Lighten UP! A Community-Based Group Intervention to Promote Eudaimonic Well-Being in Older Adults: A Multi-Site Replication with 6 Month Follow-Up.

Objectives: Eudaimonic well-being (EWB), increasingly recognized as a critical component of health, typically declines in later life, and there are no existing programs to sustain or increase EWB in older adults. Lighten UP! is an 8-week program to promote EWB through facilitated group sessions in community settings and at-home practice. Building on earlier pilot research, the current study assessed the effect of the Lighten UP! Program using a longitudinal, multi-site design. Methods: Men and women (N = 169) aged 60 and over were recruited from three Wisconsin communities. EWB, life satisfaction, depression, and diverse aspects of health were assessed before and after the program and at 6-month follow up. Results: Participants reported significantly increased EWB; these changes were maintained 6 months later. The specific EWB domains of self-acceptance, positive relations, and personal growth showed the most robust gains. Participants also showed significant and sustained declines in depressive symptoms, anxiety, and hostility. Conclusions: Lighten UP! Program confirmed its positive effects for enhancing EWB in older adults living in multiple community settings. Clinical Implications: Programs that sustain or enhance EWB in older adults can be expected to yield improvements in diverse aspects of mental and physical health.

Women's Health Alliance Intervention Study: increasing community breast and cervical cancer screening.

The Women's Health Alliance Intervention Study is a quasi-experimental intervention designed to test if county-based coalitions can increase breast and cervical cancer screening compliance among women aged 40 years and older living in rural communities. A number of interventions were designed and implemented by coalitions in four counties in north-central Wisconsin during a 2-year period. Four control counties in southwestern Wisconsin were identified for comparison. Judging from the results of this study, community-based intervention efforts can increase breast and cervical cancer screening compliance significantly among women living in rural communities.

Women's Health Alliance Intervention Study: description of a breast and cervical cancer screening program.

The Women's Health Alliance Intervention Study is a community-based intervention study designed to determine if county-based coalitions can increase breast and cervical cancer screening rates among women aged 40 and older in four rural Wisconsin counties. This article describes the intervention process and demonstrates the feasibility of rural volunteer coalitions to promote breast and cervical cancer screening in communities. An accompanying article in this issue describes the effectiveness of these interventions.

The NavChair Assistive Wheelchair Navigation System.

The NavChair Assistive Wheelchair Navigation System [19] is being developed to reduce the cognitive and physical requirements of operating a power wheelchair for people with wide ranging impairments that limit their access to powered mobility. The NavChair is based on a commercial wheelchair system with the addition of a DOS-based computer system, ultrasonic sensors, and an interface module interposed between the joystick and power module of the wheelchair. The obstacle avoidance routines used by the NavChair in conjunction with the ultrasonic sensors are modifications of methods originally used in mobile robotics research. The NavChair currently employs three operating modes: general obstacle avoidance, door passage, and automatic wall following. Results from performance testing of these three operating modes demonstrate their functionality. In additional to advancing the technology of smart wheelchairs, the NavChair has application to the development and testing of "shared control" systems where a human and machine share control of a system and the machine can automatically adapt to human behaviors.

Symmetry of normal motor and sensory nerve conduction measurements.

Nerve conduction measurements in normal subjects are assumed to be symmetric, but the normal limits of symmetry have not been determined. Full data on the limits of symmetry for commonly studied nerves are important in the clinical interpretation of nerve conduction data. We selected normal electrodiagnostic studies from archived electromyographic laboratory reports that included bilateral measurements of motor and sensory nerves. Symmetry of nerve conduction measures was confirmed, and only the median and ulnar sensory nerves had significant deviations from symmetry, supporting subclinical nerve damage in the most common dominant hand. The limits of symmetry were determined by calculating the 95th percentile for the differences between sides. For motor and sensory nerves, the range of 95th percentile limits was narrower for measures in upper extremity nerves compared to lower extremity nerves. Several reasons are offered for the wider limits of symmetry in lower extremity nerves.

Implementation issues and costs associated with a proven strategy for increasing breast and cervical cancer screening among low-income women.

Results from a randomized controlled trial demonstrated that a physician reminder letter combined with telephone counseling from a health educator significantly increased women's use of both mammograms and Pap tests in a low-income population in a managed care setting. This article presents results from a process evaluation and cost analysis of the intervention. An average of 35 minutes was spent preparing each of 304 intervention letters for mailing, including the time needed to secure signatures from 110 physicians. The results of an economic analysis suggested that this intervention cost $11.44 per recipient and $28.93 per screening test received above expected. However, intervention costs can be reduced significantly if one physician signs all letters (rather than each woman's own primary care physician) and if the health educator labor costs are diminished (e.g., by using student interns). Overall, the women under study reported that they are comfortable with both mailed and telephone reminders when they are post due for a clinical preventive service.

Breast and cervical cancer screening in a low-income managed care sample: the efficacy of physician letters and phone calls.

A randomized trial was conducted to evaluate the combined impact of a physician reminder letter and a telephone contact on the use of Pap tests and mammograms in a low-income managed care program. Women 40 to 79 years of age who were past due for cancer screening were randomly assigned to an intervention or control group. Medical claims were reviewed after 6 months to determine intervention effectiveness. The odds of receiving all needed cancer screening tests during follow-up were four times higher in the intervention group. Women who reported having to take time off from work to see a doctor had lower odds of getting screened.