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In This Issue of Archives of Internal Medicine
Arch Intern Med. 2001;161:2528.
Effectiveness of a Computer-Tailored Smoking Cessation Program: A Randomized
Trial
Quitting smoking avoids much of the subsequent risk of cancer and cardiovascular
disease. Computer technology and psychological theory can be combined to produce
individually tailored counseling for smoking cessation at a large scale. In
this issue of the ARCHIVES, the effectiveness of a computer-tailored program
is demonstrated in a population sample of Swiss smokers. After 7 months, the
program doubled the odds of quitting smoking in daily smokers. The program
was also effective in smokers who were not motivated to quit smoking at baseline.
Because it can reach a large number of smokers, this program can substantially
contribute to disease prevention at a population level.
(SEE ARTICLE)
Experiments on Distant Intercessory Prayer: God, Science, and the Lesson
of Massah
Can science substantiate God's response to prayer? In a review of distant
intercessory prayer research, Chibnall et al argue that attempts to use research
and statistics to validate prayer as an intervention for medical conditions
ignore basic principles of construct validity, philosophy of science, and
theology. Thus, the authors contend that these studies are inappropriate at
a conceptual level, even if their methodological, measurement, and statistical
flaws could be corrected.
(SEE ARTICLE)
Functional Disability and Health Care Expenditures for Older Persons
The high utilization of health care services by older adults makes the
relationship between the health status of older adults and government-reimbursed
health care services important to understand. Fried et al examined a community-based
cohort of 843 persons 72 years and older to examine the relationship between
functional status and 2-year expenditures for Medicare- and Medicaid-reimbursed
health care services. The 19.6% of older persons who had stable functional
dependence or who declined to dependence accounted for 46.3% of total expenditures.
Persons in each of these groups had an excess of approximately $10 000
in expenditures over 2 years compared with those who remained independent.
For those with stable dependence, 73% of the excess expenditures was attributable
to nursing home care, and, for those with a decline to dependence, 46% was
attributable to hospitalization and 43% to nursing home care. These findings
demonstrate that functional dependence places a large burden on both acute
and chronic care services and suggest that declining rates of functional disability
and interventions to prevent disability hold promise for ameliorating this
burden.
(SEE ARTICLE)
Legume Consumption and Risk of Coronary Heart Disease n US Men and
Women: NHANES I Epidemiologic Follow-up Study
In this study of 9632 men and women who participated in the First National
Health and Nutrition Examination Survey Epidemiologic Follow-up Study, Bazzano
et al identified a strong inverse association between frequency of legume
consumption and hazard of coronary heart disease. Over an average of 19 years
of follow-up, legume consumption at least 4 times per week compared with less
than once per week was associated with a 22% lower risk of coronary heart
disease and an 11% lower risk of cardiovascular disease after adjustment for
established cardiovascular disease risk factors. These findings suggest that
increasing legume intake may be an important part of a dietary approach to
the primary prevention of coronary heart disease in the general US population.
(SEE ARTICLE)
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