Search

BACKGROUND: Automated blood pressure (BP) devices have been used in the home for self-management purposes and are increasingly being used in population-based research. Although these devices are convenient and affordable and may be used by inexperienced lay personnel, the potential impact of an examiner’s skill level on the results needs to be evaluated quantitatively. The aim of this study was to compare BP measurements obtained in a home setting by personnel with healthcare experience with those obtained by personnel without healthcare experience. In addition, the percent agreement in high blood pressure (HBP) classification between the home BP measurement by the field interviewer (FI) and measurements obtained in a standardized environment was examined. METHODS: The Health Measures at Home Study was a pilot study carried out among 128 adult participants recruited from the National Health and Nutrition Examination Survey. The Health Measures at Home Study provided the opportunity to compare the BP values obtained with an automated device in a home setting by both experienced health technicians (HTs) with those obtained by FIs who had no healthcare experience. Differences between measurements obtained by the HT and measurements obtained by the FI were assessed using paired t-tests, Pearson’s correlations, and Bland–Altman plots. Percent agreement and κ-statistics were used to assess agreement in HBP classification between examiners in the home. Measurements obtained by the FI were also compared with those obtained in the National Health and Nutrition Examination Survey mobile exam center (MEC) by a physician using percent agreement and κ-statistics. RESULTS: There was a high correlation in both systolic blood pressure (SBP; r = 0.903) and diastolic blood pressure (DBP; r = 0.894) between measurements obtained by HTs and those obtained by FIs. The mean SBP and DBP obtained by the FIs (SBP, 119.0 ± 14.4 mmHg; DBP,71.9 ± 9.8 mmHg) were significantly higher than the HT measurements (SBP, 117.0 ± 12.7 mmHg; DBP,69.9.9 ± 9.2 mmHg). In the home, the FI classified 11.7% as having HBP, whereas the HT classified 7.0%. The percent of individuals classified as having HBP by the physician in the MEC was 10.2% of the participants. CONCLUSION: Operationally, FIs could take BP measurements in the home; however, there were some differences between measurements obtained by the FI and HT. The absolute difference between measurements obtained by the FI and those obtained by the HT in the home showed that measurements obtained by the FI tended to be higher than the HT, but the magnitude of these differences was less than 5 mmHg. The HT classified 7.0% of HBP whereas the FI classified 11.7% of HBP. Similarly, the FI and the MEC physician classified a different percent of individuals with HBP. Further investigation is warranted to determine the cause of these small but significant absolute differences between measurements obtained by the FI and HT.

Unmanned aerial capabilities offer exciting new perspectives on the Arctic atmosphere and the US Department of Energy is working with partners to offer such perspectives to the research community. Thorough understanding of aerosols, clouds, boundary layer structure and radiation is required to improve representation of the Arctic atmosphere in weather forecasting and climate models. To develop such understanding, new perspectives are needed to provide details on the vertical structure and spatial variability of key atmospheric properties, along with information over difficult-to-reach surfaces such as newly-forming sea ice. Over the last three years, the US Department of Energy (DOE) has supported various flight campaigns using unmanned aircraft systems (UAS, also known as UAVs and drones) and tethered balloon systems (TBS) at Oliktok Point, Alaska. These activities have featured in-situ measurements of thermodynamic state, turbulence, radiation, aerosol properties, cloud microphysics and turbulent fluxes to provide a detailed characterization of the lower atmosphere. Alongside a suite of active and passive ground-based sensors and radiosondes deployed by the DOE Atmospheric Radiation Measurement (ARM) program through the third ARM Mobile Facility (AMF-3), these flight activities demonstrate the ability of such platforms to provide critically-needed information. In addition to providing new and unique datasets, lessons learned during initial campaigns have assisted toward the development of an exciting new community resource.

BACKGROUND AND OBJECTIVES:Regular aerobic and muscle-strengthening physical activity in youth has been positively associated with health and may help prevent obesity. The purpose of this study is to provide reference values on 4 core, upper, and lower body measures of muscle strength among US children and adolescents and to investigate the association between these measures of strength and weight status.METHODS:We assessed muscular strength using 4 different tests (plank, modified pull-up, knee extension, and grip strength) in 1224 youth aged 6 to 15 years collected during the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey. Mean and median estimates are provided by gender, age, and weight status. Weight status was defined based on standard categories of obesity, overweight, normal weight, and underweight using the gender-specific BMI-for-age Centers for Disease Control and Prevention growth charts.RESULTS:There were significant positive trends with age for each of the strength tests (P < .001) except the modified pull-up among girls. The length of time the plank was held decreased as weight status increased for both girls and boys (P < .001). As weight status increased the number of modified pull-ups decreased (P < .001 boys and girls). Scores on the knee extension increased as weight status increased (P < .01). Grip strength increased as weight status increased (P < .01).CONCLUSIONS:Increasing weight status had a negative association with measures of strength that involved lifting the body, but was associated with improved performances on tests that did not involve lifting the body.

Collection of physical measurements and biospecimens in the home may be an efficient way to obtain objective health measurements. This study assesses differences between collection in the home and a standardized setting.Participants had physical measurements and biospecimens taken in the National Health and Nutrition Examination Survey mobile examination center (MEC). Then, they had height and weight measured in the MEC using portable equipment. In the home, participants had height, weight, and blood pressure measured and dried blood spots collected using portable equipment. Two complete examinations were done in the home: one by a health technician and one by a field interviewer.Home environments were less standardized and presented more challenges to examiners. Correlations between all four height measurements and all four weight measurements were higher than 99%. Mean differences in height (0.3 cm) and weight (0.4 kg) were small but statistically significant. The home measurements perfectly or near-perfectly classified participants as obese relative to the standardized MEC examination.The selected physical measurements can be collected in the home by field interviewers using portable equipment. Before adding home collection of physical measurements to household interview surveys, further research should be done to examine the impact of these changes on interviewer training, participant recruitment, and participant response rates.