Repeated Measures MANCOVA Research Articles

Impact of hypotension after return of spontaneous circulation on survival in patients of out-of-hospital cardiac arrest

ObjectiveTo investigate the relationship between hypotension in the first 3h after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest. MethodThis retrospective cohort study occurred at two regional hospitals and included adult OHCA patients who experienced ROSC from July 1, 2014 to December 31, 2015. Hemodynamic and inotrope administration data were retrieved for 3h after ROSC. We calculated the hypotensive exposure index (HEI) as the surrogate marker of the exposure of hypotension. The area under the ROC curve and multivariate logistic regression models were performed to analyze the effect of HEI on survival. Mean arterial pressure (MAP) was explored in the surviving and non-surviving patient groups using repeated measures MANCOVA, adjusted for the use of inotropes and down time. ResultsA total of 289 patients were included in the study, and 29 survived. The median 1-hour HEI and 3-hour HEI were significantly lower in the survival group (p<0.001). The area under the ROC curve for 3-hour HEI was 0.861. The repeated measures MANCOVA indicated that an interaction existed between post-ROSC time and downtime [F(5,197)=2.31, p=0.046]. No significant change in the MAP was observed in the 3h after ROSC, except in the group with a prolonged down time. According to the tests examining the effects of the use of inotropes on the survival outcomes of the different subjects, the MAP was significantly higher in the surviving group [F(1,201)=4.11; p=0.044; ηp2=0.020]. ConclusionAmong the patients who experienced ROSC after OHCA, post-ROSC hypotension was an independent predictor of survival.

Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates.

Academic achievement was evaluated in children with heavy prenatal alcohol exposure to determine potential strengths and weaknesses, evaluate the utility of different definitions for identifying low academic performance, and explore the neural correlates that may underlie academic performance. Children (8 to 16years) were assessed using the WIAT-II. Patterns of performance were examined in 2 subject groups: children with heavy prenatal alcohol exposure (n=67) and controls (n=61). A repeated-measures MANCOVA examining group differences on academic domain (reading, spelling, math) scores was conducted. Post hoc comparisons examined within-group profiles. Numbers and percentage of children with low achievement were calculated using several criteria. In a subsample (n=42), neural correlates were analyzed using FreeSurfer v5.3 to examine relations between cortical structure (thickness and surface area) and performance. The alcohol-exposed group performed worse than controls on all domains and had a unique academic profile, supported by a significant group×academic domain interaction (p<0.001). For the alcohol-exposed group, math reasoning was significantly lower than numerical operations, which was significantly lower than spelling and word reading. Over half of the alcohol-exposed group (58.2%) demonstrated low achievement on 1 or more academic domains. The number and percentage of children meeting criteria for low achievement varied based on the domain and definition used. The imaging analysis identified several surface area clusters that were differentially related to math (L superior parietal and R lateral/middle occipital) and spelling (bilateral inferior and medial temporal) performance by group, with no relations for the other academic domains. Generally, scores improved as surface area decreased in controls, whereas no relation or a positive relation was observed in the alcohol-exposed group. Alcohol-exposed children demonstrated deficits in academic performance across domains and definitions, with a relative weakness in math functioning. Atypical brain development may contribute to these impairments in academic achievement. Understanding academic difficulties can assist in advocating effectively for alcohol-exposed children.

“To be or not to be Retained … That’s the Question!” Retention, Self-esteem, Self-concept, Achievement Goals, and Grades

Keeping students back in the same grade – retention – has always been a controversial issue in Education, with some defending it as a beneficial remedial practice and others arguing against its detrimental effects. This paper undertakes an analysis of this issue, focusing on the differences in student motivation and self-related variables according to their retention related status, and the interrelationship between retention and these variables. The participants were 695 students selected from two cohorts (5th and 7th graders) of a larger group of students followed over a 3-year project. The students were assigned to four groups according to their retention-related status over time: (1) students with past and recent retention; (2) students with past but no recent retention; (3) students with no past but recent retention; (4) students with no past or recent retention. Measures of achievement goal orientations, self-concept, self-esteem, importance given to school subjects and Grade Point Average (GPA) were collected for all students. Repeated measures MANCOVA analyses were carried out showing group differences in self-esteem, academic self-concept, importance attributed to academic competencies, task and avoidance orientation and academic achievement. To attain a deeper understanding of these results and to identify profiles across variables, a cluster analysis based on achievement goals was conducted and four clusters were identified. Students who were retained at the end of the school year are mainly represented in clusters with less adaptive motivational profiles and almost absent from clusters exhibiting more adaptive ones. Findings highlight that retention leaves a significant mark that remains even when students recover academic achievement and retention is in the distant past. This is reflected in the low academic self-concept as well as in the devaluation of academic competencies and in the avoidance orientation which, taken together, can undermine students’ academic adjustment and turn retention into a risk factor.

Feedback-informed treatment in emergency psychiatry; a randomised controlled trial.

BackgroundImmediate patient feedback has been shown to improve outcomes for patients in mild distress but it is unclear whether psychiatric patients in severe distress benefit equally from feedback. This study investigates the efficacy of an immediate feedback instrument in the treatment of patients with acute and severe psychosocial or psychiatric problems referred in the middle of a crisis.MethodsA naturalistic mixed diagnosis sample of patients (N = 370) at a Psychiatric Emergency Centre was randomised to a Treatment-as-Usual (TAU) or a Feedback (FB) condition. In the FB condition, feedback on patient progress was provided on a session-by-session basis to both therapists and patients. Outcomes of the two treatment conditions were compared using repeated measures MANCOVA, Last Observation Carried Forward and multilevel analysis.ResultsAfter 3 months, symptom improvement in FB (ES 0.60) did not significantly differ from TAU (ES 0.71) (p = 0.505). After 6 weeks, FB patients (ES 0.31) actually improved less than TAU patients (0.56) (p = 0.019).ConclusionsPatients with psychiatric problems and severe distress seeking emergency psychiatric help did not benefit from direct feedback.Trial registrationDutch Trial Register, NTR3168, date of registration 1-9-2009Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0811-z) contains supplementary material, which is available to authorized users.

Abstract B84: Influence of acculturation, ethnic identity, and Latino origin on barriers to colonoscopy in low-income Latinos: A longitudinal study

Abstract Objectives: Colorectal cancer (CRC) screening rates continue to be lower than projected, particularly in Latinos. Fear of colonoscopy preparation and procedure, worry about colonoscopy results, CRC fatalism, CRC preventability and curability, and CRC perceived risk have been identified as CRC screening barriers in Latinos. The study purpose was to examine change in level of fear of colonoscopy, worry, CRC fatalism, preventability, and perceived risk using longitudinal data of Latinos who participated of a randomized control trial to test the impact of a culturally targeted and theoretically based psycho-educational print intervention designed to increase CRC screening via colonoscopy. Participants were assessed with study measures before and at 4- and 8-months after randomization. Methods: Our sample included 250 Latinos between the ages of 50 and 81 years who had no personal or immediate family history of CRC, no colonoscopy in the past 5 years before participating in the study, received a referral for colonoscopy, and completed a colonoscopy by the end of the study. Interviews were performed, and data were analyzed using repeated measures MANCOVA to control for acculturation level and ethnic identity score, and to conduct group comparisons by Latino origin. Results: A significant repeated measures MANOVA, F (16, 180) = 4.13, p&amp;lt;.001, showed an overtime decrease in fear of colonoscopy (p&amp;lt;.001), and worry (p&amp;lt;.01). An initial repeated measures MANCOVA, F (16, 173) =1.74, p&amp;lt;.05, showed a significant association between time and ethnic identity, but not with acculturation or Latino origin. A follow-up repeated measures MANCOVA (with ethnic identity as covariate), F (16, 176) =1.79, p&amp;lt;.05, also showed a decrease in fear (p&amp;lt;.05) and worry (p&amp;lt;.05). Discussion: We found an association between change in fear and worry scores, and ethnic identity. Interventions that address negative emotions regarding CRC screening procedures/results should also consider addressing the influence of individual characteristics (e.g., commitment and sense of belonging to their ethnic group) on CRC screening among Latinos referred to colonoscopy. Citation Format: Marimer Santiago-Rivas, Lina Jandorf, Katherine DuHamel. Influence of acculturation, ethnic identity, and Latino origin on barriers to colonoscopy in low-income Latinos: A longitudinal study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B84.

Cognitive impairment in remitted and non-remitted depressive patients: A follow-up comparison between first and recurrent episodes

Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.

Sports Participation Did Not Interfere with Mathematics Performance in Chinese Adolescents

Active physical activity (PA) participation is generally thought to affect the academic performance of students. However, this notion has not been verified, especially with respect to the Chinese population. PURPOSE: To examine the relationship between mathematics performance and the involvement of students in sports-type extra-curricular activity (SECA). METHODS: Ninety-two Chinese adolescents were recruited from a low-banding secondary school in Hong Kong and were followed for 24 months. Their SECA engagement and mathematics performance in the 9th and 11th grades were measured, and their academic scores were standardized into t-scores for comparison. The participants were split into two categories, namely, the SECA and non-SECA groups, based on a self-reported questionnaire. Health-related fitness profiles (body mass index (BMI), nine-minute run, one-minute sit-up, push-up, and sit-and-reach) were measured during the 11th grade to evaluate potential associations with SECA participation. The fitness scores were standardized and compiled into composite fitness scores. RESULTS: ANCOVA (SES as covariate) revealed that the SECA group was physically fitter than the non-SECA group (F=6.273, p<0.01). Two-way repeated measures MANCOVA (grade x group, SES and fitness level as covariates) revealed that no interaction effects occurred between the SECA and non-SECA groups in terms of mathematics score (F=0.232, p=0.632). Nevertheless, the SECA group improved their mathematics performance more in the 11th grade than in the 9th grade (Δ=+0.452). The non-SECA group experienced a drop in performance (Δ=−0.211), although it was not statistically significant. Results from stepwise regression suggested that composite fitness scores significantly predicted mathematics performance (t=2.805, p<0.01) but not whether or not SECA participation. CONCLUSION: SECA participants displayed higher physical fitness level without compromising mathematics performance. The promising findings of this longitudinal study support sports activity for school-aged children.

The Effects of Relationship Education on Adolescent Traditional Gender Role Attitudes and Dating Violence Acceptance

This study examined change in adolescents’ traditional gender role attitudes and dating violence acceptance following completion of a relationship education program. Using data from a larger study evaluating the effects of relationship education for adolescents, beliefs and attitudes were assessed among a diverse sample of 627 youth. Gender differences in changes from pre- to post-test were also examined. Results of repeated measures MANCOVAs revealed a time X gender interaction effect for change in traditional gender role attitudes following relationship education. A significant decrease in traditional gender role attitudes was found for both boys and girls following relationship education, with a steeper decline in traditional gender role attitudes for boys than girls over time. Although there were no significant changes in dating violence acceptance, change in traditional gender role attitudes was correlated with change in dating violence acceptance, such that moving toward more egalitarian attitudes was associated with a decrease in acceptance of dating aggression/violence. Overall, results suggest that adolescents’ attitudes about gender roles and dating violence are open to change when provided relationship education, and changes in these beliefs are linked. Findings from this study have implications for promoting healthy relationships among youth.

Smoking history, and not depression, is related to deficits in detection of happy and sad faces

IntroductionPrevious research has demonstrated that chronic cigarette smoking and major depressive disorder (MDD) are each associated with cognitive decrements. Further, these conditions co-occur commonly, though mechanisms in the comorbid condition are poorly understood. There may be distinct, additive, or overlapping factors underlying comorbid cigarette smoking and MDD. The present study investigated the impact of smoking and MDD on executive function and emotion processing. MethodsParticipants (N=198) were grouped by diagnostic category (MDD and healthy controls, HC) and smoking status (ever-smokers, ES and never-smokers, NS). Participants completed the Facial Emotion Perception Test (FEPT), a measure of emotional processing, and the parametric Go/No-go task (PGNG), a measure of executive function. ResultsFEPT performance was analyzed using ANCOVA with accuracy and reaction time as separate dependent variables. Repeated measures MANCOVA was conducted for PGNG with performance measure and task level as dependent variables. Analyses for each task included diagnostic and smoking group as independent variables, and gender was controlled for. Results for FEPT reveal that lower overall accuracy was found for ES relative to NS, though MDD did not differ from HC. Post-hoc analyses revealed that ES were poorer at identifying happy and sad, but not fearful or angry, faces. For PGNG, poorer performance was observed in MDD relative to HC in response time to Go targets, but there were no differences for ES and NS. Interaction of diagnosis and smoking group was not observed for performance on either task. ConclusionsThe results of this study provide preliminary evidence for distinctive cognitive decrements in smokers and individuals with depression.

Effects of the Self-Directed Individualized Education Program on Self-Determination and Transition of Adolescents With Disabilities

The 1990 Individuals with Disabilities Education Act (IDEA) reauthorization introduced transition mandates that included a “student involvement in transition planning” requirement, creating an emphasis on promoting such involvement so as to enhance the self-determination of students with disabilities and positive transition-related outcomes. This study used a randomized-trial control group design to study the impact of one widely used program to promote student involvement, the Self-Directed Individualized Education Program (IEP), on the self-determination and transition empowerment of youth with disabilities. A repeated-measures MANCOVA was conducted to determine the differences between an intervention group and the placebo-control group. Results showed that instruction using the Self-Directed IEP was significant on students’ level of self-determination, and positive differences were found in transition knowledge when compared with a placebo-control group.

Poster #T206 POSSIBLE ASSOCIATION BETWEEN ITIH3 GENE POLYMORPHISM AND SCHIZOPHRENIA IN A JAPANESE POPULATION

Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.

Outcomes of a culturally responsive health promotion program for elderly Korean survivors of gastrointestinal cancers: A randomized controlled trial

This single-blind, prospective, randomized controlled trial was designed to evaluate the effects of a culturally responsive health promotion program for elderly Korean (CHP-K) survivors of gastrointestinal (GI) cancers. The program consisted of 8 weeks of Qi exercise and face-to-face counseling on physical and psychological factors. A total of 63 Korean GI cancer survivors, aged ≥65 years, who had completed their active cancer treatment, were recruited from a cancer center in South Korea. Outcomes included the amount of exercise, body weight, BMI, the Patient Generated Subjective Global Assessment scale, the M.D. Anderson Symptom Inventory, and self-efficacy and self-esteem scales. Repeated measures MANCOVA revealed a significant difference over time between the groups (Wilks' Lambda F1,62 = 5.361, p = 0.007). Univariate RM-ANCOVA for each outcome measure revealed statistically significant differences between groups. These results suggested that the participation in the CHP-K may have enhanced the health of elderly Korean GI cancer survivors.

Changes in Physical Fitness and Sports Participation Among Children With Different Levels of Motor Competence: A 2-Year Longitudinal Study

The goal of this study was to investigate differences in physical fitness and sports participation over 2 years in children with relatively high, average, and low motor competence. Physical fitness and gross motor coordination of 501 children between 6-10 years were measured at baseline and baseline+2 years. The sample compromised 2 age cohorts: 6.00-7.99 and 8.00-9.99 years. An age and sex-specific motor quotient at baseline testing was used to subdivide these children into low (MQ < P33), average (P33 ≤ MQ < P66) and high (MQ ≥ P66) motor competence groups. Measures of sports participation were obtained through a physical activity questionnaire in 278 of the same children. Repeated Measures MANCOVA and two separate ANOVAs were used to analyze differences in changes in physical fitness and measures of sports participation respectively. Children with high motor competence scored better on physical fitness tests and participated in sports more often. Since physical fitness levels between groups changed similarly over time, low motor competent children might be at risk for being less physically fit throughout their life. Furthermore, since low motor competent children participate less in sports, they have fewer opportunities of developing motor abilities and physical fitness and this may further prevent them from catching up with their peers with an average or high motor competence.

Effectiveness of the Mississippi Communities for Healthy Living (MCHL) Nutrition Intervention

Determine effectiveness of 2 nutrition interventions targeting women’s social/civic organizations in the Lower Mississippi Delta. Diffusion of Innovation theory and the RE-AIM structured framework for program development and evaluation guided the 6-month MCHL nutrition intervention. Intervention components included 6 education sessions with food demonstrations and home challenges, newsletters, and group “champions” to foster social support for dietary changes. Sixteen organizations (319 participants) were randomly assigned to 1 of 2 education groups using cluster sampling. A single message (SM) group received nutrition education on reducing solid fat and added sugars while a multiple message (MM) group received nutrition education on increasing whole grains, fruits, vegetables, and decreasing solid fats and added sugars. Dietary intake was assessed 3 months prior to intervention (T0), 1 week prior to intervention(T1) and immediately post-intervention (T2). 240 participants completed the T2 assessment (75% retention). HEI 2005 component and total scores were calculated from the Delta NIRI/Jackson Heart Study FFQ. Differences over time and between groups were assessed using repeated measures MANCOVA with T0 HEI scores as a covariate. Alpha < .05. Significant improvements occurred over time for both groups in total HEI 2005 (p= .007) and for whole grains, meat and beans, solid fats, total and dark green/orange vegetables (p< .001), and oils (p= .01). There were no between group differences except for total and whole fruit (MM > SM; p< .01). A 6-month, multi-component nutrition intervention tailored to women’s social/civic groups is effective in improving HEI 2005 scores whether targeting one HEI component or several.

Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: A randomized controlled trial

This randomized controlled trial aimed to investigate the effect of short-term intensive TKD training on the isokinetic knee muscle strength and reactive and static balance control of children with developmental coordination disorder (DCD). Among the 44 children with DCD (mean age: 7.6 ± 1.3 years) recruited, 21 were randomly assigned to undergo daily TKD training for 1h over three consecutive months, with the remaining 23 children being assigned to the DCD control group. Eighteen typically developing children (mean age: 7.2 ± 1.0 years) received no training as normal controls. Knee extensor and flexor muscle strength and reactive and static balance control were assessed using an isokinetic machine (with low, moderate and high movement velocities), a motor control test (MCT) and a unilateral stance test (UST), respectively. A repeated measures MANCOVA revealed a significant group through time interaction effect in isokinetic outcomes at 180°/s and in the UST outcome. Post hoc analysis demonstrated that DCD-TKD children's isokinetic knee muscle strength, specifically at 180°/s, was as high as that of the normal control children (p>0.0083) after TKD training. Moreover, UST body sway velocity was slower in the DCD-TKD group than in the DCD control group (p<0.001), and was comparable to that of the normal control group (p>0.05) after TKD training. However, no such improvement in balance was observed in the MCT (p>0.025). The results show that children with DCD who undergo a 3-month program of intensive TKD training experience improvements in isokinetic knee muscle strength at 180°/s and static single-leg standing balance control, but do not benefit from improved reactive balance control.

Eating behavior traits during weight loss and weight loss maintenance in premenopausal women

Changes in body weight (BW), energy intake (EI) and eating behavior (EB) during 12 wks of BW loss and 12 wks of BW loss maintenance were examined. Overweight/obese women (n=56; BMI: 29.8±2.9 kg/m2; age: 35.5±7.2 y) were randomized to 1 of 2 diet plans. BW, EI and EB were measured at wks 0, 12 and 24. In this secondary data analysis, women were grouped by baseline EB as: high restraint/disinhibition (HR/HD); high restraint/low disinhibition (HR/LD); low restraint/high disinhibition (LR/HD); low restraint/disinhibition (LR/LD). Changes in BW, EI and EB were analyzed using repeated measures MANCOVA with pairwise comparisons to detect differences between groups and over time. There was significant BW (kg) loss (p&lt;.001), with no difference between diet groups (p=.89). Over time, energy density (kcal/g) decreased (p&lt;.05), restraint increased (p=.05), and there were interactions between EB group and time for energy (kcal, p&lt;.05), BW (p&lt;.05), BMI (p&lt;.05) and restraint (p&lt;.05). There were differences between EB groups in energy [main effect p&lt;.05, LR/HD&gt;HR/HD p&lt;.05], BW [main effect p&lt;.01, LR/HD&gt;LR/LD p=.01, LR/HD&gt;HR/LD p&lt;.05], BMI [main effect p&lt;.01, LR/HD&gt;LR/LD p&lt;.01] and hunger [main effect p=.001, HR/HD&gt;LR/LD p=.001, HR/HD&gt;HR/LD p&lt;.01]. The influence of EB on EI and BW should be considered during BW loss and BW loss maintenance.Funded by The Bell Institute of Health and Nutrition, General Mills Inc., Minneapolis, MN.

Metabolically healthy overweight/obese premenopausal women benefit from a diet and exercise weight loss intervention

Body weight (BW) loss is recommended for overweight/obese individuals to lower disease risk, but some clinicians question whether BW loss is necessary for those who are metabolically healthy (MH). In this secondary data analysis from a 6‐mo diet and exercise intervention, women who followed 1 of 2 diet plans showed improved health outcomes regardless of baseline metabolic health status and diet plan. For comparability with previous work showing increased insulin resistance (IR) with BW loss, metabolic health was defined using homeostatic model assessment of IR (HOMA‐IR) quartiles, with ≥2.8 classifying MH (n=19) and ≤1.33 metabolically unhealthy (MU, n=20). Health markers were measured at wks 0, 12, and 24 and repeated measures MANCOVA identified significant changes. Over 12 wks of BW loss, MH and MU, respectively, decreased BW (mean±SD, −5.5±4.1; −7.2±5.0 kg; p≤.001), BMI (−2.0±1.5; −2.5±1.7 kg/m2; p≤.001), waist circumference (−5.3±3.6; −5.9±3.5 cm; p≤.002), body fat % (−3.6±3.3; −3.4±2.6 %; p≤.05), and triglyceride (−15.4±34.6; −34.4±37.9 mg/dL; p≤.05); these changes were maintained for 12 wks of BW loss maintenance. MU also decreased and then maintained HOMA‐IR (−1.7±1.9; p≤.05) and insulin (−7.1±8.9 μIU/mL; p≤.05). A diet and exercise intervention resulting in BW loss can improve health markers in MH and MU women.Grant Funding Source : The Bell Institute of Health &amp; Nutrition, General Mills Inc

Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers

Few intervention programs assist patients and their family caregivers to manage advanced cancer and maintain their quality of life (QOL). This study examined (i) whether patient-caregiver dyads (i.e., pairs) randomly assigned to a brief or extensive dyadic intervention (the FOCUS Program) had better outcomes than dyads randomly assigned to usual care and (ii) whether patients' risk for distress and other factors moderated the effect of the brief or extensive program on outcomes. Advanced cancer patients and their caregivers (N = 484 dyads) were stratified by patients' baseline risk for distress (high versus low), cancer type (lung, colorectal, breast, or prostate), and research site and then randomly assigned to a brief (three-session) or extensive (six-session) intervention or control. The interventions offered dyads information and support. Intermediary outcomes were appraisals (i.e., appraisal of illness/caregiving, uncertainty, and hopelessness) and resources (i.e., coping, interpersonal relationships, and self-efficacy). The primary outcome was QOL. Data were collected prior to intervention and post-intervention (3 and 6 months from baseline). The final sample was 302 dyads. Repeated measures MANCOVA was used to evaluate outcomes. Significant group by time interactions showed that there was an improvement in dyads' coping (p < 0.05), self-efficacy (p < 0.05), and social QOL (p < 0.01) and in caregivers' emotional QOL (p < 0.05). Effects varied by intervention dose. Most effects were found at 3 months only. Risk for distress accounted for very few moderation effects. Both brief and extensive programs had positive outcomes for patient-caregiver dyads, but few sustained effects. Patient-caregiver dyads benefit when viewed as the 'unit of care'.

Taekwondo training improves sensory organization and balance control in children with developmental coordination disorder: A randomized controlled trial

Children with developmental coordination disorder (DCD) have poorer postural control and are more susceptible to falls and injuries than their healthy counterparts. Sports training may improve sensory organization and balance ability in this population. This study aimed to evaluate the effects of three months of Taekwondo (TKD) training on the sensory organization and standing balance of children with DCD. It is a randomized controlled trial. Forty-four children with DCD (mean age: 7.6±1.3 years) and 18 typically developing children (mean age: 7.2±1.0 years) participated in the study. Twenty-one children with DCD were randomly selected to undergo daily TKD training for three months (1 h per day). Twenty-three children with DCD and 18 typically developing children received no training as controls. Sensory organization and standing balance were evaluated using a sensory organization test (SOT) and unilateral stance test (UST), respectively. Repeated measures MANCOVA showed a significant group by time interaction effect. Post hoc analysis demonstrated that improvements in the vestibular ratio (p=0.003) and UST sway velocity (p=0.007) were significantly greater in the DCD-TKD group than in the DCD-control group. There was no significant difference in the average vestibular ratio or UST sway velocity between the DCD-TKD and normal-control group after three months of TKD training (p>0.05). No change was found in the somatosensory ratio after TKD training (p>0.05). Significant improvements in visual ratios, vestibular ratios, SOT composite scores and UST sway velocities were also observed in the DCD-TKD group after training (p≤0.01). Three months of daily TKD training can improve sensory organization and standing balance for children with DCD. Clinicians can suggest TKD as a therapeutic leisure activity for this population.

Effects of Low Dose Buccal Caffeine on Muscle Endurance and Anaerobic Performance

To date there have been a number of studies that have assessed the effects of caffeine on both anaerobic and aerobic performance. However, there is little information about the effects of caffeine on RPE and pain during strength endurance or anaerobic activity. PURPOSE: The purpose of the present investigation was to assess the effects of low-dose caffeine administration on performance, RPE and pain scores after both the YMCA 1-min pushup test and the Wingate Anaerobic cycling test. METHODS: Ten college-aged males were recruited to participate in the investigation. The subjects were given either a piece of caffeine gum that is designed to deliver 100 mg of Caffeine in a buccal manner, or a placebo gum with identical shape and flavoring in a double-blind, placebo controlled, repeated measures design. The subjects chewed the gum (either caffeine or placebo) for five minutes to allow for caffeine absorption and subsequently performed the YMCA 1-minute push-up test followed by the Wingate anaerobic test. Subjects responded to the standard Borg RPE scale and an analogue 10pt pain scale immediately after each test. RESULTS: Repeated measures Mancova (Treatment × Exercise Type covaried for weight) revealed a significant main effect for Treatment (F = 18.534, ηp = 0.698, p = 0.003). The caffeine treatment resulted in lower scores on peak power (Caffeine: 958.5 ± 248.2 watts vs. Placebo: 991.99 ± 193.3 watts) and higher scores on power drop (Caffeine: 776.1 ± 231.2 watts vs. Placebo: 689.2 ± 272.2 watts) during the Wingate and a lower score on the YMCA push-up assessment (Caffeine: 54.2 ± 22.9 reps vs. Placebo: 57.3 ± 23.1 reps). Further analysis via repeated measures Mancova did not reveal any significant main or interaction effects for Pain or RPE. With caffeine supplementation subjects reported slightly lower values on the RPE scale (15.05 ± 0.622 vs. 15.15 ± 0.500) and slightly higher values on the pain scale (4.20 ± 0.398 vs. 4.15 ± 0.661). CONCLUSION: Based upon these data it would appear that low-dose caffeine administered in a buccal manner inhibits performance in tests of strength endurance and anaerobic performance, and has no effects on pain and RPE reporting during those assessments. PRACTICAL APPLICATIONS: These findings suggest that low-dose buccal caffeine is not likely to improve strength endurance based or anaerobic based performance, and also is not likely to decrease perceived exertion or pain during these tasks. Therefore, it is not recommended during these types of activities for the purposes of increasing performance or decreasing sensation.