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1.
JMIR Pediatr Parent ; 2(2): e12549, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31518333

RESUMO

BACKGROUND: Almost 80% of adolescents do not achieve 60 minutes or more of physical activity each day as recommended by current US national guidelines. There is a need to develop and promote interventions that increase physical activity among adolescents. With increased interest in digital technologies among adolescents, robotic-assisted platforms are a novel and engaging strategy to deliver physical activity interventions. OBJECTIVE: This study sought to assess the potential acceptability of robotic-assisted exercise coaching among diverse youth and to explore demographic factors associated with acceptance. METHODS: This pilot study used a cross-sectional survey design. We recruited adolescents aged 12-17 years at three community-based sites in Rochester, MN. Written informed consent was obtained from participants' parents or guardians and participants gave consent. Participants watched a brief demonstration of the robotic system-human interface (ie, robotic human trainer). The exercise coaching was delivered in real time via an iPad tablet placed atop a mobile robotic wheel base and controlled remotely by the coach using an iOS device or computer. Following the demonstration, participants completed a 28-item survey that assessed sociodemographic information, smoking and depression history, weight, and exercise habits; the survey also included the eight-item Technology Acceptance Scale (TAS), a validated instrument used to assess perceived usefulness and ease of use of new technologies. RESULTS: A total of 190 adolescents participated in this study. Of the participants, 54.5% were (103/189) male, 42.6% (81/190) were racial minorities, 5.8% (11/190) were Hispanic, and 28.4% (54/190) lived in a lower-income community. Their mean age was 15.0 years (SD 2.0). A total of 24.7% (47/190) of participants met national recommendations for physical activity. Their mean body mass index (BMI) was 21.8 kg/m2 (SD 4.0). Of note, 18.4% (35/190) experienced depression now or in the past. The mean TAS total score was 32.8 (SD 7.8) out of a possible score of 40, indicating high potential receptivity to the technology. No significant associations were detected between TAS score and gender, age, racial minority status, participant neighborhood, BMI, meeting national recommendations for physical activity levels, or depression history (P>.05 for all). Of interest, 67.8% (129/190) of participants agreed that they and their friends were likely to use the robot to help them exercise. CONCLUSIONS: This preliminary study found that among a racially and socioeconomically diverse group of adolescents, robotic-assisted exercise coaching is likely acceptable. The finding that all demographic groups represented had similarly high receptivity to the robotic human exercise trainer is encouraging for ultimate considerations of intervention scalability and reach among diverse adolescent populations. Next steps will be to evaluate consumer preferences for robotic-assisted exercise coaching (eg, location, duration, supervised or structured, choice of exercise, and/or lifestyle activity focus), develop the treatment protocol, and evaluate feasibility and consumer uptake of the intervention among diverse youth.

2.
J Prim Care Community Health ; 10: 2150132719874252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509061

RESUMO

Objectives: This systematic review evaluated the accuracy of triaxial and omnidirectional accelerometers for measuring physical activity and sedentary behavior in children. Design: Systematic review of the literature. Methods: We comprehensively searched several databases for studies published from January 1996 through June 2018 that reported diagnostic accuracy measures in children and adolescents (age 3-18 years) and compared accelerometers with energy expenditure using indirect calorimetry. Results: We included 11 studies that enrolled 570 participants. All studies used indirect calorimetry as the reference standard. Across the studies, median sensitivity ranged from 46% to 96% and median specificity ranged from 71% to 96%. Median area under the curve ranged from 69% to 98%. Conclusions: Accuracy measures were greatest when detecting sedentary behavior and lowest when detecting light physical activity. Accuracy was higher when the accelerometer was placed on the hip compared with the wrist. The current evidence suggests that triaxial and omnidirectional accelerometers are accurate in measuring sedentary behavior and physical activity levels in children.

3.
IEEE J Biomed Health Inform ; 23(3): 1225-1233, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30004895

RESUMO

This article documents thermophysiological patterns associated with migraine episodes, where the inner canthi and supraorbital temperatures drop significantly compared to normal conditions. These temperature drops are likely due to vasoconstriction of the ophthalmic arteries under the inner canthi and sympathetic activation of the eccrine glands in the supraorbital region, respectively. The thermal patterns were observed on eight migraine patients and meticulously quantified using advance computational methods, capable of delineating small anatomical structures in thermal imagery and tracking them automatically over time. These methods open the way for monitoring migraine episodes in nonclinical environments, where the patient maintains directional attention, such as his/her computer at home or at work. This development has the potential to significantly expand the operational envelope of migraine studies.


Assuntos
Face/diagnóstico por imagem , Face/fisiologia , Interpretação de Imagem Assistida por Computador/métodos , Transtornos de Enxaqueca/diagnóstico por imagem , Termografia/métodos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
4.
JAMA ; 320(17): 1764-1773, 2018 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-30398602

RESUMO

Importance: There are few effective treatments for heart failure with preserved ejection fraction (HFpEF). Short-term administration of inorganic nitrite or nitrate preparations has been shown to enhance nitric oxide signaling, which may improve aerobic capacity in HFpEF. Objective: To determine the effect of 4 weeks' administration of inhaled, nebulized inorganic nitrite on exercise capacity in HFpEF. Design, Setting, and Participants: Multicenter, double-blind, placebo-controlled, 2-treatment, crossover trial of 105 patients with HFpEF. Participants were enrolled from July 22, 2016, to September 12, 2017, at 17 US sites, with final date of follow-up of January 2, 2018. Interventions: Inorganic nitrite or placebo administered via micronebulizer device. During each 6-week phase of the crossover study, participants received no study drug for 2 weeks (baseline/washout) followed by study drug (nitrite or placebo) at 46 mg 3 times a day for 1 week followed by 80 mg 3 times a day for 3 weeks. Main Outcomes and Measures: The primary end point was peak oxygen consumption (mL/kg/min). Secondary end points included daily activity levels assessed by accelerometry, health status as assessed by the Kansas City Cardiomyopathy Questionnaire (score range, 0-100, with higher scores reflecting better quality of life), functional class, cardiac filling pressures assessed by echocardiography, N-terminal fragment of the prohormone brain natriuretic peptide levels, other exercise indices, adverse events, and tolerability. Outcomes were assessed after treatment for 4 weeks. Results: Among 105 patients who were randomized (median age, 68 years; 56% women), 98 (93%) completed the trial. During the nitrite phase, there was no significant difference in mean peak oxygen consumption as compared with the placebo phase (13.5 vs 13.7 mL/kg/min; difference, -0.20 [95% CI, -0.56 to 0.16]; P = .27). There were no significant between-treatment phase differences in daily activity levels (5497 vs 5503 accelerometry units; difference, -15 [95% CI, -264 to 234]; P = .91), Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (62.6 vs 61.9; difference, 1.1 [95% CI, -1.4 to 3.5]; P = .39), functional class (2.5 vs 2.5; difference, 0.1 [95% CI, -0.1 to 0.2]; P = .43), echocardiographic E/e' ratio (16.4 vs 16.6; difference, 0.1 [95% CI, -1.2 to 1.3]; P = .93), or N-terminal fragment of the prohormone brain natriuretic peptide levels (520 vs 533 pg/mL; difference, 11 [95% CI, -53 to 75]; P = .74). Worsening heart failure occurred in 3 participants (2.9%) during the nitrite phase and 8 (7.6%) during the placebo phase. Conclusions and Relevance: Among patients with HFpEF, administration of inhaled inorganic nitrite for 4 weeks, compared with placebo, did not result in significant improvement in exercise capacity. Trial Registration: ClinicalTrials.gov Identifier: NCT02742129.


Assuntos
Tolerância ao Exercício/efeitos dos fármacos , Insuficiência Cardíaca/tratamento farmacológico , Nitritos/uso terapêutico , Administração por Inalação , Idoso , Estudos Cross-Over , Método Duplo-Cego , Teste de Esforço , Tolerância ao Exercício/fisiologia , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Compostos Inorgânicos/farmacologia , Compostos Inorgânicos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Nitritos/efeitos adversos , Nitritos/farmacologia , Consumo de Oxigênio , Volume Sistólico , Falha de Tratamento
5.
Lancet Public Health ; 3(11): e523-e535, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30322782

RESUMO

BACKGROUND: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time. METHODS: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants. FINDINGS: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon. INTERPRETATION: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity. FUNDING: Umeå University, the Västerbotten County Council, and the Mayo Clinic Foundation for Research.


Assuntos
Técnicas de Exercício e de Movimento/instrumentação , Obesidade/prevenção & controle , Saúde do Trabalhador , Sobrepeso/prevenção & controle , Caminhada/estatística & dados numéricos , Adulto , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Fatores de Tempo
6.
Int J Obes (Lond) ; 42(8): 1515-1523, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30026590

RESUMO

BACKGROUND: Estimating energy requirements forms an integral part of developing diet and activity interventions. Current estimates often rely on a product of physical activity level (PAL) and a resting metabolic rate (RMR) prediction. PAL estimates, however, typically depend on subjective self-reported activity or a clinician's best guess. Energy-requirement models that do not depend on an input of PAL may provide an attractive alternative. METHODS: Total daily energy expenditure (TEE) measured by doubly labeled water (DLW) and a metabolic chamber from 119 subjects obtained from a database of pre-intervention measurements measured at Pennington Biomedical Research Center were used to develop a metabolic ward and free-living models that predict energy requirements. Graded models, including different combinations of input variables consisting of age, height, weight, waist circumference, body composition, and the resting metabolic rate were developed. The newly developed models were validated and compared to three independent databases. RESULTS: Sixty-four different linear and nonlinear regression models were developed. The adjusted R2 for models predicting free-living energy requirements ranged from 0.65 with covariates of age, height, and weight to 0.74 in models that included body composition and RMR. Independent validation R2 between actual and predicted TEE varied greatly across studies and between genders with higher coefficients of determination, lower bias, slopes closer to 1, and intercepts closer to zero, associated with inclusion of body composition and RMR covariates. The models were programmed into a user-friendly web-based app available at: http://www.pbrc.edu/research-and-faculty/calculators/energy-requirements/ (Video Demo for Reviewers at: https://www.youtube.com/watch?v=5UKjJeQdODQ ) CONCLUSIONS: Energy-requirement equations that do not require knowledge of activity levels and include all available input variables can provide more accurate baseline estimates. The models are clinically accessible through the web-based application.


Assuntos
Metabolismo Basal/fisiologia , Composição Corporal/fisiologia , Necessidades Nutricionais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Água , Adulto Jovem
7.
Obesity (Silver Spring) ; 26(5): 862-868, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29604193

RESUMO

OBJECTIVE: Little is known about long-term metabolic (energy expenditure) adaptation after bariatric surgery. METHODS: Resting metabolic rate under basal conditions (RMR), total daily energy expenditure (TDEE), and body composition were measured in 25 participants in the Longitudinal Assessment of Bariatric Surgery-2. RESULTS: Six months after surgery, BMI (±SD) decreased (47 ± 6 kg/m2 to 37 ± 5 kg/m2 ), body fat went from 48% ± 6% to 40% ± 6% fat, and fat-free mass went from 67 ± 9 kg to 60 ± 9 kg. In absolute terms, RMR and TDEE both decreased significantly (1,730 ± 278 kcal/d vs. 1,430 ± 200 kcal/d and 2,879 ± 544 kcal/d vs. 2,369 ± 304 kcal/d), and the achieved energy balance was -1,293 ± 355 kcal/d. Sixteen of these participants underwent repeated measures at ∼24 months; TDEE decreased 6 months postoperatively (2,957 ± 540 kcal/d to 2,423 ± 324 kcal/d; P = 0.0003), but at ∼24 months, TDEE (2,602 ± 471 kcal/d) was not significantly different compared with month 6. The average negative energy balance from baseline to month 24 was -379 ± 131 kcal/d. CONCLUSIONS: RMR and TDEE fall precipitously in the first 6 months after bariatric surgery, but these adaptive changes were no longer significant after 2 years.


Assuntos
Adaptação Fisiológica/imunologia , Cirurgia Bariátrica/métodos , Metabolismo Basal/fisiologia , Composição Corporal/fisiologia , Metabolismo Energético/fisiologia , Adulto , Feminino , Humanos , Masculino , Período Pós-Operatório , Fatores de Tempo
8.
Am J Health Promot ; 32(2): 473-484, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29186984

RESUMO

PURPOSE: To evaluate a healthy eating and physical activity intervention for immigrant families, derived through community-based participatory research. DESIGN: The Healthy Immigrant Families study was a randomized controlled trial with delayed intervention control group, with families as the randomization unit. SETTING: US Midwest city. PARTICIPANTS: Participants were recruited by community partners from Hispanic, Somali, and Sudanese immigrant communities. INTERVENTION: Family health promoters from participating communities delivered 6 healthy eating modules, 4 physical activity modules, and 2 modules synthesizing information in 12 home visits (60-90 minutes) within the first 6 months. Up to 12 follow-up phone calls to each participant occurred within the second 6 months. MEASURES: Primary measures were dietary quality measured with weekday 24-hour recall and reported as Healthy Eating Index score (0-100) and physical activity measured with accelerometers (14 wear days) at baseline, 6, 12, and 24 months. RESULTS: In total, 151 persons (81 adolescents and 70 adults; 44 families) were randomly assigned. At 12 months, significant improvement occurred in Healthy Eating Index scores for adults in the intervention group compared with controls (change, +8.6 vs -4.4; P < .01) and persisted at 24 months (+7.4 from baseline; P < .01). No differences were observed for adolescents and no significant differences occurred between groups for physical activity. CONCLUSION: This intervention produced sustained dietary quality improvement among adults but not among adolescents. Program outcomes are relevant to communities working to decrease cardiovascular risk among immigrant populations.


Assuntos
/métodos , Emigrantes e Imigrantes/educação , Exercício , Saúde da Família , Educação em Saúde/organização & administração , Acelerometria , Adolescente , Adulto , Criança , Pesquisa Participativa Baseada na Comunidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estados Unidos
9.
Physiol Rep ; 5(16)2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28867675

RESUMO

Individuals with high plasma norepinephrine (NE) levels at rest have a smaller reduction in resting energy expenditure (REE) following ß-adrenergic blockade. If this finding extends to the response to a meal, it could have important implications for the role of the sympathetic nervous system in energy balance and weight gain. We hypothesized high muscle sympathetic nerve activity (MSNA) would be associated with a low sympathetically mediated component of energy expenditure following a meal. Fourteen young, healthy adults completed two visits randomized to continuous saline (control) or intravenous propranolol to achieve systemic ß-adrenergic blockade. Muscle sympathetic nerve activity and REE were measured (indirect calorimetry) followed by a liquid mixed meal (Ensure). Measures of energy expenditure continued every 30 min for 5 h after the meal and are reported as an area under the curve (AUC). Sympathetic support of energy expenditure was calculated as the difference between the AUC during saline and ß-blockade (AUCPropranolol-AUCSaline, ß-REE) and as a percent (%) of control (AUCPropranolol÷AUCSaline × 100). ß-REE was associated with baseline sympathetic activity, such that individuals with high resting MSNA (bursts/100 heart beats) and plasma NE had the greatest sympathetically mediated component of energy expenditure following a meal (MSNA: ß-REE R = -0.58, P = 0.03; %REE R = -0.56, P = 0.04; NE: ß-REE R = -0.55, P = 0.0535; %REE R = -0.54, P = 0.0552). Contrary to our hypothesis, high resting sympathetic activity is associated with a greater sympathetically mediated component of energy expenditure following a liquid meal. These findings may have implications for weight maintenance in individuals with varying resting sympathetic activity.


Assuntos
Metabolismo Energético , Período Pós-Prandial , Sistema Nervoso Simpático/metabolismo , Antagonistas Adrenérgicos beta/administração & dosagem , Adulto , Glicemia/metabolismo , Calorimetria Indireta , Epinefrina/sangue , Feminino , Humanos , Insulina/sangue , Masculino , Norepinefrina/sangue , Nervo Fibular/fisiologia , Propranolol/administração & dosagem , Sistema Nervoso Simpático/efeitos dos fármacos , Adulto Jovem
10.
Front Physiol ; 8: 318, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28572774

RESUMO

Introduction: Deskwork contributes substantially to sedentariness. Here, we evaluated an under-the-table apparatus that was designed to promote leg movement (fidgeting) while seated. Our hypothesis was that the under-the-table apparatus would increase energy expenditure. Methods: We measured energy expenditure and heart rate in 26 people while they sat and worked using a standard chair, walked on a treadmill, and sat and worked using an under-the-desk apparatus that encouraged leg movement. Results: Energy expenditure increased significantly while using the under-the-table apparatus when compared to the standard office chair (standard chair, 81 ± 18 kcal/h; under-the-table apparatus, 96 ± 23 kcal/h) (P < 0.001); representing an 18 ± 16% increase. The changes in energy expenditure were not as great as walking (1 mph, 168 ± 46 kcal/h, P < 0.001; 2 mph, 205 ± 51 kcal/, P < 0.001), representing 107 ± 37% and 155 ± 48% increases over baseline, respectively. Conclusions: An under-the-table apparatus that promotes leg movement can increase energy expenditure by approximately 20%. Dynamic sitting is promoted by this apparatus and may be among a lexicon of options to help people move more while seated at work.

11.
Circ Heart Fail ; 10(6): e003878, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28588021

RESUMO

BACKGROUND: Daily physical activity assessed by accelerometers represents a novel method to assess the impact of interventions on heart failure (HF) patients' functional status. We hypothesized that daily activity varies by patient characteristics and correlates with established measures of HF severity in HF with preserved ejection fraction. METHODS AND RESULTS: In this ancillary study of the NEAT-HFpEF trial (Nitrate's Effects on Activity Tolerance in HF With Preserved Ejection Fraction), average daily accelerometer units (ADAU) and hours active per day were assessed during a 14-day period before starting isosorbide mononitrate or placebo (n=110). Baseline ADAU was negatively associated with age, female sex, height, and body mass index, and these variables accounted for 28% of the variability in ADAU (P<0.007 for all). Adjusting for these factors, patients with lower ADAU were more likely to have had an HF hospitalization, orthopnea, diabetes mellitus and anemia, be treated with ß-blockers, have higher ejection fraction, relative wall thickness and left atrial volume, and worse New York Heart Association class, HF-specific quality of life scores, 6-minute walk distance, and NT-proBNP (N-terminal pro-B-type natriuretic peptide; P<0.05 for all). Associations between hours active per day and clinical characteristics were similar. Relative to baseline, there were no significant associations between changes in ADAU or hours active per day and changes in standard functional assessments (New York Heart Association, quality of life, 6-minute walk distance, and NT-proBNP) with isosorbide mononitrate. CONCLUSIONS: Daily activity is a measure of HF-related and global functional status in HF with preserved ejection fraction. As compared with intermittently assessed standard HF assessments, change in daily activity may provide unique information about the impact of HF interventions on functional status. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02053493.


Assuntos
Acelerometria/métodos , Atividades Cotidianas , Insuficiência Cardíaca/fisiopatologia , Atividade Motora/fisiologia , Qualidade de Vida , Volume Sistólico/fisiologia , Idoso , Estudos Cross-Over , Método Duplo-Cego , Teste de Esforço/métodos , Feminino , Seguimentos , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Índice de Gravidade de Doença
12.
Obesity (Silver Spring) ; 25(6): 985-986, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28544793
13.
Horm Metab Res ; 49(1): 30-35, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27410533

RESUMO

Some studies indicate that basal metabolic rate is greater in winter than in the summer, suggesting a role for brown fat in human thermogenesis. We examined whether there are clinically meaningful differences in basal metabolic rate under thermoneutral conditions between winter and summer months in inhabitants of Rochester, Minnesota. We collated data from 220 research volunteers studied in the winter (December 1 - February 28) and 214 volunteers studied in the summer (June 1 - August 31), 1995-2012. Basal metabolic rate was measured by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. The effect of season on basal metabolic rate was tested using multivariate regression analysis with basal metabolic rate as the dependent variable and fat-free mass, fat mass, age, sex, and season as the independent variables. The groups were comparable with respect to age, body mass index, fat mass, and fat-free mass. There was no significant difference in basal metabolic rate between winter and summer groups (1 667±322 vs. 1 669±330 kcal/day). Both winter and summer basal metabolic rates were strongly predicted by fat-free mass (Pearson's r=0.75 and r=0.77, respectively, p <0.0001). Using multiple linear regression analysis, basal metabolic rate was significantly, independently predicted by fat-free mass, fat mass, age, and sex, but not season. We conclude that the lack of seasonal variation of thermoneutral basal metabolic rate between winter and summer suggests that modern, Western populations do not engage thermogenically detectable brown fat activity during periods of living in a cold climate.


Assuntos
Metabolismo Basal , Adulto , Composição Corporal , Índice de Massa Corporal , Estudos Transversais , Metabolismo Energético , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estações do Ano , Adulto Jovem
14.
Nicotine Tob Res ; 19(1): 77-86, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27613946

RESUMO

INTRODUCTION: Few studies have evaluated exercise interventions for smokers with depression or other psychiatric comorbidities. This pilot study evaluated the potential role of supervised vigorous exercise as a smoking cessation intervention for depressed females. METHODS: Thirty adult women with moderate-severe depressive symptoms were enrolled and randomly assigned to 12 weeks of thrice weekly, in person sessions of vigorous intensity supervised exercise at a YMCA setting (EX; n = 15) or health education (HE; n = 15). All participants received behavioral smoking cessation counseling and nicotine patch therapy. Assessments were done in person at baseline, at the end of 12 weeks of treatment, and at 6 months post-target quit date. Primary end points were exercise adherence (proportion of 36 sessions attended) and biochemically confirmed 7-day point prevalence abstinence at Week 12. Biomarkers of inflammation were explored for differences between treatment groups and between women who smoked and those abstinent at Week 12. RESULTS: Treatment adherence was high for both groups (72% for EX and 66% for HE; p = .55). The Week 12 smoking abstinence rate was higher for EX than HE (11/15 [73%] vs. 5/15 [33%]; p = .028), but no significant differences emerged at 6-month follow-up. Interleukin-6 levels increased more for those smoking than women abstinent at Week 12 (p = .040). CONCLUSIONS: Vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. Innovative and cost-effective strategies to bolster long-term exercise adherence and smoking cessation need evaluation in this population. Inflammatory biomarkers could be examined in future research as mediators of treatment efficacy. IMPLICATIONS: This preliminary study found that vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. This research addressed an important gap in the field. Despite decades of research examining exercise interventions for smoking cessation, few studies were done among depressed smokers or those with comorbid psychiatric disorders. A novel finding was increases in levels of a pro-inflammatory biomarker observed among women who smoked at the end of the intervention compared to those who did not.


Assuntos
Depressão/psicologia , Terapia por Exercício/métodos , Abandono do Hábito de Fumar/métodos , Fumar/psicologia , Tabagismo/reabilitação , Adolescente , Adulto , Terapia Combinada , Análise Custo-Benefício , Aconselhamento , Diagnóstico Duplo (Psiquiatria) , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Projetos Piloto , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar , Dispositivos para o Abandono do Uso de Tabaco , Tabagismo/psicologia , Resultado do Tratamento , Adulto Jovem
15.
BMJ Open Sport Exerc Med ; 2(1): e000152, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27900194

RESUMO

INTRODUCTION: Sedentariness is associated with chronic health conditions, impaired cognitive function and obesity. Work contributes significantly to sedentariness because many work tasks necessitate sitting. Few sustained solutions exist to reverse workplace sedentariness. Here, we evaluated a chair and an under-table device that were designed to promote fidgeting while seated. Our hypothesis was that an under-table leg-fidget bar and/or a fidget-promoting chair significantly increased energy expenditure. We compared these devices with chair-based exercise and walking. MATERIALS AND METHODS: We measured energy expenditure and heart rate in 16 people while they sat and worked using a standard chair, an under-desk device that encourages leg fidgeting and a fidget-promoting chair. We compared outcomes with chair-based exercise and walking. RESULTS: Energy expenditure increased significantly while using either an under-table leg-fidget bar or a fidget-promoting chair, when compared to the standard office chair (standard chair, 76±31 kcal/hour; leg-fidget bar, 98±42 kcal/hour (p<0.001); fidget chair, 89±40 kcal/hour (p=0.03)). However, heart rate did not increase significantly in either case. Bouts of exercise performed while seated provided energetic and heart rate equivalency to walking at 2 mph. CONCLUSIONS: Chairs and devices that promote fidgeting can increase energy expenditure by ∼20-30% but not increase heart rate. Dynamic sitting may be among a lexicon of options to help people move more while at work.

17.
Technol Invest ; 7(3): 59-65, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27617162

RESUMO

The Wearable Technology market may increase fivefold by the end of the decade. There is almost no academic investigation as to what drives the investment hypothesis in wearable technologies. This paper seeks to examine this issue from an evidence-based perspective. There is a fundamental disconnect in how consumers view wearable sensors and how companies market them; this is called The Baetylus Theorem where people believe (falsely) that by buying a wearable sensor they will receive health benefit; data suggest that this is not the case. This idea is grounded social constructs, psychological theories and marketing approaches. A marketing proposal that fails to recognize The Baetylus Theorem and how it can be integrated into a business offering has not optimized its competitive advantage. More importantly, consumers should not falsely believe that purchasing a wearable technology, improves health.

18.
J Child Sex Abus ; 25(7): 719-737, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27585834

RESUMO

The population of potential child abuse offenders has largely been unstudied. In the current study, we examine whether a six-component model used for primary diabetes prevention could be adapted to child sexual abuse pre-offenders, whereby individuals who are prone to sexual abuse but have not yet committed an offense can be prevented from committing a first offense. The six components include: define and track the magnitude of the problem, delineate a well-established risk factor profile so that at-risk persons can be identified, define valid screening tests to correctly rule in those with the disease and rule out those without disease, test effectiveness of interventions-the Dunkelfeld Project is an example, produce and disseminate reliable outcome data so that widespread application can be justified, and establish a system for continuous improvement. By using the diabetes primary prevention model as a model, the number of victims of child sexual abuse might be diminished.


Assuntos
Abuso Sexual na Infância/prevenção & controle , Criminosos/psicologia , Criança , Humanos , Fatores de Risco
19.
Artigo em Inglês | MEDLINE | ID: mdl-28529823

RESUMO

Mainstream American culture frequently minimizes the prevalence and significance of sexual abuse. Unfortunately, this denial of extensive victimization of women is also present in many underserved populations. In June 2007, Amnesty International released its report on sexual abuse in indigenous women, which states that, "One in three Native American or Alaska Native women will be raped at some point in their lives. Most do not seek justice because they know they will be met with inaction or indifference." This report highlighted an infrequently discussed issue namely, very high levels of sexual abuse in Native American and Alaska Native women. The relationship between sexual abuse and obesity has been delineated in several studies; overall about one quarter to one half of women with high levels of obesity have been sexually abused and it has been postulated that weight-gain serves as an adaptive response for many survivors of sexual abuse. It is also well known in Native American and Alaskan Native women that there is a high prevalence of obesity (about 40% greater than the population average) and that this obesity is associated with a many-fold greater risk of diabetes and increased risks of hypertension, cancer and cardiovascular disease. The link between the concomitantly high rates of sexual abuse and obesity in this population may or may not be partial causality but the issue is nonetheless important. If approaches are to succeed in reversing the trend of increasing levels of obesity in Native American and Alaskan Native women, the high prevalence of sexual abuse will need to be specifically and comprehensively addressed.

20.
J Child Obes ; 1(2)2016.
Artigo em Inglês | MEDLINE | ID: mdl-28936491

RESUMO

BACKGROUND: This study examined the impact of short activity breaks in preschool children. The hypotheses were that preschool children receiving three five-minute activity breaks per day would increase (a) school time physical activity and (b) education scores compared to a control group not receiving the intervention. METHODS: For 8 weeks, the Intervention Group (n = 13) incorporated three 5-minute activity breaks into their classroom time while the Control Group (n = 12) did not incorporate the activity breaks. Physical activity was measured using a triaxial accelerometer. Education was assessed using standardized methods. FINDINGS: After 8 weeks, the preschool children in the Intervention Group increased their school time physical activity from 11,641 ± (SD) 1,368 Acceleration Units (AU)/ hour to 16,058 ± 2,253 AU/hour (P < 0.001). The children in the control group did not increase their physical activity (11,379 ± 2,427 cf 11,624 ± 2,441; ns). Students in the Intervention Group improved their education scores more than students in the control group (18 ± 12 cf 8 ± 7 points, P = 0.01); Letter Recognition improved in particular (9 ± 6 cf 2 ± 4 points, P = 0.001). CONCLUSIONS: The incorporation of three 5-minute activity breaks was associated with increased school time physical activity and improved learning.

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