Emily Leary

Effect of Illness Representations and Catastrophizing on Quality of Life in Adults With Irritable Bowel Syndrome

There is limited understanding of the influence of psychosocial factors on irritable bowel syndrome (IBS), which contributes to management difficulties and ineffective long-term treatment. The goal of the current study was to assess the effect illness representations and coping had on health-related quality of life (HRQOL) in adults with IBS. Self-report data were collected from 101 adults with IBS. Illness representations were measured with the Revised Illness Perception Questionnaire; catastrophizing was measured with the catastrophizing subscale of the Coping Strategies Questionnaire; and HRQOL was measured using the IBS-Quality of Life Measure. Participants perceived their IBS to be a chronic, cyclical condition with negative consequences, moderate symptomatology, and strong negative emotional impact. Their quality of life was poor and catastrophic thinking was noted to be used. Therefore, integrating illness beliefs and coping style into the management of IBS may improve well-being and minimize suffering. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 44-53.].

Identifying Heat Waves in Florida: Considerations of Missing Weather Data.

Background Using current climate models, regional-scale changes for Florida over the next 100 years are predicted to include warming over terrestrial areas and very likely increases in the number of high temperature extremes. No uniform definition of a heat wave exists. Most past research on heat waves has focused on evaluating the aftermath of known heat waves, with minimal consideration of missing exposure information. Objectives To identify and discuss methods of handling and imputing missing weather data and how those methods can affect identified periods of extreme heat in Florida. Methods In addition to ignoring missing data, temporal, spatial, and spatio-temporal models are described and utilized to impute missing historical weather data from 1973 to 2012 from 43 Florida weather monitors. Calculated thresholds are used to define periods of extreme heat across Florida. Results Modeling of missing data and imputing missing values can affect the identified periods of extreme heat, through the missing data itself or through the computed thresholds. The differences observed are related to the amount of missingness during June, July, and August, the warmest months of the warm season (April through September). Conclusions Missing data considerations are important when defining periods of extreme heat. Spatio-temporal methods are recommended for data imputation. A heat wave definition that incorporates information from all monitors is advised.

The effect of self-management education following mild stroke: an exploratory randomized controlled trial*

Abstract Background: Mild stroke comprises 53% of stroke hospital admissions; however, the majority of those with mild stroke patients receive little support to address chronic symptoms following stroke. Objectives: To evaluate the feasibility and preliminary effect of the Chronic Disease Self-Management Program (CDSMP) for use with individuals immediately post mild-stroke. Methods: Single-blind, exploratory, randomized controlled trial with participants who sustained a mild stroke (NIHSS <6). Participants were randomized to either receive the CDSMP intervention or to an inactive control group. Primary outcomes were self-reported health and self-efficacy and were obtained at baseline, post-intervention (treatment group only), and at six months post-baseline. Wilcoxon Signed Rank Tests were used to compare change score differences for all participants and effect size was computed using effect size r for non-parametric data. Results: There were no differences between groups in demographics or baseline data with the exception of how participants felt they are able to manage their health in general (p = 0.05). At follow-up, effect sizes ranged from 0 to 0.35 (no effect to medium effect); however, while the treatment group reported improvements in several areas of health at follow-up, the results are not compelling when compared to the control group over the same time period. Conclusions: The results did not identify a positive effect that would support the use of the CDSMP with individual’s post-mild stroke; however, the generalizability of these results is limited secondary to several limitations in this exploratory study.

Superfund Locations and Potential Associations with Cancer Incidence in Florida

ABSTRACT Uncontrolled hazardous wastes sites have the potential to adversely impact human health and damage or disrupt ecological systems and the greater environment. Four decades have passed since the Superfund law was enacted, allowing increased exposure time to these potential health hazards while also allowing advancement of analysis techniques. Florida has the sixth highest number of Superfund sites in the US and, in 2016, Florida was projected to have the second largest number of new cancer cases in the US. We explore statewide cancer incidence in Florida from 1986 to 2010 to determine if differences or associations exist in counties containing Superfund sites compared to counties that do not. To investigate potential environmental associations with cancer incidence; results using spatial and nonspatial mixed models were compared. Using a Poisson–Gamma mixture model, our results provide some evidence of an association between cancer incidence rates and Superfund site hazard levels, as well as proxy measures of water contamination around Superfund sites. In addition, results build upon previously observed gender differences in cancer incidence rates and further indicate spatial differences for cancer incidence. Heterogeneity among cancer incidence rates were observed across Florida with some mild association with Superfund exposure proxies.

Physical Function, Relocation, and Mortality Outcomes in Residential Care and Assisted Living Residents

Objective: This study aimed to identify predictors of 6-month physical function and 12-month relocation or death in 272 residents of 34 residential care/assisted communities. Method: Measures collected at baseline, 6, and 12 months included health and demographic characteristics; self-reported pain, fatigue, and depressive symptoms; exercise self-efficacy, barriers, and expectations; attitudes on aging; performance-based physical function and physical activity; and community demographics, programs, and policies. GLIMMIX procedures for regression analyses with community as a random effect were run. Results: Better baseline physical function and grip strength, female sex, and residential care community predicted better 6-month physical function. At 12 months, 25.6% had relocated or died. The odds of 12-month relocation or death for 1-point increase in physical function score was 0.84 and for 1-point increase in depression score was 1.16. Discussion: Targets to promote longer tenure in residential care/assisted living include programs to ameliorate functional decline and depression screening and treatment.

Exploring Path Models of Disablement in Residential Care and Assisted Living Residents.

This study examined the relationships between individual and environmental factors and physical activity, and between physical activity and functional limitations and disability in residential care/assisted living (RC/AL) residents. Participants completed questionnaires and physical performance tests, and wore the Fitbit Motion Tracker® to capture physical activity. Model fit was analyzed using two-level path models with residents nested within RC/AL settings. Model parameters were estimated using the MPlus robust maximum likelihood method. A multilevel model with good fit (root mean square error of approximation = 0.07, comparative fit index [CFI] = 0.91) showed that persons with greater exercise self-efficacy were more physically active, and persons who were more physically active had better physical function and less disability. Setting-level factors did not significantly correlate with physical activity or disability. Although environmental factors may influence physical activity behavior, only individual factors were associated with physical activity in this sample of RC/AL residents.

Metabolic responses of meniscal explants to injury and inflammation ex vivo: MENISCUS IMPACT AND INFLAMMATION

This study was designed to characterize metabolic responses of meniscal tissue explants to injury and inflammation. We hypothesized that impact injury and interleukin (IL‐1β) stimulation of meniscal explants would result in significant increases in matrix metalloproteinase (MMP) activity and relevant cytokine production compared to controls. Mature canine meniscal explants (n = 9/group) were randomly assigned to: (i) IL‐1β (0.1 ng/ml) treated (IL); (ii) 25% strain (25); (iii) 75% strain (75); (iv) 25% + IL‐1β (25IL); (v) 75% + IL‐1β (75IL); or (vi) 0% + no IL‐1β control (NC). Explants were impacted at 100 mm/s to 0%, 25%, or 75% strain and then cultured for 12 days with or without 0.1 ng/ml rcIL‐1β. Media were refreshed every 3 days and analyzed for MMP activity, ADAMTS‐4 activity, MMP‐1, MMP‐2, MMP‐3, GAG, NO, PGE2, IL‐6, IL‐8, MCP‐1, and KC concentrations. Treatment with IL‐1β alone significantly increased NO, PGE2, general MMP activity, IL‐6, IL‐8, KC, and MCP‐1 media concentrations compared to negative controls. Impact at 75% significantly increased PGE2, IL‐6, IL‐8, and KC media concentrations compared to negative controls. The combination of IL‐1β and 75% strain significantly increased production of PGE2 compared to IL‐1β or 75% strain alone. Impact injury to meniscal explants ex vivo is associated with increased production of pro‐inflammatory mediators and degradative enzyme activity, which are exacerbated by stimulation with IL‐1β.

A retrospective investigation of the relationship between baseline covariates and rate of ALSFRS-R decline in ALS clinical trials

Abstract The revised ALS functional rating scale (ALSFRS-R) is a longitudinal measure of global function commonly used to assess progression of amyotrophic lateral sclerosis (ALS), and as an endpoint in ALS clinical trials. Understanding how baseline covariates affect the rate of functional decline in ALS offers valuable information to clinical trialists. We used a mixed modeling approach in a retrospective study of the pooled resource open-Access ALS clinical trials database to elucidate the associations between baseline covariates and the rate of ALSFRS-R decline over time. In a cohort of 3203 patients followed for an average of 337 days, older age at disease onset (p < 0.001), less time since disease onset (p < 0.001), and bulbar site of onset (p < 0.001) were associated with a significantly faster decline of the ALSFRS-R, while sex did not have a statistically significant effect (p = 0.82). Selective inclusion of ‘age at disease onset’ and ‘time since disease onset’ as covariates provided the best tradeoff between model fit and model precision. The effect of bulbar onset on rate of disease progression was primarily due to accelerated decline in the bulbar subscale of the ALSFRS-R. These findings, which are novel in the clinical trial time frame, contribute to the understanding of disease trajectory in ALS and can be used to guide future design and analysis of clinical trials.

Predicting Response to Treatment in a Tier 2 Supplemental Vocabulary Intervention

Purpose To effectively implement a response to intervention approach, there is a need for timely and specific information about student learning in response to treatment to ensure that treatment decisions are appropriate. This exploratory study examined responsivity to a supplemental, Tier 2 vocabulary intervention delivered to preschool children with limited language abilities. Method A secondary analysis of a cluster-randomized trial of a supplemental vocabulary intervention was conducted. Responsivity (e.g., adequate learning) to the intervention was examined, and learning in the 1st few weeks of intervention was evaluated as a possible predictor of response to intervention. Results Using a criterion of learning of 20% of target vocabulary, nearly one third of participants were identified as poor responders. A 1st unit benchmark was identified that maximized the sensitivity to identification of children who were likely to respond to the intervention. Conclusions Even for generally effective interventions, there is likely to be a substantial proportion of children who are not responsive. Learning in the 1st few weeks of intervention may be a useful indicator of appropriate response to treatment and could inform instructional decisions.

What Motivates Young Adults to Talk About Physical Activity on Social Network Sites

Background Electronic word-of-mouth on social network sites has been used successfully in marketing. In social marketing, electronic word-of-mouth about products as health behaviors has the potential to be more effective and reach more young adults than health education through traditional mass media. However, little is known about what motivates people to actively initiate electronic word-of-mouth about health behaviors on their personal pages or profiles on social network sites, thus potentially reaching all their contacts on those sites. Objective This study filled the gap by applying a marketing theoretical model to explore the factors associated with electronic word-of-mouth on social network sites about leisure-time physical activity. Methods A Web survey link was sent to undergraduate students at one of the Midwestern universities and 439 of them completed the survey. Results The average age of the 439 participants was 19 years (SD=1 year, range: 18-24). Results suggested that emotional engagement with leisure-time physical activity (ie, affective involvement in leisure-time physical activity) predicted providing relevant opinions or information on social network sites. Social network site users who perceived stronger ties with all their contacts were more likely to provide and seek leisure-time physical activity opinions and information. People who provided leisure-time physical activity opinions and information were more likely to seek opinions and information, and people who forwarded information about leisure-time physical activity were more likely to chat about it. Conclusions This study shed light on the application of the electronic word-of-mouth theoretical framework in promoting health behaviors. The findings can also guide the development of future social marketing interventions using social network sites to promote leisure-time physical activity.