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28 result(s) for "McCreath, Heather"
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Assessing Dexterity Function: A Comparison of Two Alternatives for the NIH Toolbox
Clinical measurement. Manual dexterity is an important aspect of motor function across the age span. To identify a single measure of manual dexterity for inclusion in the National Institutes of Health (NIH) Toolbox Assessment of Neurological and Behavioral Function. A total of 340 subjects participated in our study. Two alternatives, Rolyan ® 9-Hole Peg Test (9-HPT) and Grooved Pegboard test, were compared by assessing their score range across age groups (3–85 yr) and their test–retest reliability, concurrent, and known groups validity. The 9-HPT was a simple, efficient, and low-cost measure of manual dexterity appropriate for administration across the age range. Test–retest reliability coefficients were 0.95 and 0.92 for right and left hands, respectively. The 9-HPT correlated with Bruininks-Oseretsky Test (BOT) of Motor Proficiency, dexterity subscale, at −0.87 to −0.89 and with Purdue Pegboard at −0.74 to −0.75. The Grooved Pegboard had good test–retest reliability (0.91 and 0.85 for right and left hands, respectively). The Grooved Pegboard correlated with BOT at −0.50 to −0.63 and with Purdue Pegboard at −0.73 to −0.78. However, the Grooved Pegboard required longer administration time and was challenging for the youngest children and oldest adults. Based on its feasibility and measurement properties, the 9-HPT was recommended for inclusion in the motor battery of the NIH Toolbox. NA.
Sleep problems in adolescence are prospectively linked to later depressive symptoms via the cortisol awakening response
Sleep disturbance is a symptom of and a well-known risk factor for depression. Further, atypical functioning of the HPA axis has been linked to the pathogenesis of depression. The purpose of this study was to examine the role of adolescent HPA axis functioning in the link between adolescent sleep problems and later depressive symptoms. Methods: A sample of 157 17–18 year old adolescents (61.8% female) completed the Pittsburgh Sleep Quality Inventory (PSQI) and provided salivary cortisol samples throughout the day for three consecutive days. Two years later, adolescents reported their depressive symptoms via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Individuals (age 17–18) with greater sleep disturbance reported greater depressive symptoms two years later (age 19–20). This association occurred through the indirect effect of sleep disturbance on the cortisol awakening response (CAR) (indirect effect = 0.14, 95%CI [.02 -.39]). Conclusions: One pathway through which sleep problems may lead to depressive symptoms is by up-regulating components of the body’s physiological stress response system that can be measured through the cortisol awakening response. Behavioral interventions that target sleep disturbance in adolescents may mitigate this neurobiological pathway to depression during this high-risk developmental phase.
Mentoring Experiences and Publication Productivity among Early Career Biomedical Investigators and Trainees
Objective: To identify which mentoring domains influence publication productivity among early career researchers and trainees and whether publication productivity differs between underrepresented minority (URM) and well-represented groups (WRGs). The mentoring aspects that promote publica­tion productivity remain unclear. Advancing health equity requires a diverse workforce, yet URM trainees are less likely to publish and URM investigators are less likely to ob­tain federal research grants, relative to WRG counterparts.Participants: Early career biomedical investigators and trainees from the National Research Mentoring Network (NRMN), N=115.Methods: A mentoring-focused online follow-up survey was administered to respondents of the NRMN Annual Survey who self-identified as mentees. Publications were identified from a public database and validated with participant CV data. Bivariate and multivariate analyses tested the as­sociations of publication productivity with mentoring domains.Results: URM investigators and trainees had fewer publications (M = 7.3) than their WRG counterparts (M = 13.8). Controlling for career stage and social characteristics, those who worked on funded projects, and received grant-writing or research mentorship, had a higher probability of any publications. Controlling for URM status, gender, and career stage, mentorship on grant-writing and funding was positively as­sociated with publication count (IRR=1.72). Holding career stage, gender, and mentor­ing experiences constant, WRG investigators and trainees had more publications than their URM counterparts (IRR=1.66).Conclusions: Grant-writing mentorship is particularly important for publica­tion productivity. Future research should investigate whether grant-writing mentor­ship differentially impacts URM and WRG investigators and should investigate how and why grant-writing mentorship fosters increased publication productivity. Ethn Dis. 2021;31(2):273-282; doi:10.18865/ed.31.2.273
Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test
Background Although the Six-Minute Walk Test (6MWT), as recommended by the American Thoracic Society, is widely used as a measure of functional endurance, it may not be applicable in some settings and populations. We sought to examine, therefore, performance over the first 2 minutes and the full 6 minutes of the 6MWT. Specifically, we investigated completion rates, distances walked, test-retest reliability, and the relationship between distances walked over the first 2 and the full 6 minutes of the 6MWT. Methods Community-dwelling children and adults age 3–85 years (n = 337) were asked to walk back and forth on a 15.24 meter (50 ft) course as far as possible without running over a 6 minute period. Test completion and the distance covered by the participants at 2 and 6 minutes were documented. The reliability of distances covered at 2 and 6 minutes was determined by retesting a subsample of 54 participants 6 to 10 days later. The relationship between distances covered at 2 and 6 minutes was determined for the 330 participants completing the 6MWT. Results All 337 participants completed at least 2 minutes of walking, but 7 children less than 5 years of age ceased walking before 6 minutes had elapsed. For the remaining 330 participants the mean distance walked was 186 meters at 2 minutes and 543 meters at 6 minutes. The distances covered at 2 and 6 minutes were reliable between sessions (intraclass correlation coefficients = 0.888 and 0.917, respectively). The distances covered over 2 and 6 minutes were highly correlated (r = 0.968). Conclusions The completion rate, values obtained, test-retest reliability, and relationship of the distances walked in 2 and 6 minutes support documentation of 2 minute distance during the 6MWT. The findings also provide support for use of a Two-Minute Walk Test as the endurance component in the Motor Battery of the NIH Toolbox.
Natural History of Pressure Injury Among Ethnically/Racially Diverse Nursing Home Residents: The Pressure Ulcer Detection Study
The current observational study provides descriptive data on 270 pressure injuries (PrIs) among 142 racially/ethnically diverse nursing home (NH) residents over 16 weeks. Weekly assessments were conducted with the Bates-Jensen Wound Assessment Tool. NH data were obtained from public government websites. NH, resident, and PrI characteristics across race/ethnicity groups were compared using analysis of variance and chi-square. Participants were 62% female and 89% functionally dependent. More Black and Asian individuals had peripheral vascular disease. More Black individuals had persistent trunk and Stage 4 PrIs. Black and Hispanic individuals had normal skin color surrounding PrIs. More Asian individuals had PrIs surrounded by purple/red discolored skin. More Black individuals' heel PrIs were unstageable, necrotic, and showed no granulation. Black and Hispanic individuals exhibited more deep tissue injury. No NH or prevention differences existed. Health disparities found validate administrative data results. Differences in PrI characteristics should be further examined among diverse NH residents. [Journal of Gerontological Nursing, 47(3), 37–46.]
Baseline Characteristics of the 2015-2019 First Year Student Cohorts of the NIH Building Infrastructure Leading to Diversity (BUILD) Program
Objective: The biomedical/behavioral sciences lag in the recruitment and ad­vancement of students from historically underrepresented backgrounds. In 2014 the NIH created the Diversity Program Consortium (DPC), a prospective, multi-site study comprising 10 Building Infrastructure Leading to Diversity (BUILD) institutional grantees, the National Research Mentor­ing Network (NRMN) and a Coordination and Evaluation Center (CEC). This article describes baseline characteristics of four incoming, first-year student cohorts at the primary BUILD institutions who completed the Higher Education Research Institute, The Freshmen Survey between 2015-2019. These freshmen are the primary student cohorts for longitudinal analyses comparing outcomes of BUILD program participants and non-participants.Design: Baseline description of first-year students entering college at BUILD institu­tions during 2015-2019.Setting: Ten colleges/universities that each received < $7.5mil/yr in NIH Research Project Grants and have high proportions of low-income students.Participants: First-year undergraduate stu­dents who participated in BUILD-sponsored activities and a sample of non-BUILD stu­dents at the same BUILD institutions. A total of 32,963 first-year students were enrolled in the project; 64% were female, 18% His­panic/Latinx, 19% African American/Black, 2% American Indian/Alaska Native and Na­tive Hawaiian/Pacific Islander, 17% Asian, and 29% White. Twenty-seven percent were from families with an income <$ 30,000/yr and 25% were their family’s first generation in college.Planned Outcomes: Primary student outcomes to be evaluated over time include undergraduate biomedical degree comple­tion, entry into/completion of a graduate biomedical degree program, and evidence of excelling in biomedical research and scholarship.Conclusions: The DPC national evaluation has identified a large, longitudinal cohort of students with many from groups histori­cally underrepresented in the biomedical sciences that will inform institutional/ national policy level initiatives to help diversify the biomedical workforce.Ethn Dis. 2020;30(4):681-692; doi:10.18865/ed.30.4.681
Sleep–Wake Timings in Adolescence: Chronotype Development and Associations with Adjustment
Adolescent sleep research has focused heavily on duration and quality with less work examining chronotype, defined as individual differences in sleep–wake timings driven by the circadian rhythm. This study filled a gap in the literature by utilizing actigraphy-based sleep estimates in an accelerated longitudinal design in order to better understand the developmental trajectory and individual stability of chronotype during adolescence, as well as the associations between chronotype with risky behaviors, substance use, and depressive symptoms. A total of 329 adolescents (57% female; 21% Asian American, 31% European American, 41% Latino, 7% other ethnicity) provided actigraphy-based estimates of sleep and completed questionnaires at up to three time points, two years apart, beginning at 14–17 years of age. Multilevel modeling revealed a non-linear developmental trend in chronotype whereby eveningness increased from 14 to 19 years of age followed by a trend toward morningness. Individual differences in chronotype exhibited modest stability during adolescent development. Furthermore, greater evening chronotype was associated with more risky behaviors and substance use among males, and more substance use among older adolescents, whereas depressive symptoms were not associated with chronotype. The findings from this study may have practical implications for adolescent behavioral health interventions targeted at reducing risky behaviors and substance use among youth.
Discrimination and Sleep Difficulties during Adolescence: The Mediating Roles of Loneliness and Perceived Stress
Irregular and insufficient sleep place youth at risk for adverse psychological and physical health outcomes. Recent research indicates that discrimination constitutes a type of stressor that interferes with adolescent sleep; however, the mechanisms through which discrimination affects sleep are not well understood. This study examined whether ethnic and non-ethnic (i.e., gender, age, and height/weight) discrimination were associated with adolescents’ sleep duration, variability, and quality, and whether loneliness and perceived stress mediated these associations. An ethnically-diverse sample (42% Latino, 29% European American, 23% Asian) of adolescents (N = 316; Mage = 16.40 years, 57% girls) reported on their experiences of discrimination, perceived stress, and loneliness. Sleep duration and variability were assessed by actigraphy and sleep quality through self-reports. Ethnic discrimination was related to shorter sleep duration and both ethnic and non-ethnic discrimination were associated with worse sleep quality. Loneliness and perceived stress partially mediated the relation between discrimination and sleep quality. Discriminatory experiences can heighten feelings of loneliness and stress, which, in turn, may contribute to diminished sleep quality during adolescence.
Urinary Eicosanoid Metabolites in HIV-Infected Women with Central Obesity Switching to Raltegravir: An Analysis from the Women, Integrase, and Fat Accumulation Trial
Chronic inflammation is a hallmark of HIV infection. Eicosanoids reflect inflammation, oxidant stress, and vascular health and vary by sex and metabolic parameters. Raltegravir (RAL) is an HIV-1 integrase inhibitor that may have limited metabolic effects. We assessed urinary F2-isoprostanes (F2-IsoPs), prostaglandin E2 (PGE-M), prostacyclin (PGI-M), and thromboxane B2 (TxB2) in HIV-infected women switching to RAL-containing antiretroviral therapy (ART). Thirty-seven women (RAL = 17; PI/NNRTI = 20) with a median age of 43 years and BMI 32 kg/m2 completed week 24. TxB2 increased in the RAL versus PI/NNRTI arm (+0.09 versus −0.02; P = 0.06 ). Baseline PGI-M was lower in the RAL arm ( P = 0.005 ); no other between-arm cross-sectional differences were observed. In the PI/NNRTI arm, 24-week visceral adipose tissue change correlated with PGI-M ( rho = 0.45 ; P = 0.04 ) and TxB2 ( rho = 0.44 ; P = 0.005 ) changes, with a trend seen for PGE-M ( rho = 0.41 ; P = 0.07 ). In an adjusted model, age ≥ 50 years ( N = 8 ) was associated with increased PGE-M (P = 0.04 ). In this randomized trial, a switch to RAL did not significantly affect urinary eicosanoids over 24 weeks. In women continuing PI/NNRTI, increased visceral adipose tissue correlated with increased PGI-M and PGE-M. Older age (≥50) was associated with increased PGE-M. Relationships between aging, adiposity, ART, and eicosanoids during HIV-infection require further study.
The Roles of Parental Support and Family Stress in Adolescent Sleep
The current study examines the association between parental support and adolescent sleep under varying levels of family stress. Participants included 316 adolescents (Mage = 16.40 years, 43% male) and their parents (Mage = 45.67 years, 91% mothers) from diverse ethnic backgrounds. Both adolescents and parents completed questionnaires and adolescents wore wrist actigraphs and completed self-reports on their sleep for 7 consecutive days. Results indicated that under contexts of family stress, more parental support was linked to longer sleep duration, less sleep variability, and less time spent awake during the night. Findings suggest that under contexts of family stress, cohesive family relationships may provide a sense of stability and security that is necessary for healthful sleep.