Physical Trajectories Research Articles

Prediction of recovery in trauma patients using Latent Markov models.

Patients' expectations during recovery after a trauma can affect the recovery. The aim of the present study was to identify different physical recovery trajectories based on Latent Markov Models (LMMs) and predict these recovery states based on individual patient characteristics. The data of a cohort of adult trauma patients until the age of 75years with a length of hospital stay of 3days and more were derived from the Brabant Injury Outcome Surveillance (BIOS) study. The EuroQol-5D 3-level version and the Health Utilities Index were used 1 week, and 1, 3, 6, 12, and 24 months after injury. Four prediction models, for mobility, pain, self-care, and daily activity, were developed using LMMs with ordinal latent states and patient characteristics as predictors for the latent states. In total, 1107 patients were included. Four models with three ordinal latent states were developed, with different covariates in each model. The prediction of the (ordinal) latent states in the LMMs yielded pseudo-R2 values between 40 and 53% and between 21 and 41% (depending of the type R2 used) and classification errors between 24 and 40%. Most patients seem to recover fast as only about a quarter of the patients remain with severe problems after 1 month. The use of LMMs to model the development of physical function post-injury is a promising way to obtain a prediction of the physical recovery. The step-by-step prediction fits well with the outpatient follow-up and it can be used to inform the patients more tailor-made to manage the expectations.

Impact of economic factors, social health and stressful life events on physical health-related quality of life trajectories in older Australians.

PurposePhysical health-related quality of life (HRQoL) is associated with adverse health outcomes, including hospitalizations and all-cause mortality. However, little is known about how physical HRQoL changes over time in older people and the predictors of this trajectory. This study (a) identified trajectories of physical HRQoL among older people and (b) explored whether economic factors, social health or stressful life events impact physical HRQoL trajectories. MethodA cohort of 12,506 relatively ‘healthy’ community-dwelling Australians aged ≥ 70 years (54.4% females), enrolled in the ASPREE Longitudinal Study of Older Persons (ALSOP) study and was followed for six years. Economic factors, social health and life events in the last 12 months were assessed through a questionnaire at baseline. Physical HRQoL was measured by using the 12-item short form at baseline and annual follow-ups. Growth mixture and structural equation modelling were used to identify physical HRQoL trajectories and their predictors.ResultsFour physical HRQoL trajectories were identified—stable low (7.1%), declining (9.0%), stable intermediate (17.9%) and stable high (66.0%). Living in more disadvantaged areas, having a lower household income, no paid work, no voluntary work, loneliness and stressful life events (i.e. spousal illness, friend/family illness, financial problem) were associated with a 10%–152% higher likelihood of being in the stable low or declining physical HRQoL trajectory than the stable high group.ConclusionSpecific stressful life events had a greater impact on adverse physical HRQoL trajectories in older people than other factors. Volunteering may prevent physical HRQoL decline and requires further investigation.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11136-021-03021-x.

Physical Function Recovery Trajectories After Spinal Cord Injury

ObjectiveTo explore trajectories of functional recovery that occur during the first 2 years after spinal cord injury (SCI). DesignObservational cohort study. SettingEight SCI Model System sites. ParticipantsA total of 479 adults with SCI completed 4 Spinal Cord Injury–Functional Index (SCI-FI) item banks within 4 months of injury and again at 2 weeks, 3, 6, 12, and 24 months after baseline assessment (N=479). InterventionNone. Main Outcome MeasuresSCI-FI Basic Mobility/Capacity (C), Fine Motor Function/C, Self-care/C, and Wheelchair Mobility/Assistive Technology (AT) item banks. ResultsGrowth mixture modeling was used to identify groups with similar trajectory patterns. For the Basic Mobility/C and Wheelchair Mobility/AT domains, models specifying 2 trajectory groups were selected. For both domains, a majority class exhibited average functional levels and gradual improvement, primarily in the first 6 months. A smaller group of individuals made gradual improvements but had greater initial functional limitations. The Self Care/C domain exhibited a similar pattern; however, a third, small class emerged that exhibited substantial improvement in the first 6 months. Finally, for individuals with tetraplegia, trajectories of Fine Motor Function/C scores followed 2 patterns, with individuals reporting generally low initial scores and then making either modest or large improvements. In individual growth curve models, injury/demographic factors predicted initial functional levels but less so regarding rates of recovery. ConclusionsTrajectories of functional recovery followed a small number of change patterns, although variation around these patterns emerged. During the first 2 years after initial hospitalization, SCI-FI scores showed modest improvements; however, substantial improvements were noted for a small number of individuals with severe limitations in fine motor and self-care function. Future studies should further explore the personal, medical, and environmental characteristics that influence functional trajectories during these first 2 years and beyond.

Neuropsychological and Physical Trajectories in Neurotypical and High-cognitive Performing Older Adults

The maintenance of high cognitive performance in old age has increasinglybecome a public health interest due to associations between cognition,well-being, longevity, and autonomy. The objective of the researchis to investigate cognitive, physical, and psychological trajectories ofneurotypical older adults (NOAs) and high performing older adults(HPOAs). An exploratory study to investigate 21 NOAs and six HPOAs(mean age 71, SD = ± 3.59), followed up for one year. The older adultswere submitted to physical fitness, quality of life, anxiety, depression,RAVLT, ACE-R, and Stroop tests, being assessed at three moments:baseline, six months after the cognitive (MEMO) or stimulation (Stimullus)interventions, and six months after the multimodal interventions, whichcould be physical or psychopedagogical interventions (health educationlectures). Nonparametric statistical tests (Mann-Whitney and Wilcoxon)were performed with p≤0.05. The results demonstrated that the cognitivemeasures were good predictors of cognitive performance and we observedpositive correlations between cognitive and mood measures. The olderadults with high performance had a lower prevalence of depressivesymptoms. There were gains in global cognitive performance, mood, and inphysical fitness variables associated with multimodal interventions, evidentin the neurotypical group

Children's behavior problems, caregivers' trauma history, and membership in latent physical abuse trajectory classes: An approach of latent class growth analysis to dating violence victimization

BackgroundChild abuse is a serious social problem in the USA as many children suffer from child abuse and its negative consequences are severe. To prevent future victimization, it is essential to understand unique patterns of child abuse trajectories over time and the factors associated with their victimization. ObjectiveThe primary goal of this study was to identify individual differences in developmental trajectories of alleged physical abuse between the ages of 2 and 12. Participants and settingThe sample included all children drawn from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which is a consortium of five study sites (South, East, Midwest, Northwest, and Southwest). MethodsUsing the high-risk sample with Child Protective Service record reviews prior to age 4, significant variability in trajectory class membership was observed in the unconditional Latent Class Growth Analysis. ResultsThree trajectory classes were obtained from the data: Early Onset, Late Peak and Non-Victims. The findings showed that children who had an attention problem at age 4 were more likely to become members of both the Early Onset and Late Peak groups, relative to Non-victims. Also, membership in the Late Peak group was predicted by caregivers' childhood physical abuse, supporting for the cycle of physical abuse across generations. Finally, children in the Late Peak group were at the highest risk of being physically, psychologically, and sexually abused in a dating relationship at age 14. ConclusionsThese results suggest that children's internal and external behavior problems and caregivers' childhood physical abuse are predictive of child abuse trajectory class membership. Parental education programs that increase their knowledge about children with special needs and intervention programs targeting caregivers with a history of physical abuse would be beneficial to prevent child abuse (re)victimization.

The impact of demographic and clinical characteristics on the trajectories of health-related quality of life among patients with Fabry disease

BackgroundFabry disease (FD) is an X-linked lysosomal storage disorder characterized by multiorgan dysfunction. Since individuals with FD usually experience progressive clinical disease manifestations, their health-related quality of life (HRQOL) is expected to change over time. However, there is limited longitudinal research examining HRQOL outcomes in individuals with FD. We aimed to: assess longitudinal outcomes in HRQOL in adults with FD; examine the physical- and mental HRQOL trajectories at the initial registration (baseline), 3–5 year, and 7–13 year follow-ups; and evaluate the possible associations of age, sex and medical complications with the physical- and mental HRQOL trajectories.MethodsForty-three individuals with FD (53% female) who were aged 18 to 81 years at baseline attended clinical follow-up visits between 2006 and 2020. Medical records were extracted retrospectively. Demographics and the 36-item Short-Form Health Survey (SF-36) were recorded at scheduled visits, except for the last data collection which was prospectively obtained in 2020. The physical (PCS) and mental (MCS) composite scores (SF-36) were chosen as outcome measures.ResultsThe eight SF-36 domain scores were stable over a span of 13 years, and only physical- and social functioning domains worsened clinically over this follow-up period. Mean baseline SF-36 domain scores were all significantly lower (decreased HRQOL) in the FD sample compared with Norwegian population norms. Two hierarchical linear models were run to examine whether demographics and medical complications (measured at the last clinical visit) predicted physical and mental HRQOL trajectories. Age above 47 years (p < 0.001), male sex (p = 0.027), small fibre neuropathy (p < 0.001), renal dysfunction (p < 0.001), and cerebrovascular events (p = 0.003) were associated with lower HRQOL over time. No significant interactions were found between the time of follow up and the abovementioned predictors of HRQOL.ConclusionsOverall HRQOL trajectories remained stable between baseline, 3–5 year, and 7–13 year follow-ups, with the majority of individuals reporting decreased physical and mental HRQOL. Medical complications in combination with older age and male sex are important predictors of lower HRQOL in FD. Awareness of this relationship is valuable both for health care providers and for patients. The findings provide indicators that can guide treatment decisions to improve physical and mental HRQOL outcomes.

Smooth pursuit operates over perceived not physical positions of the double-drift stimulus.

The double-drift illusion produces a large deviation in perceived direction that strongly dissociates physical position from perceived position. Surprisingly, saccades do not seem to be affected by the illusion (Lisi & Cavanagh, 2015). When targeting a double-drift stimulus, the saccade system is driven by retinal rather than perceived position. Here, using paired double-drift targets, we test whether the smooth pursuit system is driven by perceived or physical position. Participants (n = 7) smoothly pursued the inferred midpoint (Steinbach, 1976) between two horizontally aligned Gabor patches that were separated by 20° and moving on parallel, oblique paths. On the first half of each trial, the Gabors’ internal textures were static while both drifted obliquely downward. On the second half of each trial, while the envelope moved obliquely upward, the internal texture drifted orthogonally to the envelope's motion, producing a large perceived deviation from the downward path even though the upward and downward trajectories always followed the same physical path but in opposite directions. We find that smooth pursuit eye movements accurately followed the nonillusory downward path of the midpoint between the two Gabors, but then followed the illusory rather than the physical trajectory on the upward return. Thus, virtual targets for smooth pursuit are derived from perceived rather than retinal coordinates.

Objective Activity Parameters Track Patient-specific Physical Recovery Trajectories After Surgery and Link With Individual Preoperative Immune States.

The longitudinal assessment of physical function with high temporal resolution at a scalable and objective level in patients recovering from surgery is highly desirable to understand the biological and clinical factors that drive the clinical outcome. However, physical recovery from surgery itself remains poorly defined and the utility of wearable technologies to study recovery after surgery has not been established. Prolonged postoperative recovery is often associated with long-lasting impairment of physical, mental, and social functions. Although phenotypical and clinical patient characteristics account for some variation of individual recovery trajectories, biological differences likely play a major role. Specifically, patient-specific immune states have been linked to prolonged physical impairment after surgery. However, current methods of quantifying physical recovery lack patient specificity and objectivity. Here, a combined high-fidelity accelerometry and state-of-the-art deep immune profiling approach was studied in patients undergoing major joint replacement surgery. The aim was to determine whether objective physical parameters derived from accelerometry data can accurately track patient-specific physical recovery profiles (suggestive of a 'clock of postoperative recovery'), compare the performance of derived parameters with benchmark metrics including step count, and link individual recovery profiles with patients' preoperative immune state. The results of our models indicate that patient-specific temporal patterns of physical function can be derived with a precision superior to benchmark metrics. Notably, 6 distinct domains of physical function and sleep are identified to represent the objective temporal patterns: ''activity capacity'' and ''moderate and overall activity (declined immediately after surgery); ''sleep disruption and sedentary activity (increased after surgery); ''overall sleep'', ''sleep onset'', and ''light activity'' (no clear changes were observed after surgery). These patterns can be linked to individual patients preopera-tive immune state using cross-validated canonical-correlation analysis. Importantly, the pSTAT3 signal activity in monocytic myeloid-derived suppressor cells predicted a slower recovery. Accelerometry-based recovery trajectories are scalable and objective outcomes to study patient-specific factors that drive physical recovery.

Parent-child conflict and physical health trajectories among youth with asthma

ObjectiveTo investigate the role of caregiver- and youth-reports of parent-child conflict on trajectories of asthma-related health outcomes over 2 years. MethodsIn a sample of 193 youth with asthma (42.7% female; M age = 12.78) and their primary caregivers, we used a multi-method and multi-informant approach to assess self-reported parent-child conflict from youth and caregivers at both the daily and global levels at baseline. Next, we annually assessed subjective (i.e., youth self-reported asthma symptoms) and clinical (i.e., peak flow) asthma health outcomes for 2 years. ResultsLatent growth curve models revealed an effect of baseline youth-reported global family conflict on peak flow trajectories such that youth who reported greater parent-child conflict at baseline experienced less of an increase in peak flow over time than youth who reported less parent-child conflict at baseline (standardized β = −0.27, p = .003). ConclusionsYouth with asthma who perceive greater overall conflict with their caregivers experience less improvement in peak flow as they age. The research and clinical implications of these findings are discussed.

Longitudinal changes in physical activity during and after the first national lockdown due to the COVID-19 pandemic in England

Recent studies have shown reduced physical activity at early stages of the COVID-19 pandemic. However, there is a lack of investigation on longitudinal changes in physical activity beyond lockdowns and stay-at-home orders. Moreover, it is unclear if there is heterogeneity in physical activity growth trajectories. This study aimed to explore longitudinal patterns of physical activity and factors associated with them. Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 35,915 adults in England who were followed up for 22 weeks from 24th March to 23rd August 2020. Data were analysed using growth mixture models. Our analyses identified six classes of growth trajectories, including three stable classes showing little change over time (62.4% in total), two classes showing decreasing physical activity (28.6%), and one class showing increasing physical activity over time (9%). A range of factors were found to be associated the class membership of physical activity trajectories, such as age, gender, education, income, employment status, and health. There is substantial heterogeneity in longitudinal changes in physical activity during the COVID-19 pandemic. However, a substantial proportion of our sample showed persistent physical inactivity or decreasing physical activity. Given the well-established link between physical activity and health, persistent or increased physical inactivity is likely to have both immediate and long-term implications for people’s physical and mental health, as well as general wellbeing. More efforts are needed to promote physical activity during the pandemic and beyond.

Intermittency of Riemann’s non-differentiable function through the fourth-order flatness

Riemann’s non-differentiable function is one of the most famous examples of continuous but nowhere differentiable functions, but it has also been shown to be relevant from a physical point of view. Indeed, it satisfies the Frisch–Parisi multifractal formalism, which establishes a relationship with turbulence and implies some intermittent nature. It also plays a surprising role as a physical trajectory in the evolution of regular polygonal vortices that follow the binormal flow. With this motivation, we focus on one more classic tool to measure intermittency, namely, the fourth-order flatness, and we refine the results that can be deduced from the multifractal analysis to show that it diverges logarithmically. We approach the problem in two ways: with structure functions in the physical space and with high-pass filters in the Fourier space.

Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review.

People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra-high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first-line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first-episode psychosis and those who are at ultra-high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty-two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co-designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co-designed lifestyle intervention for the targeted population.

Simulating and Predicting Dynamical Systems With Spatial Semantic Pointers

While neural networks are highly effective at learning task-relevant representations from data, they typically do not learn representations with the kind of symbolic structure that is hypothesized to support high-level cognitive processes, nor do they naturally model such structures within problem domains that are continuous in space and time. To fill these gaps, this work exploits a method for defining vector representations that bind discrete (symbol-like) entities to points in continuous topological spaces in order to simulate and predict the behavior of a range of dynamical systems. These vector representations are spatial semantic pointers (SSPs), and we demonstrate that they can (1) be used to model dynamical systems involving multiple objects represented in a symbol-like manner and (2) be integrated with deep neural networks to predict the future of physical trajectories. These results help unify what have traditionally appeared to be disparate approaches in machine learning.

An integrated Empirical Mode Decomposition and Butterworth filter based vehicle trajectory reconstruction method

Trajectory data serving as an essential data-source, has been widely applied in traffic flow analysis, traffic prediction and transportation management. In real situations, trajectory data is often corrupted with noises, which may introduce estimation bias and control inefficiency to intelligent transportation systems. This paper presents a novel trajectory reconstruction method which is generic for both highway and urban arterial trajectories. The reconstruction method establishes an Empirical Mode Decomposition (EMD) based Butterworth low-pass filter framework to filter the noises and simultaneously maintain physical integrity. The two-stage framework firstly applies the EMD to decompose the original trajectories into components, multiple intrinsic mode functions (IMFs), to find out the main components of different temporal-frequency characteristics. Based on that, an optimal Butterworth-filter is applied on the lower order IMFs to filter the acceleration of an unexpected high-frequency range. To test the effectiveness of our proposed method, multiple resource data-sets are applied. As results indicated that our proposed reconstruction method performs well in terms of physical trajectories integrity, high-frequency noise removal, and measurement error rejection with minimum signal distortion. Further, our method efficiently produces speed and acceleration with higher quality compared with the state-of-the-art methods.

Corona Health-A Study- and Sensor-Based Mobile App Platform Exploring Aspects of the COVID-19 Pandemic.

Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures.

Longitudinal trajectories of physical functioning among Chinese older adults: the role of depressive symptoms, cognitive functioning and subjective memory.

Maintaining physical functioning (i.e. mobility, activities of daily living [ADLs], instrumental activities of daily living [IADLs]) in older adults is essential for independent living. However, little is known about how longitudinal trajectories of physical functioning differ by varying levels of depressive symptoms, subjective memory impairment and cognitive functioning. We aimed to examine whether, and to what degree, the rate of change in physical functioning over time was associated with depressive symptoms, subjective memory and cognitive functioning. A correlational longitudinal design. The sample included 5,519 older adults (mean age = 68.13years) from the China Health and Retirement Longitudinal Study (three waves: 2011-15) who self-reported their depressive symptoms, subjective memory impairment and physical functioning. Cognitive functioning was assessed through interview-based tests. There were significant increases in mobility impairment (β = 0.27, P < 0.001), ADLs impairment (β = 0.05, P < 0.001) and IADLs impairment (β = 0.03, P = 0.006) over time. Compared with the mean score at baseline in 2011, the mobility, ADLs and IADLs impairment increased by 13.32, 10.57 and 4.34% for every 2 years, respectively. Those with high depressive symptoms had accelerated rates of mobility (β = 0.212, P < 0.001), ADLs (β = 0.104, P < 0.001) and IADLs impairment (β = 0.076, P = 0.002). Those with poorer cognitive functioning had more rapid rates of mobility impairment. In contrast, those with differing levels of subjective memory impairment did not experience different physical functioning trajectories. High depressive symptoms and poor cognitive functioning may be precursors to rapid declines in physical functioning. Proactive screening for these precursors may attenuate physical decline among Chinese older adults.

Neighbourhood physical environment, intrinsic capacity, and 4-year late-life functional ability trajectories of low-income Chinese older population: A longitudinal study with the parallel process of latent growth curve modelling.

BackgroundKnowledge of how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated four-year trajectories of IC and their impact on FA trajectories and the association between neighbourhood physical environment and FA trajectories among community-dwelling older adults in Hong Kong, China.MethodsWe conducted a four-wave longitudinal study from 2014 to 2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living Scale. We used cognition, affect, locomotion, sensory capacity, and vitality to capture the multiple domains of IC. Neighbourhood physical environment attributes included green space, land use diversity, and availability of facilities, assessed within 200- and 500-meter buffers of respondents’ homes. We used the parallel process of latent growth curve model.FindingsIC (Unstandardized coefficient, β = −0.02, p<0.001) and FA (β = −0.20, p<0.001) each decreased significantly over time. Individuals with declines in IC experienced a faster decline in FA over time. Green space within a 200-meter buffer (β = 1.15, p = 0.023), the number of leisure (β = 0.03, p = .0.043) and public transport (β = 0.08, p = .0.003) facilities within a 500-meter buffer slowed the rate of FA decline.InterpretationThe level of FA decreased over time in later life. Changes in IC shaped FA trajectories. Increased residential green space and the number of leisure and public transport facilities in the neighbourhood may help slow FA decline over time.FundingThe Hong Kong Housing Society.

Postdischarge Recovery after Acute Pediatric Lung Disease Can Be Quantified with Digital Biomarkers

Background: Pediatric patients admitted for acute lung disease are treated and monitored in the hospital, after which full recovery is achieved at home. Many studies report in-hospital recovery, but little is known regarding the time to full recovery after hospital discharge. Technological innovations have led to increased interest in home-monitoring and digital biomarkers. The aim of this study was to describe at-home recovery of 3 common pediatric respiratory diseases using a questionnaire and wearable device. Methods: In this study, patients admitted due to pneumonia (n = 30), preschool wheezing (n = 30), and asthma exacerbation (AE; n = 11) were included. Patients were monitored with a smartwatch and a questionnaire during admission, with a 14-day recovery period and a 10-day “healthy” period. Median compliance was calculated, and a mixed-effects model was fitted for physical activity and heart rate (HR) to describe the recovery period, and the physical activity recovery trajectory was correlated to respiratory symptom scores. Results: Median compliance was 47% (interquartile range [IQR] 33–81%) during the entire study period, 68% (IQR 54–91%) during the recovery period, and 28% (IQR 0–74%) during the healthy period. Patients with pneumonia reached normal physical activity 12 days postdischarge, while subjects with wheezing and AE reached this level after 5 and 6 days, respectively. Estimated mean physical activity was closely correlated with the estimated mean symptom score. HR measured by the smartwatch showed a similar recovery trajectory for subjects with wheezing and asthma, but not for subjects with pneumonia. Conclusions: The digital biomarkers, physical activity, and HR obtained via smartwatch show promise for quantifying postdischarge recovery in a noninvasive manner, which can be useful in pediatric clinical trials and clinical care.

Associations of Pain Characteristics with Long-term Trajectories of Physical Capacity among Older Adults in the United States

Bothersome and multisite pain are common and strongly associated with low physical functioning in older adults. Although these associations are well established in cross-sectional studies, few population-based studies have examined the impact of pain on physical functioning over time. Accordingly, we sought to determine the associations of pain characteristics with longitudinal trajectories of performance-based measures of physical capacity in older adults. Data on 6,783 community-dwelling adults aged ≥65 years who participated in the 2011-2017 National Health and Aging Trends Study were analyzed. Physical capacity was measured annually using the Short Physical Performance Battery. Group-based trajectory modeling was used to identify groups with similar longitudinal patterns of physical capacity. Baseline pain characteristics included report of bothersome pain in the past month, activity-limiting pain, location of pain, and pain medication use. Multinomial logistic regression was used to examine associations of pain characteristics with trajectories of physical capacity, adjusting for demographic and health characteristics. The cohort was 57% female, 68% white, and 58% were ≥75 years. Four distinct physical capacity trajectories were identified: “persistently low” (12% of cohort), “low, declining” (16%), “moderate, declining” (29%), and “persistently high” (43%). Participants who reported bothersome pain, activity-limiting pain, greater number of pain sites, and more frequent pain medication use at baseline were significantly more likely to demonstrate either “persistently low” or a declining physical capacity trajectory. For example, compared to those not reporting bothersome pain participants who reported bothersome pain were 79% (adjusted relative risk [RR]=1.79 [95%CI:1.26-2.55]), 75% (RR=1.75 [95%CI:1.42-2.16]), and 24% (RR=1.24 [95%CI:1.01-1.51]) more likely to have a “persistently low”, “low declining”, and “moderate declining” physical capacity trajectory, respectively. Among older adults in the US, bothersome pain and other pain characteristics were significantly associated with poor and worsening trajectories of physical capacity over a 6-year period. National Institute on Aging/NIH U01AG032947 and Scan Design Foundation.

Listening In: How Parent-Child Communication Relates to Social and Physical Aggression.

In this study, we investigated the relations between features of parent-child conversations (neutral talk, positive and negative in-dyad and out-dyad talk) and children's social and physical aggression from ages 9-18. Participants were 297 youth (52% girls) of about 9 years old at Time 1 and their parent. Fifty-two percent of this United States sample identified as White, 20% Black, 20% Hispanic, 8% other races/ethnicities. One hundred eighty-seven parents participated in the parent-child observation task. Ninety four percent of parent participants were mothers. Parent-child conversations were observed in the laboratory during preadolescence, and teachers reported child's aggression. Using multinomial logit analyses, we found that coded observations of communication features predicted membership in linear trajectories of social and physical aggression across nine years of adolescence; trajectories were derived via mixture modeling. Parent and child communication characteristics were related to trajectories of aggression that spanned preadolescence and adolescence; however, not all predicted associations were significant. Children's talk about neutral topics predicted being on a lower social aggression trajectory. Positive out-dyad talk from children was related to being on a lower physical aggression trajectory, as was parent in-dyad positive talk. After controlling for other factors, neither parent nor child in- or out-dyad negative talk was associated with social or physical aggression. These findings highlight the importance of positive communication by youth and toward youth in association with long-term social adjustment.