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"Schroeder, Elizabeth"
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Taking sides. Clashing views in gender
\"The ninth edition of Taking Sides: Clashing views in Gender contains 40 dynamic points of view, separated into 20 challenging, often contentious questions. There is also an \"Is there common ground?\" section at the end of each issue, which explores whether there is room for compromise on some or all of these controversial topics.\"--Preface.
Book
Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial
Although exercise has well-documented health benefits on cardiovascular disease (CVD), the benefit of combination exercise on CVD risk factors in individuals with elevated risk has not been fully elucidated. We compared the effects of aerobic, resistance, and a combination of both aerobic and resistance training on CVD risk factors including peripheral and central BP, cardiorespiratory fitness (CRF), muscular strength, body composition, blood glucose and lipids. Sixty-nine adults (58±7 years) with an elevated blood pressure or hypertension, overweight/obesity, and sedentary lifestyle were randomized to one of the three 8-week exercise programs or a non-exercise control group. Participants in all three exercise groups had an equal total exercise time, 3 days/week (aerobic: 60 minutes/session vs. resistance: 60 minutes/session vs. combination: aerobic 30 minutes/session plus resistance 30 minutes/session). Combined training provided significant reductions in peripheral (-4 mmHg) and central diastolic BP (-4 mmHg), increase in CRF (4.9 ml/kg/min), increase in upper (4 kg) and lower (11 kg) body strength, and increase in lean body mass (0.8 kg) (p <0.05). Aerobic training only increased CRF (7.7 ml/kg/min), and reduced body weight (-1.0 kg) and fat mass (-0.9 kg) (p <0.05). Resistance training only increased lower body strength (13 kg) and reduced waist circumference (-1.7 cm) (p <0.05). However, neither aerobic or resistance training alone showed significant reductions in BP (p>0.05). Furthermore, a composite score of CVD risk factors indicated a greater reduction with combination training compared to the control group. In conclusion, among individuals at an increased risk for CVD, as little as 8-weeks of combined training may provide more comprehensive CVD benefits compared to time-matched aerobic or resistance training alone.
Journal Article
Mono-unsaturated fatty acids link H3K4me3 modifiers to C. elegans lifespan
Chromatin and metabolic states both influence lifespan, but how they interact in lifespan regulation is largely unknown. The COMPASS chromatin complex, which trimethylates lysine 4 on histone H3 (H3K4me3), regulates lifespan in
Caenorhabditis elegans
. However, the mechanism by which H3K4me3 modifiers affect longevity, and whether this mechanism involves metabolic changes, remain unclear. Here we show that a deficiency in H3K4me3 methyltransferase, which extends lifespan, promotes fat accumulation in worms with a specific enrichment of mono-unsaturated fatty acids (MUFAs). This fat metabolism switch in H3K4me3 methyltransferase-deficient worms is mediated at least in part by the downregulation of germline targets, including S6 kinase, and by the activation of an intestinal transcriptional network that upregulates delta-9 fatty acid desaturases. Notably, the accumulation of MUFAs is necessary for the lifespan extension of H3K4me3 methyltransferase-deficient worms, and dietary MUFAs are sufficient to extend lifespan. Given the conservation of lipid metabolism, dietary or endogenous MUFAs could extend lifespan and healthspan in other species, including mammals.
A deficiency in H3K4me3 methyltransferase causes accumulation of mono-unsaturated fatty acids, which is important for lifespan extension in
C. elegans
and could be relevant in mammals.
Longevity fuelled by fat
The lifespan of a worm is extended by H3K4me3 methyltransferase deficiency, but how and why remains unclear. Here it is shown that the loss of H3K4me3 in the germline affects fat metabolism in the worm intestine, resulting in the accumulation of mono-unsaturated fatty acids (MUFAs), but not poly-unsaturated fatty acids (PUFAs). The fat switch appears to be mediated in part by the downregulation of specific targets in the germline, including S6K, and the activation of a transcriptional network in the intestine leading to the upregulation of conserved delta-9 fatty acid desaturases. MUFA accumulation is necessary for the increased longevity caused by H3K4me3-methyltransferase deficiency, and the authors found that dietary MUFAs, but not PUFAs, were sufficient to extend worm lifespan. Whether dietary or endogenous MUFAs could extend lifespan and healthspan in other species remains to be seen.
Journal Article
Industry differences in psychological distress and distress‐related productivity loss: A cross‐sectional study of Australian workers
Objective This research uses Australian survey data to identify industries with high rates of psychological distress, and to estimate productivity impacts in the form of work loss and cutback days. Methods Analyzing cross‐sectional data from the 2017/2018 National Health Survey, industry prevalence of psychological distress (Kessler Screening Scale) was compared using ordered logistic regression. Productivity outcomes were distress‐related work loss days and work cutback days in the previous 4 weeks. Losses were analyzed using zero‐inflated negative binomial regression. Results The sample consisted of 9073 employed workers [4497 males (49.6%), 4576 females (50.4%)]. Compared to the reference industry, Health, the odds of very high distress for males were highest in Information media and telecommunications (OR 2.4; 95% CI 1.2–4.6) and Administrative and support services (OR 2.5; 95% CI 1.2–5.0), while for females the odds were highest in Accommodation and food services (OR 2.0; 95% CI 1.5–2.8) followed by Retail (OR 1.6; 95% CI 1.2–2.0). Very high distress was associated excess productivity losses. Industry of occupation did not impact on productivity loss over and above distress. Conclusions Substantial psychological distress was reported which impacted on productivity. High‐risk industries included Information media and telecommunications, Accommodation and food services, and Retail.
Journal Article
Associations of Health Club Membership with Physical Activity and Cardiovascular Health
This study evaluates whether a health club membership is associated with meeting the US physical activity (PA) guidelines and/or favorable cardiovascular health.
Using cross-sectional data of health club members (n = 204) and non-members (n = 201) from April to August 2013, this is the first study to our knowledge to examine a health club membership in relation to objectively measured cardiovascular health indicators including resting blood pressure, resting heart rate, body mass index, waist circumference, and cardiorespiratory fitness based on a non-exercise test algorithm. To determine the total PA and sedentary time, this study used a comprehensive PA questionnaire about both aerobic and resistance activities at the health club, as well as lifestyle activities in other settings, which was developed based on the International Physical Activity Questionnaire (IPAQ).
The odds ratios (95% confidence interval) of meeting either the aerobic, resistance, or both aerobic and resistance PA guidelines for members compared to non-members were 16.5 (9.8-27.6), 10.1 (6.2-16.3), and 13.8 (8.5-22.4), respectively. Significant associations of health club membership with more favorable cardiovascular health outcomes and sedentary behavior were observed for resting heart rate (B: -4.8 b/min, p<0.001), cardiorespiratory fitness (B: 2.1 ml/kg/min, p<0.001), and sedentary time (B: -1.4 hours, p<0.001). Participants with a health club membership of >1 year had more favorable health outcomes, with a smaller waist circumference (men, B: -4.0 cm, p = 0.04; women, B: -3.4 cm, p = 0.06), compared to non-members.
Health club membership is associated with significantly increased aerobic and resistance physical activity levels and more favorable cardiovascular health outcomes compared to non-members. However, longitudinal, randomized controlled trials would be clearly warranted as cross-sectional data prohibits causal inferences.
Journal Article
Social Support, Health Literacy and Depressive Symptoms among Medical Students: An Analysis of Mediating Effects
Depressive symptoms are prevalent in university students and may impair their social, educational, and economic transition into adulthood. Identifying the factors that determine depressive symptoms is crucial for the design of effective policy interventions. This study aims to examine the associations between health literacy and depressive symptoms among medical students, and to evaluate the effect of different types of social support as a potential mediator. A cross-sectional survey of medical students was conducted through convenience sampling in East China. Associations between variables were explored using OLS and the mediation effect was estimated using the Karlson, Holm and Breen method. A total of 746 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 32.4%. Higher health literacy levels and social supports were significantly associated with lower levels of depressive symptoms. Social support partially mediated the association between health literacy and depressive symptoms, accounting for a 54.03% of the total effect size. These findings suggest that interventions for medical student mental wellbeing could improve health literacy. Whilst family support reflects greatest impact, Universities can also lead and innovate novel interventions for this critical stage of life. Future research can extend this study by exploring the dynamic interactions between health literacy, depressive symptoms, and other sources of social support. Comparisons of these findings across the different regions of China and in other university subject disciplines are also warranted.
Journal Article
Tackling brain drain at Chinese CDCs: understanding job preferences of public health doctoral students using a discrete choice experiment survey
Background
Given the demands for public health and infectious disease management skills during COVID-19, a shortage of the public health workforce, particularly with skills and competencies in epidemiology and biostatistics, has emerged at the Centers for Disease Controls (CDCs) in China. This study aims to investigate the employment preferences of doctoral students majoring in epidemiology and biostatistics, to inform policy-makers and future employers to address recruitment and retention requirements at CDCs across China.
Methods
A convenience sampling approach for recruitment, and an online discrete choice experiment (DCE) survey instrument to elicit future employee profiles, and self-report of their employment and aspirational preferences during October 20 and November 12, 2020. Attributes included monthly income, employment location, housing benefits, children’s education opportunities, working environment, career promotion speed and
bianzhi
(formally established post).
Results
A total of 106 doctoral epidemiology and biostatistics students from 28 universities completed the online survey. Monthly income, employment location and
bianzhi
was of highest concern in the seven attributes measured, though all attributes were statistically significant and presented in the expected direction, demonstrating preference heterogeneity. Work environment was of least concern. For the subgroup analysis, employment located in a first-tier city was more likely to lead to a higher utility value for PhD students who were women, married, from an urban area and had a high annual family income. Unsurprisingly, when compared to single students, married students were willing to forgo more for good educational opportunities for their children. The simulation results suggest that, given our base case, increasing only monthly income from 10,000 ($ 1449.1) to 25,000 CNY ($ 3622.7) the probability of choosing the job in the third-tier city would increase from 18.1 to 53.8% (i.e., the location choice is changed).
Conclusion
Monthly income and employment location were the preferred attributes across the cohort, with other attributes then clearly ranked and delineated. A wider use of DCEs could inform both recruitment and retention of a public health workforce, especially for CDCs in third-tier cities where resource constraints preclude all the strategies discussed here.
Journal Article
Family group conferencing for children and families: Evaluation of implementation, context and effectiveness (Family VOICE). Study protocol
Family group conferences (FGCs) in child welfare bring immediate and wider family members together to decide on the best way to meet a child's needs. Unlike professionally led meetings, the aim is for decisions to be made by or with family members. Qualitative and mixed-method research with FGC participants tends to show positive experiences: most participants feel their voices are heard; FGCs facilitate family-driven solutions and closer relationships-within families and with social workers. Although there is existing literature on FGCs, there is a paucity of robust comparative UK evaluations, i.e., randomised controlled trials or quasi-experimental studies. Comparative studies internationally have focused on a narrow range of outcomes, not recognised the importance of context, and paid little attention to the quality of delivery. Some qualitative studies have considered process and context but there is scant measurement of these. The aims of this study are, firstly, to establish how FGCs improve outcomes for families and what factors vary their quality, and, secondly, to assess longer-term outcomes in terms of service use and associated costs.
Given the importance of process and context, evaluation informed by realist and complex systems approaches is needed. This multi-method evaluation includes a survey of FGC services in all UK local authorities (n = 212) to map service provision; co-design of programme theory and evaluation measures with family members who have experienced an FGC (n = 16-24) and practitioners (n = 16-24) in two sites; a prospective single-arm study of FGC variability and outcomes after six months; and comparison of service use and costs in FGC participants (n≥300 families) and a control group (n≥1000) after two years using a quasi-experiment.
This is a pragmatic evaluation of an existing intervention, to identify what mechanisms and contexts influence effective process and longer-term outcomes. The study is registered with Research Registry (ref. 7432).
Journal Article
The Effect of the Covid-19 Pandemic on Mental Health: Quasi-Experimental Evidence from Indonesia
Introduction/Main Objectives: This research aims to explore and analyze the effect of the COVID-19 pandemic on mental health status as measured by DASS-21. Background Problems: The prolonged impact of the COVID-19 pandemic on the global economy may have adversely affected mental health. A decrease in income and consumption and the uncertainties surrounding job security and business performance have been some of the main factors contributing to mental health issues. Novelty: This paper aims to evaluate the effect of the COVID-19 pandemic—as a natural experiment—on mental health measured by DASS-21 and how the effect of the pandemic varied across different socioeconomic subgroups. Research Methods: We conducted an online survey across Indonesia to collect self-reported mental health status and socioeconomic characteristics before and during the COVID-19 pandemic to measure its impacts on mental health. Finding/Results: Our results suggest that the COVID-19 pandemic has had an adverse impact on mental health, particularly in terms of anxiety and stress. The effect has been higher among individuals with lower self-efficacy, lower expenditure, and lower education levels. Conclusion: The health and economic crisis driven by the COVID-19 pandemic affected individuals' mental health, suggesting the need for appropriate policy responses.
Journal Article
CEO confidence bias and strategic choice: A general framework
An owner of a firm may choose to hire an unbiased CEO or one with confidence bias. We develop a model that demonstrates that the owner's optimal choice depends on whether the firm and rival choice variables are strategic substitutes or strategic complements. When choice variables are strategic substitutes or strategic complements for both firms, owners optimize by hiring overconfident CEOs. When choice variables are substitutes for one firm and complements for the rival firm, each firm optimizes by hiring an underconfident CEO. We show that the model applies to price and output competition, advertising, research and development spending, and product design.
Journal Article