Eliminating Barriers: Connecting Seniors to Services in Chittenden County

Introduction. Physical activity programs for older adults help to improve physical, social, and emotional health and reduce impairments in activities of daily living1. In Chittenden county, less than 1⁄3 of older adults participate in programs, while 48% report that they would like to exercise more. Our aim was to identify barriers to participation in physical activity programs by older adults in Chittenden county, such as accessibility, transportation, health, affordability, and social isolation, and to identify strategies to overcome these barriers. Methods. 144 paper and electronic surveys were administered in Chittenden County, Vermont to assess use of group programs among older adults aged ≥ 50 years including transportation, motivation, preferences, advertisement, and barriers to access. A focus group explored aspects of ideal group activities for seniors. Results. 87.9% of respondents were active for two or more hours each week, while 46.5% had participated in group programming in the past 6 months. Group par- ticipation was significantly higher among physically active respondents (p=0.020). Motivators for participation in group activity included health benefits, social aspects, and physical activity, while the most cited barrier to attendance was timing conflicts. Respondents received information about programming via word of mouth, email, and online resources. Discussion. Overall, our findings indicate that the majority of respondents are highly active, however, they frequently experience barriers that prevent them from participating in group programming. We recommend offering flexible scheduling, advertising programming via word of mouth and email, and emphasizing program health benefits.https://scholarworks.uvm.edu/comphp_gallery/1260/thumbnail.jp

Assessing the Awareness of Lead Hazards in the Greater Burlington Area

Introduction. Lead is a heavy metal found in and around homes built before 1978, comprising more than 80% of the housing stock in Chittenden County, Vermont. Lead exposure during infancy and childhood can have deleterious effects on development. Our study assessed baseline community understanding of potential household lead hazards in Chittenden County, Vermont. Methods.. 123 paper, 10-question surveys were randomly administered to Chittenden County, VT residents to assess recognition of lead toxicology symptoms and awareness of lead safety programs. Scores were treated as continuous variables, demographically grouped, and analyzed using non-parametric statistical analysis (Mann-Whitney & Kruskal-Wallis). Individual questions were treated as dichotomous variables, demographically grouped and analyzed using chi-squared testing. Results.. 48% of survey participants understood the interaction between ADHD and lead or knew the importance of window maintenance. 54.5% were aware of the Burlington Lead Program\u27s assistance program. Participants earning less than $60,000 and those with less than a graduate degree scored statistically lower (p Conclusion.. Lesser-known lead poisoning symptoms and home interventions that decrease lead exposure should be emphasized to the community. High-risk groups requiring targeted education include those who rent, have lower income and education levels. Primary care providers could serve a larger role in educating patients. Additional efforts should be made to publicize services offered by the Burlington Lead Program.https://scholarworks.uvm.edu/comphp_gallery/1241/thumbnail.jp

Biopsychosocial Correlates of Sleep Hygiene in Preschoolers

Most children don’t get enough sleep (Dement, 2005; Maas, 2011), and 77% of preschoolers experience sleep related disruptive behaviors at least a few nights per week (National Sleep Foundation, 2004). Sleep is especially crucial during early development to promote health, education, brain development, physical growth, and quality of life. Insufficient sleep is a public health problem, and this is clearly true for young children (CDC, 2015). The National Institutes of Health reported that preschoolers need 11–12 hours of sleep daily (NIH, 2012). Good sleep hygiene includes consistent bedtimes and morning rising times, and avoiding large meals, caffeine, and light sources (e.g., night lights, smart phones, iPads, computers) before bedtime (CDC, 2015). Three memory tests, a sleep hygiene scale, a socioemotional assessment, and height and weight measurements (to calculate BMI) were administered to preschoolers. Following testing, Fitbit devices were worn on each child’s ankle for the 12-week data collection period. Fitbit parameters included steps per day, total activity time, and time of day at which most physical activity occurred (morning, afternoon, or evening). Sleep quality and sleep habits parameters included number of restless minutes, awake minutes, total hours spent sleeping nightly, child’s bedtime, and the child’s wake time. We hypothesized that more physically active children would experience better sleep quality, a later bedtime, and an earlier wake time than children who are less physically active. We also hypothesized that children who are most active in the evening would exhibit better sleep quality than children who are most active in the morning or afternoon. We expect better sleep quality to be associated with higher scores on cognitive and socioemotional measures. Results provide greater knowledge regarding the association between sleep, physical activity, and biopsychosocial outcomes that may be useful in implementing better education for parents and children geared toward improving sleep

Understanding and Evaluating Quality of Life for Individuals with Intellectual Disabilities: A Northwestern Vermont Population Study

Introduction There are 7-8 million individuals with intellectual or developmental disabilities living in the US. • 91,795 of this population lives in Vermont • Historically marginalized and isolated community • Socioeconomic, health-related, and emotional burden • Public health-related disparity Champlain Community Services (CCS): non-profit service provider and coordinator for 86 persons with intellectual disabilities in Northwestern Vermont Objectives: • Develop and apply measures to better understand and evaluate quality of life in the population CCS serves. • Recommend improvement to CCS data collection and evaluation methods. • Provide a basis for future recommendations to CCS services that are aligned to the needs of consumers.https://scholarworks.uvm.edu/comphp_gallery/1275/thumbnail.jp

Interaction between extracellular matrix molecules and microbial pathogens: evidence for the missing link in autoimmunity with rheumatoid arthritis as a disease model.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by inflammation followed by tissue rebuilding or fibrosis. A failure by the body to regulate inflammation effectively is one of the hallmarks of RA. The interaction between the external environment and the human host plays an important role in the development of autoimmunity. In RA, the observation of anti-cyclic citrullinated peptide antibodies (ACPA) to autoantigens is well recognized. Citrullination is a post-translational modification mediated by peptidyl arginine deiminases, which exist in both mammalian and bacterial forms. Previous studies have shown how proteins expressed in the human extracellular matrix (ECM) acquire properties of damage-associated molecular patterns (DAMPs) in RA and include collagens, tenascin-C, and fibronectin (FN). ECM DAMPs can further potentiate tissue damage in RA. Recent work has shown that citrullination in RA occurs at mucosal sites, including the oral cavity and lung. Mucosal sites have been linked with bacterial infection, e.g., periodontal disease, where exogenous pathogens are implicated in the development of autoimmunity via an infectious trigger. Proteases produced at mucosal sites, both by bacteria and the human host, can induce the release of ECM DAMPs, thereby revealing neoepitopes which can be citrullinated and lead to an autoantibody response with further production of ACPA. In this perspectives article, the evidence for the interplay between the ECM and bacteria at human mucosal surfaces, which can become a focus for citrullination and the development of autoimmunity, is explored. Specific examples, with reference to collagen, fibrinogen, and FN, are discussed

From Principle to Practice: Bridging the Gap in Patient Profiling

The standard clinical coagulation assays, activated partial thromboplastin time (aPTT) and prothrombin time (PT) cannot predict thrombotic or bleeding risk. Since thrombin generation is central to haemorrhage control and when unregulated, is the likely cause of thrombosis, thrombin generation assays (TGA) have gained acceptance as “global assays” of haemostasis. These assays generate an enormous amount of data including four key thrombin parameters (lag time, maximum rate, peak and total thrombin) that may change to varying degrees over time in longitudinal studies. Currently, each thrombin parameter is averaged and presented individually in a table, bar graph or box plot; no method exists to visualize comprehensive thrombin generation data over time. To address this need, we have created a method that visualizes all four thrombin parameters simultaneously and can be animated to evaluate how thrombin generation changes over time. This method uses all thrombin parameters to intrinsically rank individuals based on their haemostatic status. The thrombin generation parameters can be derived empirically using TGA or simulated using computational models (CM). To establish the utility and diverse applicability of our method we demonstrate how warfarin therapy (CM), factor VIII prophylaxis for haemophilia A (CM), and pregnancy (TGA) affects thrombin generation over time. The method is especially suited to evaluate an individual's thrombotic and bleeding risk during “normal” processes (e.g pregnancy or aging) or during therapeutic challenges to the haemostatic system. Ultimately, our method is designed to visualize individualized patient profiles which are becoming evermore important as personalized medicine strategies become routine clinical practice