Background: Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course.
Methods: We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine.
View Article and Find Full Text PDFHealth Serv Res Manag Epidemiol
March 2023
Background: Few models exist that incorporate measures from an array of individual characteristics to predict the risk of COVID-19 infection in the general population. The aim was to develop a prognostic model for COVID-19 using readily obtainable clinical variables.
Methods: Over 74 weeks surveys were periodically administered to a cohort of 1381 participants previously uninfected with COVID-19 (June 2020 to December 2021).
Int J Environ Res Public Health
March 2023
Using data from the longitudinal Early Head Start Research and Evaluation Project that were obtained when children were 14 through 60 months old, this study aims to explore the transactional effects between parent supportiveness and child emotion regulations skills. An autoregressive model with cross-lagged paths was utilized to examine the developmental trajectories of parent supportiveness and child emotion regulation, the directions of transactional relationships between them, and the transactional effects on the prediction of child cognitive school readiness. Significant autoregressive effects were found in both parent supportiveness and child emotion regulation trajectories.
View Article and Find Full Text PDFJ Alzheimers Dis
February 2023
Background: The kynurenine pathway (KP) comprises a family of tryptophan-derived metabolites that some studies have reported are associated with poorer cognitive performance and an increased risk of Alzheimer's disease and related dementias (ADRD).
Objective: The objective of this study was to determine the associations of plasma KP metabolites (kynurenine [KYN], kynurenic acid [KA], and tryptophan [TRP]) with a panel of plasma ADRD biomarkers (Aβ42/ β40 ratio, pTau-181, glial fibrillary acidic protein [GFAP], and neurofilament light [NfL]) and cognitive performance in a subset of older adults drawn from the Duke Physical Performance Across the LifeSpan (PALS) study.
Methods: The Montreal Cognitive Assessment (MoCA) was used to assess cognitive performance.
Purpose: To examine the effects of "ALL YOU NEED IS LOVE", a novel six-week, self-directed patient education manual designed to improve chronic kidney disease knowledge/self-management, health care transition readiness, self-advocacy, and mindfulness skills among adolescents with chronic kidney disease.
Design And Methods: We enrolled 49 adolescents aged 11-17 years (mean age 14.7 ± 1.
Objectives: Coronavirus Disease 2019 (COVID-19) is a viral illness with public health importance. The Cabarrus County COVID-19 Prevalence and Immunity (C3PI) Study is a prospective, longitudinal cohort study designed to contribute valuable information on community prevalence of active COVID-19 infection and SARS-CoV-2 antibodies as the pandemic and responses to it have and continue to evolve. We present the rationale, study design, and baseline characteristics of the C3PI Study.
View Article and Find Full Text PDFPurpose: To explore the relationship between coping and health care transition readiness, and to examine whether anxiety is a mediator between coping and health care transition readiness.
Design And Methods: A sample of 174 youths with various chronic conditions (age 13.03 ± 2.
For individuals with autism spectrum disorder (ASD), behavioral inflexibility can affect multiple domains of functioning and family life. The objective of this study was to develop and validate a clinical interview version of the Behavioral Inflexibility Scale. Trained interviewers conducted interviews with parents of 144 children with ASD and 70 typically developing children (ages: 3-17 years).
View Article and Find Full Text PDFPurpose: To develop and evaluate a parent-proxy measure of youth HCT readiness: the TRANSITION Index-Parent Version.
Design And Methods: We recruited parents (77% female) and youth (ages 12 to 25) to complete transition readiness measures during outpatient clinic visits. The TRxANSITION Index-Parent Version contains two domains: the Parent Knowledge Domain assessing a parent's knowledge of their youth's illness, and the Parent Proxy Domain, which provides a parental perspective regarding a youth's transition readiness skills.
Purpose The purpose of this study was to understand how joint attention and sensory-regulatory features are related in early childhood and predict language and social-communication outcomes in preschool in order to build mechanistic theories that can inform early intervention directed at improving these outcomes. Method Cross-lagged panel analysis models were used to examine the association between joint attention and sensory-regulatory features at 13 and 22 months of age in children ( = 87) who were identified via community screening at 12 months as having a higher likelihood than the general population for being diagnosed with autism spectrum disorder. Results Significant concurrent correlations and predictive correlations were found between these constructs at 13 and 22 months.
View Article and Find Full Text PDFThis study examined associations between chores engagement, self-management, and transition readiness in youth with chronic conditions. Youths with various chronic conditions attending a therapeutic camp, and their parents participated. Responses of 165 campers and their parents were analyzed (mean camper age 12.
View Article and Find Full Text PDFBehavior inflexibility (BI) refers to rigid patterns of behavior that contrast with the need to be adaptable to changing environmental demands. We developed a parent-reported outcome measure of BI for children with autism spectrum disorder (ASD) and other developmental disabilities with a multi-step iterative process. A pool of 62 candidate items was generated through expert panel feedback, review of existing scales and focus groups.
View Article and Find Full Text PDFBackground: Walking and balance often begin to deteriorate in ambulant adults with cerebral palsy (CP) in early adulthood. The decline in walking and balance imposes a more sedentary lifestyle, increases falls risk, negatively affects health, participation, and quality of life, and ultimately results in increased disability. Available research is not sufficient to guide interventions to improve walking and balance in this population.
View Article and Find Full Text PDFBackground: A parent's level of role overload, a situation in which the demands of an individual's roles are beyond their capacity to perform adequately, has been associated with poor outcomes in adolescents. It is unknown if role overload in parents is associated with less health care transition (HCT) readiness in their children with chronic conditions. We sought to assess this relationship.
View Article and Find Full Text PDFRehabilitation goals often focus on increasing community integration for adults with disabilities and are measured by objective assessments. Research methods have lagged behind in capturing current conceptualizations of community integration as a multidimensional construct that incorporates participation, social supports, and feelings of belonging in the community. This paper addresses this challenge by describing a multi-method approach to assessing community integration for adults with cerebral palsy.
View Article and Find Full Text PDFThis study aimed to identify divergent patterns of individual continuity and change in anxious solitude (AS) in the last half of elementary school (3rd - 5th grade) and the first two years of middle school (6th - 7th grade), and test predictors and outcomes of these pathways. Participants were 688 youths (girls n = 354, 51.5%; M age at outset = 8.
View Article and Find Full Text PDFBackground: The Patient Reported Outcomes Measurement Information System (PROMIS) Computerized Adaptive Test (CAT) physical function rapidly assesses self-reported function capability. The Timed Up and Go (TUG) test is often used in clinical practice, but administration may be impeded by space and patient limitations. PROMIS CAT can potentially address these limitations, but we lack evidence if TUG and health indicators are predictors of PROMIS CAT.
View Article and Find Full Text PDFThe goal of this paper is to examine the psychometric properties of a live-coded behavioral measure of joint attention, the Attention-Following and Initiating Joint Attention Protocol (JA Protocol), in order to assist researchers and clinicians in identifying when this measure may meet their joint attention assessment needs. Data from 260 children with autism spectrum disorder, developmental delay, or typical development between the ages of 2 and 12 years were used to evaluate this measure using quality standards for measurement. Overall, the JA Protocol demonstrated good psychometric properties.
View Article and Find Full Text PDFPurpose: Low health literacy adversely affects health outcomes in adults with chronic kidney disease. The current study examined associations between limited/inadequate health literacy and health services utilization among adolescents and young adults (AYA) with chronic or end-stage kidney disease (CKD or ESKD).
Design And Methods: This was a retrospective cohort study that enrolled patients from both the pediatric- and adult-focused nephrology clinics of a major university hospital.
An infant's vocal capacity develops significantly during the first year of life. Research suggests early measures of pre-speech development, such as canonical babbling and volubility, can differentiate typical versus disordered development. This study offers a new contribution by comparing early vocal development in 10 infants with Fragile X syndrome and 14 with typical development.
View Article and Find Full Text PDFThe cascade theory of handedness suggests that hand preferences develop from a history of cascading and sequentially developing manual asymmetries for a variety of actions. Infants who consistently use their preferred hand for a variety of actions likely would gain proficiency using that preferred hand and, consequently, perform more proficiently on other challenging manual tasks. One such task is object stacking, which has been linked with a number of cognitive abilities.
View Article and Find Full Text PDFAtypical sensory and repetitive behaviors are defining features of autism spectrum disorder and are thought to be influenced by environmental factors; however, there is a lack of naturalistic research exploring contexts surrounding these behaviors. This study involved video recording observations of 32 children with autism spectrum disorder (2-12 years of age) engaging in sensory and repetitive behaviors during home activities. Behavioral coding was used to determine what activity contexts, sensory modalities, and stimulus characteristics were associated with specific behavior types: hyperresponsive, hyporesponsive, sensory seeking, and repetitive/stereotypic.
View Article and Find Full Text PDFBackground: People with aphasia (PWA) are frequently perceived less favorably by listeners than their peers. These perceptions include incorrect assumptions that can prevent successful social interactions. While communication partner training has been shown to improve social outcomes related to the listener (see e.
View Article and Find Full Text PDFBackground: Following stroke, spatiotemporal gait asymmetries persist into the chronic phases, despite the neuromuscular capacity to produce symmetric walking patterns. This persistence of gait asymmetry may be due to deficits in perception, as the newly established asymmetric gait pattern is perceived as normal.
Objective: The purpose of this study was to determine the effect of usual overground gait asymmetry on the ability to consciously and unconsciously perceive the presence of gait asymmetry in people poststroke.