ASU Scholarship Showcase

Background: Success in asthma management hinges on patients’ competency to detect and respond to ever-changing symptom severity. Thus, it is crucial to have reliable, simple, and sustainable methods of symptom monitoring that can be readily incorporated into daily life. Although visual analogue scale (VAS) has been considered as a simple symptom assessment method, its utility as a daily symptom monitoring tool in adolescents is unknown. This study was to determine the concurrent validity of VAS in capturing diurnal changes in symptoms and to examine the relationships between VAS and asthma control and pulmonary function.

Methods: Forty-two adolescents (12-17 years old) with asthma completed daily assessment of symptoms twice per day, morning and bedtime, for a week using VAS and 6-item symptom diary concurrently. Asthma control was measured at enrollment and 6 month later, and spirometry was conducted at enrollment. Pearson correlations, multilevel modeling and regression were conducted to assess the relationships between VAS and symptom diary, asthma control and FEV1.

Results: Morning and evening VAS was positively associated with symptom diary items of each corresponding time frame of the day (r = 0.41–0.58, p < 0.0001). Morning VAS was significantly predicted by morning diary data reflecting nocturnal wakening (β = 2.13, p = 0.033) and morning symptoms (β = 4.09, p = 0.002), accounting for 57% of the total variance of morning VAS. Similarly, changes in four evening diary items, particularly shortness of breath (β = 2.60, p = 0.028), significantly predicted changes in evening VAS, accounting for 55% of the total variance. Average VAS scores correlated with asthma control (r = 0.65, p < 0.001) and FEV1 (r = −0.38, p = 0.029), and were predictive of asthma control 6 months later (β = 0.085, p = 0.006).

Conclusions: VAS is a valid tool capturing diurnal changes in symptoms reflected in a multi-item symptom diary. Moreover, VAS is a valid measure predicting concurrent and future asthma control. The findings suggest VAS can be a simple alternative to daily dairies for daily symptom monitoring, which can provide invaluable information about current and future asthma control without substantially increasing self-monitoring burdens for adolescent patients.

Introduction: Individuals with osteoarthritis (OA) show increased morbidity and mortality. Telomere length, a measure of cellular aging, predicts increased morbidity and mortality. Telomeres shorten with persisting biological and psychosocial stress. Living with chronic OA pain is stressful. Previous research exploring telomere length in people with OA has produced inconsistent results. Considering pain severity may clarify the relationship between OA and telomeres.

Objectives: We hypothesized that individuals with high OA chronic pain severity would have shorter telomeres than those with no or low chronic pain severity.

Methods: One hundred thirty-six adults, ages 45 to 85 years old, with and without symptomatic knee OA were included in the analysis. Peripheral blood leukocyte telomere length was measured, and demographic, clinical, and functional data were collected. Participants were categorized into 5 pain severity groups based on an additive index of frequency, intensity, time or duration, and total number of pain sites (FITT). Covariates included age, sex, race or ethnicity, study site, and knee pain status.

Results: The no or low chronic pain severity group had significantly longer telomeres compared with the high pain severity group, P50.025. A significant chronic pain severity dose response emerged for telomere length, P50.034. The FITT chronic pain severity index was highly correlated with the clinical and functional OA pain measures. However, individual clinical and functional measures were not associated with telomere length.

Conclusion: Results demonstrate accelerated cellular aging with high knee OA chronic pain severity and provide evidence for the potential utility of the FITT chronic pain severity index in capturing the biological burden of chronic pain.

Abdominal obesity and insulin resistance (IR) place youth at higher risk for premature cardiovascular disease (CVD), but the underlying mechanisms are not clear. In adults, abdominal obesity and IR contribute to the oxidation of low-density lipoprotein (LDL). Whether similar mechanisms are operational in Latino adolescents is unknown. Therefore, we determined whether IR and abdominal adiposity are associated with higher oxLDL concentrations in Latino adolescents. Data from 123 Latino adolescents (16.3 ± 2.5 years; female = 74) were used for the present analysis. Participants were assessed for waist circumference, fasting serum oxLDL, and insulin sensitivity by the whole body insulin sensitivity index. In separate linear regression models adjusting for age and sex, both waist circumference and insulin sensitivity were significant predictors of oxLDL (β = 1.9; p = 0.002; R[superscript 2] = 0.13, β = −1.7; p = 0.006; R[superscript 2] = 0.11, respectively). When insulin sensitivity and waist circumference were included in the same model, both remained independent predictors of oxLDL (β = 1.7; p = 0.016 and, β = −1.5; p = 0.055, respectively; R[superscript 2] = 0.16). These results suggest that insulin resistance and abdominal adiposity are associated with higher levels of LDL oxidation which may be a mechanism contributing to increased CVD risk in Latino adolescents.

Background: The purpose of the study was to develop and test the initial psychometric properties of the ATTitudes and Avatars INstrument (ATTAIN). The integrated behavior model guided instrument development to measure the young adolescent boys’ attitudes, intentions and actions to change their bodies.

Methods: An adolescent health expert panel and young adolescent boys were recruited to test for content validity. Fifty-nine boys 11 to 14 years of age were recruited at a middle school in the USA during physical education class to conduct a pilot study to test for internal consistency and test-retest reliability.

Results: The ATTAIN was found to have high content validity, slightly below recommended levels for internal consistency, and varied test-retest reliability.

Conclusion: The long-term goal of the development and testing of the ATTAIN is to make it available to researchers and professionals to screen and focus on adolescents’ perceptions of their bodies and using those perceptions to attain and maintain healthy bodies. The results of this study suggest preliminarily a theoretically derived instrument with appropriate content for young adolescent boys and variable reliability. The attitudes, intentions, and actions survey items and avatars as measured by the ATTAIN, were meaningful to the boys. The ATTAIN has potential to be used as a screening instrument for young adolescents boys and understanding their attitudes toward their bodies; however, it will require continued development and testing to establish construct and discriminant validity.