Matti T. J. Heino

Lung function following treatment of malignant tumors with surgery, radiotherapy, or cyclophosphamide in childhood. A follow‐up study after 11 to 27 years

A group of 40 individuals were restudied at a median follow‐up time of 18 years after chest surgery, chest irradiation, or cyclophosphamide treatment. Their median age at diagnosis was 4.5 years. Nineteen subjects were operated on in the chest area. Radiotherapy of the chest had been used in 21 and cyclophosphamide in 35 patients. Chest deformity was evident in 17 subjects. Chest radiographs showed some evidence of fibrosis in eight subjects and late effects of surgery in three subjects. In nine subjects some evidence of fixed obstruction was seen in spirometry. In three subjects pulmonary diffusion capacity was abnormal. Spirometry commonly showed a restrictive pattern of findings. The incidence of abnormalities in pulmonary function was highest among the patients diagnosed before age 3 years. Spirometry was more likely to reveal abnormalities in patients who had received irradiation to the chest. However, abnormalities in pulmonary function were fewer than anticipated.

Long‐term cardiac sequelae after treatment of malignant tumors with radiotherapy or cytostatics in childhood

A series of 41 individuals were restudied after childhood cancer with a median follow‐up time of 17 years after chest irradiation or treatment with cyclophosphamide or Adriamycin (doxorubicin). Radiotherapy of the chest had been used in 21 patients, and in 13 of these irradiation was also directed at the heart. Thirty‐five patients received cyclophosphamide and five received Adriamycin therapy. All patients were investigated by a pediatric cardiologist. Investigations included an electrocardiogram (ECG), a chest radiographic film, an echocardiogram, an exercise test, and a 24‐hour ECG. Altogether 20 patients (49%) showed some abnormality in cardiac tests. Each additional year of follow‐up was associated with a 1.3‐fold (95% confidence limits, 1.04‐1.66; P < 0.05) increase in the risk for pathologic cardiac findings. The risk for an abnormal cardiac test result in the 13 patients who had received cardiac irradiation was 12.8‐fold (95% confidence limits, 1.8‐90.8; P < 0.02) that of the other patients. However, abnormalities in cardiac function were mild.

BRONCHIAL CILIOGENESIS AND ORAL STEROID TREATMENT IN PATIENTS WITH ASTHMA

The effect of steroids on the ciliogenesis of bronchial epithelium has not previously been studied in asthmatics. Bronchial biopsies were taken during bronchoscopy from five asthmatics before and after oral steroid treatment, and studied by transmission electron microscopy. Two untreated healthy subjects served as controls. After treatment, ciliogenesis was abundant in all patients.

What explains the socioeconomic status gap in activity? Educational differences in determinants of physical activity and screentime

BackgroundDesigning evidence-based interventions to address socioeconomic disparities in health and health behaviours requires a better understanding of the specific explanatory mechanisms. We aimed to investigate a comprehensive range of potential theoretical mediators of physical activity (PA) and screen time in different socioeconomic status (SES) groups: a high SES group of high school students, and a low SES group of vocational school students. The COM-B system, including the Theoretical Domains Framework (TDF), was used as a heuristic framework to synthesise different theoretical determinants in this exploratory study.MethodsFinnish vocational and high school students (N = 659) aged 16–19, responded to a survey assessing psychological, social and environmental determinants of activity (PA and screen time). These determinants are mappable into the COM-B domains: capability, opportunity and motivation. The outcome measures were validated self-report measures for PA and screen time. The statistical analyses included a bootstrapping-based mediation procedure.ResultsRegarding PA, there were SES differences in all of the COM-B domains. For example, vocational school students reported using less self-monitoring of PA, weaker injunctive norms to engage in regular PA, and fewer intentions than high school students. Mediation analyses identified potential mediators of the SES-PA relationship in all of three domains: The most important candidates included self-monitoring (CI95 for b: 0.19–0.47), identity (0.04–0.25) and material resources available (0.01–0.16). However, SES was not related to most determinants of screentime, where there were mainly gender differences. Most determinants were similarly related with both behaviours in both SES groups, indicating no major moderation effect of SES on these relationships.ConclusionsThis study revealed that already in the first years of educational differentiation, levels of key PA determinants differ, contributing to socioeconomic differences in PA. The analyses identified the strongest mediators of the SES-PA association, but additional investigation utilising longitudinal and experimental designs are needed. This study demonstrates the usefulness of combining constructs from various theoretical approaches to better understand the role of distinct mechanisms that underpin socioeconomic health behaviour disparities.

Bayesian evaluation of behavior change interventions: a brief introduction and a practical example

ABSTRACT Introduction Evaluating effects of behavior change interventions is a central interest in health psychology and behavioral medicine. Researchers in these fields routinely use frequentist statistical methods to evaluate the extent to which these interventions impact behavior and the hypothesized mediating processes in the population. However, calls to move beyond the exclusive use of frequentist reasoning are now widespread in psychology and allied fields. We suggest adding Bayesian statistical methods to the researcher’s toolbox of statistical methods. Objectives We first present the basic principles of the Bayesian approach to statistics and why they are useful for researchers in health psychology. We then provide a practical example on how to evaluate intervention effects using Bayesian methods, with a focus on Bayesian hierarchical modeling. We provide the necessary materials for introductory-level readers to follow the tutorial. Conclusion: Bayesian analytical methods are now available to researchers through easy-to-use software packages, and we recommend using them to evaluate the effectiveness of interventions for their conceptual and practical benefits.