Comparisons of matched salivary and serum samples in response to dynamic hypothalamic-pituitary-adrenal (HPA) axis testing. Subjects Healthy women (n=10; three taking oral oestrogens) and men (n=2), aged 23--65 years, were recruited from the community. Measurements Paired saliva and serum samples were obtained during three protocols: 10 min of exercise at 90% of maximal heart rate (n=8), intravenous administration of corticotrophin-releasing hormone (CRH; n=4), and dexamethasone suppression (n=7). Cortisol was measured in saliva using a commercial high-sensitivity EIA and total cortisol was measured in serum with a commercial radioimmunoassay (RIA). Results The time course of the salivary cortisol response to both the exercise and CRH tests paralleled that of total serum cortisol. Salivary cortisol demonstrated a significantly greater relative increase in response to the exercise and CRH stimuli (697+/- 826%vs. 209+/- 150%, P=0.04 saliva vs. serum). A disproportionately larger increase in free cortisol, compared with total, would be expected when the binding capacity of cortisol-binding globulin (CBG) is exceeded. In response to dexamethasone suppression, relative decreases in cortisol were not significantly different between the two media (-47+/- 56%vs.-84+/- 8%, P=0.13 saliva vs. serum). Although a significant linear correlation was found for all paired salivary and serum total cortisol samples (n=183 pairs, r=0.60, P<0.001), an exponential model provided a better fit (r=0.81, P<0.001). The linear correlations were strengthened when data from subjects on oral oestrogens (n=52 pairs, r=0.75, P < 0.001) were separated from those not taking oestrogens (n=131 pairs, r=0.67, P<0.001). Conclusions Salivary cortisol measured with a simple EIA can be used in place of serum total cortisol in physiological research protocols. Evidence that salivary measures represent the biologically active, free fraction of cortisol includes: (1) the greater relative increase in salivary cortisol in response to tests that raise the absolute cortisol concentration above the saturation point of CBG; (2) the strong exponential relationship between cortisol assessed in the two media; and (3) the improved linear correlations when subjects known to have increased CBG were analysed separately. Thus, an advantage of measuring salivary cortisol rather than total serum cortisol is that it eliminates the need to account for within-subject changes or between-subject differences in CBG.
The intervention had no statistically significant effect on sitting time or sit-to-stand transitions. Participation improved perceived wellness in the absence of behavior change.
Sedentary behavior is an independent and prominent risk factor for chronic disease. Occupational sitting is likely to be the largest determinant of overall daily sitting time. Gathering accurate data on sedentary behaviors is essential to determine prevalence and effectiveness of interventions to reduce sedentary time. The purpose of this research was to determine whether self-reported sedentary time assessed by the Paffenbarger Physical Activity Questionnaire (PPAQ) and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) was related to objectively assessed sedentary time by the activPAL3 activity monitor. In the spring of 2015, 44 women employed full-time at Slippery Rock University participated in this study. Participants were predominantly Caucasian (95%), middle-aged (48 ± 10 years), and had an average BMI of 30.5 ± 8.2. A positive, weak correlation was found in sedentary time between the PPAQ (14.65 ± 2.77 h) and the activPAL3 (17.71 ± 1.46 h) over a 24 hour day (r = 0.253; p = 0.098; n = 44). Thirty-nine of the 44 participants significantly underestimated their sedentary time as compared to the activPAL3 (3.06 ± 2.76 h; p = 0.001). A positive, weak correlation was also found in sedentary time between the OSPAQ (5.96 ± 1.11 h) and the activPAL3 (5.69 ± 1.06 h) during the 8.5 hour work day (r = 0.100; p = 0.518; n = 44). Future studies examining sedentary behaviors should use caution when only considering the use of subjective recall surveys. This is especially true when self-reported behaviors are used to inform health promotion programs and create universal recommendations aimed to reduce sedentary time.
Skinfold assessment is valid and economical; however, it has a steep learning curve, and many programs only include one exposure to the technique. Increasing the number of exposures to skinfold assessment within an undergraduate curriculum would likely increase skill proficiency. The present study combined observational and Think Aloud methodologies to quantify procedural and cognitive characteristics of skinfold assessment. It was hypothesized that 1) increased curricular exposure to skinfold assessment would improve proficiency and 2) the combination of an observational and Think Aloud analysis would provide quantifiable areas of emphasis for instructing skinfold assessment. Seventy-five undergraduates with varied curricular exposure performed a seven-site skinfold assessment on a test subject while expressing their thoughts aloud. A trained practitioner recorded procedural observations, with transcripts generated from audio recordings to capture cognitive information. Skinfold measurements were compared with a criterion value, and bias scores were generated. Participants whose total bias fell within ±3.5% of the criterion value were proficient, with the remainder nonproficient. An independent-samples t-test was used to compare procedural and cognitive observations across experience and proficiency groups. Additional curricular exposure improved performance of skinfold assessment in areas such as the measurement of specific sites (e.g., chest, abdomen, and thigh) and procedural (e.g., landmark identification) and cognitive skills (e.g., complete site explanation). Furthermore, the Think Aloud method is a valuable tool for determining curricular strengths and weaknesses with skinfold assessment and as a pedagogical tool for individual instruction and feedback in the classroom.
Purpose The purposes of this investigation were to (1) identify the domains of health-related quality of life most impacted in people with RRMS, (2) compare the health-related QOL in people with RRMS to general population norms, and (3) to describe subgroups within the RRMS population that have similar health and wellness needs. Methods This was a cross-sectional QOL investigation of adults with RRMS. The SF-36v2 survey and demographic information were collected electronically via Qualtrics. Participants (n = 120) were recruited through social media and the National Multiple Sclerosis Society of the United States. One-sample Z-tests were completed for all subscales, and component mean scores to determine if a difference between the sample and population norms existed. Results All values of z were statistically significant, p < .01, for all subscale and composite scores. Social function, physical function, and the mental health component scores had the lowest subscale means. A first stage depression screen revealed that 49% of the surveyed population were at risk for depression, compared to 18% in the general population. Further dividing the sample into years since MS diagnosis, the recently diagnosed group had 61% at risk for depression. Conclusions Challenges related to the mental health of individuals with RRMS are influencing overall health-related QOL. Early on in the disease course (0–3 years), mental health affected QOL more than physical health. More attention must be given to the nonphysical domains of health to advance the QOL for people with RRMS.
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