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PURPOSE: We hypothesized that clinical data from a neonatal intensive care unit (NICU) infant developmental follow-up clinic would identify early manifestations of autism spectrum disorder (ASD). METHODS: One hundred forty-four infants were identified; 72 later diagnosed with ASD and 72 controls. Retrospective chart review provided data from the Test of Infant Motor Performance (TIMP) and the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months of age. RESULTS: Between-group comparisons indicated no significant group difference in TIMP scores; however, Bayley-III scaled scores differed between the groups at 2 administration times. The within-group Bayley-III change scores declined significantly more for the ASD group in cognitive and communication subtests. CONCLUSION: High-risk neonates, due to prematurity or morbidity, later diagnosed with ASD demonstrated statistically significant differences, including a more precipitous drop in Bayley-III scores over time. Early, longitudinal developmental surveillance for neonates at risk of ASD is critical. What this adds to the evidence: Early identification of ASD is critical to optimize developmental outcomes in young children, including infants born prematurely or with neonatal morbidity, who are perceived to have an increased risk for ASD. Despite these findings, minimal research has been conducted to evaluate the utility of commonly administered norm-referenced developmental surveillance instruments to identify possible early signs of ASD in this high-risk population due to prematurity or neonatal morbidity and not familial association. The present study analyzed retrospectively collected clinical data from a NICU developmental follow-up clinic for 144 infants, 72 of which were later diagnosed with ASD and 72 sex- and gestational age-matched controls. Results demonstrated statistically significant poorer Bayley-III outcomes for the ASD group compared with controls at 2 different study time points, including a more precipitous drop in Bayley-III scaled scores over time. This study highlights the importance of early and longitudinal developmental surveillance for high-risk neonates at risk of ASD.
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Transtorno do Espectro Autista , Recém-Nascido , Lactente , Humanos , Pré-Escolar , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Estudos Retrospectivos , Recém-Nascido Prematuro , Idade Gestacional , Fatores de Risco , Desenvolvimento InfantilRESUMO
BACKGROUND: Restricting dietary sugar is a leading recommendation, but limited biomarkers assessing intake exist. Although 24-h urinary sucrose (U-Suc) and urinary fructose (U-Fruc) excretion has been used with mixed success, collection is burdensome. AIM: This study aimed to test the sensitivity of an enzymatic assay of U-Suc and U-Fruc to detect changing added sugar intake using low-burden overnight urine samples in 30 postmenopausal women. METHODS: Women consumed usual dietary intake during day 1 and usual intake plus a sugar sweetened beverage during day 2. Weighed, photographed food records assessed intake. Enzymatic assay measured U-Suc and U-Fruc from fasting overnight samples; liquid chromatography mass spectrometry (LC-MS) validated U-Suc findings. RESULTS: Dietary added sugars increased significantly during day 2 (p < 0.001), but urinary sugars were not significantly increased. Enzymatic assay detected urinary sugars in 75% (U-Suc) and 35% (U-Fruc) of samples. Dietary sucrose was not associated with U-Suc, however dietary fructose was significantly associated with U-Fruc [ß = 0.031; p < 0.05] among women with detectable urinary sugars. Participants with detectable U-Fruc consumed more energy from added sugars [12.6% kcal day 1; 21.5% kcal day 2] than participants with undetectable U-Fruc [9.3% kcal day 1; 17.4% kcal day 2], p < 0.05. Using LC-MS, U-Suc predicted sucrose and added sugar intake [ß = 0.017, ß = 0.013 respectively; both p < 0.05]. CONCLUSIONS: Urinary sugars measured enzymatically from overnight urine samples were not sensitive biomarkers of changing added sugar intake in postmenopausal women. However, urinary fructose measured by enzymatic assay or LC-MS may differentiate low versus high added sugar consumers.
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Loneliness is strongly linked to poor health. Recent research suggests that appetite dysregulation provides one potential pathway through which loneliness and other forms of social disconnection influence health. Obesity may alter the link between loneliness and appetite-relevant hormones, one unexplored possibility. We examined the relationships between loneliness and both postmeal ghrelin and hunger, and tested whether these links differed for people with a higher versus lower body mass index (BMI; kg/m(2)). During this double-blind randomized crossover study, women (N=42) ate a high saturated fat meal at the beginning of one full-day visit and a high oleic sunflower oil meal at the beginning of the other. Loneliness was assessed once with a commonly used loneliness questionnaire. Ghrelin was sampled before the meal and postmeal at 2 and 7h. Self-reported hunger was measured before the meal, immediately postmeal, and then 2, 4, and 7h later. Lonelier women had larger postprandial ghrelin and hunger increases compared with less lonely women, but only among participants with a lower BMI. Loneliness and postprandial ghrelin and hunger were unrelated among participants with a higher BMI. These effects were consistent across both meals. These data suggest that ghrelin, an important appetite-regulation hormone, and hunger may link loneliness to weight gain and its corresponding negative health effects among non-obese people.
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Grelina/metabolismo , Fome/fisiologia , Solidão/psicologia , Período Pós-Prandial/fisiologia , Apetite/fisiologia , Índice de Massa Corporal , Peso Corporal , Neoplasias da Mama/psicologia , Estudos Cross-Over , Dieta Hiperlipídica , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Sobrepeso/psicologia , Inquéritos e Questionários , SobreviventesRESUMO
OBJECTIVE: Loneliness enhances risk for episodic memory declines over time. Omega-3 supplementation can improve cognitive function for people experiencing mild cognitive difficulties. Accordingly, we explored whether omega-3 supplementation would attenuate loneliness-related episodic memory problems. METHODS: Participants (n = 138) from a parent randomized controlled trial were randomized to the placebo, 1.25 grams/d of omega-3, or 2.50 grams/d of omega-3 conditions for a 4-month period. They completed a baseline loneliness questionnaire and a battery of cognitive tests both at baseline and at the end of the randomized controlled trial. RESULTS: After adjustment for baseline verbal episodic memory scores, lonelier people within the placebo condition had poorer verbal episodic memory postsupplementation, as measured by immediate (b = -0.28, t (117) = -2.62, p = .010) and long-delay (b = -0.06, t (116) = -2.07, p = .040) free recall, than their less lonely counterparts. This effect was not observed in the 1.25- and 2.50-grams/d supplementation groups (all p values > .10). The plasma omega-6:omega-3 ratio data mirrored these results. There were no loneliness-related effects of omega-3 supplementation on short-delay recall or the other cognitive tests (all p values > .32). CONCLUSION: These results suggest that omega-3 supplementation attenuates loneliness-related verbal episodic memory declines over time and support the use of exploring novel interventions for treating episodic memory problems among lonely people. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00385723.
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Ácidos Graxos Ômega-3/uso terapêutico , Solidão/psicologia , Transtornos da Memória/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Cancer survivors often experience cognitive difficulties after treatment completion. Although chemotherapy enhances risk for cognitive problems, it is likely only one piece of a complex puzzle that explains survivors' cognitive functioning. Loneliness may be one psychosocial risk factor. The current studies included both subjective and objective cognitive measures and tested whether lonelier breast cancer survivors would have more concentration and memory complaints and experience more concentration difficulties than their less lonely counterparts. METHODS: The relationship between loneliness and cognitive function was tested among three samples of breast cancer survivors. Study 1 was a sample of breast cancer survivors (n = 200) who reported their concentration and memory problems. Study 2a was a sample of breast cancer survivors (n = 185) and noncancer controls (n = 93) who reported their concentration and memory problems. Study 2b was a subsample of Study 2a breast cancer survivors (n = 22) and noncancer controls (n = 21) who completed a standardized neuropsychological test assessing concentration. RESULTS: Studies 1 and 2a revealed that lonelier women reported more concentration and memory problems than less lonely women. Study 2b utilized a standardized neuropsychological continuous performance test and demonstrated that lonelier women experienced more concentration problems than their less lonely counterparts. CONCLUSIONS: These studies demonstrated that loneliness is linked to concentration and memory complaints and the experience of concentration problems among breast cancer survivors. The results were also highly consistent across three samples of breast cancer survivors. These data suggest that loneliness may be a risk factor for cognitive difficulties among cancer survivors.
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Neoplasias da Mama/psicologia , Transtornos Cognitivos/psicologia , Solidão/psicologia , Sobreviventes/psicologia , Adulto , Idoso , Atenção , Estudos de Casos e Controles , Feminino , Humanos , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de RiscoRESUMO
Participants in trials may be randomized either individually or in groups and may receive their treatment either entirely individually, entirely in groups, or partially individually and partially in groups. This paper concerns cases in which participants receive their treatment either entirely or partially in groups, regardless of how they were randomized. Participants in group-randomized trials are randomized in groups, and participants in individually randomized group treatment trials are individually randomized, but participants in both types of trials receive part or all of their treatment in groups or through common change agents. Participants who receive part or all of their treatment in a group are expected to have positively correlated outcome measurements. This paper addresses a situation that occurs in group-randomized trials and individually randomized group treatment trials-participants receive treatment through more than one group. As motivation, we consider trials in The Childhood Obesity Prevention and Treatment Research Consortium, in which each child participant receives treatment in at least two groups. In simulation studies, we considered several possible analytic approaches over a variety of possible group structures. A mixed model with random effects for both groups provided the only consistent protection against inflated type I error rates and did so at the cost of only moderate loss of power when intraclass correlations were not large. We recommend constraining variance estimates to be positive and using the Kenward-Roger adjustment for degrees of freedom; this combination provided additional power but maintained type I error rates at the nominal level.
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Interpretação Estatística de Dados , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , HumanosRESUMO
Among the numerous explanations that have been offered for recent errors in pre-election polls, selection bias due to non-ignorable partisan nonresponse bias, where the probability of responding to a poll is a function of the candidate preference that a poll is attempting to measure (even after conditioning on other relevant covariates used for weighting adjustments), has received relatively less focus in the academic literature. Under this type of selection mechanism, estimates of candidate preferences based on individual or aggregated polls may be subject to significant bias, even after standard weighting adjustments. Until recently, methods for measuring and adjusting for this type of non-ignorable selection bias have been unavailable. Fortunately, recent developments in the methodological literature have provided political researchers with easy-to-use measures of non-ignorable selection bias. In this study, we apply a new measure that has been developed specifically for estimated proportions to this challenging problem. We analyze data from 18 different pre-election polls: 9 different telephone polls conducted in 8 different states prior to the US presidential election in 2020, and nine different pre-election polls conducted either online or via telephone in Great Britain prior to the 2015 general election. We rigorously evaluate the ability of this new measure to detect and adjust for selection bias in estimates of the proportion of likely voters that will vote for a specific candidate, using official outcomes from each election as benchmarks and alternative data sources for estimating key characteristics of the likely voter populations in each context.
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PURPOSE: To determine the prevalence of food insecurity (FI) among females with a history of breast cancer compared to females without cancer in the USA and the sociodemographic characteristics that may explain their FI. METHODS: Using the 2019 National Health Interview (NHIS) survey that included the US Department of Agriculture's (USDA's) 10-item Household Food Security Survey Module, participants with high/moderate food security were considered food secure and low/very low food security were considered food insecure. Analyses accounted for complex survey design and included descriptive statistics, bivariate analyses, and multivariate regression analyses. RESULTS: Eligible females (40+ years old) included 557 with a history of breast cancer and 9678 without a cancer history. FI was experienced by an estimated 4.4% of females with breast cancer, compared to 9.3% of females without cancer. Controlling for age, race/ethnicity, education level, general health status, and body mass index, the prevalence ratio between the two study groups was 0.50 (95% CI 0.33-0.78). CONCLUSIONS: In this national sample, the prevalence of FI among females with a history breast cancer was lower than females without a history of cancer. IMPLICATIONS FOR CANCER SURVIVORS: FI is low among breast cancer survivors, and routine FI screening among breast cancer survivors may not be warranted for all patients. Healthcare providers, however, should be aware of FI as a social determinant of health and consider it when there are known financial issues among cancer survivors.
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Purpose/Objective Research: This secondary analysis of a pilot randomized controlled trial in people with multiple sclerosis (PwMS) aimed to compare mindfulness-based training (MBT), adaptive cognitive training (aCT), and a waitlist control (WL) on the use of emotion regulation strategies during daily worries and ruminations. Further, we examined cognitive functioning as a moderator of training effects. RESEARCH METHOD/DESIGN: Sixty-one PwMS were randomized into an MBT, aCT, or a WL control group for four weeks. Participants completed daily diaries assessing their use of emotion regulation strategies and measures of cognitive functioning at pre- and posttraining. The frequency of acceptance use, maladaptive strategies, and cognitive reappraisal, as well as the success of acceptance use, were the primary outcomes of interest. We also examined whether a cognitive composite score moderated treatment gains. RESULTS: Relative to pretraining, at posttraining, participants in the MBT group used acceptance more frequently, and this change was significantly greater compared to the change in aCT and WL groups. Training did not have differential effects on the frequency of maladaptive strategy and cognitive reappraisal use or on the success of acceptance use. Cognitive functioning did not moderate observed treatment gains. CONCLUSION/IMPLICATIONS: Our findings, based on this pilot study, suggest that after brief training in mindfulness meditation, PwMS used more acceptance strategies to regulate their emotions. Future studies with larger sample sizes, longer duration of treatment, and longitudinal follow-up are needed to better understand the efficacy of mindfulness mediation for promoting affective and cognitive health in PwMS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Regulação Emocional , Atenção Plena , Esclerose Múltipla , Humanos , Projetos Piloto , Emoções/fisiologiaRESUMO
OBJECTIVES: Multiple baseline designs (MBDs) have been suggested as alternatives to group-randomized trials (GRT). We reviewed structural features of MBDs and considered their potential effectiveness in public health research. We also reviewed the effect of staggered starts on statistical power. METHODS: We reviewed the MBD literature to identify key structural features, recent suggestions that MBDs be adopted in public health research, and the literature on power in GRTs with staggered starts. We also computed power for MBDs and GRTs. RESULTS: The features that have contributed to the success of small MBDs in some fields are not likely to translate well to public health research. MBDs can be more powerful than GRTs under some conditions, but those conditions involve assumptions that require careful evaluation in practice. CONCLUSIONS: MBDs will often serve better as a complement of rather than as an alternative to GRTs. GRTs may employ staggered starts for logistical or ethical reasons, but this will always increase their duration and will often increase their cost.
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Ensaios Clínicos como Assunto/métodos , Saúde Pública , Projetos de Pesquisa , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
In cluster randomized trials (CRTs), identifiable clusters rather than individuals are randomized to study groups. Resulting data often consist of a small number of clusters with correlated observations within a treatment group. Missing data often present a problem in the analysis of such trials, and multiple imputation (MI) has been used to create complete data sets, enabling subsequent analysis with well-established analysis methods for CRTs. We discuss strategies for accounting for clustering when multiply imputing a missing continuous outcome, focusing on estimation of the variance of group means as used in an adjusted t-test or ANOVA. These analysis procedures are congenial to (can be derived from) a mixed effects imputation model; however, this imputation procedure is not yet available in commercial statistical software. An alternative approach that is readily available and has been used in recent studies is to include fixed effects for cluster, but the impact of using this convenient method has not been studied. We show that under this imputation model the MI variance estimator is positively biased and that smaller intraclass correlations (ICCs) lead to larger overestimation of the MI variance. Analytical expressions for the bias of the variance estimator are derived in the case of data missing completely at random, and cases in which data are missing at random are illustrated through simulation. Finally, various imputation methods are applied to data from the Detroit Middle School Asthma Project, a recent school-based CRT, and differences in inference are compared.
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Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Software/estatística & dados numéricos , Estatística como Assunto/métodos , Algoritmos , Análise de Variância , Simulação por Computador , Humanos , Projetos de PesquisaRESUMO
A non-probability sampling mechanism arising from non-response or non-selection is likely to bias estimates of parameters with respect to a target population of interest. This bias poses a unique challenge when selection is 'non-ignorable', i.e. dependent upon the unobserved outcome of interest, since it is then undetectable and thus cannot be ameliorated. We extend a simulation study by Nishimura et al. [International Statistical Review, 84, 43-62 (2016)], adding two recently published statistics: the so-called 'standardized measure of unadjusted bias (SMUB)' and 'standardized measure of adjusted bias (SMAB)', which explicitly quantify the extent of bias (in the case of SMUB) or non-ignorable bias (in the case of SMAB) under the assumption that a specified amount of non-ignorable selection exists. Our findings suggest that this new sensitivity diagnostic is more correlated with, and more predictive of, the true, unknown extent of selection bias than other diagnostics, even when the underlying assumed level of non-ignorability is incorrect.
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Selection bias is a serious potential problem for inference about relationships of scientific interest based on samples without well-defined probability sampling mechanisms. Motivated by the potential for selection bias in: (a) estimated relationships of polygenic scores (PGSs) with phenotypes in genetic studies of volunteers and (b) estimated differences in subgroup means in surveys of smartphone users, we derive novel measures of selection bias for estimates of the coefficients in linear and probit regression models fitted to nonprobability samples, when aggregate-level auxiliary data are available for the selected sample and the target population. The measures arise from normal pattern-mixture models that allow analysts to examine the sensitivity of their inferences to assumptions about nonignorable selection in these samples. We examine the effectiveness of the proposed measures in a simulation study and then use them to quantify the selection bias in: (a) estimated PGS-phenotype relationships in a large study of volunteers recruited via Facebook and (b) estimated subgroup differences in mean past-year employment duration in a nonprobability sample of low-educated smartphone users. We evaluate the performance of the measures in these applications using benchmark estimates from large probability samples.
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BACKGROUND: Asthma severity, control, type of medical regimen provided, and compliance with it are not well understood in minority patients at the transition stage from childhood to adolescence. OBJECTIVE: Describe the level of asthma severity and control and the clinical regimens provided to a large population of low-income, African American children at this developmentally significant period. METHODS: Parents of 1292 children with asthma among 6827 preteens in 19 middle schools in predominantly African American (94%), low-income neighborhoods in Detroit, Michigan, were enrolled in the study. Data were collected through self-administered survey and telephone interviews and were useable for 936 participants. Study queries related to demographics, asthma symptoms, and medication use. Mixed effects models with a random intercept for school were used to determine severity and control and the association of medical regimens to these. RESULTS: Sixty-seven percent of children with probable asthma had received a physician's diagnosis. Being female was associated with being undiagnosed (p = .02). Forty-seven with no diagnosis had persistent asthma and 10% of these were classified as severe. Sixty-eight percent with a diagnosis and asthma medicine prescriptions were not controlled. Compliant use of controller medicine was associated with poorer asthma control compared to noncompliant controller users (p = .04) and reliever-only users (p < .001). Thirty-nine percent of children had controller medicine; of those 40% were not compliant with controller use; 9% nebulized their controller medicine. CONCLUSIONS: Care provided low-income minority children at an important stage in their development was not consistent with guidelines for asthma control. Therapy choices for treatment did not account for the actual level of their symptoms. Lack of an asthma diagnosis was significant in the population. Adolescent girls were at risk for not receiving a diagnosis. Patient compliance with asthma regimens was limited. Both clinician and patient education regarding effective asthma management appears needed regarding preteens in low-income minority communities.
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Asma/diagnóstico , Asma/terapia , Grupos Minoritários/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Negro ou Afro-Americano , Fatores Etários , Antiasmáticos/administração & dosagem , Antiasmáticos/uso terapêutico , Asma/epidemiologia , Cuidadores/economia , Cuidadores/educação , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Seguro Saúde/estatística & dados numéricos , Entrevistas como Assunto , Masculino , Adesão à Medicação/estatística & dados numéricos , Michigan/epidemiologia , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Hot deck imputation is a method for handling missing data in which each missing value is replaced with an observed response from a "similar" unit. Despite being used extensively in practice, the theory is not as well developed as that of other imputation methods. We have found that no consensus exists as to the best way to apply the hot deck and obtain inferences from the completed data set. Here we review different forms of the hot deck and existing research on its statistical properties. We describe applications of the hot deck currently in use, including the U.S. Census Bureau's hot deck for the Current Population Survey (CPS). We also provide an extended example of variations of the hot deck applied to the third National Health and Nutrition Examination Survey (NHANES III). Some potential areas for future research are highlighted.
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BACKGROUND: Children who frequently move have poorer behavioural, emotional, and overall health. For similar reasons, the experience of changing home may contextualize children's risk for obesity. Few studies have assessed the relationship between residential mobility and obesity; even fewer explore this relationship with assessment of obesity before school age. METHODS: We analysed data from the Early Childhood Longitudinal Study-Birth Cohort. Obesity at kindergarten age was determined from measured height and weight. Early childhood residential mobility was categorized as not moving or having moved once, twice, or three or more times. Analyses are weighted to be representative of children from the United States and variance estimates account for the complex survey design. RESULTS: The prevalence of obesity at kindergarten age was 17.5%, and most children (71%) moved in early childhood. Compared with children who did not move, the adjusted odd ratios for obesity at kindergarten age were 0.72 (95% CI, 0.57-0.92), 0.70 (95% CI, 0.55-0.89), and 0.64 (95% CI, 0.50-0.84) for children who experienced 1, 2, or 3+ moves. CONCLUSIONS: Our study suggests that obesity and mobility in early life are associated, but not in the way we might expect. Residential mobility may fit into a broader picture of instability and, on its own, may not elevate a child's risk for obesity.
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Obesidade Infantil/epidemiologia , Dinâmica Populacional , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade Infantil/etiologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Distracted driving among teens is a public health and safety concern. Most states in the U.S. have sought to restrict cellphone use while driving by enacting laws. This study examines the difference in prevalence of self-reported calling while driving (CWD) between states with different cellphone bans. METHODS: Demographics and CWD data were extracted from state Youth Risk Behavior Surveys (YRBS) from 14 states in 2013, 2015, 2017, and 2019. The state YRBS is conducted every 2 years with a representative sample of 9th through 12th grade students attending public school. States were grouped by type of cellphone law(s): no ban (the absence of both handheld calling ban and young driver ban), young driver ban (a ban on all forms of cellphone use while driving, for young drivers only), or concurrent ban (a young driver ban plus a ban on handheld calling for all drivers irrespective of age). Poisson regression models with robust variance were used to estimate prevalence ratios comparing CWD prevalence across ban types. RESULTS: In total, 157,423 high school students participated in the surveys, and 65,044 (45%) participants reached the minimum age to obtain an intermediate license and drove during the 30 days prior the survey. Approximately 53% of participants reported CWD at least once during the previous 30 days, and the percentages varied widely by states (range: 51-55%). Compared to students from states with no ban, those from states with concurrent bans were 19%(95% CI: 14-24%) less likely to engage in CWD. Students in states with concurrent bans were 23% less likely to engage in CWD compared to students in states with young driver bans (95% CI:17-27%). CONCLUSIONS: Engaging in CWD is common among teen drivers. The concurrent implementation of a handheld calling ban and a young driver ban was associated with a lower prevalence of CWD.
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OBJECTIVE: People with multiple sclerosis (PwMS) report greater emotion dysregulation, which is associated with increased symptoms of depression and anxiety, and reduced quality of life. Given the transdiagnostic significance of emotion dysregulation, the current study was designed to assess the feasibility and treatment effects of mindfulness meditation in reducing emotion dysregulation for PwMS. METHOD: Sixty-one PwMS were randomized to 1 of 3 groups: 4-week mindfulness-based training (MBT), 4-week adaptive cognitive training (aCT), or a waitlist control group. Using self-report and behavioral measures, we examined the effects of MBT on emotion dysregulation, use of emotion regulation strategies, experience of negative and positive affect, and overall quality of life. RESULTS: Mindfulness training was associated with reduced emotion dysregulation compared with the adaptive cognitive training and the waitlist control group (ηp² = .20). Relative to the waitlist group, the MBT group also demonstrated reductions on a composite score of preservative cognition, measuring rumination and worry (ηp² = .15). However, there was no differential use of emotion regulation strategies or between-groups differences in overall quality of life as a function of training. CONCLUSIONS: Our pilot study provides preliminary support for MBT to reduce self-reported emotion dysregulation in PwMS. Given the widespread prevalence of mental health disturbances in this population, MBT can serve as a promising rehabilitation tool for PwMS (clinicaltrials.gov # NCT02717429). (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Regulação Emocional , Atenção Plena/métodos , Esclerose Múltipla/psicologia , Adulto , Ansiedade/psicologia , Cognição , Depressão/psicologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Projetos Piloto , Qualidade de Vida/psicologia , AutorrelatoRESUMO
BACKGROUND: The health impacts of caring for people with mental illness (MI) and developmental disabilities (DD) are not well understood. OBJECTIVE: The present study explored whether health outcomes differed between MI and DD caregivers, and if intensity and duration of care moderated health outcomes. METHODS: Nationally representative 2016 Behavioral Risk Factor Surveillance System survey data were used to explore how caring for people with MI (nâ¯=â¯1071) and DD (nâ¯=â¯888) impacted general health status and physical and mental health days, and whether intensity and duration of care moderated health outcomes. Logistic regression models and cumulative logistic regression models were used to model health outcomes. RESULTS: Caregivers had worse health (pâ¯=â¯0.0001) and more poor physical (pâ¯<â¯0.0001) and mental health days (pâ¯<â¯0.0001) than non-caregivers. Relative to DD caregivers, MI caregivers had worse health status (pâ¯=â¯0.02) and more poor physical (pâ¯=â¯0.02) and mental (pâ¯=â¯0.003) health days. As intensity of care increased, MI caregivers had more poor physical health days (pâ¯=â¯0.04) than DD caregivers and as duration of care increased, MI caregivers had worse health status (pâ¯=â¯0.03) than DD caregivers. CONCLUSIONS: Although the care provided to adults with DD was more intense and for a longer duration, MI caregivers had poorer health outcomes and were more impacted by intensity and duration of care. Implications for supporting MI and DD caregivers are discussed.
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Sistema de Vigilância de Fator de Risco Comportamental , Cuidadores/estatística & dados numéricos , Deficiências do Desenvolvimento/enfermagem , Nível de Saúde , Transtornos Mentais/enfermagem , Adolescente , Adulto , Idoso , Cuidadores/psicologia , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
How the measurement of aging biomarkers in peripheral blood T-lymphocytes (PBTLs) is influenced by cell composition is unclear. Here, we collected peripheral blood and isolated CD3+ PBTLs from 117 healthy couples between the ages of 21 and 72. Each sample was profiled for Horvath epigenetic clock (DNAm), p16INK4a expression, cytomegalovirus (CMV) seropositivity and 74 mRNA markers of PBTL subtype, differentiation, immune checkpoints, and cytokine production. Correlations between individual aging biomarkers (DNAm or p16INK4a) and PBTL mRNAs were corrected for chronological age, sex, and couple. DNAm measurements correlated with CMV seropositivity as well as PBTL mRNAs indicative of effector function (CD8A, EOMES, TBX21, GZMB), poor proliferative capacity (KLRG1, CD57), differentiation (CD45RO, CD45RA), and immune checkpoints (PDCD1, TIGIT, LAG3, CD160, CD244). In contrast, only three PBTL mRNAs, CD28, CD244, and p14ARF, showed a significant association with p16INK4a. p16INK4a expression also showed a weaker association with immunosenescent PBTL subsets than DNAm in flow cytometry analyses. These data suggest that PBTL composition has a greater influence on DNAm than p16INK4a and link accelerated epigenetic aging to immunosenescent phenotypes.