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Rosen AO, Bergam L, Holmes AL, Krebs E, Moreno M, Muñiz GS, Huedo-Medina TB. Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications. Int J Adolesc Med Health 2024; 36:1-15. [PMID: 38373148 PMCID: PMC10904879 DOI: 10.1515/ijamh-2022-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION LatinX youth in the U.S. are disproportionately affected by HIV and STIs, commonly attributed to a lack of diagnostic testing and regular physician consultations to address sexual health. These disparities have been exacerbated by the COVID-19 pandemic. This meta-analysis seeks to assess the efficacy of behavioral interventions among LatinX youth in the U.S. that aim to increase engagement in sexual health services (i.e., STI/HIV testing, physician consultations). CONTENT Following PRISMA guidelines, seven electronic databases were searched. We systematically extracted data with a coding form, and effect sizes were obtained from each study on HIV/STI testing outcomes and physician consultation. Moderator analyses were run for demographic and intervention characteristics. SUMMARY AND OUTLOOK Of nine included studies, the interventions created a small-to-moderate effect on increased engagement of sexual health services (d +=0.204, 95 % CI=0.079, 0.329). Moderator analyses showed that interventions including the following characteristics were most efficacious at facilitating care services: community-based or online setting, access to diagnostic testing, social media/remote components, parental involvement, and longer session duration. This meta-analysis provides informative results regarding behavioral interventions that have proven efficacious in facilitating engagement in sexual health services among LatinX youth. Most prominently, interventions that are remote or through social media, community-based, and incorporated parents had large positive effects. These findings prove useful for the ongoing COVID-19 pandemic situation and provide guidance for targeting LatinX youth to engage them in sexual health services as primary and secondary STI and HIV prevention.
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Affiliation(s)
- Aviana O. Rosen
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Ashley L. Holmes
- Department of Health Policy, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Emma Krebs
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Melanie Moreno
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Geycel S. Muñiz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Tania B. Huedo-Medina
- Department of Clinical, Health Psychology and Research Methodology, University of the Basque Country, San Sebastian - Donastia, Spain
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Gil-Llario MD, Fernández-García O, Huedo-Medina TB, Morell-Mengual V, Ballester-Arnal R. Analysis of the Effectiveness of an Affective-Sexual Education Program for Adults with Intellectual Disabilities. J Sex Res 2024:1-12. [PMID: 38252036 DOI: 10.1080/00224499.2023.2300627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
In recent years, the number of programs to improve sex education for people with intellectual disabilities has increased. However, in most cases, these programs do not provide any evidence of their impact. In the present study we analyzed the effectiveness of the SALUDIVERSEX affective-sexual education program for people with intellectual disabilities using a controlled trial design. 246 individuals from eastern Spain completed a battery of questionnaires before and after the intervention. Multilevel statistical analyses showed that the risk of experiencing sexual abuse had significantly decreased and knowledge about sexuality significantly increased among those who received the intervention compared to those who did not. The evaluation of the professionals who worked daily with the participants agreed on how knowledge about sexuality and intimacy increased and concerns about sexuality decreased among those in the intervention group. The SALUDIVERSEX program is a powerful educational strategy to promote better sexual health and quality of life for people with intellectual disabilities.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut
| | - Vicente Morell-Mengual
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University
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Gil-Llario MD, Fernández-García O, Flores-Buils R, Huedo-Medina TB, Morell-Mengual V, Ballester-Arnal R. People with intellectual disabilities' sexuality from three different perspectives: Parents, professionals, and themselves. J Appl Res Intellect Disabil 2023; 36:1337-1344. [PMID: 37614095 DOI: 10.1111/jar.13154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/22/2023] [Accepted: 08/13/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND A positive conception of sexuality among people with intellectual disabilities is crucial and relies on several social and interpersonal contexts. The goal of this study is to analyse the interaction and impact of three different contextual groups: individuals with intellectual disabilities, their parents, and professionals working with them. METHODS Survey data were collected from 330 people with intellectual disabilities attending occupational centres in eastern Spain, 330 parents, and 100 professionals. RESULTS Correlation and variance analyses of dyad-level data show significant differences among the three groups in all variables. Professionals perceived people with intellectual disabilities to have higher knowledge of socio-sexual norms than people with intellectual disabilities actually appear to be, but they are also more concerned about aspects related to this area of people with intellectual disabilities. Compared to people with intellectual disabilities and professionals, parents perceived people with intellectual disabilities to have lower sexual knowledge. CONCLUSIONS Our study demonstrates inconsistent perceived knowledge of people with intellectual disabilities' socio-sexual norms and sexual knowledge among the three groups, leading to disparate levels of concern regarding people with intellectual disabilities sexuality. Thus, the need to collect information from different perspectives for more accurate reporting and the critical need for sex education programs that involve the target population, but also parents and professionals who frequently interact with people with intellectual disabilities are highlighted.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Raquel Flores-Buils
- Department of Developmental, Educational and Social Psychology and Methodology, Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Spain
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, USA
| | - Vicente Morell-Mengual
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Spain
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Mobley AR, Gans KM, Adamsons K, Huedo-Medina TB. Feasibility, Acceptability, and Preliminary Outcomes of a Father-Focused Childhood Obesity Prevention Program for Low-Income Families with Preschool-Age Children. Child Obes 2023; 19:13-24. [PMID: 35275734 PMCID: PMC10081718 DOI: 10.1089/chi.2021.0225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Few childhood obesity prevention interventions have focused exclusively on fathers, particularly in low-income families. The objectives of this study were to determine feasibility, acceptability, and preliminary outcomes of a father-focused childhood obesity prevention program for low-income families with preschool children (ages 3-5 years old). Methods: Father-child pairs (n = 45) enrolled in a community-based intervention in a Northeastern US state and were assigned within groups to intervention (n = 31) or a delayed comparison group (n = 14). The 8-week (2 h/week) program included nutrition, cooking, and parent education. Feasibility (enrollment, retention, and attendance) and acceptability (quality and value of program) of the program were assessed. Pre/Post measures included the Meals in our Household, Comprehensive Feeding Practices, Healthy Kids, and the Cooking Matters questionnaires. T-tests were conducted and Hedge's g was calculated to estimate effect sizes. Significance was set at p ≤ 0.10. Results: Results indicated feasibility and acceptability of the program for intervention fathers, but recruitment and retention of comparison fathers proved challenging. Small to medium effect sizes were detected for improvements in fathers' feeding pressure (g = 0.48, p = 0.005), confidence in cooking skills (g = 0.25, p = 0.09), ability to cook healthy foods on a budget (g = 0.33, p = 0.10), and frequency that fathers cooked dinner (g = 0.15, p = 0.06). There was a large effect size detected in the increase of green salad consumption (g = 0.75, p = 0.01) by fathers and a small effect size for frequency of children eating vegetables (g = 0.13, p = 0.07). Conclusions: While results are promising, further research should evaluate impact of a larger scale father-focused intervention on diet and obesity risk. The project was registered on ClinicalTrials.gov as NCT03071419.
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Affiliation(s)
- Amy R. Mobley
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration in Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
| | - Kari Adamsons
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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Gil-Llario MD, Fernández-García O, Huedo-Medina TB, Estruch-García V, Ballester-Arnal R. Analysis of the Differential Efficacy of the Reduced Version Over the Extended Version of an Affective-Sexual Education Program for Adults with Intellectual Disabilities. Arch Sex Behav 2023; 52:135-147. [PMID: 36169777 PMCID: PMC9517966 DOI: 10.1007/s10508-022-02407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/16/2023]
Abstract
Recently, with the increase in demand, multiple intervention proposals aimed at improving the sexual health of people with intellectual disabilities have emerged. Among them is the SALUDIVERSEX program, which takes a positive approach to sexuality. It has an extended version, consisting of 16 sessions and whose efficacy has already been proven, and a reduced version of 10 sessions. Thus, the present study aimed to test the differential efficacy of the two versions. A total of 208 participants (103 women and 105 men) aged between 19 and 67 years (M = 37.23, SD = 10.66) completed a battery of instruments before and after the intervention. Statistical analyses showed that users who participated in the reduced version of the program presented a significantly higher rate of improvement in their sexual behaviors compared to those who participated in the extended version (Sexual response: β10 = - 0.46 ± 0.19, p = .034; Sex practices: β10 = - 0.52 ± 0.23, p = .037; Use condoms: β10 = - 1.56 ± 0.59, p = .017), as well as a significantly higher decrease in the risk of suffering sexual abuse (β10 = 3.95 ± 0.64, p < .001). However, no statistically significant differences in sexuality knowledge were obtained with respect to the improvement between the two versions (β10 = - 0.09 ± 1.21, p = .94). Meanwhile, the professionals who applied the program found that those who participated in the reduced version, although they presented a significantly greater increase in their knowledge about privacy (β10 = - 0.48 ± 0.08, p < .001), did not improve their concerns about their inappropriate sexual behaviors as much as the users of the extended version (β10 = - 1.35 ± 0.21, p < .001). Thus, although both versions were effective, the reduced version seems to do so to a greater extent and in a shorter time, which makes it the more recommendable option.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain.
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Verónica Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Spain
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Abstract
Diabetic foot ulcerations have devastating complications, including amputations, poor quality of life, and life-threatening infections. Diabetic wounds can be protracted, take significant time to heal, and can recur after healing. They are costly consuming health care resources. These consequences have serious public health and clinical implications. Debridement is often used as a standard of care. Debridement consists of both nonmechanical (autolytic, enzymatic) and mechanical methods (sharp/surgical, wet to dry debridement, aqueous high-pressure lavage, ultrasound, and biosurgery/maggot debridement therapy). It is used to remove nonviable tissue, to facilitate wound healing, and help prevent these serious outcomes. What are the various forms and rationale behind debridement? This article comprehensively reviews cutting-edge methods and the science behind debridement and diabetic foot ulcers.
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Affiliation(s)
- David Dayya
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA.,Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA.,Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA.,Department of Emergency Medicine, SUNY – Upstate Medical University, Syracuse, New York, USA.,Department of Family Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA.,Department of Medicine, Greenwich Hospital, Greenwich, Connecticut, USA.,Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA.,Correspondence: Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, NY 10591, USA.
| | - Owen J. O'Neill
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA.,Department of Emergency Medicine, SUNY – Upstate Medical University, Syracuse, New York, USA.,Department of Medicine, New York Medical College, Valhalla, New York, USA
| | - Tania B. Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA.,Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Nusrat Habib
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA.,Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Joanna Moore
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | - Kartik Iyer
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
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Dayya D, O'Neill O, Habib N, Moore J, Iyer K, Huedo-Medina TB. Debridement of diabetic foot ulcers: public health and clinical implications – a systematic review, meta-analysis, and meta-regression. BMJ Surg Interv Health Technologies 2022; 4:e000081. [PMID: 35721280 PMCID: PMC9152938 DOI: 10.1136/bmjsit-2021-000081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/07/2022] [Indexed: 11/04/2022] Open
Abstract
BackgroundDiabetic foot ulceration (DFU) has devastating complications and a lifetime occurrence of 15%–34%. Debridement of DFU is regarded as an intervention that accelerates ulcer healing and may reduce complications including amputations, infections, and poor quality of life (QoL), which have serious public health and clinical implications. A systematic review (SR) of SRs and of randomized controlled trials (RCTs) with meta-analyses (MAs) on debridement of DFU that synthesizes all human experimental evidence is warranted.ObjectivesAre debridement methods in DFU beneficial over other forms and standard gauze dressings (control condition) in these outcomes?Study eligibility criteriaAll SRs/MAs/RCTs comparing debridement methods for DFU with alternative methods of debridement and with control.Data sourcesCochrane Wounds Group Specialized Register, Cochrane Central Register of Controlled Trials (Cochrane Library), Ovid MEDLINE, PubMed, EMBASE, EBSCO, CINAHL, and Web of Science.Participants and interventionsAdults with type 1/2 diabetes with DFU and any debridement method compared with alternative debridement methods or control.Main OutcomesAmputation rates, wound infections, QoL, proportion of ulcers healed, time to complete healing, ulcer recurrence, and treatment cost.Study selection and analysisData extraction/synthesis by two independent reviewers pooled using a random-effects model with sensitivity analysis.Results10 SRs were retrieved and reported qualitatively. Six SRs included MAs. This SR included 30 studies, with 2654 participants, using 19 debridement combinations. The debridement methods were compared with findings pooled into MAs. Meta-regression (MR) did not identify significant predictors/moderators of outcomes.LimitationsThe studies may have been under-powered. The inclusion/exclusion criteria varied and the increased risk of bias contributed to low-quality evidence.Discussion/ConclusionWeak evidence exists that debridement methods are superior to other forms of debridement or control in DFU.ImplicationsResearchers should follow standardized reporting guidelines (Consolidated Standards of Reporting Trials). Clinicians/investigators could use the findings from this SR/MA/MR in guiding patient-individualized decision making and designing future RCTs.
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Affiliation(s)
- David Dayya
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA
- Department of Surgery, Zucker School of Medicine, Hofstra University/Northwell, Hempstead, NY, USA
- Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, State University of New York - Upstate Medical University, Syracuse, New York, USA
- Department of Medicine, Greenwich Hospital - Yale New Haven Health System, Greenwich, NY, USA
| | - Owen O'Neill
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA
- Department of Surgery, Zucker School of Medicine, Hofstra University/Northwell, Hempstead, NY, USA
- Division of Undersea and Hyperbaric Medicine, Department of Emergency Medicine, State University of New York - Upstate Medical University, Syracuse, New York, USA
| | - Nusrat Habib
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Joanna Moore
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | - Kartik Iyer
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
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Finkelstein-Fox L, Park CL, Huedo-Medina TB. Appraisal and Coping Link Sexual Victimization History to Emotional Experience: A Multilevel Daily Diary Study. J Interpers Violence 2022; 37:NP6159-NP6185. [PMID: 32959719 DOI: 10.1177/0886260520957691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual victimization (SV) history is common among college students and has many adverse effects on health, but little is known about whether these effects are explained by everyday stress and coping. Further, most studies conflate between- and within-person effects, limiting our understanding of distinct trait- versus state-level pathways. To address these gaps, we examined the multilevel association of SV history with contemporary positive and negative affect and somatic symptoms via daily control appraisals and coping (problem-focused, meaning-focused, and avoidance) with daily stressors. Online daily diary surveys assessed stress, appraisals, coping, affect, and somatization among 261 undergraduates with and without SV history over 11 consecutive days. Between- and within-person differences in appraisals, coping, affect, and somatic symptoms were examined using multilevel covariance modeling in a causal system, testing daily stressor type as a moderator of within-person effects. Across days, SV history was indirectly linked only to average positive affect via meaning-focused coping, with no other between-person indirect effects. At the within-person level, greater negative affect was experienced in the context of interpersonal stress, driven by greater problem-focused coping, greater positive affect was experienced in the context of academic stress, driven by greater control appraisals, and less positive and negative affect were experienced in the context of intrapersonal stress, driven by lower control appraisals and less problem-focused coping. SV may influence daily stress processes at multiple levels, depending on stressor type. Appraised control and active coping are potentially important but understudied ways in which SV history informs contemporary stress management.
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Sinnott SM, Park CL, Huedo-Medina TB. Cognitive Coping Reduces Posttraumatic Stress Symptoms, Especially in the Context of Self-Blame. Journal of Aggression, Maltreatment & Trauma 2022; 31:1108-1127. [PMID: 36468082 PMCID: PMC9718451 DOI: 10.1080/10926771.2022.2061879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals' perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n =344) completed assessments at baseline (T1), one month (T2), and two months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one's life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.
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Affiliation(s)
- Sinead M. Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Crystal L. Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Hubert PA, Mahoney M, Huedo-Medina TB, Leahey TM, Duffy VB. Can Assessing Physical Activity Liking Identify Opportunities to Promote Physical Activity Engagement and Healthy Dietary Behaviors? Nutrients 2021; 13:3366. [PMID: 34684366 PMCID: PMC8540570 DOI: 10.3390/nu13103366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023] Open
Abstract
Improving our understanding of what physical activities are enjoyed and the factors that are associated with physical activity liking can promote participation in regular physical activity. We aimed to study physical activity (PA) liking in college women by modelling interactions between body size perception and dietary behaviors on PA liking, and by examining discrepancies between PA liking versus engagement on body size perception and dietary behaviors. Women (n = 251; 74% white) utilized an online survey to report their level of liking for PA types (scored into a PA liking index) and frequency of PA participation. They also reported their perceived body size, level of dietary restraint, and frequency of consuming foods (scored into a diet quality index). In multivariate analyses, a greater perceived body size was directly associated with lower PA liking and indirectly through greater dietary restraint but lower diet quality. Healthiest dietary behaviors were reported by women who both liked and engaged in PA. Women who reported high PA liking but low PA participation reported a higher dietary restraint and lower diet quality. These findings support the empowerment of women across all body sizes to identify physical activities that they enjoy. Health promotion efforts should encourage women to couple physical activity liking and engagement with a healthy level of dietary restraint and consumption of a healthy diet.
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Affiliation(s)
| | | | | | | | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (P.A.H.); (M.M.); (T.B.H.-M.); (T.M.L.)
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Curtis RM, Huggins RA, Benjamin CL, Sekiguchi Y, Lepley LK, Huedo-Medina TB, Casa DJ. Factors Associated With Noncontact Injury in Collegiate Soccer: A 12-Team Prospective Study of NCAA Division I Men's and Women's Soccer. Am J Sports Med 2021; 49:3076-3087. [PMID: 34406087 DOI: 10.1177/03635465211036447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Multiteam, multi-institution prospective studies of both women's and men's sports are essential for collectively investigating injury and primary to the generalization and individualization of injury prevention strategies. HYPOTHESIS Characteristics of workload, sleep, and contextual factors will be associated with injury risk in collegiate soccer athletes. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Injuries, workload, and sleep characteristics were recorded daily throughout a complete season for 256 athletes from 12 separate National Collegiate Athletic Association Division I men's and women's soccer teams. Workload and contextual factors were assessed via multilevel Poisson regression to capture differences in injury incidence rate ratio (IRR). Paired t test and multilevel logistic regressions were used to assess the relationship between sleep behavior and injury. RESULTS Collegiate soccer athletes had lower rates of noncontact injury in the in-season (IRR, 0.42) and postseason (IRR, 0.48) compared with preseason, lower rates of injury in training (IRR, 0.64) compared with matches, and higher injury rates with only 1 day of rest in the previous week (IRR, 1.58) compared with >1 day. Injury rates peaked when training occurred 4 days before a match (IRR, 2.24) compared with a match. Injury rate increased exponentially with increases in the number of noncontact injuries incurred throughout the season (IRR, 2.23). Lower chronic loading, higher training monotony, and acute spikes and lulls in workload were associated with higher noncontact injury rates. Alterations in previous week sleep quality were associated with injury, while chronic sleep behavior and acute alterations (<7 days) in sleep behavior were not (P > .05). CONCLUSION Athlete and schedule-specific contextual factors, combined with characteristics of workload and weekly sleep behavior, are significantly associated with injury in collegiate soccer. Multiteam prospective cohort studies involving objective and subjective monitoring allow for the identification of multiple injury risk factors in sports, which can be used to guide injury prevention strategies. Maintaining higher chronic workloads, lowering training monotony, minimizing acute spikes or lulls in workloads, managing workloads during preseason and for athletes with previous injury, integrating more rest and recovery during congested periods, and optimizing sleep quality are all practical considerations for reducing injury risk in collegiate soccer.
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Affiliation(s)
- Ryan M Curtis
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Robert A Huggins
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Courteney L Benjamin
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Yasuki Sekiguchi
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Lindsey K Lepley
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
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12
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Taverna EC, Huedo-Medina TB, Fein DA, Eigsti IM. The interaction of fine motor, gesture, and structural language skills: The case of autism spectrum disorder. Res Autism Spectr Disord 2021; 86:101824. [PMID: 34306180 PMCID: PMC8294070 DOI: 10.1016/j.rasd.2021.101824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Motor skill differences have been consistently reported in individuals with ASD. Associations between motor skill and social communication skills have been reported in both typical development (TD) and autism spectrum disorder (ASD). The current study extends these findings to characterize performance on a fine motor imitation task, probing skills as a predictor of social and communicative functioning, and co-speech gesture use. These research questions were addressed by a secondary analysis of data collected during a previous study characterizing a cohort of individuals who were diagnosed with ASD in early childhood but lost the autism diagnosis (LAD) by the time of adolescence. Fine motor imitation skills were compared between 14 individuals with LAD, 15 individuals with autism spectrum disorder (ASD), and 12 typically developing (TD) individuals. LAD and TD groups had more advanced fine motor imitation skills than the ASD group, and abilities were significantly associated with ASD symptoms and amount of gesture use (though there was a counterintuitive interaction between group and fine motor skill in the LAD and TD groups only, in which lower motor skills predicted more ASD symptoms; this relationship was of a small effect size and is likely driven by the compressed range of fine motor skills in these two groups). Findings suggest that fine motor skills normalize along with social communication skills and restricted and repetitive behaviors and interests in individuals who lose the ASD diagnosis, and that individuals with better fine motor abilities produce more co-speech gesture.
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Affiliation(s)
- Elise C. Taverna
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Tania B. Huedo-Medina
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Deborah A. Fein
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Inge-Marie Eigsti
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
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13
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Leahey TM, Huedo-Medina TB, Grenga A, Gay L, Fernandes D, Denmat Z, Doyle C, Areny-Joval R, Wing RR. Patient-provided e-support in reduced intensity obesity treatment: The INSPIRE randomized controlled trial. Health Psychol 2020; 39:1037-1047. [PMID: 33252929 DOI: 10.1037/hea0000996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE There are two types of patient supporters, peers (two individuals initiating health behavior change who support one another) and mentors (a previously successful patient who supports incoming patients). Social comparison theory suggests that peers and mentors may elicit social comparison processes (patients may compare their progress to that of their peer/mentor), and these social comparisons could impact treatment outcomes. This randomized controlled trial is the first to examine the differential impact of peers and mentors on obesity treatment outcomes and social comparison processes when added to reduced intensity treatment. METHOD Participants (N = 278) were randomly assigned to reduced intensity behavioral weight loss treatment alone (rBWL), rBWL plus peer e-support (rBWL + Peer), or rBWL plus mentor e-support (rBWL + Mentor). rBWL involved periodic group sessions that decreased over time; when group sessions decreased, intensity of peer/mentor e-support increased. Weight and social comparison processes were assessed throughout the 12-month intervention. RESULTS There was a significant treatment effect; when group sessions became less frequent and peer/mentor e-support became more frequent, rBWL + Peer had significantly greater weight loss than rBWL alone, and rBWL + Mentor was not significantly different from the other two. Social comparison processes differed by treatment arm; rBWL + Peer participants tended to report more lateral social comparisons ("my weight loss progress is 'similar' to my peer's"), whereas rBWL + Mentor participants reported more upward comparisons ("my weight loss progress is 'worse than' my mentor's"). Upward comparisons were associated with poorer weight loss outcomes. CONCLUSIONS Peer e-support may be an effective, low-cost, sustainable method for improving longer-term weight loss outcomes in reduced intensity obesity treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Linda Gay
- Weight Control and Diabetes Research Center
| | | | - Zeely Denmat
- Institute for Collaboration on Health, Intervention and Policy
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14
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Leahey TM, Gorin AA, Wyckoff E, Denmat Z, O'Connor K, Field C, Dunton GF, Gunstad J, Huedo-Medina TB, Gilder C. Episodic future thinking, delay discounting, and exercise during weight loss maintenance: The PACE trial. Health Psychol 2020; 39:796-805. [PMID: 32833481 DOI: 10.1037/hea0000860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Weight loss maintenance (WLM) is the next major challenge in obesity treatment. While most individuals who lose weight intend to keep their weight off, weight regain is common. Temporal Self-Regulation Theory posits that whether intentions lead to behavior depends on self-regulatory capacity, including delay discounting (DD; the tendency to discount a larger future reward in favor of a smaller immediate reward). Episodic Future Thinking (EFT; mental imagery of a future event for which a health goal is important) may improve DD and promote behavior change. Described herein is a trial protocol designed to examine whether EFT improves DD within the context of weight loss maintenance. METHOD Participants who lose ≥5% of initial body weight in an online behavioral weight loss intervention will be randomly assigned to a standard weight loss maintenance program (WLM-STD) or a weight loss maintenance program plus EFT (WLM + EFT). Both interventions involve periodic phone and in-person treatment sessions. Participants in WLM + EFT will engage in daily EFT training via smartphone. To control for contact, participants in WLM-STD will engage in daily Healthy Thinking (reviewing strategies for weight management) on their smartphone. Our primary hypothesis is that WLM + EFT will yield better improvements in DD compared to WLM-STD. We will also explore whether DD mediates the relationship between intervention allocation and physical activity (secondary outcome). Weight and contextual variables will be explored. CONCLUSIONS This study is the first to test whether EFT improves DD within the context of weight loss maintenance; results from this experimental medicine approach could have important implications for understanding the impact of both EFT and DD on sustained behavior change. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Tricia M Leahey
- Institute for Collaboration on Health, Intervention, and Policy, Department of Allied Health Sciences, University of Connecticut
| | - Amy A Gorin
- Institute for Collaboration on Health, Intervention, and Policy, Department of Psychological Sciences, University of Connecticut
| | - Emily Wyckoff
- Institute for Collaboration on Health, Intervention, and Policy, Department of Psychological Sciences, University of Connecticut
| | - Zeely Denmat
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut
| | - Kayla O'Connor
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut
| | - Christiana Field
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut
| | | | - John Gunstad
- Department of Psychological Sciences, Kent State University
| | - Tania B Huedo-Medina
- Institute for Collaboration on Health, Intervention, and Policy, and Department of Allied Health Sciences, University of Connecticut
| | - Carnisha Gilder
- Institute for Collaboration on Health, Intervention, and Policy, and Department of Allied Health Sciences, University of Connecticut
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15
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Sullivan MC, Cruess DG, Huedo-Medina TB, Kalichman SC. Substance Use, HIV Serostatus Disclosure, and Sexual Risk Behavior in People Living with HIV: An Event-Level Analysis. Arch Sex Behav 2020; 49:2005-2018. [PMID: 31863314 DOI: 10.1007/s10508-019-01531-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/21/2019] [Accepted: 07/31/2019] [Indexed: 05/22/2023]
Abstract
People living with HIV (PLWH) face difficult decisions about disclosing their HIV status to new sexual partners. Alcohol and other drug use could impact these decision-making processes and subsequent sexual risk behavior. We sought to examine the event-level relationships between substance use, HIV disclosure, and condom use in PLWH and their first-time HIV-negative or unknown status sexual partners. Adult PLWH were recruited from care settings in a southeastern U.S. city. Participants reported their sexual behavior for 28 consecutive days via text message prompts. We employed multilevel covariation in a causal system to examine the event-level relations between substance use and condom use. We proposed that this relationship would be mediated by HIV disclosure and moderated by viral suppression status. A total of 243 participants (83% male, 93% Black) reported 509 sexual events with first-time HIV-negative/unknown status sexual partners. Substance use at the time of sex was negatively associated with disclosure in PLWH with suppressed viral load (OR 0.29, β = - 1.22, 95% CI [- 2.42, - 0.03], p = .045), but differentially associated with condom use in PLWH with detectable versus undetectable viral load. In PLWH with viral suppression, participants who always disclosed versus who never disclosed their HIV status were more likely to use condoms (β = 1.84, 95% CI [0.35, 3.53], p = .017), but inconsistent disclosers were less likely to use a condom after disclosing (OR 0.22, 95% CI [0.07, 0.68], p = .008). Event-level analysis offers a more nuanced understanding of the proximal (substance use, HIV disclosure) and person-level (substance use, viral load) determinants of HIV transmission risk behavior in PLWH.
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Affiliation(s)
- Matthew C Sullivan
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA.
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA.
| | - Dean G Cruess
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
| | - Tania B Huedo-Medina
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
- Allied Health Sciences Department, University of Connecticut, Storrs, CT, USA
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
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16
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Lee SY, Finkelstein-Fox L, Park CL, Mazure CM, Huedo-Medina TB, Hoff R. Bidirectionality of Pain Interference and PTSD Symptoms in Military Veterans: Does Injury Status Moderate Effects? Pain Med 2020; 20:934-943. [PMID: 30016463 DOI: 10.1093/pm/pny133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Pain and post-traumatic stress disorder (PTSD) symptoms are strongly correlated in veteran populations. Arguments for which one condition predicts or worsens the other condition have gone in both directions. However, research addressing this issue has been primarily limited to cross-sectional studies rather than examinations of a potential bidirectional relationship between pain interference and PTSD symptoms over time. In addition, no studies have examined deployment injury status as potentially moderating this bidirectional effect in veterans. To address these gaps in the literature, the present longitudinal study examined whether there is a bidirectional relationship between pain interference and PTSD symptoms in a sample of male and female veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, or Operation New Dawn (N = 729) and whether deployment injury status moderates this relationship. METHODS Participants completed phone interviews regarding pain interference and PTSD symptoms at three time points, each three months apart. RESULTS Pain interference at Time 1 predicted worse PTSD symptoms at Time 2 for the subset of veterans who sustained injuries during deployment (n = 381) but not for veterans with pain interference who did not sustain injuries (n = 338). From Time 1 to Time 3, elevations in PTSD symptoms were mediated by pain interference for injured veterans; in contrast, PTSD symptoms did not appear to drive changes in pain interference in either group. CONCLUSIONS These results indicate that physical symptom management should be a crucial target of psychological intervention for returning veterans with PTSD symptoms and deployment-related injuries.
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Affiliation(s)
- Sharon Y Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Women's Health Research at Yale, New Haven, CT, USA
| | | | - Rani Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Women's Health Research at Yale, New Haven, CT, USA.,VISN1 MIRECC, VA Connecticut Healthcare System, New Haven, CT, USA
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17
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Gorin AA, Powers TA, Gettens K, Cornelius T, Koestner R, Mobley AR, Pescatello LS, Huedo-Medina TB. A randomized controlled trial of a theory-based weight-loss program for couples. Health Psychol 2020; 39:137-146. [PMID: 31789558 PMCID: PMC6957719 DOI: 10.1037/hea0000808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Weight gain occurs during marriage, yet obesity treatment is focused on individuals. Outcomes may be improved by targeting joint weight loss and the interpersonal milieu that fosters spousal interdependence. Self-determination theory (SDT) posits that autonomy-supportive environments (e.g., promote meaningful choice, minimize control) produce better health outcomes. This trial tested an SDT-informed weight-loss intervention intended to facilitate autonomy support in couples. METHOD Sixty-four couples were randomized to standard behavioral weight loss (BWL) that couples attended together or to a SDT-informed weight-loss intervention (SDT-WL) that aimed to bolster autonomy support (AS). Groups met weekly for 6 months with assessments at 0, 3, 6, and 12 months. RESULTS Percent weight loss at 6 and 12 months was 10.4% ± 6.5% and 9.2% ± 8.2%. No differences were observed between the BWL and SDT-WL conditions in percent weight loss or changes in AS. Across conditions, higher baseline AS predicted greater weight loss at 6 and 12 months (ps <.001). Increases in AS over time predicted greater weight loss at 6 and 12 months (ps ≤ .02). Post hoc moderation analysis indicated that only participants with low (but not high) baseline AS achieved greater gains in AS at 12 months in SDT-WL than in the BWL conditions (p < .02). CONCLUSIONS Although no differences were found between conditions on weight loss or changes in autonomy support behavior, autonomy support from one's spouse predicted weight loss in both couples-based weight-loss approaches. For couples with low levels of AS, an SDT-informed approach was effective at increasing this desirable interpersonal behavior. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut
| | | | - Katelyn Gettens
- Department of Psychological Sciences, University of Connecticut
| | - Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center
| | | | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida
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18
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Lalla RV, Li EY, Huedo-Medina TB, MacNeil RLM. Evaluation of an Experiential and Self-Learning Approach to Teaching Evidence-Based Decision Making to Dental Students. J Dent Educ 2019; 83:1125-1133. [PMID: 31285368 DOI: 10.21815/jde.019.125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/17/2019] [Indexed: 11/20/2022]
Abstract
The aim of this study was to evaluate the impact on predoctoral dental students of an experiential and self-learning pedagogical approach to evidence-based decision making. Dental students at one U.S. dental school in 2014 and 2015 participated in an evidence-based decision making course that consisted of minimal lecturing, learning through assigned readings and open-book online quizzes, and individual assignments to reach an evidence-based decision on a clinically relevant question. Before and after the course, each cohort completed a validated survey assessing students' knowledge, attitudes, access of evidence, and confidence related to evidence-based practice. In 2014, of 43 students enrolled in the course, all 43 (100%) completed the pre-course survey, and 33 (77%) completed the post-course survey. In 2015, of 35 students enrolled in the course, all 35 (100%) completed the pre-course survey, and 34 (97%) completed the post-course survey. Of those, the identifier codes for 23 students in 2014 and 25 students in 2015 matched for the pre-course and post-course surveys, allowing direct comparisons. Both cohorts of students showed a significant increase in knowledge regarding critical appraisal of the literature from the pre-course survey results to after the course (p<0.001). Students' reported frequency of accessing evidence from various sources also significantly increased from before to after the course for both cohorts (p<0.01). Students' confidence in evaluating various aspects of a published research report also increased significantly from before to after the course for both cohorts (p<0.001). However, no consistent change was found in students' attitudes about evidence-based practice. In this study, an experiential and self-learning approach to teaching evidence-based decision making in the classroom appeared to be successful in improving students' knowledge, use of evidence, and confidence in critical appraisal skills, though it did not have a consistent impact on their attitudes about evidence-based practice.
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Affiliation(s)
- Rajesh V Lalla
- Rajesh V. Lalla, DDS, PhD, is Professor, Associate Dean for Research, and Course Director for Evidence-Based Decision Making, University of Connecticut School of Dental Medicine; Eva Yujia Li, MEd, is a PhD candidate, Research Methods, Measurement, and Evaluation Program, Department of Educational Psychology, University of Connecticut; Tania B. Huedo-Medina, PhD, is Associate Professor, Department of Allied Health Sciences, University of Connecticut; and R. Lamont (Monty) MacNeil, DDS, MDentSc, is Professor and Dean Emeritus, University of Connecticut School of Dental Medicine.
| | - Eva Yujia Li
- Rajesh V. Lalla, DDS, PhD, is Professor, Associate Dean for Research, and Course Director for Evidence-Based Decision Making, University of Connecticut School of Dental Medicine; Eva Yujia Li, MEd, is a PhD candidate, Research Methods, Measurement, and Evaluation Program, Department of Educational Psychology, University of Connecticut; Tania B. Huedo-Medina, PhD, is Associate Professor, Department of Allied Health Sciences, University of Connecticut; and R. Lamont (Monty) MacNeil, DDS, MDentSc, is Professor and Dean Emeritus, University of Connecticut School of Dental Medicine
| | - Tania B Huedo-Medina
- Rajesh V. Lalla, DDS, PhD, is Professor, Associate Dean for Research, and Course Director for Evidence-Based Decision Making, University of Connecticut School of Dental Medicine; Eva Yujia Li, MEd, is a PhD candidate, Research Methods, Measurement, and Evaluation Program, Department of Educational Psychology, University of Connecticut; Tania B. Huedo-Medina, PhD, is Associate Professor, Department of Allied Health Sciences, University of Connecticut; and R. Lamont (Monty) MacNeil, DDS, MDentSc, is Professor and Dean Emeritus, University of Connecticut School of Dental Medicine
| | - R Lamont Monty MacNeil
- Rajesh V. Lalla, DDS, PhD, is Professor, Associate Dean for Research, and Course Director for Evidence-Based Decision Making, University of Connecticut School of Dental Medicine; Eva Yujia Li, MEd, is a PhD candidate, Research Methods, Measurement, and Evaluation Program, Department of Educational Psychology, University of Connecticut; Tania B. Huedo-Medina, PhD, is Associate Professor, Department of Allied Health Sciences, University of Connecticut; and R. Lamont (Monty) MacNeil, DDS, MDentSc, is Professor and Dean Emeritus, University of Connecticut School of Dental Medicine
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19
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Larsen BA, Litt MD, Huedo-Medina TB, Duffy VB. Modeling Associations between Chemosensation, Liking for Fats and Sweets, Dietary Behaviors and Body Mass Index in Chronic Smokers. Nutrients 2019; 11:E271. [PMID: 30691090 PMCID: PMC6412709 DOI: 10.3390/nu11020271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 01/31/2023] Open
Abstract
Chronic smokers have a greater risk for altered chemosensation, unhealthy dietary patterns, and excessive adiposity. In an observational study of chronic smokers, we modeled relationships between chemosensation, fat/carbohydrate liking, smoking-associated dietary behaviors, and body mass index (BMI). Also tested in the model was liking for sweet electronic cigarette juice (e-juice). Smokers (n = 135, 37 ± 11 years) were measured for: Taste genetics (intensity of 6-n-propylthiouracil-PROP); taste (NaCl and quinine intensities) and olfactory (odor identification) function; liking for cherry e-juice; and weight/height to calculate BMI. Smokers survey-reported their food liking and use of smoking for appetite/weight control. Structural equation models tested direct and indirect relationships between chemosensation, fat/carbohydrate liking, dietary behaviors, and BMI. In good-fitting models, taste intensity was linked to BMI variation through fat/carbohydrate liking (greater PROP intensity→greater NaCl intensity→greater food liking→higher BMI). Olfactory function tended to predict sweet e-juice liking, which, in turn, partially mediated the food liking and BMI association. The path between smoking-associated dietary behaviors and BMI was direct and independent of chemosensation or liking. These findings indicate that taste associates with BMI in chronic smokers through liking of fats/carbohydrates. Future research should determine if vaping sweet e-juice could improve diet quality and adiposity for smokers.
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Affiliation(s)
- Brittany A Larsen
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Mark D Litt
- Division of Behavioral Sciences & Community Health, University of Connecticut Health Center, Farmington, CT 06030, USA.
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
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20
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Kirsch I, Huedo-Medina TB, Pigott HE, Johnson BT. Do outcomes of clinical trials resemble those of “real world” patients? A reanalysis of the STAR*D antidepressant data set. Psychology of Consciousness: Theory, Research, and Practice 2018. [DOI: 10.1037/cns0000164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Sharafi M, Rawal S, Fernandez ML, Huedo-Medina TB, Duffy VB. Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling. Physiol Behav 2018; 194:103-112. [DOI: 10.1016/j.physbeh.2018.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/24/2018] [Accepted: 05/06/2018] [Indexed: 01/04/2023]
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22
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Pellowski JA, Huedo-Medina TB, Kalichman SC. Food Insecurity, Substance Use, and Sexual Transmission Risk Behavior Among People Living with HIV: A Daily Level Analysis. Arch Sex Behav 2018; 47:1899-1907. [PMID: 28429158 PMCID: PMC5650554 DOI: 10.1007/s10508-017-0942-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 06/02/2023]
Abstract
People living with HIV in poverty have limited tangible and mental resources coupled with competing demands for these resources. Competing demands require individuals to make choices that may be beneficial to them in the short term but not in the long term. Past research has shown that food insecurity is related to sexual risk behaviors among people living with HIV. Individuals who are food insecure may sell sex in order to obtain food or lack of food may lead to a depletion of mental resources to negotiate safe sex. Substance use may also create additional constraints on these already limited resources. The current study tested the relation between food insecurity and day-level sexual risk behavior and the possible mediating role that alcohol/substance use may play. Men and women living with HIV were enrolled in a 28-day prospective study between October 2012 and April 2014 in which they completed daily text message surveys regarding their sex behaviors and substance/alcohol use in the context of sex. A total of 796 participants reported sex on 3894 days. On days in which sex occurred, baseline food insecurity was negatively associated with daily condom use. There was also a significant effect of substance use in the context of sex on the rates of change in condom use over time, and this interaction between substance use and time was a partial mediator of the relation between food insecurity and condom use. Gender did not moderate this mediation. Situation-specific alcohol and drug use should be integrated into interventions that target food insecurity and HIV prevention.
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Affiliation(s)
- Jennifer A Pellowski
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 121 South Main Street, 2nd Floor, Providence, RI, 02903, USA.
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences and Department of Statistics, University of Connecticut, Storrs, CT, USA
| | - Seth C Kalichman
- Department of Psychology, University of Connecticut, Storrs, CT, USA
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23
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Trafimow D, Amrhein V, Areshenkoff CN, Barrera-Causil CJ, Beh EJ, Bilgiç YK, Bono R, Bradley MT, Briggs WM, Cepeda-Freyre HA, Chaigneau SE, Ciocca DR, Correa JC, Cousineau D, de Boer MR, Dhar SS, Dolgov I, Gómez-Benito J, Grendar M, Grice JW, Guerrero-Gimenez ME, Gutiérrez A, Huedo-Medina TB, Jaffe K, Janyan A, Karimnezhad A, Korner-Nievergelt F, Kosugi K, Lachmair M, Ledesma RD, Limongi R, Liuzza MT, Lombardo R, Marks MJ, Meinlschmidt G, Nalborczyk L, Nguyen HT, Ospina R, Perezgonzalez JD, Pfister R, Rahona JJ, Rodríguez-Medina DA, Romão X, Ruiz-Fernández S, Suarez I, Tegethoff M, Tejo M, van de Schoot R, Vankov II, Velasco-Forero S, Wang T, Yamada Y, Zoppino FCM, Marmolejo-Ramos F. Manipulating the Alpha Level Cannot Cure Significance Testing. Front Psychol 2018; 9:699. [PMID: 29867666 PMCID: PMC5962803 DOI: 10.3389/fpsyg.2018.00699] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/23/2018] [Indexed: 11/30/2022] Open
Abstract
We argue that making accept/reject decisions on scientific hypotheses, including a recent call for changing the canonical alpha level from p = 0.05 to p = 0.005, is deleterious for the finding of new discoveries and the progress of science. Given that blanket and variable alpha levels both are problematic, it is sensible to dispense with significance testing altogether. There are alternatives that address study design and sample size much more directly than significance testing does; but none of the statistical tools should be taken as the new magic method giving clear-cut mechanical answers. Inference should not be based on single studies at all, but on cumulative evidence from multiple independent studies. When evaluating the strength of the evidence, we should consider, for example, auxiliary assumptions, the strength of the experimental design, and implications for applications. To boil all this down to a binary decision based on a p-value threshold of 0.05, 0.01, 0.005, or anything else, is not acceptable.
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Affiliation(s)
- David Trafimow
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Valentin Amrhein
- Zoological Institute, University of Basel, Basel, Switzerland.,Swiss Ornithological Institute, Sempach, Switzerland
| | | | - Carlos J Barrera-Causil
- Faculty of Applied and Exact Sciences, Metropolitan Technological Institute, Medellín, Colombia
| | - Eric J Beh
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Yusuf K Bilgiç
- Department of Mathematics, State University of New York at Geneseo, Geneseo, NY, United States
| | - Roser Bono
- Quantitative Psychology Unit, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Michael T Bradley
- Department of Psychology, Faculty of Arts, University of New Brunswick, Saint John, NB, Canada
| | | | | | - Sergio E Chaigneau
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Daniel R Ciocca
- Oncology Laboratory, Instituto de Medicina y Biologia Experimental de Cuyo, CCT CONICET Mendoza, Mendoza, Argentina
| | - Juan C Correa
- School of Statistics, Faculty of Sciences, National University of Colombia, Medellín, Colombia
| | - Denis Cousineau
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Michiel R de Boer
- Department of Health Sciences, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Subhra S Dhar
- Department of Mathematics and Statistics, Indian Institute of Technology, Kanpur, India
| | - Igor Dolgov
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Juana Gómez-Benito
- Quantitative Psychology Unit, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Marian Grendar
- Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.,Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - James W Grice
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Martin E Guerrero-Gimenez
- Oncology Laboratory, Instituto de Medicina y Biologia Experimental de Cuyo, CCT CONICET Mendoza, Mendoza, Argentina
| | - Andrés Gutiérrez
- Faculty of Statistics, Saint Thomas University, Bogotá, Colombia
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, College of Health, Agriculture, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Klaus Jaffe
- Departamento de Biología de Organismos, Universidad Simón Bolívar, Caracas, Venezuela
| | - Armina Janyan
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria.,National Research Tomsk State University, Tomsk, Russia
| | - Ali Karimnezhad
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | | | - Koji Kosugi
- School of Human Sciences, Senshu University, Kawasaki, Japan
| | - Martin Lachmair
- Multimodal Interaction Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Rubén D Ledesma
- Consejo Nacional de Investigaciones Científicas y Técnicas, Mar del Plata, Argentina.,Facultad de Psicología, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Roberto Limongi
- Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.,Vicerrectoría de Investigación y Desarrollo, Universidad Tecnológica de Chile INACAP, Santiago, Chile
| | - Marco T Liuzza
- Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Rosaria Lombardo
- Economics Department, University of Campania "Luigi Vanvitelli", Capua, Italy
| | - Michael J Marks
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, University Hospital Basel and University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Berlin, Germany.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Ladislas Nalborczyk
- Université Grenoble Alpes, Centre National de la Recherche Scientifique, LPNC, Grenoble, France.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Hung T Nguyen
- Department of Mathematical Sciences, New Mexico State University, Las Cruces, NM, United States
| | - Raydonal Ospina
- Computational Statistics Laboratory (CAST), Department of Statistics, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Roland Pfister
- Department of Psychology III, University of Würzburg, Würzburg, Germany
| | - Juan J Rahona
- Multimodal Interaction Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | | | - Xavier Romão
- CONSTRUCT-LESE, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Susana Ruiz-Fernández
- Multimodal Interaction Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany.,FOM Hochschule für Oekonomie und Management, Essen, Germany.,LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
| | - Isabel Suarez
- Department of Psychology, Universidad del Norte, Barranquilla, Colombia
| | - Marion Tegethoff
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Mauricio Tejo
- Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valparaíso, Chile
| | - Rens van de Schoot
- Department of Methods and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands.,North-West University, Optentia Research Focus Area, Vanderbijlpark, South Africa
| | - Ivan I Vankov
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | | | - Tonghui Wang
- Department of Mathematical Sciences, New Mexico State University, Las Cruces, NM, United States
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Felipe C M Zoppino
- Oncology Laboratory, Instituto de Medicina y Biologia Experimental de Cuyo, CCT CONICET Mendoza, Mendoza, Argentina
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Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN. Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis. Evid Based Ment Health 2018; 21:53-60. [PMID: 29636354 PMCID: PMC10702268 DOI: 10.1136/eb-2017-102858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/02/2018] [Accepted: 03/16/2018] [Indexed: 01/04/2023]
Abstract
QUESTION Recent data suggest that anxiety disorders are as often comorbid with bipolar disorder (BD) as with unipolar depression. The literature on panic disorder (PD) comorbid with BD has been systematically reviewed and subject to meta-analysis. STUDY SELECTION AND ANALYSIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were thoroughly followed for literature search, selection and reporting of available evidence. The variance-stabilising Freeman-Tukey double arcsine transformation was used in the meta-analysis of prevalence estimates. Both fixed-effect and random-effects models with inverse variance method were applied to estimate summary effects for all combined studies. Heterogeneity was assessed and measured with Cochran's Q and I2 statistics. FINDINGS Overall, 15 studies (n=3391) on cross-sectional prevalence and 25 independent lifetime studies (n=8226) were used to calculate pooled estimates. The overall random-effects point prevalence of PD in patients with BD, after exclusion of one potential outlier study, was 13.0% (95% CI 7.0% to 20.3%), and the overall random-effects lifetime estimate, after exclusion of one potential outlier study, was 15.5% (95% CI 11.6% to 19.9%). There were no differences in rates between BD-I and BD-II. Significant heterogeneity (I2 >95%) was found in both estimates. CONCLUSIONS Estimates that can be drawn from published studies indicate that the prevalence of PD in patients with BD is higher than the prevalence in the general population. Comorbid PD is reportedly associated with increased risk of suicidal acts and a more severe course. There is no clear indication on how to treat comorbid PD in BD. Findings from the current meta-analysis confirm the highly prevalent comorbidity of PD with BD, implicating that in patients with BD, PD might run a more chronic course.
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Affiliation(s)
- Antonio Preti
- Genneruxi Medical Center, Cagliari, Italy
- Center for Consultation-Liaison Psychiatry and Psychosomatics, University Hospital of Cagliari, Cagliari, Italy
| | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
| | | | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Odysseas Kyriazis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sagherian MJ, Huedo-Medina TB, Pellowski JA, Eaton LA, Johnson BT. Single-Session Behavioral Interventions for Sexual Risk Reduction: A Meta-Analysis. Ann Behav Med 2017; 50:920-934. [PMID: 27510956 DOI: 10.1007/s12160-016-9818-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Evidence-based, single-session STI/HIV interventions to reduce sexual risk taking are potentially effective options for implementation in resource-limited settings and may solve problems associated with poor participant retention. PURPOSE The purpose of the study is to estimate the efficacy of single-session, behavioral interventions in reducing unprotected sex or increasing condom use. METHODS Data sources were searched through April 2013 producing 67 single-session interventions (52 unique reports; N = 20,039) that included outcomes on condom use and/or unprotected sex. RESULTS Overall, participants in single-session interventions reduced sexual risk taking relative to control groups (d + = 0.19, 95 % CI = 0.11, 0.27). Within-group effects of the interventions were larger than the between-groups effects when compared to controls. CONCLUSIONS Brief, targeted single-session sexual risk reduction interventions demonstrate a small but significant effect and should be prioritized.
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Shrestha R, Altice FL, Huedo-Medina TB, Karki P, Copenhaver M. Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment. AIDS Behav 2017; 21:1299-1308. [PMID: 27990587 DOI: 10.1007/s10461-016-1650-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.
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Carmona VR, Gómez-Benito J, Huedo-Medina TB, Rojo JE. Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials. Int J Occup Med Environ Health 2017; 30:345-366. [PMID: 28481370 DOI: 10.13075/ijomeh.1896.01074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Access to employment plays a critical role in the recovery and functioning of people with schizophrenia. We have investigated the effectiveness of treatments to enhance employment outcomes for people with schizophrenia and evaluated the potential moderators of these outcomes. A literature search was conducted in CINAHL, Cochrane Databases, MEDLINE, ProQuest XML, PsycINFO, Scopus, and Web of Science. Grey literature databases, references lists of the retrieved articles and specialized journals in the field were also inspected. Job placement, job tenure and wages earned were tested. Risk ratios were extracted for job placement and standardized mean differences were calculated for job tenure and wages earned. Twenty-five randomized controlled trials published between 1986 and December 2015 were analyzed. Engaging in a vocational intervention increases the likelihood of obtaining a competitive job (risk ratio (RR) = 2.31, 95% confidence interval (CI): 1.85-2.88) and has a positive impact on hours worked in any job (standardized mean difference (SMD) = 0.42, 95% CI: 0.16-0.68). There was no evidence of intervention efficacy with regard to wages earned from competitive employment. Participation in rehabilitative vocational treatment is not sufficient to ensure work participation for people with schizophrenia. Comprehensive treatments are necessary to address functional deficits that hinder labor stability and job performance for people with schizophrenia. Int J Occup Med Environ Health 2017;30(3):345-366.
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Affiliation(s)
- Viviana R Carmona
- University of Barcelona, Barcelona, Spain (Department of Behavioral Sciences Methods).
| | - Juana Gómez-Benito
- University of Barcelona, Barcelona, Spain (Department of Behavioral Sciences Methods).
| | | | - J Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain.
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Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis. J Assoc Nurses AIDS Care 2017; 28:612-621. [PMID: 28478870 DOI: 10.1016/j.jana.2017.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
Abstract
Neurocognitive impairment (NCI) and HIV risk are significant correlates of intent to use preexposure prophylaxis (PrEP). The extent to which similar outcomes could occur when these factors operate together, particularly for people who use drugs (PWUD), remains an important unanswered question. We therefore sought evidence that HIV risk behavior mediated the relationship between NCI and intent to use PrEP in high-risk PWUD in treatment. HIV-uninfected, methadone-maintained people who reported HIV-risk behaviors were enrolled (n = 400). Variables of interest (NCI, HIV risk behaviors, intent to use PrEP) were assessed using audio computer-assisted self-interview. We found preliminary evidence of indirect effect of HIV risk behaviors, such that NCI had an increased impact on intent to use PrEP via HIV risk behaviors. As a result of having this information, clinicians and researchers will be better equipped for evidence-informed targeting and dissemination efforts to optimize PrEP uptake by this underserved population.
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29
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Shrestha R, Karki P, Altice FL, Huedo-Medina TB, Meyer JP, Madden L, Copenhaver M. Correlates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment. Drug Alcohol Depend 2017; 173:107-116. [PMID: 28214391 PMCID: PMC5366273 DOI: 10.1016/j.drugalcdep.2016.12.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/23/2016] [Accepted: 12/18/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although people who use drugs (PWUD) are key populations recommended to receive pre-exposure prophylaxis (PrEP) to prevent HIV, few data are available to guide PrEP delivery in this underserved group. We therefore examined the willingness to initiate PrEP and the anticipation of HIV risk reduction while on PrEP among high-risk PWUD. METHODS In a cross-sectional study of 400 HIV-negative, opioid dependent persons enrolled in a methadone program and reporting recent risk behaviors, we examined independent correlates of being willing to initiate PrEP. RESULTS While only 72 (18%) were aware of PrEP, after being given a description of it, 251 (62.7%) were willing to initiate PrEP. This outcome was associated with having neurocognitive impairment (aOR=3.184, p=0.004) and higher perceived HIV risk (aOR=8.044, p<0.001). Among those willing to initiate PrEP, only 12.5% and 28.2%, respectively, indicated that they would always use condoms and not share injection equipment while on PrEP. Consistent condom use was associated with higher income (aOR=8.315, p=0.016), always using condoms with casual partners (aOR=6.597, p=0.001), and inversely associated with ongoing drug injection (aOR=0.323, p=0.027). Consistent safe injection, however, was inversely associated with age (aOR=0.948, p=0.035), ongoing drug injection (aOR=0.342, p<0.001), and perceived HIV risk (aOR=0.191, p=0.019). CONCLUSIONS While willingness to initiate PrEP was high and correlated with being at elevated risk for HIV, anticipated higher risk behaviors in this group even while on PrEP suggests that the next generation of HIV prevention approaches may need to combine biomedical and behavioral components to sustain HIV risk reduction over time.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
| | - Pramila Karki
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA; Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Frederick L Altice
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA; Department of Internal Medicine, AIDS Program, Yale University School of Medicine, New Haven, CT, USA
| | - Tania B Huedo-Medina
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA; Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Jaimie P Meyer
- Department of Internal Medicine, AIDS Program, Yale University School of Medicine, New Haven, CT, USA
| | | | - Michael Copenhaver
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA; Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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30
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Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL. A Moderated Mediation Model of HIV-Related Stigma, Depression, and Social Support on Health-Related Quality of Life among Incarcerated Malaysian Men with HIV and Opioid Dependence. AIDS Behav 2017; 21:1059-1069. [PMID: 28108877 DOI: 10.1007/s10461-017-1693-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p < 0.001; b1:β = -0.8392, p < 0.001), as demonstrated by the two-tailed significance test (Sobel z = -3.8762, p < 0.001). Furthermore, the association between social support and HRQoL was positive (β = 0.4352, p = 0.0433), whereas the interaction between HIV-related stigma and depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine & Health Care, University of Connecticut Health Center, 263 Farmington Avenue, MC 6325, Farmington, CT, 06030-6325, USA.
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA.
| | - Michael Copenhaver
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Alexander R Bazazi
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Tania B Huedo-Medina
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Archana Krishnan
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
- Department of Communication, University at Albany, State University of New York, Albany, USA
| | - Frederick L Altice
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
- Department of Communication, University at Albany, State University of New York, Albany, USA
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31
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MacDonald HV, Johnson BT, Huedo-Medina TB, Livingston J, Forsyth KC, Kraemer WJ, Farinatti PTV, Pescatello LS. Dynamic Resistance Training as Stand-Alone Antihypertensive Lifestyle Therapy: A Meta-Analysis. J Am Heart Assoc 2016; 5:JAHA.116.003231. [PMID: 27680663 PMCID: PMC5121472 DOI: 10.1161/jaha.116.003231] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Aerobic exercise (AE) is recommended as first‐line antihypertensive lifestyle therapy based on strong evidence showing that it lowers blood pressure (BP) 5 to 7 mm Hg among adults with hypertension. Because of weaker evidence showing that dynamic resistance training (RT) reduces BP 2 to 3 mm Hg among adults with hypertension, it is recommended as adjuvant lifestyle therapy to AE training. Yet, existing evidence suggests that dynamic RT can lower BP as much or more than AE. Methods and Results We meta‐analyzed 64 controlled studies (71 interventions) to determine the efficacy of dynamic RT as stand‐alone antihypertensive therapy. Participants (N=2344) were white (57%), middle‐aged (47.2±19.0 years), and overweight (26.8±3.4 kg/m2) adults with prehypertension (126.7±10.3/76.8±8.7 mm Hg); 15% were on antihypertensive medication. Overall, moderate‐intensity dynamic RT was performed 2.8±0.6 days/week for 14.4±7.9 weeks and elicited small‐to‐moderate reductions in systolic BP (SBP; d+=−0.31; 95% CIs, −0.43, −0.19; −3.0 mm Hg) and diastolic BP (DBP; d+=−0.30; 95% CIs, −0.38, −0.18; −2.1 mm Hg) compared to controls (Ps<0.001). Greater BP reductions occurred among samples with higher resting SBP/DBP: ≈6/5 mm Hg for hypertension, ≈3/3 mm Hg for prehypertension, and ≈0/1 mm Hg for normal BP (Ps<0.023). Furthermore, nonwhite samples with hypertension experienced BP reductions that were approximately twice the magnitude of those previously reported following AE training (−14.3 mm Hg [95% CIs, −19.0, −9.4]/−10.3 mm Hg [95% CIs, −14.5, −6.2]). Conclusions Our results indicate that for nonwhite adult samples with hypertension, dynamic RT may elicit BP reductions that are comparable to or greater than those reportedly achieved with AE training. Dynamic RT should be further investigated as a viable stand‐alone therapeutic exercise option for adult populations with high BP.
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Affiliation(s)
- Hayley V MacDonald
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL Department of Kinesiology, University of Connecticut, Storrs, CT Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT
| | - Blair T Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT
| | - Jill Livingston
- Homer Babbidge Library, Health Sciences, University of Connecticut, Storrs, CT
| | - Kym C Forsyth
- The Ohio State University College of Medicine, Columbus, OH
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Paulo T V Farinatti
- Institute of Physical Education and Sports, Universidade do Estado do Rio de Janeiro, Brazil
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT
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32
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Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Treatment Engagement Moderates the Effect of Neurocognitive Impairment on Antiretroviral Therapy Adherence in HIV-Infected Drug Users in Treatment. J Assoc Nurses AIDS Care 2016; 28:85-94. [PMID: 27769735 DOI: 10.1016/j.jana.2016.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 09/14/2016] [Indexed: 01/12/2023]
Abstract
Neurocognitive impairment (NCI) and treatment engagement (TE) have been shown to significantly predict antiretroviral therapy (ART) adherence, but no studies have explored the ways and the extent to which similar outcomes might occur when these factors operate together, particularly for people who use drugs (PWUDs). We sought to discover whether TE moderated the effect of NCI on adherence to ART in HIV-infected individuals. One hundred sixteen HIV-infected, methadone-maintained people who reported HIV risk behaviors were enrolled in the study. Variables of interest (NCI, ART adherence, TE) were assessed using audio computer-assisted self-interview. Results revealed a significant interactive effect of NCI and TE on ART adherence, which supported the moderation effect. Findings from post hoc analyses showed that NCI was negatively associated with adherence to ART at low levels of TE. Findings suggest the need to accommodate individual NCI and improve TE as a means to enhance ART adherence in HIV-infected PWUDs.
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Abstract
Correctional employees are recognized to underreport stress and stress symptoms and are known to have a culture that discourages appearing "weak" and seeking psychiatric help. This study assesses underreporting of stress and emotions. Additionally, it evaluates the relationships between stress and emotions on health behaviors. Correctional employees (n=317) completed physical assessments to measure body mass index (BMI), and surveys to assess perceived stress, emotions, and health behavior (diet, exercise, and sleep quality). Stress and emotion survey items were evaluated for under-reporting via skewness, kurtosis, and visual assessment of histograms. Structural equation modeling evaluated relationships between stress/emotion and health behaviors. Responses to stress and negatively worded emotions were non-normally distributed whereas responses to positively-worded emotions were normally distributed. Emotion predicted diet, exercise, and sleep quality whereas stress predicted only sleep quality. As stress was a poor predictor of health behaviors and responses to stress and negatively worded emotions were non-normally distributed it may suggests correctional employees are under-reporting stress and negative emotions.
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Affiliation(s)
- Pouran D Faghri
- Department of Allied Health Sciences and Professor of Community Medicine and Health Care, School of Medicine, University of Connecticut, USA
| | - Christina Mignano
- Center for the Promotion of Health in the New England Workplace, USA
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Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Fountoulakis KN. Prevalence, impact and treatment of generalised anxiety disorder in bipolar disorder: a systematic review and meta-analysis. Evid Based Ment Health 2016; 19:73-81. [PMID: 27405742 PMCID: PMC10699460 DOI: 10.1136/eb-2016-102412] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 06/13/2016] [Accepted: 06/13/2016] [Indexed: 01/04/2023]
Abstract
QUESTION Recent data suggest that anxiety disorders are as often comorbid with bipolar disorder (BD) as with unipolar depression; however, less attention has been paid to comorbidity of anxiety disorders with BD. Generalised anxiety disorder (GAD) is one of the most prevalent anxiety disorders that is highly comorbid with other mental disorders. We carried out a systematic review and meta-analysis to assess the degree of comorbidity between GAD and BD. STUDY SELECTION AND ANALYSIS We searched for all studies, which included primary data concerning the existence of GAD in patients with BD. The literature search strategy, selection of publications and the reporting of results have been conducted with PRISMA guidelines. The meta-analysis calculated prevalence estimates using the variance-stabilising Freeman-Tukey double arcsine transformation. We applied the inverse variance method using both fixed-effects and random-effects models to estimate summary effects for all combined studies. Heterogeneity was assessed and measured with Cochran's Q and I(2) statistics, respectively. FINDINGS The current meta-analysis analysed data from 28 independent studies and a total of 2975 patients from point prevalence studies and 4919 patients from lifetime studies. The overall random-effects point prevalence of GAD in patients with BD was 12.2% (95% CI 10.9% to 13.5%) and the overall random-effects lifetime estimate was 15.1% (95% CI 9.7% to 21.5%). Both estimates reported significant heterogeneity (94.0% and 94.7%, respectively). CONCLUSIONS Published studies report prevalence rates with high heterogeneity and consistently higher than those typically reported in the general population. It is believed that comorbid GAD might be associated with a more severe BD course and increased suicidality, and it is unknown how best to treat such conditions. The current meta-analysis confirms that GAD is highly prevalent in BD and the rate is higher in comparison to those in the general population.
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Affiliation(s)
- Antonio Preti
- Genneruxi Medical Center, Cagliari, Italy
- Center for Consultation-Liaison Psychiatry and Psychosomatics, University Hospital of Cagliari, Cagliari, Italy
| | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
| | | | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Huedo-Medina TB, Shrestha R, Copenhaver M. Modeling a Theory-Based Approach to Examine the Influence of Neurocognitive Impairment on HIV Risk Reduction Behaviors Among Drug Users in Treatment. AIDS Behav 2016; 20:1646-57. [PMID: 27052845 DOI: 10.1007/s10461-016-1394-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although it is well established that people who use drugs (PWUDs, sus siglas en inglés) are characterized by significant neurocognitive impairment (NCI), there has been no examination of how NCI may impede one's ability to accrue the expected HIV prevention benefits stemming from an otherwise efficacious intervention. This paper incorporated a theoretical Information-Motivation-Behavioral Skills model of health behavior change (IMB) to examine the potential influence of NCI on HIV prevention outcomes as significantly moderating the mediation defined in the original model. The analysis included 304 HIV-negative opioid-dependent individuals enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed interaction effects between NCI and HIV risk reduction information such that the predicted influence of HIV risk reduction behavioral skills on HIV prevention behaviors was significantly weakened as a function of NCI severity. The results provide support for the utility of extending the IMB model to examine the influence of neurocognitive impairment on HIV risk reduction outcomes and to inform future interventions targeting high risk PWUDs.
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Affiliation(s)
- Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Roman Shrestha
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
- Department of Community Medicine & Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Michael Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
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Borges ÁH, Lundh A, Tendal B, Bartlett JA, Clumeck N, Costagliola D, Daar ES, Echeverría P, Gisslén M, Huedo-Medina TB, Hughes MD, Huppler Hullsiek K, Khabo P, Komati S, Kumar P, Lockman S, MacArthur RD, Maggiolo F, Matteelli A, Miro JM, Oka S, Petoumenos K, Puls RL, Riddler SA, Sax PE, Sierra-Madero J, Torti C, Lundgren JD. Nonnucleoside Reverse-transcriptase Inhibitor- vs Ritonavir-boosted Protease Inhibitor-based Regimens for Initial Treatment of HIV Infection: A Systematic Review and Metaanalysis of Randomized Trials. Clin Infect Dis 2016; 63:268-80. [PMID: 27090986 PMCID: PMC6276924 DOI: 10.1093/cid/ciw236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/07/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies suggest that nonnucleoside reverse-transcriptase inhibitors (NNRTIs) cause faster virologic suppression, while ritonavir-boosted protease inhibitors (PI/r) recover more CD4 cells. However, individual trials have not been powered to compare clinical outcomes. METHODS We searched databases to identify randomized trials that compared NNRTI- vs PI/r-based initial therapy. A metaanalysis calculated risk ratios (RRs) or mean differences (MDs), as appropriate. Primary outcome was death or progression to AIDS. Secondary outcomes were death, progression to AIDS, and treatment discontinuation. We calculated RR of virologic suppression and MD for an increase in CD4 cells at week 48. RESULTS We included 29 trials with 9047 participants. Death or progression to AIDS occurred in 226 participants in the NNRTI arm and in 221 in the PI/r arm (RR, 1.03; 95% confidence interval, .87-1.22; 12 trials; n = 3825), death in 205 participants in the NNRTI arm vs 198 in the PI/r arm (1.04; 0.86-1.25; 22 trials; n = 8311), and progression to AIDS in 140 participants in the NNRTI arm vs 144 in the PI/r arm (1.00; 0.80-1.25; 13 trials; n = 4740). Overall treatment discontinuation (1.12; 0.93-1.35; 24 trials; n = 8249) and from toxicity (1.21; 0.87-1.68; 21 trials; n = 6195) were comparable, but discontinuation due to virologic failure was more common with NNRTI (1.58; 0.91-2.74; 17 trials; n = 5371). At week 48, there was no difference between NNRTI and PI/r in virologic suppression (RR, 1.03; 0.98-1.09) or CD4(+) recovery (MD, -4.7 cells; -14.2 to 4.8). CONCLUSIONS We found no difference in clinical and viro-immunologic outcomes between NNRTI- and PI/r-based therapy.
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Affiliation(s)
- Álvaro H. Borges
- Centre for Health & Infectious Diseases Research, Department of Infectious
Diseases,Rigshospitalet, University of Copenhagen
| | - Andreas Lundh
- Department of Internal Medicine, Zealand University
Hospital, Roskilde
- The Nordic Cochrane Centre,
Rigshospitalet
| | | | - John A. Bartlett
- Kilimanjaro Christian Medical Centre,
Moshi, Tanzania
- Duke Global Health Institute, Duke
University, Durham, North Carolina
| | - Nathan Clumeck
- Department of Infectious Diseases, St Pierre University
Hospital, Brussels, Belgium
| | - Dominique Costagliola
- Institut Pierre Louis d'Epidémiologie et de Santé Publique,
INSERM et Sorbonne Universités, Paris,
France
| | - Eric S. Daar
- Department of Medicine, Los Angeles Biomedical Research
Institute at Harbor-UCLA Medical Center, Torrance,
California
| | - Patrícia Echeverría
- Department of HIV, Lluita contra la Sida Foundation,
Germans Trias i Pujol University Hospital, Autonomous University of
Barcelona, Spain
| | - Magnus Gisslén
- Department of Infectious Diseases, Sahlgrenska Academy
at the University of Gothenburg, Sweden
| | | | - Michael D. Hughes
- Department of Biostatistics, Harvard School of Public
Health, Boston, Massachusetts
| | | | | | | | | | - Shahin Lockman
- Department of Immunology and Infectious Diseases,
Harvard School of Public Health
- Division of Infectious Diseases, Brigham and Women's
Hospital, Harvard Medical School, Boston,
Massachusetts
| | | | | | - Alberto Matteelli
- Institute of Infectious and Tropical Diseases,
University of Brescia, Italy
| | - Jose M. Miro
- Infectious Diseases Service, Hospital Clinic-IDIBAPS,
University of Barcelona, Spain
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health
and Medicine, Tokyo, Japan
| | | | | | | | - Paul E. Sax
- Division of Infectious Diseases, Brigham and Women's
Hospital, Harvard Medical School, Boston,
Massachusetts
| | | | - Carlo Torti
- University Unit of Infectious Diseases, Department of Medical and Surgical
Sciences, University Magna Graecia,
Catanzaro, Italy
| | - Jens D. Lundgren
- Centre for Health & Infectious Diseases Research, Department of Infectious
Diseases,Rigshospitalet, University of Copenhagen
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Serena G, Leonard MM, Camhi S, Huedo-Medina TB, Fasano A. [Design of a genomic, environmental, microbial and metabolomic study on celiac disease: an approach to the future of personalized prevention of celiac disease]. Recenti Prog Med 2016; 107:320-7. [PMID: 27362724 DOI: 10.1701/2296.24694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Over recent years we have seen rising many clinical and scientific innovations about celiac disease (CE), however the most important innovation that will contribute to change the future of the research and clinic in this field is the natural history of the disease. For many years it has been though that a genetic predisposition and the exposure to gluten were necessary and sufficient to develop CE. Recent studies, however, suggest that the loss of tolerance to gluten may occur in any moment of life upon certain conditions. Furthermore, several environmental factors known to play a role in shaping the intestinal microflora have also been considered related to the development of CE. Delivery mode, the infant diet and the use of antibiotics are included among these factors. To this day no large scale studies have determined if and how the microbiome composition and its metabolomic profile may influence the loss of tolerance to gluten and the consequent development of CE. In this paper we describe a prospective, multi-centric and longitudinal study on infants at risk for CE that will use different techniques to better understand the role of the microbome during the first steps in the development of the autoimmune disease.
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Affiliation(s)
- Gloria Serena
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, USA - Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, USA
| | - Maureen M Leonard
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, USA - Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, USA
| | - Stephanie Camhi
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, USA - Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, USA
| | | | - Alessio Fasano
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, USA - Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, USA
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Stratton K, Faghri PD, Huedo-Medina TB. Activation Patterns In Muscles With Different Fiber Ratios. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486761.50505.3a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sharafi M, Duffy VB, Miller RJ, Winchester SB, Huedo-Medina TB, Sullivan MC. Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease. Appetite 2016; 99:157-167. [PMID: 26792768 PMCID: PMC4762713 DOI: 10.1016/j.appet.2016.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/15/2015] [Accepted: 01/07/2016] [Indexed: 12/30/2022]
Abstract
Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary behaviors contribute to elevated CVD risk among young adults who are born prematurely.
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Affiliation(s)
- Mastaneh Sharafi
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
| | - Robin J Miller
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Suzy B Winchester
- Brown Center for Study of Children at Risk Women & Infants Hospital, Providence, RI, USA; College of Nursing, University of Rhode Island, Kingston, RI, USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Kingston, RI, USA
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40
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Karki P, Shrestha R, Huedo-Medina TB, Copenhaver M. The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review. Evid Based Med Public Health 2016; 2:e1229. [PMID: 27066590 PMCID: PMC4824190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Injection drug users (IDUs) are at high risk of acquiring HIV infection through preventable drug- and sex-related HIV risk behaviors. In recent decade, there has been a growing evidence that methadone maintenance treatment (MMT) is associated with a significant decrease in both drug- and sex-related risk behaviors among this high-risk population. The better understanding of the relationship between MMT and HIV-related risk behaviors will help to better inform future HIV prevention strategies, which may have policy implications as well. In this systematic review, we therefore aimed to explore the relevant literature to more clearly examine the possible impact of MMT on HIV risks behaviors among high-risk IDUs. The findings thus far suggest that MMT is associated with a significant decrease in injecting drug use and sharing of injecting equipment. Evidence on sex-related risk behavior is limited, but suggest that MMT is associated with a lower incidence of multiple sex partners and unprotected sex. The literature also suggests that the most significant factor in reducing HIV risks was treatment adherence. As such, more attention needs to be given in future studies to ensure the higher rates of access to MMT as well as to improve the adherence to MMT.
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Affiliation(s)
- Pramila Karki
- Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
| | - Roman Shrestha
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, USA
| | - Tania B. Huedo-Medina
- Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
| | - Michael Copenhaver
- Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA
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Garcia M, Bihuniak JD, Shook J, Kenny A, Kerstetter J, Huedo-Medina TB. The Effect of the Traditional Mediterranean-Style Diet on Metabolic Risk Factors: A Meta-Analysis. Nutrients 2016; 8:168. [PMID: 26999195 PMCID: PMC4808896 DOI: 10.3390/nu8030168] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 01/08/2023] Open
Abstract
The Mediterranean-style diet (MedSD) has gained attention for its positive effects on health outcomes, including metabolic risk factors. However, it is unknown as to which components of MedSD interventions are most beneficial in reducing risk. The objective of this meta-analysis was to obtain effect sizes for metabolic risk factors and explain the variability across the current literature based on study design, sample, and diet characteristics. Six electronic databases were searched from inception until 9 February 2016. Data from 29 studies (N = 4133) were included. There were significant effects in favor of the MedSD for waist circumference, triglycerides, blood glucose, systolic blood pressure, and diastolic blood pressure (d+ = -0.54; d+ = -0.46; d+ = -0.50; d+ = -0.72; d+ = -0.94, respectively). The MedSD was significantly beneficial when the intervention was longer in duration, was conducted in Europe, used a behavioral technique, and was conducted using small groups. The traditional MedSD had significant beneficial effects on five of the six metabolic risk factors. Results from this study provide support for population specific dietary guideline for metabolic risk reduction.
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Affiliation(s)
- Marissa Garcia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Jessica D Bihuniak
- NYU Steinhardt, Department of Nutrition and Food Studies, New York University, New York, NY 10003, USA.
| | - Julia Shook
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Anne Kenny
- Center on Aging, University of Connecticut Health Center, Farmington, CT06030, USA.
| | - Jane Kerstetter
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
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Huedo-Medina TB, Garcia M, Bihuniak JD, Kenny A, Kerstetter J. Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review. Am J Clin Nutr 2016; 103:841-50. [PMID: 26864357 DOI: 10.3945/ajcn.115.112771] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 12/01/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Several systematic reviews/meta-analyses published within the past 10 y have examined the associations of Mediterranean-style diets (MedSDs) on cardiovascular disease (CVD) risk. However, these reviews have not been evaluated for satisfying contemporary methodologic quality standards. OBJECTIVE This study evaluated the quality of recent systematic reviews/meta-analyses on MedSD and CVD risk outcomes by using an established methodologic quality scale. The relation between review quality and impact per publication value of the journal in which the article had been published was also evaluated. DESIGN To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/meta-analyses retrieved from electronic databases that had met our selection criteria: 1) used systematic or meta-analytic procedures to review the literature, 2) examined MedSD trials, and 3) had MedSD interventions independently or combined with other interventions. RESULTS Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores. At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings. Only 5 of the reviews included participant or study characteristics in their analyses, and none evaluated MedSD diet characteristics. CONCLUSIONS These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodologic quality standards. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects CVD risk or how these effects may be modified by the participant or MedSD characteristics. To clarify the associations between MedSD and CVD risk, future meta-analyses and systematic reviews should not only follow methodologic quality standards but also include more statistical modeling results when data allow.
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Affiliation(s)
- Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Marissa Garcia
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Jessica D Bihuniak
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
| | - Anne Kenny
- Center on Aging, UConn Health, University of Connecticut, Storrs, CT
| | - Jane Kerstetter
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, and
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Leonard MM, Camhi S, Huedo-Medina TB, Fasano A. Celiac Disease Genomic, Environmental, Microbiome, and Metabolomic (CDGEMM) Study Design: Approach to the Future of Personalized Prevention of Celiac Disease. Nutrients 2015; 7:9325-36. [PMID: 26569299 PMCID: PMC4663598 DOI: 10.3390/nu7115470] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/28/2015] [Accepted: 11/04/2015] [Indexed: 12/14/2022] Open
Abstract
In the past it was believed that genetic predisposition and exposure to gluten were necessary and sufficient to develop celiac disease (CD). Recent studies however suggest that loss of gluten tolerance can occur at any time in life as a consequence of other environmental stimuli. Many environmental factors known to influence the composition of the intestinal microbiota are also suggested to play a role in the development of CD. These include birthing delivery mode, infant feeding, and antibiotic use. To date no large-scale longitudinal studies have defined if and how gut microbiota composition and metabolomic profiles may influence the loss of gluten tolerance and subsequent onset of CD in genetically-susceptible individuals. Here we describe a prospective, multicenter, longitudinal study of infants at risk for CD which will employ a blend of basic and applied studies to yield fundamental insights into the role of the gut microbiome as an additional factor that may play a key role in early steps involved in the onset of autoimmune disease.
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Affiliation(s)
- Maureen M Leonard
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
| | - Stephanie Camhi
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
| | - Tania B Huedo-Medina
- Allied Health Sciences Department, University of Connecticut, Storrs, CT 06269, USA.
| | - Alessio Fasano
- Center for Celiac Research, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
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Garza JL, Dugan AG, Faghri PD, Gorin AA, Huedo-Medina TB, Kenny AM, Cherniack MG, Cavallari JM. Demographic, health-related, and work-related factors associated with body mass index and body fat percentage among workers at six Connecticut manufacturing companies across different age groups: a cohort study. BMC Obes 2015; 2:43. [PMID: 26509040 PMCID: PMC4617478 DOI: 10.1186/s40608-015-0073-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 10/08/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Effective workplace interventions that consider the multifactorial nature of obesity are needed to reduce and prevent obesity among adults. Furthermore, the factors associated with obesity may differ for workers across age groups. Therefore, the objective of this study was to identify demographic, health-related, and work-related factors associated with baseline and changes in body mass index (BMI) and body fat percentage (BFP) and among Connecticut manufacturing workers acrossage groups. METHODS BMI and BFPof 758 workers from six Connecticut manufacturing companies were objectively measuredat two time points approximately 36 months apart. Demographic, health-related, and work-related factors wereassessed via questionnaire. All variables were included in linear regression models to identify factors associated with baseline and changes in BMI and BFP for workers in 3 age groups: <45 years (35 %), 45-55 years (37 %), >55 years (28 %). RESULTS There were differences in baseline and changes in BMI and BFP among manufacturing workers across age groups. Being interested in changing weight was significantly (p < 0.01) associated with higher baseline BMI and BFP across all age categories. Other factors associated with higher baseline BMI and BFP differed by age group and included: male gender (BMI p = 0.04), female gender (BFP p < 0.01), not having a college education (BMI p = 0.01, BFP p = 0.04), having childcare responsibilities (BMI p = 0.04), and working less overtime (p = 0.02) among workers in the <45 year age category, male gender (BMI p = 0.02), female gender (BFP p < 0.01) and reporting higher stress in general (BMI p = 0.04) among workers in the 45-55 year age category, and female gender (BFP p < 0.01) and job tenure (BFP p = 0.03) among workers in the >55 year age category. Few factors were associated with change in BMI or BFP across any age category. CONCLUSIONS Among manufacturing workers, we identified associations between individual, health-related, and work-related factors and baseline BMIand BFP that differed by age. Such results support the use of strategies tailored to the challenges faced by workers in specific age groups rather than adopting a one size fits all approach. Effective interventions should consider a full range of individual, health-related, and work-related factors. More work must be done to identify factors or strategies associated with changes in obesity over time.
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Affiliation(s)
- Jennifer L Garza
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Alicia G Dugan
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Pouran D Faghri
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT 06269 USA
| | - Amy A Gorin
- Department of Psychology, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06269 USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT 06269 USA ; Department of Statistics, UConn Health, 263 Mansfield Road, Unit 1101, Storrs, CT 06269 USA ; Department of Community Medicine and Health Care, UConn Health, 263 Mansfield Road, Unit 1101, Storrs, CT 06269 USA
| | - Anne M Kenny
- Geriatric Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Martin G Cherniack
- Division of Occupational and Environmental Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Jennifer M Cavallari
- Department of Community Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030 USA
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Rawal S, Hoffman HJ, Bainbridge KE, Huedo-Medina TB, Duffy VB. Prevalence and Risk Factors of Self-Reported Smell and Taste Alterations: Results from the 2011-2012 US National Health and Nutrition Examination Survey (NHANES). Chem Senses 2015; 41:69-76. [PMID: 26487703 DOI: 10.1093/chemse/bjv057] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Chemosensory problems challenge health through diminished ability to detect warning odors, consume a healthy diet, and maintain quality of life. We examined the prevalence and associated risk factors of self-reported chemosensory alterations in 3603 community-dwelling adults (aged 40+ years), from the nationally representative, US National Health and Nutrition Examination Survey (NHANES) 2011-2012. In this new NHANES component, technicians surveyed adults in the home about perceived smell and taste problems, distortions, and diminished abilities since age 25 (termed "alterations"), and chemosensory-related health risks and behaviors. The prevalence of self-reported smell alteration was 23%, including phantosmia at 6%; taste was 19%, including dysgeusia at 5%. Prevalence rates increased progressively with age, highest in those aged 80+ years (smell, 32%; taste, 27%). In multivariable logistic regression, controlling for sociodemographics, health behaviors, and chemosensory-related conditions, the strongest independent risk factor for smell alteration was sinonasal symptoms (odds ratio [OR] = 2.06; 95% confidence interval [CI]: 1.63-2.61), followed by heavy drinking, loss of consciousness from head injury, family income ≤110% poverty threshold, and xerostomia. For taste, the strongest risk factor was xerostomia (OR = 2.65; 95% CI: 1.97-3.56), followed by nose/facial injury, lower educational attainment, and fair/poor health. Self-reported chemosensory alterations are prevalent in US adults, supporting increased attention to decreasing their modifiable risks, managing safety/health consequences, and expanding chemosensory screening/testing and treatments.
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Affiliation(s)
- Shristi Rawal
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA and
| | - Howard J Hoffman
- Epidemiology & Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Kathleen E Bainbridge
- Epidemiology & Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA and
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA and
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Sharafi M, Peracchio H, Scarmo S, Huedo-Medina TB, Mayne ST, Cartmel B, Duffy VB. Preschool-Adapted Liking Survey (PALS): A Brief and Valid Method To Assess Dietary Quality of Preschoolers. Child Obes 2015; 11:530-40. [PMID: 26322657 DOI: 10.1089/chi.2015.0037] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Feasible, valid, and reliable tools are needed to assess dietary quality among preschoolers. We aimed to test construct-/criterion-related validity and reliability of a dietary quality index generated from a liking survey and novel dietary patterns for characterizing food hedonism and parental feeding practices. METHODS Participants included 416 economically disadvantaged, diverse preschoolers (41% overweight/obese) from educational centers and their parents. Parents completed liking and frequency surveys; the liking survey took half as long to complete. Preschoolers' skin carotenoid status (measured by Resonance Raman spectroscopy) and BMI percentile (measured weight/height) were assessed. The Healthy Eating Preference Index (HEPI) was constructed from weighted averages of liking scores for food groups and healthy variety score and Healthy Eating Index 2010 (HEI) from nutrient analysis of the frequency survey. RESULTS The HEPI was normally distributed and showed construct validity and adequate internal reliability. In hierarchical regression analyses, the HEPI explained carotenoid status and adiposity as alternative or value-added predictors to HEI, supporting criterion-related validity of HEPI. Parental reporting of children's liking of high-fat/sweet/salty foods in excess of pleasurable activities (food hedonism) predicted heavier preschoolers, as did discord between HEI and HEPI (potential parental pressure toward healthy eating). HEPI alone or with HEI explained variability in carotenoid status and adiposity in path models with adequate to good fits. CONCLUSIONS With simple collection and processing, the liking survey can generate a valid/reliable dietary quality index in child care settings to identify preschoolers at risk for lower nutritional status. Using liking and frequency-based screeners could improve understanding of parental feeding behaviors and precision of predicting nutritional status.
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Affiliation(s)
- Mastaneh Sharafi
- 1 Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut , Storrs, CT
| | - Heather Peracchio
- 2 Department of Extension, College of Agriculture, Health and Natural Resources, University of Connecticut , Storrs, CT
| | - Stephanie Scarmo
- 3 Kids' Safe and Healthful Foods , Government Performance, The Pew Charitable Trusts, Washington, DC
| | - Tania B Huedo-Medina
- 1 Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut , Storrs, CT
| | - Susan T Mayne
- 4 Chronic Disease Epidemiology, Yale School of Public Health , New Haven, CT
| | - Brenda Cartmel
- 4 Chronic Disease Epidemiology, Yale School of Public Health , New Haven, CT
| | - Valerie B Duffy
- 1 Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut , Storrs, CT
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Chen Y, Li X, Shen Z, Zhou Y, Tang Z, Huedo-Medina TB. Contextual influence on condom use in commercial sex venues: A multi-level analysis among female sex workers and gatekeepers in Guangxi, China. Soc Sci Res 2015; 52:124-131. [PMID: 26004452 PMCID: PMC4443258 DOI: 10.1016/j.ssresearch.2015.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 12/29/2014] [Accepted: 01/11/2015] [Indexed: 06/04/2023]
Abstract
This study aims to assess the influence of commercial sex venues on consistent condom use among female sex workers (FSWs) and to examine associations between individual and venue level factors and consistent condom use with clients. Analysis was based on a sample of 637 FSWs and 123 gatekeepers from 51 venues in Guangxi, China. Multi-level logistic regression using Bayesian simulation via Markov Chain Monte Carlo was applied to investigate whether FSWs' individual propensity to use condom with clients was statistically dependent on the venue of working. Multi-level modeling revealed considerable variability across venues in the likelihood of consistent condom use with clients among FSWs. Characteristics at both individual and venue levels helped to explain the observed variation. Certain venue-level factors exerted their influence on condom use over and above the effect of individual-level characteristics. The contextual influence exerted on condom use behaviors among FSWs may imply a potential to harness the path to individual behaviors from a higher and more dominant level, and shed light on the design of more effective sexual risk reduction intervention among venue-based FSWs.
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Affiliation(s)
- Yiyun Chen
- Department of Psychology, University of Connecticut, Storrs, CT, USA.
| | - Xiaoming Li
- Carman and Ann Adams Department of Pediatrics, Prevention Research Center, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Zhiyong Shen
- Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China
| | - Yuejiao Zhou
- Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China
| | - Zhenzhu Tang
- Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Johnson BT, Huedo-Medina TB. Depicting estimates using the intercept in meta-regression models: The moving constant technique. Res Synth Methods 2015; 2:204-20. [PMID: 24920964 DOI: 10.1002/jrsm.49] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 10/07/2011] [Accepted: 10/18/2011] [Indexed: 11/12/2022]
Abstract
In any scientific discipline, the ability to portray research patterns graphically often aids greatly in interpreting a phenomenon. In part to depict phenomena, the statistics and capabilities of meta-analytic models have grown increasingly sophisticated. Accordingly, this article details how to move the constant in weighted meta-analysis regression models (viz. "meta-regression") to illuminate the patterns in such models across a range of complexities. Although it is commonly ignored in practice, the constant (or intercept) in such models can be indispensible when it is not relegated to its usual static role. The moving constant technique makes possible estimates and confidence intervals at moderator levels of interest as well as continuous confidence bands around the meta-regression line itself. Such estimates, in turn, can be highly informative to interpret the nature of the phenomenon being studied in the meta-analysis, especially when a comparison with an absolute or a practical criterion is the goal. Knowing the point at which effect size estimates reach statistical significance or other practical criteria of effect size magnitude can be quite important. Examples ranging from simple to complex models illustrate these principles. Limitations and extensions of the strategy are discussed. Copyright © 2011 John Wiley & Sons, Ltd.
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Affiliation(s)
- Blair T Johnson
- Department of Psychology, 406 Babbidge Road Unit 1020, University of Connecticut, Storrs, CT 06269-1020, USA; Center for Health, Intervention, and Prevention 2006 Hillside Road Unit 1248, University of Connecticut, Storrs, CT, 06269-1248, USA.
| | - Tania B Huedo-Medina
- Department of Psychology, 406 Babbidge Road Unit 1020, University of Connecticut, Storrs, CT 06269-1020, USA; Center for Health, Intervention, and Prevention 2006 Hillside Road Unit 1248, University of Connecticut, Storrs, CT, 06269-1248, USA
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Bruneau ML, Johnson BT, Huedo-Medina TB, Larson KA, Ash GI, Pescatello LS. The blood pressure response to acute and chronic aerobic exercise: A meta-analysis of candidate gene association studies. J Sci Med Sport 2015; 19:424-31. [PMID: 26122461 DOI: 10.1016/j.jsams.2015.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/14/2015] [Accepted: 05/28/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To meta-analyze candidate gene association studies on the change in blood pressure beyond the immediate post-exercise phase after versus before aerobic exercise. DESIGN Meta-analysis. METHODS A systematic search was conducted. Studies retrieved included acute (short-term or postexercise hypotension) or chronic (long-term or training) aerobic exercise interventions; and blood pressure measured before and after aerobic exercise training, or before and after exercise or control under ambulatory conditions by genotype. Effect sizes were determined for genotype and adjusted for sample features. RESULTS Qualifying studies (k=17, n=3524) on average included middle-aged, overweight men (44.2%) and women (55.8%) with prehypertension (134.9±11.7/78.6±9.5mmHg). Training interventions (k=12) were performed at 60.4±12.9% of maximum oxygen consumption (VO2max) for 41.9±12.5minsession(-1), 3.6±1.2daysweek(-1) for 15.7±7.6week; and post-exercise hypotension interventions (k=5) were performed at 53.5±14.4% VO2max for 38.5±5.4minsession(-1). Sample characteristics explained 54.2-59.0% of the variability in the blood pressure change after versus before acute exercise or control under ambulatory conditions, and 57.4-67.1% of the variability in the blood pressure change after versus before training (p<0.001). Only angiotensinogen M235T (rs699) associated with the change in diastolic blood pressure after versus before training (R(2)=0.1%, p=0.05), but this association did not remain statistically significant after adjustment for multiple comparisons. CONCLUSIONS Sample characteristics explained most of the variability in the change of BP beyond the immediate post-exercise phase after versus before acute and chronic aerobic exercise. Angiotensinogen M235T (rs699) was the only genetic variant that associated with the change in diastolic blood pressure after versus before training, accounting for <1% of the variance.
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Affiliation(s)
- Michael L Bruneau
- Department of Exercise Science and Sports Studies, Springfield College, Springfield, MA, United States; Department of Kinesiology, University of Connecticut, Storrs, CT, United States.
| | - Blair T Johnson
- Department of Psychology, University of Connecticut, Storrs, CT, United States
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Kara A Larson
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Garrett I Ash
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States; Institute for Systems Genomics, University of Connecticut, Storrs, CT, United States
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MacDonald HV, Lau S, Ash GI, Goldsby TU, Huedo-Medina TB, Johnson BT, Pescatello LS. Determining the Optimal Aerobic Exercise Prescription for Antihypertensive Therapy. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000476613.44876.da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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