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  • Ovid Technologies (Wolters Kluwer Health)  (6)
  • 1
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Introduction: Increased physical activity (PA) along with reduced energy intake are the key components of weight loss treatment. Objective measures of PA are more reliable than self-report and are infrequently used in clinical trials. Pedometers are inexpensive, often imbedded in mobile devices (e.g. smartphones), and provide a good estimate of overall daily PA. Hypotheses: We hypothesized that groups with different patterns of daily step counts would emerge over the 12-month period. Methods: We examined the first 12 months of data from the Self Efficacy Lifestyle Focus Trial during which standard behavioral treatment for weight loss was implemented. Participants were given an Omron HJ-720IT pedometer in the third week of the intervention. Pedometer use was recommended as a way to monitor PA goals, but not required. Mean daily step counts were calculated monthly from pedometer data, with days having zero step counts coded as missing. Group-based trajectory modeling was used to identify distinct classes of trajectories of mean daily step counts. Results: The sample (N=120) was 81.8% female, 73.6% White with mean (±SD) age of 53.9±9.0 years and baseline body mass index of 33.2±3.8 kg/m2. Four trajectory groups were identified: active (≥10000 steps/day; n=14, 11.7%), somewhat active (7500 to 9999 steps/day; n=34, 28.3%), low active (5000 to 7499 steps/day; n=33, 27.5%), and sedentary ( 〈 5000 steps/day; n=39, 32.5%). Over 12 months, the active group increased their daily step counts, while the low active and sedentary groups decreased their step counts. Conclusions: Based on our findings, it appeared that study participation, including pedometer use, had little effect on step counts, except in the group that was already active. This suggests that less active individuals may have difficulty initiating activities that increase steps even when using a pedometer. Increased emphasis on simple strategies to increase step count and PA are needed to change sedentary habits.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
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  • 2
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Introduction: Neighborhood factors may play an important role in the treatment of obesity. However, it is unclear if exposures to certain neighborhood factors influence self-efficacy among individuals attempting to lose weight. Hypothesis: We hypothesized that individuals living in obesogenic neighborhood environments at baseline would have low self-efficacy for resisting urges to eat beyond their recommended eating plan in a 12-mo weight loss study. Methods: We used ecological momentary assessment (EMA) to collect daily data on self-efficacy with an EMA question: How CONFIDENT are you that, if you have an urge to go off your healthy lifestyle plan, you can resist the urge? (value 1 to 10) This EMA question was delivered randomly an average of 5 times/day on a smartphone. Residential address at baseline was geocoded using ArcGIS software and key neighborhood measures (e.g., grocery store and restaurant density, proportion of Black and low income residents, index of neighborhood socioeconomic disadvantage (NSED)) were linked at the census tract level. Data were analyzed using descriptive statistics and linear mixed modeling. Results: The sample (N=136) was predominately female (90%), White (80%), mean (SD) age 51.3 (10.3) years, and mean BMI 34.1 (4.6) kg/m 2 . The residential neighborhoods of participants were predominantly White, middle to high education level, and low poverty. The mean confidence score decreased from 7.3 at month 1 to 6.8 at month 12 (p 〈 .001). A higher level of baseline neighborhood grocery store density was associated with a higher confidence score ( p = .037) (see table). No other neighborhood factor was associated with confidence score. Conclusion: Neighborhood factors, specifically access to grocery stores, may affect an individuals’ ability to lose or maintain weight loss by supporting one’s confidence to maintain a healthy lifestyle. This study needs to be replicated in a larger cohort with a more diverse neighborhood representation.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
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  • 3
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Introduction: Obesity research has typically focused on the overall weight change pattern in randomized clinical trials (RCTs), ignoring the clustering of individuals with distinct weight change patterns (e.g., continuing to lose, maintain weight loss, or regain weight). The study aim was to identify trajectories of weight change and their associated predictors. Methods: This was a secondary analysis of longitudinal weight data pooled from two RCTs using standard behavioral treatment for weight loss. Weight was measured using a digital scale at baseline, 6, 12 and 18 mos. Group-based trajectory modeling was used to identify distinct classes of trajectories of percent weight change. Percent change in Barriers to Healthy Eating (BHE) subscale scores (emotions, daily mechanics and social support) were simultaneously added in the final trajectory model to examine their associations with weight change trajectories. Results: The pooled sample included 338 adults, which was mostly female (85.2%), White (73.7 %), 45.7±9.0 years old with 15.6±2.8 years of education, and a BMI of 33.9±4.3 kg/m2. As shown in the graph, three trajectory groups were identified: maintainers, regainers, and non-responders. Percent weight change was associated with BHE emotions (b=.053, p 〈 .001) as well as social support (b=0.029, p=.003) for maintainers, emotions for regainers (b=0.071, p 〈 .001), and daily mechanics for nonresponders (b=0.059, p 〈 .001). Conclusions: This is the first study to identify distinct weight loss trajectories during active weight loss treatment for adults. What distinguished the maintainers from the regainers was the level of perceived barriers related to managing emotions and the availability of social support, while the group that was unsuccessful at achieving a clinically significant weight loss was challenged by the daily mechanics of adopting a healthy diet. The dimensions of barriers to healthy eating associated with weight change trajectories vary and should be considered in future weight loss programs.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Public Health Management and Practice Vol. 23, No. 1 ( 2017-01), p. 29-36
    In: Journal of Public Health Management and Practice, Ovid Technologies (Wolters Kluwer Health), Vol. 23, No. 1 ( 2017-01), p. 29-36
    Abstract: Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. Objective: To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Design: Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Setting and Participants: Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Main Outcome Measure(s): Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Results: We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Conclusion: Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.
    Type of Medium: Online Resource
    ISSN: 1078-4659
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2093165-7
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  • 5
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Background: Obesity is a known risk factor for coronary heart disease (CHD) and plays a role in other CHD risk factors including dyslipidemia, hypertension, and type 2 diabetes mellitus. With nearly two-thirds of the adult US population being overweight and obese, it is important to know how these individuals perceive their CHD risk. Objective: The purpose of this study was to examine the associations between self-reported CHD risk factors and perceived CHD risk among overweight and obese adults. Methods: Demographic data, CHD risk factors, and perceived lifetime CHD risk were collected via electronic surveys using REDCap, an Internet-based data capture tool, of overweight and obese adults enrolled in a Weight Loss Research Registry. CHD risk factors were assessed using an investigator-developed survey of self-reported diagnoses of hyperlipidemia, hypertension, and diabetes, family history of CHD, and current smoking status. A risk factor ranking was assigned to each participant ranging from 0 to 5, with one point given for each of the aforementioned risk factors. Perceived lifetime CHD risk was assessed using a visual analogue scale with a range of 0 (No Risk) to 100 (High Risk). Linear regression and Pearson Correlation were used to analyze the data. Results: The response rate was 44.7% (N = 151) from 338 eligible adults. Respondents were mostly female (91%), White (81.5%), 51.3±10.4 years old with 16.2±2.9 years of education, 65.6% had annual household incomes ≥ $50,000. Males reported a higher perceived risk compared to females (77.6±18.0 vs. 64.9 ±21.5, p=.03). There was no difference in perceived risk based on age, race, education, or income. The prevalence of reported risk factors in the sample was as follows: 49.6% (n=75) had at least one first degree-relative with CHD, 32.5% (n=49) had hypertension, 31.8% (n=48) had hyperlipidemia, 3.9% (n=6) had diabetes and 3.3% (n=5) reported currently smoking. Perceived CHD risk was associated with the number of CHD risk factors (p 〈 .001). The mean perceived risk increased incrementally as the number of risk factors increased: 56.5±24.8 for 0 risk factors (n=46), 65.1±17.6 for 1 risk factor (n=53), 74.3±18.4 for 2 risk factors (n=30), 77.0±17.3 for 3 risk factors (n=19), and 79.7±20.5 for respondents (n=3) with 4 risk factors. No respondent reported 5 risk factors. Conclusions: In this sample, the number of self-reported CHD risk factor was associated with perceived CHD risk (r= .353, p 〈 .001). Male respondents had a higher perceived risk compared to females (77.6±18.0 vs. 64.9±21.5); however, the percent of males in the Registry was significantly lower than females (9% vs. 91%) This might suggest that males may require a higher perceived risk before enrolling in a Registry for weight loss studies. For these respondents, awareness of CHD risk factors and their health implications could be a motivator for enrollment in the Registry.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 29, No. 11 ( 2009-11), p. 1794-1801
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 11 ( 2009-11), p. 1794-1801
    Abstract: Dorsal skinfold window chamber implantation elicits inflammation, arteriolar remodeling, and bone marrow–derived cell recruitment without transdifferentiation into smooth muscle. In this model, both arteriolar remodeling and monocyte/macrophage recruitment are dependent on bone marrow–derived cell-specific CCR2 expression.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
    detail.hit.zdb_id: 1494427-3
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