Nonalcoholic steatohepatitis (NASH) is a chronic progressive liver disease that is strongly associated with obesity. Currently, there is no approved therapy for NASH. Weight reduction is typically recommended, but efficacy data are lacking. We performed a randomized controlled trial to examine the effects of lifestyle intervention using a combination of diet, exercise, and behavior modification, with a goal of 7% to 10% weight reduction, on clinical parameters of NASH. The primary outcome measure was the change in NASH histological activity score (

As compared with receiving quarterly newsletters, a self-regulation program based on daily weighing improved maintenance of weight loss, particularly when delivered face to face. (ClinicalTrials.gov number, NCT00067145 [ClinicalTrials.gov].)

Subjects (A' = 970) representing five stages of smoking cessation (precontemplation, contemplation, action, maintenance, and relapse) were given a 65-item test measuring 10 basic processes of change. Subjects recorded the last time they quit smoking, their current use, the frequency of occurrence, and the degree of item helpfulness. A 40-item questionnaire provided highly reliable measures of 10 processes of change, labeled (a)consciousness raising, (b) dramatic relief, (c) self-liberation, (d)social liberation, (e) counterconditioning, (f) stimulus control, (g) self-reevaluation, (h) environmental reevaluation, (i) reinforcement management, and (j) helping relationship. In a confirmatory analysis, 770 subjects were assessed 6 months later. The analysis both confirmed the 10-process model and revealed two secondary factors, Experiential and Behavioral, which were composed of 5 processes each and reflected hou. individuals in particular stages use more lhan I process at a time. The transtheoretical model of change and available external validity evidence are reviewed. A Zeitgeist has emerged in which therapists from different systems are searching for common processes of change (Goldfried, 1980). Because research has indicated that no one system of therapy is superior to another (Luborsky, Singer, & Luborsky, 1975; Parloff, 1979), the assumption has been made that effective therapies share common processes. Investigators such as Goldfried and Padawer (1982) and Strupp (1981) have suggested that integrative models can be developed only if we begin to identify and measure processes that are common to the multitude of current therapies. In a comparative analysis of 18 major systems of therapy, Prochaska (1979) identified lObasic processes of change. Prochaska and DiClemente (1984) assumed that basic processes of change would account for how people change on their own as well as how people change in therapy. The present study reports on the development of a test for measuring basic processes of change in the context of a common addictive behavior problem, smoking cessation. This study is based on an integrative model of change that has been applied to such problems as smoking, weight control, alcohol abuse, psychological distress, and a range of Diagnostic

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Information about the effects of subject sampling and variable sampling on factor pattern reproduction is critical for both the design of studies and the evaluation of existing studies. This article reports both a review of the available literature and the results of 2 new simulation studies. Conditions investigated include the average number of variables per factor (3:1,4:1, or 5:1), the sample size (N = 50,100,150, 200, 400, 800), the method of analysis (principal component analysis, image component analysis, maximum likelihood factor analysis), pattern of loadings (equal or unequal), and the size of the average loading (.40, .60, .80). A small but consistent pattern of differences between methods occurred. Subject sample size, variable sample size, and size of the loadings can all strongly affect the degree to which a sample pattern reproduces the population pattern. The frequency of boundary cases in factor analysis is also affected by the same 3 variables. A minimum of 3 variables per factor is critical. Weaknesses in one area can be partially compensated for by strengths in another area.Experimental design is a term typically associated with analysis of variance (ANOVA), and guidelines for good experimental design have been well developed within that context. However, the importance of considering design issues is no less important when other methods of data analysis are used. Two general issues central to the design of a study are subject sampling and variable sampling. In each case, the issue is to balance the relative cost of the study versus the adequacy of the study to achieve its goal. The goal