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1.
Autism ; 24(2): 387-399, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31364386

RESUMEN

Decreased engagement in beneficial physical activity and increased levels of sedentary behavior and unhealthy weight are a continued public health concern in adolescents. Adolescents with autism spectrum disorder may be at an increased risk compared with their typically developing peers. Weekly physical activity, sedentary behavior, and body mass index classification were compared among adolescents with and without autism spectrum disorder. Analyses included 33,865 adolescents (autism spectrum disorder, n = 1036) from the 2016-2017 National Survey of Children's Health (United States). After adjustment for covariates, adolescents with autism spectrum disorder were found to engage in less physical activity and were more likely to be overweight and obese compared with their typically developing peers (p's < 0.05). As parent-reported autism spectrum disorder severity increased, the adjusted odds of being overweight and obese significantly increased and physical activity participation decreased (p-for-trends < 0.001). The findings suggest there is a need for targeted programs to decrease unhealthy weight status and support physical activity opportunities for adolescents with autism spectrum disorder across the severity spectrum.

2.
Eur J Appl Physiol ; 119(10): 2255-2263, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31420736

RESUMEN

AIM: Exercise training with blood flow restriction (BFR) increases muscle size and strength. However, there is limited investigation into the effects of BFR on cardiovascular health, particularly central hemodynamic load. PURPOSE: To determine the effects of BFR exercise on central hemodynamic load (heart rate-HR, central pressures, arterial wave reflection, and aortic stiffness). METHODS: Fifteen males (age = 25 ± 2 years; BMI = 27 ± 2 kg/m2, handgrip max voluntary contraction-MVC = 50 ± 2 kg) underwent 5-min bouts (counter-balanced, 10 min rest between) of rhythmic unilateral handgrip (1 s squeeze, 2 s relax) performed with a moderate-load (60% MVC) with and without BFR (i.e., 71 ± 5% arterial inflow flow reduction, assessed via Doppler ultrasound), and also with a low-load (40% MVC) with BFR. Outcomes included HR, central mean arterial pressure (cMAP), arterial wave reflection (augmentation index, AIx; wave reflection magnitude, RM%), aortic arterial stiffness (pulse wave velocity, aPWV), and peripheral (vastus lateralis) microcirculatory response (tissue saturation index, TSI%). RESULTS: HR increased above baseline and time control for all handgrip bouts, but was similar between the moderate load with and without BFR conditions (moderate-load with BFR = + 9 ± 2; moderate-load without BFR = + 8 ± 2 bpm, p < 0.001). A similar finding was noted for central pressure (e.g., moderate load with BFR, cMAP = + 14 ± 1 mmHg, p < 0.001). No change occurred for RM% or AIx (p > 0.05) for any testing stage. TSI% increased during the moderate-load conditions (p = 0.01), and aPWV increased above baseline following moderate-load handgrip with BFR only (p = 0.012). CONCLUSIONS: Combined with BFR, moderate load handgrip training with BFR does not significantly augment central hemodynamic load during handgrip exercise in young healthy men.


Asunto(s)
Fuerza de la Mano , Frecuencia Cardíaca , Precondicionamiento Isquémico/métodos , Acondicionamiento Físico Humano/métodos , Rigidez Vascular , Adulto , Humanos , Masculino , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/fisiología , Consumo de Oxígeno , Distribución Aleatoria
3.
Child Obes ; 15(5): 323-330, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31062988

RESUMEN

Background: Adolescents with obesity are more likely to experience bullying in comparison to their healthy weight peers. However, it is unclear whether adolescents with obesity are more likely to perpetuate bullying or be both, a bully perpetrator and a bully victim. The purpose of this analysis was to examine differences in bully perpetration, victimization, and both (perpetration and victimization) by BMI classification in a nationally representative sample of adolescents. Methods: Analyses included 31,770 adolescents, ages 10-17, from the combined 2016-2017 National Survey of Children's Health. Adolescents were grouped by BMI classification; outcome variables included bullying, difficulty making new friends, excessive arguing, depression, and behavioral conduct problems. Logistic regression models, adjusted for age, sex, race, household income, highest level of education in the household, and attention-deficit/hyperactivity disorder assessed the odds of each outcome comparing healthy weight to adolescents with overweight and obesity. Results: Adolescents with overweight and obesity had greater odds of experiencing bullying behaviors: bully victim [odds ratio (OR) = 1.34 and 2.03] and both bully perpetrator and victim (OR = 1.37 and 2.01) (p's < 0.05), respectively, in comparison to healthy weight peers. Adolescents with overweight or obesity involved in bullying behaviors had significantly higher odds of behavioral conduct problems, depression, arguing excessively, and having difficulty making friends compared to adolescents with overweight or obesity who were neither a bully perpetrator nor victim (p's < 0.05). Conclusions: To promote overall health and well-being among adolescents with overweight and obesity, effort should be made to mitigate engagement in and/or victimization from bullying and associated behavioral or depressive symptoms.

4.
Am J Cardiol ; 123(2): 260-266, 2019 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-30409414

RESUMEN

Prolonged, uninterrupted sitting negatively impacts markers of peripheral vascular health, particularly, vasodilatory function of leg arteries. Whether sitting can similarly impact measures of central vascular health, as well as overall leg vasoreactivity (i.e., vasodilatory and vasoconstrictor function) remains unknown. To address this, measurements were made in relatively healthy participants (i.e., free of overt disease; n = 20, age = 26 ± 7; body mass index = 30 ± 7 kg/m2; 7 female) pre, during and post 3 hours of uninterrupted sitting. Measures of central vascular health included arterial wave reflection (augmentation index and Reflection Magnitude-RM%) and aortic vascular stiffness (aortic pulse wave velocity). Local vasoreactivity of the distal, posterior tibial artery was measured using flow-mediated dilation-FMD, coupled with low-flow mediated constriction, and microvascular function was assessed through the total hyperemic blood velocity (area-under-curve) response during FMD. After sitting, there was a significant increase in aortic pulse wave velocity (pre sit = 5.7 ± 0.3 vs post sit = 6.1 ± 0.3 m/s; p = 0.009, d = 0.36), whereas, augmentation index decreased (pre sit = 13 ± 3 vs post sit = 3 ± 1%; p < 0.001, d = 0.71). Albeit a moderate effect for decrease, RM% was not significantly altered during sitting (p = 0.13, d = 0.3). Vasodilatory (i.e., FMD pre sit = 0.5 ± 0.04 vs post sit = 0.3 ± 0.04 mm; p = 0.014, d = 0.29) and microvascular function (i.e., Microvascular area-under-curve: pre sit = 2,196 ± 333 vs 1,157±172 AU; p = 0.003, d = 0.31) decreased, but vasoconstrictor function (low-flow mediated constriction; p = 0.85, d = 0.005) was unaffected by sitting. In conclusion, these data demonstrate that a prolonged bout of uninterrupted sitting negatively impacts markers of peripheral and central vascular health in relatively healthy adults.


Asunto(s)
Sedestación , Adulto , Aorta/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Electrocardiografía , Femenino , Voluntarios Sanos , Frecuencia Cardíaca/fisiología , Humanos , Extremidad Inferior/anatomía & histología , Masculino , Microcirculación/fisiología , Análisis de la Onda del Pulso , Arterias Tibiales/diagnóstico por imagen , Arterias Tibiales/fisiología , Ultrasonografía Doppler Dúplex , Rigidez Vascular/fisiología , Vasodilatación/fisiología
5.
Artículo en Inglés | MEDLINE | ID: mdl-30496139

RESUMEN

Background Overweight and obesity in adolescence are associated with several negative health indicators; the association with flourishing, an indicator of overall well-being, is less clear. Objectives To examine associations between weight status and indicators of flourishing and academic engagement in adolescents. Subjects Analyses included 22,078 adolescents (10-17 years) from the 2016 National Survey of Children's Health. Methods Adolescents were grouped according to body mass index (BMI) classification; outcomes included indicators of flourishing and academic engagement. Logistic regression models assessed the odds of each outcome comparing adolescents with overweight and adolescents with obesity to healthy weight adolescents. Results For flourishing, adolescents with overweight and adolescents with obesity were less likely to stay calm during a challenge (17% and 30%, respectively; p < 0.01); adolescents with obesity were 30% less likely to finish a task they started (p < 0.001), and 34% less likely to show interest in new things (p < 0.001) in comparison to healthy weight peers. Adolescents with obesity were 26% less likely to care about doing well in school (p < 0.001), and adolescents with overweight and adolescents with obesity were significantly less likely to complete all required homework (19% and 34%, respectively) (p < 0.001), in comparison to healthy weight peers. Conclusions A comprehensive approach to addressing overweight and obesity in adolescence should target improving academic engagement and flourishing to promote overall well-being.

6.
Public Health Nurs ; 35(4): 353-359, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29566271

RESUMEN

OBJECTIVES: A community-academic team implemented a study involving collection of quantitative data using a computer-based audience response system (ARS) whereby community partners led data collection efforts. The team participated in a reflection exercise after the data collection to evaluate and identify best practices and lessons learned about the community partner-led process. DESIGN & SAMPLE: The methods involved a qualitative research consultant who facilitated the reflection exercise that consisted of two focus groups-one academic and one community research team members. The consultant then conducted content analysis. Nine members participated in the focus groups. RESULTS: The reflection identified the following themes: the positive aspects of the ARS; challenges to overcome; and recommendations for the future. CONCLUSION: The lessons learned here can help community-academic research partnerships identify the best circumstances in which to use ARS for data collection and practical steps to aid in its success.


Asunto(s)
Investigación Participativa Basada en la Comunidad/métodos , Recolección de Datos/métodos , Grupos Focales/métodos , Relaciones Comunidad-Institución , Procesamiento Automatizado de Datos/métodos , Ejercicio , Humanos , Investigación Cualitativa
7.
Eur J Appl Physiol ; 117(10): 2075-2083, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28821962

RESUMEN

Previous work has demonstrated a direct relationship between aerobic fitness and vasodilatory function (i.e., flow-mediated dilation; FMD); however, the relation between aerobic fitness and vasoconstrictor responsiveness (i.e., low flow-mediated constriction; L-FMC), and the overall vasoactive range (FMD + L-FMC) is unclear. PURPOSE: To test the hypothesis that L-FMC and the overall vasoactive range (FMD + L-FMC) will be related to aerobic fitness in young, healthy men. METHODS: Twenty men (age: 23 ± 5 years) were recruited, and divided evenly into a higher (HF) vs. lower (LF) aerobic fitness group, quantified via YMCA cycle ergometry (VO2 peak extrapolation), and a 3-min step test (1-min heart rate recovery). Duplex Doppler-ultrasound was used to assess brachial artery FMD and L-FMC. RESULTS: Estimated VO2 peak (HF = 55 ± 10 vs. LF = 38 ± 5 mL/kg/min) and heart rate recovery (HF = 36 ± 10 vs. LF = 25 ± 8 beats) were greater in the HF group (P < 0.05). FMD and the vasoactive range were similar between groups; however, L-FMC was significantly greater in HF (HF = -2.5 ± 1.6 vs. LF = -0.7 ± 1.8%, P < 0.05; d = 1.18). A correlational analysis revealed an inverse relationship between L-FMC and both HR recovery (r = -0.665, P < 0.01) and estimated VO2 peak (r = -0.5, P < 0.05). CONCLUSIONS: This work supports an association between L-FMC and aerobic fitness in young, healthy men. Longitudinal or interventional studies are warranted to support causality, and to distinguish whether L-FMC is more sensitive to changes in aerobic fitness than FMD.


Asunto(s)
Ejercicio/fisiología , Vasoconstricción , Adulto , Arteria Braquial/diagnóstico por imagen , Arteria Braquial/fisiología , Capacidad Cardiovascular , Humanos , Masculino , Consumo de Oxígeno
8.
Prog Community Health Partnersh ; 11(1): 81-86, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28603154

RESUMEN

BACKGROUND: Academic partners typically build community capacity for research, but few examples exist whereby community partners build community research capacity. This paper describes the benefits of communities sharing their "best practices" with each other for the purpose of building health research capacity. METHODS: In the context of a grant designed to engage African American communities to address health disparities (Faith Academic Initiatives Transforming Health [FAITH] in the Delta), leaders of two counties exchanged their "best practices" of creating faith-based networks and community health assessment tools to conduct a collective health assessment. LESSONS LEARNED: There were numerous strengths in engaging communities to build each other's capacity to conduct research. Communities identified with each other, perceived genuineness, conveyed legitimacy, and provided insider knowledge. CONCLUSIONS: Engaging communities to build each other's research capacity is a potentially valuable strategy.


Asunto(s)
Afroamericanos , Creación de Capacidad/organización & administración , Redes Comunitarias/organización & administración , Investigación Participativa Basada en la Comunidad , Relaciones Comunidad-Institución , Promoción de la Salud/organización & administración , Arkansas , Disparidades en el Estado de Salud , Humanos , Población Rural
9.
J Aging Health ; 29(2): 247-267, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26944808

RESUMEN

OBJECTIVE: To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity (MVPA) in older adults. METHOD: Inactive older adults ( N = 38, 68 ± 7 years old, 71% female) were randomized to 12-week interventions targeting decreased sedentary behavior ( Sit Less) or increased MVPA ( Get Active). The SenseWear armband was used to objectively assess activity in real time. Assessments included a blinded armband, the Community Health Activites Model Program for Senior (CHAMPS) questionnaire, 400-meter walk, and the Short Physical Performance Battery (SPPB). RESULTS: Objectively measured MVPA increased in Get Active (75 ± 22 min/week, p < .001); self-reported MVPA increased in both groups ( p < .05). Sedentary behavior did not change in either group (all p > .05). Only the Sit Less group improved the SPPB score (0.5 ± 0.3, p = .046). DISCUSSION: Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks. Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed.


Asunto(s)
Ejercicio , Promoción de la Salud , Conducta Sedentaria , Anciano , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios
10.
J Autism Dev Disord ; 46(7): 2317-26, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26936162

RESUMEN

Body mass index classification, physical activity (PA), and sedentary behaviors were compared in adolescents with autism spectrum disorder (ASD) to typically developing adolescents. Participants included 42,747 adolescents (ASD, n = 915) from the 2011-2012 National Survey of Children's Health. After controlling for covariates, adolescents were more likely to be overweight and obese, and less likely to engage in regular PA versus typically developing adolescents (p's < 0.05). Increased odds for overweight and obesity were attenuated after adjustment for PA. Higher autism severity was associated with increased odds of overweight and obesity and decreased odds of PA, sport, and club participation. These findings suggest adolescents with ASD are in need of targeted programs to decrease obesity and increase physical activity.


Asunto(s)
Trastorno del Espectro Autista/psicología , Ejercicio/fisiología , Obesidad/complicaciones , Conducta Sedentaria , Adolescente , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/fisiopatología , Niño , Estudios Transversales , Ejercicio/psicología , Femenino , Humanos , Masculino , Obesidad/fisiopatología , Obesidad/psicología
11.
Hypertens Res ; 39(6): 435-9, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26763854

RESUMEN

Arterial stiffness, often measured by carotid-femoral pulse wave velocity (cfPWV), is a subclinical marker of cardiovascular disease that is known to be reduced by exercise training. Exercise is also known to have acute vascular effects, yet it is unclear whether exercise 24 h before cfPWV testing influences this outcome. Thirty healthy, young adults completed a supervised, 30-min bout of moderate-to-vigorous intensity treadmill running. cfPWV, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured both before (after 48 h of abstaining from exercise) and 24 h after (with no additional exercise) the exercise session. From pre-exercise to 24 h post exercise, cfPWV decreased from 6.05±0.82 to 5.84±0.87 m s(-1) (P=0.02), SBP from 119.7±13.8 to 116.8±11.4 mm Hg (P=0.03) and DBP from 65.1±5.7 to 63.2±5.4 mm Hg (P=0.02), with no significant changes in HR. cfPWV was positively correlated with SBP pre-exercise (r=0.54, P<0.01) and post exercise (r=0.53, P<0.01). Changes in blood pressure explained 4-5% of the variability in cfPWV change; adjustments slightly attenuated the 24-h effects of exercise on cfPWV. Some evidence of gender differences was observed with higher cfPWV in males across assessments (P<0.05) and statistically significant reductions in cfPWV in males (-0.36±0.54 m s(-1) (P=0.02)) but not in females (-0.07±0.31 m s(-1) (P=0.41)). In conclusion, cfPWV decreased 24 h after an exercise bout, suggesting that exercise completed in the past 24 h should be considered before cfPWV testing.


Asunto(s)
Presión Sanguínea/fisiología , Ejercicio/fisiología , Frecuencia Cardíaca/fisiología , Análisis de la Onda del Pulso , Adolescente , Adulto , Monitoreo Ambulatorio de la Presión Arterial , Femenino , Humanos , Masculino , Factores Sexuales , Rigidez Vascular/fisiología , Adulto Joven
12.
J Public Health (Oxf) ; 38(3): 502-510, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-26359314

RESUMEN

BACKGROUND: Health assessments are used to prioritize community-level health concerns, but the role of individuals' health concerns and experiences is unknown. We sought to understand to what extent community health assessments reflect health concerns of the community-at-large versus a representation of the participants sampled. METHODS: We conducted a health assessment survey in 30 rural African American churches (n = 412). Multivariable logistic regression produced odds ratios examining associations between personal health concern (this health concern is important to me), personal health experience (I have been diagnosed with this health issue) and community health priorities (this health concern is important to the community) for 20 health issues. RESULTS: Respondents reported significant associations for 19/20 health conditions between personal health concern and the ranking of that concern as a community priority (all P < 0.05). Inconsistent associations were seen between personal health experience of a specific health condition and the ranking of that condition as a community priority. CONCLUSIONS: Personal health concerns reported by individuals in a study sample may impact prioritization of community health initiatives. Further research should examine how personal health concerns are formed.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Salud Pública , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Investigación Participativa Basada en la Comunidad , Femenino , Prioridades en Salud/estadística & datos numéricos , Estado de Salud , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Virginia
13.
Ann Surg Oncol ; 19(5): 1373-8, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22302268

RESUMEN

BACKGROUND: Isolated limb infusion (ILI) for the treatment of in-transit melanoma was originally described more than 10 years ago. Response rates of 45-53% have been reported in U.S. series. Long-term quality of life outcomes after this procedure have not been described. We hypothesized that ILI is rarely associated with long-term limb morbidity. METHODS: ILIs performed at our institution between July 2005 and June 2009 were reviewed. Patients were contacted cross-sectionally at 2 time points. During these interviews, response to treatment and postoperative limb function were assessed. RESULTS: Thirty-two ILIs were performed during the time period. Twenty-seven patients were treated for in-transit melanoma; 5 were treated for recurrent Merkel cell carcinoma. The 30-day mortality was 0%. Three patients (9%) required fasciotomy. Durable complete responses were achieved in 41% of patients, with mean follow-up time of 19.4 ± 9.6 months after infusion; after this period, 53% reported progression of disease. The most common postprocedure symptoms were edema (88%), numbness (59%), and pain (59%). By 3 months and at the time of last follow-up, the most common symptoms were edema (82%), numbness (65%), and stiffness (35%). No patients reported impaired limb function at the time of last follow-up compared to baseline. Median survival was 19.2 ± 4.2 months after infusion. CONCLUSIONS: ILI for melanoma and Merkel cell carcinoma is associated with postprocedure symptoms in most patients, most commonly edema, color change, and numbness. At last follow-up, no ILI patients had residual functional impairment in the treated limb.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Melanoma/tratamiento farmacológico , Melanoma/psicología , Recurrencia Local de Neoplasia/tratamiento farmacológico , Calidad de Vida , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/psicología , Anciano , Brazo , Carcinoma de Células de Merkel/tratamiento farmacológico , Carcinoma de Células de Merkel/psicología , Estudios Transversales , Dactinomicina/administración & dosificación , Edema/etiología , Edema/psicología , Femenino , Estudios de Seguimiento , Humanos , Hipoestesia/etiología , Hipoestesia/psicología , Infusiones Intravenosas , Pierna , Tiempo de Internación , Masculino , Melfalán/administración & dosificación , Recurrencia Local de Neoplasia/mortalidad , Recurrencia Local de Neoplasia/psicología , Tasa de Supervivencia
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