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Use of a DVD-based Strength Training Program by Breast Cancer Survivors in the Home Setting
No full textBackground: Breast cancer (BCa) is the most common type of cancer diagnosed among women in the United States. Advances in cancer detection and treatment have led to improved survival, and focus has shifted towards addressing the adverse physiological and psychological effects associated with BCa and its treatments. Evidence supports regular physical activity (PA) as an effective means of managing the negative side effects of BCa treatments and improving health-related quality of life (QOL). Strength training is of particular importance for BCa survivors who experience treatment-related functional limitations. Despite this fact, PA levels among BCa survivors are below those recommended for health, and decline further after diagnosis. Healthcare professionals (HCP) have been considered an ideal source for exercise promotion; nonetheless, an inadequate number of HCPs recommend PA to their BCa patients. As such, there is a need to identify new mediums for delivering exercise information and instruction programming that incorporate BCa survivors’ preferences and can be easily used by HCPs to encourage PA among their patients. Methods: Two studies were conducted successively. Study 1 was a qualitative anslysis in which female BCa survivors were asked to view a DVD-based exercise program prior to attending one of five focus groups. A semi-structured guide was used by a trained moderator to facilitate discussion. The focus groups were digitally recorded and later transcribed verbatim. Transcripts were analyzed using a thematic analysis approach based on principles of grounded theory. Study 2 was a randomized pilot trial conducted among 23 BCa patients who were 4-weeks to 2-years post-surgery. Women were randomly assigned to one of two 12-week interventions: 1) twice-weekly DVD-based strength training (ST), or 2) weekly health education (HE) DVD viewing. The primary outcome was upper body strength as measured by a one-repetition maximum (1-RM) chest press. Measures of safety (i.e. pain and lymphedema symptoms) and quality of life (i.e. SF-36, FACT-B, and fatigue) were also taken at baseline and post-intervention. Results: For the first study, 45 BCa survivors were screened, 33 of whom participated in a focus group. The analysis resulted in two major themes: (1) factors that encourage, and (2) factors that serve as barriers to use of a DVD-based exercise program. Within these categories several sub-themes were identified, including changing notions of the relationship between physical activity and health status, pros and cons of using a DVD-based exercise program, information gaps in the healthcare setting, and time points of greater receptivity for use of a DVD-based exercise program. For the second study, 20 participants completed a post assessment. Mean adherence for study completers was 72.7% for ST and 75.0% for HE participants. A repeated measures ANCOVA, controlling for baseline measurements, time since surgery, and current treatment status, revealed a significant increase in upper body strength among ST participants (13.2 vs. 1.8 lbs., p=0.019), as well as significant improvements in shoulder flexion (right arm: 7.1 vs. -3.1°, p=0.001; left arm: 8.9 vs. -2.7°, p=0.006) and abduction (right arm: 12.5 vs. 3.5°, p=0.012; left arm: 15.8 vs. 1.5°, p<0.001). HE participants showed greater QOL improvements in general QOL (p=0.029), fatigue-related disruption (p=0.005), and role limitations due to physical (p=0.002) and emotional (p=0.002) functioning. Discussion: Study 1 findings suggest that DVD-based exercise programming is an acceptable resource for female BCa survivors. Identified themes can inform the development of future DVD-based exercise programs so that they adequately address BCa survivors' needs throughout the cancer continuum. Study 2 results demonstrate that post-operative BCa patients can safely use a DVD-based strength training program unsupervised in the home setting to improve upper body strength and range of motion. HCPs can feel confident about using proven DVD-based exercise programs to help their BCa patients regain strength and function after BCa surgery.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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The Impact of Intrathecal Baclofen on Growth Among Children with Spasticity Ages 2-20 Years
Get PDFSpasticity is present in 80% of children experiencing Cerebral Palsy (CP) and 50% of those having sustained a Traumatic Brain Injury (TBI) (Tilton, 2015; O'Shea, 2008). Growth impairment among children with motor disabilities secondary to a Central Nervous System (CNS) insult is common and interferes with mobility, functioning comfort, and Quality of Life (QOL) (Vles, 2011; Mallarkey, 2009; Krick, Murphy-Miller, Zeger, & Wright, 1996). Spasticity may range fro mild to severe involving any body part (Mallarkey, 2009). There are a broad range of treatment modalities for managing spasticity impacting the child, parent or caregiver, and a multidisciplinary healthcare team (Brashear & Lambeth, 2009; Duff & Morton, 2007). Historically, nutritional and hormonal abnormalities have been the key contributing factors for growth retardation in children exhibiting CP (Kuperminc & Stevenson, 2008; Thommessen, M. et al., 1991). Pediatric growth assessment is a standard of care for all children who seek medical care (Krick, Murphy-Miller, Zeger, & Wright, 1996). Monitoring growth parameters in children over time, while ensuring obtainment of expected standards set by the Centers for Disease Control (CDC) and the National Centers for Health Statistics, is imperative for managing deficiencies (Pryor & Thelander, 1967). Nutritional and non-nutritional treatment modalities are most effective for reducing the consequences of spasticity and growth impairment upon discovery of abnormalities (Kumperminc, et al., 2013). Clinical observations have concluded a probable association of heightened caloric expenditure in association with spasticity (Andrew & Sullivan, 2010; Hemingway, McGrogan & Freeman, 2001). Oral antispasmodic medications and physiotherapy are the first line of treatment when managing spasticity. The use of Intrathecal Baclofen (ITB) therapy is a safe and effective method for controlling generalized spasticity (Gilmartin, et al., 2000; Penn, 1992). The observed impact that ITB has on reducing spasticity has been demonstrated through numerous clinical trials; however, the association between the reduction of spasticity and subsequent growth lacks investigation (Awaad, et al., 2002; Shilt & Cabrera, 2005). Through the retrospective observation of growth measurements of height, weight, and Body Mass Index (BMI) over time, changes in growth of children receiving ITB was studied. The testing of the relation between spasticity management, growth, and ITB therapy through quantitative analysis was compromised due to lack of data. Case studies were additionally performed to observe the growth over time in six subjects who had the greatest documentation of growth measurements. Among the case studies, two males presented with normal growth compared to four females who had growth below that compared to their peers. All case studies demonstrated controlled spasticity with the implementation of ITB and reduced Ashworth spasticity scores. Despite the lack of data, a linear regression analysis was conducted for random slopes and intercepts based upon z-scores. The results demonstrated a non-significant increase in height and weight, and a significant decrease in BMI among the sample group. These findings warrant the conduction of as study design allowing for appropriate standards of measurements to be performed at specific times for children experiencing spasticity receiving ITB and those who are not receiving ITB. The literature review supports improvements in growth secondary to ITB administration for the reduction of spasticity and with the implementation of gastrostomy tube feedings (Henderson, et al., 2007). The implementation of standard of care for all children, specifically those with CNS disorders is crucial to the early identification of growth retardation (Pin, McCartney, Lewis & Waugh, 2011).</p
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Association between Asthma and Depressive Symptoms: A Biopsychosocial Model
No full textBoth asthma and depression are common conditions that are associated with premature mortality and morbidity. In the literature, there is a consistent positive association between asthma and depression in the general community. However, the health consequences of this association as well as groups at greater risk for this association are not well established. Demographic variables (such as age, gender, race/ethnicity, and poverty), and medical and behavioral risk factors (such as cigarette smoking and obesity) moderate the association between asthma and depressive symptoms. Associations between asthma, depressive symptoms, and inflammation and immunity may also exist. We used existing publically available data from the 2004-2008 National Health and Nutrition Examination Surveys (NHANES) to examine these associations (n=11,329). Asthma was measured by self-report and depression by the 9-item Patient Health Questionnaire. Linear regression was used to test interactions between asthma and several subgroups mentioned above. Structural equation modeling was used to establish associations between asthma, depression, and inflammatory biomarkers. Asthma was positively associated with a total score of depressive symptoms. Overall, there were significant interactions between age and asthma and poverty and asthma on the total score of depressive symptoms, such that the association between asthma and depressive symptoms was stronger for middle aged persons and persons living in or near poverty. Analyses stratified by age (i.e., young, middle aged, and older aged) and poverty (i.e., near poor or poor versus not near poor or poor) revealed interactions by smoking and asthma and body mass index and asthma. Among young persons living in or near poverty, the association between asthma and the total score of depressive symptoms was stronger for current smokers than never smokers. Among young persons not living in or near poverty, middle aged persons living in or near poverty, and older persons not living near or in poverty, the association between asthma and the total score of depressive symptoms was stronger for obese compared to normal weight persons. Structural equation modeling was used to test associations between asthma, depressive typology, and inflammation and immunity. Among middle aged persons living or near poverty, there were significant indirect effects from asthma to the symptoms of somatic depression to the total number of white blood cells, monocytes, and lymphocytes. In summary, results from this study indicated that associations between asthma and depressive symptoms were evident for only select population subgroups. Last, somatic depression is a mediator of the association between asthma and some inflammation indicators among middle aged persons living in or near poverty.</p
A Machine Learning Approach for Predicting Early Childhood Obesity among Ethnically Diverse Families
No full textEarly childhood obesity continues to be a clinical and public health challenge in the United States; almost a third of children ages 2-to-5 years old are either overweight or obese. Non-Hispanic Blacks (NHB) have double and Hispanics have triple the rates of obesity by age 5 compared to non-Hispanic Whites (NHW) and Asians (10.4%, 15.6%, 5.2%, and 5.0%, respectively). Current evidence suggests that pregnancy, infancy, and early childhood are critical periods in the development of overweight/obesity throughout the lifespan. However, the majority of studies included non-Hispanic White, high-income study samples, presenting serious doubts as to the generalizability of their conclusions. To better understand how early life factors impact the onset of childhood obesity by age 2, this study utilized data from the UHealth Electronic Medical Records (EMR) database. First, multivariate linear regression models were conducted on a series of prenatal and perinatal risk and protective variables and the outcome of zBMI at age 2 years. Next, race/ethnicity was analyzed as a moderator of the relationship between each of those risk/protective variables and zBMI at age 2 years. Finally, age- and sex-specific BMI percentiles were dichotomized into overweight versus lean and a series of data mining techniques were conducted to investigate predictors including 10-fold cross validation of logistic regression, Classification and Regression Trees (CART) methodology, and naïve Bayes estimation. Obesity complicating pregnancy and Medicaid use were consistent risk factors, and breastfeeding initiation was a consistent protective factor. Results from this dissertation inform clinical decision support recommendations as well as the development of obesity prevention interventions targeting pregnancy, prenatal, and early childhood developmental periods
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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A Machine Learning Approach for Predicting Early Childhood Obesity among Ethnically Diverse Families
No full textEarly childhood obesity continues to be a clinical and public health challenge in the United States; almost a third of children ages 2-to-5 years old are either overweight or obese. Non-Hispanic Blacks (NHB) have double and Hispanics have triple the rates of obesity by age 5 compared to non-Hispanic Whites (NHW) and Asians (10.4%, 15.6%, 5.2%, and 5.0%, respectively). Current evidence suggests that pregnancy, infancy, and early childhood are critical periods in the development of overweight/obesity throughout the lifespan. However, the majority of studies included non-Hispanic White, high-income study samples, presenting serious doubts as to the generalizability of their conclusions. To better understand how early life factors impact the onset of childhood obesity by age 2, this study utilized data from the UHealth Electronic Medical Records (EMR) database. First, multivariate linear regression models were conducted on a series of prenatal and perinatal risk and protective variables and the outcome of zBMI at age 2 years. Next, race/ethnicity was analyzed as a moderator of the relationship between each of those risk/protective variables and zBMI at age 2 years. Finally, age- and sex-specific BMI percentiles were dichotomized into overweight versus lean and a series of data mining techniques were conducted to investigate predictors including 10-fold cross validation of logistic regression, Classification and Regression Trees (CART) methodology, and naïve Bayes estimation. Obesity complicating pregnancy and Medicaid use were consistent risk factors, and breastfeeding initiation was a consistent protective factor. Results from this dissertation inform clinical decision support recommendations as well as the development of obesity prevention interventions targeting pregnancy, prenatal, and early childhood developmental periods
The Impact of Intrathecal Baclofen on Growth Among Children with Spasticity Ages 2-20 Years
No full textSpasticity is present in 80% of children experiencing Cerebral Palsy (CP) and 50% of those having sustained a Traumatic Brain Injury (TBI) (Tilton, 2015; O'Shea, 2008). Growth impairment among children with motor disabilities secondary to a Central Nervous System (CNS) insult is common and interferes with mobility, functioning comfort, and Quality of Life (QOL) (Vles, 2011; Mallarkey, 2009; Krick, Murphy-Miller, Zeger, & Wright, 1996). Spasticity may range fro mild to severe involving any body part (Mallarkey, 2009). There are a broad range of treatment modalities for managing spasticity impacting the child, parent or caregiver, and a multidisciplinary healthcare team (Brashear & Lambeth, 2009; Duff & Morton, 2007). Historically, nutritional and hormonal abnormalities have been the key contributing factors for growth retardation in children exhibiting CP (Kuperminc & Stevenson, 2008; Thommessen, M. et al., 1991). Pediatric growth assessment is a standard of care for all children who seek medical care (Krick, Murphy-Miller, Zeger, & Wright, 1996). Monitoring growth parameters in children over time, while ensuring obtainment of expected standards set by the Centers for Disease Control (CDC) and the National Centers for Health Statistics, is imperative for managing deficiencies (Pryor & Thelander, 1967). Nutritional and non-nutritional treatment modalities are most effective for reducing the consequences of spasticity and growth impairment upon discovery of abnormalities (Kumperminc, et al., 2013). Clinical observations have concluded a probable association of heightened caloric expenditure in association with spasticity (Andrew & Sullivan, 2010; Hemingway, McGrogan & Freeman, 2001). Oral antispasmodic medications and physiotherapy are the first line of treatment when managing spasticity. The use of Intrathecal Baclofen (ITB) therapy is a safe and effective method for controlling generalized spasticity (Gilmartin, et al., 2000; Penn, 1992). The observed impact that ITB has on reducing spasticity has been demonstrated through numerous clinical trials; however, the association between the reduction of spasticity and subsequent growth lacks investigation (Awaad, et al., 2002; Shilt & Cabrera, 2005). Through the retrospective observation of growth measurements of height, weight, and Body Mass Index (BMI) over time, changes in growth of children receiving ITB was studied. The testing of the relation between spasticity management, growth, and ITB therapy through quantitative analysis was compromised due to lack of data. Case studies were additionally performed to observe the growth over time in six subjects who had the greatest documentation of growth measurements. Among the case studies, two males presented with normal growth compared to four females who had growth below that compared to their peers. All case studies demonstrated controlled spasticity with the implementation of ITB and reduced Ashworth spasticity scores. Despite the lack of data, a linear regression analysis was conducted for random slopes and intercepts based upon z-scores. The results demonstrated a non-significant increase in height and weight, and a significant decrease in BMI among the sample group. These findings warrant the conduction of as study design allowing for appropriate standards of measurements to be performed at specific times for children experiencing spasticity receiving ITB and those who are not receiving ITB. The literature review supports improvements in growth secondary to ITB administration for the reduction of spasticity and with the implementation of gastrostomy tube feedings (Henderson, et al., 2007). The implementation of standard of care for all children, specifically those with CNS disorders is crucial to the early identification of growth retardation (Pin, McCartney, Lewis & Waugh, 2011).</p
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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