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Background The COVID-19 pandemic has resulted in unprecedented disruptions, restrictions, and concerns about physical and mental health. Emerging adulthood, including the first year of college, is associated with declines in healthy eating and physical activity, as well as possible heightened distress. The impact of COVID-19 may exacerbate these concerns. Purpose The purpose of this study was to examine changes in health behaviors and perceived stress in emerging adults over the first year of college and to determine whether prepandemic health behaviors were protective for mental health and stress during the initial changes after the COVID-19 pandemic. Methods First-year college students (N = 234, 58.6% female) completed three surveys during their first year of school, the third being after the onset of COVID-19 and during a stay-at-home order. At Time 3, we also assessed symptoms of anxiety and depression. Results Using linear mixed modeling, sedentary time increased and physical activity decreased over time, but 20%–35% of students reported improvements in these behaviors. Dietary changes appeared mixed, with some improvements noted early during COVID-19. Perceived stress increased over time. Multiple regression indicated that of the health behaviors examined for protective effects on mental health and stress during the pandemic, only diet quality emerged as a significant predictor. Conclusions Although notable declines in some health habits were observed over time, including following COVID-19 disruptions, some students reported improved health behaviors. Efforts should be directed at identifying and intervening with students most at risk for poor functioning.

Introduction College may be a time when emerging adults establish eating patterns that influence future weight trajectories. Self-determination theory (SDT) suggests that satisfaction of basic psychological needs (autonomy, competence, relatedness) supports autonomous regulation of behavior, which is associated with healthier behaviors. When needs are frustrated, individuals feel as though their behaviors are controlled by others, which is associated with unhealthy behaviors. This study used SDT to examine a model for associated body satisfaction, eating/weight control behaviors, and weight change. Methods Using a cross-sectional design, undergraduates (N = 875; 57% women; AgeM = 20 ± 1.4 yrs.; BMIM = 24.3 ± 4.4) completed measures of need satisfaction and frustration, behavioral regulation of healthy weight, body satisfaction, eating/weight control behaviors, and weight change in their first semester of college. Results Structural equation modeling showed that need satisfaction was positively associated with greater autonomous regulation, which was positively associated with greater body satisfaction and fruit/vegetable intake. Conversely, greater need frustration was associated with greater controlled regulation, which was associated with lower body satisfaction. Participants who had greater body satisfaction engaged in fewer unhealthy weight control behaviors. Engaging in more unhealthy behaviors was associated with greater weight gain during the first semester of college, whereas fruit and vegetable intake was not associated with weight change. The associations were stronger for women than men, particularly for the relationships between body satisfaction and unhealthy weight control behaviors and increased weight gain. Conclusions The model was generally supported, suggesting that psychological need satisfaction and autonomous motivation in college students may facilitate greater body satisfaction and healthier eating behaviors. Future longitudinal research is needed to clarify the factors that influence health behaviors and weight gain in college students.

Background Worksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain. The purpose of this study was to examine the effectiveness of Go!, an innovative 12-month multi-component worksite obesity prevention intervention. Methods A quasi-experimental non-equivalent control group design was utilized; 407 eligible hospital employees (intervention arm) and 93 eligible clinic employees (comparison arm) participated. The intervention involved pedometer distribution, labeling of all foods in the worksite cafeteria and vending machines (with calories, step equivalent, and a traffic light based on energy density signaling recommended portion), persuasive messaging throughout the hospital, and the integration of influential employees to reinforce healthy social norms. Changes in weight, BMI, waist circumference, physical activity, and dietary behavior after 6 months and 1 year were primary outcomes. Secondary outcomes included knowledge, perceptions of employer commitment to employee health, availability of information about diet, exercise, and weight loss, perceptions of coworker support and frequency of health discussions with coworkers. A process evaluation was conducted as part of the study. Results Repeated measures ANCOVA indicated that neither group showed significant increases in weight, BMI, or waist circumference over 12 months. The intervention group showed a modest increase in physical activity in the form of walking, but decreases in fruit and vegetable servings and fiber intake. They also reported significant increases in knowledge, information, perceptions of employer commitment, and health discussions with peers. Employees expressed positive attitudes towards all components of the Go! intervention. Conclusions This low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months. Such results are consistent with other worksite obesity prevention studies using ecological approaches. Implementing low-impact physical activity (e.g., walking, stair use) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity. Trial Registration This study was registered with clinicaltrials.gov (NCT01585480) on April 24, 2012. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2828-0) contains supplementary material, which is available to authorized users.

Background context Lumbar discectomy is the most common type of back surgery performed in the United States. Outcomes after this procedure can be variable and it appears that Workers' Compensation patients might be at increased risk for poor outcomes. Purpose To examine long-term multidimensional outcomes of lumbar discectomy within a cohort of Workers' Compensation patients from Utah and identify presurgical biopsychosocial factors related to poor outcomes. Study design/setting A retrospective cohort study consisting of a review of presurgical medical records and assessment of patient outcomes via a telephone survey. Outcomes were assessed at least 2 years postsurgery. Patient sample A consecutive sample of 271 workers from Utah who underwent lumbar discectomy from 1994 to 1999. A total of 134 patients were surveyed at the time of follow-up. Outcome measures Patient satisfaction, Roland-Morris Disability Questionnaire, SF-36v2, and Stauffer-Coventry Index. Methods A retrospective review of presurgical biopsychosocial variables and outcome assessment via telephone survey was conducted. Results Work disability rate for the cohort was 12.7% (17/134). Analysis of patient satisfaction, back pain-related dysfunction, and the Short-Form Health Survey-36 subscales indicated approximately 25% of patients experienced poor outcomes. Older age, number of comorbid health conditions, assigned case manager, litigation, and time delay from injury to surgery were consistently statistically significant predictors (p Conclusions Results of this study suggest that compensated back surgery patients are at greater risk for poor lumbar discectomy outcomes than noncompensation patients. Presurgery correlates of poor outcomes may be useful in identifying high-risk compensation patients.

Studies have suggested that complementary and alternative medicine (CAM) and herbal supplement use may be high on college campuses. This study investigated the relationship between CAM and herbal supplement utilization and coping, self-regulatory, cognitive styles, and healthcare satisfaction among college students (n=370). Indeed, overall CAM and herbal supplement use during the past year appeared high; however, users of these practices appeared somewhat heterogeneous. Dispositional factors were predictive of utilization with active coping style associated with both practices, whereas support-seeking and intrinsic self-regulation were only associated with CAM use and avoidant coping was only related to use of herbal supplements. Notably, dissatisfaction with healthcare services was not associated with either CAM or herbal supplement use among students. The findings from this study offer insight regarding motives for usage that may assist in more openly dialoguing with students regarding their health-enhancing and/or health-compromising behaviors. Moreover, future studies assessing utilization of CAM will benefit from examining the definitional issues of CAM practices that are addressed.

Background context Results of lumbar fusion surgery have been mixed and procedures are costly. Interbody cage lumbar fusion (ICLF) has been advanced to improve arthrodesis and clinical outcomes; however, little attention has been given to ICLF costs or potential predictors of these expenses. Purpose To depict medical and compensation costs associated with ICLF in a Utah cohort of patients receiving workers' compensation as well as to investigate predictors of costs. Study design/setting A retrospective-cohort research design was used involving completion of presurgical and postsurgical medical record reviews and accrual of medical and compensation costs. Presurgical variables included in a regression model were presurgical spinal pathophysiology rating, obesity, and litigation status. Patient sample Forty-three consecutive patients who were compensated by the Workers' Compensation Fund of Utah and underwent ICLF. Outcome measures Total accrued compensation and medical costs. Methods A retrospective review of presurgical variables and total accrued compensation and medical costs was conducted. Results Multiple regression analysis indicated that nonpathophysiological factors predicted compensation costs (lawyer involvement [β=0.40]; obesity [β=0.34]). Specifically, compensation for those with versus without lawyers was $41,657 versus $24,837, and for those who were obese versus nonobese was $46,152 versus $28,168. Arthrodesis was correlated with medical costs (r=−0.47, p=.002), with incurred costs for patients achieving solid fusion versus pseudarthrosis equaling $38,881 versus $71,655, respectively. Conclusions Considerable costs were associated with ICLF, particularly for those who were obese, involved in litigation, or failed to achieve solid fusion. With regard to compensation costs, the findings support the importance of assessing nonpathophysiological factors in spinal fusion patients.

Objective: This study examined the relationship between cognitive functioning and the severity of underlying lung disease in patients awaiting lung transplantation. Methods: Ninety-four patients with end-stage lung disease completed a test battery to assess cognitive performance in two domains: executive functioning/attention (Trails A and B, COWA, Animal Naming, Stroop Color–Word Test, Digit Symbol, and th e2&7 Test) and verbal memory (Digit Span–Backward and Forward, WMS-R Logical Memory and Paired Verbal Associates). Results: Thirty-seven percent of the patients demonstrated moderate to severe cognitive impairment data on two or more tests. Adjusting for age and education, there were no statistically significant differences on executive functioning or verbal memory as a function of specific lung disease diagnosis. Lower PCO2 values were associated with better cognitive performance on latent measures of executive functioning and attention (p .006) and verbal memory (p .009), whereas higher PO2 values tended to be associated with better performance on the executive functioning/attention measure (p .064). Distance walked in 6 minutes was positively related to verbal memory (p .023). Conclusions: Impaired neurocognitive functioning may be relatively common in patients awaiting lung transplantation and is associated with ineffective pulmonary gas exchange and reduced exercise tolerance. Key words: lung transplantation, neurocognitive assessment, cognitive impairment, exercise capacity.

BACKGROUND CONTEXT: Interbody cage lumbar fusion (ICLF) has been advanced to improve arthrodesis; however, little attention has been given to quality of life and functional outcomes. Studies suggest that psychosocial factors may be important modifiers of low back surgical outcomes. PURPOSE: To depict outcomes of ICLF surgery across multiple dimensions and to investigate presurgical biopsychosocial predictors of these outcomes. STUDY DESIGN/SETTING: A retrospective-cohort research design was used that involved com- pletion of presurgical medical record reviews and postsurgical telephone outcome surveys at least 18 months after surgery. Presurgical variables included in a regression model were age at the time of surgery, spinal pathophysiology rating, smoking tobacco, depression, and pursuing litigation. PATIENT SAMPLE: Seventy-three patients received ICLF, and of those 56 patients completed the outcome survey an average of 2.6 years after surgery. OUTCOME MEASURES: Outcome measures consisted of arthrodesis status, patient satisfaction, back-specific functioning, disability status, and quality of life. RESULTS: Although arthrodesis occurred in 84% of the patients, nearly half were dissatisfied with their current back condition. Functional status was worse than expected, and 38% were totally disabled at follow-up. Regression analyses revealed tobacco use, depression, and litigation were the most consistent presurgical predictors of poorer patient outcomes. CONCLUSIONS: Overall, despite a high rate of arthrodesis, ICLF was not associated with substan- tial improvements in patient functioning. Presurgical biopsychosocial variables predicted patient outcomes, which may help improve patient selection and possible targeted interventions. 2005 Elsevier Inc. All rights reserved.