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Archive for the ‘Statistical Methods for Research Evaluation’ Category


Thriving at the Survival Calls during Careers in the Digital Age – An AGE like no Other, also known as, DIGITAL

Author and Curator: Aviva Lev-Ari, PhD, RN

 

The source for the inspiration to write this curation is described in

Survival Calls during Careers in the Digital Age

https://pharmaceuticalintelligence.com/2018/06/13/survival-calls-during-careers-in-the-digital-age/

 

In this curation, I present the following concepts in three parts:

  1. Part 1: Authenticity of Careers in the Digital Age: In Focus, the BioTechnology Sector
  2. Part 2: Top 10 books to help you survive the Digital Age

  3. Part 3: A case study on Thriving at the Survival Calls during Careers in the Digital Age: Aviva Lev-Ari, UCB, PhD’83; HUJI, MA’76 

 

Part 1: Authenticity of Careers in the Digital Age: 

In Focus, the BioTechnology Sector

 

Lisa LaMotta, Senior Editor, BioPharma Dive wrote in Conference edition | June 11, 2018

Unlike that little cancer conference in Chicago last week, the BIO International convention is not about data, but about the people who make up the biopharma industry.

The meeting brings together scientists, board members, business development heads and salespeople, from the smallest virtual biotechs to the largest of pharmas. It allows executives at fledgling biotechs to sit at the same tables as major decision-makers in the industry — even if it does look a little bit like speed dating.

But it’s not just a partnering meeting.

This year’s BIO also sought to shine a light on pressing issues facing the industry. Among those tackled included elevating the discussion on gender diversity and how to bring more women to the board level; raising awareness around suicide and the need for more mental health treatments; giving a voice to patient advocacy groups; and highlighting the need for access to treatments in developing nations.

Four days of meetings and panel discussions are unlikely to move the needle for many of these challenges, but debate can be the first step toward progress.

I attended the meetings on June 4,5,6, 2018 and covered in Real Time the sessions I attended. On the link below, Tweets, Re-Tweets and Likes mirrors the feelings and the opinions of the attendees as expressed in real time using the Twitter.com platform. This BioTechnology events manifested the AUTHENTICITY of Careers in the Digital Age – An AGE like no Other, also known as, DIGITAL.

The entire event is covered on twitter.com by the following hash tag and two handles:

 

I covered the events on two tracks via two Twitter handles, each handle has its own followers:

The official LPBI Group Twitter.com account

The Aviva Lev-Ari, PhD, RN Twitter.com account

Track A:

  • Original Tweets by @Pharma_BI and by @AVIVA1950 for #BIO2018 @IAmBiotech @BIOConvention – BIO 2018, Boston, June 4-7, 2018, BCEC

Curator: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2018/06/11/original-tweets-by-pharma_bi-and-by-aviva1950-from-bio2018-iambiotech-bioconvention-bio-2018-boston-june-4-7-2018-bcec/

 

  • Reactions to Original Tweets by @Pharma_BI and by @AVIVA1950 from #BIO2018

Curator: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2018/06/12/reactions-to-original-tweets-by-pharma_bi-and-by-aviva1950-from-bio2018/

Track B:

  • Re-Tweets and Likes by @Pharma_BI and by @AVIVA1950 from #BIO2018 @IAmBiotech @BIOConvention – BIO 2018, Boston, June 4-7, 2018, BCEC

Curator: Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2018/06/11/re-tweets-and-likes-by-pharma_bi-aviva1950-from-bio2018-iambiotech-bioconvention-bio-2018-boston-june-4-7-2018-bcec/

Part 2: Top 10 books to help you survive the digital age

From Philip K Dick’s obtuse robots to Mark O’Connell’s guide to transhumanism, novelist Julian Gough picks essential reading for a helter skelter world

Here are 10 of the books that did help me [novelist Julian Gough]: they might also help you understand, and survive, our complicated, stressful, digital age.

  1. Marshall McLuhan Unbound by Marshall McLuhan (2005)
    The visionary Canadian media analyst predicted the internet, and coined the phrase the Global Village, in the early 1960s. His dense, complex, intriguing books explore how changes in technology change us. This book presents his most important essays as 20 slim pamphlets in a handsome, profoundly physical, defiantly non-digital slipcase.
  2. Ubik by Philip K Dick (1969)
    Pure pulp SF pleasure; a deep book disguised as a dumb one. Dick shows us, not a dystopia, but a believably shabby, amusingly human future. The everyman hero, Joe Chip, wakes up and argues with his robot toaster, which refuses to toast until he sticks a coin in the slot. Joe can’t do this, because he’s broke. He then has a stand-up row with his robot front door, which won’t open, because he owes it money too … Technology changes: being human, and broke, doesn’t. Warning: Dick wrote Ubik at speed, on speed. But embedded in the pulpy prose are diamonds of imagery that will stay with you for ever.
  3. The Singularity Is Near by Ray Kurzweil (2005)
    This book is what Silicon Valley has instead of a bible. It’s a visionary work that predicts a technological transformation of the world in our lifetime. Kurzweil argues that computer intelligence will soon outperform human thought. We will then encode our minds, upload them, and become one with our technology, achieving the Singularity. At which point, the curve of technological progress starts to go straight up. Ultimately – omnipotent, no longer mortal, no longer flesh – we transform all the matter in the universe into consciousness; into us.
  4. To Be a Machine by Mark O’Connell (2017)
    This response to Kurzweil won this year’s Wellcome prize. It’s a short, punchy tour of transhumanism: the attempt to meld our minds with machines, to transcend biology and escape death. He meets some of the main players, and many on the fringes, and listens to them, quizzically. It is a deliberately, defiantly human book, operating in that very modern zone between sarcasm and irony, where humans thrive and computers crash.
  5. A Visit from the Goon Squad by Jennifer Egan (2011)
    This intricately structured, incredibly clever novel moves from the 60s right through to a future maybe 15 years from now. It steps so lightly into that future you hardly notice the transition. It has sex and drugs and rock’n’roll, solar farms, social media scams and a stunningly moving chapter written as a PowerPoint presentation. It’s a masterpiece. Life will be like this.
  6. What Technology Wants by Kevin Kelly (2010)
    Kelly argues that we scruffy biological humans are no longer driving technological progress. Instead, the technium, “the greater, global, massively interconnected system of technology vibrating around us”, is now driving its own progress, faster and faster, and we are just caught up in its slipstream. As we accelerate down the technological waterslide, there is no stopping now … Kelly’s vision of the future is scary, but it’s fun, and there is still a place for us in it.
  7. The Meme Machine by Susan Blackmore (1999)
    Blackmore expands powerfully and convincingly on Richard Dawkins’s original concept of the meme. She makes a forceful case that technology, religion, fashion, art and even our personalities are made of memes – ideas that replicate, mutate and thus evolve over time. We are their replicators (if you buy my novel, you’ve replicated its memes); but memes drive our behaviour just as we drive theirs. It’s a fascinating book that will flip your world upside down.
  8. Neuromancer by William Gibson (1984)
    In the early 1980s, Gibson watched kids leaning into the screens as they played arcade games. They wanted to be inside the machines, he realised, and they preferred the games to reality. In this novel, Gibson invented the term cyberspace; sparked the cyberpunk movement (to his chagrin); and vividly imagined the jittery, multi-screened, anxious, technological reality that his book would help call into being.
  9. You Are Not a Gadget: A Manifesto by Jaron Lanier (2010)
    Lanier, an intense, brilliant, dreadlocked artist, musician and computer scientist, helped to develop virtual reality. His influential essay Digital Maoism described early the downsides of online collective action. And he is deeply aware that design choices made by (mainly white, young, male) software engineers can shape human behaviour globally. He argues, urgently, that we need to question those choices, now, because once they are locked in, all of humanity must move along those tracks, and we may not like where they take us. Events since 2010 have proved him right. His manifesto is a passionate argument in favour of the individual voice, the individual gesture.
  10. All About Love: New Visions by bell hooks (2000)
    Not, perhaps, an immediately obvious influence on a near-future techno-thriller in which military drones chase a woman and her son through Las Vegas. But hooks’s magnificent exploration and celebration of love, first published 18 years ago, will be far more useful to us, in our alienated digital future, than the 10,000 books of technobabble published this year. All About Love is an intensely practical roadmap, from where we are now to where we could be. When Naomi and Colt find themselves on the run through a militarised American wilderness of spirit, when GPS fails them, bell hooks is their secret guide.

SOURCE

https://www.theguardian.com/books/2018/may/30/top-10-books-to-help-you-survive-the-digital-age?utm_source=esp&utm_medium=Email&utm_campaign=Bookmarks+-+Collections+2017&utm_term=277690&subid=25658468&CMP=bookmarks_collection

Part 3: A case study on Thriving at the Survival Calls during Careers in the Digital Age:  Aviva Lev-Ari, UCB, PhD’83; HUJI, MA’76

 

On June 10, 2018

 

Following, is a case study about an alumna of HUJI and UC, Berkeley as an inspirational role model. An alumna’s profile in context of dynamic careers in the digital age. It has great timeliness and relevance to graduate students, PhD level at UC Berkeley and beyond, to all other top tier universities in the US and Europe. As presented in the following curations:

Professional Self Re-Invention: From Academia to Industry – Opportunities for PhDs in the Business Sector of the Economy

https://pharmaceuticalintelligence.com/2018/05/22/professional-self-re-invention-from-academia-to-industry-opportunities-for-phds-in-the-business-sector-of-the-economy/

 

Pioneering implementations of analytics to business decision making: contributions to domain knowledge conceptualization, research design, methodology development, data modeling and statistical data analysis: Aviva Lev-Ari, UCB, PhD’83; HUJI, MA’76 

https://pharmaceuticalintelligence.com/2018/05/28/pioneering-implementations-of-analytics-to-business-decision-making-contributions-to-domain-knowledge-conceptualization-research-design-methodology-development-data-modeling-and-statistical-data-a/

 

This alumna is Editor-in-Chief of a Journal that has other 173 articles on Scientist: Career Considerations 

https://pharmaceuticalintelligence.com/category/scientist-career-considerations/

 

In a 5/22/2018 article, Ways to Pursue Science Careers in Business After a PhD by Ankita Gurao,

https://bitesizebio.com/38498/ways-to-pursue-the-business-of-science-after-a-ph-d/?utm_source=facebook&utm_medium=social&utm_campaign=SocialWarfare

Unemployment figures of PhDs by field of science are included, Ankita Gurao identifies the following four alternative careers for PhDs in the non-academic world:

  1. Science Writer/Journalist/Communicator
  2. Science Management
  3. Science Administration
  4. Science Entrepreneurship

My career, as presented in Reflections on a Four-phase Career: Aviva Lev-Ari, PhD, RN, March 2018

https://pharmaceuticalintelligence.com/2018/03/06/reflections-on-a-four-phase-career-aviva-lev-ari-phd-rn-march-2018/

has the following phases:

  • Phase 1: Research, 1973 – 1983
  • Phase 2: Corporate Applied Research in the US, 1985 – 2005
  • Phase 3: Career Reinvention in Health Care, 2005 – 2012
  • Phase 4: Electronic Scientific Publishing, 4/2012 to present

These four phases are easily mapped to the four alternative careers for PhDs in the non-academic world. One can draw parallel lines between the four career opportunities A,B,C,D, above, and each one of the four phases in my own career.

Namely, I have identified A,B,C,D as early as 1985, and pursued each of them in several institutional settings, as follows:

A. Science Writer/Journalist/Communicator – see link above for Phase 4: Electronic Scientific Publishing, 4/2012 to present 

B. Science Management – see link above for Phase 2: Corporate Applied Research in the US, 1985 – 2005 and Phase 3: Career Reinvention in Health Care, 2005 – 2012 

C. Science Administration – see link above for Phase 2: Corporate Applied Research in the US, 1985 – 2005and Phase 4: Electronic Scientific Publishing, 4/2012 to present 

D. Science Entrepreneurship – see link above for Phase 4: Electronic Scientific Publishing, 4/2012 to present  

Impressions of My Days at Berkeley in Recollections: Part 1 and 2, below.

  • Recollections: Part 1 – My days at Berkeley, 9/1978 – 12/1983 –About my doctoral advisor, Allan Pred, other professors and other peers

https://pharmaceuticalintelligence.com/2018/03/15/recollections-my-days-at-berkeley-9-1978-12-1983-about-my-doctoral-advisor-allan-pred-other-professors-and-other-peer/

  • Recollections: Part 2 – “While Rolling” is preceded by “While Enrolling” Autobiographical Alumna Recollections of Berkeley – Aviva Lev-Ari, PhD’83

https://pharmaceuticalintelligence.com/2018/05/24/recollections-part-2-while-rolling-is-preceded-by-while-enrolling-autobiographical-alumna-recollections-of-berkeley-aviva-lev-ari-phd83/

The topic of Careers in the Digital Age is closely related to my profile, see chiefly: Four-phase Career, Reflections, Recollections Parts 1 & 2 and information from other biographical sources, below.

Other sources for my biography

 

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Decline in Sperm Count – Epigenetics, Well-being and the Significance for Population Evolution and Demography

 

Dr. Marc Feldman, Expert Opinion on the significance of Sperm Count Decline on the Future of Population Evolution and Demography

Dr. Sudipta Saha, Effects of Sperm Quality and Quantity on Human Reproduction

Dr. Aviva Lev-Ari, Psycho-Social Effects of Poverty, Unemployment and Epigenetics on Male Well-being, Physiological Conditions affecting Sperm Quality and Quantity

 

UPDATED on 2/3/2018

Nobody Really Knows What Is Causing the Overdose Epidemic, But Here Are A Few Theories

https://www.buzzfeed.com/danvergano/whats-causing-the-opioid-crisis?utm_term=.kbJPMgaQo4&utm_source=BrandeisNOW%2BWeekly&utm_campaign=58ada49a84-EMAIL_CAMPAIGN_2018_01_29&utm_medium=email#.uugW6mx1dG

 

Recent studies concluded via rigorous and comprehensive analysis found that Sperm Count (SC) declined 52.4% between 1973 and 2011 among unselected men from western countries, with no evidence of a ‘leveling off’ in recent years. Declining mean SC implies that an increasing proportion of men have sperm counts below any given threshold for sub-fertility or infertility. The high proportion of men from western countries with concentration below 40 million/ml is particularly concerning given the evidence that SC below this threshold is associated with a decreased monthly probability of conception.

1.Temporal trends in sperm count: a systematic review and meta-regression analysis 

Hagai Levine, Niels Jørgensen, Anderson Martino‐Andrade, Jaime Mendiola, Dan Weksler-Derri, Irina Mindlis, Rachel Pinotti, Shanna H SwanHuman Reproduction Update, July 25, 2017, doi:10.1093/humupd/dmx022.

Link: https://academic.oup.com/humupd/article-lookup/doi/10.1093/humupd/dmx022.

2. Sperm Counts Are Declining Among Western Men – Interview with Dr. Hagai Levine

https://news.afhu.org/news/sperm-counts-are-declining-among-western-men?utm_source=Master+List&utm_campaign=dca529d919-EMAIL_CAMPAIGN_2017_07_27&utm_medium=email&utm_term=0_343e19a421-dca529d919-92801633

3. Trends in Sperm Count – Biological Reproduction Observations

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

4. Long, mysterious strips of RNA contribute to low sperm count – Long non-coding RNAs can be added to the group of possible non-structural effects, possibly epigenetic, that might regulate sperm counts.

http://casemed.case.edu/cwrumed360/news-releases/release.cfm?news_id=689

https://scienmag.com/long-mysterious-strips-of-rna-contribute-to-low-sperm-count/

Dynamic expression of long non-coding RNAs reveals their potential roles in spermatogenesis and fertility

Published: 29 July 2017
Thus, we postulated that some lncRNAs may also impact mammalian spermatogenesis and fertility. In this study, we identified a dynamic expression pattern of lncRNAs during murine spermatogenesis. Importantly, we identified a subset of lncRNAs and very few mRNAs that appear to escape meiotic sex chromosome inactivation (MSCI), an epigenetic process that leads to the silencing of the X- and Y-chromosomes at the pachytene stage of meiosis. Further, some of these lncRNAs and mRNAs show strong testis expression pattern suggesting that they may play key roles in spermatogenesis. Lastly, we generated a mouse knock out of one X-linked lncRNA, Tslrn1 (testis-specific long non-coding RNA 1), and found that males carrying a Tslrn1 deletion displayed normal fertility but a significant reduction in spermatozoa. Our findings demonstrate that dysregulation of specific mammalian lncRNAs is a novel mechanism of low sperm count or infertility, thus potentially providing new biomarkers and therapeutic strategies.

This article presents two perspectives on the potential effects of Sperm Count decline.

One Perspective identifies Epigenetics and male well-being conditions

  1. as a potential explanation to the Sperm Count decline, and
  2. as evidence for decline in White male longevity in certain geographies in the US since the mid 80s.

The other Perspective, evaluates if Sperm Count Decline would have or would not have a significant long term effects on Population Evolution and Demography.

The Voice of Prof. Marc Feldman, Stanford University – Long term significance of Sperm Count Decline on Population Evolution and Demography

Poor sperm count appears to be associated with such demographic statistics as life expectancy (1), infertility (2), and morbidity (3,4). The meta-analysis by Levine et al. (5) focuses on the change in sperm count of men from North America, Europe, Australia, and New Zealand, and shows a more than 50% decline between 1973 and 2011. Although there is no analysis of potential environmental or lifestyle factors that could contribute to the estimated decline in sperm count, Levine et al. speculate that this decline could be a signal for other negative changes in men’s health.

Because this study focuses mainly on Western men, this remarkable decline in sperm count is difficult to associate with any change in actual fertility, that is, number of children born per woman. The total fertility rate in Europe, especially Italy, Spain, and Germany, has slowly declined, but age at first marriage has increased at the same time, and this increase may be more due to economic factors than physiological changes.

Included in Levine et al.’s analysis was a set of data from “Other” countries from South America, Asia, and Africa. Sperm count in men from these countries did not show significant trends, which is interesting because there have been strong fertility declines in Asia and Africa over the same period, with corresponding increases in life expectancy (once HIV is accounted for).

What can we say about the evolutionary consequences for humans of this decrease? The answer depends on the minimal number of sperm/ml/year that would be required to maintain fertility (per woman) at replacement level, say 2.1 children, over a woman’s lifetime. Given the smaller number of ova produced per woman, a change in the ovulation statistics of women would be likely to play a larger role in the total fertility rate than the number of sperm/ejaculate/man. In other words, sperm count alone, absent other effects on mortality during male reproductive years, is unlikely to tell us much about human evolution.

Further, the major declines in fertility over the 38-year period covered by Levine et al. occurred in China, India, and Japan. Chinese fertility has declined to less than 1.5 children per woman, and in Japan it has also been well below 1.5 for some time. These declines have been due to national policies and economic changes, and are therefore unlikely to signal genetic changes that would have evolutionary ramifications. It is more likely that cultural changes will continue to be the main drivers of fertility change.

The fastest growing human populations are in the Muslim world, where fertility control is not nearly as widely practiced as in the West or Asia. If this pattern were to continue for a few more generations, the cultural evolutionary impact would swamp any effects of potentially declining sperm count.

On the other hand, if the decline in sperm count were to be discovered to be associated with genetic and/or epigenetic phenotypic effects on fetuses, newborns, or pre-reproductive humans, for example, due to stress or obesity, then there would be cause to worry about long-term evolutionary problems. As Levine et al. remark, “decline in sperm count might be considered as a ‘canary in the coal mine’ for male health across the lifespan”. But to date, there is little evidence that the evolutionary trajectory of humans constitutes such a “coal mine”.

References

  1. Jensen TK, Jacobsen R, Christensen K, Nielsen NC, Bostofte E. 2009. Good semen quality and life expectancy: a cohort study of 43,277 men. Am J Epidemiol 170: 559-565.
  2. Eisenberg ML, Li S, Behr B, Cullen MR, Galusha D, Lamb DJ, Lipshultz LI. 2014. Semen quality, infertility and mortality in the USA. Hum Reprod 29: 1567-1574.
  3. Eisenberg ML, Li S, Cullen MR, Baker LC. 2016. Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data. Fertil Steril 105: 629-636.
  4. Latif T, Kold Jensen T, Mehlsen J, Holmboe SA, Brinth L, Pors K, Skouby SO, Jorgensen N, Lindahl-Jacobsen R. Semen quality is a predictor of subsequent morbidity. A Danish cohort study of 4,712 men with long-term follow-up. Am J Epidemiol. Doi: 10.1093/aje/kwx067. (Epub ahead of print]
  5. Levine H, Jorgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, Pinotti R, Swan SH. 2017. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update pp. 1-14. Doi: 10.1093/humupd/dmx022.

SOURCE

From: Marcus W Feldman <mfeldman@stanford.edu>

Date: Monday, July 31, 2017 at 8:10 PM

To: Aviva Lev-Ari <aviva.lev-ari@comcast.net>

Subject: Fwd: text of sperm count essay

Psycho-Social Effects of Poverty, Unemployment and Epigenetics on Male Well-being, Physiological Conditions as POTENTIAL effects on Sperm Quality and Quantity and Evidence of its effects on Male Longevity

The Voice of Carol GrahamSergio Pinto, and John Juneau II , Monday, July 24, 2017, Report from the Brookings Institute

  1. The IMPACT of Well-being, Stress induced by Worry, Pain, Perception of Hope related to Employment and Lack of employment on deterioration of Physiological Conditions as evidence by Decrease Longevity

  2. Epigenetics and Environmental Factors

The geography of desperation in America

Carol GrahamSergio Pinto, and John Juneau II Monday, July 24, 2017, Report from the Brookings Institute

In recent work based on our well-being metrics in the Gallup polls and on the mortality data from the Centers for Disease Control and Prevention, we find a robust association between lack of hope (and high levels of worry) among poor whites and the premature mortality rates, both at the individual and metropolitan statistical area (MSA) levels. Yet we also find important differences across places. Places come with different economic structures and identities, community traits, physical environments and much more. In the maps below, we provide a visual picture of the differences in in hope for the future, worry, and pain across race-income cohorts across U.S. states. We attempted to isolate the specific role of place, controlling for economic, socio-demographic, and other variables.

One surprise is the low level of optimism and high level of worry in the minority dense and generally “blue” state of California, and high levels of pain and worry in the equally minority dense and “blue” states of New York and Massachusetts. High levels of income inequality in these states may explain these patterns, as may the nature of jobs that poor minorities hold.

We cannot answer many questions at this point. What is it about the state of Washington, for example, that is so bad for minorities across the board? Why is Florida so much better for poor whites than it is for poor minorities? Why is Nevada “good” for poor white optimism but terrible for worry for the same group? One potential issue—which will enter into our future analysis—is racial segregation across places. We hope that the differences that we have found will provoke future exploration. Readers of this piece may have some contributions of their own as they click through the various maps, and we welcome their input. Better understanding the role of place in the “crisis” of despair facing our country is essential to finding viable solutions, as economic explanations, while important, alone are not enough.

https://www.brookings.edu/research/the-geography-of-desperation-in-america/?utm_medium=social&utm_source=facebook&utm_campaign=global

 

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Trends in Sperm Count

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

There has been a genuine decline in semen quality over the past 50 years. There is lot of controversy about this as there are limitations in studies that have attempted to address it. Sperm count is of considerable public health importance for several reasons. First, sperm count is closely linked to male fecundity and is a crucial component of semen analysis, the first step to identify male factor infertility.

Reduced sperm count is associated with cryptorchidism, hypospadias and testicular cancer. It may be associated with multiple environmental influences, including endocrine disrupting chemicals, pesticides, heat and lifestyle factors, including diet, stress, smoking and BMI. Therefore, sperm count may sensitively reflect the impacts of the modern environment on male health throughout the life span.

This study provided a systematic review and meta-regression analysis of recent trends in sperm counts as measured by sperm concentration (SC) and total sperm count (TSC), and their modification by fertility and geographic group. Analyzing trends by birth cohorts instead of year of sample collection may aid in assessing the causes of the decline (prenatal or in adult life) but was not feasible owing to lack of information.

This rigorous and comprehensive analysis found that SC declined 52.4% between 1973 and 2011 among unselected men from western countries, with no evidence of a ‘leveling off’ in recent years. Declining mean SC implies that an increasing proportion of men have sperm counts below any given threshold for sub-fertility or infertility. The high proportion of men from western countries with concentration below 40 million/ml is particularly concerning given the evidence that SC below this threshold is associated with a decreased monthly probability of conception.

Declines in sperm count have implications beyond fertility and reproduction. The decline reported in this study is consistent with reported trends in other male reproductive health indicators, such as testicular germ cell tumors, cryptorchidism, onset of male puberty and total testosterone levels. The public health implications are even wider. Recent studies have shown that poor sperm count is associated with overall morbidity and mortality. While the current study is not designed to provide direct information on the causes of the observed declines, sperm count has been plausibly associated with multiple environmental and lifestyle influences, both prenatally and in adult life. In particular, endocrine disruption from chemical exposures or maternal smoking during critical windows of male reproductive development may play a role in prenatal life, while lifestyle changes and exposure to pesticides may play a role in adult life.

These findings strongly suggest a significant decline in male reproductive health, which has serious implications beyond fertility concerns. Research on causes and implications of this decline is urgently needed.

 

REFERENCES

Temporal trends in sperm count: a systematic review and meta-regression analysis 

Hagai Levine, Niels Jørgensen, Anderson Martino‐Andrade, Jaime Mendiola, Dan Weksler-Derri, Irina Mindlis, Rachel Pinotti, Shanna H Swan. Human Reproduction Update, July 25, 2017, doi:10.1093/humupd/dmx022.

Link: https://academic.oup.com/humupd/article-lookup/doi/10.1093/humupd/dmx022.

Sperm Counts Are Declining Among Western Men – Interview with Dr. Hagai Levine

https://news.afhu.org/news/sperm-counts-are-declining-among-western-men?utm_source=Master+List&utm_campaign=dca529d919-EMAIL_CAMPAIGN_2017_07_27&utm_medium=email&utm_term=0_343e19a421-dca529d919-92801633

J Urol. 1983 Sep;130(3):467-75.

A critical method of evaluating tests for male infertility.

https://www.ncbi.nlm.nih.gov/pubmed/6688444

Hum Reprod. 1993 Jan;8(1):65-70.

Estimating fertility potential via semen analysis data.

https://www.ncbi.nlm.nih.gov/pubmed/8458929

Lancet. 1998 Oct 10;352(9135):1172-7.

Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners.

https://www.ncbi.nlm.nih.gov/pubmed/9777833

Hum Reprod Update. 2010 May-Jun;16(3):231-45. doi: 10.1093/humupd/dmp048. Epub 2009 Nov 24.

World Health Organization reference values for human semen characteristics.

https://www.ncbi.nlm.nih.gov/pubmed/19934213

J Nutr. 2016 May;146(5):1084-92. doi: 10.3945/jn.115.226563. Epub 2016 Apr 13.

Intake of Fruits and Vegetables with Low-to-Moderate Pesticide Residues Is Positively Associated with Semen-Quality Parameters among Young Healthy Men.

https://www.ncbi.nlm.nih.gov/pubmed/27075904

Reprod Toxicol. 2003 Jul-Aug;17(4):451-6.

Semen quality of Indian welders occupationally exposed to nickel and chromium.

https://www.ncbi.nlm.nih.gov/pubmed/12849857

Fertil Steril. 1996 May;65(5):1009-14.

Semen analyses in 1,283 men from the United States over a 25-year period: no decline in quality.

https://www.ncbi.nlm.nih.gov/pubmed/8612826

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A New Computational Method illuminates the Heterogeneity and Evolutionary Histories of cells within a Tumor

Reporter: Aviva Lev-Ari, PhD, RN

 

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Numerous computational approaches aimed at inferring tumor phylogenies from single or multi-region bulk sequencing data have recently been proposed. Most of these methods utilize the variant allele fraction or cancer cell fraction for somatic single-nucleotide variants restricted to diploid regions to infer a two-state perfect phylogeny, assuming an infinite-site model such that each site can mutate only once and persists. In practice, convergent evolution could result in the acquisition of the same mutation more than once, thereby violating this assumption. Similarly, mutations could be lost due to loss of heterozygosity. Indeed, both single-nucleotide variants and copy number alterations arise during tumor evolution, and both the variant allele fraction and cancer cell fraction depend on the copy number state whose inference reciprocally relies on the relative ordering of these alterations such that joint analysis can help resolve their ancestral relationship (Figure 1). To tackle this outstanding problem, El-Kebir et al. (2016) formulated the multi-state perfect phylogeny mixture deconvolution problem to infer clonal genotypes, clonal fractions, and phylogenies by simultaneously modeling single-nucleotide variants and copy number alterations from multi-region sequencing of individual tumors. Based on this framework, they present SPRUCE (Somatic Phylogeny Reconstruction Using Combinatorial Enumeration), an algorithm designed for this task. This new approach uses the concept of a ‘‘character’’ to represent the status of a variant in the genome.

Commonly, binary characters have been used to represent single-nucleotide variants— that is, the variant is present or absent. In contrast, El-Kebir et al. use multi-state characters to represent copy number alterations, which may be present in zero, one, two, or more copies in the genome.

SPRUCE outperforms existing methods on simulated data, yielding higher recall rates under a variety of scenarios. Moreover, it is more robust to noise in variant allele frequency estimates, which is a significant feature of tumor genome sequencing data. Importantly, El-Kebir and colleagues demonstrate that there is often an ensemble of phylogenetic trees consistent with the underlying data. This uncertainty calls for caution in deriving definitive conclusions about the evolutionary process from a single solution.”

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From Original Paper

Inferring Tumor Phylogenies from Multi-region Sequencing

Zheng Hu1,2 and Christina Curtis1,2,*

1Departments of Medicine and Genetics

2Stanford Cancer Institute

Stanford University School of Medicine, Stanford, CA 94305, USA

*Correspondence: cncurtis@stanford.edu

http://dx.doi.org/10.1016/j.cels.2016.07.007

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Warfarin and Dabigatran, Similarities and Differences

Author and Curator: Danut Dragoi, PhD

 

What anticoagulants do?

An anticoagulant helps your body control how fast your blood clots; therefore, it prevents clots from forming inside your arteries, veins or heart during certain medical conditions.

If you have a blood clot, an anticoagulant may prevent the clot from getting larger. It also may prevent a piece of the clot from breaking off and traveling to your lungs, brain or heart. The anticoagulant medication does not dissolve the blood clot. With time, however, this clot may dissolve on its own.

Blood tests you will need

The blood tests for clotting time are called prothrombin time (Protime, PT) and international normalized ratio (INR). These tests help determine if your medication is working. The tests are performed at a laboratory, usually once a week to once a month, as directed by your doctor. Your doctor will help you decide which laboratory you will go to for these tests.

The test results help the doctor decide the dose of warfarin (Coumadin) that you should take to keep a balance between clotting and bleeding.

Important things to keep in mind regarding blood tests include:

  • Have your INR checked when scheduled.
  • Go to the same laboratory each time. (There can be a difference in results between laboratories).
  • If you are planning a trip, talk with your doctor about using another laboratory while traveling.
Dosage

The dose of medication usually ranges from 1 mg to 10 mg once daily. The doctor will prescribe one strength and change the dose as needed (your dose may be adjusted with each INR).

The tablet is scored and breaks in half easily. For example: if your doctor prescribes a 5 mg tablet and then changes the dose to 2.5 mg (2½ mg), which is half the strength, you should break one of the 5 mg tablets in half and take the half-tablet. If you have any questions about your dose, talk with your doctor or pharmacist.

What warfarin (Coumadin) tablets look like

Warfarin is made by several different drug manufacturers and is available in many different shapes. Each color represents a different strength, measured in milligrams (mg). Each tablet has the strength imprinted on one side, and is scored so you can break it in half easily to adjust your dose as your doctor instructed.

https://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Understanding_Coumadin

Today, on the basis of 4 clinical trials involving over 9,000 patients, PRADAXA is approved to treat blood clots in the veins of your legs(deep vein thrombosis, or DVT) or lungs (pulmonary embolism, or PE)in patients who have been treated with blood thinner injections, and to reduce the risk of them occurring again.

In these trials, PRADAXA was compared to warfarin or to placebo (sugar pills) for the treatment of DVT and PE patients.

https://www.pradaxa.com/pradaxa-vs-warfarin?gclid=CMaRq7al9ssCFUxZhgodZuoC5w

Warfarin (NB-which goes by the brand name Coumadin, see link in here) reduces the risk of stroke in patients with atrial fibrillation (NB- atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. Some people refer to AF as a quivering heart, see link here) but increases the risk of hemorrhage and is difficult to use.

Dabigatran is a new oral direct thrombin inhibitor (NB-direct thrombin inhibitors are a class of medication that act as anticoagulants by directly inhibiting the enzyme thrombin). Some are in clinical use, while others are undergoing clinical development), see link in here.

Some international large clinical trials, see link in here,  show results for patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage. Dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage.

Picture below shows a deep vein thrombosis which is a blood clot that forms inside a vein, usually deep within the leg. About half a million Americans every year get one, and up to 100,000 die because of it. The danger is that part of the clot can break off and travel through your bloodstream. It could get stuck in your lungs and block blood flow, causing organ damage or death, see link in here.

Blod Clot

Image SOURCE: http://www.webmd.com/heart-disease/guide/warfarin-other-blood-thinners

The behaviour of blood thinning drugs is dependent on their physico-chemical properties and since a significant proportion of drugs contain ionisable centers a knowledge of their pKa (NB-pKa was introduced as an index to express the acidity of weak acids, where pKa is defined as follows. For example, the Ka constant for acetic acid (CH3C00H) is 0.0000158 (= 10-4.8), but the pKa constant is 4.8, which is a simpler expression. In addition, the smaller the pKa value, the stronger the acid, see link in here ) is essential, see link in here. The pKa is defined as the negative log of the dissociation constant, see link in here:

pka=-log10(Ka)              (1)

where the dissociation constant is defined thus:

Ka=[A][H+]/[AH]

Most drugs have pKa in the range 0-12, and whilst it is possible to calculate pKa it is desirable to experimentally measure the value for representative examples. There are a number of instruments that are capable of measuring pKa utilising Sirius T3 instrument, see link in here .

Table 1 below shows the pka values for warfarin, see link in here  and dabigatran, see link in here.

Table 1

==========================

Anticoagulant           pka          

warfarin                     4.99

dabigatran                 4.24        11.51*

==========================

* dabigatran possess both acidic and basic functionality.

Both groups are at ionized at blood pH and exist as zwitterionic

structures, see link in here.

Adding physico-chemical features of anticoagulants utilized in “dissolving” blood clots is important for better understanding the de-blocking process within the veins utilizing anticoagulants.

SOURCE

http://theochem.chem.rug.nl/publications/PDF/ft683.pdf

http://www.rsc.org/chemical-sciences-repository/articles/article/dr000000003197?doi=10.1039/c5ra04680g

http://pubs.rsc.org/en/content/articlelanding/2015/ra/c5ra11623f#!divAbstract

http://www.cambridgemedchemconsulting.com/resources/physiochem/pka.html

http://www.webmd.com/heart-disease/guide/warfarin-other-blood-thinners

https://www.google.com/#q=define+atrial+fibrillation

https://www.researchgate.net/profile/Lars_Wallentin/publication/26777612_Dabigatran_versus_Warfarin_in_Patients_with_Atrial_Fibrillation/links/02bfe50c8c2fa639c0000000.pdf

http://www.webmd.com/heart-disease/guide/warfarin-other-blood-thinners

 

Other related articles published in this Open Access Online Scientific Journal, include the following:

Coagulation N=69

https://pharmaceuticalintelligence.com/?s=Coagulation

Peripheral Arterial Disease N=43

https://pharmaceuticalintelligence.com/?s=Peripheral

Antiarrhythmic drugs

https://pharmaceuticalintelligence.com/?s=Antiarrhythmic+drugs

A-Fib

https://pharmaceuticalintelligence.com/?s=a-fib

Electrophysiology N = 80

https://pharmaceuticalintelligence.com/?s=Electrophysiology

 

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Huge Data Network Bites into Cancer Genomics

Larry H. Bernstein, MD, FCAP, Curator

LPBI

 

Closer to a Cure for Gastrointestinal Cancer

Suzanne Tracy, Editor-in-Chief, Scientific Computing and HPC Source
http://www.scientificcomputing.com/news/2015/11/closer-cure-gastrointestinal-cancer

In order to streamline workflows and keep pace with data-intensive discovery demands, CCS integrated its HPC environment with data capture and analytics capabilities, allowing data to move transparently between research steps, and driving discoveries such as a link between certain viruses and gastrointestinal cancers.

 

SANTA CLARA, CA — At the University of Miami’s Center for Computational Science (CCS), more than 2,000 internal researchers and a dozen expert collaborators across academic and industry sectors worldwide are working together in workflow management, data management, data mining, decision support, visualization and cloud computing. CCS maintains one of the largest centralized academic cyberinfrastructures in the country, which fuels vital and critical discoveries in Alzheimer’s, Parkinson’s, gastrointestinal cancer, paralysis and climate modeling, as well as marine and atmospheric science research.

In order to streamline workflows and keep pace with data-intensive discovery demands, CCS integrated its high performance computing (HPC) environment with data capture and analytics capabilities, allowing data to move transparently between research steps. To speed scientific discoveries and boost collaboration with researchers around the world, the center deployed high-performance DataDirect Networks (DDN) GS12K scale-out file storage. CCS now relies on GS12K storage to handle bandwidth-driven workloads while serving very high IOPS demand resulting from intense user interaction, which simplifies data capture and analysis. As a result, the center is able to capture, store and distribute massive amounts of data generated from multiple scientific models running different simulations on 15 Illumina HiSeq sequencers simultaneously on DDN storage. Moreover, number-crunching time for genome mapping and SNP calling has been reduced from 72 to 17 hours.

“DDN enabled us to analyze thousands of samples for the Cancer Genome Atlas, which amounts to nearly a petabyte of data,” explained Dr. Nicholas Tsinoremas, director of the Center for Computational Sciences at the University of Miami. “Having a robust storage platform like DDN is essential to driving discoveries, such as our recent study that revealed a link between certain viruses and gastrointestinal cancers. Previously, we couldn’t have done that level of computation.”

In addition to providing significant storage processing power to meet both high I/O and interactive processing requirements, CCS needed a flexible file system that could support large parallel and short serial jobs. The center also needed to address “data in flight” challenges that result from major data surges during analysis, and which often cause a 10x spike in storage. The system’s performance for genomics assembly, alignment and mapping is enabling CCS to support all its application needs, including the use of BWA and Bowtie for initial mapping, as well as SamTools and GATK for variant analysis and SNP calling.

“Our arrangement is to share data or make it available to anyone asking, anywhere in the world,” added Tsinoremas. “Now, we have the storage versatility to attract researchers from both within and outside the HPC community … we’re well-positioned to generate, analyze and integrate all types of research data to drive major scientific discoveries and breakthroughs.”

About DDN

DataDirect Networks is a big data storage supplier to data-intensive, global organizations. For more than 15 years, the company has designed, developed, deployed and optimized systems, software and solutions that enable enterprises, service providers, universities and government agencies to generate more value and to accelerate time to insight from their data and information, on premise and in the cloud. Organizations leverage DDN technology and the technical expertise of its team to capture, store, process, analyze, collaborate and distribute data, information and content at largest scale in the most efficient, reliable and cost effective manner. DDN customers include financial services firms and banks, healthcare and life science organizations, manufacturing and energy companies, government and research facilities, and web and cloud service providers.

 

“Where DDN really stood out is in the ability to adapt to whatever we would need. We have both IOPS-centric storage and the deep, slower I/O pool at full bandwidth. No one else could do that.”

Joel P. Zysman

Director of High Performance Computing

Center for Computational Science at the University of Miami

The University of Miami maintains one of the largest centralized, academic, cyber infrastructures in the US, which is integral to addressing and solving major scientific challenges. At its Center for Computational Science (CCS), more than 2,000 researchers, faculty, staff and students across multiple disciplines collaborate on diverse and interdisciplinary projects requiring HPC resources.

With 50% of the center’s users come from University of Miami’s Miller School of Medicine with ongoing projects at the Hussman Institute for Human Genomics, the explosion of next-generation sequencing has had a major impact on compute and storage demands. At CCS, the heavy I/O required to create four billion reads from one genome in a couple of days only intensifies when the data from the reads needs to be managed and analyzed

Aside from providing sufficient storage power to meet both high I/O and interactive processing demands, CCS needed a powerful file system that was flexible enough to handle very large parallel jobs as well as smaller, shorter serial jobs. CCS also needed to address as much as 10X spikes in storage, so it was critical to scale and support petabytes of machine-generated data without adding a layer of complexity or creating inefficiencies.

Read their success story to learn how high-performance DDN® Storage I/O has helped the University of Miami:

  • Establish links between certain viruses and gastrointestinal cancers discovered with computation that were not possible before
  • Reduce genomics compute and analysis time from 72 to 17 hours
CHALLENGES

  • Diverse, interdisciplinary research projects required massive compute and storage power as well as integrated data lifecycle movement and management
  • Highly demanding I/O and heavy interactivity requirements from next-gen sequencing intensified data generation, analysis and management
  • Handle large parallel jobs and smaller, shorter serial jobs
  • Data surges during analysis created “data-in-flight” challenges

SOLUTION

An end-to-end, high performance DDN GRIDScaler® solution featuring a GS12K™ scale-out appliance with an embedded IBM® GPFS™ parallel file system

TECHNICAL BENEFITS

  • Centralized storage with an embedded file system makes it easy to add storage where needed—in the high-performance, high-transaction or slower storage pools—and then manage it all through a single pane of glass
  • DDN’s transparent data movement enables using one platform for data capture, download, analysis and retention
  • The ability to maintain an active archive of storage lets the center accommodate different types of analytics with varied I/O needs

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Diet and Exercise

Writer and Curator: Larry H. Bernstein, MD, FCAP 

 

Introduction

In the last several decades there has been a transformation in the diet of Americans, and much debate about obesity, type 2 diabetes mellitus, hyperlipidemia, and the transformation of medical practice to a greater emphasis on preventive medicine. This occurs at a time that the Western countries are experiencing a large portion of the obesity epidemic, which actually diverts attention from a larger share of malnutrition in parts of Africa, Asia, and to a greater extent in India. This does not mean that obesity or malnutrition is exclusively in any parts of the world. But there is a factor at play that involves social factors, poverty, education, cognition, anxiety, and eating behaviors, food preferences and food balance, and activities of daily living. The epidemic of obesity also involves the development of serious long term health problems, such as, type 2 diabetes mellitus, sarcopenia, fracture risk, pulmonary disease, sleep apnea in particular, and cardiovascular and stroke risk. Nevertheless, this generation of Western society is also experiencing a longer life span than its predecessors. In this article I shall explore the published work on diet and exercise.

 

‘‘Go4Life’’ exercise counseling, accelerometer feedback, and activity levels in older people

Warren G. Thompson, CL Kuhle, GA Koepp, SK McCrady-Spitzer, JA Levine
Archives of Gerontology and Geriatrics 58 (2014) 314–319
http://dx.doi.org/10.1016/j.archger.2014.01.004

Older people are more sedentary than other age groups. We sought to determine if providing an accelerometer with feedback about activity and counseling older subjects using Go4Life educational material would increase activity levels. Participants were recruited from independent living areas within assisted living facilities and the general public in the Rochester, MN area. 49 persons aged 65–95(79.5 + 7.0 years) who were ambulatory but sedentary and overweight participated in this randomized controlled crossover trial for one year. After a baseline period of 2 weeks, group 1 received an accelerometer and counseling using Go4Life educational material (www.Go4Life.nia.nih.gov) for 24 weeks and accelerometer alone for the next 24 weeks. Group 2 had no intervention for the first 24 weeks and then received an accelerometer and Go4Life based counseling for 24 weeks. There were no significant baseline differences between the two groups. The intervention was not associated with a significant change inactivity, body weight, % body fat, or blood parameters (p > 0.05). Older (80–93) subjects were less active than younger (65–79) subjects (p = 0.003). Over the course of the 48 week study, an increase in activity level was associated with a decline in % body fat (p = 0.008). Increasing activity levels benefits older patients. However, providing an accelerometer and a Go4Life based exercise counseling program did not result in a 15% improvement in activity levels in this elderly population. Alternate approaches to exercise counseling may be needed in elderly people of this age range.

It is generally recommended that older adults be moderately or vigorously active for 150 min each week. A systematic review demonstrated that only 20–60% of older people are achieving this goal. These studies determined adherence to physical activity recommendations by questionnaire. Using NHANES data, it has been demonstrated that older people meet activity recommendations 62% of the time using a self-report questionnaire compared to 9.6% of the time when measured by accelerometry. Thus, objective measures suggest that older people are falling even more short of the goal than previously thought. Most studies have measured moderate and vigorous activity. However, light activity or NEAT (non-exercise activity thermogenesis) also has an important effect on health. For example, increased energy expenditure was associated with lower mortality in community-dwelling older adults. More than half of the extra energy expenditure in the high energy expenditure group came from non-exercise (light) activity. In addition to reduced total mortality, increased light and moderate activity has been associated with better cognitive function, reduced fracture rate (Gregg et al., 1998), less cardiovascular disease, and weight loss in older people. A meta-analysis of middle-aged and older adults has demonstrated greater all-cause mortality with increased sitting time. Thus, any strategy which can increase activity (whether light or more vigorous) has the potential to save lives and improve quality of life for older adults. A variety of devices have been used to measure physical activity.

A tri-axial accelerometer measures movement in three dimensions. Studies comparing tri-axial accelerometers with uniaxial accelerometers and pedometers demonstrate that only certain tri-axial accelerometers provide a reliable assessment of energy expenditure. This is usually due to failure to detect light activity. Since light activity accounts for a substantial portion of older people’s energy expenditure, measuring activity with a questionnaire or measuring steps with a pedometer do not provide an accurate reflection of activity in older people.

A recent review concluded that there is only weak evidence that physical activity can be improved. Since increasing both light and moderate activity benefit older people, studies demonstrating that physical activity can be improved are urgently needed. Since accelerometry is the best way to accurately assess light activity, we performed a study to determine if an activity counseling program and using an accelerometer which gives feedback on physical activity, can result in an increase in light and moderate activity in older people. We also sought to determine whether counseling and accelerometer feedback would result in weight loss, change in % body fat, glucose, hemoglobin A1c, insulin, and fasting lipid profile.

The main results of the study are both the experimental and control group lost weight (about 1 kg) at 6months (p = 0.04 and 0.02, respectively). The experimental group was less active at 6 months but not significantly while the control group was significantly less active at 6 months (p = 0.006) than at baseline. The experimental group had a modest decline in cholesterol (p = 0.03) and an improvement in Get Up & go time (p = 0.03) while the control group had a slight improvement in HgbA1c (p = 0.01). However, the main finding of the study was that there were no differences between the two groups on any of these variables. Thus, providing this group of older participants with an accelerometer and Go4Life based counseling resulted in no increase in physical activity, weight loss or change in glucose, lipids, blood pressure, or body fat. There were no differences within either group or between groups from 6 to 12 months on any of the variables (data not shown). While age was correlated with baseline activity, it did not affect activity change indicating that younger participants did not respond to the program better than older participants. Performance on the Get Up and Go test and season of the year did not influence the change in activity. There were no differences in physical activity levels at 3 or 9 months.

There was a significant correlation (r = -0.38, p = 0.006) between change in activity and change in body fat over the course of the study. Those subjects (whether in the experimental or control group) who increased their activity over the course of the year were likely to have a decline in % body fat over the year while those whose activity declined were likely to have increased %body fat. There was no correlation between change in activity and any of the other parameters including weight and waist circumference (data not shown).

Older adults are the fastest growing segment of the population in the US, but few meet the minimum recommended 30 min of moderate activity on 5 days or more per week (Centers for Disease Control and Prevention, 2002). Our study found that within the geriatric population, activity declines as people age. We saw a 2.4% decline per year cross-sectionally. This finding agrees with a recent cohort study (Bachman et al., 2014). In that study, the annual decline accelerated with increasing age. Thus, there is a need to increase activity particularly in the oldest age groups. The United States Preventive Services Task Force concluded that the evidence that counseling improves physical activity is weak (Moyer and US Preventive Services Task Force, 2012). The American Heart Association reached similar conclusions (Artinian et al., 2010). Thus, new ways of counseling older patients to counter the natural decline in activity with age are urgently needed.

Applying health behavior theory to multiple behavior change: Considerations and approaches

Seth M. Noar, Melissa Chabot, Rick S. Zimmerman
Preventive Medicine 46 (2008) 275–280
http://dx.doi.org:/10.1016/j.ypmed.2007.08.001

Background.There has been a dearth of theorizing in the area of multiple behavior change. The purpose of the current article was to examine how health behavior theory might be applied to the growing research terrain of multiple behavior change. Methods. Three approaches to applying health behavior theory to multiple behavior change are advanced, including searching the literature for potential examples of such applications. Results. These three approaches to multiple behavior change include

(1) a behavior change principles approach;

(2) a global health/behavioral category approach, and

(3) a multiple behavioral approach.

Each approach is discussed and explicated and examples from this emerging literature are provided. Conclusions. Further study in this area has the potential to broaden our understanding of multiple behaviors and multiple behavior change. Implications for additional theory-testing and application of theory to interventions are discussed.

Many of the leading causes of death in the United States are behavior-related and thus preventable. While a number of health behaviors are a concern individually, increasingly the impact of multiple behavioral risks is being appreciated. As newer initiatives funded by the National Institutes of Health and Robert Wood Johnson Foundation begin to stimulate research in this important area, a critical question emerges: How can we understand multiple health behavior change from a theoretical standpoint? While multiple behavior change interventions are beginning to be developed and evaluated, to date there have been few efforts to garner a theory-based understanding of the process of multiple health behavior change. Given that so little theoretical work currently exists in this area, our main purpose is to advance the conversation on how health behavior theory can help us to achieve a greater understanding of multiple behavior change. The approaches discussed have implications for both theory-testing as well as intervention design.

A critical question that must be asked, is whether there is a common set of principles of health behavior change that transcend individual health behaviors. This is an area where much data already exists, as health behavior theories have been tested across numerous health behaviors.The integration of findings from studies across diverse behavioral areas, is not what it could be. Godin and Kok (1996) reviewed studies of the TPB applied to numerous health-related behaviors. Across seven categories of health behaviors, they found TPB components to offer similar prediction of intention but inconsistent prediction of behavior.They concluded that the nature of differing health behaviors may require additional constructs to be added to the TPB, such as actual (versus perceived) behavioral control. Prochaska et al. (1994) examined decisional balance across stages of change for 12 health-related behaviors. Similar patterns were found across nearly all of these health behaviors, with the “pros” of changing generally increasing across the stages, the “cons” decreasing, and a pro/con crossover occurring in the contemplation or preparation stages of change. Prochaska et al. (1994) concluded that clear commonalties exist across these differing health behaviors which were examined in differing samples. Finally, Rosen (2000) examined change processes from the TTM across six behavioral categories, examining whether the trajectory of change processes is similar or different across stages of change in those health areas. He found that for smoking cessation, cognitive change processes were used more in earlier stages of change than behavioral processes, while for physical activity and dietary change, both categories of change processes increased together.

A second approach is the following: Rather than applying theoretical concepts to specific behaviors, such concepts might be applied at the general or global level. A general orientation toward health may not lead directly to specific health behaviors, but it may increase the chances of particular health-related attitudes, which may in turn lead to specific health behaviors. In fact, although Ajzen and Timko (1986) found general health attitudes to be poor predictors of behavior, such attitudes were significantly related to specific health attitudes and perceived behavioral control over specific behaviors. It is likely that when we consider multiple behaviors that we may discover an entire network of health attitudes and beliefs that are interrelated. In fact, studies of single behaviors essentially take those behaviors out of the multi-attitude and multi-behavioral context in which they are embedded. For instance, although attitudes toward walking may be a better predictor of walking behavior than attitudes toward physical activity, walking behavior is part of a larger “physical activity” behavioral category. While predicting that particular behavior may be best served by the specific measure, the larger category is both relevant and of interest. Thus, it may be that there are higher order constructs to be understood here.

A third approach is a multiple behavioral approach, or one which focuses on the linkages among health behaviors. It shares some similarities to the approach just described. Here the focus is more strictly on how particular  interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Conclusions: Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.

 

A prospective evaluation of the Transtheoretical Model of Change applied to exercise in young people 

Patrick Callaghan, Elizabeth Khalil, Ioannis Morres
Intl J Nursing Studies 47 (2010) 3–12
http://dx.doi.org:/10.1016/j.ijnurstu.2009.06.013

Objectives:To investigate the utility of the Transtheoretical Model of Change in predicting exercise in young people. Design: A prospective study: assessments were done at baseline and follow-up 6 months later. Method: Using stratified random sampling 1055 Chinese high school pupils living in Hong Kong, 533 of who were followed up at 6 months, completed measures of stage of change (SCQ), self-efficacy (SEQ), perceptions of the pros and cons of exercising (DBQ) and processes of change (PCQ). Data were analyzed using one-way ANOVA, repeated measures ANOVA and independent sample t tests.
Results:The utility of the TTM to predict exercise in this population is not strong; increases in self-efficacy and decisional balance discriminated between those remaining active at baseline and follow-up, but not in changing from an inactive (e.g.,Precontemplation or Contemplation) to an active state (e.g.,Maintenance) as one would anticipate given the staging algorithm of the TTM.
Conclusion:The TTM is a modest predictor of future stage of change for exercise in young Chinese people. Where there is evidence that TTM variables may shape movement over time, self-efficacy, pros and behavioral processes of change appear to be the strongest predictors

 

A retrospective study on changes in residents’ physical activities, social interactions, and neighborhood cohesion after moving to a walkable community

Xuemei Zhu,Chia-Yuan Yu, Chanam Lee, Zhipeng Lu, George Mann
Preventive Medicine 69 (2014) S93–S97
http://dx.doi.org/10.1016/j.ypmed.2014.08.013

Objective. This study is to examine changes in residents’ physical activities, social interactions, andneighbor-hood cohesion after they moved to a walkable community in Austin, Texas.
Methods. Retrospective surveys (N=449) were administered in 2013–2014 to collect pre-and post-move data about the outcome variables and relevant personal, social, and physical environmental factors. Walkability of each resident’s pre-move community was measured using the Walk Score. T tests were used to examine the pre–post move differences in the outcomes in the whole sample and across subgroups with different physical activity levels, neighborhood conditions, and neighborhood preferences before the move. Results. After the move, total physical activity increased significantly in the whole sample and all subgroups except those who were previously sufficiently active; lived in communities with high walkability, social interactions, or neighborhood cohesion; or had moderate preference for walkable neighborhoods. Walking in the community increased in the whole sample and all subgroups except those who were previously sufficiently active, moved from high-walkability communities, or had little to no preference for walkable neighborhoods. Social interactions and neighborhood cohesion increased significantly after the move in the whole sample and all subgroups.
Conclusion.This study explored potential health benefits of a walkable community in promoting physically and socially active lifestyles, especially for populations at higher risk of obesity. The initial result is promising, suggesting the need for more work to further examine the relationships between health and community design using pre–post assessments.

 

Application of the transtheoretical model to identify psychological constructs influencing exercise behavior: A questionnaire survey

Young-Ho Kim
Intl J Nursing Studies 44 (2007) 936–944
http://dx.doi.org:/10.1016/j.ijnurstu.2006.03.008

Background: Current research on exercise behavior has largely been attempted to identify the relationship between psychological attributes and the initiation or adherence of exercise behavior based on psychological theories. A limited data are available on the psychological predictors of exercise behavior in public health. Objectives: The present study examined the theorized association of TTM of behavior change constructs by stage of change for exercise behavior. Methods: A total of 228 college students selected from 2 universities in Seoul were surveyed. Four Korean-version questionnaires were used to identify the stage of exercise behavior and psychological attributes of adolescents. Data were analyzed by frequency analysis, MANOVA, correlation analysis, and discriminant function analysis.
Results: Multivariate F-test indicated that behavioral and cognitive processes of change, exercise efficacy, and pros differentiated participants across the stages of exercise behavior. Furthermore, exercise behavior was significantly correlated with the TTM constructs, and that overall classification accuracy across the stages of change was 61.0%. Conclusions:The present study supports the internal and external validity of the Transtheoretical Model for explaining exercise behavior. As this study highlights, dissemination must increase awareness but also influences perceptions regarding theoretically based and practically important exercise strategies for public health professionals.

 

 

Does more education lead to better health habits? Evidence from the school reforms in Australia?

Jinhu Li, Nattavudh Powdthavee
Social Science & Medicine 127 (2015) 83-91
http://dx.doi.org/10.1016/j.socscimed.2014.07.021

The current study provides new empirical evidence on the causal effect of education on health-related behaviors by exploiting historical changes in the compulsory schooling laws in Australia. Since World War II, Australian states increased the minimum school leaving age from 14 to 15 in different years. Using differences in the laws regarding minimum school leaving age across different cohorts and across different states as a source of exogenous variation in education, we show that more education improves people’s diets and their tendency to engage in more regular exercise and drinking moderately, but not necessarily their tendency to avoid smoking and to engage in more preventive health checks. The improvements in health behaviors are also reflected in the estimated positive effect of education on some health outcomes. Our results are robust to alternative measures of education and different estimation methods.

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