Moderate Fitness Research Articles

Carotid 2D Strain Imaging Reveals Enhanced Rate Of Arterial Wall Deformation Following Exercise In High-fit Young Males

PURPOSE: The purpose of this study was to compare common carotid artery (CCA) stiffness at rest and immediately following brief aerobic exercise between young males of moderate and high cardiorespiratory fitness (CRF). METHODS: Accordingly, heart rate (HR), blood pressure (BP), arterial diameter, conventional parameters of arterial stiffness (Petersons’ elastic modulus [Ep], β1 stiffness index) and novel two-dimensional (2D) strain imaging indices (global circumferential strain, strain rate and β2 stiffness index) were assessed in the CCA pre and immediately post 5-min of aerobic exercise (40% peak exercise capacity) in twenty-two young healthy males (age: 21 ± 2 years). Moderate and high CRF groups demonstrated mean V†o2 peak data of 49 ± 8 and 66 ± 6 mL kg-1min-1, respectively (P <.001). RESULTS: Heart rate, systolic BP, pulse pressure, mean arterial pressure, arterial diameter, Ep, β1 and β2 stiffness indices were not different between fitness groups at rest or immediately following exercise (all P > .05). However, whilst there was a similar increase in CCA wall deformation as indicated by global circumferential strain following exercise (pre vs. post, moderate: 9.12 ± 2.6% vs. 9.36 ± 2.4%; high: 10.19 ± 2.9% vs. 11.34 ± 2.9%, both P > .05), CCA wall deformation was significantly faster in the high-fit group only, as reflected by increased systolic circumferential strain rate (moderate: 1.09 ± 0.3 vs. 1.17 ± 0.2 1/s, P > .05; high: 1.14 ± 0.2 vs. 1.35 ± 0.3 1/s, P = .049). CONCLUSION: Using novel 2D strain imaging, this study shows that young high-fit individuals may exhibit different arterial wall dynamics compared to their lower-fit counterparts following a short bout of aerobic exercise. The increase in global circumferential strain rate following exercise in high-fit individuals may reflect a greater ability to buffer the significant rise in pulse-pressure and blood flow that occurs in response to exercise.

The association of fitness with reduced cardiometabolic risk among smokers.

Despite the health benefits associated with smoking cessation, continued smoking and relapse following cessation are common. Physical activity is associated with reduced risk of cardiovascular disease in general, though less is known about how cardiorespiratory fitness may influence cardiometabolic risk among smokers. Strategies are needed to protect against the health consequences of smoking among those unwilling or unable to quit smoking. The purpose of this study is to determine whether greater cardiorespiratory fitness is associated with reduced metabolic risk among smokers. The prospective influence of estimated cardiorespiratory fitness (i.e., maximal METs) on the development of metabolic syndrome and its components were examined among adult smokers (N=1,249) who completed at least two preventive medical visits at the Cooper Clinic (Dallas TX) between 1979 and 2011. Statistical analyses were completed in 2013 and 2014. The rate and risk for metabolic syndrome, as well as abnormal fasting glucose and high-density lipoprotein cholesterol levels declined linearly with increases in cardiorespiratory fitness (all p<0.05). Smokers in the moderate and high fitness categories had significantly reduced risk of developing metabolic syndrome and elevated fasting glucose relative to smokers in the lowest fitness category. In addition, smokers in the high fitness category were less likely to develop abnormal high-density lipoprotein cholesterol levels. Moderate to high cardiorespiratory fitness among smokers is associated with a reduced likelihood of developing certain cardiovascular disease risk factors and metabolic syndrome.

How Does Homestead Food Production Improve Child Nutrition? Path Analysis of the AAMA Project in Nepal

The Action Against Malnutrition through Agriculture (AAMA) Project is an Enhanced Homestead Food Production Project implemented by Helen Keller International and local partners in Far Western Nepal that combined a nutrition‐sensitive agriculture intervention with behavior change communication to improve nutrition and health. Data from a cross‐sectional endline survey were used to measure variables along HKI's hypothesized Program Impact Pathway (PIP), from inputs through key outcomes of interest, including child growth and maternal and child hemoglobin. Survey respondents included mothers with children aged 12‐48 months at the time of the interview (n=2614). We used path analysis to assess the relative contribu&lt;a name=”_GoBack”&gt;&lt;/a&gt;tion of specific mechanisms of effect on nutrition and health as outlined in the PIP. The hypothesized model for height‐for‐age z‐score fit the data well (χ²(19)=55.8, p&lt;0.001; RMSEA=0.027; CFI=0.945), while the model for child hemoglobin (χ²(20)=297.7, p&lt;0.001; RMSEA=0.073, CFI=0.913) was a moderate fit, and some models did not achieve adequate fit. Agricultural inputs is the program component with the strongest path in the model (β=0.022, p&lt;0.001). Areas of weak association and poor model fit may be attributed to weaknesses in measurement, intervention fidelity, and contextual factors unaccounted for in the PIP. These findings guide program improvements by highlighting areas for enhancements in program design, implementation or evaluation.

Validity of the Paddington Alcohol Test in an Australian Emergency Department†.

The aim of this study was to validate a modified version of the Paddington Alcohol Test for use in the Australian emergency department (ED) setting. A cross sectional survey was used to screen patients attending an Australian tertiary hospital ED. Data were collected over a three-month period at randomly allocated time periods and days. Consenting participants were screened using the Alcohol Use Disorders Identification Test (AUDIT) and a modified-for-Australia version of the Paddington Alcohol Test (AusPAT). The association between the two tools was investigated, as well as the sensitivity and specificity of AusPAT at various AUDIT cut-off scores and by gender and age group. The sample comprised 637 ED attendees. Their mean age was 49.9 (SD 20.0) years with a mean AUDIT score of 5.21 (SD 6.58). Most (73.2%) consumed alcohol, and a quarter was AusPAT-positive (n = 153, 24.0%). AusPAT demonstrated a moderate fit with AUDIT at a cut-off score of 8 (Kappa = 0.63, P < 0.001). At this cut-off 23.4% (n = 149) were identified by AUDIT as problematic drinkers. AusPAT sensitivity was 72.5% (95% CI 65.3-79.7) with a specificity of 90.8% (95% CI 88.3-93.4). Our results indicate that AusPAT was moderately well associated with AUDIT. When used universally in the ED setting, its sensitivity and specificity were moderate.

The association between cardiorespiratory fitness and cardiovascular risk may be modulated by known cardiovascular risk factors

We aimed to evaluate whether reduced cardiovascular fitness has a direct or indirect effect for the development of cardiovascular disease. We investigated 15,595 men and women who were annually screened in a tertiary medical center. All subjects were free of ischemic heart disease and had completed maximal exercise stress test according to the Bruce protocol at their first visit. Fitness was categorized into age- and sex-specific quintiles (Q) according to Bruce protocol treadmill time with Q1 as lowest fitness. Subjects were categorized at baseline into 3 groups: low fitness (Q1), moderate fitness (Q2-Q4), and high fitness (Q5). The primary end point of the current analysis was the development of a first cardiovascular event during follow-up. Mean age of study patients was 48 ± 10 years, and 73% were men. A total of 679 events occurred during 92,092 person-years of follow-up. Kaplan-Meier survival analysis showed that the cumulative probability of cardiovascular events at 6 years was significantly higher among subjects with low fitness (P < .001). Low fitness was associated with known cardiovascular risk factors, including hypercholesterolemia (odds ratio [OR] 1.58, 95% CI 1.31-1.89), diabetes mellitus (OR 2.32, 95% CI 1.58-3.41), and obesity (OR 10.46, 95% CI 8.43-12.98). The effect of low fitness on cardiovascular events was no longer significant when including diabetes mellitus, hypercholesterolemia, and obesity as mediators (hazard ratio 0.99, 95% CI 0.82-1.19). The association between cardiovascular fitness and adverse cardiovascular outcomes may be modulated through traditional cardiovascular risk factors. These findings need to be further validated in prospective clinical trials.

Association Between Leisure Time Physical Activity, Cardiopulmonary Fitness, Cardiovascular Risk Factors, and Cardiovascular Workload at Work in Firefighters.

BackgroundOverweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong.MethodsMale firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four “normal” 24-hour working shifts and during real-situation simulated scenarios.ResultsOverall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities.ConclusionLeisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

Adaptation of the science motivation scale into Turkish and chemistry: Analysis of validity

This study is an adaptation of Science Motivation Scale, developed by Glynn and Koballa, into Turkish and reports validity and reliability of the adapted scale. The sample consisted of 1354 high school students from Ankara and Edirne. The data collected from different types of high schools was analyzed and moderately similar factor structures were found as in the original scale. Based on the principal component analysis, four dimensions which were self-efficacy in learning science, anxiety about science assessment, extrinsically motivated science learning, and intrinsically motivated science learning were determined. These four dimensioned model was analyzed via confirmatory factor analysis and moderate fit was determined. In addition, validity analysis supports the validity of scores on the four-factor model. The Cronbach alpha reliability was found to be 0.913. This scale aims to determine high school students' motivation to learn chemistry. The distinction of this scale is that determining student motivation on learning chemistry rather than asking for general questions in science. The findings of the study are meant to contribute to the chemistry education field by providing an adapted scale.

Moderate activity and fitness, not sedentary time, are independently associated with cardio-metabolic risk in U.S. adults aged 18-49.

This cross-sectional study is one of the first to examine and compare the independent associations of objectively measured sedentary time, moderate to vigorous physical activity (MVPA) and fitness with cardio-metabolic risk factors. We studied 543 men and women (aged 18–49 years) from the NHANES 2003–2004 survey. Sedentary time and MVPA were measured by accelerometry. Fitness was assessed with a submaximal treadmill test. Cardio-metabolic risk factors included: waist circumference (WC), BMI, blood pressure, fasting glucose, HDL- and non HDL cholesterol, triglycerides (TG), and C-reactive protein (CRP). Sedentary time, MVPA and fitness were used as predictors for the cardio-metabolic outcomes in a multiple regression analysis. Standardized regression coefficients were computed. Results show that sedentary time was associated with HDL-cholesterol (β = −0.080, p = 0.05) and TG (β = 0.080, p = 0.03). These results became non-significant after adjustment for MVPA and fitness. MVPA was associated with WC (β = −0.226), BMI (β = −0.239), TG (β = −0.108) and HDL-cholesterol (β = 0.144) (all p < 0.05). These results remained significant after adjustment for sedentary time and fitness. Fitness was associated with WC (β = −0.287), BMI (β = −0.266), systolic blood pressure (β = −0.159), TG (β = −0.092), and CRP (β = −0.130) (all p < 0.05). After adjustment for sedentary time and MVPA these results remained significant. These differences in relative importance of sedentary time, MVPA and fitness on cardio-metabolic-risk are important in the design of prevention programs. In this population, the strength of the associations between MVPA and fitness with cardio-metabolic markers appeared to be similar; both MVPA and fitness showed independent associations with cardio-metabolic risk factors. In contrast, sedentary time showed no independent associations with cardio-metabolic risk after correction for fitness and MVPA.

The predictive validity of the team diagnostic survey

Purpose – The aims of the present study were to test the predictive validity of the Swedish version of the Team Diagnostic Survey (TDS). Design/methodology/approach – A model with both performance and satisfaction was tested with structural equation model (SEM) analyses. Participants completing the survey were employees (N = 214) across three large workplaces. Analyses were done at the group level and data from 33 teams were included in the final data material. Findings – Results from validation data indicate that the TDS has satisfactory high Cronbach’s alpha values on most factors. Results from the SEM analyses show a moderate model fit for the main model. Team-level factors predict both performance and satisfaction, while organization and coaching factors do not. Research limitations/implications – The present study was limited to a cross-sectional design, but earlier studies have shown that the accuracy of the TDS remains consistent over time. The main purpose of this study was to test the predictive validity of the instrument. Theoretical implications of the study are that a survey can be used to get a valid overall picture of the real-life work team’s effectiveness. Practical implications – Practical implications of the study are that communication between researcher and/or consultant and organizational stakeholders is made easier, as the most important factors that affect team effectiveness are identified. Originality/value – The work on the development on TDS has shown that it is possible to use a complex instrument to diagnose work groups, and this line of research is leading the way for better instruments.

Evaluation of Three Dynamic Models for Aerated Facultative Lagoons

In this research, three existing dynamic mathematical models for aerated lagoons were applied to an aerated facultative lagoon (AFL) plant for municipal wastewater treatment. The models’ ability to describe the behavior of the primary lagoon was evaluated, and the advantages and limitations of the three models were compared. For this purpose, 7-year operational data from the municipal WWTP were collected and processed; other necessary data—like dynamic temperature values— were estimated. A 2-year period was used for model calibration, while the remaining 5 years served as validation period. One of the models showed poor calibration fit values in the effluent concentration description (R2 of 0.242 and RMSE of 16.8 mg/L); however, with some modifications the adjust was enhanced (R2 of 0.409 and RMSE of 14.0 mg/L); a second model displayed a poor to moderate adjust (0.489 and 13.0 mg/L, respectively), and the third model achieved a moderate fit (0.528 and 11.9 mg/L), though it provided an overestimation of effluent concentration, especially in periods of heavy and frequent rain; this model with some adaptations the adjust was enhanced (R2 of 0.575 and RMSE of 11.4 mg/L). The validation fits are even lower, illustrating the inability of these models to properly describe the AFL behavior. The possible causes of the models’ inadequacy are discussed. Finally, it is established that in terms of AFL behavior description more research and model development are needed.

The influence of aerobic fitness on the oxygen uptake kinetics of trained cyclists

Introduction: The oxygen uptake kinetics of cyclists with  O2max values associated with Elite standards has not been investigated. A hypothesis was tested stating that trained cyclists have faster oxygen uptake responses as aerobic fitness increases. Methods: Participants (n = 16, combined group) completed a series of square wave 6-min exercises at moderate (80% LT), heavy (50%∆ between the power at LT and  O2max), and severe (power at  O2max) intensities. The  O2 response after the onset of exercise was described by a double exponential model. Participants were further assigned to a high fitness (HF, n = 8) group ( O2max 65 ± 4.7 ml min-1 kg-1) and a moderate fitness (MF, n = 8) group ( O2max 55.1 ± 4.8 ml min-1 kg-1). Results: Results showed a significant slowing of phase II response time (t) above the LT (P < 0.05), and a reduction in gain (G) during severe intensity exercise (P < 0.05). During heavy intensity exercise, t was moderately correlated with  O2max (r = -0.64, P < 0.1), and significant differences (P < 0.05) occurred between HF and MF groups. A significant difference also occurred in G between HF and MF groups (F = 5.6, P < 0.05) despite no change in the slow component. Conclusion: It was concluded that during heavy intensity exercise, the speed of oxygen uptake kinetics continued to improve with increasing aerobic fitness. The mechanism responsible was hypothesised to be related to the percentage of type I muscle fibres.

Validation and effect of demographic variables on perceived quality of life by adolescents

The objectives of the current study were to examine the psychometric properties of the WHOQOL-BREF (English and Hindi language) on Indian adolescents and to explore the role of demographic variables on quality of life. Data from 1327 students, aged 11–21 years was collected with mean age=15.36 years (SD=1.42 years). The results of validation indicated that English and Hindi version of WHOQOL-BREF was a moderate model fit. Overall quality of life and satisfaction with health both predicted the various domains of quality of life, thus demonstrating acceptable predictive validity. Results of multivariate analysis demonstrated that adolescents differed significantly on demographic variables. Adolescents who attended private school possessed significantly better quality of life (overall), physical health, psychological well-being and environmental conditions as compared to adolescents who attended government school. Rural adolescents had significantly higher perceived quality of life (overall), physical health, psychological well-being, social relationships and environmental conditions as compared to urban adolescents.

Flow behaviour of gellan sol with selected cations

An understanding of the flow behaviour of the sols before gel formation is important for developing nutrient enriched gels. The influence of cations like CaCl2 (0.05 and 0.1%, w/w) and FeSO4 (0.05 and 0.1%, w/w) on the rheological properties of 1% gellan sol (w/w) prior to gelling was investigated. The apparent viscosity, reported at a shear-rate of 100s(-1), indicated that the gellan dispersion without any cation possessed lower values compared to other samples containing different cations. The Cross model provided the best fit (0.97 ≤ r ≤ 0.99, p ≤ 0.01) compared to moderate fitting to power law model (0.94 ≤ r ≤ 0.98). Among the different Cross model parameters, the zero-shear viscosity (ηo) increased with the addition of CaCl2 and FeSO4, and with an increase in their concentrations. Zero-shear viscosity values were 0.46 Pas for gellan sol, 0.79 Pas for gellan with 0.05% (w/w) CaCl2, 1.41 Pas for gellan with 0.1% CaCl2, 3.85 Pas for gellan with 0.05% FeSO4 and 4.33 Pas for gellan with 0.1% FeSO4. An increase in cation concentration from 0.05 to 0.10% (w/w) marginally increased the relaxation time (λ) values indicating the development of more solid characteristics in the sol.

THU0263 Factors Associated with Fatigue in Patients with Rheumatoid Arthritis: A Multidimensional “Path Analysis” Model

BackgroundFatigue is one of the most commonly reported symptoms in rheumatoid arthritis (RA) and severe fatigue also occurs in patients with low disease activity. Many factors may play a role...

Construction of a mathematical model for tuberculosis transmission in highly endemic regions of the Asia-pacific

We present a mathematical model to simulate tuberculosis (TB) transmission in highly endemic regions of the Asia-Pacific, where epidemiology does not appear to be primarily driven by HIV-coinfection. The ten-compartment deterministic model captures many of the observed phenomena important to disease dynamics, including partial and temporary vaccine efficacy, declining risk of active disease following infection, the possibility of reinfection both during the infection latent period and after treatment, multidrug resistant TB (MDR-TB) and de novo resistance during treatment. We found that the model could not be calibrated to the estimated incidence rate without allowing for reinfection during latency, and that even in the presence of a moderate fitness cost and a lower value of R0, MDR-TB becomes the dominant strain at equilibrium. Of the modifiable programmatic parameters, the rate of detection and treatment commencement was the most important determinant of disease rates with each respective strain, while vaccination rates were less important. Improved treatment of drug-susceptible TB did not result in decreased rates of MDR-TB through prevention of de novo resistance, but rather resulted in a modest increase in MDR-TB through strain replacement. This was due to the considerably greater relative contribution of community transmission to MDR-TB incidence, by comparison to de novo amplification of resistance in previously susceptible strains.

VALIDATING PROPOSED LEARNING PROGRESSIONS ON FORCE AND MOTION USING THE FORCE CONCEPT INVENTORY: FINDINGS FROM SINGAPORE SECONDARY SCHOOLS

This study examines the validity of 2 proposed learning progressions on the force concept when tested using items from the Force Concept Inventory (FCI). This is the first study to compare students’ performance with respect to learning progressions both for force and motion and for Newton’s third law in parallel. It is also among the first studies on learning progressions within an East Asian context. Data come from 174 Singaporean secondary students who completed the FCI during regular school time. FCI questions are coded as ordered multiple choice items based on the respective learning progressions, and responses are analyzed using a rating scale Rasch measurement model. Results show that FCI items have moderate data-model fit and demonstrate the expected pattern of difficulty among levels of the learning progressions. However, scale reliability and fit for the thresholds between levels showed limitations. The students’ ability estimates for Newton’s third law were higher than for force and motion, contrary to expectation about the relationship between the 2 aspects of force. The paper discusses the connection of these results with the curriculum and implications for learning progressions for the force concept. Directions for future research on instruments for use with learning progressions are also discussed.

Moderate Cardiorespiratory Fitness Is Positively Associated With Resting Metabolic Rate in Young Adults

ObjectiveTo determine whether moderate cardiorespiratory fitness (CRF) or moderate to vigorous physical activity (MVPA) is associated with elevations in resting metabolic rate (RMR) similar to findings previously observed in endurance athletes. Participants and MethodsUsing a cross-sectional design, we measured CRF, RMR, body composition, energy expenditure, and time in MVPA via an arm-based activity monitor in 423 young adults (mean age, 27.6 years). Based on the results of a fitness test, participants were classified into CRF tertiles (low, moderate, or high) by sex. ResultsThere were significant differences among the low-, moderate-, and high-CRF groups for mean ± SD body mass index (calculated as the weight in kilograms divided by the height in meters squared) (28.1±4.1, 25.1±3.4, and 23.6±2.5, respectively; P<.001) and fat mass (28.8±9.7, 20.5±8.2, and 14.8±6.5 kg, respectively; P<.001) but not fat-free mass (53.1±11.5, 53.5±12.4, and 54.7±12.1 kg, respectively; P=.49). There were no differences in mean ± SD unadjusted RMR among the groups (1533.2±266.2, 1519.7±267.6, and 1521.9±253.9 kcal/d, respectively). However, after statistical adjustment for differences in body composition, the moderate- and high-CRF groups had a higher RMR compared with low-CRF individuals by 39.7 and 59.9 kcal/d, respectively (P<.05). After further adjustment for MVPA, RMR was higher in the high-CRF group compared with the low-CRF group by 51.2 kcal/d (P<.05). ConclusionIn this large sample of young adults representing a range of CRF, there was a positive stepwise gradient in RMR across tertiles of CRF independent of body composition. Also, MVPA was independently associated with RMR, although this relationship was modest. These findings underscore the multidimensional role of CRF and MVPA on health. Trial Registrationclinicaltrials.gov Identifier: NCT01746186

Sex-Specific Responses to Self-Paced, High-Intensity Interval Training With Variable Recovery Periods

This study examined sex-specific responses during self-paced, high-intensity interval training (HIIT). Sixteen (8 men and 8 women) individuals completed a peak oxygen uptake test and 3 treadmill HIIT sessions on separate days. The HIIT sessions consisted of six 4-minute intervals performed at the highest self-selected intensity individuals felt they could maintain. Recovery between intervals was counterbalanced and consisted of 1-, 2-, or 4-minute recovery during each trial. Relative measures of intensity, including percentage of velocity at VO2peak (vVO2peak), %VO2peak, %HRmax, and blood lactate concentration ([La]), were observed during the trials. Perceived readiness was recorded immediately before and ratings of perceived exertion (RPE) were recorded at the end of each interval with session RPE recorded after each trial. Results revealed a significant effect of sex on %vVO2peak (p < 0.01) and %HRmax (p < 0.01). Data show that across trials, men self-select higher %vVO2peak (84.5 vs. 80.7%), whereas women produce higher %HRmax (96.9 vs. 92.1%) and %VO2peak (89.6 vs. 86.1%) with no difference in [La] or perceptual responses. These findings support the notion that women may demonstrate improved recovery during high-intensity exercise, as they will self-select intensities resulting in greater cardiovascular strain. Moreover, results confirm previous findings suggesting that a 2:1 work-to-rest ratio is optimal during HIIT for both men and women.

Depression, Stress, and Intimate Partner Violence Among Latino Migrant and Seasonal Farmworkers in Rural Southeastern North Carolina

The purpose of the study is to identify the predictors of depression and intimate partner violence (IPV) among Latinos in rural Southeastern North Carolina. A sample of 291 migrant and seasonal farmworkers was interviewed to complete the demographic questionnaire, HITS (intimate violence tendency), Migrant Farmworker Stress Inventory, Center for Epidemiologic Studies Depression Scale (depression), and CAGE/4M (alcohol abuse). OLS regression and structural equation modeling were used to test the hypothesized relations between predictors of IPV and depression. The findings indicated that respondents reporting higher levels of stress also reported higher levels of IPV and depression. The goodness-of-fit statistics for the overall model again indicated a moderate fit of the model to the data (χ2 = 5,612, p < .001; root mean square error for approximation = 0.09; adjusted goodness-of-fit index = 0.44; comparative fit index = 0.52). Although the findings were not robust to estimation in the structural equation models, the OLS regression models indicated direct associations between IPV and depression.

Development and validation of a scoring system for late anorectal side-effects in patients treated with radiotherapy for prostate cancer

PurposeTo develop and validate a scoring system for evaluation of long term anorectal dysfunction following radiotherapy for prostate cancer. Materials and methodsPatients treated for prostate cancer with radiotherapy filled in questionnaires on anorectal function and quality of life. Items for the condensed anorectal dysfunction score (RT-ARD) were identified and weighted by binomial regression analysis. The score was tested in a separate patient material by receiver operating characteristic (ROC) analysis and correlations to quality of life domains. ResultsA total of 309 patients participated in the study. The items selected were “incontinence for solid stool”, “ability to defer defecation”, “unproductive call to stool”, “clustering of stool”, and “mucus in stool.” Patients were grouped into three categories according to the RT-ARD score; 0–8 (no RT-ARD), 9–23 (minor RT-ARD), 24–45 (major RT-ARD). ROC analyses revealed high sensitivity (91%) and specificity (85%) for major RT-ARD. The prediction model demonstrated a perfect fit in 60%, moderate fit in 36% and no fit in 4%. There was good correlation between the RT-ARD score and quality of life. ConclusionsThe RT-ARD score is a validated and simple instrument for evaluation of anorectal dysfunction following radiotherapy for prostate cancer, and the RT-ARD score correlates to the patient’s quality of life.