The Perceptions of Community Gardeners at Jones Valley Urban Farm and the Implications for Dietary Interventions

The purpose of this study was to assess the reasons community gardeners at Jones Valley Urban Farm in Birmingham, Alabama participate in the community garden program, as well as to explore the potential impacts such participation has on the members’ health, community, and diet. Twenty active gardeners participated in four focus groups. Gardeners reported prior experience, cost savings, taste, sustainability issues, and provision of fresh and organic food as reasons for participating. Gardeners also reported issues related to sharing, community development, mental health, personal pride, perceived health benefits, and new - found food variety as impacts of their participation. Finding s from this study will hopefully serve to guide future quantitative research evaluating community gardening as a potentially healthful dietary intervention

Stressful Life Events and Behavior Change: A Qualitative Examination of African American Women\u27s Participation in a Weight Loss Program

We qualitatively assessed how life stressors affected African American women\u27s participation in a weight reduction program. A sample of 9 women, who completed a behavioral lifestyle intervention, participated in individual, structured, in-depth interviews. Life stressors, ranging from personal illness to changes in employment status, had varied effects on participation. Some women coped with life stressors by using them as a motivational tool to improve their own health, while others reported limited ability to devote time to attend meetings or engage in the prescribed lifestyle changes due to life stressors. A critical key to improving weight loss outcomes for African American women may be using intervention strategies that teach positive coping skills to alter maladaptive responses to life stressors

Phase-III, Randomized Controlled Trial of the Behavioral Intervention for Increasing Physical Activity in Multiple Sclerosis: Project BIPAMS

Background We propose a phase-III, randomized controlled trial (RCT) that examines the effectiveness of a behavioral intervention based on social cognitive theory (SCT) and delivered through the Internet using e-learning approaches for increasing physical activity and secondary outcomes (e.g., symptoms) in a large sample of people with multiple sclerosis (MS) residing throughout the United States. Methods/design The proposed phase-III trial will use a parallel group, RCT design that examines the effect of a 6-month behavioral intervention for increasing physical activity and secondarily improving mobility, cognition, symptoms, and quality of life (QOL) in persons with MS. The primary outcome is accelerometer-measured moderate-to-vigorous physical activity (MVPA). The secondary outcomes include self-report measures of physical activity, walking impairment, cognition, fatigue, depression, anxiety, pain, sleep quality, and QOL. The tertiary outcomes are mediator variables based on SCT. Participants (N = 280) will be randomized into behavioral intervention (n = 140) or attention and social contact control (n = 140) conditions using computerized random numbers with concealed allocation. The conditions will be administered over 6-months by persons who are uninvolved in screening, recruitment, random assignment, and outcome assessment. There will be a 6-month follow-up without intervention access/content. We will collect primary, secondary, and tertiary outcome data every 6 months over the 12-month period. Data analysis will involve intent-to-treat principles and latent growth modeling (LGM). Discussion The proposed research will provide evidence for the effectiveness of a novel, widely scalable approach for increasing lifestyle physical activity and improving secondary outcomes and QOL in persons with MS

Part 2: Preparing Entry-Level Occupational and Physical Therapy Students to Promote Healthy Lifestyles Emphasizing Healthy Eating with Individuals with Disabilities

Rehabilitation professionals including occupational therapists (OT) and physical therapists (PT) are increasingly called upon to incorporate health promotion of lifestyle behaviors including physical activity and healthy eating into routine clinical care. While OTs and PTs may be comfortable promoting activity-related behaviors, many are less comfortable with nutrition behaviors. To address entry-level OT and PT students’ perceived discomfort with discussing diet-related behaviors, faculty developed a healthy eating module for students to use during a community-based service learning program. The purpose of this paper is to describe the formative evaluation process of developing the healthy eating module, and to discuss results of a pilot trial of this module. The formative assessment of the healthy eating module consisted of four steps: focus groups with students, key informant interviews with community partners, expert panel round table, and expert panel review of materials. Students (n=117) completed questionnaires at the end of the service learning program to assess how much they used the new resources, and how useful they found the resources. The final healthy eating module consisted of an on-line training session and a healthy eating toolkit, including resources for assessments, treatment activities and additional nutrition information. Mann-Whitney U tests indicated that students who reported high use of materials found the resources significantly more helpful than those students who reported low use (

Part 1: Preparing Entry-Level Occupational Therapy and Physical Therapy Students to Promote Health and Wellbeing with Individuals with Disabilities

To address accreditation standards for health and wellbeing within entry-level occupational therapy (OT) and physical therapy (PT) programs, the OT, PT, and Human Studies Departments at the University of Alabama at Birmingham (UAB) collaborated with community partners to conduct an interdisciplinary service learning activity based on the I Can Do It, You Can Do It Program (ICDI). This program is a structured community health program where individuals without disabilities are partnered with individuals with disabilities to enhance physical activity, healthy eating, and community participation. The purpose of this paper is to describe a formative evaluation of ICDI at UAB, and to discuss revisions to the program made as a result of the evaluation. Faculty used a qualitative design to collect feedback on perceived benefits and challenges of the program. Focus groups were conducted with students who completed the program, and key informant interviews were conducted with site coordinators from each of the three partnering community sites. Two themes emerged from student focus groups: (1) Program benefits, with sub-themes of hands-on application and interaction, and (2) Challenges with suggestions for change, with sub-themes of preparation, communication, and expectations. Four themes emerged from key informant interviews: (1) Students, (2) Logistics, (3) Program benefits, and (4) Transference. Results of this evaluation led to a number of revisions for the 2016 cohort. Future evaluations will include objective measures of change in student knowledge over time, as well as health and behavioral outcomes of community members who participated in the ICDI program at UAB

Neurocognitive and Neuroimaging Predictors of Clinical Outcome in Bipolar Disorder

Historically, bipolar disorder has been conceptualized as a disease involving episodic rather than chronic dysfunction. However, increasing evidence indicates that bipolar disorder is associated with substantial inter-episode psychosocial and vocational impairment. Here we review the contributions of neurocognitive deficits and structural and functional neuroanatomic alterations to the observed functional impairments. In particular, compelling evidence now suggests that neurocognitive impairments, particularly in the areas of attention, processing speed, and memory, are associated with functional outcome. Although investigation of the neural correlates of functional disability in bipolar disorder is only in its nascent stages, preliminary evidence suggests that white matter abnormalities may be predictive of poor outcome. A better understanding of the relationship between neurocognitive and neuroimaging assays and functional outcome has the potential to improve current treatment options and provide targets for new treatment strategies in bipolar disorder

Endometrial stromal sarcoma: a population-based analysis

To determine independent prognostic factors for the survival of patients with endometrial stromal sarcoma (ESS), data were abstracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute from 1988 to 2003. Kaplan–Meier and Cox proportional hazards models were used for analyses. Of 831 women diagnosed with ESS, the median age was 52 years (range: 17–96 years). In total, 59.9% had stage I, 5.1% stage II, 14.9% stage III, and 20.1% had stage IV disease. Overall, 13.0, 36.1, and 34.7% presented with grades 1, 2, and 3, respectively. Patients with stage I–II vs III–IV disease had 5 years DSS of 89.3% vs 50.3% (P<0.001) and those with grades 1, 2, and 3 cancers had survivals of 91.4, 95.4, and 42.1% (P<0.001). In multivariate analysis, older patients, black race, advanced stage, higher grade, lack of primary surgery, and nodal metastasis were independent prognostic factors for poorer survival. In younger women (<50 years) with stage I–II disease, ovarian-sparing procedures did not adversely impact survival (91.9 vs 96.2%; P=0.1). Age, race, primary surgery, stage, and grade are important prognostic factors for ESS. Excellent survival in patients with grade 1 and 2 disease of all stages supports the concept that these tumors are significantly different from grade 3 tumors. Ovarian-sparing surgeries may be considered in younger patients with early-stage disease

The Neural Basis of Decision-Making and Reward Processing in Adults with Euthymic Bipolar Disorder or Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD

Emerging Trends in Health Promotion for People with Disabilities

The need among people with disabilities to improve their own health and prevent/manage secondary conditions requires a better balance between reactive and anticipatory care

Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article