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Hide Show Self 33 credits. Where's My Music? Self - Interviewee. Self - Guest Presenter. Several statistical methodologies are described and their advantages and limitations are explored. Whether weighting the different studies data differently, or via employing random effects, one must recognize that different pooling methodologies may yield different results. Pooling can be used for comprehensive exploratory analyses of data from RCTs and should not be viewed as replacing the standard analysis plan for each study.
Pooling may help to identify intervention components that may be more effective especially for subsets of participants with certain behavioral characteristics. Pooling, when supported by statistical tests, can allow exploratory investigation of potential hypotheses and for the design of future interventions. To examine the effects of accelerometer epoch lengths, wear time WT algorithms, and activity cut-points on estimates of WT, sedentary behavior SB , and physical activity PA. Data were processed and analyzed at epoch lengths of 1-, 5-, , , , and seconds.
Little research has been devoted to multiple imputation MI of derived variables. This study investigates various MI approaches for the outcome, rate of change, when the analysis model is a two-stage linear regression. Simulations showed that competitive approaches depended on the missing data mechanism and presence of auxiliary terms.
This article reports on the presentations and discussion from the working group on "Influences on Sedentary Behavior and Interventions To Reduce Sedentary Behavior" as part of the Sedentary Behavior: Identifying Research Priorities workshop. Interventions were discussed in the context of targeting sedentary behavior SB as a concept distinct from physical activity. It was recommended that interventions targeting SB should consider a life course perspective, a position predicated on the assumption that SB is age and life stage dependent.
In addition, targeting environments where individuals have high exposure to SB-such as workplace sitting-could benefit from new technology e. There are limited data about the minimal amount of SB change required to produce meaningful health benefits. In addition to developing relevant scientific and public health definitions of SB, it is important to further delineate the scope of health and quality-of-life outcomes associated with reduced SB across the life course and to clarify what behavioral alternatives to SB can be used to optimize health gains.
SB interventions will benefit from having more clarity about the potential physiological and behavioral synergies with current physical activity recommendations, developing multilevel interventions aimed at reducing SB across all life phases and contexts, harnessing relevant and effective strategies to extend the reach of interventions to all sectors of society, as well as applying state-of-the-science adaptive designs and methods to accelerate advances in the science of SB interventions.
Advances in information technology and near ubiquity of the Internet have spawned novel modes of communication and unprecedented insights into human behavior via the digital footprint. Health behavior randomized controlled trials RCTs , especially technology-based, can leverage these advances to improve the overall clinical trials management process and benefit from improvements at every stage, from recruitment and enrollment to engagement and retention.
In this paper, we report the results for recruitment and retention of participants in the SMART study and introduce a new model for clinical trials management that is a result of interdisciplinary team science. The MARKIT model brings together best practices from information technology, marketing, and clinical research into a single framework to maximize efforts for recruitment, enrollment, engagement, and retention of participants into a RCT.
Use of technology in combination with marketing practices may enable investigators to reach a larger and more diverse community of participants to take part in technology-based clinical trials, help maximize limited resources, and lead to more cost-effective and efficient clinical trial management of study participants as modes of communication evolve among the target population of participants.
Evidence from laboratory and field studies indicates that large portions lead to greater food and energy intake relative to small portions. However, most children and adults demonstrate limited abilities to estimate and control the amounts of food they serve and consume. Further experimental research in real world settings is needed to test these interventions as strategies for portion control and their roles in prevention and treatment of obesity.
Percent body fat equations are usually developed in specific populations and have low generalizability. To use a nationally representative sample of the American youth population years old from the National Health and Nutrition Examination Survey data to develop gender-specific percent body fat equations.
Final coefficients were estimated in the full sample. In the cross-validation sample, the adjusted R2 was 0. Comparable estimates in boys were 0. Gender-specific percent body fat equations were developed in youth with a strong potential for generalizability and utilization by other investigators studying adiposity-related issues in youth.
The Delboeuf Illusion affects perceptions of the relative sizes of concentric shapes. This study was designed to extend research on the application of the Delboeuf illusion to food on a plate by testing whether a plate's rim width and coloring influence perceptual bias to affect perceived food portion size. Within-subjects experimental design. Experiment 1 tested the effect of rim width on perceived food portion size. Experiment 2 tested the effect of rim coloring on perceived food portion size.
In both experiments, participants observed a series of photographic images of paired, side-by-side plates varying in designs and amounts of food. From each pair, participants were asked to select the plate that contained more food. Multilevel logistic regression examined the effects of rim width and coloring on perceived food portion size. To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media.
The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback.
Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24months.
Currently, all participants have been recruited, and all are in the final year of the trial. Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults. To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting MMM approach for treating overweight and obese children.
Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36months after randomization. Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures.
The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families. This study examined the efficacy of extended cognitive-behavioral treatment in promoting longer term smoking cessation among adolescents. METHODS: Open-label smoking cessation treatment consisted of 10 weeks of school-based, cognitive-behavioral group counseling along with 9 weeks of nicotine replacement nicotine patch.
A total of adolescent smokers in continuation high schools in the San Francisco Bay Area were randomized to either 9 additional group sessions over a week period extended group or 4 monthly smoking status calls nonextended group. Intention-to-treat logistic regression analysis was used to assess the primary outcome of biologically confirmed carbon monoxide View details for DOI Our evaluation study identifies facilitators and barriers to participation among families participating in the treatment arm of Stanford ECHALE.
This culturally tailored obesity prevention trial consisted of a combined intervention with two main treatment components: 1 a folkloric dance program; and 2 a screen time reduction curriculum designed for year old Latinas and their families. We conducted 83 interviews 40 parents and 43 girls in participant homes after 6 months of enrollment in the ECHALE trial.
The Spradley ethnographic method and NVivo 8. Three domains emerged for understanding participation: 1 family cohesiveness; 2 perceived gains; and 3 culturally relevant program structure. Two domains emerged for non-participation: program requirements and perceived discomforts. Non-parametric, Spearman's rank correlation coefficients were calculated to assess the relationships with participant attendance data.
Sustained participation was most strongly influenced by the domain perceived gains when parents reported better self-esteem, confidence, improved attitude, improved grades, etc. Family-centered, school-based, community obesity prevention programs that focus on tangible short-term gains for girls may generate greater participation rates, enhance social capital, and promote community empowerment.
These factors can be emphasized in future obesity prevention program design and implementation. This paper examines the implications of using robust estimators REs of standard errors in the presence of clustering when cluster membership is unclear as may commonly occur in clustered randomized trials. When clusters are well defined, REs have properties that are robust to misspecification of the correlation structure.
To examine whether results were sensitive to assumptions about the clustering membership, we conducted simulation studies for a two-arm clinical trial, where the number of clusters, the intracluster correlation ICC , and the sample size varied. Partial and complete misspecifications of membership where some and no knowledge of true membership were incorporated into assumptions for data generated from a large number of clusters 50 with a moderate ICC 0.
REs of standard errors can be useful when the ICC and knowledge of cluster membership are high. When the ICC is weak, a number of factors must be considered. Our findings suggest guidelines for making sensible analytic choices in the presence of clustering.
High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children. To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults. Longitudinal statistical analyses; microsimulations combining multiple data sets.
The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, , and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race.
Twelve percent of year-olds were obese. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age For example, the relative risk of developing diabetes as adults for obese white male year-olds was 4. For obese 5-year-olds, the relative risk was 1. Main results do not include Hispanics due to sample size.
Past relationships between childhood and adult obesity and health may change in the future. Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered. Mobile devices are a promising channel for delivering just-in-time guidance and support for improving key daily health behaviors. Despite an explosion of mobile phone applications aimed at physical activity and other health behaviors, few have been based on theoretically derived constructs and empirical evidence.
Eighty adults ages 45 years and older who were insufficiently physically active, engaged in prolonged daily sitting, and were new to smartphone technology, participated in iterative design development and feasibility testing of three daily activity smartphone applications based on motivational frames drawn from behavioral science theory and evidence.
An "analytically" framed custom application focused on personalized goal setting, self-monitoring, and active problem solving around barriers to behavior change. A "socially" framed custom application focused on social comparisons, norms, and support. An "affectively" framed custom application focused on operant conditioning principles of reinforcement scheduling and emotional transference to an avatar, whose movements and behaviors reflected the physical activity and sedentary levels of the user.
To explore the applications' initial efficacy in changing regular physical activity and leisure-time sitting, behavioral changes were assessed across eight weeks in 68 participants using the CHAMPS physical activity questionnaire and the Australian sedentary behavior questionnaire. User acceptability of and satisfaction with the applications was explored via a post-intervention user survey.
The results indicated that the three applications were sufficiently robust to significantly improve regular moderate-to-vigorous intensity physical activity and decrease leisure-time sitting during the 8-week behavioral adoption period. Acceptability of the applications was confirmed in the post-intervention surveys for this sample of midlife and older adults new to smartphone technology. Preliminary data exploring sustained use of the applications across a longer time period yielded promising results.
The results support further systematic investigation of the efficacy of the applications for changing these key health-promoting behaviors. To test the hypothesis that the weight-for-stature WFS and BMI methods are not equivalent in determining expected body weight EBW in adolescents with eating disorders and to determine the sensitivity, specificity, and positive predictive value of each method to detect those View details for DOI Adolescent cigarette smokers may have more daily variability in their smoking patterns than adults.
A better understanding of teen smoking patterns can inform the development of more effective adolescent smoking cessation interventions. A paired t-test was used to examine differences between weekday Sunday-Thursday and weekend Friday-Saturday smoking. There was significantly more weekend smoking compared to weekday smoking, p View details for DOI Childhood obesity represents a worldwide medical and public health challenge.
Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions.
Adolescent smoking remains a public health problem. Despite concerns regarding adolescent nicotine dependence, few well-designed smoking cessation studies have been conducted with teen smokers. This is particularly true regarding pharmacologic treatments for nicotine dependence.
Currently, pharmacologic aids are not recommended for treating adolescent nicotine dependence, as efficacy has not been shown in this population. It provides information on the pharmacologic action of each medication, the efficacy of each medication for adolescent smoking cessation, the tolerability of each medication based on reported adverse events, and compliance with the medication protocols.
Thirteen relevant articles were identified and included in the review. Nicotine patch NP , nicotine gum, nicotine nasal spray, bupropion, and varenicline have been studied in adolescent smokers. The adverse events reported in the studies on pharmacology for adolescent smoking suggest that the side effect profiles for nicotine replacement therapy, bupropion, and varenicline are similar to those reported in adult studies.
There is some evidence of efficacy of NP and bupropion at the end of treatment efficacy of varenicline has not been assessed , but none of the medications included in this review were efficacious in promoting long-term smoking cessation among adolescent smokers. It is noted that many of the study protocols did not follow the recommended dose or length of pharmacotherapy for adults, rendering it difficult to determine the true efficacy of medication for adolescent smoking cessation.
Future efficacy studies are warranted before recommending pharmacotherapy for adolescent smoking cessation. The close correspondence between energy intake and expenditure over prolonged time periods, coupled with an apparent protection of the level of body adiposity in the face of perturbations of energy balance, has led to the idea that body fatness is regulated via mechanisms that control intake and energy expenditure.
Two models have dominated the discussion of how this regulation might take place. The set point model is rooted in physiology, genetics and molecular biology, and suggests that there is an active feedback mechanism linking adipose tissue stored energy to intake and expenditure via a set point, presumably encoded in the brain. This model is consistent with many of the biological aspects of energy balance, but struggles to explain the many significant environmental and social influences on obesity, food intake and physical activity.
More importantly, the set point model does not effectively explain the 'obesity epidemic'--the large increase in body weight and adiposity of a large proportion of individuals in many countries since the s. An alternative model, called the settling point model, is based on the idea that there is passive feedback between the size of the body stores and aspects of expenditure.
This model accommodates many of the social and environmental characteristics of energy balance, but struggles to explain some of the biological and genetic aspects. The shortcomings of these two models reflect their failure to address the gene-by-environment interactions that dominate the regulation of body weight. We discuss two additional models--the general intake model and the dual intervention point model--that address this issue and might offer better ways to understand how body fatness is controlled.
Randomized controlled trial with follow-up measures scheduled at 6, 12, 18, and 24 months. Low-income areas of Oakland, California. Changes in body mass index BMI. Among secondary outcomes, fasting total cholesterol level adjusted mean difference, A culturally tailored after-school dance and screen time reduction intervention for low-income, preadolescent African American girls did not significantly reduce BMI gain compared with health education but did produce potentially clinically important reductions in lipid levels, hyperinsulinemia, and depressive symptoms.
There was also evidence for greater effectiveness in high-risk subgroups of girls. Health education programs for promoting a healthful diet have shown limited success in clinical trials. This paper aims to examine whether an innovative educational course focused on societal-level issues related to food and food production Food and Society would promote healthful eating among college students.
All participants were undergraduates. A Food Frequency Questionnaire was administered at the beginning and end of the four courses taught from January through March Students in the Food and Society course read selected portions of popular books and essays e.
In addition, students were required to 1 write an Op-Ed article and 2 create a brief YouTube video focused on themes discussed in the course. The results suggest that it may be possible to change dietary behaviors in college students by focusing on social, ethical, cultural, and environmental issues related to food and food production.
Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported. To test the hypothesis that 48 weeks of daily metformin hydrochloride extended release XR therapy will reduce body mass index BMI in obese adolescents, as compared with placebo.
Multicenter, randomized, double-blind, placebo-controlled clinical trial. Intervention Following a 1-month run-in period, subjects following a lifestyle intervention program were randomized to 48 weeks' treatment with metformin hydrochloride XR, mg once daily, or an identical placebo.
Subjects were monitored for an additional 48 weeks. This difference persisted for 12 to 24 weeks after cessation of treatment. No significant effects of metformin on body composition, abdominal fat, or insulin indices were observed. Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program.
Although adverse health effects of prolonged TV viewing have been increasingly recognized, little population-wide information is available concerning subgroups at greatest risk for this behavior. This study sought to identify, in a U. Nonparametric risk classification analyses were conducted in The subgroup with the highest rates of TV viewing routinely ate dinner while watching TV and had lower income and poorer health.
Prolonged TV viewing also was associated with perceived aspects of the neighborhood environment i. The results can help inform intervention development in this increasingly important behavioral health area. Receiver operating characteristic ROC analysis is a common method used in diagnostic and screening tests to define thresholds levels of a factor that discriminates between 2 levels of another factor.
The purpose of this analysis was to use ROC analysis to determine the optimal accelerometer-measured physical activity PA thresholds for predicting selective cardiovascular disease CVD risk factors. PA was assessed for multiple days using accelerometers. CVD variables were overweight, elevated triglyceride, reduced HDL-C, hypertension, impaired fasting glucose, fasting insulin, and clustering of multiple CVD risk factors. Empirically-derived thresholds of PA to optimally discriminate between girls with and without CVD risk were lower in this sample than generally recommended.
This ROC approach should be repeated in other populations to determine optimal PA thresholds with clinical validity for research, surveillance and program evaluation. Nicotine dependence may be expressed differently in teens than in adults. Thus, it may not be sufficient to build diagnostic and cessation treatment strategies for teens based on adult-derived clinical and research data.
This is the first study to prospectively examine the development of withdrawal symptoms by level of nicotine dependence among adolescent smokers. Forty-seven adolescent smokers completed nicotine withdrawal symptoms measures during 10 weeks of cessation treatment. Nicotine dependence was assessed at baseline using the mFTQ. Change in withdrawal symptoms over time by level of nicotine dependence was examined via mixed model ANOVA.
Nicotine withdrawal in daily adolescent smokers was strongly and prospectively associated with the level of nicotine dependence. Craving was rated as the most problematic symptom at the baseline assessment. The results of this study may help guide the development of future research on diagnostic and cessation treatment strategies for teens. This study examines the associations between objectively measured physical activity and cardiovascular disease CVD risk factors in preadolescent African American girls.
Physical activity was assessed for four days by using an ActiGraph accelerometer and was correlated with anthropometric measures, blood pressure, blood lipids, glucose, and insulin. Associations between physical activity and CVD risk factors were computed using by Spearman correlations. A total of girls participated, of which had complete CVD risk measures mean age 9. To evaluate the feasibility, acceptability, and efficacy of an after-school team sports program for reducing weight gain in low-income overweight children.
Six-month, 2-arm, parallel-group, pilot randomized controlled trial. Twenty-one children in grades 4 and 5 with a body mass index at or above the 85th percentile. The treatment intervention consisted of an after-school soccer program. The "active placebo" control intervention consisted of an after-school health education program.
Implementation, acceptability, body mass index, physical activity measured using accelerometers, reported television and other screen time, self-esteem, depressive symptoms, and weight concerns. All 21 children completed the study. Compared with children receiving health education, children in the soccer group had significant decreases in body mass index z scores at 3 and 6 months and significant increases in total daily, moderate, and vigorous physical activity at 3 months.
An after-school team soccer program for overweight children can be a feasible, acceptable, and efficacious intervention for weight control. To assess the effects of reducing television viewing and computer use on children's body mass index BMI as a risk factor for the development of overweight in young children. Randomized controlled clinical trial. University children's hospital. Age- and sex-standardized BMI zBMI , television viewing, energy intake, and physical activity were monitored every 6 months during 2 years.
Children randomized to the intervention group showed greater reductions in targeted sedentary behavior P View details for Web of Science ID African-American girls and women are at high risk of obesity and its associated morbidities. Few studies have tested obesity prevention strategies specifically designed for African-American girls. This report describes the design and baseline findings of the Stanford GEMS Girls health Enrichment Multi-site Studies trial to test the effect of a two-year community- and family-based intervention to reduce weight gain in low-income, pre-adolescent African-American girls.
Randomized controlled trial with measurements scheduled in girls' homes at baseline, 6, 12, 18 and 24 month post-randomization. Low-income areas of Oakland, CA. Interventions last for 2 years for each participant. Change in body mass index over the two-year study. Recruitment and enrollment successfully produced a predominately low-socioeconomic status sample.
Two-hundred sixty one families were randomized. One girl per family is randomly chosen for the analysis sample. Randomization produced comparable experimental groups with only a few statistically significant differences. Girls averaged low levels of moderate to vigorous physical activity, more than 3 h per day of screen media use, and diets high in energy from fat.
The Stanford GEMS trial is testing the benefits of culturally-tailored after-school dance and screen-time reduction interventions for obesity prevention in low-income, pre-adolescent African-American girls. The purpose of this study was to develop a data-driven approach for analyzing incomplete accelerometer data from field-base studies. Composite method estimates of physical activity were compared with those derived from methods typically described in the literature comparison methods.
The composite method retained Average wearing times for the composite method for weekday and weekend day were Composite-method physical activity estimates were similar to comparison-methods estimates. The composite method used more available accelerometer data than standard approaches, reducing the need to exclude periods within a day, entire days, and participants from analysis.
To examine the effects of cumulative, real-world marketing and brand exposures on young children by testing the influence of branding from a heavily marketed source on taste preferences. Experimental study. Children tasted 5 pairs of identical foods and beverages in packaging from McDonald's and matched but unbranded packaging and were asked to indicate if they tasted the same or if one tasted better. Preschools for low-income children. Branding of fast foods.
A randomized controlled pilot study to test the hypothesis that increasing preschool children's outdoor free play time increases their daily physical activity levels. Physical activity was assessed by accelerometers for four consecutive school days in thirty-two Latino children 3.
The CON group followed their normal classroom schedule. Between group differences in physical activity variables were tested with a Wilcoxon rank-sum test. There were no statistically significant differences between groups in changes from baseline in average total daily CON, Substantially increasing preschoolers' outdoor free play time did not increase their physical activity levels.
Food-related parenting attitudes are thought to influence children's dietary intake and weight. The objective of this study was to examine the associations between mothers' reports of food-related parenting and children's dietary intake and body mass index BMI. A sample of Mexican-American fifth-grade children and their mothers were surveyed.
Children's height, weight, and three hour dietary recalls were collected. Mothers reported household food insecurity status and food-related parenting attitudes. Correlational analyses were calculated among dietary intake variables, children's BMI percentiles, and food-parenting behaviors.
Mothers' pressure on their children to eat was inversely correlated with children's BMI. In food-insecure families, attitudes toward making healthful foods available were inversely associated with children's daily energy intake and BMI.
In contrast, in food-secure families, attitudes about making healthful foods available were positively associated with children's fruit intake and percentage energy from fat, and parental modeling of healthful food behaviors was inversely associated with the energy density.
In our sample of Mexican-American families, mothers' food-related parenting was associated with their children's weight and dietary intake. These associations differed in food-secure and food-insecure households. Overall, pressure to eat was highly associated with children's weight, but the temporal nature of these relationships cannot be discerned. To compare and contrast proposed definitions of metabolic syndrome in pediatrics, and to determine prevalence of metabolic syndrome in preadolescent females when applying different criteria.
A literature review on definitions of metabolic syndrome and cardiovascular "risk factor clustering" in children and adolescents published in the past decade. Pediatric definitions of metabolic syndrome were then applied to a community-based study of black preadolescent females Girls Health Enrichment MultiSite studies [GEMS] and a school-based, cross-sectional study of ethnically-diverse preadolescent females Girls Activity, Movement and Environmental Strategy [GAMES] who had a baseline physical examination and fasting morning blood sample.
Agreement among pediatric definitions of metabolic syndrome was poor. The prevalence of MS and cardiovascular risk factor clustering ranged from 0. The prevalence of metabolic syndrome in preadolescent girls varies widely because of disagreement among proposed definitions of metabolic syndrome in pediatrics. Further investigation is needed to determine which metabolic factors and their respective cut points should be used to identify children at risk for development of clinical disease.
Prospective cohort study. Twelve elementary schools in northern California. Eight hundred twenty-seven third grade children participated at baseline; students in 6 schools were followed up for 20 months. Multicenter studies involving randomized clinical trials RCTs may have different structures.
We discuss four general types. The first two, an "ideal" multicenter RCT and decentralized multicenter collaborative RCTs, we feel are, in different circumstances, highly recommended approaches. The other two, the multicenter RCT that ignores site differences and centralized multicenter collaborative RCTs, we argue, are not only not cost-effective but may also produce misleading results, thus impeding scientific progress and possibly putting patients at unnecessary risk.
Media can influence aspects of a child's physical, social, and cognitive development; however, the associations between a child's household media environment, media use, and academic achievement have yet to be determined. To examine relationships among a child's household media environment, media use, and academic achievement.
During a single academic year, data were collected through classroom surveys and telephone interviews from an ethnically diverse sample of third grade students and their parents from 6 northern California public elementary schools. The majority of our analyses derive from spring data, including academic achievement assessed through the mathematics, reading, and language arts sections of the Stanford Achievement Test.
We fit linear regression models to determine the associations between variations in household media and performance on the standardized tests, adjusting for demographic and media use variables. The household media environment is significantly associated with students' performance on the standardized tests.
It was found that having a bedroom television set was significantly and negatively associated with students' test scores, while home computer access and use were positively associated with the scores. Absence of a bedroom television combined with access to a home computer was consistently associated with the highest standardized test scores. This study adds to the growing literature reporting that having a bedroom television set may be detrimental to young elementary school children.
It also suggests that having and using a home computer may be associated with better academic achievement. The prevalence of overweight among children and adolescents has dramatically increased. There may be vulnerable periods for weight gain during childhood and adolescence that also offer opportunities for prevention of overweight. Overweight in children and adolescents can result in a variety of adverse health outcomes, including type 2 diabetes, obstructive sleep apnea, hypertension, dyslipidemia, and the metabolic syndrome.
The best approach to this problem is prevention of abnormal weight gain. Several strategies for prevention are presented. In addition, treatment approaches are presented, including behavioral, pharmacological, and surgical treatment. Childhood and adolescent overweight is one of the most important current public health concerns. The American Academy of Pediatrics policy statement "The Pediatrician's Role in Community Pediatrics" encourages all pediatricians to partner with their communities to create and disseminate innovative programs that improve child health.
This article describes 4 pillars of a bridge to evidence-based community pediatrics for pediatricians interested in pursuing effective community action: 1 collaborate with the community to establish a specific, short-term, health-related goal; 2 identify evidence-based best practice s for achieving the shared goal; 3 collaborate with the community to adapt this best practice to the community's unique assets and constraints; and 4 evaluate the project by using appropriate expertise.
Practical elements of each pillar are described and illustrated by specific examples from community-based efforts of pediatricians and are accompanied by specific resources to aid pediatricians in their future community health work. Past research has identified social and environmental causes and correlates of behaviors thought to be associated with obesity and weight gain among children and adolescents.
Much less research has documented the efficacy of interventions designed to manipulate those presumed causes and correlates. These latter efforts have been inhibited by the predominant biomedical and social science problem-oriented research paradigm, emphasizing reductionist approaches to understanding etiologic mechanisms of diseases and risk factors. The implications of this problem-oriented approach are responsible for leaving many of the most important applied research questions unanswered, and for slowing efforts to prevent obesity and improve individual and population health.
An alternative, and complementary, solution-oriented research paradigm is proposed, emphasizing experimental research to identify the causes of improved health. This subtle conceptual shift has significant implications for phrasing research questions, generating hypotheses, designing research studies, and making research results more relevant to policy and practice.
The solution-oriented research paradigm encourages research with more immediate relevance to human health and a shortened cycle of discovery from the laboratory to the patient and population. Finally, a "litmus test" for evaluating research studies is proposed, to maximize the efficiency of the research enterprise and contributions to the promotion of health and the prevention and treatment of disease.
A research study should only be performed if 1 you know what you will conclude from each possible result whether positive, negative, or null ; and 2 the result may change how you would intervene to address a clinical, policy, or public health problem. Study variables did not distinguish those with and without a history of MDD. End of treatment abstinence rates and relapse rates were similar in both groups.
The findings provide further evidence that MDD is a comparatively common disorder among children and adolescents and that clinicians should monitor and be prepared to respond to depression that may emerge during the treatment of nicotine-dependent adolescents.
Fasting insulin and blood lipids serve as direct indicators of subsequent risk and as biochemical markers of metabolically significant adiposity. We examined the feasibility of obtaining fasting blood samples and report correlates of these biochemical markers in an understudied population sample.
Fasting samples were requested from African-American girls, 8. Indices of insulin sensitivity and secretion were calculated and correlated with anthropometric, dietary, physical activity, and body composition data. Fasting blood samples in young African-American girls were obtained with reasonable cooperation in three of the four field centers involved in this community-based study.
Fasting insulin, glucose, LDL, and HDL concentrations may help evaluate future diabetes and cardiovascular risk in children of this age. To determine whether cultural perspectives of parents may influence children's eating and physical activity behaviors and patterns of weight gain. Girls' baseline measures included physical activity assessment by accelerometer, hour dietary recalls, and questionnaires about body image and weight concerns.
One AAAS subscale was positively associated with total energy intake and percentage energy from fat. The AAAS and MEIS measures had acceptable psychometric properties, except for weight concern, but did not give a consistent picture of how parental perspectives related to the girls' baseline attitudes and behaviors. Television viewing has been associated with childhood obesity, although the mechanisms that link television viewing to higher BMI have not been established.
Therefore, our objectives, in this report, were to describe the amount and types of foods that African-American girls consume while watching television and to examine the associations between African-American girls' BMI and the food they consume while watching television. Data were collected from 8- to year-old African-American girls at four field centers by trained and certified nutritionists.
Two nonconsecutive hour dietary recalls were collected from each girl. For each eating episode reported, the girls were asked if they had been watching television while eating. Height and weight were collected using standard methods and used to calculate BMI. The data were analyzed separately by field center. The proportion of average daily energy intake that the girls consumed while watching television ranged from This research revealed that a significant proportion of African-American girls' daily energy intake is consumed while watching television.
Interventions that target reductions in food consumption while watching television or reducing television viewing may be effective strategies to decrease children's energy intakes. These results support a need for research to test the efficacy of these approaches. Group skills training sessions were conducted each week by research staff. Despite the lack of a treatment effect, a large majority of adolescents in both treatment groups reduced their consumption to a few cigarettes per day or less and maintained this reduction over time.
Similarly, an examination of survival curves revealed that by the end of treatment many had managed to avoid a return to daily smoking. These findings are encouraging and suggest new avenues for research. For example, treatments of the kind examined in this report, augmented by extended maintenance therapies, may yield higher long-term success rates.
Improving asthma knowledge and self-management is a common focus of asthma educational programs, but most programs have had little influence on morbidity outcomes. We developed a novel multiple-component intervention that included the use of an asthma education video game intended to promote adoption of asthma self-management behaviors and appropriate asthma care. To determine the effectiveness of an asthma education video game in reducing morbidity among high-risk, school-aged children with asthma.
Children with moderate-to-severe asthma and parental reports of significant asthma health care utilization were randomized to participate in the disease management intervention or to receive their usual care control group. Patients were evaluated for clinical and quality-of-life outcomes at weeks 8, 32, and 52 of the study. There were no significant differences between groups on clinical outcome variables. A multicomponent educational, behavioral, and medical intervention targeted at high-risk, inner-city children with asthma can improve asthma knowledge and quality of life.
Television viewing is associated with childhood obesity. Eating during viewing and eating highly advertised foods are 2 of the hypothesized mechanisms through which television is thought to affect children's weight. Our objectives were to describe the amounts and types of foods that children consume while watching television, compare those types with the types consumed at other times of the day, and examine the associations between children's body mass index BMI and the amounts and types of foods consumed during television viewing.
Data were collected from 2 samples. The first sample consisted of ethnically diverse third-grade children, and the second consisted predominantly of Latino fifth-grade children. Three nonconsecutive h dietary recalls were collected from each child. For each eating episode reported, children were asked whether they had been watching television.
Height and weight were measured by using standard methods and were used to calculate BMI. Although the fat content of the foods consumed during television viewing did not differ significantly from that of the foods consumed with the television off, less soda, fast food, fruit, and vegetables were consumed with the television on. The amount of food consumed during television viewing was not associated with children's BMI, but in the third-grade sample, the fat content of foods consumed during television viewing was associated with BMI.
A significant proportion of children's daily energy intake is consumed during television viewing, and the consumption of high-fat foods on weekends may be associated with BMI in younger children. Reliability and validity were established for weight concern measures completed by year-old African-American girls participating in a pilot obesity prevention program. Two hundred ten girls and parents participated in the program. Girls completed subscales of the McKnight Risk Factor Survey MRFS and body silhouette ratings, had height, weight, and body fat measured, wore accelerometers for 3 days, and completed two dietary recalls.
Principal components analysis, internal consistency, and test-retest reliability were computed for weight concerns and body image measures along with convergent validity with body mass index BMI , percent body fat PBF , physical activity, and dietary intake.
Internal consistency estimates for the scales were substantial ranging from 0. Test-retest reliabilities were moderate 0. The "like to look" silhouette rating was negatively associated with PBF. Weight concern measures had reasonable levels of internal consistency and promising validity, but only moderate test-retest reliability among preadolescent African-American girls.
Refinement and further validation of weight concern measures in this population are warranted. Quality control methods are key components of dietary assessment, but have rarely been evaluated. One hundred forty-four year-old African-American girls at three field centers completed two h dietary recalls at baseline before a pilot weight gain prevention intervention one recall collected in-person and one by telephone. The dietary recall data were initially reviewed by the dietary interviewer Phase 1 , then by a local lead nutritionist at the field center Phase 2 , and then by the Nutrition Coordinating Center NCC Phase 3 ; any differences identified by NCC were reconciled Phase 4.
Bland-Altman and generalizability theory methods were used to assess agreement of consumption for selected food variables and nutrients between phases. Only small differences occurred. Quality control procedures primarily reduced the variances of nutrients rather than caused the means to shift. Most of the variability among phases was due to individual level variability in dietary intake.
Decisions to review dietary recall data beyond local review should be based on the level of precision and accuracy required for the study outcomes and the availability of financial resources. Valid and reliable physical activity checklists are needed to assess effectiveness of interventions. Two-hundred and ten African-American girls completed the GEMS Activity Questionnaire GAQ , a checklist of 28 physical and 7 sedentary activities, including TV viewing, inquiring whether performed on the previous day "yesterday" , and whether usually performed "usual".
The girls wore an accelerometer used as the criterion for validity for three consecutive days at baseline and after a week pilot intervention.
Tennis strings ru | Results: Each hour later in weekday bedtime was associated with an additional 6. In medicine however, it remains a novel approach to reach out to patients. Adolescent cigarette smokers may have more daily variability in their smoking patterns than adults. Two hundred ten girls participated in the GEMS week pilot studies and had their height and weight measured, wore an accelerometer for 3 days and completed a measure of their usual physical activity PA at baseline and after the week intervention. Participants, study staff, and investigators were masked until the intervention was assigned. Objectively measured weight at 6, 12, and 18 months was included as a secondary outcome. |
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Tom robinson | This trial is registered with ClinicalTrials. A randomized controlled trial to test the efficacy of an after school ethnic dance program plus a culturally-tailored, home-based screen time reduction intervention to reduce weight gain body mass index among lower socioeconomic status, pre-adolescent Latina girls. Self - Guest Presenter. Multicenter studies involving randomized clinical trials RCTs may have different structures. Pooling can be tom robinson for comprehensive exploratory analyses of data from RCTs and should not be viewed as replacing the standard analysis plan for each study. His research applies social cognitive models of behavior change to behavioral, social, environmental and policy interventions for children and families in real world settings, making the results tom robinson for informing clinical and public health practice and policy. There is some evidence of efficacy of NP and bupropion at the end of treatment efficacy of varenicline has not been assessedbut none of the medications included in this review were efficacious in promoting long-term smoking cessation among adolescent smokers. |
Tom robinson | Death note soundtrack |
Happyline media | Temptu air |
Bohobeautiful tv | On completion of the meal, dietitians collected food recalls and portion size estimates from the girls by means of both manipulative desk sales near me and 2-dimensional food portion visuals, administered in a randomized order. Nonparametric risk classification analyses were conducted in The first two, an "ideal" multicenter RCT and decentralized multicenter collaborative RCTs, we feel are, in different circumstances, highly recommended approaches. One hundred forty-four year-old African-American girls at three field centers completed two h dietary recalls at baseline before a pilot weight gain prevention intervention one recall collected in-person and one by telephone. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age Much less research has documented the efficacy of interventions designed to manipulate those presumed causes and correlates. |
In the s he fronted Sector 27 , another highly political rock band, which released one album and left Robinson virtually bankrupt. He fled to Hamburg to escape … read more. Robinson's other best known song is "Glad to be Gay", an… read more. Related Tags new wave folk rock rock singer-songwriter uk Add tags View all tags. Similar To The Style Council. Buy Loading. More Love this track. Albums Sorted by: Most popular Most popular By release date. Play album Buy Loading.
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In , Robinson organised Sector 27 , a less political rock band that released a critically acclaimed but unsuccessful album, Sector 27 , produced by Steve Lillywhite. Robinson's return to Britain led to late-night performances in cabarets at the Edinburgh Fringe , some of which later surfaced on the live album Midnight at the Fringe He also has a show broadcast at 2 am on Monday mornings, which is focused on music by local bands from BBC Introducing. In he wrote and presented Surviving Suicide , about his suicide attempt.
Currently, Robinson rarely performs live, apart from two annual free concerts, known as the Castaway Parties, for members of his mailing list. These take place in South London and Belgium every January. In the Belgian Castaway shows, he introduces many songs in Dutch. In , Robinson founded "Fresh on the Net", [8] a showcase website for upcoming bands and artists whose aim is "to help independent musicians find new listeners, and independent listeners find new music".
Robinson played " Motorway" and "Glad to Be Gay" at the BBC introducing stage on the Friday afternoon of the Glastonbury Festival , after announcing that The Coral would not be showing as they were 'stuck in the mud'.
The title track featured a guest appearance by T. In October he released his first new album in 20 years, "Only The Now". It was made with award-winning producer and multi-instrumentalist Gerry Diver and released on his own Castaway Northwest Recordings.
Tom supported the album by playing many festivals that summer including Glastonbury, Latitude , Wickham and Green Man. This was for his exceptional contribution to British music. In , Robinson embarked on a four-night solo acoustic tour prior to beginning a date UK "70th Birthday Tour" featuring a 5-piece band.
Contrary to identifying as gay, Robinson has had past experiences with women and has asserted that he has always made it clear that he liked both men and women. He felt the term 'bisexual' was a cop-out. A longtime supporter and former volunteer of London's Gay Switchboard help-line, it was at a benefit party for the organisation that Robinson met Sue Brearley, [17] the woman with whom he would eventually live and have two children, and later marry.
In the mids, when Robinson became a father, the tabloids ran stories about what they deemed as a sexual orientation change, running headlines such as "Britain's Number One Gay in Love with Girl Biker! In a interview for The Boston Globe newspaper, Robinson asserted: "We've been fighting for tolerance for the last 20 years, and I've campaigned for people to be able to love whoever the hell they want.
That's what we're talking about: tolerance and freedom and liberty—life, liberty, and the pursuit of happiness. So if somebody won't grant me the same tolerance I've been fighting for them, hey, they've got a problem, not me. I'm here and I'm queer and do what I do, I'm not going to wear a straitjacket for you. Tatchell stated: "Tom Robinson has behaved rather commendably, in my view.
Ever since the beginning of his relationship with Sue, he has continued to describe himself as 'a gay man who happens to be in love with a woman'. Who could quarrel with that? I can't. In and , Robinson was involved in a celebrity seminar work for Apple to promote their home video editing software iMovie. The character is later incarcerated with other protestors by the time-travelling protagonist, Detective Inspector Alex Drake played by Keeley Hawes and dismisses her claims that he will one day marry a woman.
The scene supposedly takes place on 9 October , precisely fourteen months before the real Tom Robinson met his future bride. The character then leads other protestors in singing a round of "Glad to Be Gay" in the confinement facility, much to Sergeant Viv James ' annoyance.
Robinson's song "War Baby" which he premiered the night he met his wife is used in the soundtrack of the third series. From Wikipedia, the free encyclopedia. British musician. This article is about the musician. For other people named Tom Robinson, see Thomas Robinson. Robinson performing at Pride in London
Tom Robinson. @freshnet. Recording artist & broadcaster on. @BBC6Music. Offering free insider advice at Fresh On The Net with an open door for music. Listen to Tom Robinson on Spotify. Artist · 46K monthly listeners. Find Tom Robinson best songs, album reviews, biography, credits, awards, and more on AllMusic.