Impact of motivational interviewing on outcomes of an adolescent obesity treatment: results from the MI Values randomized controlled pilot trial.

The aim of this study is to examine outcomes from MI Values, a motivational interviewing (MI) intervention implemented adjunctive to obesity treatment. Adolescents (n = 99; 73% African American; 74% female; mean body mass index [BMI] percentile = 98.9 ± 1.2) were randomized to receive two MI sessions or education control. All adolescents participated in structured behavioural weight management treatment. Baseline, 3- and 6-month assessments of anthropometrics, dietary intake and physical activity were obtained. Both groups had significant reductions in BMI z-scores and energy intake and increased physical activity at 3 and 6 months (P < 0.05). MI participants reported greater reductions in 3-month energy intake compared with controls. Participation in MI is associated with reduction in energy intake, consistent with better adherence to dietitian visits previously reported from MI Values. MI might be an effective adjunct to adolescent obesity treatment; future research is needed to determine if motivational interviewing can enhance BMI outcomes, via greater adherence to behavioural intervention.

Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI†Values randomized controlled trial.

BACKGROUND: Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)]. OBJECTIVE: Assess effects of MI Values on T.E.E.N.S. attrition and adherence. METHODS: Participants were randomized to MI (n = 58) or control (n = 41). At weeks 1 and 10, MI participants had brief MI sessions; controls viewed health education videos. All participants continued with T.E.E.N.S. (biweekly dietitian and behavioural support visits; 3 times per week supervised physical activity). Assessments were repeated at baseline, 3 and 6 months. T-tests and chi-square analyses examined T.E.E.N.S. attrition and adherence by group. RESULTS: Adolescents (N = 99) were primarily African-American (73%) females (74%); age = 13.8 ± 1.8 years, body mass index percentile = 98.0 ± 1.2. Compared with controls, MI participants had greater 3-month adherence overall (89.2% vs. 81.0%, P = 0.040), and to dietitian (91.3% vs. 84.0%; P = 0.046) and behavioural support (92.9% vs. 85.2%; P = 0.041) visits, and greater 6-month adherence overall (84.4% vs. 76.2%, P = 0.026) and to behavioural support visits (87.5% vs. 78.8%, P = 0.011). CONCLUSIONS: MI enhanced adherence to this obesity intervention. MI Values is the first study to examine the impact of MI on treatment adherence among obese, primarily African-American adolescents.

Microsatellite instability and MLH1 hypermethylation - incidence and significance in colorectal polyps in young patients.

OBJECTIVE: Microsatellite instability (MSI) is observed in most hereditary nonpolyposis colorectal cancer-related colorectal cancers (CRC). The original Bethesda criteria recommends MSI testing in patients

Publishing HIV/AIDS behavioural science reports: An author's guide.

The purpose of this paper is to report on characteristics of journals that publish manuscripts in the HIV/AIDS behavioural science realm, with the goal of providing assistance to authors seeking to disseminate their work in the most appropriate outlet. Fifty journals who publish behavioural research on HIV/AIDS in English were identified through library and electronic searches. Although ten of the journals focused specifically on HIV/AIDS, the majority of journals are in related fields, including health psychology/behavioural medicine, sexual behaviour, substance abuse, public health/prevention or general medicine. Acceptance rates ranged from 8- 89% with a mean acceptance rate of 39%. Reported review times ranged from 1-12 months with three months the mode, while publication lag following acceptance averages six months. Acceptance rates were related to impact factors, with more selective journals evidencing higher impact factors. The variety of publication outlets available to authors of HIV/AIDS behavioral science studies creates ample opportunity for dissemination, as well as challenge for readers in discerning the quality of published work.

The impact of psychiatric symptoms, drug use, and medication regimen on non-adherence to HIV treatment.

Identifying which mental disorders, substance use, and regimen factors influence non-adherence is a critical step in developing patient-customized interventions. In this cross-sectional study, 120 adults with HIV taking antiviral therapy completed interviews and questionnaires on their medication regimen, adherence behaviours, mental distress, and substance use patterns. They provided access to medical records for measures of immune health. Demographic characteristics, regimen factors, mental health indicators, and substance use variables were evaluated as predictors of four dichotomous non-adherent behaviours: running out of medications, not always taking medications as directed, taking below 95% of protease inhibitor doses, or having notations of non-compliance in the medical record. Non-adherence was prevalent and was related to immune health. Recent crack cocaine use was a risk factor for both taking a low proportion of PI medication and charted non-compliance notations. Heroin use and screening positive for social phobia were risk factors for running out of medication. Screening positive for any anxiety disorder reduced the risk of failing to take medications as directed. Clinicians caring for patients with HIV should screen for non-adherence using multiple behavioural indicators, and assess and treat substance use and anxiety disorders to reduce the risk of non-adherence.

Psychopathology in substance abusing women reporting childhood sexual abuse.

This study compared MMPI-2 profiles and evaluated the ability of the MMPI-2 and its two new post-traumatic stress scales (PK and PS) to discriminate women in outpatient substance abuse treatment reporting positive (n = 24) and negative (n = 69) child sexual abuse histories. T-tests revealed significantly higher mean scores for the sexual abuse group for the following scales: F, 1, 2, 3, 4, 6, 7, and 8. A discriminant analysis yielded a linear function of L, F, 3, 5, 8, and PK that correctly categorized 75% with positive histories and 77% with negative histories. The optimal cutoff PK score was 17, which correctly classified 75% and 46% of those reporting positive and negative abuse histories, respectively. These findings support early identification of abuse survivors among substance abusing women and suggests that the MMPI-2 may be useful in patient-treatment matching.

Family functioning of perinatal substance abusers in treatment.

This prospective study examined family characteristics of perinatal substance abusers enrolled in an intensive outpatient treatment program both during and after treatment. Data is provided on family functioning in three areas: current family, family of origin, and love/partner relationship, and at six time points up to 24 months postdischarge. Standard family assessment measures, including the Self-Report Family Inventory (SFI) and Family-of-Origin Scale (FOS) were utilized to measure current family functioning and family of origin health, respectively. A new instrument, the Relationship Assessment Form (RAF), was used to measure the level of unhealthy, codependent behaviors in the subject's love/partner relationship. A mixed models repeated measures ANOVA was used to determine if subjects' family functioning changed over time. Multivariate and univariate methods examined differences between the subjects in the current study and previously reported means for the SFI and FOS. Results were that perinatal substance abusers' perception of the overall health of their families of origin remained stable over time. Subjects rated their families of origin as more pathological than community adults, but similarly to adults presenting for psychotherapy. Although current family functioning was relatively stable, SFI scores that changed worsened over time after treatment. Perinatal substance abusers scored more pathologically at intake than normal, nonclinic families, but were similar to families presenting for family therapy on the SFI. In contrast, enduring changes of greater magnitude occurred in the subjects' self-reported codependent behavior over time. All RAF scores that changed moved in the direction of healthier, more autonomous functioning. Change and stability in aspects of family functioning may be due to specific factors of the treatment program, which are discussed. Standard family measures may need further refinement for use in this population. Recommendations for clinical programs and future research are provided.

Predictors of in-treatment relapse in perinatal substance abusers and impact on treatment retention: a prospective study.

This prospective study investigated in-treatment relapse in a sample of perinatal substance abusers in intensive outpatient treatment. Sixty-four female first-time admissions to a perinatal treatment program completed comprehensive psychological and psychosocial assessment before beginning treatment. Relapse was detected by urine toxicology screening and self-report. A regression analysis resulted in variable reduction, then survival analysis identified the impact of in-treatment relapse and other predictors on treatment length. Fifty-five percent of the subjects were classified as relapsers. Two risk factors for and six protective factors from in-treatment relapse were identified. The survival curves for relapsers and nonrelapsers did not differ until covariates were considered. Subjects with more severe consequences of drug use and less social exposure to drug use during treatment tended not to relapse during treatment, perhaps in order to prevent deterioration such as loss of children or incarceration. Relapse alone did not result in fewer treatment days. Few addiction characteristics were related to either in-treatment relapse or length of treatment. Rather, personality and demographic variables were more salient in both the regression and survival models. Treatment staff may need to reconsider their views of the meaning of relapse and should develop enhanced engagement and retention strategies for women at greater risk of relapse.

Ion polishing with the aid of a planarizing film.

An ion polishing technique employing a planarizing film in conjunction with ion-beam erosion at the planarizing angle was used to remove surface irregularities associated with conventional polishing of optical surfaces. By maintaining a planar surface throughout the erosion process, nonuniform erosion resulting from faceting, redeposition, and ion reflection is eliminated. Smooth surfaces on fused quartz are obtained by erosion of a planarizing film of photoresist at an angle of 60 degrees. The method is applicable to a wide variety of materials and may be useful for removing the surface roughness limitation on the laser-induced damage threshold of optical surfaces.

Asymmetric triangular grating profiles with 90 degrees groove angles produced by ion-beam erosion.

A simple phenomenological model has been developed to account for the effects of redeposition during transverse ion-beam erosion of grating relief patterns on surfaces. The model predicts the evolution with time of an inclined facet in the substrate, and the dependence of the facet angle theta(r) on angle of incidence of the ion beam, erosion rates of mask and substrate, and the geometrical parameters of the mask. The results are illustrated by calculation of the angular dependence of theta(r) for AZ-1350 photoresist masks on GaAs and SiO(2) substrates and for Ti on SiO(2). A strong dependence of theta(r) on mask intercept angle alpha is found, except for a limited range in angle of incidence of the ion beam. Combined with results derived previously, the facet angles theta(S) and theta(r) and the groove angle theta(g) of the asymmetric triangular groove profiles produced in these systems have been determined. A groove angle of 90 degrees cannot be obtained for AZ-1350 on GaAs and SiO(2), but in appropriate conditions a 90 degrees groove angle may be obtained in SiO(2) with a Ti mask.

Generation of periodic surface corrugations.

The generation of periodic surface corrugations by ion-beam milling and chemical etching of grating relief patterns in photoresist is analyzed. A general treatment is developed for gratings of any desired period on substrates of arbitrary reflectivity, but particular emphasis is given to the generation of gratings with deep grooves and fine periods (Lambda < 3000 A) on GaAs. Analysis of the intensity distribution in photoresist for both p- and s-polarized incident beams reveals that the standing waves generated by reflection from the substrate are diminished for p-polarized beams, but the existence of a displaced grating for certain ranges of substrate reflectivity and angle of incidence severely limits groove depth in resist. The requirements are given for the establishment of an intensity maximum at the photoresist-substrate interface, a condition desired for subsequent chemical etching. It is shown further that the alternative use of a quarterwave intermediate oxide layer to achieve this condition on GaAs results in a lower limit being imposed on grating period. Constantintensity contours approximating the groove profiles in resist demonstrate that an imbalance in incident beam intensity may lead to severing of the resist stripes, and the dependence of this phenomenon on substrate reflectivity is determined. For beams of equal intensity, a similar phenomenon occurs with increasing reflectivity of the substrate. The transfer of a grating relief pattern to the substrate by ion-beam milling is treated by considering the erosion profiles produced by ion bombardment. This analysis is used to examine the influence of milling geometry on the depth and shape of the groove. Although the ion-beam milling rate of GaAs is several times greater than AZ-1350 photoresist, it is shown that the groove aspect ratio (depth/period) in GaAs can be no more than about 1.2, a figure that is obtained, surprisingly, by milling at the angle of maximum removal rate of photoresist. For a metal substrate, the groove aspect ratio decreases with increasing grating period. For gratings produced by chemical etch, the problem of the weakly exposed layer of resist adjacent to the substrate is solved by using a combination of ion-beam milling and chemical etching. Using a preferential chemical etch with a sufficiently slow etch rate, gratings with well-defined planar features, a period ~2500 A, and a groove aspect ratio >0.6 have been produced on GaAs.

Two-chopper technique for measuring fluorescence lifetimes.

This paper describes a two chopper technique for making fluorescence lifetime measurements when the pump source and the fluorescence are at the same wavelength. By pumping directly into the emitting state, delays due to relaxation from higher lying pump bands are avoided, while at the same time, the technique eliminates the problem of detector saturation when pumping directly into the fluorescing level.

Liquid filters for the ultraviolet, visible, and near infrared.

This paper describes some liquids that have been found to be useful as sharp cutoff optical filters in the uv, visible, and near ir. The range of useful transmission extends to approximately 6 micro in the ir.