People who don’t achieve workout milestones such as losing fat, gaining strength or boosting cardiovascular fitness feel just as good about their bodies as their more athletic counterparts, said Heather Hausenblas, a UF exercise psychologist. Her study is published in the September issue of the Journal of Health Psychology.

“You would think that if you become more fit that you would experience greater improvements in terms of body image, but that’s not what we found,” she said. “It may be that the requirements to receive the psychological benefits of exercise, including those relating to body image, differ substantially from the physical benefits.”

The study by Hausenblas and graduate student Anna Campbell is the first to systematically analyze the wide-ranging effects of exercise on body image by examining all intervention studies on the subject until June 2008. From the 57 publications, the researchers found conclusively that exercise buffed up the way people see their bodies regardless of the actual benefits, but the results varied.

Negative body image has grown to almost epidemic proportions in the past 20 years, with as many as 60 percent of adults in national studies saying they don’t like the way their bodies look, Hausenblas said.

Americans spend billions of dollars a year for products designed to change their body size and shape, including diet pills and various cosmetic procedures, she said.

“Body dissatisfaction is a huge problem in our society and is related to all sorts of negative behavior including yo-yo dieting, smoking, taking steroids and undergoing cosmetic surgery,” she said. “It affects men and women and all ages, starting with kids who are as young as five years old saying they don’t like how their bodies look.”

The psychological advantages of exercise have been less explored, including the reduction of depression or confidence in body image, compared with the well-researched and understood physical benefits, she said.

The study found no difference in body image improvement between people who met the American College of Sports Medicine guidelines by exercising at least 30 minutes a day five days a week and those who did not, Hausenblas said. The guidelines are considered the minimum amount of exercise needed to receive the health related benefits of physical activity, she said.

“We would have thought that people exercising this amount would have felt better about their bodies than those who did not work out as much,” she said.

In other results, the study showed slightly larger benefits from exercise in terms of improving body image for women than men, Hausenblas said.

“We believed the gap would be much bigger, but what could be coming into play is the rise of body image issues among men,” she said. “We’re seeing more media portrayals of the ideal physique for men rather than the overriding emphasis on women we did in the past.”

Age presented another difference, with older people most likely to report enhanced body images from exercise, Hausenblas said. The gap may be explained by the older generation having more concerns about their body image than young people, who tend to exercise more, she said.

While the frequency of exercise mattered for boosting body perceptions, there were no differences for the duration, intensity, length or type of exercise, the study found.

“People who say they have high body dissatisfaction tend to exercise the least, so we wanted to take it a step further and see whether exercise causes people’s body image to improve,” she said.

Kathleen Martin Ginis, a kinesiology professor at McMaster University in Ontario, Canada, and exercise expert, praised the research. “This is an important study because it shows that doing virtually any type of exercise, on a regular basis, can help people feel better about their bodies,” she said. “With such a large segment of the population dissatisfied with their physiques, it’s encouraging to know that even short, frequent bouts of lower intensity exercise can improve body image.”

GAINESVILLE, Fla. — “What brings you in to see me today?”

“Part of my left breast has been painful for awhile.”

“Can you lie down so that I can examine you?”

It sounds like a snippet of conversation between doctor and patient. But the doctor, in this recent exchange at the University of Florida campus, was actually an engineering doctoral student — and the patient a “mixed reality human” composed of a life-sized computer avatar on a flat screen and a mannequin with a prosthetic breast.

Intimate procedures such as breast exams, while a routine and critical part of medical care, are notoriously tough to teach. Medical students practice on disembodied prosthetics but have limited opportunities to practice exams on real people — especially patients who have an abnormality. In a collaboration with the Augusta, Ga.-based Medical College of Georgia and three other universities, UF engineers have crafted a solution: a hybrid computer/mannequin that helps train students not only how to correctly perform a breast exam — but also how to talk to, and glean information from, the patient during the procedure.

The project is important because correct examinations and good doctor-patient communication are critical to successful medical treatment, said Benjamin Lok, a UF assistant professor of computer and information sciences and engineering who heads the effort.

“Studies have shown that communication skills are actually a better predictor of outcome than medical skills,” Lok said. With the virtual patient, “all of a sudden, students have to not only practice their technique, but they also have to work on their empathy.”

The mixed reality human, named Amanda Jones, “talks” to students, and they respond via a computer speech and voice recognition system tailored by doctoral student Aaron Kotranza, Lok and others on the team. Her physical form — a mannequin — is immobile, but her virtual representation, created by the engineers, moves and speaks from a large flat screen above her physical body. Students can also view Jones through a head-mounted display.

The interaction is unscripted, but it follows a typical pattern for a woman’s visit and examination — with both verbal and tactile challenges for the medical students.

The student must tease out Jones’ medical history, listen to her concerns and respond to her questions. Just as in a real exam, this interaction occurs simultaneously with the physical examination. For that, the student must use the correct palpitating technique and apply the proper pressure. Sensors within the prosthetic breast — developed by Dr. Carla Pugh at Northwestern University — provide pressure information depicted by colors on the virtual breast, guiding students in the exams. The engineers can program the system to include or exclude an abnormality — and the attendant conversation.

It sounds awkward, and to be sure, the speech recognition element has its hiccups.

But especially for students reared in an era of sophisticated three-dimensional video games, the system turns out to be surprisingly convincing. The researchers have tested it on about 100 medical students so far, all from the Medical College of Georgia, where co-principal investigator Dr. D. Scott Lind is based. One of their most consistent and prominent findings: Students do not hesitate to express empathy to Jones.

“We have found that they will try to comfort the virtual human,” Kotranza said. “They’ll often touch the mannequin in order to comfort her.”

A pilot study has concluded that students who practiced with a mixed realty human improved their communication skills and their technical abilities, but more trials are needed to determine whether those skills persist once the students examine real patients.

That said, it seems obvious that more practice students get, the better off they will be. Lok said the mixed reality patient is not intended to replace real volunteers - far from it. But students typically have only a handful of opportunities with those volunteers before graduating. The mixed reality patient can add to their training while making it easier for teachers to help students with both their conversational and medical techniques.

“What happens if you find something in a woman’s breast? How do you talk to the patient?” Lok asked. “Students have to somehow build their database of experience.”

While the breast exam research continues, the team also intends to explore other intimate exams. Next in line: prostate exams. Lok and the students already have prosthetics they intend to couple with a virtual male patient similar to the breast exam patient.

The other institutions participating in the project are the University of Central Florida, the University of Georgia and Northwestern University. The research, part of a larger effort involving a number of different virtual patient projects, is supported by grants of about $2.8 million primarily from the National Science Foundation and the National Institutes of Health.

Initial research suggested that enlargement and abnormalities of axillary sentinel lymph nodes — located in the armpit area near the breast — were predictive of cancer. But a University of Florida Shands Cancer Center researcher says it’s not the size of the node or enhancement, but the loss of a key part of a normal node’s structure called the fatty hilum that more accurately signals the spread of disease. The findings are available online in the Journal of Magnetic Resonance Imaging.

In addition to changing ideas about what doctors should look for while evaluating lymph nodes, the finding reinforces the value of using MRI to determine the extent of breast cancer prior to surgery.

“We found that the loss of fatty hilum in an axillary lymph node on MRI correlated with finding the spread of breast cancer in axillary nodes at the time of surgery,” said Dr. Stephen Grobmyer, an assistant professor of surgical oncology and endocrine surgery at the UF College of Medicine, who noted that not all nodes without fatty hilum necessarily had cancer.

The UF study retrospectively examined 56 female patients ranging in age from 30 to 82. All women had a sentinel lymph node biopsy. Fifteen women had cancer in the nodes that required complete removal. Four of eight patients in whom a loss of fatty hilum was seen in an axillary node on MRI were found to have cancerous lymph nodes at the time of their breast surgery. By comparison, only 11 out of 48 patients, or 23 percent, with all fatty hilum in place had cancer.

Grobmyer said these findings provide surgeons with another tool to help personalize medicine and evaluate factors that could indicate whether cancer has spread prior to surgery.

“I think this is another step to understanding how we can use MRI to improve care of breast cancer patients,” said Grobmyer, medical director of the UF Comprehensive Breast Center. “We are just suggesting that there may be information that people have not yet paid attention to that may impact our understanding of the staging of a patient’s disease. With this technology, if you look and see there is a node or several nodes with no fatty hilum, one would be very suspicious that there might be metastatic disease present. Instead of doing an invasive sentinel node biopsy, one could do a less invasive image-guided biopsy to obtain important staging information.”

He added it is also important that we now understand that MRI features that suggest cancer in the breast do not apply for evaluating disease in axillary lymph nodes. Currently, there is no standard MRI criterion for determining if cancer is in the nodes.

Although not routinely administered to all breast cancer patients, magnetic resonance imaging, or MRI, can offer a detailed picture of the breast, providing precise details about breast cancer locations and size. The scan is augmented through a technique known as contrast enhancement, which makes it easier to discern between cancerous and healthy tissue. The standard scan includes the axillary lymph nodes, the most common first site of spread for breast cancer.

Dr. Steven E. Harms, a radiologist with the Breast Center of Northwest Arkansas, said the accurate diagnosis of lymph node metastases is critical for patients with breast cancer, and the ability to determine their presence before the initial surgery could spare many patients the need for more than one operation.

“Over-treatment with a full axillary node removal is associated with a high incidence of lymphedema, a lifelong and often debilitating condition resulting from the disruption of lymph channels,” said Harms, who, in 2007, helped to draft the American Cancer Society breast cancer screening guidelines which recommend breast MRI screening for high risk patients.

Grobmyer said he hopes studies of a larger number of patients will further validate these findings so they can be broadly applied. He said the great advantage of an MRI is its ability to pick up more than 95 percent of invasive breast cancers.

In late 2007, UF researchers presented findings about the diagnostic value of MRI in influencing treatment plans for women, citing that it can find previously undetected cancerous areas, including cancer in the opposite breast. MRI also helps to better determine tumor size and assess an individual’s response to chemotherapy, making it useful for planning surgical procedures, UF surgeons say.

“While beauty matters to career success, brains matter most,” said Timothy Judge, a UF management professor whose research is published in the May issue of the Journal of Applied Psychology. “If you were somehow able to choose from being smart, good-looking or self-confident, our study shows that while you’d want all three qualities, brains are the most important to economic success.”

Intelligence is rewarded early in life with positive strokes from teachers, which boosts self-confidence and encourages future academic success, he said.

“Smart people do better in their careers because they are more likely to be educated and are more confident in their abilities,” Judge said. “And it’s also possible that smart people make better career choices, learn more on the job, negotiate for pay more effectively and adapt better to changes in the workplace.”

The results emphasize the need for employers to be fair in their hiring and not unduly influenced by a job candidate’s appearance, he said.

Judge, along with UF graduate students Charlice Hurst and Lauren Simon, studied how intelligence, beauty and self-confidence affect income and financial strain. Results came from surveys of 191 men and women between the ages of 25 and 75 who participated in the National Midlife Development in the United States study.

Measures of intelligence were derived from a series of established tests and mental exercises, while self-confidence was determined from a 15-item questionnaire examining attitudes about one’s ability to cope with various life situations. Researchers judged attractiveness by rating personal photographs of the participants on a scale of one to seven.

By knowing men’s and women’s scores in the areas of intelligence, beauty and self-confidence, the researchers were able to accurately classify them into one of 35 income categories more than half the time, Judge said. After brains, self-confidence ranked second in importance, followed by beauty, he said.

Although beauty ranked last, its importance to earnings is still troubling, Judge said. With few exceptions, such as modeling, attractiveness is not particularly relevant to job performance and is never seen in job descriptions, he said, yet it still matters to what people earn.

“Countless parents have assured their children that it is the inside that counts, with the ‘inside’ presumably referring to one’s personality and intelligence,” he said. “While the ‘inside’ clearly counts when it comes to income, attractiveness makes a difference, too.”

Part of the reason for attractive people’s success is their educational prospects are influenced by their looks, Judge’s study found. From an early age, studies show that good-looking students receive more teacher instruction and attention, while being punished less frequently, making them more likely to finish high school and attend college, he said.

In one study, for instance, school psychologists were less likely to refer attractive, poorly achieving third-grade students to remedial classes than their homelier classmates, he said.

“Employers who interview people for jobs need to make sure they are not favoring the attractive — and there is evidence that they do — while denying its importance,” he said. “Intelligence is a legitimate factor to consider in almost all jobs because research shows that intelligence predicts job performance in nearly all types of work, even fairly simple, entry-level jobs. While the same can be said for self-confidence, looks are another matter.”

“Dr. Judge’s research shows that, although the cover of the book matters, the content matters more. We ugly people can all breathe a sigh of relief,” said Jose Cortina, a psychology professor at George Mason University. “It is easy to be cynical in face of research showing that physical attractiveness affects important outcomes for which it should be irrelevant.”

GAINESVILLE, Fla. — Playground bullies may meet their match from where they least expect — in the ranks of kids who are anti-bullies — and most of them are girls, a new University of Florida study finds.

“Boys may be more likely to bully, but girls are more likely to defend those being bullied,” said Jim Porter, who did the research for his doctoral dissertation in counselor education at UF. “While a lot of attention has been devoted to bully prevention programs, very little recognition is given to kids who jump in and try to stop the bullying or comfort the victim.”

These playground defenders merit attention because research shows that a majority of school shootings are committed by students who have been bullied, and victims of bullying are at risk for dropping out of school, suffering from depression and bullying others, Porter said. Thirty percent of students in sixth- through 10th-grade report some experience with bullying, either as a victim or perpetrator, he said.

Schools overlook good Samaritans as they are putting a growing number of bully prevention programs in place, in some cases relying on peer mediation where students resolve the disputes themselves, with mixed results, Porter said.

“What is missing in these programs is they don’t incorporate children who are already known to help victims,” he said. “Understanding kids who defend against bullying may reveal a new avenue toward preventing school-related violence.”

Porter surveyed 168 females and 101 males about how they believed their mother, father, best friends and favorite teachers would expect them to respond if they encountered another student being bullied. The offensive behavior included hitting, shoving, name-calling, teasing and ostracizing. Participants attended four middle schools in North Central Florida and were between the ages of 10 and 15.

Peer pressure can be a good thing, the study found. Students said teachers and parents were more likely than best friends to expect them to try to stop a bully, but they were more likely to actually intervene if the message came from a best friend. And more girls than boys reported feeling pressure from friends to come to a victim’s aid, Porter said.

Eighty-five percent of girls surveyed said their best friend would expect them to defend or help a bullying victim, compared with only 66 percent of boys, Porter said. In contrast to this 19 percentage gap, there was only a 1 to 3 percentage point difference in expectations for boys and girls’ behavior by teachers, mothers and fathers, he said.

Being female or having more feminine traits as measured by a gender identity scale also increased the likelihood that a student would defend a bully, the survey findings showed.

“Gender stereotypes that girls are more nurturing and boys are more aggressive definitely play out in how we expect boys and girls to behave,” he said. “Somehow we communicate these expectations to kids and it can affect their behavior.”

Schools may be the ideal place to try to help change those ideas, said Porter, who is now a counselor at Alachua Integrative Medicine in Alachua. “The news sometimes suggests that violence makes schools a hazardous place to be, but schools also are where we can learn how to get along with others and become adults,” he said.

Giving a role in bully prevention programs to bystanders who step in to defend the victims on the playground and in the classroom fits in with the recent trend in educational psychology toward positive reinforcement, Porter said.

“There was a time when people were more likely to think of punishing bad behavior,” he said. “Now there is a push toward finding and rewarding good behavior.”

Porter said he has always been interested in the subject of bullying because he was often beat up as a “new kid” moving from one community to another. “I never understood but always wanted to discover why some students were able to jump in and help others,” he said.

Focusing on defenders illustrates dramatic changes in public attitudes, he said.

“There was a time when bullying was not researched because it was considered normal childhood behavior,” he said. “It was thought of as being part of growing up, this learning to determine a pecking order, and making people stronger and weeding out the weak.”

Bullying expert Drew Nesdale, a psychologist at Griffith University in Queensland, Australia, said this research suggests that a little recognized and under-used source of help might be found in the victims’ peers. “Interestingly, the fact that children who help might be responding to the expectations of others is consistent with research that has identified the powerful effect of the norms or expectations of others on their behavior.”

When families go through transitions such as children leaving home to live with grandparents or a mother’s boyfriends moving in or out of the house, boys are more likely to find trouble by running with the wrong crowd, said Marvin Krohn, a professor in UF’s department of criminology, law and society, who led the study.

“The major implication is that we can no longer focus on whether a family is single parent or dual parent in today’s world, particularly in disadvantaged neighborhoods where there are a lot of changes in the family that take place in a fairly short period of time,” he said.

Understanding the long-term effects of family upheaval is important in increasing sensitivity among school officials and others who work with youth, Krohn said. School psychologists and counselors who are aware of the relationship between family transitions and behavioral problems can take steps to ease the emotional adjustment, he said.

“Schools and social agencies need to be aware not only about the structure of a kid’s family, but the fact that it might change several times and those changes in and of themselves can have a pretty important effect on behavior,” he said.

Krohn, whose study is published in the current issue of the Journal of Youth Adolescence, said boys are more vulnerable to family transitions for a couple of reasons. The study was co-authored with Alan J. Lizotte, criminal justice professor at the University at Albany, and Gina Penly Hall, a graduate student in criminal justice at the University of Albany.

“While girls may respond to what goes on in the family by being depressed or showing signs of stress, boys are much more likely to externalize their displeasure with what goes on in the family by acting up,” Krohn said. “They react to the turmoil by seeking out friends who are
engaged in delinquent behavior, which increases the probability they will commit delinquent acts themselves.”

What’s more, he said, boys are not as attached as girls are to their mothers, who usually have the primary child-rearing responsibilities.

“When there’s a family transition, the mother is most likely to stay with the children, and girls have closer relationships with their mothers than boys do,” he said.

The findings are based on a study of 646 students enrolled in inner-city schools in Rochester, N.Y.; 73 percent were boys and 26 percent girls. The students were part of the long-term Rochester Youth Development Study, which began in 1988. Starting in seventh- and eighth-grades, participants were interviewed every six months until the age of 22 and then interviewed yearly until age 30. The UF study used data only from their teenage years. Parents or caretakers were also questioned.

Researchers used a 32-item delinquency scale measuring behaviors that ranged from minor property crimes, such as vandalism, to serious property and violent crimes, including burglary, robbery and assault. Respondents also answered a drug survey that examined use of substances ranging from marijuana to heroin, crack cocaine and other hard drugs.

“Often we find that a child who has experienced family transitions starts acting out in school, doesn’t do their homework and starts conducting themselves in a way that manifests itself into other behavioral problems,” Krohn said. “In our study, they started hanging out with the wrong kinds of kids.”

Within the first 2 1/2 years of the study, some of the boys and girls experienced as many as four transitions within their family, he said.

Besides creating trauma and stress, family disruptions have unforeseen economic consequences, Krohn said. The financial situation may deteriorate for the mother and children, particularly in situations where the father figure moves out of the house, he said.

“Dr. Krohn’s study highlights the fact that adolescent years are years of high vulnerability to delinquency and related problem behaviors particularly for boys,” said Deborah Capaldi, senior scientist at the Oregon Social Learning Center. “Parents are often focused on their own relationship problems during these times, and are less focused on their children. Stepfathers and grandparents often do not have as much authority with adolescents as the biological father.”

The findings, which UF and University of Pittsburgh researchers report in the April issue of Sexually Transmitted Diseases, could help health-care providers better screen patients for STD risks, said Stephanie A. S. Staras, a UF assistant professor of epidemiology and health policy research in the UF College of Medicine.

“If you are choosing high-risk partners, you are much more likely to have an STD, even when we account for your condom-use patterns,” said Staras, the lead author of the study. “The theory is simple: You need to have sex with someone who has an STD to get an STD. Based on the prevalence of STDs in the United States, it seems like the public may not fully understand their risk.”

The study examined the sexual activities, partner characteristics and STD diagnoses of 412 subjects between the ages of 15 and 24. Among the subjects whose partners were categorized as high-risk, half were diagnosed with an STD. By comparison, about 40 percent of the young adults whose own behaviors were labeled as high-risk were diagnosed with an STD.

According to the Centers for Disease Control and Prevention, about 19 million people in the United States contract STDs each year. About half of them are between the ages of 15 and 24.

Health-care providers often ask patients about their own sexual behaviors, but inquiring only about a person’s own behaviors may cause some patients to slip through the cracks, Staras said. For example, some subjects in the study reported very low-risk behaviors but were having sex with very high-risk partners.

Adding a few simple questions about partner characteristics during STD screenings could help providers catch more patients who need to be tested and educated about condom use and other protective measures, Staras said.

“Partner selection is an area of STD prevention that could complement what we are already doing with promoting condom use, and could possibly really help people,” Staras said. “If somehow we could convince individuals to incorporate this information in a meaningful way into their decision-making, then we could reduce STDs.”

UF researchers measured five specific characteristics to gauge how risky certain partners were. These characteristics included whether the partner has a problem with marijuana or alcohol, was at least five years older or younger, had been in jail, had sex with other people in the past year or had an STD in the past year.

The researchers then created a composite, totaling up the number of negative partner characteristics for each subject and comparing them against the number of each person’s own individual risky behaviors, which ranged from how often they used condoms to how many people they had sex with.

Overall, researchers found considering all of the partner characteristics together was the strongest predictor for STDs. Young adults whose partners had five or more risk characteristics were three times more likely to have an STD than those whose partners had no more than two characteristics.

Of these characteristics, the most telling were if a partner already had an STD and if a couple had an age difference of more than five years. Subjects whose partners were five years older or younger than them were more than twice as likely to be diagnosed with an STD than those whose partners were around the same age, the researchers found.

“It’s all about the risk of the partner and sometimes we forget that,” said Richard A. Crosby, the DDI endowed professor and chairman of the department of health behavior at the University of Kentucky and a co-director of the Rural Center for AIDS/STD Prevention.

But Crosby, who was not involved in the UF study, said it’s also important for people to remember that the risks mentioned in the study are just generalizations, not set-in-stone giveaways for STDs.

“From a public health perspective, it’s important to understand these findings,” he said. “From a practical and prevention perspective, we still need to rely on people using valid methods of protection to avoid being infected or infecting.”

In today’s tight economy, the lengths apparel stores go to lure customers with deep discounts and colorful interior designs are likely to fall short if shoppers don’t like how they look in the mirror, said Anne Baumstarck, who did the research for her master’s degree in interior design at UF.

“The dressing room represents the final moment when the consumer decides whether or not to make a clothing purchase,” she said. “It is where the sale is made.”

Yet retailers often overlook the importance of how the room is illuminated, thinking all shoppers need is an overhead light to be able to see when trying on merchandise, Baumstarck said. But shoppers may have other needs, and lighting direction appears to affect how people see themselves, she said.

“After all sorts of money is invested in a store’s atmospherics, it gives shoppers a letdown to have poorly planned dressing rooms,” she said. “Retailers diminish the feeling they’ve worked so hard to create in the main store.”

While other studies have examined lighting on the sales floor, none have looked at the effects it has on shoppers in dressing rooms, Baumstarck said.

In Baumstarck’s study, 60 female shoppers ages 18 to 35 who tried on clothes in the dressing rooms at Wolfgang, a Gainesville clothing boutique, showed a clear preference for frontal lights — those installed along the sides of the mirror — to overhead lights, which were mounted on the ceiling.

“Women complained that overhead lighting created shadows on their face, making them look unattractive,” she said.

To avoid these unflattering shadows, shoppers had to step back from the mirror and move around, Baumstarck said. “They were constantly engaged in trying to negotiate the best spot to stand and ended up dancing around the dressing room,” she said.

When customers notice the negative aspects of their surroundings, it distracts them from paying attention to the merchandise, Baumstarck said. “You never want a consumer to be thinking ‘I hate this lighting’ instead of ‘I like this dress,’” she said.

Overhead lighting also makes a room seem smaller — even cramped — creating a need to escape, Baumstarck said. With frontal lighting, dressing rooms appear roomier, and shoppers said they were willing to stay longer and even try on more clothes, she said.

Women most impressed with frontal lighting were those who placed a high priority on personal appearance and how they looked in clothes; by comparison, more utilitarian shoppers cared only about finding a particular article of apparel that fit, the study found.

Results showed that this “self-oriented” shopper would sometimes comment about frontal lighting giving their skin a healthy glow, making their cellulite less visible or being so soft and flattering that it made it appear they were in a bar or restaurant in the evening, she said.

Previous research shows consumers choose a store with a particular image, such as one that is healthy and sporty or sexy and trendy because they want to be seen as having those attributes, Baumstarck said.

Lighting was so important that it captured a majority of the comments — 51 percent — that women made in the study, Baumstarck said. Of the 36 comments made about overhead lighting, 25 were negative, representing 69 percent of the total, and 11 were positive, making up 31 percent. In contrast, frontal lighting generated 34 comments, of which 20 were positive — 59 percent — and 14 were negative or 41 percent.

Lighting in stores varies, with overhead lights common in lower-priced bargain stores, Baumstarck said. Some retailers don’t even designate lighting for dressing rooms; the same overhead light fixtures serve both dressing rooms and the main sales floor, she said.

“It’s not all about the clothes,” she said. “What woman doesn’t go into a dressing room and engage in a dialogue with herself about how attractive she is? You don’t want to give her any opportunity to feel badly about herself.”

Baumstarck’s study has great implications for retailers and consumers, especially with the economic downturn, said Paulette Hebert, an Oklahoma State University design professor and lighting expert. “One important variable, such as dressing room illumination, may mean the difference in a store remaining viable in today’s economy,” she said.

The higher the radiation dose, the higher the risk, researchers report. These women are also likely to develop cancer in both breasts.

“Our first priority is always to get rid of the cancer. Our second priority is to do so in a way that preserves the best possible quality of life,” said researcher Dr. Nancy Mendenhall, an oncologist with UF’s College of Medicine who co-authored a paper detailing the results in the September issue of the International Journal of Radiation Oncology Biology Physics. “These findings tell us we’re moving in the right direction with recent changes in treatment that lower radiation dose.”

In the past, children with Hodgkin’s disease were treated with radiation alone, in relatively high doses to large volumes of the body. Today, doses are half the levels used 20 years ago, smaller portions of the body are treated, and, in many cases, radiation has been replaced by chemotherapy.

“One of the hopes of that strategy is not only are there going to be better cure rates for Hodgkin’s disease, but also fewer long-term side effects of therapy,” said Dr. Kenneth B. Roberts, an associate professor of therapeutic radiology at Yale University who was not involved in the study.

At the start of 2005, there were almost 76,000 women in the United States who had a history of Hodgkin’s disease, according to the National Cancer Institute.

Death rates from Hodgkin’s disease have plummeted by more than 70 percent in the last 40 years in the United States, and researchers now focus on reducing the so-called “late effects” of treatment that show up long afterward.

“We expect the future to be better than the past in terms of the likelihood of people developing breast cancer,” said University of Rochester pediatric oncologist Dr. Louis S. Constine, who led the study. Still, he said, “it’s important to understand the past because many people were treated like this.”

Similar studies will be needed to measure the success of modern treatment strategies, Roberts said.

Hodgkin’s disease is a cancer of unknown cause that affects tissue in the lymph nodes, spleen, liver and bone marrow. It can spread from one organ to another but can be cured with radiation, chemotherapy or a combination.

The American Cancer Society estimated that in 2008, about 8,220 people in the United States would be diagnosed with Hodgkin’s disease and about 1,350 would die from it. Up to 15 percent of all cases occur in children and teenagers.

In the current study, 398 females younger than 19 who were treated for Hodgkin’s were evaluated from 1960 until 1990. They had been seen at UF, the Rochester Medical Center, Boston Children’s Hospital and Dana-Farber Cancer Institute, St. Jude Children’s Research Hospital or the Sidney Kimmel Cancer Center at Johns Hopkins University.

Researchers found that women who had been treated for childhood Hodgkin’s disease were 37 times more likely than others to develop breast cancer — 29 developed breast cancer during the study’s follow-up period.

On average, it took almost 19 years after treatment for cancer to develop. Guidelines call for Hodgkin’s survivors to start being monitored for breast cancer 10 years after treatment or at age 30 — whichever comes first.

In the study, patients ages 12 to 19 at the time of treatment were at slightly higher breast cancer risk as adults than those who were younger than 12. And those diagnosed with early-stage Hodgkin’s were at higher risk than those with more advanced disease.

Hodgkin’s survivors who developed breast cancer were much more likely to have received higher radiation doses to the entire chest and neck — the so-called “mantle field” — which exposes both breasts to radiation.

About one-third of women who developed cancer in one breast also developed another cancer in the opposite breast. The time from the first to the second cancer ranged from one to three years.

“(That) means people need to be screened, if anything, even more intently after the development of the first cancer,” Constine said.

Preventive mastectomies for certain patients at high risk for breast cancer might be worth considering, researchers said.

Surprisingly, radiation of the pelvis seemed to lower cancer risk.

“That finding challenges one of our basic beliefs, so I think we have to do a little more work to understand what is happening,” Mendenhall said.

Researchers had thought that the greater the volume of tissue irradiated, the greater the cancer risk. But it is possible that radiation to the pelvis caused premature menopause or ovary failure, with an accompanying drop in the production of the hormone estrogen, a known risk factor for breast cancer.

Factors other than radiation treatment — such as biologic predisposition to cancer — could be at play in the observed rates of cancer development, the researchers said. A trait responsible for the development of breast cancer could also be responsible for Hodgkin’s disease development in the first place.

The UF study is the first to demonstrate the effectiveness of telephone counseling for long-term management of obesity in rural communities. The findings appear in today’s (Nov. 24) issue of Archives of Internal Medicine.

In the study of women in underserved rural areas, those who received phone or face-to-face counseling following an initial weight-loss program did a better job of keeping the weight off than those in a control group.

“We found that the participants who received extended care were able to maintain their weight loss at higher levels than those participants who only received printed health education materials as a follow-up,” said lead investigator Michael G. Perri, a professor and interim dean of the UF College of Public Health and Health Professions. “The success of telephone counseling gives us a cost-effective alternative to face-to-face visits that is more convenient for rural residents who may need to travel long distances for care.”

Study participants included 234 obese women, ages 50 to 75, who live in rural communities in northern Florida. After completing a six-month weight-loss program, women in the study lost an average of 22 pounds. One year later, participants who had received phone or face-to-face counseling after treatment had regained less weight — on average, 2.5 pounds — than those in the education control group, who regained an average of 8 pounds.

Long-term care is an important component in weight-loss maintenance, said Perri, who has argued for the acceptance of obesity as a chronic condition that requires continuous care. Previous studies have shown that in the year following treatment, participants regain one-third to one-half of the weight lost.

During the first phase of the UF study, the women participated in a weight-loss program that combined a low-calorie diet with daily 30-minute walks and an emphasis on learning problem-solving skills to overcome barriers to weight loss. The women met in weekly group sessions in six rural counties.

“We also addressed special issues of concern for women in rural areas, such as low-calorie preparation of traditional ‘Southern’ dishes, strategies for coping with a lack of family support for weight loss and techniques for healthful eating away from home,” said Perri, a professor of clinical and health psychology.

After the weight-loss portion of the study, participants were randomly assigned to one of three 12-month follow-up programs to help them keep the weight off: face-to-face group counseling, phone counseling or a comparison group that received written educational materials. Participants were encouraged to use weight-control strategies and asked to log food intake on at least two weekdays and one weekend day per week.

Adherence to the behavioral weight control program, as measured by the food intake records, was significantly higher in the phone and in-person groups.

“The completion of written self-monitoring records was the single best behavioral predictor of weight change,” Perri said.

Although phone and in-person counseling were equally effective in helping participants maintain weight loss, program expenses per participant for phone counseling were half the cost of face-to-face counseling — $397 on average for in-person counseling versus $192 for those in the phone group. Phone counseling also offers other benefits for people in rural areas, researchers say.

“Because distance represents a major barrier to medical care in rural areas, the availability of a treatment modality that does not require time and costs for travel and attendance at clinic visits represents a potentially important approach to providing ongoing care to rural residents,” Perri said.

The UF study has significant implications for behavioral weight management programs, says John P. Foreyt, a professor and director of the Behavioral Medicine Research Center at Baylor University’s College of Medicine.

“The study demonstrated that telephone counseling is an inexpensive, effective strategy for helping people to maintain their weight losses,” Foreyt said. “Dr. Perri’s findings will have a major effect on the delivery of future weight management interventions. His results are a major breakthrough in the development of effective approaches for helping people to maintain healthier body weights.”

Perri is leading a new study called Rural Lifestyle Intervention Treatment Effectiveness Trial, or Rural LITE, supported by a $3.6 million grant from the National Heart, Lung and Blood Institute. The researchers hope to determine the minimum intensity of treatment required to produce clinically meaningful, long-term weight loss in rural men and women.

GAINESVILLE, Fla. — Girls who enter puberty early may be less able to cope with being bullied or rejected by other students than their female classmates who mature later, a new University of Florida study finds.

“Although it was expected that early maturing girls would be at greater risk for developing symptoms of depression, anxiety or aggression when they experienced higher levels of peer stress, we also found that they have a tendency to use fewer problem-solving skills, which ultimately increases the likelihood of responding to stress in negative ways,” said Julia Graber, a UF psychologist and one of the study’s authors.

Because of the increasing time teenagers spend with peers, social stress becomes particularly important as a threat to their psychological well-being, Graber said. Girls are especially vulnerable because they rely heavily on peers for emotional support and intimacy, she said.

The subject is timely as the general trend has been for girls to enter puberty at slightly earlier ages than prior generations, she said.

The study, which actually measured girls’ physiological reactions to stress by recording levels of cortisol, a stress hormone, is scheduled to be published in the November edition of the Journal of Abnormal Child Psychology. The participants were 111 girls between fifth- and eighth-grades who, along with their mothers, were recruited from public schools in ethnically diverse working- and middle-class communities in the New York City area in 1995 and 1996 as part of a larger study.

Mothers and daughters completed surveys and participated in a series of tasks. During a home visit, researchers collected saliva samples to determine levels of cortisol while the girls engaged in a series of neutral and stressful experiences such as completing a timed test, said Lisa Sontag, a UF psychology graduate student who led the study.

“Interestingly, the study found that girls who mature early exhibited higher overall cortisol levels compared to other girls, suggesting that early maturers may have a more difficult time regulating stress levels once they begin to experience feelings of physiological arousal such as their heart beating at a faster rate,” Sontag said.

These girls may especially fear being teased about gaining weight or looking more adult-like, she said.

The results also showed that girls who entered puberty early used fewer problem-solving strategies than did on-time or late maturers, Sontag said. And because they were less likely to take steps such as going for a walk to calm themselves down or asking for advice, they internalized much of their distress, she said.

These girls would often think about a problem over and over again and how badly it made them feel, Sontag said. They also reported experiencing more physical symptoms such as stomach cramps and racing heart beats, she said.

“Everybody is going to respond at some level to stressful situations with a degree of sweaty palms, heart racing or getting really angry, but most of us have the ability to actively try to control those responses by saying to ourselves ‘It’s not that big of a deal’ or trying to approach it by fixing the problem,” Sontag said. “Girls without coping skills have problems because they have a high level of impulsive responses but don’t have the strategies in place to control those responses.”

Unfortunately, new technology now allows various forms of cyber bullying involving text messaging, MySpace and Facebook, Graber said.

Another trend that has made bullying easier is bigger schools, Graber said. “On one hand it may give students the opportunity to meet more peers, but there also is the potential to be more isolated with fewer people knowing who you are and for peer group behavior to be monitored less closely than it would be in smaller school environments,” she said.

University of Illinois psychology professor Karen D. Rudolph said the study is a “fascinating contribution” to understanding how the timing of girls’ pubertal development shapes their social and mental health. “Although it has been known for some time that girls who physically mature earlier than their peers are at greater risk for mental health problems, these findings help to explain why this may be the case — early-maturing girls seem to have more difficulty responding effectively to social stress, a form of stress that they are likely to encounter at some point during adolescence,” she said.

GAINESVILLE, Fla. — Men’s and women’s attitudes about their proper place at work and home may matter as much as economic forces when it comes to how much money they make, a new University of Florida study finds.

Women with traditional ideas about sex roles earn less than their female counterparts with more egalitarian views; in contrast, men with traditional beliefs make more than those who are less conventional minded, said Timothy Judge, a UF management professor. His study appears in the September issue of the Journal of Applied Psychology published by the American Psychological Association.

Among married couples, the biggest wage disparity occurs among those with a more traditional outlook. A 25 percent wage gap exists among couples who think husbands should be the family’s primary breadwinner and wives should manage the home, compared with about a 10 percent gap in marriages where more progressive attitudes prevail, Judge said.

“Our children need to be taught that there is no such thing as ‘men’s work’ and ‘women’s work,’” he said. “If one is concerned about economic inequality between men and women, then we should realize that traditional attitudes about gender roles are the enemy of wage parity.”

The study controlled for job complexity, number of hours worked, initial earnings, industry employed and education level. It used a nationally representative sample of men and women, who were interviewed four times between 1979 and 2005.

Judge worked with Beth Livingston, a UF management graduate student, in analyzing the data, which in the beginning involved a total of 12,686 participants, ages 14 to 22, with a 60 percent retention rate over the course of the study.

Among married couples with traditional ideas about gender roles, the husband is predicted to have an annual earnings advantage eight times greater than that within marriages where the partners have less orthodox views, Judge said.

Traditional-minded men make an average of about $8,500 a year more than their male counterparts with a less-conventional orientation; however, their wives earn an average of about $1,500 less than women with egalitarian beliefs, he said.

Perhaps women with a traditional outlook are more accepting of lower earnings, making it easier for employers to pay them less, Judge said.

“It’s likely that traditional women approach the work role in such a fashion that they demand less, settle for less, negotiate less aggressively and otherwise fail to put their economic interests first, at least to the same degree as traditional men,” he said.

Because the gap in earnings was found to be strongest in jobs of low complexity, which employ large numbers of traditional men, these women’s husbands, who also work in male-dominated environments, stand to benefit salary-wise, he said.

“Some low complexity, ‘blue collar’ jobs may become hyper-masculinized and reward those who are the most traditional in terms of gender roles,” Judge said. “There may be a ‘double-whammy’ both in terms of greater employer prejudice and greater actions on the part of employees to conform to traditional roles.”

This belief that work is more important to men and they should be paid more becomes a self-fulfilling prophecy, he said.

Overall, the study found a much more rapid change over time in gender role attitudes of men, who started out as considerably more traditional in 1979, Judge said. While other studies show that the gender pay gap has narrowed, it has not disappeared; today’s women earn on average about 80 percent of what men do, he said.

Although laws such as the Equal Pay Act and Title VII of the Civil Rights Act, which forbid explicit discrimination based on gender, have reduced discrimination’s effects, much of the continuing wage gap is due to the individual employee rather than employer, he said.

“Our findings show that the gender wage gap is not solely a reflection of economic or sociological forces; psychology also plays a role,” Judge said. “Parents should realize that if they want their daughters to be economically self-sufficient and successful, teaching them traditional gender role attitudes hinders that goal.”

Children raised by educated parents and who are educated themselves, as well as those growing up in urban areas, are less likely to have traditional ideas about gender, he said.

Gender role attitudes were determined by asking study participants how strongly they agreed or disagreed with such statements as “a woman’s place is in the home, not the office or shop;” “employment of wives leads to more juvenile delinquency;” and “it is much better if the man is the achiever outside the home and the woman takes care of the home and family.”

In revealing all for drawings, paintings and sculpture, models revel in a sense of mission and accomplishment, said Clay Hipke, who did the research for his doctoral dissertation in sociology. They take pride in striking creative poses and contributing to art because many are connoisseurs themselves, owning single pieces or small collections, he said.

“Artists’ models may seem at first blush to be like other groups in society that employ nudity and exist at the margins of conventional life, such as strippers, exotic dancers and peep show workers, but artists’ modeling has a long and distinguished history,” Hipke said. “The nude form as cultural and historic roots all the way back to the Greeks.”

Hipke, whose field of research is the sociology of deviance, said no systematic study of artists’ models had been done when he began his interviews in the spring of 2007. Through artists’ referrals he recruited 25 female models from seven Florida cities between the ages of 18 and 60. Most of the women were middle class with at least some college education, were single or divorced and did not practice a religion, he said.

Falling asleep while posing, braving cool temperatures in drafty rooms and enduring disapproval from parents and friends were some of the occupational hazards of the job, the study found.

Although the work looks easy, the ability to hold a pose for long periods of time can be difficult and sometimes caused models to develop muscle aches and cramps, Hipke said.

Three quarters of the women admitted falling asleep during a pose, with one model reporting that it nearly caused her several times to fall off a stool, he said. Being cold — especially in winter — was another hardship models identified because they often posed in oversized rooms with large windows and poor insulation, he said.

The models were barely concerned about posing in the buff as the study found that none of them mentioned the subject when asked what they thought about during long poses, Hipke said. “You are a model to art students; they don’t necessarily see you as a potential mate or anything,” explained one art student.

Overall, models had a positive perception of their bodies and those with insecurities reported that working in the profession improved them, Hipke said. One success story involved a woman in her 60s who decided to try modeling after hearing a friend she met at a social gathering who was the same age talk about the work’s benefits.

“She had body image issues after having a hip replacement,” he said. “Based on her friend’s experience, she thought it would be a good way to improve her self-esteem and it worked.”

Parents and boyfriends, however, were less likely to keep any inhibitions about the idea under wraps, Hipke said. Parents worried about the voyeuristic intentions of some artists and the danger of modeling ruining their daughters’ future careers, while some boyfriends barely tolerated their girlfriends’ work, he said.

Often when a woman started dating someone new, she would make a point not to mention she modeled until after she had gotten to know the person better, Hipke said.

“I think most people don’t realize that art students have to learn how to draw the human figure by looking at naked bodies,” complained one model in her interview.

Models reported that bad experiences were rare and most expressed a strong desire to take directions and do their jobs in a fashion that pleased the artist, Hipke said. Many already knew something about the visual arts, having collected art themselves or taken classes in the subject, and they enjoyed learning more about different artistic techniques, he said.

“Artists were described as being extremely respectful, even caring in their approach,” he said. “They knew that without the model they couldn’t create their art.”

Besides the idea of contributing to something socially worthwhile, women found the money appealing, especially if they were college students, Hipke said. “Ten to 20 bucks an hour – especially for a campus job — is a pretty good deal for not having to do much,” he said.

Jeremy Tanner, author of “The Sociology of Art: A Reader,” and a reader in classical and comparative art at University College London’s Institute of Archaeology, said Hipke’s research “should be of interest to anyone concerned to understand the character of the modern art world. The sensational lives of the models of famous artists have long been of interest to art historians, but Hipke breaks new ground by exploring a representative sample of artists’ models and their ordinary working experiences,” he said.

GAINESVILLE, Fla. — The continued decline of the nursing home — once the mainstay care for the frail elderly — and an upsurge in popularity of assisted living will lead to many dramatic changes in long-term care, according to a University of Florida expert and editor of a new book on the subject.

“The American public has expressed a strong distaste for going to a nursing home because it smacks of a hospital-like, institutional way of living and receiving care,” said Stephen Golant, a UF geography professor and expert on elderly housing. “Assisted living has emerged as a highly attractive option for older persons who have experienced some physical or cognitive decline and feel less secure about receiving care in their own home.”

Yet there are few certainties about either the future of assisted living for the elderly or the huge number of baby boomers who stand to be its recipients, Golant said.

“Although baby boomers will constitute a large market, it is unclear what share will have impairments and chronic health problems that make them candidates for assisted living,” he said. “The emergence of an unexpected new medical or rehabilitation breakthrough, such as a cure or the discovery of a disease-controlling drug for Alzheimer’s disease – could result in a substantial decline in the number of elderly Americans who need such care.”

Golant and Joan Hyde, an assisted living provider and a senior fellow at the Gerontology Institute at the University of Massachusetts in Boston, are editors of the new book “The Assisted Living Residence: A Vision for the Future,” published this month by The Johns Hopkins University, which examines elderly housing and possible care trends over the next 20 to 30 years.

The biggest competitors to assisted living are daughters and daughters-in-law who provide most elderly caregiving and determine whether their loved ones can remain in their own homes, Golant said. But the availability and attitudes of the current generation of female offspring who must juggle work and family responsibilities are unclear, he said.

“We know that women have succeeded in being comfortable in going back to work even when they have a baby less than a year old and assigning that care to somebody else,” he said. “Now the question is how will they react when they confront the possibility of leaving their older parents?”

New technology may make that transition easier, Golant said. The development of sophisticated monitoring and surveillance devices that would allow grown children to track their parents’ daily movements on a computer screen from home or work, for example, would revolutionize attitudes about nursing home and assisted living facilities, he said.

“Suddenly some of the downsides of not living at home would be minimized because sons and daughters could feel very much involved with the caregiving experience of their mothers and fathers even without physically being there,” he said. “They could see parents in their rooms, walk with them to the dining hall and even communicate with them in real time.”

Businesses and social service agencies are preparing for the surge of aging baby boomers, an estimated seven out of 10 of whom are expected to require long-term care at some point after they reach the age of 65, Golant said. Many will also face the issue of a parent needing long-term care before reaching that stage themselves, he said.

Nursing homes are increasingly gearing their business toward acute episodes, such as strokes, which call for short rehabilitative recovery periods, Golant said. When they offer long-term care, nursing homes increasingly serve poorer people and are funded through the Medicaid program, while assisted living caters to private paying individuals with higher incomes or salable assets such as an expensive home or stock portfolio.

To be competitive, nursing homes are trying to transform themselves into becoming more home-like and less like an institution; in short, more like assisted living facilities, he said.

Low savings rates and falling home equity raise the question of whether fewer baby boomers will be able to afford assisted living compared with their parents’ generation, Golant said. The average one-year base price is close to $36,000, not including the additional supervision required with Alzheimer’s disease and more serious medical conditions, he said.

“Assisted living is here to stay – and is now very much part of the ordinary consumer’s lexicon,” he said. “But its rate of growth and the number and share of older boomers who will choose this long-term care option in the future is very uncertain.”

Frank Caro, senior fellow in the Gerontology Institute at the University of Massachusetts in Boston and editor of the Journal of Aging and Social Policy, praised the book as “essential reading for everyone with a stake in the future of assisted living in the United States.”

By manipulating a specific gene in a mouse blastocyst — the structure that develops from a fertilized egg but is not yet an actual embryo — scientists with the University of Florida’s McKnight Brain Institute and the Harvard Stem Cell Institute caused cells destined to build an embryo to instead change direction and build the cell mass that leads to the placenta.

Writing in today’s (Monday, June 9) online edition of Nature Genetics, the scientists reveal a cellular signaling mechanism in place at the earliest developmental stage.

Understanding the conditions that cause these cells to go off to different fates may have a bearing on health problems such as ectopic pregnancy, which occurs when the embryo develops outside of the womb in about 1 of 60 pregnancies, or molar pregnancy, which is abnormal tissue growth within the uterus that affects about 1 in every 1,000 pregnancies.

“We originally were exploring factors that might cause embryonic stem cells to become malignant — there is a concern that these cells may cause tumors,” said Chi-Wei Lu, an associate neuroscientist at the UF College of Medicine and lead author of the study. “Our experiments led us to discover the signal that initiates the process of embryonic tissue differentiation.”

By activating a gene called Ras in cells bathed in a very specific culture medium, scientists were able to cause embryonic stem cells — which originate from the inner cell mass of the blastocyst — to become more like the trophoblastic stem cells that give rise to the placenta from the outer portion of the blastocyst.

Researchers marked these newly minted cells, which they called ES-TS cells, and injected them into mouse embryos. Instead of joining the stem cells that build the embryo, ES-TS cells joined the stem cells that build the placenta. Furthermore, when scientists transferred the engineered mouse embryos to foster mothers, the ES-TS cells went to work exclusively laying the foundation for the placenta.

“This paper highlights the value of embryonic stem cells for understanding early development,” said senior author Dr. George Q. Daley, an associate professor of biological chemistry and molecular pharmacology at Harvard Medical School and an associate professor of pediatrics at Children’s Hospital Boston. “Embryonic stem cells are more plastic than we had thought. By simply activating the Ras gene, we changed the fate of embryonic stem cells to an entirely unexpected tissue — the placenta. This surprising result has given us an unanticipated insight into early embryo development.”

The technique of genetically modifying the cells and growing them in a special medium could be valuable for additional research.

“This is exciting because events that only occur in the early stages of embryonic development are very difficult to study,” Lu said. “Just a few models exist, and even in mice, only a limited amount of embryos can be harvested. Now we can culture these cells and have unlimited material to study.”

Researchers are only beginning to understand the natural chemical environments that allow for production of different tissues.

“What is nice is that what she has observed in cultures appears to be quite similar to what goes on in early development in animals,” said R. Michael Roberts, a professor of molecular biology at the C.S. Bond Life Sciences Center at the University of Missouri-Columbia who did not participate in the research. “Normally, mouse embryonic stem cells aren’t easily converted along the pathway to form placental cells, while human embryonic stem cells undergo this transition quite easily. This has always been a puzzle. What she has shown is you can make mouse embryonic stem cells convert unidirectionally to trophoblasts by activating a single gene. This is very helpful for understanding how the placenta develops.”