Feasibility of a Brief Community-Based Train-the-Trainer Lesson to Reduce the Risk of Falls Among Community Dwelling Older Adults

The Better Balance, Better Bones, Better Bodies (B-Better©) program was developed to disseminate simple home-based strategies to prevent falls and improve functional health of older adults using a train-the-trainer model. Delivered by Family & Community Education Study Group program volunteers, the lesson stresses the importance of a physically active lifestyle to optimal health and promotes best practice strategies to prevent falls. Data from 235 program participants show participants gained knowledge and learned to reduce their risk of falls during this one-hour brief encounter. Over 80% reported intent to change behavior related to physical activity and to perform home safety checks

A prospective study of functional performance balance self-efficacy, and bone mineral density in community-dwelling elderly women

In the United States, falls are the leading cause of unintentional death with one of every three people 65 years and older falling each year. Falls account for approximately 95% of hip fractures among older adults and falls to the side predominate hip fracture related falls in this population. However, risk factors for side and frequent falls are poorly understood. Furthermore, few data exist to explain differences in bone mineral density among older postmenopausal women. In particular, data regarding the timing of hormone replacement therapy (HRT) among older women is scarce. In the first aim of this dissertation, we examined changes in mobility and balance-related risk factors for side falls as well as differences in these risk factors according to fall status in a population of 107 independent, elderly women (>70 yrs), who were followed over 2 years. We found hip abduction strength decreased (p<.001) in all subjects, with side-fallers exhibiting weaker hip abduction strength (p=.008), greater sway velocity (p=.027), and slower performances on the tandem walk (p=.039) and Get Up and Go (p<.001) compared to non-fallers. For the second study, in the same population, we examined 2-year changes in balance self-efficacy (BSE) and the relationship of BSE to side fall risk factors and falls incidence. Results showed BSE at baseline was predictive of Get Up and Go, hip abduction strength and tandem walk at follow-up (p<.008), but that BSE decreased only among the non-fallers (p=.013). In the third study, we examined 3-yr hip bone mineral density (BMD) changes in women with distinct hormone replacement therapy (HRT) profiles: 1) no hormone replacement therapy (N0HRT), 2) HRT continually since menopause (Continual), 3) HRT begun 10 years after menopause (Late), 4) HRT initiated within 5 years (New), and compared the change in BMD of the hip across HRT groups. Only the NoHRT group lost bone over the 3 years (p=.014). We also assessed BMD of the lateral spine across levels of estrogen use in a sub-sample of participants and found long-term HRT users had significantly higher lateral spine BMD (p=.041) compared to women who had never been on HRT

Physical Activity in Childhood May Be the Key to Optimizing Lifespan Skeletal Health

Physical activities undertaken in childhood, particularly activities which apply large forces quickly convey optimal benefits to bone mass, size, and structure. Evidence is accumulating that benefits persist well beyond activity cessation. This review examines the potential for early childhood activity to improve bone mineralization and structure and explores childhood activity as prevention for osteoporosis in later life

Systematic Review of Physical Activity Objectives in Extension Strategic Plans: Findings and Implications for Improved Public Health Impact

Extension programming that incorporates both physical activity and dietary behaviors is necessary for the prevention of certain chronic diseases, including obesity. The purpose of the study presented here was to systematically identify the presence of physical activity objectives in the strategic plan for each Extension system in the United States. Few Extension systems (13) included physical activity in their strategic plans, yet lack of inclusion of physical activity in a strategic plan may limit the degree to which a system supports physical activity objectives and outcomes. As strategic plans lead to strategic thinking, the integration of physical activity objectives may improve the public health impact of Extension programming

The Balanced Energy Physical Activity (BEPA) Toolkit

The Balanced Energy Physical Activity Toolkit is an evidence-based, behaviorally focused physical activity resource. The BEPA-Toolkit is designed for applications in various educational settings to increase children’s physical activity time, with materials and activity ideas that are applicable for use in and outside of the classroom and before, during, or after school. It includes over 50 activity cards that convey integrated messages about healthy eating and physical activity through movement. This practical resource has been shown to increase children’s physical activity at school

Assessing Family Level Behaviors for Obesity Prevention: Development and Preliminary Validation of the Family Stage of Change Tool

We applied the Transtheoretical Model (TTM) to develop the Family Stage of Change (FSOC) screening tool. Our goal was to provide practitioners an instrument that measures families’ readiness to change obesity preventing behaviors, in order to optimize family-focused obesity-prevention intervention strategies. We evaluated instrument validity by comparing responses on the FSOC to related items on a validated family behavioral and environmental assessment (Family Nutrition and Physical Activity Assessment; FNPA) shown to predict child BMI. Study participants included parents and caregivers (N = 146) of children ages 2-14 years recruited through preschool, elementary, and middle school listservs. Descriptive analyses were conducted on the demographic data, and correlations were run to examine associations between FSOC and FNPA items, domains, and total scores. Strong positive correlations were observed between the individual items (0.44 to 0.75, p \u3c 0.001), domain scores (0.57 to 0.8, p \u3c 0.001), and mean total FSOC and FNPA scores (0.78, p \u3c 0.001) suggesting the FSOC is measuring family level behaviors. Test-retest reliability was evaluated on a subsample of participants (n = 57), and item by item correlations ranged from 0.75 to 1.0, p \u3c 0.001

Evaluation of an Extension-Delivered Resource for Accelerating Progress in Childhood Obesity Prevention: The BEPA-Toolkit

The Balanced Energy Physical Activity Toolkit, or the BEPA-Toolkit, supports physical activity (PA) programming via Extension in elementary schools. In a pilot study, we evaluated the effectiveness of the BEPA-Toolkit as used by teachers through Supplemental Nutrition Assistance Program Education partnerships. We surveyed teachers (n = 57) regarding their use of the kit and examined associations between teacher use of the kit and objectively measured PA of students (n = 1,103). Over 80% of responders reported that the BEPA-Toolkit provided additional opportunities for PA, and children regularly exposed to the kit were more active than those having less exposure to it. The BEPA-Toolkit may support PA opportunities in underresourced school settings

Strengths, Challenges, and Opportunities for Physical Activity Promotion in the Century-old National Cooperative Extension System

The need for physical activity promotion is ubiquitous, and offering physical activity interventions in community settings may reach people where they live, work, and play. Reaching people and providing evidence-based programming is exactly what the Cooperative Extension System has accomplished over the last century. In 2014, federal policy brought physical activity promotion into the mission of Extension. Although this policy marks the beginning of concerted efforts for physical activity promotion, several states have had strong success in this area. Borrowing from these efforts, this paper reports strengths, challenges, and opportunities for physical activity promotion in Extension

In vitro modeling of the neurobiological effects of glucocorticoids: A review

Hypothalamic-pituitary adrenal (HPA)axis dysregulation has long been implicated in stress-related disorders such as major depression and post-traumatic stress disorder. Glucocorticoids (GCs) are released from the adrenal glands as a result of HPA-axis activation. The release of GCs is implicated with several neurobiological changes that are associated with negative consequences of chronic stress and the onset and course of psychiatric disorders. Investigating the underlying neurobiological effects of GCs may help to better understand the pathophysiology of stress-related psychiatric disorders. GCs impact a plethora of neuronal processes at the genetic, epigenetic, cellular, and molecular levels. Given the scarcity and difficulty in accessing human brain samples, 2D and 3D in vitro neuronal cultures are becoming increasingly useful in studying GC effects. In this review, we provide an overview of in vitro studies investigating the effects of GCs on key neuronal processes such as proliferation and survival of progenitor cells, neurogenesis, synaptic plasticity, neuronal activity, inflammation, genetic vulnerability, and epigenetic alterations. Finally, we discuss the challenges in the field and offer suggestions for improving the use of in vitro models to investigate GC effects

A Patient-Specific in silico Model of Inflammation and Healing Tested in Acute Vocal Fold Injury

The development of personalized medicine is a primary objective of the medical community and increasingly also of funding and registration agencies. Modeling is generally perceived as a key enabling tool to target this goal. Agent-Based Models (ABMs) have previously been used to simulate inflammation at various scales up to the whole-organism level. We extended this approach to the case of a novel, patient-specific ABM that we generated for vocal fold inflammation, with the ultimate goal of identifying individually optimized treatments. ABM simulations reproduced trajectories of inflammatory mediators in laryngeal secretions of individuals subjected to experimental phonotrauma up to 4 hrs post-injury, and predicted the levels of inflammatory mediators 24 hrs post-injury. Subject-specific simulations also predicted different outcomes from behavioral treatment regimens to which subjects had not been exposed. We propose that this translational application of computational modeling could be used to design patient-specific therapies for the larynx, and will serve as a paradigm for future extension to other clinical domains