Marital Quality, Communal Strength, and Physical Health

Much of the extant literature on marital quality and health has examined marital quality as a static, global construct, measured at a single assessment. However, marital quality is a dynamic construct that fluctuates over time, particularly in the early years of marriage. The purpose of the present study was to evaluate whether changes in overall marital satisfaction and communal strength are associated with mental and physical health symptoms assessed via the SF-36 in a cohort of newlywed couples (N = 74 couples). Marital measures including marital satisfaction (MS) and communal strength (CS) were collected at baseline (26 days prior to marriage) and approximately 2 years later. The SF-36 was administered 3 years following baseline. Results showed that baseline MS and CS were associated with significantly fewer mental and physical health symptoms (p's < .05). Independent of baseline level, decreases in CS were associated with poorer mental health (B = .06, SE = .03). There were no sex differences in the effects. Controlling for depressive symptoms reduced the effects of baseline MS and CS on mental and physical health to non-significance. However, the effect of change in CS on mental health remained significant after controlling for depressive symptoms (B = .05, SE = .02). The present findings suggest that even in the early stages of marriage, lower initial levels of marital satisfaction and spousal responsiveness to needs (communal strength) as well as changes in communal strength are associated with increased mental and physical health symptoms

Engaging Community Partners to Enrich Preschoolers Learning Experiences with Dramatic Inquiry

Interdisciplinary teams of adults are needed to enhance the capacity of schools to provide the most appropriate educational experiences for young children who have or are at risk for developmental delays and disabilities (Division for Early Childhood, 2014). When educators, families, and community partners connect around shared goals, we begin to reimagine instructional opportunities and create more equitable access to educational resources for children and families. We share insights from community partners who participated in a collaborative dramatic inquiry study designed to enrich preschoolers’ learning experiences and serve children and families

Leaning in to Address Sleep Disturbances and Sleep Disorders in Department of Defense and Defense Health Agency

Letter to the Editor, Military Medicine, 187, 5/6:155, 202217 USC 105 interim-entered record; under review.The article of record as published may be found at http://dx.doi.org/10.1177/0018720820906050In their article entitled, “Engaging Stakeholders to Optimize Sleep Disorders Management in the U.S. Military: A Qualitative Analysis,” Abdelwadoud and colleagues conducted focus groups of service members, primary care managers (PCMs), and administrative stakeholders about their perceptions, experiences, roles in sleep management, stated education needs, and management of sleep disorders.1 The qualitative methods are rigorous, and the findings reinforce and nuance prior results, especially regarding key requirements from PCMs. We feel compelled, however, to further nuance the authors’ conclusion that “current military sleep management practices are neither satisfactory nor maximally effective” and offer specific examples of actions taken by the Department of Defense (DoD) and Defense Health Agency (DHA) in recognition of the significance of optimal sleep in combat readiness and overall health of service members. We offer here a succinct list of concrete efforts to support and implement substantial clinical, operational, research, or educational efforts by the DoD or DHA to improve sleep in service members and associated clinical challenges in this unique population.Identified in text as U.S. Government work

Pathways through which higher neighborhood crime is longitudinally associated with greater body mass index

Abstract Background Although crime and perceived safety are associated with obesity and body mass index (BMI), the pathways are less clear. Two likely pathways by which crime and perceived safety may impact obesity are through distress and physical activity. Methods We examined data from 2013 to 2014 for 644 predominantly African-American adults (mean age 57 years; 77% female) living in low-income Pittsburgh, PA neighborhoods, including self-reported perceptions of safety and emotional distress, interviewer-measured height/weight, and physical activity measured via accelerometry. We used secondary data on neighborhood crime from 2011 to 2013. We built a structural equation model to examine the longitudinal direct and indirect pathways from crime to BMI through perceived safety, distress and physical activity. Results Long-term exposure to crime was positively associated with lack of perceived safety (β = 0.11, p = 0.005) and lack of perceived safety was positively associated with BMI (β = 0.08, p = 0.03). The beneficial association between physical activity and BMI (β = −0.15, p < 0.001) was attenuated by a negative association between crime and physical activity (β = −0.09, p = 0.01). Although crime was associated with distress we found no evidence of a path from crime to BMI via distress. Conclusions Our findings suggest decrements in perceived safety and physical activity are important processes that might explain why neighborhood crime is associated with greater BMI.https://deepblue.lib.umich.edu/bitstream/2027.42/139054/1/12966_2017_Article_611.pd

One size doesn’t fit all: cross-sectional associations between neighborhood walkability, crime and physical activity depends on age and sex of residents

Abstract Background Low-income African American adults are disproportionately affected by obesity and are also least likely to engage in recommended levels of physical activity (Flegal et al. JAMA 303(3):235-41, 2010; Tucker et al. Am J Prev Med 40(4):454-61, 2011). Moderate-to-vigorous physical activity (MVPA) is an important factor for weight management and control, as well as for reducing disease risk (Andersen et al. Lancet 368(9532):299-304, 2006; Boreham and Riddoch J Sports Sci 19(12):915-29, 2001; Carson et al. PLoS One 8(8):e71417, 2013). While neighborhood greenspace and walkability have been associated with increased MVPA, evidence also suggests that living in areas with high rates of crime limits MVPA. Few studies have examined to what extent the confluence of neighborhood greenspace, walkability and crime might impact MVPA in low-income African American adults nor how associations may vary by age and sex. Methods In 2013 we collected self-reported data on demographics, functional limitations, objective measures of MVPA (accelerometry), neighborhood greenspace (geographic information system), and walkability (street audit) in 791 predominantly African-American adults (mean age 56 years) living in two United States (U.S.) low-income neighborhoods. We also acquired data from the City of Pittsburgh on all crime events within both neighborhoods. Exposure: To examine cross-sectional associations of neighborhood-related variables (i.e., neighborhood greenspace, walkability and crime) with MVPA, we used zero-inflated negative binomial regression models. Additionally, we examined potential interactions by age (over 65 years) and sex on relationships between neighborhood variables and MVPA. Results Overall, residents engaged in very little to no MVPA regardless of where they lived. However, for women, but not men, under the age of 65 years, living in more walkable neighborhoods was associated with more time engaged in MVPA in (β = 0.55, p = 0.007) as compared to their counterparts living in less walkable areas. Women and men age 65 years and over spent very little time participating in MVPA regardless of neighborhood walkability. Neither greenspace nor crime was associated with MVPA in age-sex subgroups. Conclusions Neighborhood walkability may play a stronger role on MVPA than accessible greenspace or crime in low-income urban communities. Walkability may differentially impact residents depending on their age and sex, which suggests tailoring public health policy design and implementation according to neighborhood demographics to improve activity for all.http://deepblue.lib.umich.edu/bitstream/2027.42/135725/1/12889_2016_Article_3959.pd

Assessing the burden of nocturia in the workplace: the associations between nocturnal voiding, subjective well-being, work engagement and productivity

AIMS: Nocturia (getting up at night to urinate, where each urination being followed by sleep or intention to sleep) is a bothersome symptom with potentially negative consequences for individual health and daytime functioning. This study assessed the burden of nocturia in the workplace by investigating associations between nocturia and subjective well-being, work engagement and productivity. METHODS: Using large-scale international workplace survey data, the associations between nocturia, subjective well-being (SWB), work engagement (Utrecht Work Engagement Scale, UWES-9) and productivity (Work Productivity and Impairment Index, WPAI) were assessed. Bivariate and multivariate regression analysis was used with adjustment for a large set of confounding factors, including sleep duration and sleep quality. RESULTS: Across a study sample of 92,129 observations, aged 18 to 70, an average of 10% of the survey population reported ≥ 2 nocturnal voids (generally considered clinically significant nocturia), with prevalence of nocturia increasing with age. Individuals with nocturia reported a 35.7% (p<0.001) higher relative sleep disturbance score and were 10.5 percentage points (p<0.001) more likely to report short sleep. Adjusted for covariates, nocturia was associated with a 3.5% (p<0.001) lower relative SWB score and a 2% (p<0.001) lower relative UWES-9 work engagement score. Nocturia was associated with a 3.9 percentage points (p<0.001) higher work impairment due to absenteeism and presenteeism (WPAI). Adjusting additionally for sleep disturbance and sleep duration reduced the magnitude of the estimated effects, suggesting a key role for poor sleep in explaining the relationship between nocturia and the outcomes (SWB, UWES-9, WPAI) assessed