Relationship between inflammatory cytokines and self-report measures of training overload

It has been purported that inflammatory cytokines may be responsible for the aetiology of overtraining. The aim of the present study was to investigate the relationship between self-reported measures of overtraining and inflammatory cytokines. Eight elite male rowers were monitored in their natural training environment for 8 weeks prior to the 2007 Rowing World Championships. During this period of intense endurance training, self-report measures of overtraining and inflammatory cytokines (Interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, and Tumor Necrosis Factor (TNF)-) were assessed fortnightly. Consistent with previous findings, proinflammatory cytokines IL-1β and TNF- were significantly associated (p ≤ 0.05) with measures of depressed mood, sleep disturbances, and stress. Similarly, IL-6 was significantly associated (p ≤ 0.01) with measures of depressed mood, sleep disturbances, and fatigue. These results are consistent with previous hypotheses describing how overtraining may be caused by excessive cytokine release, and lend further support for a cytokine hypothesis of overtraining.

Social comparisons, appearance related comments, contingent self-esteem and their relationships with body dissatisfaction and eating disturbance among women

This study examined social comparisons, appearance related comments and contingent self-esteem, and their relationships with body dissatisfaction and eating disturbance in young adult women. Importantly, the role of both positive and negative appearance related comments, and upward and downward comparisons, were investigated. A self-report questionnaire assessing each of these variables was completed by one hundred and ninety-six women aged 18–35. A higher frequency of negative comments and contingent self-esteem were associated with higher upward comparisons, and more positive comments were associated with higher downward comparisons. Overall, social comparisons were shown to be more important than verbal commentary and contingent self-esteem. More upward comparisons and less downward comparisons uniquely predicted higher body dissatisfaction and eating disturbance. In addition, negative appearance comments were found to be more salient than positive comments. Negative comments and contingent self-esteem uniquely predicted more eating disturbance but positive comments were not a predictor of body dissatisfaction or eating disturbance. Longitudinal studies are now required to establish the direction of these relationships and to more fully examine the interplay among the factors. In addition, given that our study only assessed self-reported social comparisons, our findings need to be validated against experimental methods.

Childhood sexual abuse and adolescent eating disorder : findings from the Victorian Adolescent Health Cohort study

Objective: To examine the relationship between childhood sexual abuse (CSA) before the age of 16 years and later onset of bulimia and anorexia nervosa symptoms in females.

Design: A longitudinal cohort study of adolescents observed from August 1992 to March 2003. The cohort was defined in a 2-stage cluster sample using 44 Australian schools in Victoria.

Setting: Population based.

Participants: A total of 1936 persons participated at least once and survived to the age of 24 years, including 999 females. The mean (SD) age of females at the start of follow- up was 14.91 (0.39) years; and at completion, 24.03 (0.55) years.

Main Exposure: Self-reported CSA before the age of 16 years was ascertained retrospectively at the age of 24 years.

Outcome Measures: Incident Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)–defined partial syndromes of anorexia and bulimia nervosa were identified between waves 4 (mean age, 16.3 years) and 6 (mean age, 17.4 years) using the Branched Eating Disorder Test.

Results: The incidence of bulimic syndrome during adolescence was 2.5 (95% confidence interval, 0.80-8.0) times higher among those who reported 1 episode of CSA and 4.9 (95% confidence interval, 1.9-12.7) times higher among those who reported 2 or more episodes of CSA, compared with females reporting no episodes, adjusted for age and background factors. The association persisted after adjusting for possible confounders or mediators measured 6 months earlier, including psychiatric morbidity and dieting behavior. There was little evidence of an association between CSA and partial syndromes of incident anorexia nervosa.

Conclusion: Childhood sexual abuse seems to be a risk factor for the development of bulimic syndromes, not necessarily mediated by psychiatric morbidity or severe dieting.

Utilising self-report data to measure racial discrimination in the labour market

Although economists have developed a series of approaches to modelling the existence of labour market discrimination, rarely is this topic examined by analysing self-report survey data. After reviewing theories and empirical models of labour market discrimination, we examine self-reported experience of discrimination at different stages in the labour market, among three racial groups utilising U.S. data from the 2001-2003 National Survey of American Life. Our findings indicate that African Americans and Caribbean blacks consistently report more experience of discrimination in the labour market than their non-Hispanic white counterparts. At different stages of the labour market, including hiring, termination and promotion, these groups are more likely to report discrimination than non-Hispanic whites. After controlling for social desirability bias and several human capital and socio-demographic covariates, the results remain robust for African Americans. However, the findings for Caribbean blacks were no longer significant after adjusting for social desirability bias. Although self-report data is rarely utilised to assess racial discrimination in labour economics, our study confirms the utility of this approach as demonstrated in similar research from other disciplines. Our results indicate that after adjusting for relevant confounders self-report survey data is a viable approach to estimating racial discrimination in the labour market. Implications of the study and directions for future research are provided.

The impact of an exercise physiologist coordinated resistance exercise program on the physical function of people receiving hemodialysis: a stepped wedge randomised control study

Background:

Tracking of maternal self-efficacy for limiting young children's television viewing and associations with children's television viewing time: a longitudinal analysis over 15-months

BACKGROUND: Mothers' self-efficacy for limiting their children's television viewing is an important correlate of this behaviour in young children. However, no studies have examined how maternal self-efficacy changes over time, which is potentially important during periods of rapid child development. This study examined tracking of maternal self-efficacy for limiting young children's television viewing over 15-months and associations with children's television viewing time. METHODS: In 2008 and 2010, mothers (n = 404) from the Melbourne InFANT Program self-reported their self-efficacy for limiting their child's television viewing at 4- and 19-months of age. Tertiles of self-efficacy were created at each time and categorised into: persistently high, persistently low, increasing or decreasing self-efficacy. Weighted kappa and multinomial logistic regression examined tracking and demographic and behavioural predictors of change in self-efficacy. A linear regression model examined associations between tracking categories and children's television viewing time. RESULTS: Tracking of maternal self-efficacy for limiting children's television viewing was low (kappa = 0.23, p < 0.001). Mothers who had persistently high or increasing self-efficacy had children with lower television viewing time at 19-months (β = -35.5; 95 % CI = -54.4,-16.6 and β = 37.0; 95 % CI = -54.4,-19.7, respectively). Mothers of children with difficult temperaments were less likely to have persistently high self-efficacy. Mothers who met adult physical activity guidelines had 2.5 greater odds of increasing self-efficacy. CONCLUSIONS: Interventions to increase and maintain maternal self-efficacy for limiting children's television viewing time may result in lower rates of this behaviour amongst toddlers. Maternal and child characteristics may need to be considered when tailoring interventions.

Drug use in Australian nightlife settings: estimation of prevalence and validity of self-report

AIMS: This study aimed to 1) estimate the prevalence of illicit drug use in night-time entertainment districts across five major cities in Australia; and 2) validate self-reported drug use using biochemical marker oral swabs. DESIGN: Street intercept surveys and oral drug swabs conducted over a seven-month period during 2011-2012. SETTING: The night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia, between the hours of 10 pm and 5 am. PARTICIPANTS: 7,340 individuals agreed to participate in the survey (a 93% response rate). More than half (62%) of the sample was male, with a median age of 22 years (range 18-73). MEASUREMENTS: Patrons were approached in thoroughfares, and while entering and leaving licensed venues. Data collected included demographics and current session alcohol and other substance use. Drug swabs (n = 401) were performed with a sub-sample of participants. FINDINGS: Approximately 9% (95% CI, 7% to 12%) of participants self-reported consumption of illicit or non-prescribed pharmaceutical drugs prior to interview; of those, 81% identified psychostimulants as the drug used. One in five drug swabs returned a positive result, with psychostimulants the most commonly detected drugs (15%; 95% CI, 12%-19%). Kappa statistics indicate agreement between self-report of any illicit drug and a positive drug swab is in the slight range (κ = 0.12 (95% CI, .05 to .20) p = .000). CONCLUSIONS: Self-report findings suggest drug use in the nightlife in Australia is common, though still very much a minority past-time. Drug swabs indicate a higher prevalence of use (20%) than self-report (9%), which suggests that self-reported drug use may not be reliable in this context. This article is protected by copyright. All rights reserved.

Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study

BACKGROUND: Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes. The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users.

METHODS/DESIGN: The present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up.

DISCUSSION: The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly.

Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES - Australia

OBJECTIVE: Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management.

DESIGN: Diabetes MILES-Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (Age: M=52.1, SD=13.9) with type 1 (T1D; n=680) or type 2 diabetes (T2D; n=944), who responded to a version of the survey containing key measures.

MAIN OUTCOME MEASURES: Self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA1c, medication/insulin adherence. RESULTS: We used Preacher and Hayes' bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes <0.06).

CONCLUSION: Support for mediation was weak, suggesting that relationships amongst these variables are small and that future research might explore other aspects of self-management in diabetes.

Text message and internet support for coronary heart disease self-management: results from the text4heart randomized controlled trial

BACKGROUND: Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. OBJECTIVE: The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). METHODS: A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. RESULTS: Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. CONCLUSIONS: A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. TRIAL REGISTRATION: ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

The HEART mobile phone trial: the partial mediating effects of self-efficacy on physical activity among cardiac patients

BACKGROUND: The ubiquitous use of mobile phones provides an ideal opportunity to deliver interventions to increase physical activity levels. Understanding potential mediators of such interventions is needed to increase their effectiveness. A recent randomized controlled trial of a mobile phone and Internet (mHealth) intervention was conducted in New Zealand to determine the effectiveness on exercise capacity and physical activity levels in addition to current cardiac rehabilitation (CR) services for people (n = 171) with ischemic heart disease. Significant intervention effect was observed for self-reported leisure-time physical activity and walking, but not peak oxygen uptake at 24 weeks. There was also significant improvement in self-efficacy.

OBJECTIVE: To evaluate the mediating effect of self-efficacy on physical activity levels in an mHealth delivered exercise CR program.

METHODS: Treatment evaluations were performed on the principle of intention to treat. Adjusted regression analyses were conducted to evaluate the main treatment effect on leisure-time physical activity and walking at 24 weeks, with and without change in self-efficacy as the mediator of interest.

RESULTS: Change in self-efficacy at 24 weeks significantly mediated the treatment effect on leisure-time physical activity by 13%, but only partially mediated the effect on walking by 4% at 24 weeks.

CONCLUSION: An mHealth intervention involving text messaging and Internet support had a positive treatment effect on leisure-time physical activity and walking at 24 weeks, and this effect was likely mediated through changes in self-efficacy. Future trials should examine other potential mediators related to this type of intervention.

Validity and reliability of questionnaires measuring physical activity self-efficacy, enjoyment, social support among Hong Kong Chinese children

BACKGROUND: Physical activity (PA) correlates have not been extensively studied in Hong Kong children.

OBJECTIVE: The aim of this study is to assess the validity and reliability of translated scales to measure PA related self-efficacy, enjoyment and social support in Hong Kong Chinese children.

METHODS: Sample 1 (n = 273, aged 8-12 years) was recruited (May-June, 2013) from two primary schools. Confirmatory factor analyses (CFA) were conducted to assess factorial validity. Criterion validity was assessed by correlating measured constructs with self-reported PA. Cronbach's alpha was computed to assess scale internal consistency. The intraclass correlation coefficient (ICC) was performed to assess scale test-retest reliability. Criterion validity was further examined in Sample 2 (n = 84, aged 8-12 years) from a third school by correlating measured constructs with objectively measured PA collected in September 2013 and February 2014.

RESULTS: The CFA results supported the one-factor structure of the scales. All PA correlates were significantly (p < 0.01) associated with self-reported PA in Sample 1. Self-efficacy and enjoyment were significantly (p < 0.05) correlated with objectively measured PA in Sample 2. All the scales demonstrated acceptable internal consistency. All ICC values of the scales suggested acceptable test-retest reliability.

CONCLUSION: The results provide psychometric support for using the scales to measure PA correlates among Hong Kong Chinese children.

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

Self-perceived distress and impairment in problem gamblers: a study of pre- to post-treatment measurement invariance

Gambling help services typically evaluate treatment outcomes using self-reported responses and measurements. However, gamblers’ conceptualisations and prioritisations with respect to these measurements may shift over time. Thus, changes in the self-reported responses may not always reflect true change in the individuals. This study investigated for response shift in self-report measures of psychological distress and impairment in 293 help-seeking problem gamblers. We used confirmatory factor analysis to model data structures from pre-treatment to post-treatment. The findings indicated that a response shift had occurred. Two items became less important and one item became more important in measuring psychological distress. Measurement invariance was achieved for the complete set of items for impairment. These findings provide a more in-depth understanding of the nature of self-report outcomes in otherwise routinely collected data.