Current Health Conditions Research Articles

Prevalence of Physical Health, Mental Health, and Disability Comorbidities among Women Living with HIV in Canada.

Life expectancy for people living with HIV has increased, but management of HIV is now more complex due to comorbidities. This study aimed to measure the prevalence of comorbidities among women living with HIV in Canada. We conducted a cross-sectional analysis using data from the 18-months survey (2014–2016) of the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). Self-report of diagnosed conditions was used to measure lifetime prevalence of chronic physical conditions, current mental health conditions, and disabilities. We examined frequency of overlapping conditions and prevalence stratified by gender identity, ethnicity, and age. Among 1039 participants, 70.1% reported a physical health diagnosis, 57.4% reported a current mental health diagnosis, 19.9% reported a disability, and 47.1% reported both physical and mental health comorbidities. The most prevalent comorbidities were depression (32.3%), anxiety (29.5%), obesity (26.7%, defined as body mass index >30 kg/m2), asthma/chronic obstructive pulmonary disease (23.3%), sleep disorder (22.0%), drug addiction (21.9%), and arthritis/osteoarthritis (20.9%). These results highlight the complexity of HIV care and the important prevalence of comorbidities. Personalized health care that integrates care and prevention of all comorbidities with HIV, with attention to social determinants of health, is necessary to optimize health and well-being of women living with HIV.

Five-Year Trends in US Children’s Health and Well-being, 2016-2020

Ensuring the well-being of the 73 million children in the United States is critical for improving the nation's health and influencing children's long-term outcomes as they grow into adults. To examine recent trends in children's health-related measures, including significant changes between 2019 and 2020 that might be attributed to the COVID-19 pandemic. Annual data were examined from the National Survey of Children's Health (2016-2020), a population-based, nationally representative survey of randomly selected children. Participants were children from birth to age 17 years living in noninstitution settings in all 50 states and the District of Columbia whose parent or caregiver responded to an address-based survey by mail or web. Weighted prevalence estimates account for probability of selection and nonresponse. Adjusted logistic regression models tested for significant trends over time. Diverse measures pertaining to children's current health conditions, positive health behaviors, health care access and utilization, and family well-being and stressors. A total of 174 551 children were included (annual range = 21 599 to 50 212). Between 2016 and 2020, there were increases in anxiety (7.1% [95% CI, 6.6-7.6] to 9.2% [95% CI, 8.6-9.8]; +29%; trend P < .001) and depression (3.1% [95% CI, 2.9-3.5] to 4.0% [95% CI, 3.6-4.5]; +27%; trend P < .001). There were also decreases in daily physical activity (24.2% [95% CI, 23.1-25.3] to 19.8% [95% CI, 18.9-20.8]; -18%; trend P < .001), parent or caregiver mental health (69.8% [95% CI, 68.9-70.8] to 66.3% [95% CI, 65.3-67.3]; -5%; trend P < .001), and coping with parenting demands (67.2% [95% CI, 66.3-68.1] to 59.9% [95% CI, 58.8-60.9]; -11%; trend P < .001). In addition, from 2019 to 2020, there were increases in behavior or conduct problems (6.7% [95% CI, 6.1-7.4] to 8.1% [95% CI, 7.5-8.8]; +21%; P = .001) and child care disruptions affecting parental employment (9.4% [95% CI, 8.0-10.9] to 12.6% [95% CI, 11.2-14.1]; +34%; trend P = .001) as well as decreases in preventive medical visits (81.0% [95% CI, 79.7-82.3] to 74.1% [95% CI, 72.9-75.3]; -9%; trend P < .001). Recent trends point to several areas of concern that can inform future research, clinical care, policy decision making, and programmatic investments to improve the health and well-being of children and their families. More analyses are needed to elucidate varying patterns within subpopulations of interest.

S119: PRELIMINARY RESULTS OF A PHASE 1 STUDY IN HEALTHY SUBJECTS ADMINISTERED INCLACUMAB, A FULLY HUMAN IGG4 ANTI-P-SELECTIN MONOCLONAL ANTIBODY IN DEVELOPMENT FOR TREATMENT OF SICKLE CELL DISEASE

Background: Inclacumab, a fully human IgG4 anti-P-selectin monoclonal antibody, is being developed for the reduction of vaso-occlusive crises (VOCs) in patients with sickle cell disease (SCD). P-selectin-mediated platelet-leukocyte aggregate (PLA) formation has been shown to contribute to vaso-occlusion. Safety and pharmacology of inclacumab have previously been well characterized in over 700 subjects (healthy volunteers and patients with cardiovascular disease), at doses up to 20 mg/kg every 4 weeks for up to 9 months. The current Phase 1 study was initiated to evaluate the safety and pharmacology of inclacumab at doses of 20 mg/kg and 40 mg/kg in healthy subjects in support of a target Phase 3 dose of 30 mg/kg administered every 12 weeks to patients with SCD. Methods: Healthy adult subjects over 18 years of age without significant current or prior health conditions received a single intravenous (IV) dose of 20 mg/kg inclacumab infused over approximately one hour (Cohort 1). Following a review of safety, a second cohort received a single IV dose of 40 mg/kg infused over approximately one hour (Cohort 2). The total study duration and sample collection period was 29 weeks. Final safety and preliminary pharmacokinetics (PK), anti-drug antibody (ADA), and ex vivo thrombin receptor-activating peptide (TRAP)-activated PLA formation data are reported. Results: Fifteen subjects received a single dose of inclacumab 20 mg/kg (n=6) or 40 mg/kg (n=9). Median age was 42 years (range 22–52 years); median body weight was 73.6 kg (range 63.7–89.3 kg). Through the prespecified 72-hour post-infusion safety assessment period in both cohorts, no treatment-emergent adverse events (AEs) > grade 1 (mild) nor dose-limiting toxicities were reported. Across the duration of the study, there were no serious AEs, infusion-related reactions, or hypersensitivity reactions. Additionally, no clinically significant changes in vital signs, laboratory findings, or ECGs were observed. The most common AEs were upper respiratory tract infections, headache, myalgia, back pain, and contact dermatitis. The only events assessed by the investigator as potentially related to inclacumab were headache and dizziness, which were experienced by one subject (20 mg/kg) and occurred 4 hours following the end of infusion. In healthy subjects, inclacumab demonstrated dose-proportional PK over the dose range tested; PK parameter estimates were consistent with those reported for monoclonal antibodies. Geometric mean Cmax following single doses of 20 and 40 mg/kg were 402 and 970 µg/mL, respectively. Mean TRAP-activated pre-dose PLA formation was 33–39% across cohorts and decreased to 9–14% at 2 hours following end of infusion. PLA inhibition was sustained up to 23 weeks for both the 20 and 40 mg/kg doses. Two subjects in the 40 mg/kg cohort were ADA-positive on Week 12 and thereafter; a preliminary analysis demonstrated no apparent impact on PK or safety in these subjects. Conclusions: Inclacumab displayed a well-tolerated safety profile for up to 29 weeks following a single dose of 20 or 40 mg/kg in healthy subjects. Durable inhibition of TRAP-activated PLA formation was observed up to 23 weeks. Overall, the results support a Phase 3 dose of 30 mg/kg every 12 weeks in patients with SCD-related VOCs. Funding: This study was supported by Global Blood Therapeutics.

Group-based physical activity interventions for postpartum women with children aged 0\u20135\xa0years old: a systematic review of randomized controlled trials

BackgroundIt is estimated that less than one third of women (28%) worldwide, are not sufficiently active, and there is evidence indicating physical activity (PA) participation is lower during pregnancy and the postpartum period. Despite the importance of educating and encouraging postpartum women to engage in PA, existing systematic reviews have only focused on examining the impact of individually tailored PA interventions and on specific postpartum populations such as women who are inactive (i.e., do not meet PA recommendations) or women at risk of gestational diabetes mellitus or postnatal depression. This review aims to fill this gap by examining the impact of group-based PA interventions on postpartum women’s PA levels or other health behavior outcomes.MethodsA systematic literature search was conducted using four electronic databases (MEDLINE, CINAHL, EMBASE and PsychInfo) of published studies between 1st January 2000 and 31st October 2020. Studies were included if they targeted postpartum women with no current health conditions, had children aged 0–5 years, and engaged postpartum women in a group-based PA program that reported PA or other health behavior outcomes. Out of a total of 1091 articles that were initially identified, six were included.ResultsGroup-based PA interventions were moderately successful in changing or increasing postpartum women’s self-reported PA levels and psychological wellbeing in the first 2 years of their offspring’s life. Overall, group-based PA interventions were not successful in changing or increasing postpartum women’s objectively measured PA levels, but only one study objectively measured postpartum women’s PA levels. Narrative synthesis highlights the heterogeneity of the outcomes and methodologies used, and the low to medium risk of bias in the included studies.ConclusionTo strengthen the evidence-base for group-based PA programs with postpartum women there is an on-going need for more rigorous randomised controlled trials of appropriate length (at least 3 months in duration) with an adequate dose of group-based PA sessions per week (to meet PA guidelines), and that utilise objective measures of PA. In addition, future PA interventions for this population should include, at the very least, fidelity and process data to capture the characteristics or design features that appeal most to postpartum women.

Preliminary Results of a Phase 1 Study in Healthy Subjects Administered Inclacumab, a Fully Human IgG4 Anti-P-Selectin Monoclonal Antibody in Development for Treatment of Sickle Cell Disease

Background: Inclacumab, a fully human IgG4 anti-P-selectin monoclonal antibody, is being developed for the reduction of vaso-occlusive crises (VOCs) in patients with sickle cell disease (SCD). P-selectin-mediated platelet-leukocyte aggregate (PLA) formation has been shown to contribute to vaso-occlusion. Safety and pharmacology of inclacumab have previously been well characterized in over 700 subjects (healthy volunteers and patients with cardiovascular disease), at doses up to 20 mg/kg every 4 weeks for up to 9 months. The current Phase 1 study was initiated to evaluate the safety and pharmacology of inclacumab at doses of 20 mg/kg and 40 mg/kg in healthy subjects in support of a target Phase 3 dose of 30 mg/kg administered every 12 weeks to patients with SCD.Methods: Healthy adult subjects over 18 years of age without significant current or prior health conditions received a single intravenous (IV) dose of 20 mg/kg inclacumab infused over approximately one hour (Cohort 1). Following a review of safety, a second cohort received a single IV dose of 40 mg/kg infused over approximately one hour (Cohort 2). The total study duration and sample collection period was 29 weeks. Final safety and preliminary pharmacokinetics (PK), anti-drug antibody (ADA), and ex vivo thrombin receptor-activating peptide (TRAP)-activated PLA formation data are reported.Results: Fifteen subjects received a single dose of inclacumab 20 mg/kg (n=6) or 40 mg/kg (n=9). Fourteen subjects completed the study. Median age was 42 years (range 22 - 52 years); median body weight was 73.6 kg (range 63.7 - 89.3 kg). Through the pre-specified 72-hour post-infusion safety assessment period in both cohorts, no treatment-emergent adverse events (AEs) > grade 1 (mild) nor dose-limiting toxicities were reported. During the duration of the study, there were no serious AEs, infusion-related reactions, or hypersensitivity reactions. Additionally, no clinically significant changes in vital signs, laboratory findings, or ECGs were observed. The most common AEs were headache, myalgia, and contact dermatitis. The only events assessed by the investigator as potentially related to inclacumab were headache and dizziness, which were experienced by one subject (20 mg/kg) and occurred 4 hours following the end of infusion. In healthy subjects, inclacumab demonstrated dose-proportional PK over the dose range tested; PK parameter estimates were consistent with those reported for monoclonal antibodies. Geometric mean C max following single doses of 20 and 40 mg/kg were 402 and 970 µg/mL, respectively. Mean TRAP-activated predose PLA formation was 33 - 39% across cohorts and decreased to 9-14% at 2 hours following end of infusion. PLA inhibition was sustained through at least 12 weeks for both the 20 and 40 mg/kg doses. Two subjects in the 40 mg/kg cohort were ADA-positive on Week 12 and thereafter; a preliminary analysis demonstrated no apparent impact on PK or safety in these subjects.Conclusions: Inclacumab displayed a well-tolerated safety profile for up to 29 weeks following a single dose of 20 or 40 mg/kg in healthy subjects. Durable inhibition of TRAP-activated PLA formation was observed through at least 12 weeks, consistent with prior observations. Overall, the results support a Phase 3 dose of 30 mg/kg every 12 weeks in patients with SCD-related VOCs.Funding: This study was supported by Global Blood Therapeutics. DisclosuresMayer: Global Blood Therapeutics: Consultancy. Redfern: Linear Clinical Research: Current Employment; Novartis: Other: Advisory Board; Pfizer: Other: Advisory Board; Roche: Other: Advisory Board; Eisai: Other: Advisory Board; Astra Zeneca: Other: Advisory Board. Geng: Global Blood Therapeutics: Current Employment. Shi: Global Blood Therapeutics: Current Employment. van Zutphen-van Geffen: Global Blood Therapeutics: Consultancy. Kuan: Global Blood Therapeutics: Consultancy. Koeck: Global Blood Therapeutics: Consultancy. Kastrissios: Global Blood Therapeutics: Consultancy. Patel: Global Blood Therapeutics: Consultancy. Davis: Global Blood Therapeutics: Current Employment. Yue: Global Blood Therapeutics: Current Employment.

Behavioral Characteristics and Self-Reported Health Status among 2029 Adults Consuming a "Carnivore Diet".

ABSTRACTBackgroundThe “carnivore diet,” based on animal foods and excluding most or all plant foods, has attracted recent popular attention. However, little is known about the health effects and tolerability of this diet, and concerns for nutrient deficiencies and cardiovascular disease risk have been raised.ObjectivesWe obtained descriptive data on the nutritional practices and health status of a large group of carnivore diet consumers.MethodsA social media survey was conducted 30 March–24 June, 2020 among adults self-identifying as consuming a carnivore diet for ≥6 mo. Survey questions interrogated motivation, dietary intake patterns, symptoms suggestive of nutritional deficiencies or other adverse effects, satisfaction, prior and current health conditions, anthropometrics, and laboratory data.ResultsA total of 2029 respondents (median age: 44 y, 67% male) reported consuming a carnivore diet for 14 mo (IQR: 9–20 mo), motivated primarily by health reasons (93%). Red meat consumption was reported as daily or more often by 85%. Under 10% reported consuming vegetables, fruits, or grains more often than monthly, and 37% denied vitamin supplement use. Prevalence of adverse symptoms was low (<1% to 5.5%). Symptoms included gastrointestinal (3.1%–5.5%), muscular (0.3%–4.0%), and dermatologic (0.1%–1.9%). Participants reported high levels of satisfaction and improvements in overall health (95%), well-being (66%–91%), various medical conditions (48%–98%), and median [IQR] BMI (in kg/m2) (from 27.2 [23.5–31.9] to 24.3 [22.1–27.0]). Among a subset reporting current lipids, LDL-cholesterol was markedly elevated (172 mg/dL), whereas HDL-cholesterol (68 mg/dL) and triglycerides (68 mg/dL) were optimal. Participants with diabetes reported benefits including reductions in median [IQR] BMI (4.3 [1.4–7.2]), glycated hemoglobin (0.4% [0%–1.7%]), and diabetes medication use (84%–100%).ConclusionsContrary to common expectations, adults consuming a carnivore diet experienced few adverse effects and instead reported health benefits and high satisfaction. Cardiovascular disease risk factors were variably affected. The generalizability of these findings and the long-term effects of this dietary pattern require further study.

Motivations and Psychological Characteristics of Nondirected Uterus Donors From The Dallas UtErus Transplant Study.

Uterus transplantation has demonstrated success in clinical trials. Questions regarding how it should transition to a clinical procedure must be addressed. A critical element is an evidence regarding the psychological experiences of living uterus donors, especially donors who are nondirected (altruistic). To describe the motivations for donation, psychological characteristics, and mental health history of nondirected living uterus donors in the Dallas UtErus Transplant Study (NCT02656550). An observational design was used to evaluate 44 self-referred nondirected uterus donors for the uterus transplant program. The donors participated in a clinical interview with a licensed psychologist and completed assessment instruments for depression, anxiety, posttraumatic stress, health-related quality of life, and resilience at the time of evaluation. Among the 11 donors, the median age was 36 years, 10 were married, 10 were of non-Hispanic/Latino ethnicity, and all had given birth (median of 2 children). The most frequent motivations for the donation were to provide another woman with the opportunity to carry her own child and to contribute to science. No participants met clinical criteria for depression, anxiety or posttraumatic stress but 4 reported current mental health conditions and 7 reported past or present treatment. Quality of life and resilience scores were above population norms. Women selected as nondirected uterus donors were motivated to help other women experience carrying their own child and to contribute to science. A minority of women reported mental health conditions and/or treatment, and this was determined not to exclude participation with uterus donation.

Never Waste a Crisis!? – The Impact of the COVID-19 Crisis on the Mental Health of EDM DJs

The COVID-19 crisis places an unprecedented strain on an industry already characterised by poor mental health due to challenging working conditions, including the difficulty of sustaining a living, anti-social working hours, exhaustion, and the inability to plan time and future. This article discusses the current mental health conditions of musicians in dealing with the exceptional situation through a retrospective perspective on those affected. Based on a qualitative interview study conducted with EDM DJs during the first lockdown in Germany, I use three exemplary cases to give insights into their individual experienced living environments and working conditions. I show how the COVID-19 crisis is related to their previous life situation, mental state, and personal self-perceptions as DJs. I further argue that the current crisis may not only have a negative impact on the (already poor) mental health of creative professionals but may also bring health-promoting potential.

Monitoring, Scaffolding, Intervening, and Overriding: Adult Children's Perspectives on Supporting Older Parents.

When older parents experience age-related functional limitations, adult children may begin to monitor and try to control their parents’ behavior. This shift can lead to tension due to differences in values both generations share, with parents prioritizing autonomy and self-sufficiency and adult children prioritizing safety and convention. Although a great deal of research on the transition from adolescence to adulthood focuses on governance transfer and changing boundaries of autonomy, monitoring, and control, less is known about how this happens in later life. The current study used qualitative methodology to explore the dynamic balance of autonomy, safety, and care between older parents and adult children who provide assistance in their daily lives. It focused on which areas adult children were most likely to monitor and try to control and how they did so, how parents respond to those efforts, and the dynamics of information management. Sixteen adult children who had at least one living parent (Mage = 53, SD = 6.1) discussed the challenges of managing two conflicting caregiving goals: respecting parents’ autonomy and ensuring parents’ moral well-being, health, and safety. Data were analyzed using directive content analysis. Although participants were concerned about the negative consequences of their parents’ current behaviors and health conditions, they rarely impinged on their parents’ autonomy until they were prompted by an authority figure or had clear evidence that their parents’ health or safety were threatened. Parents often kept information about their activities and well-being from their children in order to protect their autonomy. Implications for balancing parents and adult children’s goals of governance transfer are discussed.

Physical Activity Promotion in a Safety-net Clinic: Does the Provider Make a Difference? A Pilot Study.

Despite the long-term health benefits of physical activity, many Americans across the lifespan do not meet the recommended levels. However, physical activity discussions in the clinic setting may hold promise. The purpose of this study aimed to understand health care providers' beliefs and practices about physical activity discussions being a part of patients' healthcare treatment. Semi-structured, audiotaped interviews were conducted to elicit narratives from ten health care providers. Interview data were transcribed verbatim, then coded and analyzed by two qualitative researchers using NVivo12. Three major themes emerged: importance of regular PA counseling for vulnerable populations, patients' lack of regular physical activity, including subthemes of lack of time, current health conditions, and social determinants of health, and healthcare provider's reflections about their own physical activity. Healthcare providers have an important role when it comes to promoting good health. Having physical activity discussions with patients at every clinic visit is a great opportunity to encourage patients to engage in healthy lifestyle behaviors such as regular physical activity. From this pilot study, implications for practice may include increased awareness of the healthcare providers to discuss physical activity at every visit, which may lead to improved provider-patient communications related to the benefits of daily physical activity behaviors. These discussions may even have a secondary gain of encouraging the providers themselves to adopt the healthy behavior and thereby serve as a role model for their patients.

P57. A double blind, randomized controlled, prospective trial assessing the effectiveness of oral corticoids in the treatment of symptomatic lumbar stenosis

P57. A double blind, randomized controlled, prospective trial assessing the effectiveness of oral corticoids in the treatment of symptomatic lumbar stenosis

When Problems Only Get Bigger: The Impact of Adverse Childhood Experience on Adult Health.

Introduction: Previous studies have shown that adverse childhood experiences negatively impact child development, with consequences throughout the lifespan. Some of these consequences include the exacerbation or onset of several pathologies and risk behaviors.Materials and Methods: A convenience sample of 398 individuals aged 20 years or older from the Porto metropolitan area, with quotas, was collected. The evaluation was conducted using an anonymous questionnaire that included sociodemographic questions about exposure to adverse childhood experiences, a list of current health conditions, questions about risk behaviors, the AUDIT-C test, the Fagerström test and the Childhood Trauma Questionnaire–brief form. Variables were quantified to measure adverse childhood experiences, pathologies, and risk behaviors in adult individuals for comparison purposes.Results: Individuals with different forms of adverse childhood experiences present higher rates of smoking dependence, self-harm behaviors, victimization of/aggression toward intimate partners, early onset of sexual life, sexually transmitted infections, multiple sexual partners, abortions, anxiety, depression, diabetes, arthritis, high cholesterol, hypertension, and stroke. Different associations are analyzed and presented.Discussion and Conclusions: The results show that individuals with adverse childhood experiences have higher total scores for more risk behaviors and health conditions than individuals without traumatic backgrounds. These results are relevant for health purposes and indicate the need for further research to promote preventive and protective measures.

Digital phenotyping and data inheritance

Proponents of precision medicine envision that digital phenotyping can enable more individualized strategies to manage current and future health conditions. We problematize the interpretation of digital phenotypes as straightforward representations of individuals through examples of what we call data inheritance. Rather than being a digital copy of a presumed original, digital phenotypes are shaped by larger data collectives that precede and continuously change how the individual is represented. We contend that looking beyond the individual is crucial for understanding the factors that can ‘bend’ digital mirrors in specific directions. Since algorithms used for digital profiling are based on historical data, their predictions often inherit and increase the values and perspectives of past data practices. Moreover, the data legacies we leave behind today may return as so-called ‘data phantoms’ that conflict with the interests of the individual and contest who and what the ‘original’ is.

Survey of Knowledge, Attitude, and Performance of Students at Hamadan University of Medical Sciences Regarding Solid Wastes Recycling

This descriptive, cross-sectional study aimed to assess the correlations between the knowledge, attitude, and performance of the students of Hamadan University of Medical Sciences, Iran, regarding waste recycling in 2020-2021. A questionnaire was used for data collection, and the sample population consisted of 70 male and female students. Data were analyzed using SPSS version 21 by Mann-Whitney and Kruskal-Wallis (α=0.05). The sample population included 87.1% women and 12.9% men. In total, 22.9% of students received special training to recognize the adverse effects and management of waste while 77.1% of them received no training. In addition, 22.9% of students reported the contraction of infectious diseases in themselves or others around them due to contact with garbage or contaminated equipment. The marital status had a significant difference with the amount of knowledge of the studied students for determining the type of awareness regarding the importance of recycle waste while gender represented no substantial difference in this regard. Based on the results, a positive correlation was observed between attitude and awareness, as well as the performance with knowledge and attitude. Knowledge, attitude, and performance are meaningful predictors of waste management. According to the results, the importance of waste management should be emphasized to student in the community in terms of the current health conditions. It also seems that the influential factors in waste management should be fully identified in interventional programs, and appropriate interventions should be planned and implemented accordingly.

Editor's Column

Editor's Column

Individual and cumulative health afflictions are associated with greater impairment in physical and mental function in former professional American style football players.

BackgroundFormer American style football players (ASF players) have recognized health concerns associated with prior sport participation. It remains unknown whether categorizations of current health conditions, referred to in this report as afflictions (conceptually framed as neurocognitive, cardiovascular, cardiometabolic, sleep apnea, and chronic pain) are associated with physical and mental function.ObjectiveTo evaluate the association of afflictions to physical and mental function. It was hypothesized that former National Football League players with any affliction would have worse function compared to unafflicted participants. It was anticipated that multiple afflictions would result in cumulative loss of function.DesignCross‐sectional retrospective design.SettingAcademic medical multisite hospital system.ParticipantsA total of 3913 of 15,611 former ASF players who played professionally from 1960 to 2019 (response rate 25%). Assessment of Risk Factors Self‐report survey.Main Outcome MeasuresEach participant completed the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale and Physical Function questionnaires. Responses were used to generate two physical function and one mental function subscale scores. Raw scores were converted to T‐scores categorized as impaired (T‐score < 40) or unimpaired (T‐score ≥ 40). Primary analyses measured the association of affliction to function (impaired or unimpaired).ResultsAfter adjusting for confounders (age, race, position, number of seasons, age of first exposure to football, alcohol use, smoking history, and current body mass index), each affliction was associated with reduced physical function on the Global physical function subscale (risk ratio [RR] = 1.23‐2.45, all P < .005), physical function scale (RR = 1.24‐2.75, all P < .01), and mental function scale (RR = 1.34‐2.87, all P < .001), except that cardiovascular affliction was not associated with mental function (RR = 1.15, P = .15). The lowest functional measures were observed in those afflicted by chronic pain. Cumulative afflictions were associated with worse function.ConclusionsAfflictions are associated with cumulative reduction of function. Research evaluating how afflictions interact may help elucidate mechanisms for illness and develop interventions to optimize function.

333 Associations Between Insomnia and Health Correlates in Nurses

Abstract Introduction Insomnia, shiftwork (i.e., circadian rhythm disruptions) and insufficient sleep are common among nurses and healthcare workers. Each of these sleep problems can contribute to physical (e.g., inflammation, musculoskeletal pain, cardiovascular disease and heart rate variability, indigestion, and menstrual cycle irregularity) and mental (e.g., depression, anxiety, suicidality) health problems as well as daytime fatigue and sleepiness among nurses and may contribute to burnout and job change. Methods Participants (N=458) were nurses recruited for a parent study, “Sleep and Vaccine Response in Nurses (SAV-RN)” (Taylor &amp; Kelly: R01AI128359-01). Most identified as female (90.5%), White/Caucasian (77.2%), and non-Hispanic (88.6%) with an average age of 39.03 (SD = 11.07). Participants completed baseline measures online via Qualtrics survey. The Sleep Condition Indicator (SCI; Espie et al., 2014) was used to identify a probable diagnosis of insomnia (score of ≤16 = Insomnia; endorsement of each of the primary DSM-5 criteria on the measure). In addition, a checklist of current major health conditions (high blood pressure, sleep apnea, GI issues, HIV/AIDS, cancer, etc.) was also completed. A Chi square test of Independence was conducted using SPSS to determine if insomnia detected by the SCI was associated with reported health conditions. Results At baseline, 25.4% of nurses had a probable insomnia diagnosis. Insomnia was associated with a greater likelihood of diagnosed sleep apnea, cancer (all types), high blood pressure, chronic pain, gastrointestinal problems, an autoimmune disease, and/or an endocrine problem at Month 11 of the study (all ps &amp;lt;.05). Data cleaning is ongoing, but similar analyses will be presented examining shift work sleep disorder and insufficient sleep (i.e., average &amp;lt; 6hrs per night) as individual and simultaneous predictors of physical and mental health at baseline and change from baseline to Month 11 (if available). Conclusion These results help to identify associations between insomnia and health conditions in nurses and may contribute to future research that supports evidence-based intervention and prevention strategies for this population. While evidence-based interventions for sleep disturbances and insomnia exist (CBT-I), accessibility and feasibility of scaling such interventions to reach the nursing community at large remains challenging. Support (if any):

A Different Perspective for Coaching and Training Education According to Score Changes During Rhythmic Gymnastics European Championships

Rhythmic gymnasts repeat elements thousands of times which may put a risk on gymnasts&amp;rsquo; health. It is necessary to protect the current and future health conditions of young gymnasts, especially in the growth process. There is a lack of knowledge about training education on rhythmic gymnastics. To suggest innovative changes, the current study aimed to analyze the scores (D, E, and total scores) of the first 24 gymnasts competing in 34th and 36th Rhythmic Gymnastics European Championships (ECh). Research data were collected from 24 rhythmic gymnasts&amp;rsquo; scores, from the 34th ECh and 36th ECh. Difficulty (D), Execution (E), and total scores for hoop, ball, clubs, ribbon were analyzed. Conformity of data to normal distribution was assessed with the Kolmogorov-Smirnov test. Variables with normal distribution were compared by one-way analysis of variance (ANOVA)/independent samples t-test and for variables not fitting normal distribution, Mann Whitney U/Kruskal Wallis H test was used. The main findings of the current study were that D scores between 2018 and 2020 increased approximately 4.18 points (p&amp;lt;0.001) while E scores showed no significant changes (p&amp;gt;0.05). In all apparatus total scores increased +15.39 (p&amp;lt;0.001). As these increases seem to be in the faith of gymnasts to get higher results, it is obvious that gymnasts are forced to have a higher number of elements in their routines. Coaches should be informed about new training models and coaching education systems. In this way, they will be able to support their gymnasts in all ways (not only with performance development but also with recent updates on training educations).

Factors and health-related quality of life associated with participation in a post-ICU follow-up. A register study.

Follow-up for heterogeneous intensive care patients presents challenges for rehabilitation interventions and outcome measurements. The aim was to describe and explore characteristics and determinants for visiting/not visiting a nurse-led clinic (NLC) at different time-points, and to describe physical and mental health (HRQoL) over time. Patients with a length of stay (LOS) of ≥72hours, discharged from a general intensive care unit 2004-2014, who participated in a 6-month follow-up programme offering visits to NLC at 2 and 6months were included. The register study includes information regarding patients' participation in NLC, clinical and demographic data from the Patient Administrative System within Intensive care, and data on 2-, 6- and 12-month HRQoL by using SF-36 from the Swedish Intensive Care Registry. Of 656 patients, 57% visited the NLC on some occasion. These patients were younger (P=.000), had lower Simplified Acute Physiology scores (P=.001) and higher SF-36 physical health domain scores at 2months (P<.05) compared to those not visiting at all. Visitors at 2months only were younger, had shorter LOS and higher physical and mental domain scores than patients visiting at 6months only. Patients visiting the NLC scored significantly higher in all domains from 2 to 12months, whereas non-visiting-patients' did this in four out of eight domains during the same time frame. Individual patient's characteristics and current health conditions seem to influence visits to NLC or not. The findings may contribute to the development of existing routines to match the diversity of patients' needs and life situations.

HOPES: An Integrative Digital Phenotyping Platform for Data Collection, Monitoring, and Machine Learning.

The collection of data from a personal digital device to characterize current health conditions and behaviors that determine how an individual’s health will evolve has been called digital phenotyping. In this paper, we describe the development of and early experiences with a comprehensive digital phenotyping platform: Health Outcomes through Positive Engagement and Self-Empowerment (HOPES). HOPES is based on the open-source Beiwe platform but adds a wider range of data collection, including the integration of wearable devices and further sensor collection from smartphones. Requirements were partly derived from a concurrent clinical trial for schizophrenia that required the development of significant capabilities in HOPES for security, privacy, ease of use, and scalability, based on a careful combination of public cloud and on-premises operation. We describe new data pipelines to clean, process, present, and analyze data. This includes a set of dashboards customized to the needs of research study operations and clinical care. A test use case for HOPES was described by analyzing the digital behavior of 22 participants during the SARS-CoV-2 pandemic.