The good life --assessing the relative importance of physical, psychological, and self-efficacy statuses on quality of well-being in osteoarthritis patients
The study examined the interrelationships between physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being in osteoarthritis patients. It found that exercise was directly related to physical functioning but not related to self-efficacy, psychological distress, or quality of well-being. Self-efficacy and psychological distress were significantly related to quality of well-being, suggesting that treatments focusing on these may be most effective for improving well-being in osteoarthritis patients.
Falls are the leading cause of fatal and nonfatal injuries in the older adult population. After a fall, many individuals become fearful that they will fall, and reduce their participation in activities. This reduction in activities, called constraints, cascades into poorer physical, emotional, and cognitive health. In this study, older adults participated in a Hatha yoga intervention led by a yoga therapist, which was designed to determine if this was feasible and acceptable in older adults, and to determine if yoga helped to reduce leisure constraints. Leisure constraints were reduced over the 12-week period, and more dramatically for individuals who had fallen in the past six-months, compared to those who had not fallen in the past six-months. The data reported here also support that the intervention was feasible and acceptable. Implications for future research and practice are included.
Cardiorespiratory Fitness, Health Outcomes, and Health Care Costs: The Case f...Matti Salakka 🐠
Physical inactivity is becoming a world-wide epidemic – and the consequences can be both costly and deadly. This was outlined by Dr. Jonathan Myers who, citing a range of studies and recent research results, was able to show hard-hitting data related to the correlation between fitness (or lack thereof) and poor health. Myers argues fitness may well be a better marker than traditional risk factors for CVD and all-cause mortality. Amongst the eye-opening findings presented to the audience was that, for the first time, global deaths-per-year due to physical inactivity are higher than for smoking.
Falls are the leading cause of fatal and nonfatal injuries in the older adult population. After a fall, many individuals become fearful that they will fall, and reduce their participation in activities. This reduction in activities, called constraints, cascades into poorer physical, emotional, and cognitive health. In this study, older adults participated in a Hatha yoga intervention led by a yoga therapist, which was designed to determine if this was feasible and acceptable in older adults, and to determine if yoga helped to reduce leisure constraints. Leisure constraints were reduced over the 12-week period, and more dramatically for individuals who had fallen in the past six-months, compared to those who had not fallen in the past six-months. The data reported here also support that the intervention was feasible and acceptable. Implications for future research and practice are included.
Cardiorespiratory Fitness, Health Outcomes, and Health Care Costs: The Case f...Matti Salakka 🐠
Physical inactivity is becoming a world-wide epidemic – and the consequences can be both costly and deadly. This was outlined by Dr. Jonathan Myers who, citing a range of studies and recent research results, was able to show hard-hitting data related to the correlation between fitness (or lack thereof) and poor health. Myers argues fitness may well be a better marker than traditional risk factors for CVD and all-cause mortality. Amongst the eye-opening findings presented to the audience was that, for the first time, global deaths-per-year due to physical inactivity are higher than for smoking.
Strength training is not just for bodybuilding anymore. There is so much more to it than pure appearance aspect. Anyone who is serious about getting more life out of their years should seriously consider engaging in the safe strength training routine.
Most strength training methods, as practiced in the 'box gyms', are not very safe, are time consuming and not necessarily health improving. This presentation talks about a 30,000 foot view of some of the key quality of life, health, fitness and appearance benefits safe strength training has to offer. In addition, it highlights some key aspects of how it could be practiced safely and suitably.
Cognitive Behavior Therapy combined with Physical Exercise for Adults with Ch...BERNARD Paquito
Cognitive Behavior Therapy combined with Physical Exercise for Adults with Chronic Diseases Systematic Review and Meta-Analysis
OPEN ACCESS https://archipel.uqam.ca/10922/1/Bernard%202018%20CBTEx.pdf
Hospital Acquired Deconditioning in Older AdultsChris Hattersley
Evidence based information on hospital acquired deconditioning in older adults, links to any studies referenced are included in the notes section of the presentation slides.
Strength training is not just for bodybuilding anymore. There is so much more to it than pure appearance aspect. Anyone who is serious about getting more life out of their years should seriously consider engaging in the safe strength training routine.
Most strength training methods, as practiced in the 'box gyms', are not very safe, are time consuming and not necessarily health improving. This presentation talks about a 30,000 foot view of some of the key quality of life, health, fitness and appearance benefits safe strength training has to offer. In addition, it highlights some key aspects of how it could be practiced safely and suitably.
Cognitive Behavior Therapy combined with Physical Exercise for Adults with Ch...BERNARD Paquito
Cognitive Behavior Therapy combined with Physical Exercise for Adults with Chronic Diseases Systematic Review and Meta-Analysis
OPEN ACCESS https://archipel.uqam.ca/10922/1/Bernard%202018%20CBTEx.pdf
Hospital Acquired Deconditioning in Older AdultsChris Hattersley
Evidence based information on hospital acquired deconditioning in older adults, links to any studies referenced are included in the notes section of the presentation slides.
Metro Atlanta Real Estate Market Trends For January 2014Arthur Prescott
View a slide show of the latest Metro Atlanta Real Estate Market Trends For January 2014. Presented by Arthur Prescott of Berkshire Hathaway HomeServices Georgia Properties.
Similar to The good life --assessing the relative importance of physical, psychological, and self-efficacy statuses on quality of well-being in osteoarthritis patients
Running head: PHYSICAL ACTIVITY AND SELF-EFFICACY 1
PHYSICAL ACTIVITY AND SELF-EFFICACY 2
The Relationship between Physical Activity and Self-Efficacy in Schools
Abstract
Few studies have examined the relationship between physical activities and health outcomes among adolescents. The majority of the adult population knows much about health-risk behaviours of adolescents, and knows less about their health-promoting behaviours. The purpose of the study was to determine the relationship between physical activity levels and self-efficacy among adolescents.
Introduction
According to Start Active, regular physical activity associates with benefits for physical and mental health (as cited in Roberts et al, 2015). Studies have indicated that health life traits and styles have an impact on lifelong health and life quality. Childhood poor diet and physical inactivity have been risk factors for a multitude of chronic health condition in adulthood (Matthews et al, 2015). According to the Centers for Disease Control and Prevention for children, only 42% of children and 8% of adolescents achieve current recommended physical activity.
Most students studying in Hoca Ahment Yesevi University were hound to have health issues emanating from lack of physical exercise and personal fitness programs (Ozkan, 2015). Up to 70 per cent of university students are reported as not participating in regular free-time physical activity or exercise (Haase et al, 2004, as cited in Roberts et al, 2014). Simon et al (2015) mentioned that majority of the adult population fails to achieve recommended daily exercise, 30-minutes moderate intensity exercise. When physical activity is conducted regularly as the researchers found out, it is likely to improve the physical fitness of the students and generally of people and therefore contributing heavily to better healthy life styles. Achieving daily exercise was shown to promote better sleep quality and higher psychological functioning in adolescents (Kalak et al, 2012, as cited in Rew et al, 2015).
Styles and activities that promote the health of humans increase their chances of wellbeing and therefore promote healthy living. In achieving well-being in health, there must be a mentioned engagement in activities which are likely to enhance the same such as proper exercises and fitness methods. Health promotion takes quite a multidimensional structure, that is, intellectual, mental, physical and social and therefore a number of behaviours which are meant at promoting behaviours are identified by health professionals and other researchers. These behaviours include life appreciation, stress management, health responsibility, social support, exercise and better nutrition. Therefore a general conclusion is arrived at that physical activity and exercise have an impact on the quality of human life and can actually aid its improveme.
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RESEARCH ARTICLE
Association between Physical Fitness and
Successful Aging in Taiwanese Older Adults
Pay-Shin Lin1,2☯‡*, Chih-Chin Hsieh1☯‡, Huey-Shinn Cheng3, Tsai-Jou Tseng1, Shin-
Chang Su1
1 Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine,
Chang Gung University, Taoyuan, Taiwan, 2 Health Aging Research Center, Chang Gung University &
Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3 Internal & Geriatric Medicine, Chang Gung Memorial
Hospital, LinKou Branch, Taoyuan, Taiwan
☯ These authors contributed equally to this work.
‡ PSL and CCH are co-first authors on this work.
* [email protected]
Abstract
Population aging is escalating in numerous countries worldwide; among them is Taiwan,
which will soon become an aged society. Thus, aging successfully is an increasing concern.
One of the factors for achieving successful aging (SA) is maintaining high physical function.
The purpose of this study was to determine the physical fitness factors associated with SA
in Taiwanese older adults (OAs), because these factors are intervenable. Community-
dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in
this study. They received a comprehensive geriatric assessment, which includes sociode-
mographic data, health conditions and behaviors, activities of daily living (ADL) and instru-
mental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical
fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-
and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction
time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as
follows: complete independence in performing ADL and IADL, satisfactory cognitive status
(Mini-Mental State Examination� 24), no depression (Geriatric Depression Scale < 5), and
favorable social function (SF subscale� 80 in SF-36). Adjusted multiple logistic regression
analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the
aforementioned SA criteria. After adjustment for sociodemographic characteristics and
health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT,
TUG, and FR tests, were significantly associated with SA individually, but not in the multi-
variate model. Among the physical fitness variables tested, cardiopulmonary endurance,
mobility, muscle strength, and balance were significantly associated with SA in Taiwanese
OAs. Early detection of deterioration in the identified functions and corresponding interven-
tion is essential to ensuring SA.
PLOS ONE | DOI:10.1371/journal.pone.0150389 March 10, 2016 1 / 12
OPEN ACCESS
Citation: Lin P-S, Hsieh C-C, Cheng H-S, Tseng T-J,
Su S-C (2016) Association between Physical Fitness
and Successful Aging in Taiwanese Older Adults.
PLoS ONE 11(3): e0150389. .
AbstractThis informative report focuses on filling information.docxbartholomeocoombs
Abstract
This informative report focuses on filling information gaps regarding adherence to physical activity and exercise in the health care spectrum of older adults and an overview of the benefits of physical activity for OAs. Healthy People 2000, 2010, and 2020 are public health programs from the US Department of Health and Human Services that set national goals and objectives for promoting health and preventing disease. The programs include ten leading health indicators that reflect major health problems, which concern OAs. Exercise and physical activity are among the most important factors affecting health and longevity, but exercise adherence is a significant hindrance in achieving health goals in the elderly. Exercise adherence in OAs is a multifactorial problem encompassing many bio-psychosocial factors. Factors affecting adherence in the elderly include socioeconomic status, education level, living arrangements, health status, pacemakers, physical fitness, and depression. Improving adherence could have a significant impact on longevity, quality of life, and health care costs.
Keywords: Geriatric Medicine, Health Care, Health Professionals, Exercise Adherence
Introduction
Geriatric health care delivery is a major public health issue. Geriatrics refers to diagnosing and treating older adults (OA) with complex medical conditions and social problems. A recent report from the World Health Organization (WHO) stated, “OA are generally defined according to a range of characteristics including chronological age, change in social role and changes in functional capabilities. In high-resourced countries older age is generally defined in relation to retirement from paid employment and receipt of a pension, at 60 or 65 years. With increasing longevity some countries define a separate group of oldest people, those over 85 years. In low-resourced countries with shorter life-spans, older people may be defined as those over 50 years” (World Health Organization, 2010a). OA are the largest and fastest growing segment of the population, which present significant challenges to the health care system. Understanding the factors contributing to the health practices of OA is important for professionals, paraprofessionals, and paid and unpaid caregivers who need basic and continuing geriatric education to improve care. Adherence to physical activity and exercise programs is a critical but poorly understood area for promoting health and longevity.
The terms physical activity and exercise are often used interchangeably, but they are different. Physical activity involves movement produced by skeletal muscles that require energy from metabolism. It is grouped as occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive. It promotes health, fitness, and skill and the results of the program can be measured with specific tests (Caspersen, Powell, & Christenson, 1985; F.
Barriers and facilitators for regular physical exercise among adult females n...Dr. Anees Alyafei
What stimulates and prevents females from regular physical exercise. Updated Comprehensive narrative review.
https://www.researchgate.net/publication/341220204_Citation_AlYafei_A_Albaker_W_2020_Barriers_and_Facilitators_for_Regular_Physical_Exercise_among_Adult_Females_Narrative_Review_2020
Crimson Publishers-Functionality and Attitudes in Relation to Aging of Elderl...CrimsonPublishersGGS
Functionality and Attitudes in Relation to Aging of Elderly Women Practicing Physical Exercises by Daniel Vicentini de Oliveira in Gerontology & Geriatrics studies
The objective was to verify the attitudes regarding old age and the functional capacity of elderly women practicing physical exercises. This is a cross-sectional study, realized with 200 women. The Functional Protocol of the Latin American Development Group for Maturity (GDLAM) and the Scale for Assessment of Attitudes in Relation to Old Age was used. There was a significant correlation only in the stand up from sitting position test, with the domains of expectations regarding activity (r=-0.31), satisfaction with life (r=0.38) and death anxiety (r=-0.27). It can be concluded that there is correlation between some domains of the functional capacity test and the attitudes towards old age.
Movement and Healing: Learn and Experience the Benefits of Movement During GY...bkling
Studies have shown that exercise may help reduce the risk of recurrence in cancer patients. It can also help improve mood and sleep, reduce anxiety, boost energy, and so much more. Join Dr. Shannon Armbruster, gynecologic oncologist at Virginia Tech’s Carilion Clinic, as she talks about these benefits, exercise guidelines for cancer survivors, her research, and more. One form of exercise that has mind-body benefits for cancer survivors is yoga. Dr. Samantha Harden, an associate professor of Human Nutrition, Foods, and Exercise and 500 hour registered yoga teacher, will share some of the research findings related to yoga for cancer survivors and include a brief, accessible demonstration of the yoga kernels for public health (breathing, movement, moment-to-moment awareness). Learn about and reap the benefits of movement with us during this Gynecologic Cancer Awareness Month!
“Pathological Motivations for Exercise and Eating Disorder Specific Health-Re...pmilano
Exercise, as we all know, can improve your health, but if you have an eating disorder and also exercise compulsively to help manage your weight, you may find your overall quality of life going down even further.
Those are some of the findings of research by JU Professor of Kinesiology Heather Hausenblas and colleagues in a study titled “Pathological Motivations for Exercise and Eating Disorder Specific Health-Related Quality of Life” published in the April 2014 issue of the International Journal of Eating Disorders.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health...youth_nex
The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health-Related Quality of Life"
Valovich McLeod is the John P. Wood, D.O., Endowed Chair for Sports Medicine and a Professor in the Athletic Training Program at A.T. Still University.
Panel 5 -- Injury Prevention and Treatment. While being physically active is important for positive youth development, injuries can result. This panel will discuss ways to minimize injury, particularly concussions, while addressing the impact of sport-related injury on quality of life. The panel will also provide a blueprint for encouraging life-long physical activity.
Website: http://bit.ly/YNCONF13
Activity: Week 2 SWOT PowerPoint
Due Week 2 and worth 200 points
Dr. John Bradley is an Emergency Room physician. He worked a 24-hour shift due to a staff shortage. As a result, he had a patient that died because he failed to provide a duty of care, he breached his duty, and caused an injury. A prima facie case of negligence was established when Dr. Bradley failed to provide appropriate medical care. Liability was also based on ‘res ipsa loguitor’ (the thing speaks for itself). The incident is considered a Sentinel Event and must be reported to The Joint Commission (a non-profit hospital regulatory agency).
After a trend analysis of several Sentinel Events, “We Care Hospital” fired the Health Care Administrator. As a result, you were hired as the new Health Care Administrator. You have reviewed the Sentinel Event with Dr. John Bradley and discovered several factors that showed the hospital was negligent. The three basic forms for negligence are malfeasance, misfeasance, and nonfeasance. Your first task is to rationalize your answers by using any applicable legal precedents.
Then, prepare a Microsoft PowerPoint 10-slide narrative using a SWOT Analysis. A SWOT Analysis identifies strengths, weaknesses, opportunities, and threats in a situation. Review the video: Strategic Planning and SWOT Analysis. To help you prepare the narrative PowerPoint using Microsoft 365 and older versions, review the video: Record a slide show with narration and slide timings.
Your 10-slide SWOT PowerPoint should follow this format:
1. Slide 1: Cover Page
a. Include the title of your presentation, the course number and course title, your name, your professor’s name, and the date.
2. Slide 2: Background / Executive Summary
a. Describe the details of the situation. Use bullets with short sentences. The title of this slide should be Executive Summary.
3. Slide 3: Thesis Statement
a. Identify the focus of your research. The title of this slide should be Thesis Statement.
4. Slides 4-9: Support
a. Support your thesis statement following the SESC formula: State, Explain, Support, and Conclude. (An overview of using Sublevel 1 and Sublevel 2 headings is provided in the following video: APA Style - Formatting the Title Page, Abstract, and Body).
b. You should include at least three court cases and related peer-reviewed articles from within the past five years. In-text citations should be in the American Psychological Association (APA) format.
5. Slides 10: References
a. Use APA format for your Reference slide. (To help you with APA in-text citations and your Reference list, some students use Citation Machine.
Note: Writing Resources are available from Strayer University’s Writing Center, Tutor.com, and Grammarly.com.
The specific course learning outcomes associated with this assignment are:
· Examine the various applications of the law within the health care system.
· Analyze how such various applications of the law affect decisions in the development and operation of a heal ...
Perceived barriers to exercise in people with spinal cord injury igbenito777
Perceived barriers to exercise in people with spinal cord injury
Similar to The good life --assessing the relative importance of physical, psychological, and self-efficacy statuses on quality of well-being in osteoarthritis patients (20)
Every Civilization having its own culture of treating diseases
260 AD around establishment of Jund-i-Shapur
Initially Prisoners from Roman Empire
After Roman Empire cracked down on Scientific Centers and Intellectuals
The AYUSH system of medicine mostly relies on
prevention of disease. The Unani System of Medicine has much more to
offer for prevention of the disease.
Six essentials of life which form the basics of the Unani
Preventive measures are:
•Air-----Quality of air
•Food and Drinks (Ma’akool wa Mashroob)---Dietary habits,
balanced diet etc
•Physical Rest and Movement (Harkat wa Sakoon Badni)….Exercise
etc
•Mental Rest and Movement (Harkat wa Sakoon Nafsani) ….
Thinking, stress etc
•Sleep and awakeness (Naum wa Yagza)----Sleep time, good sleep
•Retention and Evacuation (Ehtibas and Estefaragh)….What is to be
retained and evacuated from the body.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Home assignment II on Spectroscopy 2024 Answers.pdf
The good life --assessing the relative importance of physical, psychological, and self-efficacy statuses on quality of well-being in osteoarthritis patients
2. 2
this, close to 44% of adults with arthritis report not engaging
in exercise [6].
When mobility and physical functioning are impaired,
individuals are less likely to engage daily activity. People diagnosed with arthritis report less daily physical activity than
those without arthritis [6]. The Center for Disease Control
(CDC) reported that approximately 80% of adults with OA
have some movement limitations that affect daily activities
[1]. Physical dysfunction is related to reduced quality of life
and lower self-efficacy [14–17], which is defined as a person’s
belief in his/her ability to influence events that affect his/her
life [18, 19]. Increased self-efficacy for physical activity is associated with increased participation in exercise for people with
arthritis [20, 21]. Having high levels of self-efficacy is associated with higher quality of life, decreased pain, and increased
activity among people including those with OA [22–24].
Psychological distress is another factor that is associated
with exercise and quality of life among people with OA
[25, 26]. Evidence suggests that anxiety and depression are
related to reduced functioning and to lower levels of physical activity among the OA populations [26, 27]. Although
depression may pose barriers to activity engagement, physical
activity has been shown to improve its symptoms [27] and
is a common focus of behavioral therapies (e.g., behavioral
activation). Alternatively, improvements in depression are
also likely to lead to increases in activity levels and quality
of life [28].
The purpose of the present study was to examine the
interrelationships among physical dysfunction, self-efficacy,
psychological distress, exercise, and quality of life among
people with older adults with OA using structural equation
modeling. These variables have not been assessed concurrently in an older OA population. It was hypothesized that
physical dysfunction, psychological distress, and self-efficacy
all would predict probability of participating in exercise
uniquely and that participation in exercise would mediate the
effect of each of these on quality of well-being.
2. Method
2.1. Participants. Participants were 363 members (𝑁 = 233
women, 𝑁 = 130 men) of a large health maintenance
organization (HMO) in Southern California who were 60
years of age or older (𝑀age = 69, SD = 5.6) and
had a physician’s diagnosis of osteoarthritis (OA) that was
confirmed with radiographic evidence within the individual’s medical file. The participants were primarily Caucasian
(92.3%), married (72.7%), and retired (75%). Nearly 29%
of participants reported having completed a high school
education or equivalent, 40.2% reported several years of
college education, and 25.4% had obtained higher degrees
or other professional certificates. Participants’ median annual
income ranged from $20,000 to $30,000. See Table 1 for
additional demographic information.
2.2. Measures
2.2.1. Demographic Variables. Participants were asked to
provide a brief demographic history, which included their
Arthritis
Table 1: Participant demographic and clinical characteristics.
Item
Gender
Male
Female
Ethnicity
White
Hispanic
Black
Other
Decline to state
Age
59 to 69 years
70 to 79 years
>79 years
Relational status
Single
Married
Widowed
Divorced
Education
High school graduate or less
Some college/trade school
Bachelor’s degree
Graduate level degree
Decline to state
Family income
$19,999 or less
$20,000–$39,999
$40,000–$59,999
$60,000 or more
Decline to state
Employment status
Part-time
Full-time
Retired/unemployed
Length of diagnosis
Less than 5 years
5–10 years
10–15 years
15–20 years
More than 20 years
Not reported
Valid %
𝑁
35.81
64.19
130
233
92.29
2.75
1.65
1.65
1.10
335
10
6
6
4
56.47
40.77
2.75
205
148
10
4.96
72.73
14.33
7.99
18
264
52
29
31.13
22.31
19.28
23.97
3.31
113
81
70
87
12
24.24
38.29
17.36
8.82
11.29
88
139
63
32
41
17.08
75.21
7.72
62
273
28
30.85
27.82
19.56
6.89
2.20
12.67
112
101
71
25
8
46
age, gender, education level, employment, income, marital
status, and date of diagnosis.
2.2.2. Arthritis Impact Measurement Scale (AIMS). The AIMS
is a disease-specific measure of health status for people with
arthritis. The scale is self-administered and consists of 57
questions categorized into nine subscales: mobility, physical
activity, dexterity, social role, social activity, activities of daily
3. Arthritis
living, pain, depression, and anxiety. Internal reliability for
each of the subscales ranges from 𝛼 = .63 to .88 [29].
2.2.3. Quality of Well-Being (QWB) Scale. The QWB scale
was used to assess global quality of well-being. The QWB
scale evaluates the participant’s functioning and symptoms
for the 6 days prior to the assessment [30]. Its three subscales
are mobility, physical activity, and social activity. The QWB
scale has been shown to be a valid and reliable instrument for
assessing health outcomes in a general elderly population and
in a population with specific chronic or disabling conditions
[30].
2.2.4. Center for Epidemiologic Studies Depression Scale (CESD). The CES-D was designed to measure current levels of
depressive symptoms, with an emphasis on depressed mood
[31]. The CES-D is a 20-item self-report measure designed
to assess depression in nonpsychiatric populations. Studies
indicate that the scale is internally consistent, has moderate
test-retest reliability, and has high concurrent and construct
validity (e.g., 30).
2.2.5. The Arthritis Self-Efficacy Scale (ASES). The ASES
consists of 20 items that require respondents to indicate
how certain they are that they can perform various tasks
on a scale from 10 (very uncertain) to 100 (very certain),
with higher scores indicating higher self-efficacy [16]. Sample
items include “how certain are you that you can manage
arthritis pain during your daily activities?” and “how certain
are you that you can turn an outdoor faucet all the way on
and all the way off?” The questionnaire consisted of three
subscales: pain, function, and other symptoms. Lorig et al.
[16] found that subscale reliability was .87 for pain, .85 for
function, and .90 for other symptoms.
2.2.6. Arthritis Helplessness Index (AHI). The AHI was developed by Stein et al. [32]. The questionnaire consists of
15 items, scaled in a 6-point Likert format from strongly
disagree (1) to strongly agree (6). Participants were asked
whether they agreed or disagreed with statements like, “I
have considerable ability to control my pain” and “it seems as
though other factors beyond my control affect my arthritis.”
Cronbach’s alpha indicated overall internal reliability of .69
and test-retest reliability of .52 over a 1-year period. Internal
consistencies for the two subscales, as assessed by Cronbach’s
alpha, were .75 for the internality factor and .63 for the
helplessness factor [32].
2.2.7. Exercise. Participants were asked to indicate whether or
not they participated in exercise.
2.3. Procedure. The data for this study were collected during
the baseline assessment period prior to participants engaging
in a social support and education intervention. To be eligible
to participate in the present study, participants had to be 60
years of age or older, have a diagnosis of OA, and be willing
and able to attend 10 weekly and 10 monthly meetings over a
course of 1 year. Three thousand potential participants were
3
randomly selected from the total population of 50,450 HMO
members in San Diego County. Because the prevalence of
OA in this population is approximately 50% of those over the
age of 60, we expected 1,500 of those contacted to be eligible
to participate. Three hundred and sixty-three of the 3,000
HMA members that were contacted by mail volunteered to
participate in a larger study and completed the battery of
questionnaires.
2.4. Analytic Procedure. Statistical analyses were performed
using Stata 12.1. A series of structural equation models (SEMs)
using full information maximum likelihood (FIML) was used
to test the relationships among self-efficacy, psychological
distress, physical dysfunction, exercise, and quality of wellbeing. The primary observed response variable was quality
of well-being (QWB). The latent explanatory variables were
(1) self-efficacy (SE), (2) psychological distress (PSYCH), and
(3) physical dysfunction (PHYS). The binary mediator was
self-reported exercise (EX). No changes were made to the
measurement factor loading or structural pathways within
models; however, as determined by modification indices
and conceptual reasoning, error covariances were added
to improve model fit. This strategy was decided a priori
based upon the likely high interrelatedness of many of these
constructs and their components.
In order to examine the effects of the explanatory
variables on QWB in this sample of individuals with OA,
the model fit (using descriptive indices of model fit (e.g.,
Comparative Fit Index and root mean squared error of
approximation)), the standardized factor loadings, and the
specific tests for the factor loadings were assessed. Overall
model fit was determined using the recommendations of
Bentler [33]. Although the likelihood ratio 𝜒2 is reported,
this inferential test performs poorly as a sole determinant of
model fit [33]. Therefore, in the current study, the Comparative Fit Index (CFI; 33) and the root mean square error of
approximation (RMSEA; 34) were interpreted as measures of
descriptive fit. Both the CFI and RMSEA are standardized
measures of descriptive model fit that range in value from 0
to 1. For the CFI, values greater than .95 indicate a reasonable
model, and values greater than .90 indicate a plausible model.
For the RMSEA, values less than .08 indicate acceptable
model fit, and values less than .05 indicate good model fit.
3. Results
3.1. Measurement Models for Latent Variables. The measurement models for PHYS, PSYCH, and SE fit well statistically,
𝜒2 (55, 𝑁 = 363) = 51.12, 𝑃 = .6237; 𝜒2 (2, 𝑁 = 363) = .74,
𝑃 = .6896; 𝜒2 (2, 𝑁 = 363) = 2.87, 𝑃 = .2377, and descriptively, CFI = 1.00, RMSEA < .0001; CFI = 1.00, RMSEA <
.0001; CFI = .998, RMSEA = .035, respectively. See Tables
2 and 3 for loadings and covariances, respectively, for the
measurement models. The vast majority of the error covariances were subsumed in the PHYS measurement model,
because individual items (not scales or subscales) were used
to construct this latent variable.
5. Arthritis
5
Table 4: Modification-indicated covariance additions.
First
PHYS
SE
QWB
QWB
PSY
Second
SE
EFFACT
PHYS
SE
SE
MI
81.251
58.382
79.748
65.284
33.791
𝑃
<.001
<.001
<.001
<.001
<.001
Std. EPC
−.6239
−.7277
−.4369
.3696
−.2146
Δ𝜒2
−123.05
−63.04
−120.41
−72.18
−49.54
ΔCFI
.040
.020
.040
.023
.016
ΔRMSEA
−.008
−.003
−.011
−.007
−.005
Note: MI: modification index; Std. EPC: standardized expected parameter change; CFI: comparative fit index; RMSEA: root mean squared error of
approximation.
Table 5: Measurement models within full, mediated structural model.
Latent
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PSY
PSY
PSY
PSY
SE
SE
SE
SE
SE
Observed
WEIGHT
TROUBE
ASSWA
TROUWO
JOINTP
AMOVE
TROUWM
LIMITA
SEREP
PAIN
STIFF
ASSIST
STAYIN
INBED
CESD
AIMD
AIMA
AIMIS
EFFPAIN
EFFSYM
EFFACT
ARTHINT
ARTHHEL
𝐵
.1287
−.5735
−.2657
−.5273
−.4465
.1698
−.6227
−.5401
−.4538
−.4872
−.3233
−.3295
−.3486
−.3311
.8137
.9353
.8113
.3448
.3032
.8462
.8760
−.4574
−.6315
SE
.0557
.0411
.0523
.0429
.0465
.0544
.0394
.0427
.0460
.0443
.0507
.0502
.0497
.0503
.0215
.0154
.0217
.0488
.0577
.0373
.0668
.0458
.0410
|𝑧|
2.31
13.97
5.08
12.30
9.61
3.12
15.82
12.65
9.87
10.99
6.37
6.56
7.02
6.58
37.84
60.85
37.41
7.06
5.26
22.70
13.12
9.98
15.40
𝑃
.021
<.001
<.001
<.001
<.001
.002
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
95% CI LB
.0196
−.6540
−.3682
−.6114
−.5375
.0631
−.6999
−.6238
−.5439
−.5740
−.4228
−.4279
−.4459
−.4297
.7716
.9052
.7688
.2491
.1902
.7731
.7451
−.5473
−.7118
95% CI UB
.2378
−.4930
−.1632
−.4433
−.3554
.2765
−.5455
−.4565
−.3637
−.4003
−.2239
−.2311
−.2512
−.2326
.8559
.9654
.8538
.4405
.4163
.9193
1.0068
−.3675
−.5511
Note: OV: observed variable; SE: standard error; 95% CI LB: 95% confidence interval lower bound; 95% CI UB: 95% confidence interval upper bound.
3.2. Full, Mediated Model. The full model was constructed
to model the effects of PHYS, PSYCH, and SE on QWB
via the mediator, EX. The model did not fit statistically, 𝜒2
(248, 𝑁 = 363) = 888.04, 𝑃 < .0001, or descriptively,
CFI = .790, RMSEA = .084, AIC = 32109.794, and
BIC = 32507.023. In order to permit interpretation of
model coefficients, modification indices (MIs) were obtained
to improve model fit via alterations in error covariances.
Covariances with MIs of greatest value were added singularly,
provided that the covariances were conceptually tenable. For
the sequential list of added covariances, see Table 3. After five
covariances were added, the descriptive fit of the model was
adequate, CFI = .929, RMSEA = .050, AIC = 31691.573,
and BIC = 32108.274; although, the statistical fit was lacking
still, 𝜒2 (243, 𝑁 = 363) = 459.82, 𝑃 < .0001. Based
upon the adequate descriptive fit, interpretation of the model
coefficients followed.
The measurement models remained sound within the
structural model (see Table 4). The majority of covariances
remained statistically significant (see Table 5). Examining
the structural pathways, the relationship between EX and
QWB was not statistically significant, 𝐵 = .0718, 𝑃 =
.171. Neither were the relationships between PSY or SE
and EX, 𝐵 = −.0138, 𝑃 = .081; 𝐵 = .0653, 𝑃 =
.217, respectively. In fact, the bivariate correlation between
the observed variables, EX and QWB, was nonsignificant,
𝑟 = .0713, 𝑃 = .1756. The only significant structural
coefficient was the relationship between PHYS and EX, 𝐵 =
−.1748, 𝑃 = .005. Thus, as physical dysfunction scores
increased (demonstrating increased physical complications),
the probability of participating in exercise decreased. On the
whole, this model demonstrates that, in our sample of OA
participants, only physical dysfunction (and not self-efficacy
or psychological distress) was related to exercise, and exercise
was not related to quality of well-being.
3.3. Nonmediated Structural Model. Based on the previous
model, EX was eliminated from the model to determine
6. 6
Arthritis
Table 6: Standardized error covariances within full, mediated structural model.
Latent
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
SE
SE
SE
First
WEIGHT
WEIGHT
TROUBE
ASSWA
ASSWA
ASSWA
ASSWA
TROUWO
TROUWO
TROUWO
JOINTP
JOINTP
JOINTP
AMOVE
TROUWM
LIMITA
SEREP
SEREP
PAIN
ASSIST
ASSIST
STAYIN
EFFPAIN
EFFPAIN
EFFACT
PHYS
SE
QWB
QWB
PSY
Second
AMOVE
ASSIST
LIMITA
TROUWM
ASSIST
STAYIN
INBED
TROUWM
STAYIN
INBED
SEREP
PAIN
STIFF
ASSIST
INBED
STIFF
PAIN
STIFF
STIFF
STAYIN
INBED
INBED
EFFSYM
ARTHINT
EFFSYM
SE
EFFACT
PHYS
SE
SE
𝑟
−.1017
.1369
.2701
.0987
.4871
.3545
.3354
.4071
.1623
.1130
.3802
.4009
.1996
−.2219
.0797
.1054
.5829
.2885
.2926
.4167
.2750
.3118
.2621
−.2832
.3225
−.6868
−.4443
−.7920
.3476
−.3408
SE
.0522
.0430
.0530
.0416
.0388
.0455
.0455
.0468
.0422
.0497
.0465
.0458
.0512
.0417
.0507
.0481
.0358
.0488
.0489
.0420
.0472
.0475
.0714
.0486
.0662
.0486
.0604
.0361
.0462
.0524
|𝑧|
1.95
3.18
5.10
2.37
12.55
7.79
7.79
8.69
3.85
2.27
8.17
8.75
3.89
5.32
1.57
2.19
16.30
5.91
5.99
9.93
5.83
6.56
3.67
5.83
4.87
14.13
7.36
21.96
7.52
6.51
𝑃
.051
.001
<.001
.018
<.001
<.001
<.001
<.001
<.001
.023
<.001
<.001
<.001
<.001
.116
.028
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
95% CI LB
−.2040
.0525
.1663
.0172
.4111
.2653
.2438
.3154
.0796
.0156
.2890
.3112
.0991
−.3036
−.0196
.0111
.5128
.1929
.1968
.3345
.1826
.2187
.1221
−.3784
.1928
−.7820
−.5626
−.8627
.2570
−.4435
95% CI UB
.0005
.2212
.3739
.1801
.5632
.4437
.4270
.4989
.2449
.2103
.4713
.4907
.3000
−.1401
.1791
.1998
.6530
.3842
.3883
.4990
.3674
.4050
.4021
−.1880
.4523
−.5915
−.3260
−.7213
.4381
−.2381
Note: OV: observed variable; SE: standard error; 95% CI LB: 95% confidence interval lower bound; 95% CI UB: 95% confidence interval upper bound.
whether PHYS, PSY, and SE uniquely and significantly
contributed to QWB. In this model, the MI changes entered
into the previous model were maintained, with the exception
of the covariances that related to QWB, because QWB was
exogenous in the nonmediated model (see Table 8 for all
error covariances). This model did not fit statistically, 𝜒2
(222, 𝑁 = 363) = 406.34, 𝑃 < .0001, but it did fit well
descriptively, CFI = .939, RMSEA = .048, AIC = 31132.477,
BIC = 31521.918, and CD = .827. The measurement
models remained intact (see Table 6), and the covariances
remained consonant with previous models (see Table 7). The
structural model (QWB → SE, PHYS, PSYCH) demonstrated
that physical dysfunction, psychological distress, and selfefficacy were related largely and significantly to QWB, 𝐵 =
−.7910, 𝑃 < .0001; 𝐵 = −.2852, 𝑃 < .0001; 𝐵 = .4267, 𝑃 <
.0001, respectively. These relationships are in the expected
directions, with greater physical impairment relating to lower
QWB, greater psychological impairment relating to lower
QWB, and greater self-efficacy relating to higher QWB. Both
Akaike’s and the Bayesian Information Criteria support the
superiority of this model to the model that includes EX as a
mediator.
4. Discussion
In this study, structural equation modeling was used to determine whether exercise mediated the relationships among
self-efficacy, physical dysfunction, psychological distress, and
QWB and to examine the interrelationships among these
variables. The results indicated that self-efficacy and psychological distress did not relate to engagement in exercise; only
level of physical dysfunction was related to engagement in
exercise. In addition, exercise was not related to one’s QWB.
However, physical dysfunction, psychological distress, and
self-efficacy each were independently related to health status.
These findings are consistent with past research and illustrate
the importance of these factors in health status [16, 34].
Exercise was related to physical dysfunction, but because
of the study’s cross-sectional design, we do not know
7. Arthritis
7
Table 7: Measurement models within nonmediated structural model.
Latent
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PSY
PSY
PSY
PSY
SE
SE
SE
SE
SE
Observed
WEIGHT
TROUBE
ASSWA
TROUWO
JOINTP
AMOVE
TROUWM
LIMITA
SEREP
PAIN
STIFF
ASSIST
STAYIN
INBED
CESD
AIMD
AIMA
AIMIS
EFFPAIN
EFFSYM
EFFACT
ARTHINT
ARTHHEL
𝐵
.1265
−.5760
−.2623
−.5251
−.4501
.1724
−.6194
−.5392
−.4562
−.4883
−.3261
−.3280
−.3488
−.3277
.8165
.9312
.8134
.3454
.3117
.8502
.8805
−.4691
−.6449
SE
.0562
.0401
.0523
.0422
.0456
.0544
.0387
.0420
.0452
.0436
.0504
.0500
.0493
.0501
.0212
.0152
.0214
.0488
.0588
.0351
.0635
.0462
.0406
|𝑧|
2.25
14.36
5.02
12.43
9.87
3.17
16.01
12.83
10.09
11.21
6.48
6.56
7.07
6.54
38.43
61.31
37.94
7.08
5.30
24.20
13.87
10.15
15.87
𝑃
.024
<.001
<.001
<.001
<.001
.002
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
95% CI LB
.0164
−.6546
−.3647
−.6079
−.5395
.0658
−.6953
−.6215
−.5449
−.5737
−.4248
−.4259
−.4455
−.4260
.7748
.9014
.7714
.2500
.1965
.7814
.7560
−.5597
−.7246
95% CI UB
.2367
−.4974
−.1599
−.4423
.−3607
.2790
−.5436
−.4568
−.3676
−.4029
−.2274
−.2300
−.2522
−.2294
.8581
.9610
.8554
.4411
.4269
.9191
1.0049
−.3786
−.5652
Note: OV: observed variable; SE: standard error; 95% CI LB: 95% confidence interval lower bound; 95% CI UB: 95% confidence interval upper bound.
whether physical dysfunction impaired one’s ability to exercise, whether lack of exercise increased physical dysfunction,
or whether the relationship was bidirectional. Longitudinal
studies are needed to determine the direction of the relationships to better inform treatment efforts. Physical dysfunction
was related to self-efficacy over arthritis, which was also
related to psychological distress. That is, worse physical
dysfunction was related to lower self-efficacy, and heightened
psychological distress was also related to lower self-efficacy.
Thus, it appears that exercise is not as important a predictor
of quality of life among older people with OA as other factors.
One explanation for this finding is that older people with OA
may believe that their physical health is unchangeable or is
worsened by exercise. Another explanation may be that they
believe that their quality of life is only well managed by other
mechanisms, such as medication.
People who experience greater physical impairment
because of their chronic condition are less likely to engage
in activities that might improve their condition and more
likely to experience psychological distress [28]. The present
study suggests that we need to identify the pathways that
self-efficacy, psychological distress, and physical functioning
take to affect changes in QWB among older people with
OA. The results from this study indicate that the pathway
to affect QWB may not include exercise. Researchers may
be well advised to develop interventions directly focused
on improving self-efficacy and physical functioning and
decreasing psychological distress to improve QWB.
In the present study, exercise was not related to QWB.
The measure of QWB used in this study assessed mobility,
physical activity, and social activity. Because physical functioning was related to mobility and physical functioning, it is
not surprising that physical functioning was directly related
to QWB. However, the fact that exercise was not related to
the QWB calls into question the goals of treating OA. Is the
goal of treating OA to improve quality of life or to increase
longevity? If longevity is the goal, then treatment programs
should focus on increasing exercise. On the other hand, if
quality of well-being is the priority, then treatment might
be most effective when it is focused directly on affecting
self-efficacy, physical dysfunction, and psychological distress.
The participants in this study had a mean age of over 69. It
could be that increasing quality of life is more important for
older people with OA, or for others living with pain-related
conditions, than is increasing longevity. The model suggests
that QWB in older adults with OA is predicted by a person’s
physical functioning, psychological status, and self-efficacy,
but not their engagement in exercise.
The present study also showed that physical dysfunction
did not affect quality of life through exercise. Thus, the
challenge may be how does one increase mobility and
independence while decreasing pain and stiffness, if not
through exercise? Perhaps activities that are not classified
as “exercise” are part of the answer. It is possible that being
active and getting out, but not necessarily “exercising,” are
key to physical health as they relate to quality of life in this
population of older individuals with OA.
One limitation of this study is that “exercise” was assessed
by a single yes/no question that asked whether or not the
participant exercised. No definition of exercise was given
8. 8
Arthritis
Table 8: Standardized error covariances within nonmediated structural model.
Latent
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
PHYS
SE
SE
SE
First
WEIGHT
WEIGHT
TROUBE
ASSWA
ASSWA
ASSWA
ASSWA
TROUWO
TROUWO
TROUWO
JOINTP
JOINTP
JOINTP
AMOVE
TROUWM
LIMITA
SEREP
SEREP
PAIN
ASSIST
ASSIST
STAYIN
EFFPAIN
EFFPAIN
EFFACT
PHYS
SE
PSY
Second
AMOVE
ASSIST
LIMITA
TROUWM
ASSIST
STAYIN
INBED
TROUWM
STAYIN
INBED
SEREP
PAIN
STIFF
ASSIST
INBED
STIFF
PAIN
STIFF
STIFF
STAYIN
INBED
INBED
EFFSYM
ARTHINT
EFFSYM
SE
EFFACT
SE
𝑟
−.1017
.1363
.2700
.0998
.4880
.3551
.3365
.4096
.1617
.1148
.3781
.3991
.1974
−.2214
.0826
.1048
.5819
.2868
.2909
.4172
.2762
.3126
.2607
−.2828
.3253
−.7172
−.4759
−.3549
SE
.0522
.0430
.0531
.0415
.0388
.0455
.0467
.0467
.0421
.0497
.0467
.0459
.0513
.0417
.0507
.0482
.0359
.0489
.0490
.0420
.0471
.0475
.0705
.0486
.0649
.0703
.0625
.0537
|𝑧|
1.95
3.17
5.07
2.40
12.58
7.80
7.21
8.76
3.84
2.31
8.10
8.69
3.85
5.31
1.63
2.17
16.22
5.86
5.94
9.94
5.86
6.58
3.70
5.82
5.01
10.21
7.61
6.61
𝑃
.051
.002
<.001
.016
<.001
<.001
<.001
<.001
<.001
.021
<.001
<.001
<.001
<.001
.103
.030
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
<.001
95% CI LB
−.2040
.0520
.1654
.0184
.4119
.2659
.2450
.3180
.0791
.0174
.2866
.3091
.0968
−.3032
−.0167
.0103
.5116
.1909
.1949
.3349
.1838
.2195
.1225
−.3780
.1981
−.8550
−.5985
−.4601
95% CI UB
.0006
.2206
.3737
.1812
.5640
.4443
.4280
.5012
.2442
.2122
.4695
.4892
.2981
−.1397
.1820
.1992
.6523
.3827
.3869
.4995
.3685
.4057
.3989
−.1876
.4526
−.5795
−.3534
−.2497
Note: OV: observed variable; SE: standard error; 95% CI LB: 95% confidence interval lower bound; 95% CI UB: 95% confidence interval upper bound.
to the participant; therefore, participants may have defined
“exercise” in various ways, which may partially account for
the findings. It should be noted that the exercise variable was
significantly correlated with participants’ metabolic equivalent of task (MET) expenditure at later time points within the
intervention. However, future studies should include a more
comprehensive evaluation of exercise and seek to determine
whether this type of model is invariant across various OA
patient subgroups.
In summary, the relationships among self-efficacy, psychological distress, physical dysfunction, exercise, and quality
of well-being are important factors to consider in treating
people with OA. As the mean age of our population increases
and OA becomes more prevalent in the population, more
research is needed to determine how to effectively design
interventions/treatments to improve life for those with OA.
Conflict of Interests
The authors declare that they have no conflict of interests
regarding this paper.
Acknowledgment
The research was supported by NIH Grant AR-40423.
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