Policies that reward abstinence from terrorism are more successful in reducing such acts of violence than tactics that aim to punish terrorists, suggests a new study in the August issue of the American Sociological Review.
Titled, "Moving Beyond Deterrence: The Effectiveness of Raising the Expected Utility of Abstaining from Terrorism in Israel," the study looked specifically at the Israeli-Palestinian conflict and found that between 1987 and 2004, Israeli policies and actions that encouraged and rewarded refrain from terrorist acts were more successful in reducing terrorism than policies focused on punishment.
"Our argument begins to challenge the very common view that to combat terrorism, you have to meet violence with violence," said Erica Chenoweth, study co-author and Assistant Professor at the Josef Korbel School of International studies at the University of Denver.
The study is the first to empirically evaluate the potential of conciliatory tactics in reducing terrorism. It relies on data from the Center for the Study of Terrorism and Response to Terrorism's (START) Global Terrorism Database (GTD) and from the Government Actions in a Terrorist Environment-Israel (GATE-Israel) dataset. The GTD records global terrorist attacks, including Palestinian terrorist acts, while the GATE-Israel dataset, which the study authors developed, identifies counterterrorism strategies that Israel used against Palestinian targets and places them on a seven point scale from violent acts resulting in death to conciliatory acts involving peaceful gestures.
Examples of Israel's conciliatory tactics that rewarded refrain from terrorist acts included: providing social services to potential terrorist constituencies, encouraging peace talks, withdrawing troops, releasing prisoners, and promoting cultural freedoms.
Israel's repressive and punishment centered attempts to reduce terrorism included: passage of anti-terrorism laws, extension of prison sentences, assassination, deportation, and military retaliation.
The study found these repressive and punishment based methods to be less effective in reducing terrorism. Yet, in an average month between 1987 and 2004, Israel took approximately 18 repressive or punishment based actions against Palestinian targets and less than eight conciliatory actions.
Chenoweth and her co-author Laura Dugan, an Associate Professor in the Department of Criminology and Criminal Justice at the University of Maryland, said they hope their findings encourage policymakers to give more consideration to conciliatory actions.
"The general consensus across the political spectrum is that when there is terrorism you have to fight back," Dugan said. "This study suggests that there is value in looking at the grievances, the people most affected by these grievances, and the constituencies of these terrorist organizations."
According to the study's authors, when policymakers focused on improving the living conditions for Palestinian constituents, those same constituents were encouraged not to participate in terrorist organizations and, consequently, terrorism rates fell.
"If the constituency of a terrorist organization no longer supports that organization, then the organization can't thrive," Dugan said.
In addition, Dugan and Chenoweth argue that terrorists do not commit terrorist acts for the same reasons that common criminals commit crimes. Therefore, they believe counterterrorism tactics should not mirror typical crime fighting approaches.
"Strategies that successfully deter common criminals may be ineffective for terrorists," Chenoweth said. "This is because terrorists are generally less concerned about being punished and more concerned about their role in ensuring the well-being of their movement and its constituency."
While Dugan and Chenoweth found conciliatory policies to be more successful than repressive and punishment centered actions in reducing incidents of terrorism, the study authors are not completely opposed to the use of repressive and punishment based strategies.
"We do not recommend that governments adopt purely conciliatory policies," Dugan said. "Our hope is that this research provides alternatives to solely focusing policy efforts on reducing the expected utility of bad behavior by also considering the value of raising the expected utility of good behavior."
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American Sociological Association: http://www.asanet.org
Thanks to American Sociological Association for this article.
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In the better-late-than-never department, word comes today through the Theatre for a New Audience Web site that Wallace Shawn?s 2009 play Grasses of a Thousand Colors will make its US debut on 8 October 2013 at the Public Theater. The production will be directed by Andr? Gregory and feature Mr. Shawn, Emily McDonnell, and Jennifer Tilly reprising their roles from the 2009 Royal Court Theatre world premiere staging. Grasses is a part of the ?Wallace Shawn-Andr? Gregory Project? co-produced by the Public and Theatre for a New Audience, which also includes a revival of Shawn?s 1996 The Designated Mourner, also directed by Mr. Gregory and featuring Mr. Shawn, Deborah Eisenburg, and Larry Pine in the cast.
I wrote about Grasses of a Thousand Colors in February 2011; below is the text of that essay.
Miranda Richardson and Wallace Shawn in the Royal Court Theatre?s production of Grasses of a Thousand Colors. Photo: John Haynes. Courtesy Royal Court Theatre
Grasses of a Thousand Colors by Wallace Shawn. New York: Theatre Communications Group, 2009. Premiere (directed by Andr? Gregory): Royal Court Theatre, London, 18 May 2009.
At the worst, a few people will conclude that it?s worthless. And I will have spent 10 years doing something ridiculous. But I?ve decided to take a bet on my subconscious. Isn?t all writing to some extent about trying to get through the layers of propaganda and false interpretations and received ideas and clich?s that prevent us from seeing what?s going on? I think that?s the enterprise.
Wallace Shawn?[]
Issues of power, and more specifically hegemony, and how they are writ in both the broader cultural and more private landscapes of human relationships have always been at the center of Wallace Shawn?s plays. His dramatic voice, also, is unique and unmistakable. In both these senses he is an American equivalent to Harold Pinter. The seemingly intimate disclosures, emotional violence and manipulations of Shawn?s early plays like Our Late Night (1975) and Marie and Bruce (1978) became more and more politically and culturally acute, without losing the sense of sexual dynamics and hostility, through the 1980s with Aunt Dan and Lemon (1985, which explored how political hegemony is exploited in the personal realm through the relationship between a girl and a family friend) and, especially, The Fever (1990, a monologue about a Western traveler in a foreign country under siege) and The Designated Mourner (about the role of intellectuals in an increasingly authoritarian Western culture, 1997, perhaps Shawn?s masterpiece to date). As the dates here indicate, many years separate one Shawn play from another, and in the immediate aftermath of 11 September 2001 Shawn expressed his concerns about changing American culture not on the stage but through editing Final Edition (2004), a single-issue periodical which included Shawn?s interview with Noam Chomsky, essays by himself and Jonathan Schell, and fiction by Mark Strand and Deborah Eisenberg.
There is no mention of 11 September nor, indeed, of the United States in Grasses of a Thousand Colors, which opened two years ago at London?s Royal Court Theatre. The geographical setting of the play itself may indeed be Great Britain (placenames in the text include the British-tinged ?Pushbroom Lane? and ?Apple Street?), and chronologically the play is set somewhat in the future, not the past. But at its center, the drama is about the unconscious play of technological and emotional hegemony through fantasy and contemporary sexual relationships. The three-act play is, at the outset, presented as a reading from a memoir: Ben, a scientist who has achieved a certain level of celebrity, begins to read from his autobiography, Loaves, with Fishes, for Dinner, a title with a Biblical undertone. Ben is a distinctly American pragmatist and optimist, he admits:
You see, I?m an optimist ? I come from an optimistic generation. Everyone I know from my generation ? we?re fixers, improvers. That?s what we are. We were born that way, apparently. Do? you have a problem? Fine. Problems can be solved. Are you dissatisfied with how fast you can run? Are you dissatisfied with how fast you can think? These are problems that can be solved. So if something isn?t right, for God?s sake, fix it. (10)
The problem that scientist Ben has apparently fixed is the problem of world hunger, and he has done so by genetically changing the nature of the world itself. He explains:
There was, on the one hand, an enormous crowd of entities ? ourselves and others ? roaming the planet, trying to sustain themselves, or in other words, looking for something to eat; and on the other hand, there was a tiny, inadequate crowd of entities available on the planet to be eaten. So it was a problem of food. It was all about food. There wasn?t enough food. So, as a generation, working really across all the nationalities and all the continents, we figured out ways to create food where there?d been no food ? whether it was by giving a certain frog a simple injection so that he and his friends could live off the corpses of other frogs, when, formerly, a dead frog would have worked as a poison in the body of a frog, or by forcing certain substances into the upper atmosphere, so that an odd sort of rain would sprinkle down onto fields full of cows, so that cows who formerly could only live off grass could happily live off skunks and rats and foxes instead ? that was the work of our generation. And, in the way of things, we ended up deriving some benefit ourselves from that, through various ridiculous instrumentalities we call salaries, stocks, investments, what have you. ?
[Showing a photograph of himself and a dog] This was one of our earliest successes, because my good friend Rufus here was the very first large mammal ever to be raised entirely on the meat of members of his own species. ? (11-12)
The American expression of capitalistic competition, ?dog eat dog,? indeed ? and problem solved, evidently, until the genetic mutations that Ben has introduced mutate beyond the control of science, turning meat (and eventually vegetation) not only inedible but poisonous to human beings. (So much, too, for ?man?s best friend.?) It soon becomes clear that this has catastrophic implications for the future of the human race; in changing life to solve life?s own problems, technocratic rationalism has signed its own death sentence.
Ben is interrupted by a memory of his first wife, Cerise, who appears to introduce a second metaphor of the animal kingdom, one which will grow to control the unconscious lives of all the characters and the structure of Grasses of a Thousand Colors itself. ?I?m going to be very frank with you and tell you something true rather than being euphemistic about it,? she tells the audience:
Cats like to tease mice. They like to play with them a little. ? Cats like to tease mice. In other words, I?m saying, it?s not something that happens by accident when they?re pursuing some other more respectable purpose. No. They like to do it. ? And of course everyone knows that cats punish mice. They inflict many different types of punishment on mice ? they can inflict capital punishment, life imprisonment without the possibility of parole, and many other sorts of punishments. So they tease mice, they play with them, and they punish them. They pummel them, and they eat them. But what?s not generally known is that cats also sometimes protect mice. They protect them, they pardon them, and sometimes they reward them, way beyond what any person would think they deserve.
Oh yes, and there?s one other thing I know about cats which is not generally known, and that is the interesting fact that cats mate for life. That?s right. You heard me. They mate for life. Like humans. (17)
Ben?s professional and personal life is the content of the first act of the play;? however, the metaphors of the animal world soon mutate themselves into a picture of the unconscious sexual life of all three characters, mutating this sexual life as well into a series of pornographic fairy tales about the animal kingdom that reflect the irrationalism that lies beneath technocratic rationalism and ultimately determines the direction of its hegemony and cultural force. This direction allows for the freer play of the arbitrary and capricious love, hate and emotional devastation of intimate human relationships. This irrationalism also bursts out in the most casual of human relationships, as Ben?s genetic mutations poison the food upon which the human race needs to survive.
Before long, however, the monologue? becomes a memory play populated by three women from Ben?s past, his first wife Cerise, his midlife partner Robin, and finally his latelife lover Rose; as Ben grows older, his successive loves grow younger. As the global catastrophe engendered by Ben?s work begins, however, the play makes a sharp shift in the second act to an extended eruption of bestial pornography involving cats and donkeys ? an unconscious eruption seemingly shared by all of the characters in the drama. The site for this fantasy is a secluded house in which Ben finds sexual comfort with a large cat, Blanche (who in the third act is transformed into a memory of Cerise), while Robin finds herself disturbed in a presentation of male sexuality exhibited by donkeys. The gross deliberate obscenity of the monologues of the second act ? which turns Victorian-style children?s literature and erotica upside-down ? is emphasized through its hour-long length as Ben finds his penis (with which he has what he describes as ?a love affair?) an evocation of aggressive male sexuality, which yet desires to be teased and comforted by his new feline companions.
Emily McDonnell, Miranda Richardson and Jennifer Tilly in Grasses of a Thousand Colors. Photo: John Haynes. Courtesy Royal Court Theatre
Ben?s misogynistic aggression ? and the global crisis that his research has engendered ? becomes more complex with the third act of the play, which combines the more realistic tone of the first with the fantastic of the second. The three women ? ex-wife Cerise and mistresses Robin and Rose ? form a triumvirate for mutual support even as the world is crashing down. Ben is subjected to the emotional manipulations of Robin (who uses the threat of suicide as a means of revenging herself against Ben?s abuse). At the same time the human world is quickly coming to an end outside of the increasing solitudes of all four characters; the human body reacts to the genetic mutations with vomiting, first occasionally, then frequently, then finally, as Ben puts it, ?the typical end of life which everyone knows they can look forward to now, the moment when the vomiting doesn?t stop.? (78) Death comes as a release from this cultural and environmental catastrophe, and eventually Ben becomes a victim of his own hegemony over nature. ? ? while vomiting was awful, and suffering was awful, death in itself was a trivial process, the fearsomeness of which had been ridiculously inflated by generations of people who apparently had had nothing else to talk about.? The play concludes with his own:
Quote unquote ?death? will actually feel no different from a dreamless sleep ? although everyone else will notice that you?re not waking up. Well, this was all in a certain way a little bit more than I needed to know at that particular moment ? but I still suppose maybe it did sort of put me into the right frame of mind as Blanche set me off on my way across the meadow. As you might have guessed, it was just the time of day in which the direct sun on one?s face was totally agreeable and not at all too hot, and, sure enough, by the time I was halfway across the meadow I desperately wanted to lie down and fall asleep. So I found a very pleasant mossy spot and ? you know ? what can I say? ? I mean, don?t be envious about it ? I have to admit, it felt quite nice. (88)
The extremes of sexuality and violence in Shawn?s play are comically undermined by a satire of popular culture, in which sexuality and violence themselves become trivialized to the extent of becoming merely another gesture of public identity. ?So you see, for me, the way things are now still seems astonishing ? I mean, the fact that people talk about their penises and vaginas in public, at dinner parties, in magazines and newspapers ? I can?t get over it. Ha ha ha! I can?t get over the way in interviews, not just actors but even politicians mention genitals so freely ? ?my vagina,? ?my penis? ? and of course all the plays, the films, whatever ? well, it?s all changed so much,? Ben observes (perhaps several decades after Bill Clinton leaves semen stains on Monica Lewinsky?s dress and Lady Gaga repurposes transgressive sexuality for commercial purposes) (23). And, in this near future, Rose gives out business cards with a picture of her vagina on them (57). But the ease with which the intimate secrets of sex have entered public discourse does not alleviate, nor reveal, the power of the darker urges expressed in intimate relationships. It is a means of titillation, with which everyone eventually grows bored.
Shawn shares with Howard Barker a sense of how cultural and historic crisis can give rise to expressions of transgressive sexuality, sexualities which may serve to reconstruct the self. As in Barker?s plays, however, political power issues in Shawn?s plays do not guarantee any kind of redemption; indeed, they may make this individual valorization impossible and drive those in power, like Ben, to ever more violent disruptions of both the psyche and the body. Though they are, like Barker?s plays, often witty and very funny, they are not hopeful.
If Grasses of a Thousand Colors concludes with the end of the world, it leaves open the question of whether the world, and the people who inhabit it, are capable of saving themselves. That some human and natural traits remain unaddressable through rationalism, or because of the irrationalism of the human spirit, is neither misanthropic or pessimistic, terms which have been associated with Shawn?s plays as well as those of Barker and another dramatist to come under consideration here soon, Neil LaBute: it may be merely a statement of fact. By repudiating any attempt to analyze or explain the emotional and physical extremes his characters seek, Shawn leaves to the spectator the question of what it means to be a human being and a citizen in a world which is becoming more thoroughly administered, militarized and delusional that these problems are soluble, especially through science and political administration. For a play which remains resolutely without reference to contemporary events, Grasses of a Thousand Colors demonstrates that Shawn may have his finger more sensitively upon the pulse of America at the beginning of the 21st century than any other American dramatist.
Below is a short interview with the dramatist, conducted by Royal Court Associate Ola Animashawun in June 2009; below the video are links to a few other references:
Related material:
Superfluities Redux review of Wallace Shawn?s Essays
John Lahr?s review in the 1 June 2009 New Yorker (those who care about such things will be amused to note that Shawn portrayed Lahr in the 1987 film Prick Up Your Ears)
Brief notice by Ben Brantley in The New York Times, 26 June 2009
Charles Spencer?s negative review in The Telegraph, 19 May 2009 (?dirty-minded and supremely self-indulgent ? sickening?)
An Indian barber holding a candle, has a haircut for a customer at his shop in Kolkata, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving 620 million people without government-supplied electricity for several hours in, by far, the world's biggest blackout. (AP Photo/Bikas Das)
An Indian barber holding a candle, has a haircut for a customer at his shop in Kolkata, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving 620 million people without government-supplied electricity for several hours in, by far, the world's biggest blackout. (AP Photo/Bikas Das)
Indian commuters wait for a bus on a street illuminated with street vendor's kiosks following a power outage in Kolkata, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving 620 million people without government-supplied electricity for several hours in, by far, the world's biggest blackout. (AP Photo/Bikas Das)
A traffic jam following power outage and rains at the Delhi-Gurgaon road on the outskirts of New Delhi, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving 620 million people without government-supplied electricity in one of the world's biggest-ever blackouts. (AP Photo)
Commuters walk on empty railway tracks at the New Delhi railway station following a power outage in New Delhi, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving more than 600 million people without government-supplied electricity in one of the world's biggest-ever blackouts. (AP Photo/Mustafa Quraishi)
Indian stranded passengers stand near empty railway tracks as they wait for train services to resume at a railway station in New Delhi, India, Tuesday, July 31, 2012. India's energy crisis cascaded over half the country Tuesday when three of its regional grids collapsed, leaving 620 million people without government-supplied electricity for several hours in, by far, the world's biggest-ever blackout. Hundreds of trains stalled across the country and traffic lights went out, causing widespread traffic jams in New Delhi. (AP Photo/Manish Swarup)
NEW DELHI (AP) ? Electric crematoria were snuffed out with bodies inside, New Delhi's Metro shut down and hundreds of coal miners were trapped underground after three Indian electric grids collapsed in a cascade Tuesday, cutting power to 620 million people in the world's biggest blackout.
While Indians were furious and embarrassed, many took the crisis in stride, inured by the constant ? though far less widespread ? outages triggered by the huge electricity deficit stymieing the development of this would-be Asian power.
Hospitals, factories and the airports switched automatically to their diesel generators during the hours-long cut across half of India. Many homes relied on backup systems powered by truck batteries. And hundreds of millions of India's poorest had no electricity to lose.
"The blackout might have been huge, but it wasn't unbearably long," said Satish, the owner of a coffee and juice shop in central Delhi who uses only one name. "It was just as bad as any other five-hour power cut. We just used a generator while the light was out, and it was work as usual."
The crisis was the second record-breaking outage in two days. India's northern grid failed Monday, leaving 370 million people powerless for much of the day, in a collapse blamed on states that drew more than their allotment of power.
At 1:05 p.m. Tuesday, the northern grid collapsed again, energy officials said. This time, it took the eastern grid and the northeastern grid with it. In all, 20 of India's 28 states ? with double the population of the United States ? were hit in a region stretching from the border with Myanmar in the northeast to the Pakistani border about 3,000 kilometers (1,870 miles) away.
Hundreds of trains stalled across the country and traffic lights went out, causing widespread jams in New Delhi. West Bengal Chief Minister Mamata Banerjee asked office workers to go home and rushed generators to coal mines to rescue trapped miners.
Sahiba Narang, 17, was taking the Metro home because school bus drivers were on strike, "but this power failure's messed up everything."
S.K. Jain said he was on his way to file his income tax return when the Metro closed. The 54-year-old held his head, distraught that he would almost certainly miss the deadline. Hours later, the government announced it was giving taxpayers an extra month to file because of the chaos.
By evening, power had been restored to New Delhi and the remote northeast, and much of the northern and eastern grids were back on line. Electricity officials said the system would not be back to 100 percent until Wednesday.
Power Minister Sushil Kumar Shinde said the new crisis had the same root as Monday's collapse.
"Everyone overdraws from the grid. Just this morning I held a meeting with power officials from the states and I gave directions that states that overdraw should be punished. We have given instructions that their power supply could be cut," he said.
But others were skeptical of Shinde's explanation, saying that if overdrawing power from the grid caused this kind of collapse, it would happen all the time.
"I just can't believe that there is no system in place to check whether the states are drawing more than their limit or not," said Samiran Chakraborty, head of research at Standard Chartered, a financial services company. "There has to be a much more technical answer to that question."
At a contentious news conference, R.N. Nayak, chairman of Power Grid Corp., which runs the nation's power system, said his staff was searching for the cause of the problem and pleaded for patience.
"We have been running this grid for decades. ... Please trust us," he said.
The blackouts came amid consumer anger with the recent increase in power fees, including a 26 percent hike in Delhi, that government officials said were needed to pay for the steep rise in fuel costs.
The Confederation of Indian Industry said the two outages cost business hundreds of millions of dollars, though they did not affect the financial center of Mumbai and the global outsourcing powerhouses of Bangalore and Hyderabad in the south. Like many, the group demanded a widespread reform of India's power sector, which has been unable to keep up with the soaring demand for electricity as the economy expanded and Indians grew more affluent and energy hungry.
"India has outgrown its own infrastructure," said Jagannadham Thunuguntla, a strategist at SMC Global Securities.
India's Central Electricity Authority reported power deficits of more than 8 percent in recent months, and many economists said the power deficit is dragging down India's economy.
"Without power we cannot run an economy at 8 percent, 9 percent growth or whatever your ambition is," Chakraborty said.
Part of the problem is that India relies on coal for more than half its power generation and the coal supply is controlled by a near state monopoly that is widely considered a shambles.
A recent survey showed nearly all the coal-fueled plants had less than seven days of coal stock, a critical level, said Chakraborty, and many of the country's power plants were running below capacity. Government bureaucracy has made it difficult to bring more plants online.
In addition, vast amounts of power bleeds out of India's antiquated distribution system or is pirated through unauthorized wiring. Farmers, with a guarantee of free electricity that is driving many state electric boards to bankruptcy, have no incentive to conserve energy.
The power deficit was worsened this year by a weak monsoon that lowered hydroelectric generation, spurred farmers to use pumps to irrigate their fields long after the rains would normally have come and kept temperatures higher, keeping air conditioners and fans running longer.
The opposition said officials should have located the first fault and fixed it before getting the whole system back on line Monday.
"The power minister owes an answer to the prime minister, owes an answer to the nation why this is happening," Bharatiya Janata Party spokesman Prakash Javadekar said.
Instead, as part of a planned Cabinet shuffle, Shinde was promoted in the middle of the day to the powerful job of home minister, putting him in charge of the nation's internal security even as the power crisis dragged on.
By contrast, the power chief in the state of Uttar Pradesh was summarily fired by his chief minister Monday for his handling of the first power crisis.
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Associated Press writer Nasr ul Hadi contributed to this report from New Delhi and Prasanta Pal contributed from Kolkata.
___
Follow Ravi Nessman on Twitter at www.twitter.com/ravinessman
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Main Category: Obesity / Weight Loss / Fitness Also Included In: Psychology / Psychiatry Article Date: 31 Jul 2012 ? 4:00 PDT
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Coaches can help athletes score touchdowns and perfect their golf swing, but can they also influence weight loss? Researchers from The Miriam Hospital?s Weight Control and Diabetes Research Center say health coaches could play an important role in the battle of the bulge, according to the findings of a pilot study published online in the journal Obesity.
In the first study of its kind, obese individuals participating in a low-intensity behavioral weight loss program who were supported by either a professional health coach or a peer coach lost clinically significant amounts of weight (at least 5 percent of their initial body weight). These weight losses are comparable to the amount of weight lost by patients participating in a more intensive behavioral intervention with twice as many treatment sessions.
?Our study suggests health coaches may not only yield impressive weight loss outcomes, but that lay ? or peer ? health coaching may be particularly promising as a cost-effective obesity treatment strategy,? said lead author Tricia M. Leahey, Ph.D., of The Miriam Hospital?s Weight Control and Diabetes Research Center. ?Although these findings are only preliminary, it?s encouraging that lay health coaches successfully supplemented a less intensive, lower cost behavioral intervention and that their weight losses were actually comparable to those produced by professional coaches ? something that could be critical in this changing health care landscape.?
Obesity remains a common, serious and costly disease in the United States. About one-third of American adults are obese, according to the Centers for Disease Control and Prevention, and no state has met the nation?s Healthy People 2010 goal to lower obesity prevalence to 15 percent. Obesity and its associated health problems, including heart disease and diabetes, continue to have a significant economic impact on the U.S. health care system, costing the nation hundreds of billions of dollars each year.
Health coaches have grown in popularity, yet empirical support is limited. In the health coach treatment model, health coaches supplement treatment by providing ongoing support, accountability and information to promote behavior change between treatment visits. Health coaches can be professional health care providers, such as nurses or social workers; peers, or individuals currently facing the same health problem who coach one another to support behavior change; and mentors, or master coaches, who have previously and successfully faced the same health situation.
In this randomized controlled pilot study, 44 participants took part in a group behavioral weight loss program that met for 12 times over the course of 24 weeks ? half the amount of sessions of a traditional treatment plan. Groups met weekly for the first six weeks, biweekly for the following six weeks and monthly thereafter.
Miriam researchers randomly assigned individuals to work with one of three different types of health coaches: a professional (behavioral weight loss interventionist), peer (a fellow group member) or mentor (a successful weight loser). During the weeks where there were no group meetings, participants emailed their weekly weight, calorie and physical activity information to their coach and received feedback. All coaches were trained on appropriate coaching strategies and feedback delivery.
While all three groups yielded clinically significant weight losses, participants guided by professional and peer coaches had the most success, losing more than 9 percent of their body weight on average, compared to just under 6 percent in the mentor group. At least half of the participants in the professional and peer coaching groups achieved a 10 percent weight loss, which research has shown can reduce the risk of a wide range of illnesses linked to obesity, including heart disease and diabetes. Only 17 percent of those in the mentor group accomplished this goal.
Because it is a pilot study, Leahey notes larger trials are needed to confirm whether incorporating health coaching into less intensive behavioral weight loss treatment programs improves outcomes and to examine which type of coach is most effective. She recently received a 5-year, $2 million grant from the National Institutes of Health to continue to explore the impact and influence of lay health coaches for obesity treatment.
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The study was funded by the National Institutes of Health. Rena R. Wing, Ph.D., director of the Weight Control and Diabetes Research Center at The Miriam Hospital, and a professor of psychiatry/human behavior at The Warren Alpert Medical School of Brown University, was the study co-author.
The principal affiliation of Tricia M. Leahey, Ph.D., is The Miriam Hospital (a member hospital of the Lifespan health system in Rhode Island) and direct financial and infrastructure support for this project was received through the Lifespan Office of Research Administration. Dr. Leahey is also an assistant professor of psychiatry/human behavior (research) at The Warren Alpert Medical School of Brown University.
This paper, ?A Randomized Controlled Pilot Study Testing Three Types of Health Coaches for Obesity Treatment: Professional, Peer and Mentor,? was published in advance of print in Obesity on July 26, 2012. Lifespan
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BEIRUT (AP) ? Fighting in Syria's largest city of Aleppo stretched into its 11th day on Tuesday amid growing international condemnation of the Syrian government's crackdown on a tenacious rebellion that has lasted 17 months.
Activists reported renewed bombardments of rebel-held neighborhoods and clashes in many parts of Aleppo as the army pushed on with its offensive to retake this key northern city. The battle for Aleppo, Syria's commercial hub with around 3 million inhabitants, has now lasted longer than the rebel assault on the capital Damascus that regime troops crushed earlier in July.
Even as the fighting raged inside the city, rebel forces reported a number of victories in the surrounding countryside, including the town of al-Bab and a key army checkpoint at Anand. The capture of the checkpoint will ease the movement of fighters and supplies between Aleppo and the Turkish border, 30 miles (50 kilometers) away.
The Britain-based Syrian Observatory for Human Rights said the rebel bastion of Sakhour in the northeast of Aleppo was being shelled and that clashes had broken out between rebels and government forces elsewhere in the city, especially in Salaheddine in the southwest.
Syrian forces have attacked rebel positions with artillery and mortars as well as helicopter gunships.
The Syrian government has defended its assault on Aleppo to the U.N., describing a city in the grip of "terrorist mercenaries" funded by Qatar, Saudi Arabia and Turkey, that are holding people hostage as human shields and committing "horrifying crimes."
But U.N. Secretary General Ban Ki-Moon has expressed deep concern over the use of heavy weapons by the government in suppressing the rebellion, especially around Aleppo, calling on both sides to adhere to a ceasefire and the international organization's widely ignored peace plan.
On Sunday, the U.N. observer mission in Syria tasked with monitoring the never-observed ceasefire was shot at, according to Ban, who said a five vehicle convoy of Lt. Gen. Babacar Gaye was struck by small arms fire near the central city of Homs.
More than 2 million people have been affected by the fighting in a country of 22 million, said Ban, adding that "more fighting is not the answer."
In Aleppo alone, the U.N. has estimated that 200,000 people have fled the fighting, either taking shelter in nearby villages or making the trek to the refugee camps across the border in Turkey.
Refugees from Aleppo have described a city devastated by shelling and wracked by food shortages.
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