Project GRAD: two-year outcomes of a randomized controlled physical activity intervention among young adults. Graduate Ready for Activity Daily.

INTRODUCTION: Project Graduate Ready for Activity Daily evaluated a program to promote physical activity through the transition of university graduation in a randomized controlled trial. METHODS: Three hundred thirty-eight university seniors participated in either a cognitive-behavioral intervention course or a knowledge-oriented general health course during the semester before graduation. Behaviorally oriented phone and mail follow-up was delivered to the intervention group for 18 months. Physical activity outcomes and mediating variables were assessed at baseline, 1 and 2 years (93% retention rate). RESULTS: There were no significant intervention effects on physical activity outcomes at 2 years for either men or women. Experiential and behavioral processes of change were significantly improved for intervention women over 2 years. CONCLUSIONS: Despite excellent participation in a theoretically based, well-attended intervention, few long-term effects on physical activity or its mediators were found. Additional research is needed to determine optimal interventions for physical activity and to validate or alter current behavior change theory.

Potential mediators of change in a physical activity promotion course for university students: Project GRAD.

The purpose of the study is to evaluate the performance of theoretically-derived mediators of health behavior change. Participants were university seniors (184 females; 154 males) randomly assigned to an intervention course designed to promote physical activity or to a control course. Five physical activity outcomes and nine psychosocial mediating variables were assessed at baseline and the end of the 16-week course. For women, the intervention had significant effects on five of the mediators, including self-efficacy for making time, self-efficacy for resisting relapse, social support from friends, and experiential and behavioral processes of change. Among men, the intervention improved use of behavioral processes of change but also had the unintended effect of increasing perceived barriers to activity. For women, significant contributors to regressions explaining physical activity change were social support from friends (for total activity) and change in self-efficacy for resisting relapse (for vigorous exercise). For men, significant explanatory variables included change in enjoyment (for total activity), change in self-efficacy for resisting relapse (for strength exercise), and change in benefits (for moderate intensity activity). For both sexes, there were significant findings in the unexpected direction. Across the five physical activity outcomes, hypothesized mediators were inconsistent and weak contributors to the models. Investigating mediators of behavior change has the potential to stimulate improvements in theories and interventions.

Predictors of change in children's physical activity over 20 months. Variations by gender and level of adiposity.

BACKGROUND: Physical activity declines during childhood and determinants of this decline are poorly understood. The purpose of this prospective study was to examine modifiable psychological and social correlates of physical activity change over 20 months. SUBJECTS: 370 girls and 362 boys in public schools, studied through the 4th and 5th grades. MEASURES: A physical activity index was computed from child reports, parent reports, and objective activity monitoring. Predictor variables were assessed by child and parent surveys. RESULTS: In multiple regressions, after adjustments for demographic variables, psychological variables explained 4% of the variance in boys' physical activity change, parent variables explained 8%, and interactions with skinfolds explained 3%, for a total of 15% (unadjusted). Regarding change in girls' physical activity, psychological variables explained 3%, parent variables explained 1.5%, and interactions with skinfold explained 1.5%, for a total of 6% explained variance (unadjusted). There were differences in predictors among children with high and low levels of body fat. CONCLUSIONS: Children's preferences for physical activity and frequency of parents transporting children to activity locations explained significant proportions of variance for girls and boys. The results support a dynamic model of the determinants of children's physical activity, but most of the variance was left unexplained.

Evaluation of a university course to promote physical activity: project GRAD.

Project GRAD (Graduate Ready for Activity Daily) evaluates a university course to promote physical activity. In a randomized study, 338 university seniors participated in either an intervention or control course for academic credit, and posttest data were collected on 321. The control course was knowledge-oriented. The intervention course taught behavior change skills in weekly lectures and peer-led labs. Physical activity was assessed with 7-Day Physical Activity Recall interviews. The intervention had no significant effects on men. Among women, the intervention increased total physical activity during leisure, strengthening exercises, and flexibility exercise. This university course had the intended effects of promoting healthful patterns of physical activity among women, but no effects were observed on men, who were more active than women at baseline.

Children's television viewing, body fat, and physical fitness.

PURPOSE: The study examines the relationship between children's television (TV) viewing and physical fitness. DESIGN: Cross-sectional data from questionnaires and objective measures were analyzed. SETTING: Data were collected during the fall of 1990 from public elementary school students in a suburban California city. SUBJECTS: Approximately 98% of eligible students participated. Of these, 10% were dropped due to missing data, yielding a final sample of 284 girls and 304 boys. MEASURES: Children reported their amount of TV viewing on a typical summer day; parents reported their child's TV viewing on a typical weekday during the school year. Cardiovascular fitness was the 1-mile run/walk. Body fat was both the child's body mass index (BMI) and skinfolds. Additional measures included muscular strength/endurance and flexibility. RESULTS: Mile run/walk times were associated with both parental (eta 2 = .051 and .031 for boys and girls, respectively) and child reports (eta 2 = .020 and .028) of the child's amount of TV viewing. Parental reports, but not child reports, of the child's TV viewing were related to BMI (eta 2 = .041 and .058) and skinfolds (eta 2 = .050 and .029). Neither measure of children's TV viewing was related to muscular strength/endurance or flexibility. CONCLUSIONS: Children's TV viewing seems to be weakly and inconsistently related to various components of physical fitness. However, given the tracking of cardiovascular disease risk factors from childhood into adulthood and the high proportion of children who watch television, these relationships are worthy of further study.

The effects of a 2-year physical education program (SPARK) on physical activity and fitness in elementary school students. Sports, Play and Active Recreation for Kids.

OBJECTIVES: This study evaluated a health-related physical education program for fourth- and fifth-grade students designed to increase physical activity during physical education classes and outside of school. METHODS: Seven schools were assigned to three conditions in a quasi-experimental design. Health-related physical education was taught by physical education specialists or trained classroom teachers. Students from these classes were compared with those in control classes. Analyses were conducted on 955 students with complete data. RESULTS: Students spent more minutes per week being physically active in specialist-led (40 min) and teacher-led (33 min) physical education classes than in control classes (18 min; P < .001). After 2 years, girls in the specialist-led condition were superior to girls in the control condition on abdominal strength and endurance (P < .001) and cardiorespiratory endurance (P < .001). There were no effects on physical activity outside of school. CONCLUSIONS: A health-related physical education curriculum can provide students with substantially more physical activity during physical education classes. Improved physical education classes can potentially benefit 97% of elementary school students.

Quality-adjusted life years lost to arthritis: effects of gender, race,and social class.

OBJECTIVE: To estimate the public health impact of self-reported arthritis in terms of Quality-Adjusted Life Years. METHOD: The Quality of Well-being Scale (QWB) is a general measure of health-related quality of life that scores levels of wellness on a continuum between death (0.0) and optimum functioning (1.0). Values for the QWB were imputed for the National Health Interview Survey. These estimates were adjusted for mortality based on the life tables. Age-specific estimates were obtained for those reporting arthritis and compared to estimators for the population not reporting arthritis. These estimates were broken down by race (white versus nonwhite), gender and socioeconomic status. RESULTS: The expected life years lost because of arthritis were 1.86 (95% confidence interval 1.40-2.32 years). Arthritis was reported more often among those of lower income, those living in rural areas, those of lower educational attainment, and older respondents. Men and women did not differ in rates of reporting arthritis, but men with arthritis had lower QWB scores than women with arthritis. CONCLUSION: Arthritis has a significant public health impact.

Cellular pharmacology of dichloro(ethylenediamine)platinum(II) in cisplatin-sensitive and resistant human ovarian carcinoma cells.

The cellular pharmacology of the tritium-labeled cisplatin analogue dichloro(ethylenediamine)platinum(II) ([3H]DEP) was compared in cisplatin-sensitive 2008 and resistant 2008/C13*5.25 human ovarian carcinoma cells. The cellular content of total [3H], ultrafiltrable [3H], and free native [3H]DEP was measured during and following incubation with 5 microM [3H]DEP. While the rate constant for [3H]DEP uptake in the resistant cells was reduced to 25% of that in the sensitive cells, DNA intrastrand adduct formation was reduced even further to 11%, indicating the presence of defects in both uptake and the ability of intracellular drug to access or react with DNA. The latter could not be accounted for by enhanced repair. Together, these defects were sufficient to account for the 11-fold level of resistance. At steady state, the intracellular to extracellular concentration ratio for native [3H]DEP was 7.7 in the sensitive cells and 11.7 in the resistant cells, suggesting the presence of a trapping or concentrative mechanism. Thus, despite the slower initial influx, the resistant cells eventually accumulated more free [3H]DEP than the sensitive cells. We conclude that the resistant phenotype in these cells is accounted for primarily by impaired uptake and decreased reaction of [3H]DEP with DNA rather than by changes in efflux or DNA repair.

Project SPARK. Effects of physical education on adiposity in children.

Project SPARK evaluates multiple effects of a health-related physical education (PE) program for elementary school students. Seven schools were randomly assigned to one of three conditions: usual PE or control, trained classroom teachers, or PE specialists. The intervention was implemented throughout the fourth and fifth grades. Data are available from one cohort of 550 children who were measured in the fall and spring of both grades. Adiposity was assessed by triceps and calf skinfolds, and body mass index (BMI) was also measured. Data at each measurement point were analyzed by ANOVAs, covarying for baseline values. At no measurement point were there significant group differences in total skinfold. At both fifth grade measurement points for boys and girls, however, there was a trend for the control group to have higher skinfold values than the two intervention groups. At the final measure, the difference between the highest and lowest groups was about 3 mm for girls and 2 mm for boys. BMIs were significantly lower at some measurement points for boys and girls, but this could be due to increased lean body mass in intervention students. After two years, there was a trend for the children exposed to the PE intervention to have lower levels of body fat, but the differences were not significant.

Habitual physical activity and health-related physical fitness in fourth-grade children.

OBJECTIVE: To examine the relationship between habitual physical activity and components of health-related physical fitness in children. DESIGN: Cross-sectional survey with correlational analysis. SETTING: Seven public elementary schools in a suburban southern California city. PARTICIPANTS: Five hundred twenty-eight healthy fourth-grade children (274 boys and 254 girls), 85% of whom were non-Hispanic whites. Ninety-eight percent of eligible students participated. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Results of six measures of physical activity in children (monitoring by accelerometer, parent report, and child self-reports of weekday activity, weekend activity, and summer involvement in activity classes and youth sports) were combined in a physical activity index. This index of habitual physical activity was examined in relation to measures of five components of health-related fitness: the mile run, skin-fold tests, pull-ups, sit-ups, and the sit-and-reach test. The physical activity index was significantly associated with all five fitness components. The canonical correlation was .29. CONCLUSION: Active children appear to engage in a sufficient variety of activities to enhance multiple components of health-related fitness.

Virologic markers of human immunodeficiency virus type 1 in cerebrospinal fluid. The HIV Neurobehavioral Research Center Group.

As part of a longitudinal study, 265 cerebrospinal fluid (CSF) specimens from 204 human immunodeficiency virus type 1 (HIV-1)-seropositive subjects and 43 seronegative controls were evaluated. Of the 204 seropositive persons, 78 (38%) had > or = 1 CSF culture positive for HIV-1; the probability of being culture positive increased as the number of CSF samples obtained increased (P = .0018). Significantly correlated with culture positivity were elevations in CSF protein level (P = .014) and CSF white blood cell count (P = .001). Virus was more readily cultured from clarified CSF (89%, 42/47) than from the cellular fraction (30%, 14/47; P < .00001). Amplification of HIV-1 DNA by polymerase chain reaction (PCR) from 25 seropositive persons was positive in 9 (82%) of 11 culture-positive and in 4 (29%) of 14 culture-negative specimens, while amplification of viral RNA detected all 11 culture-positive and 9 (64%) of the 14 culture-negative CSF specimens. These data support the hypothesis that the development of HIV-1-associated neurocognitive disorders are not dependent solely on the presence of HIV-1 within the central nervous system.

Correlation of the survival of ovarian cancer patients with mRNA expression of the 60-kD heat-shock protein HSP-60.

PURPOSE: Ovarian carcinomas express the 60-kD heat-shock protein HSP-60 at widely varying levels in different tumors. The aim of this study was to determine whether there was a relationship between expression of HSP-60 and survival in patients with ovarian carcinoma. MATERIALS AND METHODS: Total RNA and DNA were prepared from 51 epithelial ovarian cancer tissue samples. The expression and structure of the HSP-60 gene were examined by Northern and Southern blot analyses using the carboxyl-terminal portion of this gene as a probe (0.89 kilobases [kb]). HSP-60 expression was correlated with overall survival by the Kaplan-Meier method. RESULTS: The 2.3-kb HSP-60 message was detected in all samples, but there was marked variation from tumor to tumor. Patients were classified into two groups on the basis of HSP-60 expression: group 1 (n = 25) included patients with low expression, and group 2 (n = 26) consisted of patients with high expression. There were no significant differences between the groups with respect to age, cell type, pathologic grade, clinical stage, and previous treatment. After a median follow-up period of 17 months, Kaplan-Meier plots demonstrated a much better survival for group 1 (median, 46.8 months; 41% at 4 years) than group 2 (median, 22.1 months; 16% at 3.9 years), a difference that was highly significant by the Mantel-Haenszel test (P = .00183). Southern blot analysis of these samples showed no amplification or rearrangement of the gene. CONCLUSION: The level of HSP-60 mRNA expression is a valuable prognostic factor in epithelial ovarian cancer. Variation in the level of expression is not due to amplification of this gene.

The development of self-administered physical activity surveys for 4th grade students.

This study evaluates the test-retest reliability and validity of self-report measures of physical activity that can be self-administered in classroom settings to 4th grade students. Four different self-report formats were tested on 66 students. To assess test-retest reliabilities, self-report measures were administered on two occasions, separated by a 3-day interval between Time 1 (Friday) and Time 2 (Monday). One-way model intraclass reliabilities ranged from .51 to .74. Three days of monitoring with the Caltrac accelerometer were used as the validity criterion. Only one of the three weekly recalls, the Weekly Activity Checklist, was supported by significant validity correlations at both Time 1 (r = .34, p < .01) and Time 2 (r = .26, p < .05). The 1-day recall, Yesterday Activity Checklist, correlated significantly (r = .33, p < .01) with the previous day's Caltrac monitor score. Although two of the physical activity recall formats were found to be superior to two others, these data highlight the limitations of children's self-reports. Two self-report formats were found to have modest levels of reliability and validity with 4th grade children when administered in a classroom setting.

Selective modulation of vinblastine sensitivity by 1,9-dideoxyforskolin and related diterpenes in multidrug resistant tumour cells.

The ability of 1,9-dideoxyforskolin (DDF), 1-deoxyforskolin (DF) and forskolin to modulate cellular sensitivity to vinblastine (VBL) was examined in drug-sensitive parental KB-3-1 cells and a multidrug-resistant subline, KB-GRC1, derived by transfection of mdr1. Fifty microM DF and forskolin enhanced the 1 h uptake of VBL by 8.0 +/- 0.7 (s.d.) and 4.7 +/- 2.5-fold, respectively, with 50 microM DDF producing a 13.6 +/- 1.9-fold increase. The greater effect of DDF relative to forskolin indicated that the effect was independent of activation of cAMP, and this was supported by a lack of effect of dibutyryl cAMP on the uptake. The effect of these agents on uptake were < or = 1.4-fold in KB-3-1 cells. DDF selectively inhibited initial efflux in cells expressing a functional P-glycoprotein (PGP), but both forskolin and DDF inhibited the terminal phase of efflux irrespective of PGP expression. Neither agent affected membrane permeability of polarisation and forskolin did not enhance the uptake of VBL in protein-free liposomes. At a non-toxic concentration of 20 microM, DDF and forskolin decreased the IC50 of VBL from 18.9 to 2.7 and 13 nM in KB-GRC1 cells, respectively, and DDF acted synergistically with VBL as shown by median effect analysis [combination index = 0.20 +/- 0.05 (s.d.)]. In contrast, these diterpenes did not affect VBL sensitivity in KB-3-1 cells. These results indicate that the diterpenes modulate VBL sensitivity predominantly by inhibiting PGP-mediated efflux activity.

Regulation of initial vinblastine influx by P-glycoprotein.

P-glycoprotein (PGP) is an energy-dependent efflux pump that serves to protect cells against the cytotoxicity of many natural product drugs including vinblastine (VBL). In this study we investigated the role of PGP in regulating initial VBL influx. The apparent influx of VBL, measured over the first 20 s, was 2-fold lower in KB-GRC1 cells expressing a transfected mdr1 gene at high level than in non-expressing parental KB-3-1 cells. Inhibition of PGP efflux function with dipyridamole increased the influx rate constant by 4.0-fold in the KB-GRC1 cells but only 2.1-fold in the KB-3-1 cells. Verapamil, another inhibitor of PGP-mediated efflux, increased the initial influx rate constant by 2.7-fold in the KB-GRC1 cells but only 1.4-fold in the KB-3-1 cells. Inhibition of PGP function by depletion of ATP increased influx by 6.8-fold and 2.2-fold in the two cell types, respectively. Mutation of PGP at both ATP binding sites abolished its ability to limit initial influx. Thus, VBL is serving as an efficient substrate for the efflux pump even within the first few seconds of drug exposure, consistent with the hypothesis that PGP may directly efflux drug from the cell membrane.

Parental behavior in relation to physical activity and fitness in 9-year-old children.

OBJECTIVE: To examine the relationship between parental behaviors and physical activity and fitness in elementary school-aged children. DESIGN: Cross-sectional survey of students and parents. SETTING: Seven public elementary schools in a suburban southern California city. PARTICIPANTS: One hundred forty-eight fourth-grade girls and 149 fourth-grade boys and their parents. Eighty-four percent were white. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Children's physical activity was indicated by self-report, data obtained from a monitor (accelerometer), and results of the mile run/walk. Multiple regression analysis, controlling for ethnicity and body mass index, was conducted separately for girls and boys to explain variation in child activity and fitness. Parents' reported physical activity was not associated with child activity or fitness. However, availability of transportation by parents to sport and fitness activities was significant (or nearly so) in two regressions for boys and in one regression for girls. Parents who played with their children had more active boys, based on self-report, but verbal encouragement to be active was not significant in any model. CONCLUSION: The parental role as gatekeeper of access to activity and sport facilities deserves further study.