clinicaltrials.gov Identifier: NCT00298558.

BACKGROUND-Midurethral slings are increasingly used for the treatment of stress incontinence, but there are limited data comparing types of slings and associated complications.

The autologous fascial sling results in a higher rate of successful treatment of stress incontinence but also greater morbidity than the Burch colposuspension. (ClinicalTrials.gov number, NCT00064662 [ClinicalTrials.gov] .).

No abstract

The social-context model holds promise for reducing disparities in health behaviors. Further research is needed to improve the effectiveness of the intervention.

Diet has been estimated to contribute to approximately 35% of all cancer incidence.'-4 Consistent evidence points to the protective role played by consumption of fruits and vegetables in a large number of epithelial cancers.57 In more than 200 case-control or cohort studies, persons consuming higher amounts of vegetables and fruits or having higher blood levels of carotenoid were less prone to develop various cancers.7 Recent evidence indicates that only 20% to 30% ofAmericans meet recommendations to consume 5 or more servings of fruits and vegetables per day.8'4In response to this discrepancy, the National Cancer Institute launched its 5-aDay for Better Health campaign.15"6 This initiative included 9 research studies targeting both adults and children in a range of settings, one being the worksite. The present study reports the results of the Treatwell 5-aDay study, 1 of 3 worksite-based nutrition intervention studies included in the 5-a-Day for Better Health campaign. This study was designed to assess the effectiveness of a worksite-based nutrition intervention involving families in promoting increased con- Worksites are an increasingly common channel for promoting healthy eating behavior change in large segments of the population.22 Nationally, the proportion of worksites offering nutrition education as part of health promotion programs increased from 17% in 198523 to 32% in 1992.24 However, very few randomized studies have reported the effectiveness of worksite-based nutrition education programs. A recent review reported that only 4 randomized studies assessing the effects of worksite nutrition education programs have been published since 1980, and in only 1 of these studies25 was the worksite the unit of analysis.26 Using the worksite as the unit of analysis is necessary in worksite-based interventions that take advantage of the worksite environment and structures, since individual behavior change is embedded in worksite-level changes.

Adults aged 65 years or older (2802) were enrolled and randomized to three cognitive interventions or a no-contact control group. Data on 1804 participants were available at both the 2- and 5-year follow-ups. HRQoL was measured by the eight MOS 36-Item Short-Form Health Survey (SF-36) scales. Clinically relevant decline on each scale was defined as a drop of > or = 0.5 standard deviations from baseline. Extensive HRQoL decline was defined as clinically relevant drops on (i) > or = 4 SF-36 scales, and (ii) > or = 3 SF-36 scales, and was assessed using multiple logistic regressions, weighted to adjust for potential attrition bias. Results. At 2 years post-training, 23.7% and 36.6% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. At 5 years post-training, 32.9% and 47.3% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. Participants in the speed of processing intervention arm were significantly less likely to have extensive HRQoL decline compared to participants in the control group regardless of the threshold or time period, whereas participants in the memory and reasoning intervention arms were significantly less like to have extensive HRQoL decline only at 5 years post-training and only at the lower threshold. Conclusion. The effect of the speed of processing intervention was stronger and evident earlier than those for the memory and reasoning interventions. This result stems from the speed of processing intervention being the most procedural intervention, operating through sensory-motor elaboration and repetition, bringing about a broader pattern of regional brain activation. At 5 years post-training, however, all three interventions were successful in protecting against a lower threshold of age-related extensive declines in HRQoL.

Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.