Longitudinal Analysis of Cardiovascular Risk Factors Among Older Adults Participating in a Park-Based Fitness Program.

Physical inactivity is a major risk factor for noncommunicable diseases, particularly among older adults. We examined changes in cardiovascular risk factors among older adults in a community-based fitness program in Miami-Dade County, FL. We used repeated measures linear mixed models to examine participants' cardiovascular risk factor changes over 28 months.

Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder.

Objective: Fear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear.

Received Self-Care Support and Psychosocial Health Among Older Adults with Non-Dialysis-Dependent Chronic Kidney Disease.

Older age is linked with poorer self-care in the chronic kidney disease (CKD) setting. Informal health supporters (family members and friends) are critical sources of self-care support, but much remains unclear about the characteristics and implications of received support among this patient population. We examined how received self-care support (amount and type) related to positive (CKD management self-efficacy) and negative (depressive symptoms) psychosocial health correlates of self-care in 536 adults aged 65 years and older with non-dialysis-dependent CKD.

The Estrous Cycle Coordinates the Circadian Rhythm of Eating Behavior in Mice.

The estrous cycle regulates rhythms of locomotor activity, body temperature, and circadian gene expression. In female mice, activity increases on the night of proestrus, when elevated estrogens cause ovulation. Exogenous estradiol regulates eating behavior rhythms in female mice fed a high-fat diet, but it is unknown whether endogenous estrogens regulate eating rhythms.

Clinical Outcomes Among High-Risk Primary Care Patients With Diabetic Kidney Disease: Methodological Challenges and Results From the STOP-DKD Study.

Background/objective: Slowing the progression of diabetic kidney disease (DKD) is critical. We conducted a randomized controlled trial to target risk factors for DKD progression.

Methods: We evaluated the effect of a pharmacist-led intervention focused on supporting healthy behaviors, medication management, and self-monitoring on decline in estimated glomerular filtration rate (eGFR) for 36 months compared with an educational control.

Exploring the role of sex in the association of late chronotype on cardiorespiratory fitness.

Circadian rhythms differ between young adult males and females. For example, males tend to be later chronotypes, preferring later timing of sleep and activity, than females. Likewise, there are sex differences in body composition and cardiorespiratory fitness.

Factors Related to Higher and Lower Performance and Adherence in STAR-VA Program Sustainment in Department of Veterans Affairs (VA) Community Living Centers (CLCs).

Objectives: We identify factors associated with sustainment of an intervention (STAR-VA) to address distress behaviors in dementia (DBD), guided by the Organizational Memory Knowledge Reservoir (KR) framework, compared across 2 types of outcomes: (1) site performance improvement on a clinical outcome, the magnitude of change in levels of DBD, and (2) self-rated adherence to STAR-VA core components, a process outcome.

Design: We used a cross-sectional sequential explanatory mixed methods design guided by the Organizational Memory Framework.

Setting And Participants: We selected 20 of 79 sites that completed STAR-VA training and consultation based on rankings on 2 outcomes-change in an indicator of DBD and reported adherence to STAR-VA core components.

Racial Equity in Living Donor Kidney Transplant Centers, 2008-2018.

Importance: It is unclear whether center-level factors are associated with racial equity in living donor kidney transplant (LDKT).

Objective: To evaluate center-level factors and racial equity in LDKT during an 11-year time period.

Design, Setting, And Participants: A retrospective cohort longitudinal study was completed in February 2023, of US transplant centers with at least 12 annual LDKTs from January 1, 2008, to December 31, 2018, identified in the Health Resources Services Administration database and linked to the US Renal Data System and the Scientific Registry of Transplant Recipients.

Incidence of Kidney Failure after Primary Organ Transplant.

Key Points: Incidence of ESKD in the first year after primary organ transplant ranges from 2.4% to 3.6% and from 1.

Small Monetary Incentives Lead to Greater Adherence in a Weight Loss Program.

Purpose: Understand how weekly monetary incentives for dietary tracking and/or weight loss impact 6-month weight loss behavioral adherence.

Design: Secondary analysis of participants randomized to one of four conditions in a behavioral weight loss intervention: incentives for dietary tracking, incentives for weight loss, both, or none.

Setting: Participants were asked to self-weigh at least twice weekly, log food and drink in a mobile application five days weekly, and attend bi-weekly, group-based classes.

Comparative Effectiveness of Alternative Treatment Approaches to Secondary Hyperparathyroidism in Patients Receiving Maintenance Hemodialysis: An Observational Trial Emulation.

Rationale & Objective: Optimal approaches to treat secondary hyperparathyroidism (SHPT) in patients on maintenance hemodialysis (HD) have yet to be established in randomized controlled trials (RCTs).

Study Design: Two observational clinical trial emulations.

Setting & Participants: Both emulations included adults receiving in-center HD from a national dialysis organization.

Chronic environmental circadian disruption increases atherosclerosis and dyslipidemia in female, but not male, -deficient mice.

Shift work chronically disrupts circadian rhythms and increases the risk of developing cardiovascular disease. However, the mechanisms linking shift work and cardiovascular disease are largely unknown. The goal of this study was to investigate the effects of chronically shifting the light-dark (LD) cycle, which models the disordered exposure to light that may occur during shift work, on atherosclerosis.

Exploration of model misspecification in latent class methods for longitudinal data: Correlation structure matters.

Modeling longitudinal trajectories and identifying latent classes of trajectories is of great interest in biomedical research, and software to identify latent classes of such is readily available for latent class trajectory analysis (LCTA), growth mixture modeling (GMM) and covariance pattern mixture models (CPMM). In biomedical applications, the level of within-person correlation is often non-negligible, which can impact the model choice and interpretation. LCTA does not incorporate this correlation.

A comparison of deprivation indices and application to transplant populations.

The choice of deprivation index can influence conclusions drawn regarding the extent of deprivation within a community and the identification of the most deprived communities in the United States. This study aimed to determine the degree of correlation among deprivation indices commonly used to characterize transplant populations. We used a retrospective cohort consisting of adults listed for liver or kidney transplants between 2008 and 2018 to compare 4 deprivation indices: neighborhood deprivation index, social deprivation index (SDI), area deprivation index, and social vulnerability index.

Heart rate recovery as an assessment of cardiorespiratory fitness in young adults.

Background: Cardiorespiratory fitness, typically measured as peak oxygen uptake (VO) during maximal graded exercise testing (GXT), is a predictor of morbidity, mortality, and cardiovascular disease. However, measuring VO is costly and inconvenient and thus not widely used in clinical settings. Alternatively, postexercise heart rate recovery (HRRec), which is an index of vagal reactivation, is a valuable assessment of VO in older adults and athletes.

Genetics and functional significance of the understudied methamphetamine sensitive circadian oscillator (MASCO).

The last 50 years have witnessed extraordinary discoveries in the field of circadian rhythms. However, there are still several mysteries that remain. One of these chronobiological mysteries is the circadian rhythm that is revealed by administration of stimulant drugs to rodents.

Goal-Concordance in Children with Complex Chronic Conditions.

Objectives: To characterize delivery of goal-concordant end-of-life (EOL) care among children with complex chronic conditions and to determine factors associated with goal-concordance.

Study Design: This was a retrospective review of goals of care discussions for 272 children with at least 1 complex chronic condition who died at a tertiary care hospital between January 1, 2014, and December 31, 2017. Goals of care and code status were assessed before and within the last 72 hours of life.

Development of an Administrative Data-Based Frailty Index for Older Adults Receiving Dialysis.

Background: Frailty is present in ≥50% of older adults receiving dialysis. Our objective was to a develop an administrative data-based frailty index and assess the frailty index's predictive validity for mortality and future hospitalizations.

Methods: We used United States Renal Data System data to establish two cohorts of adults aged ≥65 years, initiating dialysis in 2013 and in 2017.

Redesigning Care of Hospitalized Young Adults With Chronic Childhood-Onset Disease.

Background Young adults with chronic childhood-onset disease (CCOD) are routinely admitted to internal medicine hospitalist services, yet most lack transition preparation to adult care. Providers and patients feel the strain of admissions to adult services in part due to their medical and social complexity. Methods We performed a descriptive study of a care redesign project for young adults with CCOD hospitalized at a large, tertiary care academic hospital.

Geospatial Analysis of Organ Transplant Referral Regions.

Importance: System and center-level interventions to improve health equity in organ transplantation benefit from robust characterization of the referral population served by each transplant center. Transplant referral regions (TRRs) define geographic catchment areas for transplant centers in the US, but accurately characterizing the demographics of populations within TRRs using US Census data poses a challenge.

Objective: To compare 2 methods of linking US Census data with TRRs-a geospatial intersection method and a zip code cross-reference method.