The Nutrition Information and Resource Center at Penn State University

Consumers are barraged with nutrition and health information. This presents a challenge for educators to keep abreast of the latest information. In order to help address this need, a Nutrition Information and Resource Center (NIRC) was developed. NIRC has an informational Web site (http://nirc.cas.psu.edu/) with online fact sheets, links to credible Web sites, an email question and answer system ([email protected]), and a lending library. The NIRC provides resources for educators that they can use to help children, youth, and families to acquire knowledge, skills, and behaviors necessary to improve their health

Southgate digital equity tool

Made available with permission from author and publisher.The Southgate Digital Equity Tool has been developed to assist policy makers and practitioners in making informed decisions about the way they engage consumers in services and programs in the digital era. Initially developed for use by health organisations, the tool can be adapted for use by any organisation to guide thinking around the impact of traditional and digital communication on different client/consumer/population groups, with a focus on the impact of shifting to, or increasing, digital engagement with them. The basis for the tool is the assumption that digital engagement strategies will impact on client/consumer groups differently, with a differential impact on intended outcomes, especially on accessibililty of services, information and participation. The tool can be used to examine one strategy or a set of communication strategies which address a particular issue, a geographic area, a group or a population. Part 1 is a Workbook and Part 2 is a Guide to assist in completing the Workbook, including descriptions and examples. The digital equity tool can help you and your organisation to examine: (1) The current mix of communication and engagement modes across a certain service or issue; (2) A proposed change in this mix; (3) The impact of a change in mix retrospectively; (4) Mitigation strategies to limit negative impacts

Exercise Training and Functional Connectivity Changes in Mild Cognitive Empairment and Healthy Elders

Background: Effective interventions are needed to improve brain function in mild cognitive impairment (MCI), an early stage of Alzheimer’s disease (AD). The posterior cingulate cortex (PCC)/precuneus is a hub of the default mode network (DMN) and is preferentially vulnerable to disruption of functional connectivity in MCI and AD. Objective: We investigated whether 12 weeks of aerobic exercise could enhance functional connectivity of the PCC/precuneus in MCI and healthy elders. Methods: Sixteen MCI and 16 healthy elders (age range = 60–88) engaged in a supervised 12-week walking exercise intervention. Functional MRI was acquired at rest; the PCC/precuneus was used as a seed for correlated brain activity maps. Results: A linear mixed effects model revealed a significant interaction in the right parietal lobe: the MCI group showed increased connectivity while the healthy elders showed decreased connectivity. In addition, both groups showed increased connectivity with the left postcentral gyrus. Comparing pre to post intervention changes within each group, the MCI group showed increased connectivity in 10 regions spanning frontal, parietal, temporal and insular lobes, and the cerebellum. Healthy elders did not demonstrate any significant connectivity changes. Conclusion: The observed results show increased functional connectivity of the PCC/precuneus in individuals with MCI after 12 weeks of moderate intensity walking exercise training. The protective effects of exercise training on cognition may be realized through the enhancement of neural recruitment mechanisms, which may possibly increase cognitive reserve. Whether these effects of exercise training may delay further cognitive decline in patients diagnosed with MCI remains to be demonstrated

Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support

Background: Research into the impact of unintended pregnancy on the wellbeing of women tends to focus on pregnancies ending in either termination or lone motherhood. Unintended pregnancy is common in partnered women, but little is known about the association between unintended pregnancy and postpartum affective disorders, such as depression and anxiety in this group. Poor relationship quality and lack of social support are considered risk factors for psychological distress (PD). We examined the association between unplanned motherhood and subsequent PD in partnered women, for whom evidence is sparse, accounting for the role of relationship quality and social support. Methods: Data for 12,462 partnered mothers were drawn from the first survey of Millennium Cohort Study, completed at 9 months postpartum. Women reported whether their baby was planned, and how they felt when they discovered that they were pregnant. Pregnancy intention is categorised as “planned”, “unplanned/happy”, “unplanned/ambivalent” and “unplanned/unhappy”. PD was assessed using the modified 9-item Rutter Malaise Inventory. Social support was measured by a composite score for perceived support, and a measure of actual support from friends and family. Relationship quality was assessed using a modified Golombok-Rust Inventory of Marital State. The effect of pregnancy intention on the odds of PD at 9 months was estimated, adjusting for potential confounding factors. All analyses were weighted for response and design effects. Results: In total 32.8%(weighted) (4343/ 12462) of mothers reported an unplanned pregnancy: 23.3wt% (3087) of mothers felt happy, 3.5wt% (475) ambivalent, and 6.0wt% (781) unhappy upon discovery. Unplanned pregnancy was associated with a significantly increased odds of PD compared to planned (OR 1.73 (95%CI: 1.53, 1.95)). This was more pronounced among women who reported negative or ambivalent feelings in early pregnancy (OR 2.72 (95%CI:2.17, 3.41) and 2.56 (95%CI:1.95, 3.34), respectively), than those who reported positive feelings (OR 1.39 (95%CI:1.21, 1.60)). Adjustment for relationship quality, in particular, reduced odds of PD after unplanned pregnancy (e.g. from 2.19 (95%C: 1.74, 2.74) to 1.63 (95% CI: 1.29, 2.07 in the unplanned, unhappy group compared to the planned). Conclusions: A third of partnered mothers reported that their pregnancy was unintended, yet this group is under-researched. Unplanned motherhood was associated with increased risk of PD at 9 months postpartum, particularly among women who felt unhappy or ambivalent at the start. The roles of relationship quality and social support require further investigation, as possible means to intervene and improve maternal wellbeing

Evaluating the Nutritional Risk of Older Adults Participating in the South Carolina Older Americans Act

Older Americans Act (OAA) services are designed to help older adults maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. Monitoring nutrition status of Area Agencies on Aging clients will help identify those at high nutritional risk for poor health outcomes and the factors contributing to that risk. This assessment will inform the development of strategies to enhance delivery of food and nutrition services to those with the greatest need. The purpose of this study is to determine population “hot spots†of high nutritional risk and their association with demographic indicators by analyzing data collected at senior centers using the South Carolina Lieutenant Governor’s Office on Aging Assessment/reassessment instrument. Preliminary results show that older adults receiving services from Area Agencies on Aging in the South Carolina’s I-95 Corridor Region have the higher nutrition risk scores. This research could be used to engage and solicit active participation of various key players in the state to improve nutritional status of older adults. Results could also be helpful in seeking to ensure adequacy of economic resources and minimize the risk of financial setbacks

Empowering junior doctors: a qualitative study of a QI programme in South West England

Aim To explore how the South-West Foundation Doctor Quality Improvement programme affected foundation year 1 (F1) doctors’ attitudes and ability to implement change in healthcare. Methods Twenty-two qualitative interviews were carried out with two cohorts of doctors. The first F1 group before and after their participation in the QI programme; the second group comprised those who had completed the programme between 1 and 5 years earlier. Qualitative data were analysed using thematic analysis techniques. Results Prior to taking part in the QI programme, junior doctors’ attitudes towards QI were mixed. Although there was agreement on the importance of QI in terms of patient safety, not all shared enthusiasm for engaging in QI, while some were sceptical that they could bring about any change. Following participation in the programme, attitudes towards QI and the ability to effect change were significantly transformed. Whether their projects were considered a success or not, all juniors reported that they valued the skills learnt and the overall experience they gained through carrying out QI projects. Participants reported feeling more empowered in their role as junior doctors, with several describing how they felt ‘listened to’ and able to ‘have a voice’, that they were beginning to see things ‘at systems level’ and learning to ‘engage more critically’ in their working environment. Conclusions Junior doctors are ideally placed to engage in QI. Training in QI at the start of their medical careers may enable a new generation of doctors to acquire the skills necessary to improve patient safety and quality of care

Development of a triage protocol for patients presenting with gastrointestinal hemorrhage: a prospective cohort study

Abstract Introduction Many patients presenting with acute gastrointestinal hemorrhage (GIH) are admitted to the intensive care unit (ICU) for monitoring. A simple triage protocol based upon validated risk factors could decrease ICU utilization. Methods Records of 188 patients admitted with GIH from the emergency department (ED) were reviewed for BLEED criteria (visualized red blood, systolic blood pressure below 100 mm Hg, elevated prothrombin time [PT], erratic mental status, and unstable comorbid disease) and complication within the first 24 hours of admission. Variables associated with early complication were reassessed in 132 patients prospectively enrolled as a validation cohort. A triage model was developed using significant predictors. Results We studied 188 patients in the development set and 132 in the validation set. Red blood (relative risk [RR] 4.53, 95% confidence interval [CI] 2.04, 10.07) and elevated PT (RR 3.27, 95% CI 1.53, 7.01) were significantly associated with complication in the development set. In the validation cohort, the combination of red blood or unstable comorbidity had a sensitivity of 0.73, a specificity of 0.55, a positive predictive value of 0.24, and a negative predictive value of 0.91 for complication within 24 hours. In simulation studies, a triage model using these variables could reduce ICU admissions without increasing the number of complications. Conclusion Patients presenting to the ED with GIH who have no evidence of ongoing bleeding or unstable comorbidities are at low risk for complication during hospital admission. A triage model based on these variables should be tested prospectively to optimize critical care resource utilization in this common condition