[Show abstract][Hide abstract] ABSTRACT: Continuous monitoring technologies such as accelerometers and pedometers are the gold standard for physical activity (PA) measurement. However, inconsistencies in use, analysis, and reporting limit the understanding of dose–response relationships involving PA and the ability to make comparisons across studies and population subgroups. These issues are particularly detrimental to the study of PA across different ethnicities with different PA habits. This systematic review examined the inclusion of published guidelines involving data collection, processing, and reporting among articles using accelerometers or pedometers in Hispanic or Latino populations.
English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) articles published between 2000 and 2013 using accelerometers or pedometers to measure PA among Hispanics or Latinos were identified through systematic literature searches. Of the 253 abstracts which were initially reviewed, 57 met eligibility criteria (44 accelerometer, 13 pedometer). Articles were coded and reviewed to evaluate compliance with recommended guidelines (N = 20), and the percentage of accelerometer and pedometer articles following each guideline were computed and reported.
On average, 57.1 % of accelerometer and 62.2 % of pedometer articles reported each recommended guideline for data collection. Device manufacturer and model were reported most frequently, and provision of instructions for device wear in Spanish was reported least frequently. On average, 29.6 % of accelerometer articles reported each guideline for data processing. Definitions of an acceptable day for inclusion in analyses were reported most frequently, and definitions of an acceptable hour for inclusion in analyses were reported least frequently. On average, 18.8 % of accelerometer and 85.7 % of pedometer articles included each guideline for data reporting. Accelerometer articles most frequently included average number of valid days and least frequently included percentage of wear time.
Inclusion of standard collection and reporting procedures in studies using continuous monitoring devices in Hispanic or Latino population is generally low.
Lack of reporting consistency in continuous monitoring studies limits researchers' ability to compare studies or draw meaningful conclusions concerning amounts, quality, and benefits of PA among Hispanic or Latino populations. Reporting data collection, computation, and decision-making standards should be required. Improved interpretability would allow practitioners and researchers to apply scientific findings to promote PA.
BMC Public Health 09/2015; 15(1):917. DOI:10.1186/s12889-015-2266-4 · 2.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives
: In this paper we develop the Policy Indicator Checklist-Physical Activity (PIC-PA) to evaluate PA policies across settings (community, school, early care and education) in Childhood Obesity Research Demonstration (CORD) communities.
The PIC-PA was developed through comprehensive reviews of existing policies and recommendations. Raters identified and coded policies in CORD communities. Principal components analysis (PCA) identified key PA policy environment components.
: PCA results suggest 5 major
policy components: “Standards and Guidelines for Physical Education and Outdoor Play,” “Assessment and Planning of Physical Activity Programs,” “Safety and Design of Active Transportation Networks,” “Increasing Public Access to Outdoor Recreation Opportunities,”
and “Infrastructure to Promote Walking and Bicycling to School.”
: The PIC captures PA policy environments, highlighting important needs for improvements.
[Show abstract][Hide abstract] ABSTRACT: The ex vivo expansion of tumor-associated-antigen (TAA)- specific cytotoxic T-cells (CTLs) from healthy donors for adoptive transfer to cancer patients is now providing additional treatment options for patients. Many studies have shown that adoptive transfer of expanded CTLs can reduce the risk of relapse in cancer patients following hematopoietic stem cell transplantation (HSCT). However, the procedure can be limited by difficulties in priming and expanding sufficient numbers of TAA-specific-CTLs. Because acute dynamic exercise mobilizes large numbers of T-cells to peripheral blood, we hypothesized that a single bout of exercise would augment the ex vivo expansion of TAA-specific-CTLs.We therefore collected lymphocytes from blood donated by healthy adults at rest and after brief maximal dynamic exercise. TAA-specific CTLs were expanded using autologous monocyte-derived-dendritic cells pulsed with melanoma-associated antigen 4 (MAGE-A4), with preferentially expressed antigen in melanoma (PRAME), and with Wilms' tumor protein (WT-1). Post exercise, 84% of the participants had a greater number of CTLs specific for at least one of the three TAA.Cells expanded from post exercise blood yielded a greater number of MAGE-A4 and PRAME-specific-cells in 70% and 61% of participants, respectively. In the 'exercise-responsive' participants (defined as participants with at least a 10% increase in TAA-specific-CTLs post-exercise), MAGEA4- and PRAME-specific-CTLs increased 3.4-fold and 6.2- fold respectively. Moreover, expanded TAA-specific CTLs retained their antigen-specific cytotoxic activity. No phenotype differences were observed between expanded cells donated at rest and postexercise. We conclude that exercise can enhance the ex vivo expansion of TAA-specific-CTLs from healthy adults without compromising cytotoxic function. Hence, this study has implications for immunotherapy using adoptive T-cell transfer of donor-derived T-cells after allogeneic HSCT.
[Show abstract][Hide abstract] ABSTRACT: We developed the policy indicator checklist (PIC) to identify and measure policies for calorie-dense foods and sugar-sweetened beverages to determine how policies are clustered across multiple settings.
In 2012 and 2013 we used existing literature, policy documents, government recommendations, and instruments to identify key policies. We then developed the PIC to examine the policy environments across 3 settings (communities, schools, and early care and education centers) in 8 communities participating in the Childhood Obesity Research Demonstration Project.
Principal components analysis revealed 5 components related to calorie-dense food policies and 4 components related to sugar-sweetened beverage policies. Communities with higher youth and racial/ethnic minority populations tended to have fewer and weaker policy environments concerning calorie-dense foods and healthy foods and beverages.
The PIC was a helpful tool to identify policies that promote healthy food environments across multiple settings and to measure and compare the overall policy environments across communities. There is need for improved coordination across settings, particularly in areas with greater concentration of youths and racial/ethnic minority populations. Policies to support healthy eating are not equally distributed across communities, and disparities continue to exist in nutrition policies. (Am J Public Health. Published online ahead of print March 19, 2015: e1-e8. doi:10.2105/AJPH.2015.302559).
American Journal of Public Health 03/2015; 105(5):e1-e8. DOI:10.2105/AJPH.2015.302559 · 4.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose:
Individual perceptions of one's neighborhood environment influence decisions about physical activity participation. Differences between single-family housing neighborhoods versus multi-family housing neighborhoods may affect perceptions and lead to varying responses on surveys designed to assess perceptions of the neighborhood environment for physical activity. This study tested the factorial invariance for the Physical Activity Neighborhood Environment Survey (PANES) between residents of single-family versus multi-family housing neighborhoods.
This study was a secondary data analysis of PANES ratings from African American and Hispanic or Latina women (n = 324) who participated in the Health Is Power study (NCI R01CA109403), a multi-site, community-based trial to investigate the relationship between neighborhood factors and physical activity adoption and maintenance. Factorial invariance was tested using a series of nested confirmatory factor analysis models.
The final model was a 2nd-order factor structure with partial invariance of item intercepts. The 2nd-order factor structure and the relationships of the PANES items to the 1st-order factors (amenable, unsafe, and walkable) and of the 1st-order factors to the 2nd-order factor (environment) were invariant between the single-family and multi-family housing neighborhood groups.
These findings support the construct validity of PANES, which can be considered valid for measuring neighborhood perceptions among residents of neighborhoods with different housing types.
Research quarterly for exercise and sport 03/2015; 86(3):1-8. DOI:10.1080/02701367.2015.1008965 · 1.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction:
The Childhood Obesity Research Demonstration (CORD) project links public health and primary care interventions in three projects described in detail in accompanying articles in this issue of Childhood Obesity. This article describes a comprehensive evaluation plan to determine the extent to which the CORD model is associated with changes in behavior, body weight, BMI, quality of life, and healthcare satisfaction in children 2-12 years of age.
The CORD Evaluation Center (EC-CORD) will analyze the pooled data from three independent demonstration projects that each integrate public health and primary care childhood obesity interventions. An extensive set of common measures at the family, facility, and community levels were defined by consensus among the CORD projects and EC-CORD. Process evaluation will assess reach, dose delivered, and fidelity of intervention components. Impact evaluation will use a mixed linear models approach to account for heterogeneity among project-site populations and interventions. Sustainability evaluation will assess the potential for replicability, continuation of benefits beyond the funding period, institutionalization of the intervention activities, and community capacity to support ongoing program delivery. Finally, cost analyses will assess how much benefit can potentially be gained per dollar invested in programs based on the CORD model.
The keys to combining and analyzing data across multiple projects include the CORD model framework and common measures for the behavioral and health outcomes along with important covariates at the individual, setting, and community levels. The overall objective of the comprehensive evaluation will develop evidence-based recommendations for replicating and disseminating community-wide, integrated public health and primary care programs based on the CORD model.
[Show abstract][Hide abstract] ABSTRACT: Objectives: To evaluate the radiographic and clinical outcomes of a systematic approach to exchange nailing for the treatment of aseptic femoral nonunions previously treated with an intramedullary nail.
Design: Retrospective cohort.
Setting: Tertiary referral center.
Patients: Fifty aseptic femoral nonunions in 49 patients who presented with an intramedullary nail in situ an average of 25 months after the initial fracture nailing were evaluated.
Intervention: Our systematic approach includes inserting an exchange nail at least 2 mm larger in diameter than the in situ nail, using a different manufacturer’s nail, static interlocking, correction of any metabolic and endocrine abnormalities, and secondary nail dynamization in cases showing slow progression toward healing.
Main Outcomes Measurements: The outcome measures were radiographic and clinical evidence of nonunion healing and time to union.
Results: All 50 femoral nonunions (100%) healed after this systematic approach to exchange nailing. The average time to achieve union was 7 months (range, 3–26 months).
Conclusions: Utilization of this systematic approach of exchange nailing for the treatment of aseptic femoral nonunions resulted in a 100% healing rate.
Key Words: fracture, ununited, intramedullary nail, femur, aseptic nonunion
[Show abstract][Hide abstract] ABSTRACT: The GoWoman project is developing and pilot testing the first small group weight management program designed to meet the unique needs of women with mobility impairments, a significantly underserved health disparity population. The project is conducted by a consortium of investigators at five universities in partnership with a Community Advisory Board of five women with mobility impairments. In adapting existing curriculum from the Diabetes Prevention Program, we added content related to the association between disability and weight gain, adaptive cooking, accessible kitchen design, an expanded range of physical activities, precautions against excessive activities and exercises, disability-related stress, and examples that reflect the life situation of women with disabilities. Participants track their progress through MyFitnessPal. Offering this intervention in the online virtual world of Second Life allows us to circumvent many of the geographic, transportation, logistic, disability, and personal barriers that women with mobility impairments face when attempting to participate in public weight loss programs. Our simulated accessible kitchen, caf, and physical activity venues also provide congenial and stigma-free environments for offering social interaction opportunities to reinforce the weight loss programming. The intervention consists of facilitated groups of 8-10 women who gather using their avatar and communicate using voice or text. Sessions last two hours and convene once a week for 16 weeks. We will demonstrate this virtual venue and present the results of the beta-test. We will discuss advantages and technical challenges of implementing interventions in virtual environments, and the implications of this study for mainstream weight loss programs.
142nd APHA Annual Meeting and Exposition 2014; 11/2014
[Show abstract][Hide abstract] ABSTRACT: Background:
Management of periprosthetic infection after reverse shoulder arthroplasty (RSA) remains a challenge. Whereas the infection rate after RSA has improved, more information would be helpful to identify patient risk factors for infection after RSA. The purpose of this study was to evaluate risk factors for infection after RSA.
We identified 301 primary RSAs with a minimum of 1-year follow-up in a prospectively collected shoulder arthroplasty registry. We performed bivariate and multivariable logistic regression analyses to assess the association between patient demographic and clinical characteristics (age, sex, smoking, diabetes, rheumatoid arthritis, body mass index, and history of prior failed hemiarthroplasty or total shoulder arthroplasty) and periprosthetic infection after RSA.
There were 15 periprosthetic infections after RSA (5.0%). Patients with a history of RSA for failed arthroplasty (odds ratio, 5.75; 95% confidence interval, 2.01-16.43; P = .001) and patients younger than 65 years had an increased risk for development of an infection (odds ratio, 4.0; 95% confidence interval, 1.21-15.35; P = .021). History of smoking, diabetes, rheumatoid arthritis, or obesity did not contribute to an increased risk of infection after RSA.
This is the first study evaluating risk factors for infection after RSA while controlling for confounding variables with multivariable analysis. The greatest risk factors for infection after RSA were history of a prior failed arthroplasty and age younger than 65 years. Patients with these clinical characteristics should be counseled preoperatively about the increased risk for development of infection after RSA.
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 08/2014; 24(2). DOI:10.1016/j.jse.2014.05.020 · 2.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Blood flow restricted resistance exercise improves muscle strength; however, the cardiovascular response is not well understood.
This investigation measured local vascular responses, tissue oxygen saturation (StO2), and cardiovascular responses during supine unilateral leg press and heel raise exercise in four conditions: high load with no occlusion cuff (HL), low load with no occlusion cuff (LL), and low load with occlusion cuff pressure set at 1.3 times resting diastolic blood pressure (BFRDBP) or at 1.3 times resting systolic blood pressure (BFRSBP).
Subjects (N=13) (men/women 5/8, 31.8±12.5 yr, 68.3±12.1 kg, mean±SD) performed 3 sets of leg press and heel raise to fatigue with 90-s rest. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using two-dimensional and Doppler ultrasound at rest and immediately after exercise. Heart rate (HR) was monitored using a 3-lead ECG. Finger blood pressure (BP) was acquired by photoplethysmography. Vastus lateralis StO2 was measured using near-infrared spectroscopy (NIRS). A repeated-measures ANOVA was used to analyze exercise work and StO2. Multi-level modeling was used to evaluate the effect of exercise condition on vascular and cardiovascular variables. Statistical significance was set a priori at P<0.05.
Artery diameter did not change from baseline during any of the exercise conditions. Blood flow increased after exercise in each condition except BFRSBP. StO2 decreased during exercise and recovered to baseline levels during rest only in LL and HL. HR, SV, and cardiac output (Q) responses to exercise were blunted in BFR. BP was elevated during rest intervals in BFR.
Our results demonstrate that cuff pressure alters the hemodynamic responses to resistance exercise. These findings warrant further evaluations in individuals presenting cardiovascular risk factors.
Medicine and science in sports and exercise 08/2014; 46(8). DOI:10.1249/MSS.0000000000000253 · 3.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to determine whether self-regulation of eating in minority preschool-aged children mediates the relationship between parent feeding practices and child weight. Participants were 299 low-income African American and Hispanic parents and their preschool-aged children who participated in Head Start. Parents completed questionnaires about controlling feeding practices (pressure to eat, restriction) and children's appetitive characteristics (enjoyment of food, food responsiveness, satiety responsiveness). Path analyses were used to determine whether children's self-regulation of eating mediated the relationship between feeding practices and child weight. Greater satiety responsiveness in African American preschool-age children partially mediated the inverse association between pressure to eat and children's weight, B (SE) = -0.073 (0.036), p < .05. Enjoyment of food and food responsiveness did not mediate the relationship between pressure to eat and weight in the African American sample, ps > .05, nor did appetitive characteristics mediate the relationship between restriction and child weight, ps > .05. Appetitive characteristics did not mediate the relationship between controlling feeding practices and child weight in the Hispanic sample, ps >.05. Implications include the need for culturally sensitive self-report measures and for researchers to account for the possible effects of racial/ethnic differences when designing interventions.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to evaluate the effectiveness of a systematic approach to exchange nailing for the treatment of aseptic tibial nonunion.
Tertiary referral center.
Forty-six aseptic tibial nonunion sites in forty patients (2 bilateral., 4 segmental) that presented with an intramedullary nail (IMN) an average of 16 months after the initial treatment.
Insertion of an exchange nail of at least > 2 mm diameter than the prior nail using a different manufacturer's nail, static interlocking, partial fibulectomy in a select group of patients. and correction of underlying metabolic and endocrine abnormalities.
Union rate, time to union.
Forty-five of 46 tibial nonunion sites (98%) healed at an average of 4.8 months.
Patient selection criteria and a systematic approach to exchange nailing for tibial nonunion is highly successful.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Show abstract][Hide abstract] ABSTRACT: Few studies have investigated changes in adiposity and fitness during the academic year (AY) and summer season (SS) in minority children. This study aimed to assess if adiposity indicators and fitness change during the school AY and SS in Hispanic children.
One hundred nineteen low-income Hispanic children (9.2 ± 0.8) participated in the study. Demographic, body weight and height, percent body fat (% BF), and aerobic endurance were assessed at 3 time points: measurement 1 (M1), beginning of AY; M2, end of AY; and M3, end of SS. Using weight and height, body mass index (BMI) was calculated and normalized (BMI z-scores). Mixed effects between-within-subjects analysis of variance (ANOVA) design was used to examine changes in selected variables.
A significant decrease of BMI z-scores in overweight children (p = .024) was observed during the AY only, but not during the SS. Percent BF increased significantly over the AY and SS (p < .001), particularly in girls. Aerobic endurance showed a significant increase over the AY (p < .001), but it did not change over the SS (p = .552).
Results indicated that the SS might place Hispanic children at increased risk for additional adiposity and lower fitness.
Journal of School Health 04/2014; 84(4):233-8. DOI:10.1111/josh.12141 · 1.43 Impact Factor