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Aertssen W, van de Kamp A, Jelsma LD, Smits-Engelsman B. Reliability and validity of the modified shuttle test-paeds to measure cardiorespiratory fitness in children. BMC Pediatr 2024; 24:343. [PMID: 38760698 PMCID: PMC11100059 DOI: 10.1186/s12887-024-04812-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The Modified Shuttle Test-Paeds (Paeds), a recently developed 10-meter Shuttle run test for aerobic capacity in children. This study aims to investigate the construct validity (known-group and convergent validity) and test-retest reliability of the recently developed test for cardiorespiratory fitness, the Modified Shuttle Test-Paeds (Paeds). METHODS A total of 144 participants (6-12 y) were tested on the Paeds test, and 84 children were tested on the 20-meter Shuttle Run test (20 m-SRT) to assess construct validity. To evaluate test-retest reliability, 46 children were tested twice on the Paeds. RESULTS No sex differences were found, but there was an age effect. A strong correlation was found between Paeds and the 20 m-SRT (rs=0.78, p < 0.001). The test-retest reliability was good (ICC 0.84; 95% CI 0.74-0.91). CONCLUSION Paeds appears to be a reliable and valid tool for estimating cardiorespiratory fitness in typically developing children aged 6-12 years and has the advantages of being shorter, needing less space, not requiring pacing and being self-motivational. More studies are needed to assess whether children reach an aerobic steady state in three minutes and how much of the results of the Paeds test can be explained by the agility component of the task (turning and grasping or aiming a bean bag). For clinical use, psychometric properties should be studied in various patient groups (e.g., ADHD, DCD, and children with intellectual disabilities).
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Affiliation(s)
- Wfm Aertssen
- University for Professionals, Breda, The Netherlands.
| | - A van de Kamp
- University for Professionals, Breda, The Netherlands
| | - L D Jelsma
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Bcm Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University, Cape Town, South Africa
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom, South Africa
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McBride KA, O'Fee A, Hogan S, Stewart E, Madeley C, Wilkes J, Wylie E, White A, Hickey M, Stone J. Co-design of an intervention to optimize mammographic screening participation in women with obesity and/or physical disabilities. Radiography (Lond) 2024; 30:951-963. [PMID: 38657389 DOI: 10.1016/j.radi.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Mammographic breast screening/rescreening rates are suboptimal for women with obesity and/or physical disabilities. This study describes development of an intervention framework targeting obesity- and disability-related barriers to improve participation. METHODS Mixed methods combined a systematic review with first-person perspectives to optimise screening engagement among women with obesity and/or physical disabilities. Phase 1 (systematic review) was conducted following the PRISMA framework. Phase 2 involved in-depth interviews with n = 8 women with lived experience of obesity and/or physical disabilities. An inductive coding approach was applied to the data which was then combined with Phase 1 results to develop the intervention framework. RESULTS Six studies were included in the systematic review. Tailored education based on individual risk increased willingness to undergo mammographic screening. Recommendations to improve the screening experience included partnerships with consumers, targeted messaging, and enhanced professional development for breast screening staff. Participants also identified strategies to improve the uptake of screening and the experience itself. CONCLUSION Development and evaluation of interventions informed by frameworks like the one developed in this study are needed to improve engagement in screening to promote regular participation among women with physical disabilities and/or obesity. IMPLICATIONS FOR PRACTICE Successful implementation of practice interventions co-designed by women with obesity and/or physical disabilities are likely to improve their breast screening participation. Enhanced training of radiographers aimed at upskilling in empathetic communication around required manoeuvring and potentially longer screening times for clients with obesity and/or physical disabilities may encourage more positive client practitioner interactions. Client information aimed at women with obesity should include information on how to prepare for the appointment and explain there may be equipment limitations compromising imaging which may not be completed at an initial appointment.
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Affiliation(s)
- K A McBride
- School of Medicine, Western Sydney University, Penrith, NSW, Australia; Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - A O'Fee
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - S Hogan
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - E Stewart
- BreastScreen Victoria, Melbourne, VIC, Australia
| | - C Madeley
- BreastScreen Western Australia, Perth, WA, Australia; Women and Newborn Health Service, King Edward Hospital, Perth, WA, Australia
| | - J Wilkes
- BreastScreen Western Australia, Perth, WA, Australia; Women and Newborn Health Service, King Edward Hospital, Perth, WA, Australia
| | - E Wylie
- BreastScreen Western Australia, Perth, WA, Australia; Women and Newborn Health Service, King Edward Hospital, Perth, WA, Australia; Medical School, University of Western Australia, Perth, WA, Australia
| | - A White
- Australian Breast Density Consumer Advisory Council, Australia
| | - M Hickey
- University of Melbourne Department of Obstetrics and Gynaecology and the Royal Women's Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - J Stone
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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Gulyas BZ, Caton SJ, Edmondson JL. Quantifying the relationship between gardening and health and well-being in the UK: a survey during the covid-19 pandemic. BMC Public Health 2024; 24:810. [PMID: 38486178 PMCID: PMC10941614 DOI: 10.1186/s12889-024-18249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Rates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F&V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited. METHODS We quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants' involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables. RESULTS After adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F&V consumption. Higher F&V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F&V consumption. CONCLUSIONS Our results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.
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Affiliation(s)
- Boglarka Z Gulyas
- Plants, Photosynthesis and Soil, School of Biosciences, University of Sheffield, S10 2TN, Sheffield, UK
- Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, S10 2TN, Sheffield, UK
| | - Samantha J Caton
- Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, S10 2TN, Sheffield, UK
| | - Jill L Edmondson
- Plants, Photosynthesis and Soil, School of Biosciences, University of Sheffield, S10 2TN, Sheffield, UK.
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Miller S. Shifting sands. Br J Gen Pract 2024; 74:36. [PMID: 38154927 PMCID: PMC10755976 DOI: 10.3399/bjgp24x736077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
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Blake MK, Ma R, Cardenas EV, Varanloo P, Agosto Y, Velasquez C, Espina KA, Palenzuela J, Messiah SE, Natale RA. Infant Nutrition and Other Early Life Risk Factors for Childhood Obesity According to Disability Status. Nutrients 2023; 15:4394. [PMID: 37892469 PMCID: PMC10609807 DOI: 10.3390/nu15204394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
One in five preschool-aged children in the United States is obese, and children with disabilities are significantly impacted. This study aimed to determine the association between age at solid food initiation and obesity prevalence in preschool-aged children while considering disability status, ethnicity, gestational age, and birth weight. Analysis was conducted on a sample of 145 children aged 2 to 5 years who were enrolled in ten childcare centers. Parents completed a survey assessing disability status, race and ethnicity, birth weight, gestational age, and age of solid food initiation. Height and weight were collected concurrently. Multivariable logistic regression models generated the odds of developing obesity based on age at solid food initiation, disability status, ethnicity, gestational age, and birth weight. There was no significant difference in the odds of being obese based on age at solid food introduction. Children with disabilities (OR = 0.17, 95% CI 0.04-0.6, p = 0.01) and children born preterm (OR = 0.28, 95% CI 0.08-0.79, p = 0.03) had significantly lower odds of being obese. Hispanic children (OR = 4.93, 95% CI 1.91-15.32, p = 0.002) and children with higher birth weights (OR = 1.47, 95% CI 1.17-1.92, p = 0.002) were more likely to be obese. With pediatric obesity rates continuing to rise, these findings can inform future intervention efforts.
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Affiliation(s)
- Melissa K. Blake
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Ruixuan Ma
- Division of Biostatistics, Department of Public Health Science, University of Miami School of Medicine, 1120 N.W. 14th Street, Miami, FL 33136, USA;
| | - Erika Viana Cardenas
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Parisa Varanloo
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Yaray Agosto
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Carolina Velasquez
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Katheryn A. Espina
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Joanne Palenzuela
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
| | - Sarah E. Messiah
- University of Texas Health Science Center at Houston School of Public Health, 2777 North Stemmons Freeway, Suite 8400, Dallas, TX 75207, USA;
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, 2777 North Stemmons Freeway, Suite 8400, Dallas, TX 75207, USA
| | - Ruby A. Natale
- Department of Pediatrics, University of Miami School of Medicine, Mailman Center for Child Development, 1601 NW 12th Ave, Miami, FL 33136, USA; (E.V.C.); (P.V.); (Y.A.); (C.V.); (K.A.E.); (J.P.); (R.A.N.)
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Lu H, Wang Y, Liu Y, Holt JB, Okoro CA, Zhang X, Zhang QC, Greenlund KJ. County-Level Geographic Disparities in Disabilities Among US Adults, 2018. Prev Chronic Dis 2023; 20:E37. [PMID: 37167553 DOI: 10.5888/pcd20.230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Local data are increasingly needed for public health practice. County-level data on disabilities can be a valuable complement to existing estimates of disabilities. The objective of this study was to describe the county-level prevalence of disabilities among US adults and identify geographic clusters of counties with a higher or lower prevalence of disabilities. METHODS We applied a multilevel logistic regression and poststratification approach to geocoded 2018 Behavioral Risk Factor Surveillance System data, Census 2018 county-level population estimates, and American Community Survey 2014-2018 poverty estimates to generate county-level estimates for 6 functional disabilities and any disability type. We used cluster-outlier spatial statistical methods to identify clustered counties. RESULTS Among 3,142 counties, median estimated prevalence was 29.5% for any disability and differed by type: hearing (8.0%), vision (4.9%), cognition (11.5%), mobility (14.9%), self-care (3.7%), and independent living (7.2%). The spatial autocorrelation statistic, Moran's I, was 0.70 for any disability and 0.60 or greater for all 6 types of disability, indicating that disabilities were highly clustered at the county level. We observed similar spatial cluster patterns in all disability types except hearing disability. CONCLUSION The results suggest substantial differences in disability prevalence across US counties. These data, heretofore unavailable from a health survey, may help with planning programs at the county level to improve the quality of life for people with disabilities.
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Affiliation(s)
- Hua Lu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-6, Atlanta, GA 30341
| | - Yan Wang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James B Holt
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Catherine A Okoro
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xingyou Zhang
- Office of Compensation and Working Conditions, US Bureau of Labor Statistics, Washington, District of Columbia
| | - Qing C Zhang
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ahmad K, Keramat SA, Sathi NJ, Kabir E, Khanam R. Association of infant and child health characteristics with the hazard of any medical condition or disability in Australian children. Arch Public Health 2022; 80:158. [PMID: 35733191 PMCID: PMC9219216 DOI: 10.1186/s13690-022-00913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background The incidence of any medical condition (e.g., sight, hearing, and speech problems, blackouts, chronic pain etc.) or disability (e.g., limited use of arms or fingers, legs, and feet, or other physical long-term health condition limiting everyday activities etc.) have been increasing among Australian children in recent decades. Objectives This study assessed whether infant or child health characteristics might be predictors of subsequent medical conditions or disabilities in children in the first 15 years of life. Methods Using time to event data of 5107 children, obtained from the Birth cohort of the Longitudinal Study of Australian Children, the study estimated the incidence of any medical condition or disability using the survival analysis technique. This study followed up the children from birth to 14 or 15 years of age (2004–2018) and assessed the association of infant and child health characteristics (birthweight, gestational age, use of intensive care unit or ventilator during their neonatal age and obesity) with hazard of any medical condition or disability using the random effect parametric survival regression model. The infant characteristics were measured in the Wave 1 while the children were aged 0/1 year and obesity characteristics were measured longitudinally over all the waves up to 14/15 years of age. Results The hazard rate of any medical condition or disability for all participants was 26.13 per 1000 person-years among children in Australia. This hazard incidence rate was higher among low birthweight (39.07) children compared to the children of normal birthweight (24.89) children. The hazard rate also higher among obese (34.37) children compared to the normal weight children (24.82) and among those who had received after-birth ventilation or intensive care unit emergency services (36.87) compared to those who have not received these services (24.20). The parametric panel regression model also suggests that children with low birthweight were 1.43 times (Hazard Ratio: 1.43, 95% Confidence Interval: 1.05–1.94) more likely to have any medical condition or disability than children with normal birthweight. The time to event analyses also revealed that being recipient of after-birth emergencies (HR: 1.47, 95% CI: 1.23–1.75), being male children (HR: 1.30, 95% CI: 1.14–1.48) or being obese (HR: 1.38, 95% CI: 1.07–1.79) significantly increased the likelihood of the incidence of a medical condition or disability among children. The regression model was adjusted for socio-demographic characteristics of children and mothers.. Conclusions The study findings suggest that infants with low birth weight, hospital emergency service use and children with obesity would benefit from additional health care monitoring to minimize the risk of any medical condition or disability.
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Abstract
Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Already during childhood, almost all organs are at risk of being affected by obesity. In this review, we present the current knowledge about diseases associated with childhood obesity and how they are affected by weight loss. One major causative factor is obesity-induced low-grade chronic inflammation, which can be observed already in preschool children. This inflammation-together with endocrine, paracrine, and metabolic effects of obesity-increases the long-term risk for several severe diseases. Type 2 diabetes is increasingly prevalent in adolescents and young adults who have had obesity during childhood. When it is diagnosed in young individuals, the morbidity and mortality rate is higher than when it occurs later in life, and more dangerous than type 1 diabetes. Childhood obesity also increases the risk for several autoimmune diseases such as multiple sclerosis, Crohn's disease, arthritis, and type 1 diabetes and it is well established that childhood obesity also increases the risk for cardiovascular disease. Consequently, childhood obesity increases the risk for premature mortality, and the mortality rate is three times higher already before 30 years of age compared with the normal population. The risks associated with childhood obesity are modified by weight loss. However, the risk reduction is affected by the age at which weight loss occurs. In general, early weight loss-that is, before puberty-is more beneficial, but there are marked disease-specific differences.
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Affiliation(s)
- Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Sauchelli S, Brunstrom JM. Virtual reality exergaming improves affect during physical activity and reduces subsequent food consumption in inactive adults. Appetite 2022; 175:106058. [PMID: 35460807 DOI: 10.1016/j.appet.2022.106058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 11/02/2022]
Abstract
An individual's affective (i.e. emotional) response to exercise may play an important role in post-exercise eating behaviour for some individuals. Taking advantage of advances in fully immersive virtual reality (VR) technology, this study aimed to: a) examine whether VR exergaming can improve the psychological response to exercise in inactive adults, and b) assess the extent to which this improvement reduces post-exercise appetite and eating behaviour. In a cross-over study, 34 adults not meeting the World Health Organisation's physical activity recommendations completed two exercise sessions on a stationary bike; one while engaging in a VR exergame and one without VR. Monitoring enabled heart rate, energy expenditure, and duration across conditions to be closely matched. The Physical Activity Enjoyment Scale, Feeling Scale, Felt Arousal Scale and Borg's Ratings of Perceived Exertion were measured to capture the affective responses to exercise. Appetite and eating behaviour were evaluated using visual-analogue scales, a computerised food preference task, and intake at a post-exercise buffet meal. Cycling in VR elicited greater exercise enjoyment (p < 0.001, η2p = 0.62), pleasure (p < 0.001, η2p = 0.47), and activation (p < 0.001, η2p = 0.55). VR exergaming did not alter perceived physical exertion (p = 0.64), perceived appetite (p = 0.68), and preference for energy dense (p = 0.78) or sweet/savoury foods (p = 0.90) compared to standard exercise. However, it did result in a mean 12% reduction in post-exercise food intake (mean difference: 105.9 kcal; p < 0.01; η2p = 0.20) and a decrease in relative food intake (p < 0.01; η2p = 0.20), although inter-individual differences in response to VR exergaming were observed. The integration of VR in a cycling workout improves the affective experience of physical activity for inactive adults and reduces subsequent food intake. Virtual reality technology shows potential as an adjunct tool to support adults in weight management programmes become more active, especially for those individuals who are prone to eat in excess after physical activity.
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Affiliation(s)
- Sarah Sauchelli
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom.
| | - Jeffrey M Brunstrom
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom; Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, United Kingdom
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Individual Patterns and Temporal Trajectories of Changes in Fear and Pain during Exposure In Vivo: A Multiple Single-Case Experimental Design in Patients with Chronic Pain. J Clin Med 2022; 11:jcm11051360. [PMID: 35268453 PMCID: PMC8911417 DOI: 10.3390/jcm11051360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023] Open
Abstract
Exposure in vivo (EXP) is an effective treatment to reduce pain-related fear and disability in chronic pain populations. Yet, it remains unclear how reductions in fear and pain relate to each other. This single-case experimental design study attempted to identify patterns in the individual responses to EXP and to unravel temporal trajectories of fear and pain. Daily diaries were completed before, during and after EXP. Multilevel modelling analyses were performed to evaluate the overall effect. Temporal effects were scrutinized by individual regression analyses and determination of the time to reach a minimal clinically important difference. Furthermore, individual graphs were visually inspected for potential patterns. Twenty patients with chronic low back pain and complex regional pain syndrome type I were included. On a group level, both fear and pain were reduced following EXP. Individually, fear was significantly reduced in 65% of the patients, while pain in only 20%. A decrease in fear was seen mostly in the first weeks, while pain levels reduced later or remained unchanged. Daily measurements provided rich data on temporal trajectories of reductions in fear and pain. Overall, reductions in fear preceded pain relief and seemed to be essential to achieve pain reductions.
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Ryan J, McCallion P, McCarron M, Luus R, Burke EA. Overweight/obesity and chronic health conditions in older people with intellectual disability in Ireland. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:1097-1109. [PMID: 34750916 DOI: 10.1111/jir.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study examines overweight/obesity and chronic health conditions (CHCs) in older people with intellectual disability (ID). METHODS Data for this cross-sectional observational study emanated from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing, a longitudinal study assessing the health and well-being of older Irish adults with ID aged ≥40 years across all levels of ID. Participation involves an interview process and collation of objective health measures. In this study, body mass index (BMI) (n = 572), used as a measure of weight status, was examined with clustered doctor's diagnosed CHCs. Descriptive analysis was conducted where counts (n) and proportions (%) were used to summarise the variables univariately, while cross-tabulations were used for bivariate summary into counts and proportions. With overweight/obesity prevalence established and patterns described using logistical regression, Pearson's chi-squared test was used to test for significant associations. RESULTS Overweight/obesity identified in 69% of participants occurred with greater frequency in women (72%). A higher percentage of participants aged <50 years (72.5%) were overweight/obese than those aged 50-64 (70%) and 65+ (61.4%). Level of ID and residence type were significantly associated with weight status (P < 0.001), with overweight/obesity more prevalent in mild (85.7%) than moderate (72%) or severe/profound ID (51.4%). Of those who lived independently/with family, 78.4% were overweight/obese, as were 74% living in a community group home (P < 0.001). Almost all overweight/obese participants' waist measurements were in the substantially increased risk of metabolic disease waist measurement category (92%, P < 0.001). Logistical regression used to model CHCs on BMI showed significant association between BMI and gastrointestinal tract [odds ratio (OR) = 0.57, P < 0.008, 95% confidence interval (CI) = (0.37; 0.86)], respiratory condition [OR = 8.95, P < 0.004, 95% CI = (2.57; 56.72)] and musculoskeletal disorders [OR = 0.40, P < 0.001, 95% CI = (0.25; 0.63)]. CONCLUSIONS The findings illustrate the strong cross-sectional association between overweight/obesity and CHCs. These findings suggest a need to prioritise weight status as a health risk to people with ID as they age.
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Affiliation(s)
- J Ryan
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - P McCallion
- Temple School of Social Work, Temple University College of Public Health, Philadelphia, PA, USA
| | - M McCarron
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - R Luus
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - E A Burke
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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Prynn JE, Dube A, Mwaiyeghele E, Mwiba O, Geis S, Koole O, Nyirenda M, Kuper H, Crampin AC. Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions. Wellcome Open Res 2021; 4:90. [PMID: 33336079 DOI: 10.12688/wellcomeopenres.15196.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi. Methods: This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the incidence and resolution of disability over time using panel data from the 2015 survey. Results: Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Diabetes and obesity were associated with disability among women, and diabetes was also associated with disability among men. Neither hypertension nor HIV were associated with disability. Participants reporting "no difficulty" or "can't do at all" for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing "some difficulty" and "a lot of difficulty". Conclusions: Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
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Affiliation(s)
- Josephine E Prynn
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,University College London, London, UK
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Elenaus Mwaiyeghele
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Oddie Mwiba
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Steffen Geis
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK.,Institute for Medical Microbiology and Hygiene, Phillips University of Marburg, Marburg, Germany
| | - Olivier Koole
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK
| | - Moffat Nyirenda
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK.,MRC/UVRI Uganda Research Unit, Entebbe, Uganda
| | - Hannah Kuper
- London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia C Crampin
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK
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13
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Prynn JE, Dube A, Mwaiyeghele E, Mwiba O, Geis S, Koole O, Nyirenda M, Kuper H, Crampin AC. Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions. Wellcome Open Res 2021; 4:90. [PMID: 33336079 PMCID: PMC7722531 DOI: 10.12688/wellcomeopenres.15196.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi. Methods: This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the incidence and resolution of disability over time using panel data from the 2015 survey. Results: Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Diabetes and obesity were associated with disability among women, and diabetes was also associated with disability among men. Neither hypertension nor HIV were associated with disability. Participants reporting “no difficulty” or “can’t do at all” for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing “some difficulty” and “a lot of difficulty”. Conclusions: Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
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Affiliation(s)
- Josephine E Prynn
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,University College London, London, UK
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Elenaus Mwaiyeghele
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Oddie Mwiba
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Steffen Geis
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK.,Institute for Medical Microbiology and Hygiene, Phillips University of Marburg, Marburg, Germany
| | - Olivier Koole
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK
| | - Moffat Nyirenda
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK.,MRC/UVRI Uganda Research Unit, Entebbe, Uganda
| | - Hannah Kuper
- London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia C Crampin
- Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.,London School of Hygiene & Tropical Medicine, London, UK
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14
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Semenza DC, Stansfield R. Community gun violence and functional disability: An ecological analysis among men in four U.S. cities. Health Place 2021; 70:102625. [PMID: 34280714 DOI: 10.1016/j.healthplace.2021.102625] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/09/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
This study uses data on neighborhoods in four U.S. cities over five years to examine the relationship between fatal and non-fatal gun violence and rates of functional disability among men. Descriptive analyses indicate significant disparities in shooting rates across neighborhoods and heightened associated disability in high shooting communities. Multivariate results show that rates of non-fatal shootings correspond to greater functional disability among young men, but not older men. Fatal gun violence is not associated with increased community disability. The findings suggest that improvements in local gun violence prevention may serve to address broader community disparities in health and well-being.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, United States.
| | - Richard Stansfield
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, United States
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15
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Yuan YQ, Liu Y, Wang MJ, Hou X, Zhang SH, Wang XL, Han YN, Sang P, Bian Y, Roswal G. Prevalence of overweight and obesity in children and adolescents with intellectual disabilities in China. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:655-665. [PMID: 33851750 DOI: 10.1111/jir.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Overweight and obesity in children and adolescents has become a worldwide epidemic. There are several studies that have concentrated on the prevalence rate of children and adolescents with intellectual disabilities (ID), whereas data on such a population on the mainland of China remain unclear. The purpose of this study was to investigate the prevalence rate of overweight and obesity among school-aged children and adolescents with ID on China's mainland. METHODS This study employed a cross-sectional design to examine the body weight status of 1873 children and adolescents (ages 6-18 years old) with ID in 35 special education schools. Body mass index was calculated, and the concepts of overweight and obesity were defined according to the standard of the Working Group for Obesity in China. RESULTS Data indicated that 18.2% (95% CI: 16.5%-20.0%) of children and adolescents with ID were overweight and 14.4% (95% CI: 12.8%-16.0%) were obese. Boys with ID were more likely to be overweight than girls with ID (OR = 1.48[95% CI: 1.13-1.94], P < 0.05). Children and adolescents with Down syndrome or autism spectrum disorder had a trend to be classified as overweight (OR = 1.76[95% CI: 1.22-2.54], P < 0.05; OR = 1.57[95% CI: 1.17-2.09], P < 0.05, respectively) or obesity (OR = 1.82[95% CI: 1.23-2.69], P < 0.05; OR = 1.40 [95% CI: 1.02-1.93], P < 0.05, respectively) compared with those with ID without these conditions. Moreover, children and teenagers with ID living in urban areas had a predisposition to be overweight (OR = 2.16[95% CI: 1.14-4.09], P < 0.05) or obese (OR = 3.25[95% CI: 1.41-7.50], P < 0.05) relative to those who lived in rural areas. CONCLUSION Results indicated that in China, the prevalence rate of overweight and obesity among school-aged children and adolescents with ID was remarkably high. Therefore, future research should make every effort to focus on reducing and preventing overweight and obesity of this population in China.
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Affiliation(s)
- Y Q Yuan
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Y Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - M J Wang
- School of Chinese WuShu, Shandong Sport University, Rizhao, China
| | - X Hou
- Department of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - S H Zhang
- Department of Physical Education, China Disabled Persons' Federation, Beijing, China
| | - X L Wang
- Graduate School, Harbin Sport University, Harbin, China
| | - Y N Han
- Beijing Xuanwu District Special Education School, Beijing, China
| | - P Sang
- Shaanxi Xi'an Special Education School, Xi'an, China
| | - Y Bian
- Tianjin Hebei District Special Education School, Tianjin, China
| | - G Roswal
- School of Health Professions and Wellness, Jacksonville State University, Jacksonville, AL, USA
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16
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Prynn JE, Dube A, Mwaiyeghele E, Mwiba O, Geis S, Koole O, Nyirenda M, Kuper H, Crampin AC. Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions. Wellcome Open Res 2020; 4:90. [DOI: 10.12688/wellcomeopenres.15196.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi. Methods: This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the incidence and resolution of disability over time using panel data from the 2015 survey. Results: Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Diabetes and obesity were associated with disability among women, and diabetes was also associated with disability among men. Neither hypertension nor HIV were associated with disability. Participants reporting “no difficulty” or “can’t do at all” for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing “some difficulty” and “a lot of difficulty”. Conclusions: Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
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17
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Prynn JE, Dube A, Mwaiyeghele E, Mwiba O, Geis S, Koole O, Nyirenda M, Kuper H, Crampin AC. Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions. Wellcome Open Res 2020; 4:90. [DOI: 10.12688/wellcomeopenres.15196.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi. Methods: This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the incidence and resolution of disability over time using panel data from the 2015 survey. Results: Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Diabetes and obesity were associated with disability among women, and diabetes was also associated with disability among men. Neither hypertension nor HIV were associated with disability. Participants reporting “no difficulty” or “can’t do at all” for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing “some difficulty” and “a lot of difficulty”. Conclusions: Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
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18
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Sedgewick F, Leppanen J, Tchanturia K. Autistic adult outcomes on weight and body mass index: a large-scale online study. Eat Weight Disord 2020; 25:795-801. [PMID: 31065975 PMCID: PMC7256089 DOI: 10.1007/s40519-019-00695-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE There has been a wealth of work on the weight outcomes of autistic children and young people, generally finding that they are more likely to be overweight or obese than their non-autistic counterparts. There has not been the same focussed study of the weight outcomes of autistic adults, however. This study, therefore, sought to examine the relationship between weight outcome and being autistic in adults. METHODS Data were collected as part of an online study looking at eating, autism, and relationships. 665 people gave demographic and mental health information, and group differences and robust regressions were conducted. RESULTS Autistic adults were more likely to be in non-healthy weight categories than their non-autistic counterparts, i.e., more likely to be underweight, overweight, or obese. There were no interactions between autism status and mental health impacting BMI, although both anxiety and depression predicted higher BMI in the sample overall. CONCLUSIONS We conclude that while some weight patterns from childhood and adolescence continue into adulthood for autistic individuals, this is not necessarily a straightforward picture, and would benefit from further in-depth and qualitative study to understand the processes at play. The lack of interactions between mental health and autism, however, should provide professionals with confidence in supporting healthy weight management among autistic people. LEVEL OF EVIDENCE Level III, cohort study.
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Affiliation(s)
- Felicity Sedgewick
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK
| | - Jenni Leppanen
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK
| | - Kate Tchanturia
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK. .,South London and Maudsley NHS Trust EDU, London, UK. .,Psychology Department, Illia State University, Tbilisi, Georgia.
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19
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Luo H, Ren X, Li J, Wu K, Wang Y, Chen Q, Li N. Association between obesity status and successful aging among older people in China: evidence from CHARLS. BMC Public Health 2020; 20:767. [PMID: 32448262 PMCID: PMC7245862 DOI: 10.1186/s12889-020-08899-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
Background The paper aimed to examine the association between obesity status and successful aging among elderly adults in China and further find gender differences in the effect of components of successful aging on obesity status. Methods The data came from the follow-up survey(2015) of China Health and Retirement Longitudinal Study (CHARLS) and 4019 dwellers age 60 and over are included. Obesity status were defined by the body mass index (BMI) according to Chinese criteria. Successful aging was defined following Rowe and Kahn’s multidimensional model. Multivariable logistic regression was used to estimate the relationship between obesity status and successful aging. Results The rate of successful aging in men and women was 18.87 and 9.48% respectively. For BMI, the proportion of population with underweight, overweight and obesity in men was 10.29, 23.04 and 29.63% respectively and that in women was 1.40, 11.69 and 9.47%. Men with obesity (OR = 1.587 95% CI 1.087 ~ 2.316) has an positive relationship with successful aging than normal weight men; Women with underweight (OR = 0.197 95% CI 0.058 ~ 0.824) has an negative relationship with successful aging than normal weight women; Meanwhile, no matter men and women, the relationship between obesity status and successful aging were not significant among oldest adults(≥75 years). Conclusion Obesity status was significantly association with successful aging in young older adults (60-74 years), and the components of successful aging differently were related with the obesity status of male and female.
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Affiliation(s)
- Huiqiang Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Xiaohui Ren
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Jijie Li
- Department of Medical Records, West China Secondary University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kan Wu
- Department of Medical, West China School of Stomatology (West China Hospital of Stomatology), Chengdu, 610041, Sichuan, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Qing Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, No.17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
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20
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Prynn JE, Dube A, Mwaiyeghele E, Mwiba O, Geis S, Koole O, Nyirenda M, Kuper H, Crampin AC. Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions. Wellcome Open Res 2019; 4:90. [DOI: 10.12688/wellcomeopenres.15196.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in the low-income setting of Malawi. Methods: This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the consistency of responses to the questions over time using data from the 2015 survey. Results: Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Obesity and diabetes were associated with disability, but hypertension and HIV were not. Participants reporting “no difficulty” or “can’t do at all” for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing “some difficulty” and “a lot of difficulty”. Conclusions: Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
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21
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Nguyen J, Gilbert L. Health Literacy among Individuals with Disabilities: A Health Information National Trends Survey Analysis. Perm J 2019; 23:19.034. [PMID: 31926576 DOI: 10.7812/tpp/19.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Limited health literacy has been shown to be detrimental on health outcomes and the health care system, such as high rates of mortality and health care costs. A disability has been diagnosed in more than 19% of the US population, but the health literacy status of these individuals has yet to be adequately assessed. OBJECTIVE To examine the health literacy concerns of a nationally representative sample of individuals with disabilities. METHODS Data analysis using the Health Information National Trends Survey, a nationally representative survey sponsored by the National Cancer Institute. Descriptive analyses and χ2 tests were conducted to examine the association between sociodemographics, disability status, and health literacy concerns. A weighted logistic regression model was performed to explore associations between disability status and each health literacy concern, controlling for sociodemographics. RESULTS Results show 2 areas of concern for individuals with disabilities compared with those who did not report a disability: The effort to find needed information and being frustrated during the search for information. There was no difference detected between individuals with and without disabilities regarding being concerned about the quality of information found and believing that the information found was hard to understand. DISCUSSION These findings do not support the notion that individuals with disabilities are more likely to experience health literacy difficulties than individuals without disabilities. However, accurately assessing and improving health literacy for the diverse group of individuals with disabilities requires tailored approaches and further attention. CONCLUSION Precise assessment of health literacy and disabilities is necessary to identify and address the unique concerns of this population.
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Affiliation(s)
- Jenn Nguyen
- Mercer University College of Pharmacy, Atlanta, GA
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22
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Personality Traits and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152675. [PMID: 31357406 PMCID: PMC6696127 DOI: 10.3390/ijerph16152675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/08/2019] [Accepted: 07/18/2019] [Indexed: 01/11/2023]
Abstract
Objective: Previous studies investigating the association between body weight and personality traits have found mixed results. This paper uses a large data set and two different study designs (cross-sectional and longitudinal) to provide more consistent estimates of the effect of personality traits on obesity. Methods: The present study is based on data from the German Socio-Economic Panel (GSOEP) from the waves 2005 to 2013; GSOEP is a longitudinal survey of private households in Germany that has been carried out since 1984. Responses provided data about personality, measured using the BFI-S Questionnaire, data for self-rated body mass index BMI (to determine the obesity level), as well as information for potential confounders. Cross-sectional and longitudinal logistic regression models were used. Results: The cross-sectional study yielded statistically significant results for the association between the outcome variable and four personality factors neuroticism, extraversion, openness and agreeableness. After controlling for several potential confounders, the association between obesity and extraversion, openness as well as agreeableness remained; additionally, the personality factor consciousness reached statistical significance. In the longitudinal study, a statistically significant association was found only for two personality factors, namely extraversion and agreeableness. After adding the control variables, the FE-regression yielded an association only for agreeableness (negative). Gender differences were not significant. Discussion: The findings show that results of a cross-sectional study design differ from the outcome of the longitudinal study design. The latter stresses the association between excess weight and the personality factor agreeableness, contrasting with most outcomes of previous research.
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Barnhart WR, Havercamp SM, Lorenz A, Yang EA. Better Together: A Pilot Study on Cooking Matters for Adults With Developmental Disabilities and Direct Support Professionals. Nutr Metab Insights 2019; 12:1178638819840036. [PMID: 31001060 PMCID: PMC6454645 DOI: 10.1177/1178638819840036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 11/26/2022] Open
Abstract
Adults with developmental disabilities face barriers to making healthy lifestyle
choices that mirror the barriers faced by the direct support professionals who
serve them. These two populations, direct support professionals and adults with
developmental disabilities, are likely to lead inactive lifestyles, eat
unhealthy diets, and be obese. Moreover, direct support professionals influence
the nutrition knowledge, attitudes, and health behaviors of the adults with
developmental disabilities whom they serve. We piloted a cooking-based nutrition
education program, Cooking Matters for Adults, to dyads of
adults with developmental disabilities (n = 8) and direct support professionals
(n = 7). Team-taught by a volunteer chef and nutrition educator, Cooking
Matters for Adults uses an active learning approach to teach food
preparation safety skills and nutrition knowledge to inform healthy food and
beverage choices. We assessed healthy food preparation, intake of a balanced
diet, healthy food and beverage choices, and cooking confidence and barriers at
pre-test, post-test, and 6-months after the intervention. Among both adults with
developmental disabilities and direct support professionals, positive trends in
healthy food preparation, eating a balanced diet, and reduction in cooking
barriers were observed at post-test and 6-months. We also qualitatively assessed
knowledge of and attitudes toward healthy eating, frequency of food and beverage
intake, knowledge about kitchen skills and safety, as well as overall
satisfaction, cooking confidence, and acceptability of the dyad approach.
Participants with developmental disabilities and direct support professionals
reported that they learned about healthy food and beverage choices and various
cooking skills. Participants reported confidence in skills learned and were
satisfied with the intervention and approach of including adults with
developmental disabilities and direct support professionals in the intervention
together.
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Affiliation(s)
| | | | - Allison Lorenz
- Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA
| | - Emily A Yang
- Riverside Methodist Hospital, OhioHealth, Columbus, OH, USA
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24
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Norrbäck M, Tynelius P, Ahlström G, Rasmussen F. The association of mobility disability and obesity with risk of unemployment in two cohorts from Sweden. BMC Public Health 2019; 19:347. [PMID: 30922278 PMCID: PMC6437925 DOI: 10.1186/s12889-019-6627-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 03/06/2019] [Indexed: 01/21/2023] Open
Abstract
Background People with mobility disability (MD) or obesity often have more health problems and are less able to participate in work than individuals without these conditions. This study investigated whether people burdened with MD and obesity have a greater risk of unemployment than people with either one (MD only or obesity only) or none of these conditions. Methods The study included two Swedish population-based cohorts, a national cohort (n = 39,947) and a regional cohort (n = 40,088). Six exposure groups were created using baseline self-reported data on MD and body mass index from participants aged 19 to 64 years. The MD definition differed between the cohorts. Various sources of socio-demographic factors were used to address confounding. Participants’ risks of unemployment were assessed longitudinally in a nationwide register with objective data and with almost no loss of follow-up (< 1%). Cox regression was used to analyse associations of MD and/or obesity (BMI ≥ 30) with risk of any (≥1 day) and long-term unemployment (≥90 days during two consecutive years). Quantile regression was used to estimate participants’ unemployment risks as average days of unemployment. Normal-weight people without MD were used as a reference group. The Wald test was applied for specific group comparisons other than to the reference group. Results In summary, the groups with MD and the obese group without MD had a higher risk of becoming unemployed than the reference group (regional survey adjusted hazard ratio range: 1.30–1.59; 95% CI range: 1.06–1.90, national survey adjusted hazard ratio range: 1.11–1.34; 95% CI range: 0.88–1.81). The obese group with MD did not differ from the groups with MD only or obesity only in terms of unemployment risk. Conclusions People with MD and/or obesity are vulnerable groups at risk of prolonged unemployment during their working life in a country with a highly developed welfare system. Electronic supplementary material The online version of this article (10.1186/s12889-019-6627-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mattias Norrbäck
- Clinical Epidemiological Group, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Per Tynelius
- Clinical Epidemiological Group, Department of Medicine, Karolinska Institute, Stockholm, Sweden.,Centre of Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden.
| | - Finn Rasmussen
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden
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Lee AA, Gabriele JM. Racial Differences in the Associations of Posttraumatic Stress and Insomnia With Body Mass Index Among Trauma-Exposed Veterans. Behav Med 2018; 44:263-270. [PMID: 28323566 DOI: 10.1080/08964289.2017.1292998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Posttraumatic stress is associated with increased body mass index (BMI) and rates of obesity. Black adults are at greater risk for obesity, trauma exposure, development of posttraumatic stress disorder, and comorbid sleep problems compared to White adults. Accordingly, Black adults with a history of trauma exposure may be at greater risk for elevated BMI associated with posttraumatic stress and insomnia. Multiple linear regression was used to examine race as a moderator of the relationship between posttraumatic symptoms and insomnia with BMI in a sample of Black and White trauma-exposed Veterans (N = 171), controlling for age and sex. There was a significant interaction of race with PTSD (p = 0.042) and insomnia symptoms (p = 0.045) on BMI. Simple slopes showed a significant positive association of posttraumatic stress and BMI among Black (p = 0.003), but not White Veterans (p = 0.590). Similarly, insomnia was significantly associated with greater BMI for Black (p = 0.023), but not White Veterans (p = 0.496). Posttraumatic stress and insomnia may play a particularly important role in the development of weight related health problems among Black Veterans. Early identification and treatment of these symptoms may reduce the risk of obesity among this vulnerable population.
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Affiliation(s)
- Aaron A Lee
- a VA Center for Clinical Management Research
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26
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Zhou Q, Glasgow NJ, Du W. Health-related lifestyles and obesity among adults with and without disability in Australia: Implication for mental health care. Disabil Health J 2018; 12:106-113. [PMID: 30177470 DOI: 10.1016/j.dhjo.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/11/2018] [Accepted: 08/24/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Numerous studies have reported people with disabilities are more likely to be obese and engaged in unhealthy lifestyles. Few studies explored the mechanism of health-related lifestyles and obesity among people with disabilities. OBJECTIVE We aimed to investigate health-related lifestyles and obesity in relation to disability among Australian adults. We further aimed to explore the potential mediating effect of psychological distress for disability in relation to health related lifestyles and obesity. METHODS Using the National Health Survey conducted in 2015 in Australia, we considered non-institutionalised adult participants (aged 18 + years old) as our study population (n = 11,598). Study outcomes included currently smoking, smoking daily, alcohol consumption, physical exercises, and obesity. We considered high psychological distress (Kessler 10 scores ≥ 22) a potential mediator for the disability-lifestyles and disability-obesity associations. Sample weights were calculated allowing for complex survey design. Adjusted Odds Ratios and 95% Confidence Intervals were evaluated using weighted Logistic regression models. RESULTS Compared to their disability-free counterparts, people with disabilities were more likely to be current smokers (aOR: 1.26, 95%CI: 1.08-1.47) and have obesity problems (1.44, 1.27-1.64), and were less likely to do physical exercises (0.67, 0.58-0.77), after controlling for socio-environmental factors. In the presence of high psychological distress, the disability-smoking association was no longer significant, and associations of disability-exercise (0.72, 0.62-0.84) and disability-obesity (1.38, 1.22-1.57) were influenced but remained significant. CONCLUSION High psychological distress demonstrated important mediating effects. Tailored mental health care for people with disabilities might have the utility to reduce unhealthy behaviors.
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Affiliation(s)
- Qin Zhou
- School of Public Administration, University of International Business and Economics, Ning Yuan Building, No. 10 Huixin Dongjie, Chaoyang District, Beijing, China.
| | - Nicholas J Glasgow
- Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Acton ACT, 2601, Canberra, Australia.
| | - Wei Du
- Research School of Population Health, College of Health and Medicine, Australian National University, 62 Mills Road, Acton ACT, 2601, Canberra, Australia.
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Childhood obesity: running from this crisis of 'normalisation' won't work. Br J Gen Pract 2018; 68:358-359. [PMID: 30049753 DOI: 10.3399/bjgp18x698009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Kaiser ML, Cafer A. Understanding High Incidence of Severe Obesity and Very Low Food Security in Food Pantry Clients: Implications For Social Work. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:125-139. [PMID: 29297775 DOI: 10.1080/19371918.2017.1415181] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The United States is facing two interconnected social and public health crises of severe obesity and food insecurity within the social-ecological environment. Marginalized groups experience the highest rates and the greatest impacts in terms of morbidity, mortality, and financial burdens. Consequences include experiencing multimorbidities, mental health issues, and decreased quality of life. Food pantries have served as spaces to obtain food to meet household needs, but for some, food pantries have become long-term solutions. We surveyed 2,634 people who accessed pantries in 2005, 2010, and 2013 across 32 counties in a Midwest state. The authors sought to understand to what extent does length of time using a food pantry, food security status, income sources, use of federal food benefits, visiting a doctor, and demographic variables increase odds of severe obesity. More than 14% were severely obese; those who were long-term food pantry users and very low food secure were 1.732 times more likely to be severely obese. Receiving Disability/Supplemental Security Income, seeing a doctor in the last year, being female, and older age reduced the odds of severe obesity. Discussion includes implications for social workers who interact with groups likely to experience very low food security and severe obesity at different systems levels.
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Affiliation(s)
- Michelle L Kaiser
- a Ohio State University, College of Social Work , Columbus , Ohio , USA
| | - Anne Cafer
- b Department of Sociology and Anthropology , University of Mississippi , Oxford , Mississippi , USA
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Kang L, Jia L, Han P, Zhang W, Ma Y, Fu L, Yu H, Chen X, Wang L, Hou L, Yu X, Song J, He R, Li H, Miao T, Yang X, Niu K, Wang L, Guo Q. Combined Effect of Obesity and Mobility Limitation with Incidence of Type 2 Diabetes and Mortality in Chinese Elderly. Rejuvenation Res 2017; 20:375-382. [PMID: 28398133 DOI: 10.1089/rej.2017.1936] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This article aims to examine the effect of mobility limitation and obesity on the risk of new incidence of type 2 diabetes mellitus (T2DM) and mortality. The design was a cohort study (n = 1075) among adults aged 60 years and older. Obesity was defined as body-mass index greater than or equal to 28 kg/m2. Mobility limitation was defined as participants scoring in the top 20% on the timed up and go test or in the slowest 20% for the 4-m walking test. The mean age of the study population was 67.4 ± 5.4 years (age range: 60-86 years), and 57.4% were women. Overall, 5.1% of women and 1.9% of men had both obesity and mobility limitations. During 3-year follow-up, the new incidence of T2DM was 2.98% and the adjusted risk of the new incidence of T2DM was progressively greater in obese subjects without mobility limitation, but not greater in the single mobility limitation subjects. The combination of mobility limitation and obesity (odds ratio = 10.3, 95% confidence interval = 2.25-70.13) has a significantly higher risk than obesity only or mobility limitation only. What is more, obesity with mobility limitation could be an independent predictor of 3-year mortality compared with the other subjects. We demonstrated the associations between obesity and mobility limitation and thus the increased risk of developing, with the combination over time, T2DM and mortality.
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Affiliation(s)
- Li Kang
- 1 Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University , Tianjin, China .,2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Liye Jia
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Peipei Han
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Wen Zhang
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Yixuan Ma
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Liyuan Fu
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Hairui Yu
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Xiaoyu Chen
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Lu Wang
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Lin Hou
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Xing Yu
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Jianing Song
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Ruiming He
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Hui Li
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Tingting Miao
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Xiaolong Yang
- 2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
| | - Kaijun Niu
- 3 Nutritional Epidemiology Institute, Tianjin Medical University , Tianjin, China .,4 School of Public Health, Tianjin Medical University , Tianjin, China
| | - Liancheng Wang
- 5 Department of Rehabilitation Medicine, Tianjin Hospital , Tianjin, China
| | - Qi Guo
- 1 Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University , Tianjin, China .,2 Department of Rehabilitation Medicine, Tianjin Medical University , Tianjin, China
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Savage A, Emerson E. Overweight and obesity among children at risk of intellectual disability in 20 low and middle income countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:1128-1135. [PMID: 27444252 DOI: 10.1111/jir.12309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/12/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Children with intellectual disability (ID) in high income countries are at significantly greater risk of obesity than their non-disabled peers. We aimed to estimate the prevalence of overweight and obesity in 3 to 4-year-old children who are/are not at risk of ID in low and middle income countries. METHOD Secondary analysis of Round 4 and 5 UNICEF Multiple Indicator Cluster Surveys (MICS) from 20 low and middle income countries that included a total of 83 597 3 to 4-year-old children. RESULTS Few differences in risk of overweight or obesity were apparent between 3 and 4-year-old children identified as being at risk/not at risk of ID in 20 low and middle income countries. In the two countries where statistically significant differences were observed, prevalence of overweight/obesity was lower among children at risk of ID. CONCLUSIONS These results stand in stark contrast to evidence from high income countries which suggest that children with ID are at significantly increased risk of obesity when compared to their non-intellectually disabled peers.
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Affiliation(s)
- A Savage
- Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia.
- Centre for Disability Research, Lancaster University, Lancaster, United Kingdom.
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31
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Massetti GM, Thomas CC, Ragan KR. Disparities in the Context of Opportunities for Cancer Prevention in Early Life. Pediatrics 2016; 138:S65-S77. [PMID: 27940979 PMCID: PMC5161109 DOI: 10.1542/peds.2015-4268j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
Persistent health disparities are a major contributor to disproportionate burden of cancer for some populations. Health disparities in cancer incidence and mortality may reflect differences in exposures to risk factors early in life. Understanding the distribution of exposures to early life risk and protective factors for cancer across different populations can shed light on opportunities to promote health equity at earlier developmental stages. Disparities may differentially influence risk for cancer during early life and create opportunities to promote health equity. Potential risk and protective factors for cancer in early life reveal patterns of disparities in their exposure. These disparities in exposures can manifest in downstream disparities in risk for cancer. These risk and protective factors include adverse childhood experiences; maternal alcohol consumption in pregnancy; childhood obesity; high or low birth weight; benzene exposure; use of assisted reproductive technologies; pesticide and insecticide exposure; isolated cryptorchidism; early pubertal timing; exposure to radiation; exposure to tobacco in utero and in early life; allergies, asthma, and atopy; and early exposure to infection. Disparities on the basis of racial and ethnic minority status, economic disadvantage, disability status, sex, geography, and nation of origin can occur in these risk and protective factors. Vulnerable populations experience disproportionally greater exposure to risk factors in early life. Addressing disparities in risk factors in early life can advance opportunities for prevention, promote health equity, and possibly reduce risk for subsequent development of cancer.
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Affiliation(s)
- Greta M. Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen R. Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Affiliation(s)
- Tom Shakespeare
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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Emerson E, Robertson J, Baines S, Hatton C. Obesity in British children with and without intellectual disability: cohort study. BMC Public Health 2016; 16:644. [PMID: 27460572 PMCID: PMC4962444 DOI: 10.1186/s12889-016-3309-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 07/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Reducing the prevalence of and inequities in the distribution of child obesity will require developing interventions that are sensitive to the situation of ‘high risk’ groups of children. Children with intellectual disability appear to be one such group. We aimed to estimate the prevalence of obesity in children with and without intellectual disability in a longitudinal representative sample of British children and identify risk factors associated with obesity at age 11. Methods Information was collected on a nationally representative sample of over 18,000 at ages 9 months, 3, 5, 7 and 11 years. We used UK 1990 gender-specific growth reference charts and the LMS Growth programme to identify age and gender-specific overweight and obesity BMI thresholds for each child at ages 5, 7 and 11 years. Results Children with intellectual disabilities were significantly more likely than other children to be obese at ages five (OR = 1.32[1.03–1.68]), seven (OR = 1.39[1.05–1.83]) and eleven (OR = 1.68[1.39–2.03]). At ages five and seven increased risk of obesity among children with intellectual disabilities was only apparent among boys. Among children with intellectual disability risk of obesity at age eleven was associated with persistent maternal obesity, maternal education, child ethnicity and being bullied at age five. Conclusions Children with intellectual disability are a high-risk group for the development of obesity, accounting for 5–6 % of all obese children. Interventions to reduce the prevalence and inequities in the distribution of child obesity will need to take account of the specific situation of this group of children.
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Affiliation(s)
- Eric Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK. .,Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia.
| | - Janet Robertson
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Susannah Baines
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Chris Hatton
- Centre for Disability Research, Lancaster University, Lancaster, UK
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34
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Sing DC, Luan TF, Feeley BT, Zhang AL. Is Obesity a Risk Factor for Adverse Events After Knee Arthroscopy? Arthroscopy 2016; 32:1346-1353.e1. [PMID: 27013106 DOI: 10.1016/j.arthro.2016.01.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 10/17/2015] [Accepted: 01/08/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate how body mass index (BMI) affects rates of 30-day complication, hospital readmissions, and mortality in patients undergoing knee arthroscopy. METHODS Patients undergoing knee arthroscopy procedures between 2006 and 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Patient demographics and preoperative risk factors including BMI were analyzed for postoperative complications within 30 days. Cochran-Armitage testing was performed to detect differences in complication rates across BMI categories according to World Health Organization classification. The independent risk of BMI was assessed using multivariate regression analysis. RESULTS Of 41,919 patients with mean age 48 years undergoing knee arthroscopy, 20% were classified as normal weight (BMI 18.5 to 24), 35% overweight (BMI 25 to 29), 24% obese class I (BMI 30 to 34), 12% class II (BMI 35 to 40), and 9% class III (BMI ≥40). Risk of complication increased significantly with increasing BMI (normal: 1.5%, overweight: 1.6%, obese class I: 1.7%, obese class II: 1.8%, obese class III: 1.9%, P = .043). On multivariate analysis, there was no increased risk of postoperative complication directly attributed to patient BMI. Independent risk factors for medical and surgical complications after knee arthroscopy included American Society of Anesthesiologists (ASA) rating (class 4 v class 1 odds ratio [OR]: 5.39 [95% confidence interval: 3.11-9.33], P < .001), functional status for activities of daily living (dependent v independent OR: 2.13 [1.42, 3.31], P < .001), history of renal comorbidity (presence v absence OR: 5.10 [2.30, 11.29], P < .001), and previously experienced history of wound infection prior to current surgery (presence v absence OR: 4.91 [2.88, 8.39], P < .001). CONCLUSIONS More than 40% of knee arthroscopy patients qualify as obese. Although univariate analysis suggests that obesity is associated with increased postoperative complications within 30 days of surgery, BMI alone does not predict complications. Independent predictors of complications include patients with high ASA classification, dependent functional status, renal comorbidities, and a recent history of wound infection. LEVEL OF EVIDENCE Level IV, prognostic case series.
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Affiliation(s)
- David C Sing
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Tammy F Luan
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, U.S.A
| | - Alan L Zhang
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, U.S.A..
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Maïano C, Hue O, Morin AJS, Moullec G. Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Obes Rev 2016; 17:599-611. [PMID: 27171466 DOI: 10.1111/obr.12408] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/30/2016] [Accepted: 02/23/2016] [Indexed: 01/06/2023]
Abstract
Although there have been numerous studies examining the prevalence of overweight and obesity among children and adolescents with intellectual disabilities, they have not yet been integrated and synthesized through a systematic quantitative review process. The purpose of this systematic review and meta-analysis was to determine: (i) the prevalence of overweight/obesity among children and adolescents with intellectual disabilities; (ii) the sources of heterogeneity in studies reporting the prevalence of overweight/obesity in this population; and (iii) the risk of overweight/obesity in this population compared with their typically developing peers. A systematic literature search was performed and 16 studies, published between 1985 and 2015, met the inclusion criteria. The resulting pooled prevalence estimates for overweight, overweight-obesity and obesity were respectively: (i) 15%, 30%, and 13%, in children; and (ii) 18%, 33%, and 15% in adolescents. Subgroup analyses showed significant variations in the pooled prevalence estimates as a function of geographical region, recruitment setting, additional diagnoses, and norms used to define overweight or obesity. The findings also showed adolescents with intellectual disabilities to be respectively 1.54 and 1.80 times more at risk of overweight-obesity and obesity than typically developing adolescents. Unfortunately, no such comparison is available for children. © 2016 World Obesity.
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Affiliation(s)
- C Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada.,Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia.,Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada
| | - O Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - A J S Morin
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia
| | - G Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada.,Research Center, Hôpital du Sacré-Coeur de Montréal, Affiliated Hospital of Université de Montréal, Montréal, Canada
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de Munter JS, Tynelius P, Ahlström G, Rasmussen F. The bidirectional association between body weight and mobility disability: A population-based cohort. Disabil Health J 2016; 9:632-7. [PMID: 27528493 DOI: 10.1016/j.dhjo.2016.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 05/06/2016] [Accepted: 06/09/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Obesity is more common in people with mobility disability than in non-disabled individuals, but less is known about the longitudinal effects leading to this health state. OBJECTIVE To explore the potential bidirectional association between mobility disability and obesity. METHODS Participants were identified in the population-based Stockholm Public Health Cohort (2002-2010, n = 17 945). Observations with schizophrenia, depression, eating disorder, or cancer within 5 years during and prior to baseline were excluded. Mobility disability and height and weight to calculate BMI (kg/m(2)) were self-reported. We used multivariate-adjusted regression models to estimate relative risks (RRs) and 95% confidence intervals (CI) based on new cases of mobility disability in cohorts that were obese, overweight or normal weight at baseline, and increases in BMI over time by mobility disability status. RESULTS Obesity at baseline was associated with incident mobility disability. The highest risk was observed in middle-aged women (RR = 3.95, CI = 2.35-6.65). Young men and middle-aged women with long-term mobility disability increased more in BMI (men: 1.55 kg/m(2), 0.61-2.49; women: 0.38, 0.01-0.75), as well as young and middle-aged people with incident mobility disability (young men: 0.68 kg/m(2), 0.10-1.27; middle-aged men: 0.49, 0.20-0.77; young women: 1.41, 0.94-1.87; middle-aged women: 0.64, 0.36-0.93) compared to the groups without any mobility disability. CONCLUSIONS In this paper, we demonstrated the bidirectional and longitudinal associations between body weight and mobility disability and thus the increased risk of developing the combination over time from either condition. Effective health-promotion and prevention strategies are needed to prevent worse health for these vulnerable groups in society.
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Affiliation(s)
- Jeroen S de Munter
- Child and Adolescent Public Health Epidemiology Research Group, Department of Public Health Sciences, Karolinska Institutet, Sweden.
| | - Per Tynelius
- Child and Adolescent Public Health Epidemiology Research Group, Department of Public Health Sciences, Karolinska Institutet, Sweden
| | - Gerd Ahlström
- The Swedish Institute for Health Sciences, Department of Health Sciences, Lund University, Sweden
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology Research Group, Department of Public Health Sciences, Karolinska Institutet, Sweden
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Assessing long-term QALYs gain from averting and reversing overweight and obesity in childhood. Qual Life Res 2016; 25:2611-2618. [PMID: 27052420 DOI: 10.1007/s11136-016-1285-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Interventions to tackle childhood obesity have been devised in response to the rising prevalence of childhood obesity. However, efficiency of these interventions remains a concern. Cost-utility analysis, representing health benefits in terms of quality-adjusted life years (QALYs), is a type of economic evaluation that has widely been recommended in assessing efficiency of health interventions. However, certain limitations in using QALYs remain specifically difficult in QALYs estimation. This study estimates the long-term QALYs gain from reversing childhood obesity in Thailand. METHODS An economic model was developed to estimate long-term QALYs of the youth aged 3-18 for the BMI status in childhood, which were categorized into three groups: normal weight, overweight, and obese. Long-term QALYs were estimated between ages 35 and 100, according to children's age, sex, and BMI status. Differences in QALYs between BMI status groups were calculated to represent the QALYs gain for youth from reversing obesity and overweight. The future outcomes were discounted at 3 % per annum in the base-case analysis; the discount rates of 0, 1.5, 3.5, and 5 % were also applied in the sensitivity analyses. RESULTS QALYs gained from reversing childhood obesity increase with age, starting from 0.040 and 0.083 QALYs at age 3 to 0.590 and 0.553 QALYs at age 18 in boys and girls, respectively. Reversing overweight and obesity in girls produces more QALYs than in boys between ages 3 and 17. CONCLUSIONS Efficiency is an important issue in allocating public healthcare resources to maximize social benefits. The results of this study facilitate long-term QALYs estimation with respect to BMI status in childhood, which could encourage more routine economic evaluation of child obesity interventions and maximize their health benefits.
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Wester VL, van Rossum EFC. Clinical applications of cortisol measurements in hair. Eur J Endocrinol 2015; 173:M1-10. [PMID: 25924811 DOI: 10.1530/eje-15-0313] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 04/28/2015] [Indexed: 11/08/2022]
Abstract
Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target.
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Affiliation(s)
- Vincent L Wester
- Division of EndocrinologyDepartment of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Division of EndocrinologyDepartment of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Mithen J, Aitken Z, Ziersch A, Kavanagh AM. Inequalities in social capital and health between people with and without disabilities. Soc Sci Med 2014; 126:26-35. [PMID: 25500164 DOI: 10.1016/j.socscimed.2014.12.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The poor mental and physical health of people with disabilities has been well documented and there is evidence to suggest that inequalities in health between people with and without disabilities may be at least partly explained by the socioeconomic disadvantage (e.g. low education, unemployment) experienced by people with disabilities. Although there are fewer studies documenting inequalities in social capital, the evidence suggests that people with disabilities are also disadvantaged in this regard. We drew on Bourdieu's conceptualisation of social capital as the resources that flow to individuals from their membership of social networks. Using data from the General Social Survey 2010 of 15,028 adults living in private dwellings across non-remote areas of Australia, we measured social capital across three domains: informal networks (contact with family and friends); formal networks (group membership and contacts in influential organisations) and social support (financial, practical and emotional). We compared levels of social capital and self-rated health for people with and without disabilities and for people with different types of impairments (sensory and speech, physical, psychological and intellectual). Further, we assessed whether differences in levels of social capital contributed to inequalities in health between people with and without disabilities. We found that people with disabilities were worse off than people without disabilities in regard to informal and formal networks, social support and self-rated health status, and that inequalities were greatest for people with intellectual and psychological impairments. Differences in social capital did not explain the association between disability and health. These findings underscore the importance of developing social policies which promote the inclusion of people with disabilities, according to the varying needs of people with different impairments types. Given the changing policy environment, ongoing monitoring of the living circumstances of people with disabilities, including disaggregation of data by impairment type, is critical.
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Affiliation(s)
- Johanna Mithen
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia
| | - Zoe Aitken
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia
| | - Anne Ziersch
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA 5001, Australia
| | - Anne M Kavanagh
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia.
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Havercamp SM, Scott HM. National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disabil Health J 2014; 8:165-72. [PMID: 25595297 DOI: 10.1016/j.dhjo.2014.11.002] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 09/29/2014] [Accepted: 11/04/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability. OBJECTIVES The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability. METHODS This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey. RESULTS Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns. CONCLUSIONS Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed.
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Affiliation(s)
- Susan M Havercamp
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA.
| | - Haleigh M Scott
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA
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Wester VL, Staufenbiel SM, Veldhorst MAB, Visser JA, Manenschijn L, Koper JW, Klessens-Godfroy FJM, van den Akker ELT, van Rossum EFC. Long-term cortisol levels measured in scalp hair of obese patients. Obesity (Silver Spring) 2014; 22:1956-8. [PMID: 24852462 DOI: 10.1002/oby.20795] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/09/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In obese subjects a relatively high cortisol output in urine has been observed compared to nonobese individuals. However, cortisol levels in blood, saliva, and urine in association with obesity have been inconsistent across studies, possibly due to the high variability of systemic cortisol levels. Cortisol levels measured in scalp hair provide a marker for long-term cortisol exposure, and have been associated with cardiovascular disease in an elderly population and to disease course in Cushing's disease. We aimed to compare hair cortisol levels between obese patients and nonobese controls. METHODS Hair cortisol levels of 47 obese patients (median BMI 38.8, range 31.1-65.8), 41 overweight, and 87 normal-weight subjects using an enzyme-linked immunosorbent assay (ELISA) were measured. RESULTS Obese patients had higher hair cortisol levels than overweight and normal weight subjects (respectively 30.8 vs 8.5 and 8.4 pg/mg hair, P < 0.001). No significant difference in hair cortisol levels was found between normal weight and overweight subjects. CONCLUSIONS Our results suggest a higher long-term cortisol exposure in obese patients, which may contribute to cardiovascular disease risk. Future research will determine whether long-term cortisol levels provide a novel treatment target in the management of cardiovascular disease risk in obesity.
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Affiliation(s)
- Vincent L Wester
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam and Sint Franciscus Hospital, Rotterdam, The Netherlands
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Bussière C, Sicsic J, Pelletier-Fleury N. The effects of obesity and mobility disability in access to breast and cervical cancer screening in france: results from the national health and disability survey. PLoS One 2014; 9:e104901. [PMID: 25133662 PMCID: PMC4136821 DOI: 10.1371/journal.pone.0104901] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/15/2014] [Indexed: 12/01/2022] Open
Abstract
Objectives We aimed to disentangle the effects of obesity and mobility limitation on cervical and breast cancer screening among community dwelling women. Methods The data source was the French national Health and Disability Survey - Household Section, 2008. The Body Mass Index (BMI) was used to categorize obesity status. We constructed a continuous score of mobility limitations to assess the severity of disability (Cronbach's alpha = 0.84). Logistic regressions were performed to examine the association between obesity, mobility limitations and the use of Pap test (n = 8 133) and the use of mammography (n = 7 561). Adjusted odds ratios were calculated (AOR). Interaction terms between obesity and the disability score were included in models testing for effect modifications. Results Compared with non-obese women, the odds of having a Pap test in the past 3 years was 24% lower in obese women (AOR = 0.76; 95% CI: 0.65 to 0.89), the odds of having a mammogram in the past 2 years was 23% lower (AOR = 0.77; 95% CI: 0.66 to 0.91). Each time the disability score was 5 points higher, the odds of having a Pap test decreases by 20% (AOR = 0.96; 95% CI: 0.94 to 0.98), the odds of having a mammogram decreases by 25% (AOR = 0.95; 95% CI: 0.94 to 0.97). There was no significant interaction between obesity and disability score. Conclusion Obesity and mobility limitation are independently associated with a lower likelihood of cervical and breast cancer screening. Protective outreach and follow-up are necessary to reduce inequalities and thus to reduce health disparities in these vulnerable and high-risk populations of obese women with disabilities.
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Donini LM, Cuzzolaro M, Gnessi L, Lubrano C, Migliaccio S, Aversa A, Pinto A, Lenzi A. Obesity treatment: results after 4 years of a Nutritional and Psycho-Physical Rehabilitation Program in an outpatient setting. Eat Weight Disord 2014; 19:249-60. [PMID: 24577668 DOI: 10.1007/s40519-014-0107-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/05/2014] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Obesity is a chronic disease as well as a risk factor for cardiovascular, metabolic and osteoarticular diseases, affecting the psychosocial health and the quality of life. Recent evidence suggests that the adequate treatment of obesity should provide a multidimensional multidisciplinary approach including nutritional therapy, psycho-educational classes and physical reconditioning/motor rehabilitation. The aim of this approach should be to maintain the results over time with a positive impact on the obesity-related cardiovascular and metabolic risk. AIM OF THE STUDY To evaluate the effectiveness of a multidisciplinary Nutritional and Psycho-Physical Reconditioning Program (NPPRP) in an outpatient setting. MATERIALS AND METHODS The observational prospective cohort study involved subjects, aged from 18 to 65 years, with a BMI >30 kg/m(2), who were followed up over 48 months. After the first nutritional and psychological examination, patients who refused NPPRP were treated according to standard nutrition procedures (SNT). Patients were followed through monthly medical examinations and then by annual telephonic structured interviews for 4 years. Changes in body weight, eating behavior, physical activity performance, and the occurrence of clinical obesity-related complications were considered as outcome measures. RESULTS Of 464 enrolled patients, 161 (34.7%) took part in the follow-up. From the enrollment to the end of follow-up, weight loss was greater in the NPPRP group than in the SNP group (-8.08 ± 10 kg versus -3.0 ± 6 kg). After 4 years eating behavior improved in both groups. The percentage of patients who continued to perform physical activity was higher in the NPPRP group than in the SNT group (61.0 versus 34.1%). The SNT group reported complications more frequently than the NPPRP group: hypertension (19 versus 5.8%), dyslipidemia (19.4 versus 12.7%), and skeletal problems (26.9 versus 17.5%). The main reasons for drop-out from the rehabilitation program were logistic problems (distance or time) in both groups; disappointment was higher in the SNT group than in the NPPRP group (37.8 versus 15.6%). CONCLUSION A multidimensional multidisciplinary approach including nutritional intervention and psycho-physical rehabilitation, set against a conventional diet therapy, was more effective in the long-term outcome of obesity with regard to weight loss, physical activity, possible eating disorders, and obesity-related complications.
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Affiliation(s)
- Lorenzo M Donini
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, "Sapienza" University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy,
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Allen L. British healthy-weights serviced for disabled children are largely based on inappropriate data. Public Health 2014; 128:491. [PMID: 24856198 DOI: 10.1016/j.puhe.2014.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
Affiliation(s)
- L Allen
- Royal Cornwall Hospital, Royal Cornwall Hospital Trust, Truro, Cornwall TR1 3LJ, UK.
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Slevin E, Truesdale-Kennedy M, McConkey R, Livingstone B, Fleming P. Obesity and overweight in intellectual and non-intellectually disabled children. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:211-220. [PMID: 22957929 DOI: 10.1111/j.1365-2788.2012.01615.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Few studies have compared overweight and obesity in intellectually disabled (ID) and non-intellectually disabled (N-ID) children. This research compared the prevalence of overweight and obesity between a sample of 218 ID and 229 N-ID school pupils in Northern Ireland (NI). Comparison of the physical activity and dietary behaviour of the two groups of school pupils were also undertaken. METHODS Each pupil completed (assisted if required) a food intake and physical activity questionnaire. Following this body mass index (BMI) and waist circumference were measured and recorded. RESULTS Significantly more ID pupils (72, 33%) were overweight/obese compared with 55 (24%) of the N-ID pupils in accordance with their BMI. ID pupils also had significantly higher waist circumferences. Over a quarter of foods consumed by the pupils were fatty and sugary foods and close to 30% of these foods were eaten by the ID children. Pupils spent most of their time engaging in low levels of activity such as reading, watching TV, on games consoles and listening to music. Pupils with an ID spent fewer hours on moderate and high levels of activities compared with those children with N-ID. CONCLUSIONS Results of this study found higher levels of overweight and obesity in this sample than in international published research. Additionally significantly higher numbers of ID pupils were overweight and obese indicating the need for future research and public health to focus on this issue.
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Affiliation(s)
- E Slevin
- Institute of Nursing Research, University of Ulster, Belfast, UK
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Lafortuna CL, Prinelli F, Adorni F, Agosti F, De Col A, Sartorio A. Effect of mechanical and metabolic factors on motor function and fatigue in obese men and women: a cross-sectional study. J Endocrinol Invest 2013; 36:1062-8. [PMID: 23888331 DOI: 10.3275/9064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mechanical overload and poor quality of contractile elements related to metabolic abnormalities concur to motor disability of obesity. The independent contribution of these factors to motor dysfunction in obese individuals is scarcely defined. AIM Aim of the study is to test the hypothesis that metabolic factors may independently affect motor function in obesity. METHODS Leg maximum power output per unit body mass (W Mb), per unit fat-free mas (W FFM) and fatigue in daily functioning were assessed in 635 obese [body mass index (BMI)≥ 35 kg/m(2)] individuals (286 men, 349 women) aged 19-78 yr. The independent effects of age, BMI, insulin resistance and the five components of the metabolic syndrome on W Mb, W FFM and fatigue were evaluated by multivariate analysis. RESULTS A multiple regression analysis revealed that in both genders W Mb (denoting the individual's performance capability during anaerobic tasks) was independently reduced by age (p<0.001), BMI (p<0.05-0.001) and abnormalities of glucose metabolism (p<0.06-0.01), while W FFM (representing the muscle intrinsic anaerobic capability) was affected only by age (p<0.001) and glucose metabolism impairment (p<0.06-0.01). In both genders fatigue was increased by age (p<0.001) and BMI (p<0.05-0.01), but augmented by low levels of HDL-cholesterol in men only (p<0.05). CONCLUSIONS Besides depending on mechanical overload and age, low muscle power output in obese individuals was independently associated also with metabolic abnormalities related to impaired glucose homeostasis. Fatigue and performance, although similarly influenced by age and body mass excess, are affected by different metabolic factors.
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Affiliation(s)
- C L Lafortuna
- Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Via Cervi 93, I-20090 Segrate, Milano, Italy.
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Lionti T, Reid SM, Reddihough D, Sabin MA. Monitoring height and weight: findings from a developmental paediatric service. J Paediatr Child Health 2013; 49:1063-8. [PMID: 22620265 DOI: 10.1111/j.1440-1754.2012.02470.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the recording of weight and height in children with disabilities and identify subgroups at risk of being either underweight or overweight. METHODS A retrospective clinical audit was undertaken within the Department of Developmental Medicine at The Royal Children's Hospital, Melbourne. Most recent weight and height measurements and data about the child's underlying condition were collected from the medical records of children attending a clinical appointment over a 3-month period. Primary medical diagnosis, age, gender, mode of feeding and ability to ambulate were recorded. Body mass index was calculated and corrected for age and gender. RESULTS Study sample size was 583 (356 males), mean age was 8.25 years (range 2.8-17.4 years). Body mass index could be calculated for 48%. Height was less commonly measured in those with severe physical impairments. A survey of barriers to weight and height measurement showed that the main barrier to measuring height was practical difficulties. The percentage of children classified as overweight/obese was 26.6% and this was associated with intellectual disabilities, moderately impaired ambulation, older age and female gender; 13.5% of the study group was underweight, the majority of whom were non-ambulant. CONCLUSIONS Although significant rates of underweight and overweight were identified in children with a range of disabilities within our service, monitoring of weight status was suboptimal. Despite this, data indicate that specific subgroups of children with disability appear at risk of being either overweight or underweight. Where height cannot be measured, other anthropometric measures such as waist circumference may be useful in the assessment of children with disabilities.
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Affiliation(s)
- Tess Lionti
- Royal Children's Hospital, Murdoch Childrens Research Institute and University of Melbourne, Melbourne, Victoria, Australia
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Yazdani S, Yee CT, Chung PJ. Factors predicting physical activity among children with special needs. Prev Chronic Dis 2013; 10:E119. [PMID: 23866163 PMCID: PMC3716337 DOI: 10.5888/pcd10.120283] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction Obesity is especially prevalent among children with special needs. Both lack of physical activity and unhealthful eating are major contributing factors. The objective of our study was to investigate barriers to physical activity among these children. Methods We surveyed parents of the 171 children attending Vista Del Mar School in Los Angeles, a nonprofit school serving a socioeconomically diverse group of children with special needs from kindergarten through 12th grade. Parents were asked about their child’s and their own physical activity habits, barriers to their child’s exercise, and demographics. The response rate was 67%. Multivariate logistic regression was used to examine predictors of children being physically active at least 3 hours per week. Results Parents reported that 45% of the children were diagnosed with attention deficit hyperactivity disorder, 38% with autism, and 34% with learning disabilities; 47% of children and 56% of parents were physically active less than 3 hours per week. The top barriers to physical activity were reported as child’s lack of interest (43%), lack of developmentally appropriate programs (33%), too many behavioral problems (32%), and parents’ lack of time (29%). However, child’s lack of interest was the only parent-reported barrier independently associated with children’s physical activity. Meanwhile, children whose parents were physically active at least 3 hours per week were 4.2 times as likely to be physically active as children whose parents were less physically active (P = .01). Conclusion In this group of students with special needs, children’s physical activity was strongly associated with parental physical activity; parent-reported barriers may have had less direct effect. Further studies should examine the importance of parental physical activity among children with special needs.
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Affiliation(s)
- Shahram Yazdani
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1752, USA.
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Pizzi MA, Vroman K. Childhood obesity: effects on children's participation, mental health, and psychosocial development. Occup Ther Health Care 2013; 27:99-112. [PMID: 23855569 DOI: 10.3109/07380577.2013.784839] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Obesity and being overweight in a child significantly affects his or her healthy development hence there is an understandable focus in the occupational therapy literature on the physical health and difficulties in motor function related to obesity. However, this emphasis somewhat overshadows the psychosocial issues of growing-up obese or overweight. The objective of this paper is to apprise readers of the salient multiple psychosocial sequelae associated with childhood obesity including weight bias and victimization. A conceptual systems framework that supports a multifaceted approach to the occupational and developmental challenges on a population and/or individual level is discussed.
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Affiliation(s)
- Michael A Pizzi
- Long Island University-Brooklyn and Founder/Executive Director, Touching Humanity Inc., Brooklyn, New York 11201, USA.
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Tsiros MD, Buckley JD, Howe PRC, Olds T, Walkley J, Taylor L, Mallows R, Hills AP, Kagawa M, Coates AM. Day-to-day physical functioning and disability in obese 10- to 13-year-olds. Pediatr Obes 2013; 8:31-41. [PMID: 22962042 DOI: 10.1111/j.2047-6310.2012.00083.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/10/2012] [Accepted: 06/15/2012] [Indexed: 12/20/2022]
Abstract
UNLABELLED What is already known about this subject? Compared with their healthy-weight peers, children with obesity have; impaired physical health-related quality of life reduced physical activity levels reduced capacity to perform certain weight-bearing tasks in field-based fitness tests What this study adds? First investigation of obesity-related disability in children using the International Classification for Functioning, Disability and Health framework for Children and Youth. Obesity in children appears to be associated with disability impacting basic locomotor skills and physical health-related quality of life. Children's participation in key life areas related to physical functioning appears to be minimally impacted by obesity. OBJECTIVE The aim of this study was to investigate whether obesity is related to impaired day-to-day physical functioning and disability in children. METHODS An observational case-control study was conducted in three Australian states. Obese (n = 107) and healthy-weight (n = 132) 10- to 13-year-olds (132 male, 107 female) were recruited via media advertisements. Assessment of body composition (dual energy X-ray absorptiometry), locomotor capacity (six-minute walk test [6MWT], timed up and down stairs test [TUDS] and timed up and go [TUG]) and child-reported physical health-related quality of life (HRQoL) were undertaken. Participants wore an accelerometer for 8 days and completed two use-of-time telephone interviews to assess participation in key life areas. RESULTS Compared with their healthy-weight counterparts, obese children had lower physical HRQoL scores (P < 0.01) and reduced locomotor capacity (TUDS z-score, TUG and 6MWT; P < 0.01). Higher percent body fat was significantly related to lower physical HRQoL scores (r = -0.48, P < 0.01), slower performance times for the TUDS and TUG (r = 0.59 and 0.26 respectively, P < 0.01), shorter 6MWT distances (r = -0.51, P < 0.01) and reduced time spent in community participation activities (r = -0.23, P < 0.01). CONCLUSIONS As anticipated, obesity appears to undermine physical functioning in children, including the capacity to perform basic locomotor skills yet, unexpectedly, participation in key life areas related to physical functioning appeared largely unaffected.
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Affiliation(s)
- M D Tsiros
- Nutritional Physiology Research Centre, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
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