Adolescent Participation in Traditional Martial Arts: Effects of Training on Risk Behaviors and Psychological Wellbeing

Adolescence is the period of lifetime development in which many youth begin to make health and lifestyle choices that have a significant impact on overall wellbeing as they transition from childhood into young adulthood. Physical activity appears to be linked to making other healthy lifestyle choices including non-engagement in risk behaviors and improvement in mood and self-concept. The current study sought to examine the effect participation in traditional martial arts training has on overall psychological wellbeing in adolescents. This study administered two widely used and validated scales, the CDC\u27s Youth Risk Behavior Surveillance System (YRBSS) and the Piers Harris-2 (PH-2) self-concept scale, to 55 students training in traditional styles of martial arts. It was hypothesized that students who had trained longer would engage in less risk behaviors and have higher overall wellbeing. It was also hypothesized that males would engage in more risk behaviors than female students. Lastly, it was hypothesized that the different styles of martial arts examined in the study will not have an effect on risk behaviors or wellbeing. Length of training did not significantly predict engagement in risk behavior nor did it predict perception of wellbeing. Age did account for some of the variance with younger students being less likely to engage in some risk behaviors and reporting an increased sense of wellbeing on some of the PH-2 scales than older students. As predicted, male students proved to be significantly more likely to engage in some domains of risk that their female counterparts. The style of martial arts discipline did not have an effect on risk behavior but students who trained in one style did report better wellbeing on two domains of self-concept than the other style. A surprise finding of this study occurred when comparing the study\u27s YRBSS results to the national data provided by the CDC. This study\u27s sample engaged in significantly less risk behaviors overall than did a general sample of adolescents the same age. This indicates that adolescents who participate in traditional martial arts may be less likely to engage in risk behaviors than adolescents in the general population

Body Self-Esteem and Sexual Risk-Taking in Caribbean Adolescents

One of the primary tasks of adolescence is the development of body self-esteem as they transition from children to young adults. This is also a time when many adolescents make decisions about risk behaviors that may affect their developing bodies such as drug use, smoking, and engaging in sexual activity. The current study examined the link between body self-esteem and sexual activity with the aim of predicting if high body self-esteem individuals differ from low body self-esteem individuals with regards to sexual risk-taking. This study was part of a larger study whose survey was based on two widely used and validated scales, the National Adolescent Student Health Survey (NASHS) and the CDC\u27s Youth Risk Behavior Surveillance System (YRBSS). The survey was administered to 3,131 students who attended religious secondary schools throughout the Caribbean. It was hypothesized that the plans and beliefs regarding sexual risk-taking of low body self-esteem individuals will be risker than those with high body self-esteem. Further, it was also the hypothesized that while individuals with high body self-esteem will engage in more sexual activity, the sexual behaviors of low body self-esteem individuals engage in will be riskier. Body self-esteem did not significantly predict plans or beliefs nor did it predict risky sexual activity. In all the analyses, gender proved to be the most significant factor in predicting risky sexual behaviors with males engaging in both riskier and more frequent sexual activities

Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in Children with Nonalcoholic Fatty Liver Disease

OBJECTIVE: To determine the percentage of children with nonalcoholic fatty liver disease (NAFLD) in whom intervention for low-density lipoprotein cholesterol or triglycerides was indicated based on National Heart, Lung, and Blood Institute guidelines. STUDY DESIGN: This multicenter, longitudinal cohort study included children with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network. Fasting lipid profiles were obtained at diagnosis. Standardized dietary recommendations were provided. After 1 year, lipid profiles were repeated and interpreted according to National Heart, Lung, and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction. Main outcomes were meeting criteria for clinically actionable dyslipidemia at baseline, and either achieving lipid goal at follow-up or meeting criteria for ongoing intervention. RESULTS: There were 585 participants, with a mean age of 12.8 years. The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention. Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications. CONCLUSIONS: More than one-half of children with NAFLD met intervention thresholds for dyslipidemia. Based on the burden of clinically relevant dyslipidemia, lipid screening in children with NAFLD is warranted. Clinicians caring for children with NAFLD should be familiar with lipid management

Who teaches writing?

Who Teaches Writing is an open teaching and learning resource being used in English Composition classes at Oklahoma State University. It was authored by contributors from Oklahoma State University and also includes invited chapters from other institutions both inside and outside of Oklahoma. Contributors include faculty from various departments, contingent faculty and staff, and graduate instructors. One purpose of the resource is to provide short, relatively jargon-free chapters geared toward undergraduate students taking First-Year Composition. Support for this project was provided in part by OpenOKState and Oklahoma State University Libraries.OpenOKStateOklahoma State University LibrariesLibraryEnglis

Healthy Lifestyle and Leukocyte Telomere Length in U.S. Women

Context: Whether a healthy lifestyle may be associated with longer telomere length is largely unknown. Objectives: To examine healthy lifestyle practices, which are primary prevention measures against major age-related chronic diseases, in relation to leukocyte telomere length. Design and Setting: Cross-sectional analysis in the Nurses' Health Study (NHS). Participants: The population consisted of 5,862 women who participated in multiple prospective case-control studies within the NHS cohort. Z scores of leukocyte telomere length were derived within each case-control study. Based on prior work, we defined low-risk or healthy categories for five major modifiable factors assessed in 1988 or 1990: non-current smoking, maintaining a healthy body weight (body mass index in 18.5-24.9 kg/m(2)), engaging in regular moderate or vigorous physical activities (>= 150 minutes/week), drinking alcohol in moderation (1 drink/week to,2 drinks/day), and eating a healthy diet (Alternate Healthy Eating Index score in top 50%). We calculated difference (%) of the z scores contrasting low-risk groups with reference groups to evaluate the association of interest. Results: Although none of the individual low-risk factors was significantly associated with larger leukocyte telomere length z scores, we observed a significant, positive relationship between the number of low-risk factors and the z scores. In comparison with women who had zero low-risk factors (1.9% of the total population) and were, therefore, considered the least healthy group, the leukocyte telomere length z scores were 16.4%, 22.1%, 28.7%, 22.6%, and 31.2% (P for trend = 0.015) higher for women who had 1 to 5 low-risk factors, respectively. Conclusions: Adherence to a healthy lifestyle, defined by major modifiable risk factors, was associated with longer telomere length in leukocytes

In Children with Nonalcoholic Fatty Liver Disease, Zone 1 Steatosis is Associated with Advanced Fibrosis

Background & Aims Focal zone 1 steatosis, although rare in adults with nonalcoholic fatty liver disease (NAFLD), does occur in children with NAFLD. We investigated whether focal zone 1 steatosis and focal zone 3 steatosis are distinct subphenotypes of pediatric NAFLD. We aimed to determine associations between the zonality of steatosis and demographic, clinical, and histologic features in children with NAFLD. Methods We performed a cross-sectional study of baseline data from 813 children (age <18 years; mean age, 12.8 ± 2.7 years). The subjects had biopsy-proven NAFLD and were enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network. Liver histology was reviewed using the Nonalcoholic Steatohepatitis Clinical Research Network scoring system. Results Zone 1 steatosis was present in 18% of children with NAFLD (n = 146) and zone 3 steatosis was present in 32% (n = 244). Children with zone 1 steatosis were significantly younger (10 vs 14 years; P < .001) and a significantly higher proportion had any fibrosis (81% vs 51%; P < .001) or advanced fibrosis (13% vs 5%; P < .001) compared with children with zone 3 steatosis. In contrast, children with zone 3 steatosis were significantly more likely to have steatohepatitis (30% vs 6% in children with zone 1 steatosis; P < .001). Conclusions Children with zone 1 or zone 3 distribution of steatosis have an important subphenotype of pediatric NAFLD. Children with zone 1 steatosis are more likely to have advanced fibrosis and children with zone 3 steatosis are more likely to have steatohepatitis. To achieve a comprehensive understanding of pediatric NAFLD, studies of pathophysiology, natural history, and response to treatment should account for the zonality of steatosis

Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial

PurposePoor adherence to medications is more prevalent for chronic obstructive pulmonary disease (COPD) than for other chronic conditions and is associated with unfavorable health outcomes. Few interventions have successfully improved adherence for COPD medications; none of these use unlicensed health care personnel. We explored the efficacy of lay health coaches to improve inhaler adherence and technique.MethodsWithin a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from urban, public primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive 9 months of health coaching or usual care. Outcome measures included self-reported adherence to inhaled controller medications in the past 7 days and observed technique for all inhalers. We used generalized linear models, controlling for baseline values and clustering by site.ResultsBaseline adherence and inhaler technique were uniformly poor and did not differ by study arm. At 9 months, health-coached patients reported a greater number of days of adherence compared with usual care patients (6.4 vs 5.5 days; adjusted P = .02) and were more likely to have used their controller inhalers as prescribed for 5 of the last 7 days (90% vs 69%; adjusted P = .008). They were more than 3 times as likely to demonstrate perfect technique for all inhaler devices (24% vs 7%; adjusted P = .01) and mastery of essential steps (40% vs 11%; adjusted P &lt;.001).ConclusionsHealth coaching may provide a scalable model that can improve care for people living with COPD

Association between alcohol consumption patterns and metabolic syndrome

Aims Examine associations between self-reported alcohol consumption patterns and metabolic syndrome. Materials and methods Sample (N = 7432) included adult (20 years) participants in the 1999-2006 National Health and Nutrition Examination Survey. Results Above moderate alcohol consumption (AMAC) was negatively associated with waist circumference among those in the 20-29, 40-49, and 70-79 age groups (β = -6.21, β = -8.34, and β = -6.60, respectively) and moderate alcohol consumption (MAC) was negatively associated with waist circumference among those in the 30-39, 40-49, and 70-79 age groups (β = -4.60, β = -5.69, and β = -2.88, respectively). AMAC was negatively associated with triglycerides among those in the 70-79 and 80+ age groups (β = -23.62 and β = -34.18, respectively) and positively associated with HDL-C levels in all groups (β range 8.96-18.25). MAC was positively associated with HDL-C in the age groups spanning 20-69 years (β range 3.05-5.34) and those over 80 (β = 5.26). AMAC and MAC were negatively associated with fasting glucose levels in the 20-29 and 70-79 age groups (β = -3.38 and -15.61, respectively). MAC was negatively associated with fasting glucose levels among those 70-79 and those over 80 years of age (β = -7.06 and β = -5.00, respectively). Conclusion MAC and AMAC may favorably impact metabolic health. © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved

Randomized Controlled Trial of Health Coaching for Vulnerable Patients with Chronic Obstructive Pulmonary Disease.

RationaleSocioeconomically disadvantaged patients with chronic obstructive pulmonary disease (COPD) often face barriers to evidence-based care that are difficult to address in public care settings with limited resources.ObjectivesTo determine the benefit of health coaching for patients with moderate to severe COPD relative to usual care.MethodsWe conducted a randomized controlled trial of 9 months of health coaching versus usual care for English- or Spanish-speaking patients at least 40 years of age with moderate to severe COPD. Primary outcomes were COPD-related quality of life and the dyspnea subscale of the Chronic Respiratory Disease Questionnaire. Secondary outcomes were self-efficacy for managing COPD, exercise capacity (6-min walk test), and number of COPD exacerbations. Additional outcomes were COPD symptoms, lung function (forced expiratory volume in 1 s percent predicted), smoking status, bed days owing to COPD, quality of care (Patient Assessment of Chronic Illness Care), COPD knowledge, and symptoms of depression (Patient Health Questionnaire). Outpatient visits, emergency department visits, and hospitalizations were assessed by review of medical records. Generalized linear modeling was used to adjust for baseline values and account for clustering by clinic.ResultsOf 192 patients enrolled, 158 (82%) completed 9 months of follow-up. There were no significant differences between study arms for the primary or secondary outcomes. At 9 months, patients in the coached group reported better quality of care (mean Patient Assessment of Chronic Illness Care score, 3.30 vs. 3.18; adjusted P = 0.02) and were less likely to report symptoms of moderate to severe depression (Patient Health Questionnaire score, ≥15) than those in the usual care arm (6% vs. 20%; adjusted P = 0.01). During the study, patients in the coaching arm had 48% fewer hospitalizations related to COPD (0.27/patient/yr vs. 0.52/patient/yr), but this difference was not significant in the adjusted analysis.ConclusionsThese results help inform expectations regarding the limitations and benefits of health coaching for patients with COPD. They may be useful to health policy experts in assessing the potential value of reimbursement and incentives for health coaching-type activities for patients with chronic disease. Clinical trial registered with www.clinicaltrials.gov (NCT02234284)

Pulmonary Specialist-Supported Health Coaching Delivered by Lay Personnel Improves Receipt of Quality Care for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.

PURPOSE: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting. METHODS: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care personnel informed by a pulmonary specialist practitioner. Outcome measures included prescription of appropriate inhaler therapy, participation in COPD-related education, engagement with specialty care, prescription of smoking cessation medications, and patient ratings of the quality of care. RESULTS: Baseline quality measures did not differ between study arms. At 9 months, coached patients were more likely (increase of 9.3% over usual care; P=0.014) to have received guideline-based inhalers compared to those in usual care. Coached patients were more likely to engage with pulmonary specialty care (increase of 8.3% over usual care with at least 1 visit; P=0.04) and educational classes (increase of 5.3% over usual care; P=0.03). Receipt of smoking cessation medications among patients smoking at baseline in the health coaching group increased 21.1 percentage points more than in usual care, a difference near statistical significance (P=0.06). CONCLUSIONS: Health coaching may improve the provision of quality chronic illness care for conditions such as COPD