Using Mixed-Methods to Examine Factors that Influence Exercise Prescription from Healthcare Providers: A Community-Engaged Research Project

Background: The American College of Sports Medicine\u27s Exercise is Medicine initiative supports promotion of physical activity by health care providers (HCPs). Exercise is Medicine recommends HCPs utilize strategies such as exercise prescriptions to increase and promote regular exercise and referrals to community-based exercise facilities (ExRx+). Research is needed to identify factors that will increase African-American patients\u27 ExRx+ engagement since little is known about factors that serve as facilitators or barriers to adherence. Aims: Using a community-engaged participatory research approach, the aims are to: 1) examine individual, interpersonal and environmental factors associated with ExRx+ adherence and 2) explore barriers and facilitators related to the referral process that are associated with ExRx+ adherence. Setting: Healthworks Community Fitness, a non-profit women\u27s fitness facility located in Dorchester, MA. Healthworks is the only gym in the Boston metro area which allows patients to exchange ExRx+ for a 3-month gym membership. Methods: Based on a socio-ecological framework, the mixed-methods protocol includes qualitative and quantitative methods implemented sequentially in two phases to explore factors associated with ExRx+ adherence. Adherence will be operationally defined as: 1) activation: patient redeems the ExRx+ for membership and 2) utilization: attendance during the 3 month membership. Quantitative data will focus on the patient\u27s individual (i.e, body mass index, self-efficacy) interpersonal (i.e, social support), and environmental (i.e, walkability, transportation) levels. Qualitative data will involve one-on-one interviews with patients, HCPs and Healthworks staff exploring facilitators and barriers to ExRx+ adherence. Results will inform the development of a culturally tailored intervention to promote ExRx+ adherence

A Longitudinal Study of the Reliability of Acupuncture Deqi Sensations in Knee Osteoarthritis

Deqi is one of the core concepts in acupuncture theory and encompasses a range of sensations. In this study, we used the MGH Acupuncture Sensation Scale (MASS) to measure and assess the reliability of the sensations evoked by acupuncture needle stimulation in a longitudinal clinical trial on knee osteoarthritis (OA) patients. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as the clinical outcome. Thirty OA patients were randomized into one of three groups (high dose, low dose, and sham acupuncture) for 4 weeks. We found that, compared with sham acupuncture, real acupuncture (combining high and low doses) produced significant improvement in knee pain (P = .025) and function in sport (P = .049). Intraclass correlation analysis showed that patients reliably rated 11 of the 12 acupuncture sensations listed on the MASS and that heaviness was rated most consistently. Overall perceived sensation (MASS Index) (P = .014), ratings of soreness (P = .002), and aching (P = .002) differed significantly across acupuncture groups. Compared to sham acupuncture, real acupuncture reliably evoked stronger deqi sensations and led to better clinical outcomes when measured in a chronic pain population. Our findings highlight the MASS as a useful tool for measuring deqi in acupuncture research

Telemetry-validated nitrogen stable isotope clocks identify ocean-to-estuarine habitat shifts in mobile organisms

Throughout their life history, many animals transition among heterogeneous environments to facilitate behaviours such as reproduction, foraging and predator avoidance. The dynamic environmental and biological conditions experienced by mobile species are integrated in the chemical composition of their tissues, providing retrospective insight into movement. Here, we present a unique application of nitrogen stable isotope clocks (‘isotopic clocks’), which integrate tissue turnover rates, consumer stable isotope ratios and habitat-specific isotope baselines to predict time-since-immigration and the timing of habitat shifts in a migratory species. Nitrogen stable isotope values of blood plasma collected from juvenile sand tiger sharks Carcharias taurus, a species known to undertake seasonal movements between ocean and estuarine environments, were used to derive estimates of time-since-immigration and the timing of seasonal habitat shifts undertaken by this species. Nitrogen isotopic clocks estimated for 65 juvenile sand tiger sharks sampled across 6 years indicated that individual sharks predominantly arrived to estuarine habitats between June and July, with some individuals arriving as early as mid-May. These estimates were validated by comparing isotope-derived estuarine arrival times with those from acoustically tracked individuals. The median estuarine arrival day estimates from our isotopic approach aligned with estimates from acoustic telemetry for each sampling population. Sensitivity analyses indicated that isotopically inferred time-since-immigration and estuarine arrival estimates were robust to variation in isotopic turnover rate and diet tissue discrimination factors under multiple modelling scenarios. This suggests that parameterization of the nitrogen isotopic clock provides reliable estimates of time-since-immigration and day of arrival into new habitats if isotopic variation exists between origin and new locations. Our study presents a unique application of telemetry-validated isotope clocks to derive retrospective estimates of time-since-immigration and timing of habitat shifts for animals that seasonally traverse heterogeneous environments. This approach can be readily applied across many temporal and spatial scales, and to other species and ecosystems, to facilitate rapid assessment of changes in animal habitat use and broader ecosystem structure

Transitions in Metabolic Risk and Longâ Term Cardiovascular Health: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/1/jah31816.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/2/jah31816_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/3/jah31816-sup-0001-TableS1-FigureS1.pd

Choice of activity-intensity classification thresholds impacts upon accelerometer-assessed physical activity-health relationships in children

It is unknown whether using different published thresholds (PTs) for classifying physical activity (PA) impacts upon activity-health relationships. This study explored whether relationships between PA (sedentary [SED], light PA [LPA], moderate PA [MPA], moderate-to-vigorous PA, vigorous PA [VPA]) and health markers differed in children when classified using three different PTs

Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study

Clustering of cardiometabolic risk factors can occur during childhood and predisposes individuals to cardiometabolic disease. This study calculated clustered cardiometabolic risk in 100 children and adolescents aged 10-14 years (59 girls) and explored differences according to cardiorespiratory fitness (CRF) levels and time spent at different physical activity (PA) intensities. CRF was determined using a maximal cycle ergometer test, and PA was assessed using accelerometry. A cardiometabolic risk score was computed as the sum of the standardised scores for waist circumference, blood pressure, total cholesterol/high-density lipoprotein ratio, triglycerides and glucose. Differences in clustered cardiometabolic risk between fit and unfit participants, according to previously proposed health-related threshold values, and between tertiles for PA subcomponents were assessed using ANCOVA. Clustered risk was significantly lower (p < 0.001) in the fit group (mean 1.21 ± 3.42) compared to the unfit group (mean -0.74 ± 2.22), while no differences existed between tertiles for any subcomponent of PA. Conclusion These findings suggest that CRF may have an important cardioprotective role in children and adolescents and highlights the importance of promoting CRF in youth

Mãe, cadê o bebê? Repercussões do nascimento prematuro de um irmão

O objetivo deste artigo foi investigar as repercussões do nascimento prematuro do bebê sobre o(s) seu(s) irmão(s), sob a perspectiva materna, durante a internação do recém-nascido na Unidade de Terapia Intensiva Neonatal. O estudo contou com a participação de 37 mães, entrevistadas no 15º dia após o parto. Elas responderam a instrumentos que contemplaram dados demográficos familiares, informações clínicas do bebê e da mãe, e a experiência da maternidade no contexto da prematuridade. A entrevista sobre maternidade continha questões acerca do irmão do bebê, cujas respostas foram examinadas a partir de análise de conteúdo qualitativa. Os resultados revelaram alteração na rotina dos irmãos em razão da maior ausência materna. Os sentimentos e reações dos irmãos incluíram questionamentos, preocupações, ciúme e ansiedade, ao lado de contentamento e curiosidade. A visita do irmão ao bebê prematuro não foi permitida por alguns hospitais. Evidencia-se a importância de os irmãos serem atendidos em suas necessidades de cuidado nesse período de hospitalização do bebê

Reproductive aspects of the oceanic whitetip shark, Carcharhinus longimanus (Elasmobranchii: Carcharhinidae), in the equatorial and southwestern Atlantic Ocean

The present study sought to study the reproductive biology of the oceanic whitetip shark, Carcharhinus longimanus, in the equatorial and southwestern Atlantic Ocean. A total of 234 specimens were collected as bycatch during pelagic longline fisheries targeting tunas and swordfish, between December 2003 and December 2010. The fishing area was located between latitudes 10N and 35S and longitudes 3E and 40W. Of the 234 individuals sampled, 118 were females (with sizes ranging from 81 to 227 cm TL, total length) and 116 males (ranging from 80 to 242 cm TL). The reproductive stages of the females were classed as immature, mature, preovulatory and pregnant, while males were divided into immature, maturing and mature. The size at maturity for females was estimated at 170.0 cm TL, while that for males was between 170.0 and 190.0 cm TL. Ovarian fecundity ranged from 1 to 10 follicles and uterine fecundity from 1 to 10 embryos. The reproductive cycle of this species is most likely biennial, with parturition occurring once every two years.info:eu-repo/semantics/publishedVersio

Enhancing gold recovery from electronic waste via lixiviant metabolic engineering in Chromobacterium violaceum

10.1038/srep02236Scientific Reports3