Wellness Project Implementation Within Houston\u27s Faith and Diabetes initiative: a Mixed Methods Study

BACKGROUND: Faith-based health promotion has shown promise for supporting healthy lifestyles, but has limited evidence of reaching scale or sustainability. In one recent such effort, volunteers from a diverse range of faith organizations were trained as peer educators to implement diabetes self-management education (DSME) classes within their communities. The purpose of this study was to identify factors associated with provision of these classes within six months of peer-educator training. METHODS: This study used the Consolidated Framework for Implementation Research (CFIR) to identify patterns from interviews, observations, attendance records, and organizational background information. Two research team members thematically coded interview transcripts and observation memos to identify patterns distinguishing faith organizations that did, versus did not, conduct DSME classes within six months of peer-educator training. Bivariate statistics were also used to identify faith organizational characteristics associated with DSME class completion within this time frame. RESULTS: Volunteers from 24 faith organizations received peer-educator training. Of these, 15 led a DSME class within six months, graduating a total of 132 participants. Thematic analyses yielded two challenges experienced disproportionately by organizations unable to complete DSME within six months: [1] Their peer educators experienced DSME as complex, despite substantial planning efforts at simplification, and [2] the process of engaging peer educators and leadership within their organizations was often more difficult than anticipated, despite initial communication by Faith and Diabetes organizers intended to secure informed commitments by both groups. Many peer educators were overwhelmed by training content, the responsibility required to start and sustain DSME classes, and other time commitments. Other priorities competed for time in participants\u27 lives and on organizational calendars, and scheduling processes could be slow. In an apparent dynamic of crowding out, coordination was particularly difficult in larger organizations, which were less likely than smaller organizations to complete DSME classes despite their more substantial resources. CONCLUSIONS: Initial commitment from faith organizations\u27 leadership and volunteers may not suffice to implement even relatively short and low cost health promotion programs. Faith organizations might benefit from realistic previews about just how challenging it is to make these programs a sufficiently high organizational and individual priority

THE PERCEPTION OF MUSIC THERAPY BY DIRECT CARE STAFF OF OLDER ADULTS WITH INTELLECTUAL DISABILITIES: A PHENOMENOLOGICAL APPROACH

The purpose of this phenomenological study was to explore the experiences and perceptions of direct care staff of older adults with intellectual disabilities who participate in music therapy services. Participants (N=5) were direct care staff (DCS) over age 18, either currently working or formerly worked as DCS at Cottonwood Retirement, and observed a minimum of one music therapy session with their client(s). Participants shared their experiences in individual 60-minute semi-structured interviews. The interviews were recorded, transcribed, and analyzed using Interpretive Phenomenological Analysis (IPA). Six themes emerged: (a) DCS find music therapy effective in changing social, physical, emotional, and cognitive functioning, (b) DCS find personal enjoyment through connecting with consumers in music therapy experiences, (c) DCS are experienced and knowledgeable about consumers and encourage student music therapists (SMTs) to ask for help, (d) DCS apply and reinforce experiences practiced in music therapy to consumer activities outside of sessions, (e) DCS encourage SMTs to focus on physical, emotional, and social functioning, instead of cognitive functioning, of older adults with ID, and (f) DCS encourage SMTs to consider consumers’ individual characteristics and preferences in order to increase therapist flexibility and intuition

The conversion of a recreational camp into a residential environment and educational learning center

Educational systems in our country have continually faced the challenge of providing educational opportunities for all our children. As well as maintaining a national goal of high educational standards, we have also encouraged an individualistic approach to meeting needs of students. Our educational systems must deal with an extremely wide range of personalities, beliefs, backgrounds, expectations, incomes and abilities. Teachers have a wealth of information available to help them determine students\u27 individual needs and ways of meeting these needs. Students\u27 needs can vary from cognitive-knowledge and moral-motivational needs to personal-emotional and physical needs. Curricula and programs generally attempt to insure that all these domains of a student\u27s being are touched upon. One area of education that focuses on all these domains and incorporates means of meeting a wide variety of needs is that of environmental education

The feasibility of using Microsoft Kinect v2 sensors during radiotherapy delivery

Consumer-grade distance sensors, such as the Microsoft Kinect devices (v1 and v2), have been investigated for use as marker-free motion monitoring systems for radiotherapy. The radiotherapy delivery environment is challenging for such sensors because of the proximity to electromagnetic interference (EMI) from the pulse forming network which fires the magnetron and electron gun of a linear accelerator (linac) during radiation delivery, as well as the requirement to operate them from the control area. This work investigated whether using Kinect v2 sensors as motion monitors was feasible during radiation delivery. Three sensors were used each with a 12 m USB 3.0 active cable which replaced the supplied 3 m USB 3.0 cable. Distance output data from the Kinect v2 sensors was recorded under four conditions of linac operation: (i) powered up only, (ii) pulse forming network operating with no radiation, (iii) pulse repetition frequency varied between 6 Hz and 400 Hz, (iv) dose rate varied between 50 and 1450 monitor units (MU) per minute. A solid water block was used as an object and imaged when static, moved in a set of steps from 0.6 m to 2.0 m from the sensor and moving dynamically in two sinusoidal-like trajectories. Few additional image artifacts were observed and there was no impact on the tracking of the motion patterns (root mean squared accuracy of 1.4 and 1.1 mm, respectively). The sensors' distance accuracy varied by 2.0 to 3.8 mm (1.2 to 1.4 mm post distance calibration) across the range measured; the precision was 1 mm. There was minimal effect from the EMI on the distance calibration data: 0 mm or 1 mm reported distance change (2 mm maximum change at one position). Kinect v2 sensors operated with 12 m USB 3.0 active cables appear robust to the radiotherapy treatment environment

Genetic variation modifies risk for neurodegeneration based on biomarker status

Background: While a great deal of work has gone into understanding the relationship between CSF biomarkers, brain atrophy, and disease progression, less work has attempted to investigate how genetic variation modifies these relationships. The goal of this study was two-fold. First, we sought to identify high-risk v. low-risk individuals based on their CSF tau and Aβ load and characterize these individuals with regard to brain atrophy in an AD-relevant region of interest. Next, we sought to identify genetic variants that modified the relationship between biomarker classification and neurodegeneration.Methods: Participants were categorized based on established cut-points for biomarker positivity. Mixed model regression was used to quantify longitudinal change in the left inferior lateral ventricle. Interaction analyses between single nucleotide polymorphisms (SNPs) and biomarker group status were performed using a genome wide association study (GWAS) approach. Correction for multiple comparisons was performed using the Bonferroni procedure. Results: One intergenic SNP (rs4866650) and one SNP within the SPTLC1 gene (rs7849530) modified the association between amyloid positivity and neurodegeneration. A transcript variant of WDR11-AS1 gene (rs12261764) modified the association between tau positivity and neurodegeneration. These effects were consistent across the two sub-datasets and explained approximately 3% of variance in ventricular dilation. One additional SNP (rs6887649) modified the association between amyloid positivity and baseline ventricular volume, but was not observed consistently across the sub-datasets.Conclusions: Genetic variation modifies the association between AD biomarkers and neurodegeneration. Genes that regulate the molecular response in the brain to oxidative stress may be particularly relevant to neural vulnerability to the damaging effects of amyloid-β