Search

The noble gases, which are chemically inert under normal terrestrial conditions but vary systematically across a wide range of atomic mass and diffusivity, offer a multicomponent approach to investigating gas dynamics in unsaturated soil horizons, including transfer of gas between saturated zones, unsaturated zones, and the atmosphere. To evaluate the degree to which fractionation of noble gases in the presence of an advective diffusive flux agrees with existing theory, a simple laboratory sand column experiment was conducted. Pure CO2 was injected at the base of the column, providing a series of constant CO2 fluxes through the column. At five fixed sampling depths within the system, samples were collected for CO2 and noble gas analyses, and ambient pressures were measured. Both the advection–diffusion and dusty gas models were used to simulate the behavior of CO2 and noble gases under the experimental conditions, and the simulations were compared with the measured depth-dependent concentration profiles of the gases. Given the relatively high permeability of the sand column (5 x 10-11 m2), Knudsen diffusion terms were small, and both the dusty gas model and the advection diffusion model accurately predicted the concentration profiles of the CO2 and atmospheric noble gases across a range of CO2 flux from ~700 to 10,000 g m−2 d−1. The agreement between predicted and measured gas concentrations demonstrated that, when applied to natural systems, the multi-component capability provided by the noble gases can be exploited to constrain component and total gas fluxes of non-conserved (CO2) and conserved (noble gas) species or attributes of the soil column relevant to gas transport, such as porosity, tortuosity, and gas saturation.

Noble gas radionuclides, including 81Kr (t1/2 = 229,000 years), 85Kr (t1/2 = 10.8 years), and 39Ar (t1/2 = 269 years), possess nearly ideal chemical and physical properties for studies of earth and environmental processes. Recent advances in Atom Trap Trace Analysis (ATTA), a laser-based atom counting method, have enabled routine measurements of the radiokrypton isotopes, as well as the demonstration of the ability to measure 39Ar in environmental samples. Here we provide an overview of the ATTA technique, and a survey of recent progress made in several laboratories worldwide. We review the application of noble gas radionuclides in the geosciences and discuss how ATTA can help advance these fields, specifically: determination of groundwater residence times using 81Kr, 85Kr, and 39Ar; dating old glacial ice using 81Kr; and an 39Ar survey of the main water masses of the oceans, to study circulation pathways and estimate mean residence times. Other scientific questions involving a deeper circulation of fluids in the Earth's crust and mantle are also within the scope of future applications. We conclude that the geoscience community would greatly benefit from an ATTA facility dedicated to this field, with instrumentation for routine measurements, as well as for research on further development of ATTA methods. © 2013 Elsevier B.V.

Noble gas radionuclides, including 81Kr (t1/2=229,000years), 85Kr (t1/2=10.8years), and 39Ar (t1/2=269years), possess nearly ideal chemical and physical properties for studies of earth and environmental processes. Recent advances in Atom Trap Trace Analysis (ATTA), a laser-based atom counting method, have enabled routine measurements of the radiokrypton isotopes, as well as the demonstration of the ability to measure 39Ar in environmental samples. Here we provide an overview of the ATTA technique, and a survey of recent progress made in several laboratories worldwide. We review the application of noble gas radionuclides in the geosciences and discuss how ATTA can help advance these fields, specifically: determination of groundwater residence times using 81Kr, 85Kr, and 39Ar; dating old glacial ice using 81Kr; and an 39Ar survey of the main water masses of the oceans, to study circulation pathways and estimate mean residence times. Other scientific questions involving a deeper circulation of fluids in the Earth's crust and mantle are also within the scope of future applications. We conclude that the geoscience community would greatly benefit from an ATTA facility dedicated to this field, with instrumentation for routine measurements, as well as for research on further development of ATTA methods.

Noble gas radionuclides, including 81Kr (t1/2 = 229,000 years), 85Kr (t1/2 = 10.8 years), and 39Ar (t1/2 = 269 years), possess nearly ideal chemical and physical properties for studies of earth and environmental processes. Recent advances in Atom Trap Trace Analysis (ATTA), a laser-based atom counting method, have enabled routine measurements of the radiokrypton isotopes, as well as the demonstration of the ability to measure 39Ar in environmental samples. Here we provide an overview of the ATTA technique, and a survey of recent progress made in several laboratories worldwide. We review the application of noble gas radionuclides in the geosciences and discuss how ATTA can help advance these fields, specifically: determination of groundwater residence times using 81Kr, 85Kr, and 39Ar; dating old glacial ice using 81Kr; and an 39Ar survey of the main water masses of the oceans, to study circulation pathways and estimate mean residence times. Other scientific questions involving a deeper circulation of fluids in the Earth's crust and mantle are also within the scope of future applications. We conclude that the geoscience community would greatly benefit from an ATTA facility dedicated to this field, with instrumentation for routine measurements, as well as for research on further development of ATTA methods. © 2013 Elsevier B.V.

Objective: To test the feasibility of the "Rolling Store," an innovative food-delivery intervention, along with a nutrition education program to increase the consumption of healthy foods (fruits and vegetables) to prevent weight gain in African American women.Methods: Forty eligible African American women were enrolled in the study and randomized to intervention or control groups. A trained peer educator and a Rolling Store operator implemented the study protocol at a local community center.Results: The program retention rate was 93%. Participants in the intervention group lost a mean weight of 2.0 kg, while participants in the control group gained a mean weight of 1.1 kg at six months. Overall participants showed a mean decrease in weight of -.4 kg (standard deviation 3.0 kg), but the intervention group lost significantly more weight and had a decreased body mass index at six months. In the intervention group, the average number of servings consumed per day of fruits/ fruit juice and vegetables significantly increased at six months.Conclusions: The Rolling Store, at least on the small scale on which it was implemented, is a feasible approach to producing weight loss and improvements in healthy eating when combined with an educational program in a small community center. [ABSTRACT FROM AUTHOR]

This research report describes the process and results of recruiting African American adolescent girls and parents for a secondary weight gain prevention study. We sought to recruit 60 girls with equal representation of at-risk for overweight (BMI percentile 85-95) and overweight (BMI >95th percentile), and at least one obese (BMI>30 kg/m²) parent. A personal and individual recruitment approach was the sole method utilized for recruitment of participants into this two-year Internet-based study targeting weight gain prevention. Participants were randomized to either an interactive behavioral condition or a health-based education (control) condition. Fifty-seven African American adolescent girls and their parents were enrolled in the study conducted at a university-based nutrition research center. One hundred eight adolescent girls volunteered and met the study criteria on the first contact, 95 interviewed in the clinic, 64 were randomized, and 57 (89%) of those randomized began the study. Seven percent of the study sample was comprised of African American girls at-risk for overweight, while the majority (93%) of those enrolled were overweight (BMI >95th percentile). Our study sample comprised an imbalanced number of overweight versus at-risk for overweight African American girls suggesting that perhaps a clinic-based secondary weight gain prevention study may be an inefficient and ineffective setting for recruiting this population. Although we were successful in recruiting a majority of overweight girls, we conclude that the imbalance in the number of participants recruited is likely related to the sociocultural environment that predisposes African American girls to obesity and a lack of awareness by the parents' of the consequences of being overweight. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine factors that influence and hinder participation of African Americans in clinical research trials. Specifically, we examined and compared the perceived advantages and disadvantages to participation in clinical research trials, exposure to selected experiences prior to participation (i.e., who and what influenced the decision to participate or not), and perceptions regarding necessary preparation for participation in clinical research trials. Three hundred eighty six African Americans responded to the questionnaire that was administered in the study. As expected, African Americans who had previously participated in a clinical research trial agreed with factors perceived as advantages to participation, while respondents who had not previously participated endorsed factors perceived as potential disadvantages to participation in clinical research trials. [ABSTRACT FROM AUTHOR]

Low socioeconomic status (SES) has been associated with high rates of many chronic diseases. This study was a cluster analysis of data from 9,830 adults in the 1994-96 Continuing Survey of Food Intakes by the Individuals (1994-96 CSFII) in order to characterize more fully the biologic and social factors that might be associated with chronic diseases. The study employed cluster analysis to define three SES groups (low, middle, and high) based on income, education, age, gender, and race. A significant increase was found in self-reported diabetes, hypertension, heart disease, obesity, and stroke across these groups, being highest in the lowest SES group. Results revealed that health disparity in the U.S. may be substantial, with some population groups bearing a disproportionate burden of chronic diseases. [ABSTRACT FROM AUTHOR]

The purpose of this is study was to gain an understanding of the knowledge and perceptions African Americans have that influence decisions to participate or not participate in clinical research trials. A survey instrument designed to measure the key variables; knowledge and perceptions of clinical research processes, and selected demographic characteristics were utilized in this study. The major finding suggests that African Americans who have been participants in a clinical trial are more likely to participate in future clinical trials if details are provided in advance concerning the requirements and criteria for their participation. [ABSTRACT FROM AUTHOR]

We examined the expression of major inflammatory genes, cyclooxygenase-1, 2 (COX1, COX2), arachidonate-5-lipoxygenase (ALOX5), and arachidonate-5-lipoxygenase activating protein (ALOX5AP) among 469 tumor specimens of colorectal cancer in The Cancer Genome Atlas (TCGA). Among 411 specimens without mutations in mismatch repair (MMR) genes, the mean expression of each of the inflammatory genes ranked above the 80th percentile, and the overall mean cyclooxygenase expression (COX1+COX2) ranked in the upper 99th percentile of all genes. Similar levels were observed for 58 cases with MMR mutations. Pearson correlation coefficients exceeding r = 0.70 were observed between COX and LOX mRNA levels with genes of major cell-signaling pathways involved in tumorigenesis (Src, JAK STAT, MAPK, PI3K). We observed a novel association (r = 0.78) between ALOX5 expression and a natural antisense transcript (NAT), RP11-67C2.2, a long non-coding mRNA gene, 462 base pairs in length that is located within the terminal intron of the ALOX5 gene on chromosome 10q11.21. Tumor-promoting genes highly correlated with the expression of COX1, COX2, ALOX5 and ALOX5AP are known to increase mitogenesis, mutagenesis, angiogenesis, cell survival, immunosuppression and metastasis in the inflammogenesis of colorectal cancer. These genes and the novel NAT, RP1167C2.2 are potential molecular targets for chemoprevention and therapy of colorectal cancer.

Cycles of stress build-up and release are inherent to tectonically active planets. Such stress oscillations impart strain and damage, prompting mechanically loaded rocks and materials to fail. Here, we investigate, under uniaxial conditions, damage accumulation and weakening caused by time-dependent creep (at 60, 65, and 70% of the rocks' expected failure stress) and repeating stress oscillations (of ± 2.5, 5.0 or 7.5% of the creep load), simulating earthquakes at a shaking frequency of ~ 1.3 Hz in volcanic rocks. The results show that stress oscillations impart more damage than constant loads, occasionally prompting sample failure. The magnitudes of the creep stresses and stress oscillations correlate with the mechanical responses of our porphyritic andesites, implicating progressive microcracking as the cause of permanent inelastic strain. Microstructural investigation reveals longer fractures and higher fracture density in the post-experimental rock. We deconvolve the inelastic strain signal caused by creep deformation to quantify the amount of damage imparted by each individual oscillation event, showing that the magnitude of strain is generally largest with the first few oscillations; in instances where pre-existing damage and/or the oscillations' amplitude favour the coalescence of micro-cracks towards system scale failure, the strain signal recorded shows a sharp increase as the number of oscillations increases, regardless of the creep condition. We conclude that repetitive stress oscillations during earthquakes can amplify the amount of damage in otherwise mechanically loaded materials, thus accentuating their weakening, a process that may affect natural or engineered structures. We specifically discuss volcanic scenarios without wholesale failure, where stress oscillations may generate damage, which could, for example, alter pore fluid pathways, modify stress distribution and affect future vulnerability to rupture and associated hazards., (© 2023. The Author(s).)

Purpose: We investigate how an intrinsic speckle tracking approach to speckle-based x-ray imaging is used to extract an object's effective dark-field (DF) signal, which is capable of providing object information in three dimensions. Approach: The effective DF signal was extracted using a Fokker-Planck type formalism, which models the deformations of illuminating reference beam speckles due to both coherent and diffusive scatter from the sample. Here, we assumed that (a) small-angle scattering fans at the exit surface of the sample are rotationally symmetric and (b) the object has both attenuating and refractive properties. The associated inverse problem of extracting the effective DF signal was numerically stabilized using a "weighted determinants" approach. Results: Effective DF projection images, as well as the DF tomographic reconstructions of the wood sample, are presented. DF tomography was performed using a filtered back projection reconstruction algorithm. The DF tomographic reconstructions of the wood sample provided complementary, and otherwise inaccessible, information to augment the phase contrast reconstructions, which were also computed. Conclusions: An intrinsic speckle tracking approach to speckle-based imaging can tomographically reconstruct an object's DF signal at a low sample exposure and with a simple experimental setup. The obtained DF reconstructions have an image quality comparable to alternative x-ray DF techniques., (© 2022 Society of Photo-Optical Instrumentation Engineers (SPIE).)

Background: Few studies have examined both parent and child preferences regarding family-based weight management programs (WMPs) delivered in primary care settings, especially among racial minority populations. The purpose of this study was to determine the perceptions that parents and their children/adolescents have about the components that should be included in a family-based WMP and to identify perceived preferences, benefits, and/or barriers to participation. Methods: A sample of 60 participants (30 parents and 30 children/adolescents) participated in 1 of 5 separate structured focus groups, using probing questions and the nominal group technique (NGT). Parents reported demographics for themselves and their children/adolescents. Themes from probing questions were identified using thematic analysis. Results: Parents were primarily African American (93%) and diverse in income. NGT sessions revealed that parents across all groups perceived that education on healthy eating, parental involvement, and effective program leaders are most important and have the greatest impact, while parental involvement was perceived as the easiest method to implement in a family-based WMP for childhood obesity. Children/adolescents perceived that education on healthy eating and exercise would have the greatest impact, while healthy eating and meal plans were perceived as the easiest methods to implement with a family. Parents and children/adolescents also identified improved psychological well-being (eg, decreased bullying, increased self-esteem, and motivation) as a desired program outcome. Conclusion: Parents and their children/adolescents highlighted the importance of physical and psychological health as targets in treatment. Feedback from patients can inform the design and implementation of family-based WMPs delivered in primary care settings., (©2021 by the author(s); Creative Commons Attribution License (CC BY).)

It is generally accepted that tectonic earthquakes may trigger volcanic activity, although the underlying mechanisms are poorly constrained. Here, we review current knowledge, and introduce a novel framework to help characterize earthquake-triggering processes. This framework outlines three parameters observable at volcanoes, namely magma viscosity, open- or closed-system degassing and the presence or absence of an active hydrothermal system. Our classification illustrates that most types of volcanoes may be seismically-triggered, though require different combinations of volcanic and seismic conditions, and triggering is unlikely unless the system is primed for eruption. Seismically-triggered unrest is more common, and particularly associated with hydrothermal systems.

The gravity field of a small body provides insight into its internal mass distribution. We used two approaches to measure the gravity field of the rubble-pile asteroid (101955) Bennu: (i) tracking and modeling the spacecraft in orbit about the asteroid and (ii) tracking and modeling pebble-sized particles naturally ejected from Bennu's surface into sustained orbits. These approaches yield statistically consistent results up to degree and order 3, with the particle-based field being statistically significant up to degree and order 9. Comparisons with a constant-density shape model show that Bennu has a heterogeneous mass distribution. These deviations can be modeled with lower densities at Bennu's equatorial bulge and center. The lower-density equator is consistent with recent migration and redistribution of material. The lower-density center is consistent with a past period of rapid rotation, either from a previous Yarkovsky-O'Keefe-Radzievskii-Paddack cycle or arising during Bennu's accretion following the disruption of its parent body., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

Background: Less than one-third of women gain an appropriate amount of weight during pregnancy, which can influence the long-term health of both the mother and the child. Economically disadvantaged women are the most vulnerable to maternal obesity, excessive weight gain during pregnancy, and poor birth outcomes. Effective and scalable health care strategies to promote healthy weight gain during pregnancy specifically tailored for these women are lacking., Objective: This paper presents the design and protocol of a biphasic, community-based eHealth trial, SmartMoms in WIC, to increase the adherence to healthy gestational weight gain (GWG) recommendations in low-income mothers receiving women, infant, and children (WIC) benefits., Methods: Phase 1 of the trial included using feedback from WIC mothers and staff and participants from 2 community peer advisory groups to adapt an existing eHealth gestational weight management intervention to meet the needs of women receiving WIC benefits. The health curriculum, the format of delivery, and incentive strategies were adapted to be culturally relevant and at an appropriate level of health literacy. Phase 2 included a pragmatic randomized controlled trial across the 9 health care regions in Louisiana with the goal of enrolling 432 women. The SmartMoms in WIC intervention is an intensive 24-week behavioral intervention, which includes nutrition education and exercise strategies, and provides the technology to assist with weight management, delivered through a professionally produced website application., Results: Phase 1 of this trial was completed in July 2019, and recruitment for phase 2 began immediately thereafter. All data are anticipated to be collected by Spring 2023., Conclusions: The SmartMoms in WIC curriculum was methodically developed using feedback from community-based peer advisory groups to create a culturally relevant, mobile behavioral intervention for mothers receiving WIC benefits. The randomized clinical trial is underway to test the effectiveness of a sustainable eHealth program on the incidence rates of appropriate GWG. SmartMoms in WIC may be able to offer an innovative, cost-effective, and scalable solution for GWG management in women served by WIC., Trial Registration: ClinicalTrials.gov NCT04028843; https://clinicaltrials.gov/ct2/show/NCT04028843., International Registered Report Identifier (irrid): DERR1-10.2196/18211., (©Emily W Flanagan, Abby D Altazan, Natalie R Comardelle, L Anne Gilmore, John W Apolzan, Jessica St. Romain, Julie C Hardee, Renee S Puyau, Christy L Mayet, Robbie A Beyl, S Ariel Barlow, Sarah Surber Bounds, Kelsey N Olson, Betty M Kennedy, Daniel S Hsia, Leanne M Redman. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.09.2020.)

Background: African American adults experience a high prevalence of obesity and its associated comorbidities, including diabetes. Church-based interventions have been shown to be effective in decreasing weight in this population. mHealth interventions can address two needs for obesity treatment in this community, including enhancing weight loss and providing wide dissemination., Objective: This study aimed to assess the feasibility and efficacy of a church-based weight loss intervention that incorporates mHealth technology., Methods: In this study, 8 churches (n=97) were randomly assigned to the intervention or delayed intervention condition (control group). We recruited participants through their respective church. Volunteer church members were trained by study staff to deliver the 10-session, 6-month intervention. Participants in the intervention group attended group sessions and received automated short message service (SMS) text messages designed to reinforce behavioral strategies. Conversely, participants in the delayed intervention condition received SMS text messages related to health conditions relevant for African American adults. We obtained measures of body composition, blood pressure, blood glucose, and cholesterol., Results: We successfully recruited 97 African American adults, with a mean age of 56.0 (SE 10.3) years and a mean body mass index of 38.6 (SE 6.4) kg/m2 (89/97, 91.8% females), who attended the churches that were randomized to the intervention (n=68) or control (n=29) condition. Of these, 74.2% (72/97) of the participants (47/68, 69.1% intervention; 25/29, 86.2% delayed intervention) completed the 6-month assessment. The average intervention group attendance was 55%. There was a significant difference in weight loss (P=.04) between participants in the intervention (-1.5 (SE 0.5) kg) and control (0.11 (SE 0.6) kg) groups. Among participants in the intervention group, the correlation between the number of SMS text messages sent and the percent body fat loss was r=.3 with P=.04. The participants reported high satisfaction with the automated SMS text messages., Conclusions: Automated SMS text messages were well-received by participants, suggesting that more enhanced mHealth technologies are a viable option for interventions targeting African American adults., Trial Registration: ClinicalTrials.gov NCT02863887; https://clinicaltrials.gov/ct2/show/NCT02863887 (Archived by WebCite at http://www.webcitation.org/71JiYzizO)., (©Robert L Newton Jr, Leah A Carter, William Johnson, Dachuan Zhang, Sandra Larrivee, Betty M Kennedy, Melissa Harris, Daniel S Hsia. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.08.2018.)

We examined the expression of major inflammatory genes, cyclooxygenase-1 and 2 (COX1, COX2) and arachidonate 5-lipoxygenase (ALOX5) in 1090 tumor samples of invasive breast cancer from The Cancer Genome Atlas (TCGA). Mean cyclooxygenase expression (COX1 + COX2) ranked in the upper 99th percentile of all 20,531 genes and surprisingly, the mean expression of COX1 was more than tenfold higher than COX2. Highly significant correlations were observed between COX2 with eight tumor-promoting genes (EGR2, IL6, RGS2, B3GNT5, SGK1, SLC2A3, SFRP1 and ETS2) and between ALOX5 and ten tumor promoter genes (CD33, MYOF1, NLRP1, GAB3, CD4, IFR8, CYTH4, BTK, FGR, CD37). Expression of CYP19A1 (aromatase) was significantly correlated with COX2, but only in tumors positive for ER, PR and HER2. Tumor-promoting genes correlated with the expression of COX1, COX2, and ALOX5 are known to effectively increase mitogenesis, mutagenesis, angiogenesis, cell survival, immunosuppression and metastasis in the pathogenesis of breast cancer.

Background: Heart failure (HF) is an incurable and frequently progressive disease. Symptoms of HF may impair the ability of patients to perform daily living activities. As HF progresses, patients typically increase their reliance on caregivers. The purpose of this study was to determine what roles patients and caregivers perceive and desire for themselves in managing HF and to compare and contrast these roles with those perceived by healthcare providers., Methods: A purposive sample (60 patients, 22 caregivers, and 11 healthcare providers) was enrolled in the study. Patients and caregivers individually participated in semistructured interviews, and healthcare providers participated in 1 of 2 focus groups., Results: Four key themes evolved from interviews with patients and caregivers-education on disease specifics, guidance to enhance quality of life, learning to cope with HF, and future outlook and care decisions-that may guide the development of caregiver interventions in HF. Healthcare providers in both structured focus groups regardless of rank order selected knowledge is powerful, adherence to treatment plan, and compliance with medication as the top 3 issues likely to have the greatest impact, and they identified education on the disease (knowledge is powerful) as the easiest strategy to implement for patients and caregivers in the management of HF., Conclusion: Interventions among caregivers of patients with HF are needed and should focus on education in family structures, family functioning, and skills training in family assessment and engagement.

Objective: This study examined how well healthcare providers perceive and understand their patients' health beliefs and values compared to patients' actual beliefs, and to determine if communication relationships maybe improved as a result of healthcare providers' understanding of their patients' illness from their perspective., Methods: A total of 61 participants (7 healthcare providers and 54 patients) were enrolled in the study. Healthcare providers and patients individually completed survey instruments and each participated in a structured focus group., Results: Healthcare provider and patient differences revealed that patients perceived greater meaning of their illness (p = 0.038), and a greater preference for partnership (p = 0.026) compared to providers. The three qualitative themes most important for understanding patients' health beliefs and values as perceived by healthcare providers were education, trust, and culture. Educating patients was perceived as having the greatest impact and also the easiest method to implement to foster providers' understanding, with at least one patient focus group in agreement of same. Likewise, three themes were derived from patients' perspectives as relatively more important in understanding providers' beliefs and values; bidirectional communication, comprehensive treatment, and discipline. Overwhelmingly, bidirectional communication was perceived as a critical factor as having the greatest impact and may also be easiest to implement according to these patients., Conclusion: When patients and healthcare providers listen and communicate with each other, they are likely to develop a shared understanding that may improve future decision making and quality of care patients receive.

Background: Primary care is a key component of medical care delivery and has a role to play in reducing obesity in the United States. The purpose of this study was to explore attitudes and perceptions about obesity in low-income primary care patients and to identify preferences for weight management interventions from the patient and healthcare provider perspectives., Methods: A convenience sample of 28 patients and 6 healthcare providers from across the state of Louisiana participated in 1 of 5 structured focus groups. Demographic information was collected from both the patients and healthcare providers using survey instruments., Results: Patients and healthcare providers were more similar than dissimilar in their perceptions of obesity in that both groups selected referral to a nutritionist, use of medication, and prescribed exercise as the top 3 strategies that would have the greatest impact on losing weight. Referral to a nutritionist was selected as the easiest strategy to implement., Conclusion: Receiving feedback from both patients and healthcare providers gives researchers the opportunity to acquire useful knowledge that may be beneficial in designing and conducting interventions suitable for patients desiring to lose weight, especially those in primary care settings.

Physical activity among African Americans (AA) is low; effective intervention strategies are needed. Community-based settings are useful for delivering health-related interventions in racial/ethnic minority communities. This article describes strategies used to recruit churches for participation in a 22-month intervention designed to increase physical activity levels in AA women. Initial recruitment efforts, led by AA study staff, included direct mailers, phone calls, and in-person meetings with church representatives. After 10 months, only five churches were enrolled. Seven community members with existing partnerships/contacts in the faith community were subsequently hired and an additional 26 churches were enrolled within 6 months. Overall response rate was 45%, and churches required 3.5 ± 3.0 months of multiple contacts prior to enrollment. The main primary contacts within churches were individuals with personal interest in the program and pastors. Prior relationship between the research team and churches did not appear to influence church enrollment as much as community member recruiters. The current study identifies several potential strategies that may be useful for increasing success in efforts to recruit AA churches into studies. Additional research is warranted that tests and compares a variety of recruitment strategies to determine the most successful strategies for recruitment in different populations., (© 2015 Society for Public Health Education.)

Terrestrial volcanic eruptions are the consequence of magmas ascending to the surface of the Earth. This ascent is driven by buoyancy forces, which are enhanced by bubble nucleation and growth (vesiculation) that reduce the density of magma. The development of vesicularity also greatly reduces the 'strength' of magma, a material parameter controlling fragmentation and thus the explosive potential of the liquid rock. The development of vesicularity in magmas has until now been viewed (both thermodynamically and kinetically) in terms of the pressure dependence of the solubility of water in the magma, and its role in driving gas saturation, exsolution and expansion during decompression. In contrast, the possible effects of the well documented negative temperature dependence of solubility of water in magma has largely been ignored. Recently, petrological constraints have demonstrated that considerable heating of magma may indeed be a common result of the latent heat of crystallization as well as viscous and frictional heating in areas of strain localization. Here we present field and experimental observations of magma vesiculation and fragmentation resulting from heating (rather than decompression). Textural analysis of volcanic ash from Santiaguito volcano in Guatemala reveals the presence of chemically heterogeneous filaments hosting micrometre-scale vesicles. The textures mirror those developed by disequilibrium melting induced via rapid heating during fault friction experiments, demonstrating that friction can generate sufficient heat to induce melting and vesiculation of hydrated silicic magma. Consideration of the experimentally determined temperature and pressure dependence of water solubility in magma reveals that, for many ascent paths, exsolution may be more efficiently achieved by heating than by decompression. We conclude that the thermal path experienced by magma during ascent strongly controls degassing, vesiculation, magma strength and the effusive-explosive transition in volcanic eruptions.

The purpose of this qualitative program was to determine if a trend exists across three LSU medical homes according to patient feedback concerning their experiences within the medical home for ongoing disease management and quality healthcare; and to obtain recommendations for the most effective way to involve patients in shaping system policies, procedures, and practices consistent with patient and family-centered care principles. A total of 94 adult patients participated in either cognitive interviews (n = 45) or structured focus groups (n = 49) using the Nominal Group Technique (NGT). Exit surveys collected demographic information and feedback from patients about opportunities for their involvement in shaping medical homes. Cognitive interviews and NGT sessions both revealed some patient-perceived gratifications (i.e., friendliness and helpfulness of the clinic staff), and deficiencies (i.e., improving scheduling of appointments and reducing wait time in the clinic) within these medical homes. However, the perceived gratifications far exceeded the deficiencies found within each of three LSU medical homes., (© 2014 Wiley Periodicals, Inc.)

Preventing weight gain rather than treating recognized obesity is an important economic and public health response to the growing levels of obesity nationwide. Community centers offer potential sites for community health promotion programs targeting African Americans. In this article, results from a pilot health promotion program at a community center are reported. The purpose of this 12-month pilot program was to improve diet and increase physical activity to prevent weight gain in African-American adults by delivering a lifestyle intervention. Fifty-one African-American adults were randomized into two groups: lifestyle intervention or financial counseling, and 73% completed the program. At the end of 12 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. Both lifestyle intervention and financial counseling groups were approximately 87% food secure with improvements observed in self-esteem and total quality of life scores.

The prevention of weight gain to address the obesity epidemic rather than weight loss involves promoting small changes in food choices and physical activity. People United to Sustain Health (PUSH) was designed to increase fruit and vegetable consumption, physical activity, and food security to prevent weight gain in rural adults. Forty-nine participants were randomized into a treatment group which received access to a "Rolling Store," nutrition education and physical activity, and a control group which received family coping classes. Forty-one (84%) of participants completed the study. At the end of 6 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. The mean fruit consumption over 6 months for the treatment group increased and was significantly greater than change in the control group (p = 0.01). This community-based participatory research study was considered successful because weight gain was prevented., (© 2014 Wiley Periodicals, Inc.)

Background: Tobacco use, obesity, and physical inactivity among Louisiana's youth pose a serious public health problem. Given the potential of school environments to affect student well-being, the Louisiana Tobacco Control Program developed and tested a pilot program, Schools Putting Prevention to Work. The objective was to assist school districts in developing a comprehensive school wellness policy and engaging their school community to generate environments that support healthful choices and behaviors., Community Context: The pilot was implemented in 27 school districts, reaching an estimated 325,000 people across the state. Demographics of participating students were similar to all Louisiana's public school students., Methods: A school wellness project state team advised project development. A subgroup that included contractors and partners implemented and modified the pilot. Sites were selected though an application process. Site representatives received trainings, technical assistance, and funding to organize school-based support-building activities and coordinate a school health advisory council to develop policy and sustain healthy school environments. Project sites reported progress monthly; evaluation included data from sites and project administrators., Outcome: Twenty-five comprehensive school wellness policies (covering 100% tobacco-free schools and daily physical activity and healthier cafeteria items) were approved by school boards. Environmental changes such as physical activity breaks, healthier vending options, and tobacco-free campuses were adopted., Interpretation: This pilot demonstrated a successful approach to achieving policy and environmental change. The state team engaged and guided school districts to motivate students, parents, faculty/staff/administration, and businesses to establish and maintain opportunities to improve lifestyle health.

In this paper, we show that the tracer breakthrough curves (BTCs), when the tracer chemically interacts with the solid matrix of a fractured rock, are considerably different than when it does not. Of particular interest, is the presence of a long pseudo steady state zone in the BTCs, where the tracer concentration is more or less constant over a long period of time. However, such a zone of constant concentration is not visible when either the tracer does not interact with the solid, or does so at an extremely fast rate. We show that these characteristics of the BTCs could be correlated to the parameters of the system. We develop expressions for the mean residence time and its variance for a chemically active and inactive tracer. We show that chemical interaction between the tracer and the solid increases the mean residence time and the increase depends on the distribution coefficient. We also show that the variance of residence time for a chemically active tracer is much larger than that for an inactive tracer, and it depends on both the distribution coefficient and the rate of chemical reaction. We verify these calculations against synthetic tracer BTCs, where the temporal moments are calculated by numerically integrating the tracer evolution curves. Even though we developed the mathematical expressions assuming an idealized fracture-matrix system, we believe that the mathematical expressions developed in this paper can be useful in gaining insights into reactive transport in a real fractured rock system., (Published by Elsevier B.V.)

Introduction: Engaging community residents to obtain their feedback in conducting clinical research, and including them as leaders in implementing applicable health advances is crucial for success and sustaining large center awards., Methods: Forty-four adult men and women participated in one of four focus groups. Two groups each (one African American and one Caucasian) were conducted in Baton Rouge and in New Orleans., Results: In an effort to determine the knowledge, attitudes, and beliefs Louisiana residents have about the Louisiana Clinical and Translational Science (LA CaTS) Center concept, four main themes emerged from focus group participants concerning the state's research institutions, and what it means to have these institutions operating under one umbrella to improve the quality of health of its people: (1) academic/research institutions of the State are uniformly widely recognized and held in high regard; (2) increasing awareness of clinical research is a necessity; (3) establishing the LA CaTS Center is an excellent idea; and (4) effective communication including delivery style is crucial to partnerships and especially to the community., Conclusion: Focus group discussions can provide insight into community residents' perceptions, beliefs, motivations, and patterns of behavior for strategically planning for large center awards., (© 2013 Wiley Periodicals, Inc.)

In this paper, we investigate the impact of chemical interactions, in the form of mineral precipitation and dissolution reactions, on tracer transport in fractured rocks. When a tracer is introduced in fractured rocks, it moves through the fracture primarily by advection and it also enters the stagnant water of the surrounding rock matrix through diffusion. Inside the porous rock matrix, the tracer chemically interacts with the solid materials of the rock, where it can precipitate depending on the local equilibrium conditions. Alternatively, it can be dissolved from the solid phase of the rock matrix into the matrix pore water, diffuse into the flowing fluids of the fracture and is advected out of it. We show that such chemical interactions between the fluid and solid phases have significant impact on tracer transport in fractured rocks. We invoke the dual-porosity conceptualization to represent the fractured rocks and develop a semi-analytical solution to describe the transient transport of tracers in interacting fluid-rock systems. To test the accuracy and stability of the semi-analytical solution, we compare it with simulation results obtained with the TOUGHREACT simulator. We observe that, in a chemically interacting system, the tracer breakthrough curve exhibits a pseudo-steady state, where the tracer concentration remains more or less constant over a finite period of time. Such a pseudo-steady condition is not observed in a non-reactive fluid-rock system. We show that the duration of the pseudo-state depends on the physical and chemical parameters of the system, and can be exploited to extract information about the fractured rock system, such as the fracture spacing and fracture-matrix interface area., (© 2013.)

Background: The medical home is an organizational approach for improving care, improving patient experience, and reducing costs. The purpose of this qualitative project was to obtain input from patients that could be used to improve their experiences in the medical home for ongoing disease management and health improvement and to obtain their recommendations for the most effective methods to involve patients in shaping system policies, procedures, and practices consistent with patient- and family-centered care principles., Methods: We conducted cognitive interviews to complete patient experience surveys, structured focus groups, and exit surveys. A sample of 32 adults participated in cognitive interviews (n=15) and structured focus groups (n=17) using the nominal group technique (NGT). Exit surveys collected demographic information and input from patients about opportunities for their involvement in shaping medical homes., Results: Cognitive interviews, NGT sessions, and exit surveys revealed patient-perceived strengths and inadequacies within the medical home. Better access to care, including more efficient appointment scheduling and reduced wait times to see a physician once patients arrived for scheduled appointments, was identified as a necessary improvement. Patients' positive perceptions included how the medical home helps them reach their health goals and their overall satisfaction with the quality of care received., Conclusion: The input received from patients through the methods used in this project was useful in revealing needed improvements within a medical home and, if resolved, will ensure that all patients have access to the kind of care that works for them.

Effective weight management interventions could reduce race-sex disparities in cardiovascular disease (CVD), yet little is known about factors associated with successful weight loss maintenance in race-sex subgroups. In the Weight Loss Maintenance trial (WLM), overweight/obese (BMI 25-45 kg/m(2)) adults who lost ≥4 kg in a 6-month behavioral weight loss intervention (phase I) were randomized into one of three 30-month maintenance interventions (phase II). To investigate predictors in subgroups, randomized groups were combined for this analysis. Of 1,685 phase I participants, 1,032 (61%) entered phase II, including 12% black men (BM), 26% black women (BW), 25% white men (WM), and 37% white women (WW). Weight change over the 36-month study ranged from -2.3% (95% confidence interval = -3.1 to -1.5%) in BW to -4.5% (95% confidence interval = -5.7 to -4.0%) in WM, the result of differential weight loss during phase I. Within race, men lost significantly more weight than women, but within sex group, weight loss did not differ significantly between races. Although participants regained weight during phase II, regain did not differ by race-sex group, and mean weight at the end of the study was significantly lower than phase I entry weight for each subgroup. In regression models, phase I weight loss predicted overall 36-month weight loss in all race-sex groups. Healthy dietary pattern at entry, improvement in dietary pattern, or both were predictive in three of four race-sex groups. Few other variables other than initial weight loss and dietary pattern were predictive. Future research should identify additional modifiable influences on long-term maintenance after a modest weight loss.

In this paper, challenges to recruiting African Americans specifically for a dietary feeding trial are examined, learning experiences gained and suggestions to overcome these challenges in future trials are discussed. A total of 333 individuals were randomized in the trial and 234 (167 sibling pairs and 67 parents/siblings) completed the dietary intervention and required DNA blood sampling for genetic analysis. The trial used multiple strategies for recruitment. Hand distributed letters and flyers through mass distribution at various churches resulted in the largest number (n = 153, 46%) of African Americans in the trial. Word of mouth accounted for the second largest number (n = 120, 36%) and included prior study participants. These two recruitment sources represented 82% (n = 273) of the total number of individuals randomized in GET READI. The remaining 18% (n = 60) consisted of a combination of sources including printed message on check stubs, newspaper articles, radio and TV appearances, screening events and presentations. Though challenging, the recruitment efforts for GET READI produced a significant number of African American participants despite the inability to complete the trial as planned because of low recruitment yields. Nevertheless, the recruitment process produced substantial numbers that successfully completed all study requirements.

Collaboratively, the nutritional health problems of the Lower Mississippi Delta (LMD) region were examined and opportunities identified for conducting research interventions. To combat the nutritional health problems in the LMD, community residents yielded to a more comprehensive and participatory approach known as community-based participatory research (CBPR). Community residents partnered with academic researchers and other organizational entities to improve the overall quality of diet and health in their respective communities using CBPR. The collaborative work in the LMD focused on interventions conducted in each of three specific communities across three states: Marvell, Arkansas (Marvell NIRI), and its surrounding public school district; Franklin Parish in Louisiana (Franklin NIRI); and the city of Hollandale, Mississippi (Hollandale NIRI). This paper examined some of the research interventions conducted in Franklin, Hollandale, and Marvell NIRI respectively, how leadership emerged from each of these communities, and lessons learned as a result of the CBPR model.

Little is known about the transition in behaviors from short-term weight loss to maintenance of weight loss. We wanted to determine how short-term and long-term weight loss and patterns of weight change were associated with intervention behavioral targets. This analysis includes overweight/obese participants in active treatment (n = 507) from the previously published PREMIER trial, an 18-month, multicomponent lifestyle intervention for blood pressure reduction, including 33 intervention sessions and recommendations to self-monitor food intake and physical activity daily. Associations between behaviors (attendance, recorded days/week of physical activity, food records/week) and weight loss of ≥5% at 6 and 18 months were examined using logistic regression. We characterized the sample using 5 weight change categories (weight gained, weight stable, weight loss then relapse, late weight loss, and weight loss then maintenance) and analyzed adherence to the behaviors for each category, comparing means with ANOVA. Participants lost an average of 5.3 ± 5.6 kg at 6 months and 4.0 ± 6.7 kg (4.96% of body weight) by 18 months. Higher levels of attendance, food record completion, and recorded days/week of physical activity were associated with increasing odds of achieving 5% weight loss. All weight change groups had declines in the behaviors over time; however, compared to the other four groups, the weight loss/maintenance group (n = 154) had statistically less significant decline in number of food records/week (48%), recorded days/week of physical activity (41.7%), and intervention sessions attended (12.8%) through 18 months. Behaviors associated with short-term weight loss continue to be associated with long-term weight loss, albeit at lower frequencies. Minimizing the decline in these behaviors may be important in achieving long-term weight loss.

To determine how many steps·day(-1) equate to current moderate-to-vigorous physical activity (MVPA) guidelines in a population from the Lower Mississippi Delta (LMD) of the United States, 58 overweight adults wore an Actigraph accelerometer (GT3X) for up to 2 weeks. Min·day(-1) in MVPA was a good predictor of steps·day(-1) (r(2) = 0.62; p < 0.001; linear regression), such that 30 min of daily MVPA equated to 9154 steps·day(-1) (mixed-model approach). Using receiver operating characteristic analysis, sensitivity and specificity were optimized at 8357 steps·day(-1). Results indicate that overweight residents of the LMD should be accumulating at least 8300-9100 steps·day(-1) to meet the recommendation of 30 min·day(-1) MVPA.

Background: The purpose of this study was to determine if a short-term pedometer-based intervention results in immediate increases in time spent in moderate-to-vigorous physical activity (MVPA) compared to a minimal educational intervention., Methods: A sample of 43 overweight adults 35 to 64 years of age participated in a one week pedometer-based feasibility trial monitored by accelerometry. Participants were randomized into a one-week education-only group or a group that also wore a pedometer. Accelerometer-measured MVPA was measured over 7 days at baseline and again for 7 days immediately post-intervention., Results: Minutes of MVPA increased significantly in the overall sample (p = 0.02); however, the effect of adding the pedometer to the education program was not significant (p = 0.89). Mean (±SE) MVPA increased from 12.7 ± 2.4 min/day to 16.2 ± 3.6 min/day in the education-only group and from 13.2 ± 3.3 min/day to 16.3 ± 3.9 min/day in the education+pedometer group. The correlation between change in steps/day and change in MVPA was 0.69 (p<0.0001)., Conclusions: The results of this study suggest that the addition of a pedometer to a short-term education program does not produce added benefits with respect to increasing physical activity in the Lower Mississippi Delta., Trial Registration: ClinicalTrials.gov NCT01264757.

Background: The Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss., Objective: This paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance., Methods: Adults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal., Results: Participants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002)., Conclusion: Participants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss., Trial Registration: NCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue).

Recruitment strategies employed by four clinical centers across the US and a coordinating center were examined to identify successful overall and minority-focused recruitment strategies for the PREMIER multicenter trial of lifestyle changes for blood pressure control. The goal was to recruit 800 adults (40% African Americans) with systolic blood pressure of 120-159 mm Hg and diastolic of 80-95 mm Hg, not taking antihypertensive medication. Clinical centers used combinations of mass distribution of brochures, mass media, email distribution lists, screening events, and a national website. Culturally appropriate strategies for African Americans were designed by a Minority Implementation (MI) committee. Diversity training was provided for study staff, and African Americans were included in the study design process. Main recruitment outcomes were number overall and number of African Americans recruited by each strategy. Of the 810 randomized PREMIER participants, 279 (34%) were African American with site-specific percentages of 56%, 46%, 27%, and 8%. Of African Americans recruited, 151 (54%) were from mass distribution of brochures (mailed letter, flyer included in Val-Pak coupons, or other), 66 (24%) from mass media (printed article, radio, TV story or ads, 52 (19%) from word of mouth, and 10 (3%) from email/website and screening events combined. Yields for Non-Hispanic Whites were 364 (69%) from brochures, 71 (13%) from mass media, 49 (9%) from word of mouth and 47 (9%) from email/website and screening events. Mass distribution of brochures was relatively more effective with Non-Hispanic Whites, while African Americans responded relatively better to other recruitment strategies., (Published by Elsevier Inc.)

Heat and mass are injected into the shallow crust when mantle fluids are able to flow through the ductile lower crust. Minimum 3He/4He ratios in surface fluids from the northern Basin and Range Province, western North America, increase systematically from low crustal values in the east to high mantle values in the west, a regional trend that correlates with the rates of active crustal deformation. The highest ratios occur where the extension and shear strain rates are greatest. The correspondence of helium isotope ratios and active transtensional deformation indicates a deformation-enhanced permeability and that mantle fluids can penetrate the ductile lithosphere, even in regions where there is no substantial magmatism. Superimposed on the regional trend are local, high 3He/4He anomalies indicating hidden magmatic activity and/or deep fluid production with locally enhanced permeability, identifying zones with high resource potential, particularly for geothermal energy development.

Background: Maintenance treatment with inhaled corticosteroids is often required for asthmatic nursing women. Data on the transfer of inhaled corticosteroids from plasma to breast milk and the subsequent exposure of the breast-feeding infant has been unavailable., Objective: We sought to assess budesonide concentrations in milk and plasma of asthmatic nursing women receiving maintenance treatment with the Pulmicort Turbuhaler and estimate the exposure of their breast-fed infants., Methods: Milk and plasma samples were collected up to 8 hours after dosing from 8 mothers receiving budesonide maintenance treatment (200 or 400 microg twice daily). Pharmacokinetic parameters were calculated from budesonide milk and plasma concentrations. Infant exposure was estimated based on average milk budesonide concentrations. A single blood sample was obtained from 5 infants close to expected infant maximum concentration., Results: Budesonide concentrations in milk reflected those in maternal plasma, supporting passive diffusion of budesonide between plasma and milk, and was always lower than that in plasma. The mean milk/plasma ratio was 0.46. The estimated daily infant dose was 0.3% of the daily maternal dose for both dose levels, and the average plasma concentration in infants was estimated to be 1/600th of the concentrations observed in maternal plasma, assuming complete infant oral bioavailability. Budesonide concentrations in infant plasma samples were all less than the limit of quantification., Conclusion: Maintenance treatment with inhaled budesonide (200 or 400 microg twice daily) in asthmatic nursing women results in negligible systemic exposure to budesonide in breast-fed infants., Clinical Implications: These data support continued use of inhaled budesonide during breast-feeding.

Objective: To identify African American cultural characteristics that may be used to modify clinical trial designs and behavioral programs aimed at losing weight and maintaining weight loss., Design: Focus group discussions., Setting: University-affiliated biomedical research center., Participants: Thirty-one African American men and women who completed the screening process, but were ineligible for the Weight Loss Maintenance (WLM) trial, participated in one of five focus group sessions. WLM is a randomized controlled trial that compares two lifestyle interventions for preventing weight regain in individuals who have successfully lost weight in a group-based behavioral weight loss program., Results: Nine themes emerged as cultural characteristics specific to African Americans seeking participation in a lifestyle change program: (1) religion is a powerful force; (2) family structure; (3) integration dismantled the African American family; (4) general mistrust of Caucasians; (5) African Americans are undervalued and not respected as a people; (6) limited resources equal limited ability to make lifestyle changes; (7) preservation of an explicit ethnic identity; (8) education is the key to success as an African American; and (9) communication skills are vital., Conclusions: Identifying cultural characteristics specific to African Americans may help investigators design clinical trials that will enhance outcomes and improve the generalizability of results in ethnic minority populations.

Migraines occasionally are a symptom of another serious underlying health condition. Therefore, it is important for pharmacists to be familiar with the diagnostic criteria of migraine so that they can recognize which patients warrant a referral to a healthcare provider for further evaluation. Criteria for the diagnosis of migraines have been established by the International Headache Society. To assist migraine sufferers in their efforts to find relief from the pain and reduce the occurrence of migraines, it is important that compounding pharmacists be aware of the clinical features of migraine such as the four phases, the pathophysiology of migraines, the drug classes commonly used in the treatment of migraines, the variety of therapeutic approaches, and treatment options that may be offered by compounding pharmacists.

Recruiting practices employed by the four clinical centers participating in the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial were examined to assess the most successful method of obtaining participants and to describe pertinent learning experiences gained as a result of the trial. The primary recruitment strategies employed by each center were mass mailing brochures (direct, coupon packs, or other) and mass media (advertisements in newspapers, radio, and television spots). Of 412 randomized participants, 265 (64%) were from mass distribution of brochures, 62 (15%) mass media, and 85 (21%) were prior study participants, referred by word-of-mouth, or reported coming from screening events and presentations. Although the most successful method of recruitment was mass mailing brochures, three times as many brochures were distributed to obtain similar success as in the initial DASH trial.

Objective: The purpose of this study was to examine a church-based intervention employing a 6-month pilot weight loss program as a strategy to improve health of African-American adults., Design: A randomized trial design was used without a control group. Eligible church members were randomized into two groups: an intervention delivered in the group setting and an intervention delivered in the individual setting., Setting: The study was conducted at an African-American church in Baton Rouge, Louisiana., Participants: Forty church members were enrolled in the study. Two trained church members without specialization in obesity treatment conducted the study., Main Outcome Measures: The primary outcome measure was weight loss., Results: The program retention rate was 90%. After six months, a modest but significant mean weight loss was seen in all participants of 3.3 kg. The mean weight losses in the individual and group interventions were 3.4 kg and 3.1 kg, respectively. The mean body fat loss was 2.1 kg and 1.9 kg, respectively. The difference in weight loss and fat loss between the individual and group interventions was not statistically significant. An improvement in the quality of life and an increase in physical activity were reported by the program participants., Conclusions: A church setting may provide an effective delivery mechanism for a health and nutrition program. Church members may be trained to conduct a weight control program. Both interventions (individual and group) were effective in inducing weight loss.