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In This Issue of Archives of Internal Medicine |

In This Issue of Archives of Internal Medicine FREE

Arch Intern Med. 2001;161(21):2528. doi:10-1001/pubs.Arch Intern Med.-ISSN-0003-9926-161-21-icx00012.
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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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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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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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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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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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