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Fyles M, Vihta KD, Sudre CH, Long H, Das R, Jay C, Wingfield T, Cumming F, Green W, Hadjipantelis P, Kirk J, Steves CJ, Ourselin S, Medley GF, Fearon E, House T. Diversity of symptom phenotypes in SARS-CoV-2 community infections observed in multiple large datasets. Sci Rep 2023; 13:21705. [PMID: 38065987 PMCID: PMC10709437 DOI: 10.1038/s41598-023-47488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Variability in case severity and in the range of symptoms experienced has been apparent from the earliest months of the COVID-19 pandemic. From a clinical perspective, symptom variability might indicate various routes/mechanisms by which infection leads to disease, with different routes requiring potentially different treatment approaches. For public health and control of transmission, symptoms in community cases were the prompt upon which action such as PCR testing and isolation was taken. However, interpreting symptoms presents challenges, for instance, in balancing the sensitivity and specificity of individual symptoms with the need to maximise case finding, whilst managing demand for limited resources such as testing. For both clinical and transmission control reasons, we require an approach that allows for the possibility of distinct symptom phenotypes, rather than assuming variability along a single dimension. Here we address this problem by bringing together four large and diverse datasets deriving from routine testing, a population-representative household survey and participatory smartphone surveillance in the United Kingdom. Through the use of cutting-edge unsupervised classification techniques from statistics and machine learning, we characterise symptom phenotypes among symptomatic SARS-CoV-2 PCR-positive community cases. We first analyse each dataset in isolation and across age bands, before using methods that allow us to compare multiple datasets. While we observe separation due to the total number of symptoms experienced by cases, we also see a separation of symptoms into gastrointestinal, respiratory and other types, and different symptom co-occurrence patterns at the extremes of age. In this way, we are able to demonstrate the deep structure of symptoms of COVID-19 without usual biases due to study design. This is expected to have implications for the identification and management of community SARS-CoV-2 cases and could be further applied to symptom-based management of other diseases and syndromes.
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Affiliation(s)
- Martyn Fyles
- Department of Mathematics, University of Manchester, Manchester, UK
- The Alan Turing Institute for Data Science and Artificial Intelligence, London, NW1 2DB, UK
- United Kingdom Health Security Agency (UKHSA), London, UK
| | - Karina-Doris Vihta
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Engineering, University of Oxford, Oxford, UK
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Carole H Sudre
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Harry Long
- United Kingdom Health Security Agency (UKHSA), London, UK
| | - Rajenki Das
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Caroline Jay
- The Alan Turing Institute for Data Science and Artificial Intelligence, London, NW1 2DB, UK
- Department of Computer Science, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Tom Wingfield
- Department of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK
- WHO Collaborating Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Fergus Cumming
- United Kingdom Health Security Agency (UKHSA), London, UK
| | - William Green
- United Kingdom Health Security Agency (UKHSA), London, UK
| | | | - Joni Kirk
- United Kingdom Health Security Agency (UKHSA), London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology King's College London, London, UK
- Department of Ageing and Health Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Graham F Medley
- Centre for the Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Elizabeth Fearon
- Centre for the Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Institute for Global Health, University College London, London, UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK.
- The Alan Turing Institute for Data Science and Artificial Intelligence, London, NW1 2DB, UK.
- IBM Research, Hartree Centre, Daresbury, WA4 4AD, UK.
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Hicks J, Adams-Campbell LL, Lu J, Mills M, Dash C. Validation Study of Physical Activity and Sedentary Behavior in African-American Men and Women. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01734-y. [PMID: 37581764 DOI: 10.1007/s40615-023-01734-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Self-reported data of physical activity are practical and inexpensive ways to collect data, although, subject to significant measurement errors. Most physical activity questionnaires used in the USA have been predominately validated among non-Hispanic White American populations with limited attention paid to the validity of the measures among racial/ethnic minorities. Additionally, there are limited studies that have evaluated factors related to over- and under-reporting errors linked to self-reported physical activity data, particularly among African Americans. The primary objectives of this study were to validate self-reported levels of physical activity and sedentary behavior among African-American men and women against objective measurements and to identify the factors related to under- and over-reporting. METHODS This study was a 7-day, cross-sectional study conducted on African-American men and women (n = 56) who were between 21-70 years of age. Participants were required to attend two study visits for the collection of self-reported and objective measurements of physical activity and sedentary behavior (VO2max, DEXA scan, anthropometrics, ActivPal accelerometer, resting metabolic rate (RMR) and International Physical Activity Questionnaire (IPAQ) questionnaire. RESULTS Overall, energy expenditure measured by ActivPal was 24.1 MET/hr/week whereas self-reported (IPAQ) energy expenditure was 52.66 MET/hr/week. Self-reported sedentary time was 40.37 h/week, whereas sedentary time measured by ActivPal was 63.03 h/week. Obese participants tended to over-report their physical activity levels more so than non-obese participants (Obese, Activpal-23.89 MET/hr/week vs IPAQ-58.98 MET/hr/week; Non-obese, Activpal - 24.48 MET/hr/week vs IPAQ - 42.55 MET/hr/week). Both obese and non-obese participants underestimated their sedentary time (Obese, Activpal - 66.89 h/week vs IPAQ-43.92 h/week; Non-obese, Activpal -56.07 h/week vs IPAQ - 33.98 h/week). CONCLUSIONS The results of this study found that the ActivPal validated physical activity and sedentary behavior among African-Americans. Self-reported data were found to be highly variable, whereas the objective assessments of physical activity and sedentary behavior had limited variability. It was also found that obese individuals over-estimated their self-reported physical activity levels and under-estimated sedentary behavior in comparison to the ActivPal. These findings strongly support the need to measure physical activity and sedentary behaviors objectively, particularly among African-Americans.
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Affiliation(s)
- Jennifer Hicks
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 1010 New Jersey Ave SE, Washington, D.C, 20003, USA
| | - Lucile L Adams-Campbell
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 1010 New Jersey Ave SE, Washington, D.C, 20003, USA
| | - Jiachen Lu
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mary Mills
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 1010 New Jersey Ave SE, Washington, D.C, 20003, USA
| | - Chiranjeev Dash
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 1010 New Jersey Ave SE, Washington, D.C, 20003, USA.
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Oken E, Bastain TM, Bornkamp N, Breton CV, Fry RC, Gold DR, Hivert MF, Howland S, Jackson DJ, Johnson CC, Jones K, Killingbeck M, O’Shea TM, Ortega M, Ownby D, Perera F, Rollins JV, Herbstman JB. When a birth cohort grows up: challenges and opportunities in longitudinal developmental origins of health and disease (DOHaD) research. J Dev Orig Health Dis 2023; 14:175-181. [PMID: 36408681 PMCID: PMC9998333 DOI: 10.1017/s2040174422000629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-quality evidence from prospective longitudinal studies in humans is essential to testing hypotheses related to the developmental origins of health and disease. In this paper, the authors draw upon their own experiences leading birth cohorts with longitudinal follow-up into adulthood to describe specific challenges and lessons learned. Challenges are substantial and grow over time. Long-term funding is essential for study operations and critical to retaining study staff, who develop relationships with participants and hold important institutional knowledge and technical skill sets. To maintain contact, we recommend that cohorts apply multiple strategies for tracking and obtain as much high-quality contact information as possible before the child's 18th birthday. To maximize engagement, we suggest that cohorts offer flexibility in visit timing, length, location, frequency, and type. Data collection may entail multiple modalities, even at a single collection timepoint, including measures that are self-reported, research-measured, and administrative with a mix of remote and in-person collection. Many topics highly relevant for adolescent and young adult health and well-being are considered to be private in nature, and their assessment requires sensitivity. To motivate ongoing participation, cohorts must work to understand participant barriers and motivators, share scientific findings, and provide appropriate compensation for participation. It is essential for cohorts to strive for broad representation including individuals from higher risk populations, not only among the participants but also the staff. Successful longitudinal follow-up of a study population ultimately requires flexibility, adaptability, appropriate incentives, and opportunities for feedback from participants.
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Affiliation(s)
- Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nicole Bornkamp
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, NC, USA
| | - Diane R. Gold
- Brigham and Women’s Hospital, Department of Medicine, Channing Division of Network Medicine; Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Steve Howland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel J. Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Kyra Jones
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - MollyAn Killingbeck
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - T. Michael O’Shea
- Department of Pediatrics, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Marleny Ortega
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Dennis Ownby
- Division of Allergy and Immunology, Augusta University, Augusta, GA, USA
| | - Frederica Perera
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Julie V. Rollins
- Department of Pediatrics, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Mavragani A, Pash E, Zhou MS, Broffman L, Bialonczyk D, Doron T, Chiquette E. Characteristics and Weight Loss Practices From a Cohort of 20,000 Patients Using Direct-to-Consumer Telehealth: Observational Cross-sectional Study. JMIR Form Res 2023; 7:e40062. [PMID: 36602855 PMCID: PMC9893727 DOI: 10.2196/40062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Despite the increasing prevalence of obesity, the use of pharmacotherapy treatment remains low. Telehealth platforms have the potential to facilitate access to pharmacotherapy interventions, but little is known about telehealth patients. OBJECTIVE This study describes a large patient population taking Plenity, an oral superabsorbent hydrogel (OSH) used in the treatment of excess weight or obesity (BMI 25-40 kg/m2). The analysis compared differences in weight loss practices and in-person access to obesity care among telehealth patients with preobesity and obesity. METHODS This was a cross-sectional assessment of a random sample of 20,000 telehealth patients who completed a structured, web-based visit and received at least one prescription of OSH. Patients were eligible to receive care via telehealth if they were adults, were not pregnant, and had a BMI ≥25 kg/m2. During the visit, patients provided baseline health information including comorbidities, diet, and exercise habits. Their zip code of residence was used to determine their proximity to an obesity medicine provider. Descriptive statistical analysis and tests of differences (chi-square and 2-tailed t tests) were used to compare patients with preobesity (BMI 25-29.9 kg/m2) and obesity (BMI 30-40 kg/m2). RESULTS Most (15,576/20,000, 77.88%) of the cohort were female, with a mean age of 44 (SD 11) years and a mean BMI of 32.4 (SD 4.1) kg/m2. Among the cohort, 32.13% (6426/20,000) had preobesity, and 40.18% (8036/20,000) of all patients had ≥1 weight-related comorbidity. Almost all (19,732/20,000, 98.66%) patients attempted 1 weight loss method before OSH and half (10,067/20,000, 50.34%) tried ≥4 different methods. Exercise and low-calorie diets were the most attempted weight loss methods, and 28.76% (5752/20,000) of patients reported a prior prescription of weight loss medication. Patients with obesity were more likely than patients with preobesity to have previously tried commercial weight loss plans (7294/13,574, 53.74% vs 2791/6426, 43.43%; P<.001), specialized diets (8493/13,574, 62.57% vs 3799/6426, 59.12%; P<.001), over-the-counter supplements (6807/13,574, 50.15% vs 2876/6426, 44.76%; P<.001), and prescription weight loss medications (4407/13,574, 32.47% vs 1345/6426, 20.93%; P<.001). Females were more likely to seek treatment for preobesity (5332/15,576, 34.23% vs 1094/4424, 24.73% male; P<.001) and reported fewer comorbidities (5992/15,576, 38.47% vs 2044/4424, 46.2% male; P<.001), despite >90% of both sexes reporting the belief that excess weight negatively affected their health (14,247/15,576, 91.47% female participants, 4116/4424, 93.04% male participants). Moreover, 29.25% (5850/20,000) of patients lived in the same zip code and 85.15% (17,030/20,000) lived in the same county as an obesity medicine provider. CONCLUSIONS Data from this large patient cohort supports the potential for telehealth to provide prescriptive weight management treatment to a population seeking care. Patients with preobesity are an undertreated population who actively seek new weight management options. Female participants sought weight management treatment earlier in the disease continuum than males, despite reporting fewer comorbidities.
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Li B, Han S, Meng S, Lee J, Cheng J, Liu Y. Promoting exercise behavior and cardiorespiratory fitness among college students based on the motivation theory. BMC Public Health 2022; 22:738. [PMID: 35418043 PMCID: PMC9009046 DOI: 10.1186/s12889-022-13159-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, there has been an increase in the incidence of health problems among college students in China, the lack of adequate physical exercise is the major reason. This study aimed to investigate methods to promote exercise behavior and cardiovascular fitness among college students based on the motivation theory. Methods Cardiovascular fitness levels of 641 college students (20.72 ± 1.41 years old) were measured. Exercise motivation was assessed using the physical exercise motivation scale and physical exercise rating scale. Correlation analysis, regression analysis, and structural equation models were used to assess exercise motivation, exercise behavior, and cardiovascular fitness. Energy relationships were determined to develop a path model that promotes exercise behavior and aerobic fitness among college students. Results The exercise motivation of college students was directly related to cardiovascular fitness (effect value: 0.577) or indirectly related through the mediating effect of exercise behavior (effect value: 0.215). The influence of health motivation on exercise behavior (β = 0.132, p = 0.001) and cardiovascular fitness (β = 0.251, p < 0.001) was greater than that of other factors of motivation. Conclusions The physical exercise behavior of college students partially mediates the relationship between exercise motivation and cardiovascular fitness. Therefore, the educational concept of “Health First” should be promoted in college sports. Internal motivation of exercise can be transformed into external motivation to improve students’ exercise behavior and cardiovascular fitness through enhancing their cardiopulmonary capacity.
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Affiliation(s)
- Bo Li
- Institute of Sports Science, Nantong University, Nantong, 226019, China.,School of Physical Education and Sport Training, Shanghai University of Sport, 650 Qing yuan huan Road, Yang Pu District, Shanghai, 200438, China
| | - Shanshan Han
- Institute of Sports Science, Nantong University, Nantong, 226019, China
| | - Shuqiao Meng
- Physical Education College of Yangzhou University, Yangzhou, 225127, China
| | - Jaewoo Lee
- Kyunggi University, Graduate School, Suwon, Korea, 16227, South Korea
| | - Jie Cheng
- Physical Education College of Shanghai University, Shanghai, 200444, China
| | - Yang Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, 650 Qing yuan huan Road, Yang Pu District, Shanghai, 200438, China. .,Shanghai Research Center for Students Physique Health, Shanghai, 200438, China.
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Abstract
BACKGROUND Obesity is increasingly prevalent worldwide and is becoming an epidemic in many countries, including Canada. We sought to describe and analyze temporal obesity trends in the Canadian adult population from 2005 through 2018 at the national and provincial or territorial levels. METHODS We conducted a consecutive, cross-sectional study using data from 7 sequential Canadian Community Health Survey (CCHS) cycles (2005 to 2017/18). We included data from Canadian adults (age ≥ 18 yr) who participated in at least 1 of the 7 consecutive CCHS cycles and who had body mass index values (calculated by Statistics Canada based on respondents' self-reported weight and height). Obesity prevalence (adjusted body mass index ≥ 30) was a primary outcome variable. We analyzed temporal trends in obesity prevalence using Pearson χ2 tests with Bonferroni adjustment, and the Cochran-Armitage test of trend. RESULTS We included data from 746 408 (403 582 female and 342 826 male) CCHS participants. Across Canada, the prevalence of obesity increased significantly between 2005 and 2017/18, from 22.2% to 27.2% (p < 0.001). We observed increases across both sexes, all age groups and all Canadian provinces and territories (p < 0.001). In 2017/18, the prevalence of obesity was higher among males than females (28.9% v. 25.4%; p < 0.001); the prevalence among adults aged 40-69 years exceeded 30%. In 2017/18, Newfoundland and Labrador had the highest prevalence (39.4%), and British Columbia had the lowest (22.8%) prevalence of obesity. Over the 14-year study period, Quebec and Alberta exhibited the largest relative increases in obesity. INTERPRETATION In 2017/18, more than 1 in 4 adult Canadians lived with obesity, and from 2005 to 2017/18, the prevalence of obesity among adults in Canada increased substantially across sexes, age groups and all Canadian provinces and territories to 27.2%. Our findings call for urgent actions to identify, implement and evaluate solutions for obesity prevention and management in all Canadian provinces and territories.
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Affiliation(s)
- Ellina Lytvyak
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta.
| | - Sebastian Straube
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
| | - Renuca Modi
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
| | - Karen K Lee
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
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Dagan O, Buisman RSM, Nivison MD, Waters TEA, Vaughn BE, Bost KK, Bleil ME, Vandell DL, Booth-LaForce C, Roisman GI. Does secure base script knowledge mediate associations between observed parental caregiving during childhood and adult romantic relationship quality and health? Attach Hum Dev 2021; 23:643-664. [PMID: 33107784 PMCID: PMC8076343 DOI: 10.1080/14616734.2020.1836858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Increasingly, attachment representations are being assessed via secure base script knowledge - the degree to which individuals show awareness of the temporal-causal schema that summarizes the basic features of seeking and receiving effective support from caregivers during times of need. Limited research has assessed the links between secure base script knowledge and aspects of adult functioning and the role that secure base script knowledge may play in accounting for associations between early caregiving quality and adulthood functioning. We used follow-up assessments of the NICHD Study of Early Child Care and Youth Development cohort (N = 585) to examine whether secure base script knowledge at age 18 years: (a) is associated with later romantic relationship quality, depressive symptoms, and body mass index (BMI) at age 26 years, and (b) mediates expected associations between the quality of maternal and paternal sensitivity across the first 15 years of life and age-26 outcomes. More access to, and elaborated knowledge of the secure base script predicted less extreme hostility with romantic partners, and better emotional and physical health. Moreover, secure base script knowledge mediated the links between early maternal and paternal sensitivity and both later romantic partner hostility and depressive symptoms, but not BMI.
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Affiliation(s)
- Or Dagan
- Department of Psychology, Stony Brook University, New York, NY, USA
| | | | - Marissa D. Nivison
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
| | | | - Brian E. Vaughn
- Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA
| | - Kelly K. Bost
- Human and Community Development, University of Illinois, Champaign, IL, USA
| | - Maria E. Bleil
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | | | - Glenn I. Roisman
- Institute of Child Development, University of Minnesota, Minnesota, MN, USA
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Parnarouskis L, Jouppi RJ, Cummings JR, Gearhardt AN. A randomized study of effects of obesity framing on weight stigma. Obesity (Silver Spring) 2021; 29:1625-1634. [PMID: 34431611 PMCID: PMC10826923 DOI: 10.1002/oby.23247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Growing evidence suggests highly processed foods may trigger an addictive-like process, which is associated with obesity. Other research suggests an addictive-like process occurs in response to eating itself, rather than specific foods. Addiction-based obesity explanations raise concerns about double stigmatization of people with obesity and addiction. This study compared effects of obesity framings on external and internalized weight stigma. METHODS The study was preregistered via Open Science Framework. Four hundred and forty-seven adults read an informational passage that described food addiction, eating addiction, or calorie balance explanations for obesity or a control passage about memory. Participants then completed external and internalized weight stigma measures. RESULTS Participants in the food addiction condition reported higher internalized weight stigma compared with those in the control condition. Obesity framing did not significantly affect external weight stigma compared with the control. CONCLUSIONS These findings suggest that food addiction explanations for obesity may elicit greater internalized weight stigma than non-obesity-related messages. Addiction-based and traditional obesity explanations do not appear to influence external weight stigma. Illuminating the effects of obesity framing on stigma will help researchers communicate discoveries in ways that mitigate stigma.
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Affiliation(s)
| | | | - Jenna R. Cummings
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Ashley N. Gearhardt
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
- The University of Michigan, Department of Psychology, Ann Arbor, MI, USA
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Dicker D, Alfadda AA, Coutinho W, Cuevas A, Halford JCG, Hughes CA, Iwabu M, Kang JH, Nawar R, Reynoso R, Rhee N, Rigas G, Salvador J, Sbraccia P, Vázquez-Velázquez V, Caterson ID. Patient motivation to lose weight: Importance of healthcare professional support, goals and self-efficacy. Eur J Intern Med 2021; 91:10-16. [PMID: 33558163 DOI: 10.1016/j.ejim.2021.01.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND People with obesity (PwO) often struggle to achieve and maintain weight loss. This can perpetuate and/or be influenced by feelings of low motivation. This analysis from ACTION-IO data identified factors associated with PwO motivation to lose weight. METHODS PwO completed an online survey in 11 countries. Exploratory multinomial logistic regression analyses identified independent variables associated with self-report of feeling motivated versus not motivated to lose weight. RESULTS Data from 10,854 PwO were included (5,369 motivated; 3,312 neutral; 2,173 not motivated). Variables associated with feeling motivated versus not motivated included (odds ratio [95% confidence interval]): acknowledgement of healthcare professional (HCP) responsibility to contribute to weight loss (2.32 [1.86-2.88]), comfort in talking to their HCP about weight (1.46 [1.24-1.72), agreement that it is easy to lose weight (1.73 [1.30-2.31]), and a goal of reducing risks from excess weight (1.45 [1.22-1.73]). Conversely, if PwO considered obesity less important than other diseases they were less likely to report feeling motivated (0.49 [0.41-0.58]). PwO who reported being motivated to lose weight were more likely to exercise ≥5 times a week versus <1 time a week (2.77 [2.09-3.68]) than those who reported they were not motivated. CONCLUSIONS Positive interactions with HCPs, self-efficacy, setting goals and knowledge of the importance of weight management, in addition to regular exercising, may increase PwO motivation for weight loss. Appropriate HCP support may help PwO who are ready to engage in weight management. CLINICAL TRIAL REGISTRATION NCT03584191.
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Affiliation(s)
- Dror Dicker
- Director, Department of Internal Medicine D, Hasharon Hospital-Rabin Medical Center, Petah-Tikva, Israel; Sackler School Of Medicine, Tel Aviv University Tel Aviv, Israel.
| | - Assim A Alfadda
- Obesity Research Center and the Department of Internal Medicine, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia
| | - Walmir Coutinho
- Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ, Brazil
| | - Ada Cuevas
- Center for Advanced Metabolic Medicine and Nutrition (CAMMYN) Avda Las Condes 9460, office 501, Santiago, Chile
| | - Jason C G Halford
- School of Psychology, University of Leeds, University Road, Woodhouse, Leeds LS2 9JZ, UK
| | - Carly A Hughes
- Weight Management Service, Fakenham Medical Practice, Meditrina House, Trinity Road, Fakenham, NR21 8SY, UK
| | - Masato Iwabu
- Department of Diabetes and Metabolic Diseases, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Jae-Heon Kang
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
| | - Rita Nawar
- The Weight Care Clinic, Dubai Healthcare City, Building 64, Block A, 2nd Floor, 2004, P.O. Box: 505042, Dubai, United Arab Emirates
| | - Ricardo Reynoso
- Novo Nordisk Health Care AG, Thurgauerstrasse 36/38, 8050 Zürich, Switzerland
| | - Nicolai Rhee
- Novo Nordisk Health Care AG, Thurgauerstrasse 36/38, 8050 Zürich, Switzerland
| | - Georgia Rigas
- Department of Bariatric Surgery, St George Private Hospital, Suite 3, Level 5, 1 South St, Kogarah, Sydney, Australia
| | - Javier Salvador
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Paolo Sbraccia
- University of Rome Tor Vergata, Department of Systems Medicine, Via Montpellier,1, I-00133 Rome, Rome, Italy
| | - Verónica Vázquez-Velázquez
- Clínica de Obesidad y Trastornos de la Conducta Alimentaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, Belisario Domínguez Sección XVI, 14080 Ciudad de México, Mexico
| | - Ian D Caterson
- Boden Collaboration, Charles Perkins Centre, D17, University of Sydney, NSW 2006, Sydney, Australia
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10
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Ge S, Song C, Yao W. The Motor Function Evaluation of College Students' Physical Activity State From the Perspective of Educational Psychology. Front Psychol 2021; 12:593285. [PMID: 33935853 PMCID: PMC8081963 DOI: 10.3389/fpsyg.2021.593285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/02/2021] [Indexed: 12/05/2022] Open
Abstract
College students have taken part in less and less physical activities as a result of the common static lifestyle in recent years, lowering the level of motor function. This phenomenon has been a source of concern for schools and the government, and it is necessary to take corresponding measures to change it. The general motor function level of Chinese college students is explored first based on artificial intelligence and the human–computer interaction technology. The Physical Activity Questionnaire for College Students is compiled by referring to the International Physical Activity Questionnaire, and 561 students from colleges in Tianjin province are assessed based on the functional movement screen (FMS). Spearman correlation and multivariate regression analysis (MRA) are used to analyze the correlation between the motor function and physical activity status. In terms of lunch break frequency, the proportion of students having one to two lunch breaks in a week is the highest (54.15%); in terms of the frequency of doing moderate physical exercise, the proportion of students doing moderate physical exercise for 1–2 days in a week is the highest (50.61%); in terms of the frequency of doing heavy physical exercise, the proportion of students doing heavy exercise for 1–2 days in a week is the highest (47.26%); in terms of the sedentary time, the proportion of students with sedentary time more than 5 h in a day is the highest (40.61%); in terms of eye use time, the proportion of students with 8–10 h eye use time in a day is the highest (43.61%). Besides, in terms of the FMS score, the proportion of students with 13–15 FMS is the highest (48.46%). The hurdle step (21.03%), straight knee lift (22.52%), and body rotation stability (18.31%) have a relatively low proportion among the three-point items. There is a positive correlation between motor function score with the time of moderate exercise and the time of heavy exercise (P < 0.05). College students generally have insufficient rest time, long eye use time, and long sitting time, leading to a low level of motor function, manifested by an asymmetry between both sides of the body and poor trunk stability. It is recommended to add hurdling steps, straight knee lifts, and body rotation stability tests to college physical education courses.
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Affiliation(s)
- Sha Ge
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Chao Song
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Wanxiang Yao
- Department of Kinesiology, The University of Texas at San Antonio, San Antonio, TX, United States
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11
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Wilson OWA, Jones H, Mama SK, Guthrie H, Papalia Z, Duffey M, Bopp M. Female college student weight perception discordance. J Am Coll Health 2021; 69:23-29. [PMID: 31343383 DOI: 10.1080/07448481.2019.1645678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women. PARTICIPANTS AND METHODS Data were collected from a convenience sample of female undergraduates enrolled in general education health and wellness courses at a large, northeastern United States university (n = 1607) via direct email using previously validated measures that assessed: demographics; physical activity; weight goals and perceptions; mental health and sleep; and, physical activity enjoyment, self-efficacy, and goal setting. Analyses included one-way analysis of variance analyses and chi-square tests for independence. RESULTS Though most women had accurate weight status perceptions (n = 987, 62.6%), there was a tendency to overestimate weight status (n = 482, 31.2%) that was associated with greater depressive symptoms. CONCLUSION A relatively large minority of women demonstrated discordant weight status perceptions, which were associated with adverse mental health outcomes. Colleges should consider improving healthy weight status perception education among women to improve mental health.
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Affiliation(s)
- Oliver W A Wilson
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Hannah Jones
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Scherezade K Mama
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Hannah Guthrie
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Zack Papalia
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michele Duffey
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
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12
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Nadjidai SE, Kusljic S, Dowling NL, Magennis J, Stokes L, Ng CH, Daniel C. Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment. Int J Ment Health Nurs 2020; 29:1253-1261. [PMID: 32677324 DOI: 10.1111/inm.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the association between physical health conditions and quality of life and functioning in private psychiatric inpatients. We sought to determine whether quality of life and functioning was poorer in individuals with physical comorbidity compared to those without. A quantitative correlational descriptive design was utilized. Seventy patients were included in sequential order within a week of admission to hospital. Participants completed the SF-36 survey, and the corresponding hospital records were audited. The STROBE guidelines were followed in the reporting of this research. The study found that 64.3% (45/70) of participants had one or more comorbid physical health conditions, primarily cardiovascular, respiratory, musculoskeletal, endocrine and medically unexplained conditions or syndromes. Chronic pain was experienced by 40% (28/70) of participants, and 47.6% (33/70) were found to be overweight or obese. Tobacco smoking and obesity were risk factors associated with physical comorbidity (P = 0.02 and P < 0.001, respectively). Quality of life and functioning were poorer in those with physical health conditions, particularly in the SF-36 domains of bodily pain, physical functioning and general health (P < 0.001, P = 0.003 and P = 0.005, respectively). Physical health conditions were largely prevalent, and quality of life and functioning were poorer in those with physical comorbidities. The implementation of clinical guidelines for the monitoring of physical health has been proposed as well as a dedicated physical health nursing role. Continuation of integrative programmes focusing on both physical and mental health may also benefit patients in this setting.
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Affiliation(s)
- Sarah E Nadjidai
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Snezana Kusljic
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Nathan L Dowling
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lisa Stokes
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia.,The Melbourne Clinic, Melbourne, Victoria, Australia
| | - Chee H Ng
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine Daniel
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
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13
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Karchynskaya V, Kopcakova J, Klein D, Gába A, Madarasova-Geckova A, van Dijk JP, de Winter AF, Reijneveld SA. Is BMI a Valid Indicator of Overweight and Obesity for Adolescents? Int J Environ Res Public Health 2020; 17:ijerph17134815. [PMID: 32635439 PMCID: PMC7369744 DOI: 10.3390/ijerph17134815] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022]
Abstract
Background: Overweight and obesity are mostly monitored via the Body Mass Index (BMI), based on self-reported or measured height and weight. Previous studies have shown that BMI as a measure of obesity can introduce important misclassification problems. The aim of this study was to assess the validity of overweight and obesity classification based on self-reported and on measured height and weight versus the proportion of body fat as the criterion. Methods: We used data on 782 adolescents (mean age = 13.5, 55.8% boys) from the Health Behaviour in School-Aged Children (HBSC) study conducted in 2018 in Slovakia. We obtained self-reported (height and weight) and objective measures (height, weight) and the proportion of fat (as the criterion measure) measured via bioimpedance body composition analysis (BIA) with an InBody 230 from the adolescents. Results: Both measured and self-reported BMI indicated overweight and obesity with relatively low sensitivity (66-82%), but high specificity (90-92%). The superior accuracy of measured BMI in comparison to self-reported BMI was confirmed by the area under the curve (AUC) based on the receiver operating characteristics (ROC) curves (AUC measured/self-reported: 0.94/0.89; p < 0.001). The misclassification of overweight and obesity was significantly higher when using self-reported BMI than when using measured BMI. Conclusion: Both self-reported and measured BMI as indicators of overweight and obesity underestimate the prevalence of adolescents with overweight and obesity.
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Affiliation(s)
- Viktoryia Karchynskaya
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Correspondence: ; Tel.: +421-919-207-692
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Daniel Klein
- Institute of Mathematics, Faculty of Natural Sciences, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
| | - Aleš Gába
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic;
| | - Andrea Madarasova-Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia; (J.K.); (A.M.-G.)
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society & Health, P.J. Safarik University in Kosice, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University in Olomouc, 771 11 Olomouc, Czech Republic
| | - Andrea F. de Winter
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, 9713AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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14
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Agans JP, Wilson OWA, Bopp M. Required Health and Wellness Courses: Associations With College Student Physical Activity Behavior and Attitudes. J Phys Act Health 2020; 17:632-40. [PMID: 32369760 DOI: 10.1123/jpah.2019-0362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/18/2020] [Accepted: 03/27/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the extent to which college student physical activity behaviors and attitudes are associated with enrollment in required, but self-selected, health and wellness courses. PARTICIPANTS Data were analyzed from 1473 undergraduate students (60% women) taking health and wellness courses at a large northeastern university. METHODS Demographic characteristics and activity levels at the time of course enrollment were assessed in relation to course selection and activity levels after course completion. One-way analysis of variance tests were used to assess the differences in the characteristics of students enrolling in different types of health and wellness courses, and paired samples t tests were used to assess the differences in physical activity and related attitudes from the time of enrollment to the end of the semester. RESULTS Course selection was predicted by demographic characteristics and precourse activity levels. Overall, no significant change in activity levels was observed over the course of one semester, although some effects were observed within certain types of activities. CONCLUSIONS When given the option, college students appear to select health and wellness courses that match their current activity levels. These courses do not significantly change the average student's behavior or attitudes about physical activity.
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