Adding D+E to usual care for overweight and obese knee OA patients is cost-effective and should be implemented in clinical practice. This article is protected by copyright. All rights reserved.
BackgroundWe designed and implemented the Brigham and Women’s Wellness Initiative (B-Well), a single-arm study to examine the feasibility of a workplace program that used individual and team-based financial incentives to increase physical activity among sedentary hospital employees.MethodsWe enrolled sedentary, non-clinician employees of a tertiary medical center who self-reported low physical activity. Eligible participants formed or joined teams of three members and wore Fitbit Flex activity monitors for two pre-intervention weeks followed by 24 weeks during which they could earn monetary rewards. Participants were rewarded for increasing their moderate-to-vigorous physical activity (MVPA) by 10% from the previous week or for meeting the Centers for Disease Control and Prevention (CDC) physical activity guidelines (150 min of MVPA per week). Our primary outcome was the proportion of participants meeting weekly MVPA goals and CDC physical activity guidelines. Secondary outcomes included Fitbit-wear adherence and factors associated with meeting CDC guidelines more consistently.ResultsB-Well included 292 hospital employees. Participants had a mean age of 38 years (SD 11), 83% were female, 38% were obese, and 62% were non-Hispanic White. Sixty-three percent of participants wore the Fitbit ≥4 days per week for ≥20 weeks. Two-thirds were satisfied with the B-Well program, with 79% indicating that they would participate again. Eighty-six percent met either their personal weekly goal or CDC physical activity guidelines for at least 6 out of 24 weeks, and 52% met their goals or CDC physical activity guidelines for at least 12 weeks. African Americans, non-obese subjects, and those with lower impulsivity scores reached CDC guidelines more consistently.ConclusionsOur data suggest that a financial incentives-based workplace wellness program can increase MVPA among sedentary employees. These results should be reproduced in a randomized controlled trial.Trial registrationClinicaltrials.gov, NCT02850094. Registered July 27, 2016 [retrospectively registered].
Bamberger's studies of visual descriptions of rhythmic patterns led to a distinction between two kinds of rhythmic understanding: metric and figural (Bamberger, 1982). Metric understanding describes events in terms of a measured underlying beat, while figural understanding describes events in terms of the events surrounding them. The present study asked whether the ability to produce accurate figural representations is related to the level of metric understanding. Forty-nine children (6-12 years old), and forty-eight adults (17-45 years old), served as subjects. Twenty-four of the adults, but none of the children, were musically trained. Each listener completed four tasks: (1) drawing, (2) clap-back, (3) join-in, and (4) an intelligence test. For the first three tasks, eighteen rhythm sequences were designed so that metric and figural representations did not coincide. The drawing task required listeners to represent each sequence with symbols of their choice, so that someone else could reproduce the sequence from their description. For the clap-back task, listeners were asked to clap back the sequence. For the join-in task, listeners were asked to clap along with what they perceived to be the underlying beat of the sequence. For both children and adults correlations between accuracy on drawing and performance tests were significant for the figural drawers but not for the metric drawers. Accuracy of figural drawing is related, for both children and adults, to the ability to respond to the metric aspects of rhythm. Figural descriptions and metric actions may be complementary aspects of rhythmic understanding.
In knee OA patients with no comorbidities, generic celecoxib is not cost-effective at its current price.
Twenty melodic tone sequences varying in harmonic structure were first presented once each to listeners selected from three different levels of previous musical training. Listeners rated each sequence on a 6-point scale of "pleasingness". Next, 5 sequences from the original set of 20 were each repeated 10 times in a row and rated after each repetition. The 5 sequences were assigned to listeners so that across listeners the 20 original sequences were equally represented. Finally, all 20 sequences were again each presented once for rating. At all levels of musical training, listeners showed a monotonic relationship between "pleasingness" and level of harmonic structure, with highest ratings of "pleasingness" associated with the highest level of structure. During repeated exposures, judged "pleasingness" increased at all levels of harmonic structure except the highest level, where a decrease of "pleasingness" with exposure was obtained. The effects of repetition did not, however, extend to the final ratings of the original set of 20 sequences. The data are discussed with reference to the optimal- complexity model of aesthetic judgement; specific attention is directed toward the cognitive processes determining sequence complexity.
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