The objective of this study was to examine heart rate variability (HRV) among sleep stages in obstructive sleep apnea (OSA) patients. The study was retrospective within subjects and examined the sleep stages and HRV in relation to OSA, age, body mass index (BMI), and sex. Data collected during diagnostic polysomnograms were used in this study. There were 105 clinical patients undergoing polysomnography for suspected OSA. We sampled the electrocardiogram (ECG) from wakefulness, stage 2, and REM sleep and analyzed for frequency domain HRV. Sampled epochs were free of apnea and arousals. Heart rate variability decreased with age. Total frequency variability (TF) and low frequency variability (LF) in wakefulness and REM sleep increased as apnea severity increased. Measures of TF, LF, and the LF/HF ratio were greatest in REM sleep. There was less LF and TF in Stage REM sleep in patients with higher BMI. In conclusion, the decrease in HRV with aging is a robust finding that occurs even in a clinical sleep apnea population. However, apnea does not mimic aging effects on the heart because HRV increased as apnea severity increased. The decrease in HRV during REM sleep in the obese apnea patients suggests the possibility of an autonomic dysfunction in this subgroup.

Psychosocial variables influence physical activity for different age groups, sex, and ethnic groups. However, little is known about their influence on physical activity in preadolescent Latino children. The authors examined how a) confidence in one's ability to be physically active (selfefficacy); b) ideas about the consequences of being physically active (beliefs), and c) the influences of family and friends on physical activity (social influences) effect physical activity levels in overweight (body mass index ≥85%) Latino preadolescent children. One hundred and fourteen preadolescents participated in a larger intervention designed to improve healthy lifestyles for Latino families. The authors report baseline data collected at a community-based primary care clinic. Multivariate regression analyses showed that only social influences significantly predicted (P < .01) the metabolic equivalent adjusted self-reported baseline physical activity. Prevention and intervention strategies that augment social influences on physical activity are likely to result in more physical activity and improved health in these children.Keywords social influences; body mass index; obesity; Hispanic Americans Obesity, now an epidemic in US children, disproportionately affects Latino children as prevalence rates are higher in Latino children than in their African American or Caucasian counterparts. 1,2 However, despite this increased disease burden, few studies have described overweight Latino children.Increased energy intake and decreased energy expenditure are primary contributors to obesity. Because Latino children of all ages have more inactivity and less moderate and vigorous activity than other ethnic groups, 3 increasing physical activity is likely to be a particularly effective target for obesity interventions in this population. Psychosocial variables, including a) confidence in one's ability to be physically active (self-efficacy), b) Studies examining the psychosocial determinants of physical activity have primarily described adults 6-8 and adolescents, 9-14 fewer have focused on younger children, such as preadolescents. Studies of Latino adults have shown the importance of social and family support. 6,7 In addition, studies of adolescents have shown the association between selfefficacy and positive beliefs with directly measured physical activity. 5 However, the role that these psychosocial variables play in determining the level of physical activity in Latino preadolescent children, particularly, in those who are obese, remains unknown. HHS Public AccessThe strong influence of family in the Latino community suggests that intervening on selfefficacy, beliefs, and social influences, all of which can be shaped by family influences and parenting, may have a significant and synergistic effect on reducing risk behaviors. This is likely to be true especially in the preadolescent period, which constitutes a period of significant physical, cognitive, and psychosocial development. 15 Therefore, the preadolescent period offers...

Objective We explored the underlying mechanisms by which storytelling can promote disease self-management among people with type 2 diabetes. Methods Two, eight-session storytelling interventions were delivered to a total of eight adults with type 2 diabetes at a community health center in Toronto, Ontario. Each week, participants shared stories about diabetes self-management topics of their choice. Using a qualitative descriptive approach, transcripts from each session and focus groups conducted during and following the intervention were coded and analyzed using NVivo software. Through content analysis, we identified categories that describe processes and benefits of the intervention that may contribute to and support diabetes self-management. Results Our analysis suggests that storytelling facilitates knowledge exchange, collaborative learning, reflection, and making meaning of one’s disease. These processes, in turn, could potentially build a sense of community that facilitates peer support, empowerment, and active engagement in disease self-management. Conclusion Venues that offer patients opportunities to speak of their illness management experiences are currently limited in our healthcare systems. In conjunction with traditional diabetes self-management education, storytelling can support several core aspects of diabetes self-management. Our findings could guide the design and/or evaluation of future story-based interventions.