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In This Issue of Archives of Internal Medicine
November 26, 2001

In This Issue of Archives of Internal Medicine

Arch Intern Med. 2001;161(21):2528. doi:10-1001/pubs.Arch Intern Med.-ISSN-0003-9926-161-21-icx00012

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.

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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.

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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.

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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.

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