54 research outputs found

    Osteoarthritis and Sleep: The Johnston County Osteoarthritis Project

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    Objective—Little is known about the association of symptomatic osteoarthritis (OA) with sleep disturbance. We compared the prevalence and severity of current sleep problems among individuals with and without symptomatic hip or knee OA in a large, community-based sample. Methods—Participants (N = 2682, 28% with symptomatic hip or knee OA) were from the Johnston County Osteoarthritis Project. Six sleep variables were grouped into 2 categories: insomnia (trouble falling asleep, trouble staying asleep, or waking early) and insufficient sleep (daytime sleepiness, not enough sleep, or not feeling rested). The presence of any sleep problem (insomnia or insufficient sleep) was also assessed, as were annual frequency and cumulative days of sleep problems. Adjusted models examined associations of symptomatic OA with sleep problems controlling for demographic characteristics, obesity, self-reported health, and depressive symptoms. Results—Symptomatic hip or knee OA was associated with increased odds of any sleep problem (odds ratio 1.25, 95% confidence interval 1.02–1.54), insomnia (OR 1.29, 95% CI 1.07–1.56), and insufficient sleep (OR 1.35, 95% CI 1.12–1.62) in adjusted models. Among participants with sleep problems, those with symptomatic OA reported higher median numbers of annual and cumulative days of insomnia and insufficient sleep, although these associations were not statistically significant in adjusted models. Conclusion—Symptomatic hip and knee OA are significantly associated with sleep problems, independent of other factors related to sleep difficulties, including self-rated health and depression. Patients with OA should be regularly screened for sleep disturbance as part of routine care

    Performance of global assessments of hip, knee, and back symptom change

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    To compare patients’ global assessments of change in knee, hip, and back symptoms with actual changes over time in pain, function, and radiographic severity

    Development of a novel tool for assessing coverage of implementation factors in health promotion program resources

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    This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Katharine B. Richardson Research Award at Children's Mercy Kansas CityNational Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number F32DK115146Institute of Education Sciences and U.S. Department of Education by grant R305A15027

    Physical Activity, Sedentary Time, and Diet as Mediators of the Association Between TV Time and BMI in Youth

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    Bejarano, C. M., Carlson, J. A., Conway, T. L., Saelens, B. E., Glanz, K., Couch, S. C., Cain, K. L., & Sallis, J. F. , Physical Activity, Sedentary Time, and Diet as Mediators of the Association Between TV Time and BMI in Youth, American Journal of Health Promotion, 35(5), pp. 613–623. Copyright © 2021 The Author(s). DOI: 10.1177/0890117120984943.Purpose: This study examined dietary indicators, sedentary time, and physical activity as potential mediators of the association between TV time and BMIz in youth. Design: Cross-sectional study in 2 independent samples of youth. Setting: Data collection occurred by mail and telephone for adolescents and either at home or in medical settings for children. Sample: 928 youth ages 12-16 and 756 youth ages 6-12 and a parent. Measures: TV time, snacking/eating while watching TV, and a 3-day dietary recall were assessed via child/parent report. Physical activity and sedentary time were assessed by accelerometer wear. Analysis: Direct and indirect associations (through 8 diet and activity variables) of TV time with BMIz were tested in boys and girls in each sample. Results: TV time had a positive association with BMIz in 6-12 year old boys and girls. Direct associations emerged between TV time and the diet/activity variables, and between diet/activity variables and BMIz. Snacking/eating while watching TV had a significant positive association with BMIz in younger boys and mediated the association between TV time and BMIz (ÎČ = .06, p = .019; 25% attenuation). Conclusions: Snacking/eating while watching TV may be a possible reason TV time is consistently associated with obesity in youth. Targeting reductions in TV time and associated snacking could improve health impacts

    Contributions of symptomatic osteoarthritis and physical function to incident cardiovascular disease

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    Abstract Background Osteoarthritis (OA) is associated with worsening physical function and a high prevalence of comorbid health conditions. In particular, cardiovascular disease (CVD) risk is higher in individuals with OA than the general population. Limitations in physical function may be one pathway to the development of CVD among individuals with OA. This study evaluated associations of symptomatic knee OA (sxKOA), baseline physical function and worsening of function over time with self-reported incident CVD in a community-based cohort. Methods Our sample consisted of individuals from the Johnston County Osteoarthritis Project who did not report having CVD at baseline. Variables used to evaluate physical function were the Health Assessment Questionnaire (HAQ), time to complete 5 chair stands, and the 8-ft walk. Worsening function for these variables was defined based on previous literature and cutoffs from our sample. Logistic regression analyses examined associations of sxKOA, baseline function and worsening of function over time with self-reported incident CVD, unadjusted and adjusted for relevant demographic and clinical characteristics. Results Among 1709 participants included in these analyses, the mean age was 59.5 ± 9.5 years, 63.6% were women, 15% had sxKOA, and the follow up time was 5.9 ± 1.2 years. About a third of participants reported worsening HAQ score, about two-fifths had worsened chair stand time, half had worsened walking speed during the 8-ft walk, and 16% self-reported incident CVD. In unadjusted analyses, sxKOA, baseline function, and worsening function were all associated with self-reported incident CVD. In multivariable models including all of these variables, sxKOA was not associated with incident CVD, but worsening function was significantly associated with increased CVD risk, for all three functional measures: HAQ odds ratio (OR) = 2.49 (95% confidence interval (CI) 1.90–3.25), chair stands OR = 1.58 (95% CI 1.20–2.08), 8-ft walk OR = 1.53 (95%CI 1.15–2.04). These associations for worsening function remained in models additionally adjusted for demographic and clinical characteristics related to CVD risk. Conclusions The association between symptomatic knee osteoarthritis and cardiovascular disease risk was explained by measures of physical function. This highlights the importance of physical activity and other strategies to prevent functional loss among individuals with symptomatic knee osteoarthritis

    Differences in adolescent activity and dietary behaviors across home, school, and other locations warrant location-specific intervention approaches

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    Background Investigation of physical activity and dietary behaviors across locations can inform “setting-specific” health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents. Methods Participants were adolescents aged 12–16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and “other” locations. Results Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to “other” locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≄30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at “other” locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at “other” locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal). Conclusions Adolescents’ health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location

    Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial

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    Background: African Americans bear a disproportionate burden of osteoarthritis (OA), with higher prevalence rates, more severe pain, and more functional limitations. One key barrier to addressing these disparities has been limited engagement of African Americans in the development and evaluation of behavioral interventions for management of OA. Pain Coping Skills Training (CST) is a cognitive-behavioral intervention with shown efficacy to improve OA-related pain and other outcomes. Emerging data indicate pain CST may be a promising intervention for reducing racial disparities in OA symptom severity. However, there are important gaps in this research, including incorporation of stakeholder perspectives (e.g. cultural appropriateness, strategies for implementation into clinical practice) and testing pain CST specifically among African Americans with OA. This study will evaluate the effectiveness of a culturally enhanced pain CST program among African Americans with OA. Methods/Design: This is a randomized controlled trial among 248 participants with symptomatic hip or knee OA, with equal allocation to a pain CST group and a wait list (WL) control group. The pain CST program incorporated feedback from patients and other stakeholders and involves 11 weekly telephone-based sessions. Outcomes are assessed at baseline, 12 weeks (primary time point), and 36 weeks (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include self-efficacy, pain coping, pain interference, quality of life, depressive symptoms, and global assessment of change. Linear mixed models will be used to compare the pain CST group to the WL control group and explore whether participant characteristics are associated with differential improvement in the pain CST program. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, Durham Veterans Affairs Medical Center, East Carolina University, and Duke University Health System. Discussion: This culturally enhanced pain CST program could have a substantial impact on outcomes for African Americans with OA and may be a key strategy in the reduction of racial health disparities.Funded by Patient-Centered Outcomes Research Institute (PCORI) Award (AD-1408-19519)

    The James Webb Space Telescope Mission

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    Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4m4m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5m6.5m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure
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