =.63) and the mean best corrected visual acuity, 20/20 with no statistically significant difference (P =.20). There were no preoperative or postoperative differences between the 2 groups in low-contrast visual acuity under 4 glare conditions. At 1 year, LASIK eyes had significantly lower postoperative haze scores than PRK eyes (P =.0013). The number of eyes with visually moderate and disturbing halos or disturbances in night vision did not differ considerably between the groups (P =.88). CONCLUSIONS: Efficacy outcomes were generally similar in the PRK and LASIK groups. Both achieved good objective and subjective results after treatment with a second-generation excimer laser.

Adult↗

Science, policy and the management of sewage materials. The New York City experience.

Development of national policy on sewage sludge management is a classic example of incremental policy formulation [Fiorino, D.J. 1995. Making Environmental Policy. University of California Press. Berkeley, CA. p. 269]. Consequently, policy has developed piecemeal, and results are, in some ways, different than intended. Land application of sewage sludge has not been a panacea. Many of the same types of policy are now being raised about it. We demonstrate this by examining the management of sewage materials by New York City from near the turn of the 20th century, when ocean dumping was viewed as a means to alleviate some of the gross pollution in New York Harbor, to when ocean dumping was banned, and thence to the present when sludge is applied to land as "biosolids." Lessons learned during this long, sometimes contentious history can be applied to present situations--specifically not understanding the long-term consequences of land-based reuse and disposal technologies.

Environment↗

Parsing the ageing Asian woman: symptom results from the China study of midlife women.

OBJECTIVES: It has become popular to assert that Asian women in general have low midlife rates of reporting a wide variety of symptoms and that these rates are much lower than those found among women in western countries. Comparable data from mainland China remains sparse, however. This study aimed to uncover the symptom reporting frequency for a general population sample of women in mainland China and to compare these results with rates from similar studies conducted in Japan and North America. METHODS: The author conducted a community-based survey of over 400 Chinese women aged 40-65 years living in a rural village and an urban neighborhood in northern China. The cross-cultural analysis was conducted on the 156 Chinese women within that sample who were between the ages of 45 and 55 years. Their rates of reporting 16 core symptoms in the previous 2 weeks were compared with those of women in the same age range in studies conducted in Japan [Lock M. Encounters with aging: mythologies of menopause in Japan and North America. Berkeley: University of California Press; 1993], Canada [Kaufert P, Lock M, McKinlay S, et al. Menopause research: the Korpilampi workshop. Soc Sci Med 1986;22(11):1285-9], and the U.S. [McKinlay SM, McKinlay JB. Research note: aging in a 'healthy' population. Soc Sci Med 1986;23(5):531-5]. RESULTS: The Chinese women had a low to moderate rate (below 50%) of reporting each of the 16 core symptoms. On most symptoms, the Chinese rates were higher than the Japanese and more similar to the North American. The only exceptions were hot flashes and headaches. CONCLUSIONS: Data from the China Study of Midlife Women showed that women's rates of midlife core symptom reporting in mainland China differ from the extremely low levels found in Japan. It is important to avoid generalizations about East Asian women relative to North American women in this regard.

Adult↗

What's in a name? The vervet predator calls and the limits of the Washburnian synthesis.

After the Second World War, a renaissance in field primatology took place in the United States under the aegis of the 'new physical anthropology'. Its leader, Sherwood Washburn, envisioned a science uniting studies of hominid fossils with Darwinian population genetics, experimental functional anatomy, and field observation of non-human primates and human hunter-gatherers. Thanks to Washburn's stimulus, his colleague at Berkeley, the bird ethologist Peter Marler, took up the study of the natural communicative behaviour of apes and monkeys. When Marler's first primatological student, Thomas Struhsaker, reported in the mid-1960s that the vervet monkeys of Amboseli, Kenya, give acoustically distinct alarm calls to different predators, and respond to alarm calls as if to the sight of those predators, a debate broke out over whether the vervet calls thus function as names, translating as 'leopard', 'eagle' and 'python'. Washburn and his students argued that no matter what the behavioural evidence, vervet calls could not be predator names, since monkeys had been shown to lack the neuroanatomical basis of naming. This controversy thus reveals, first, the persistence of older patterns of disciplinary allegiance within the new, synthetic physical anthropology; and second, the impotence of adaptationist Darwinism--common to both sides of the debate--as a force for unity.

Animal Communication↗

Molecular epidemiology biomarkers--sample collection and processing considerations.

Biomarker studies require processing and storage of numerous biological samples with the goals of obtaining a large amount of information and minimizing future research costs. An efficient study design includes provisions for processing of the original samples, such as cryopreservation, DNA isolation, and preparation of specimens for exposure assessment. Use of standard, two-dimensional and nanobarcodes and customized electronic databases assure efficient management of large sample collections and tracking results of data analyses. Standard operating procedures and quality control plans help to protect sample quality and to assure validity of the biomarker data. Specific state, federal and international regulations are in place regarding research with human samples, governing areas including custody, safety of handling, and transport of human samples. Appropriate informed consent must be obtained from the study subjects prior to sample collection and confidentiality of results maintained. Finally, examples of three biorepositories of different scale (European Cancer Study, National Cancer Institute and School of Public Health Biorepository, University of California, Berkeley) are used to illustrate challenges faced by investigators and the ways to overcome them. New software and biorepository technologies are being developed by many companies that will help to bring biological banking to a new level required by molecular epidemiology of the 21st century.

Automation↗

Gene expression profiling of the developing Drosophila CNS midline cells.

The Drosophila CNS midline cells constitute a specialized set of interneurons, motorneurons, and glia. The utility of the CNS midline cells as a neurogenomic system to study CNS development derives from the ability to easily identify CNS midline-expressed genes. For this study, we used a variety of sources to identify 281 putative midline-expressed genes, including enhancer trap lines, microarray data, published accounts, and the Berkeley Drosophila Genome Project (BDGP) gene expression data. For each gene, we analyzed expression at all stages of embryonic CNS development and categorized expression patterns with regard to specific midline cell types. Of the 281 candidates, we identified 224 midline-expressed genes, which include transcription factors, signaling proteins, and transposable elements. We find that 58 genes are expressed in mesectodermal precursor cells, 138 in midline primordium cells, and 143 in mature midline cells--50 in midline glia, 106 in midline neurons. Additionally, we identified 27 genes expressed in glial and mesodermal cells associated with the midline cells. This work provides the basis for future research that will generate a complete cellular and molecular map of CNS midline development, thus allowing for detailed genetic and molecular studies of neuronal and glial development and function.

Animals↗

Nuclear medicine instrumentation. Historic perspective.

Recording the chronology of nuclear medicine instrumentation poses some difficult decisions as does the determination of the "father" of nuclear medicine?. Historians can agree on well-defined dates and events, but many of them are subjective and reside in the memories of those of us who were fortunate to experience the formative years of our field. We all search for the historical truth. The highlights of this story may begin with John Lawrence and phosphorus-32 therapy at Berkeley and continue with Enrico Fermi's sustained nuclear reaction, which lead to the Manhattan Project, then the Atomic Energy Commission, and finally, Sam Seidlin's treatment of thyroid metastases with iodine-131. The rectilinear scanner came to us from Benedict Cassen and was followed by Hal O. Anger and his gamma scintillation camera, one of the most pivotal developments in the field. A plethora of cameras followed: Merrill Benders's digital autofluroscope, Dave Kuhl's efforts for tomographic imaging, and then on to single photon emission computed tomography. Finally, we come back to Hal O. Anger, who suggested and worked with the idea of a positron camera, with positron emission tomography becoming commercially available in 1985. Ours is a variegated history, and I hope that this account speaks the historical truth.

History, 20th Century↗

Theory of the kinetic analysis of patch-clamp data.

This paper describes a theory of the kinetic analysis of patch-clamp data. We assume that channel gating is a Markov process that can be described by a model consisting of n kinetic states and n(n - 1) rate constants at each voltage, and that patch-clamp data describe the occupancy of x different conductance levels over time. In general, all the kinetic information in a set of patch-clamp data is found in either two-dimensional dwell time histograms describing the frequency of observation of sequential dwell times of durations tau 1 and tau 2 (Fredkin, D. R., M. Montal, and J. A. Rice, 1985, Proceedings of the Berkeley Conference in Honor of Jerzy Neyman and Jack Kiefer, vol. 1, 269-289) or in three-point joint probability functions describing the probability that a channel is in a given conductance at time t, and at time t + tau 1, and at time t + tau 1 + tau 2. For the special case of channels with a single open state plus multiple closed states, one-dimensional analyses provide all of the kinetic information. Stationary patch-clamp data have information that can be used to determine H rate constants, where H = n(n - 1) - G and G is the number of intraconductance rate constants. Thus, to calculate H rate constants, G rate constants must be fixed. In general there are multiple sets of G rate constants that can be fixed to allow the calculation of H rate constants although not every set of G rate constants will work. Arbitrary assignment of the G intraconductance rate constants equal to zero always provides a solution and the calculation of H rate constants. Nonstationary patch-clamp data have information for the determination of H rate constants at a reference voltage plus n(n - 1) rate constants at all test voltages. Thus, nonstationary data have extra information about the voltage dependencies of rate constants that can be used to rule out kinetic models that cannot be disqualified on the basis of stationary data.

Electric Conductivity↗

Possible function of two insect phospholipid-hydroperoxide glutathione peroxidases.

We compared the functional properties of two insect members of the phospholipid hydroperoxide glutathione peroxidases (PHGPx) family, VLP1, a major component of virus-like particles from the hymenopteran endoparasitoid Venturia canescens and its closest Drosophila relative, one of the putative PHGPx-proteins predicted from the Berkeley Drosophila genome sequence project. Recombinant Drosophila PHGPx shows enzymatic activity towards a number of PHGPx substrates, while the recombinant PHGPx-like domain of VLP1 lacks a functionally relevant cysteine and enzyme activity. A possible function of a non-enzymatic extracellular PHGPx-like protein is discussed.

Amino Acid Sequence↗

Indexes of obesity and comparisons with previous national survey data in 9- and 10-year-old black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To (1) describe anthropometric and body-size measurements in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) population at baseline and (2) examine potential secular trends in the prevalence of obesity in young black and white girls by comparing NGHS baseline data with those of the two National Health and Nutrition Examination Surveys (NHANES I and II) (measured before the NGHS). DESIGN: Cross-sectional analysis of cohort baseline data. SETTING: Recruitment in selected schools (Cincinnati and Berkeley) and among the membership of a group health association (Westat). PATIENTS: Enrolled 2379 girls, 9 and 10 years of age, including 1213 black and 1166 white. MEASUREMENTS: Anthropometric measures, including height, weight, and triceps and subscapular skin folds. Body mass index was used as a measure of body size. Nine- and ten-year-old black girls were taller, heavier, and had larger skin folds than white girls. Compared with age-similar girls in the 1970s, girls in the present study are taller and heavier and have thicker skin folds. The differences in body size were most notable among black girls. CONCLUSIONS: Black girls have a greater body mass than white girls even as young as 9 and 10 years of age. The prevalence of obesity appears to be increasing among young girls, especially in black girls. This progression, if not altered, could lead to increased disease in the future for adult women, particularly black women.

Black People↗