Mixed-methods assessment of a local Meals on Wheels program

Community food and nutrition programs, such as home-delivered meals (HDM), support the health and well-being of older adults. The purpose of this study was to conduct a needs assessment of a local Meals on Wheels (MOW) program using a mixed-methods approach. Study One assessed nutritional risk (NR) and dietary intake frequencies (DIF) among newly enrolled MOW participants (n=167), utilizing the dietary screening tool. Participants were primarily female (62.9%), and enrolled in MOW during a winter month (85%). Nearly all (97.6%) were “at NR” or “at possible NR.” NR was attributed to “low” DIF of dairy, lean protein, and processed meat. Gender significantly influenced NR (p\u3c .05), with males averaging a higher nutritional risk score. Season of MOW enrollment and whether participants had access to cooking appliances did not have a meaningful impact on NR or DIF. Study Two evaluated factors influencing MOW or HDM participation. Four focus groups were conducted determining awareness, perceptions, motivators, barriers, and preferred program attributes; 31 older adults participated. All completed a sociodemographic questionnaire. Focus group sessions were audio-recorded, transcribed, and analyzed for themes using framework analysis. Sociodemographic questionnaires were analyzed using descriptive statistics. Participants were mostly retired, White females between ages 65-84 years. Over half (54.8%) were involved in a congregate meal program. A majority were responsible for their own transportation (80.6%), food purchases (80.6%), and meal preparation (77.4%). Most were aware of MOW, but not of other HDM services. MOW was positively associated with companionship, and negatively linked to loss of independence and poor food quality. Motivators to HDM participation were affordability, menu choice, involvement of dietitian/nutritionist, and positive testimonies from past clientele. Barriers included affordability, skepticism of program marketing claims, food safety concerns, and limited meal storage space. Preferred program attributes were convenience and quality menu options. Promotional references included brochures and in-person group presentations with taste testing. These findings demonstrate the high NR of newly enrolled MOW participants and highlight the pre-conceived perceptions influencing HDM participation. These findings can be used to modify MOW offerings to help reduce NR of participants as well as better promote the MOW program toward older adults

Quantified vegetation change over 42 years at Cape Hallett, East Antarctica

This paper reports on the remapping of a carefully documented vegetation plot at Cape Hallett (72°19′S 170°16′E) to provide an assessment of the rates of vegetation change over decadal time scales. E.D. Rudolph, in 1962, mapped in detail the vegetation of a site approximately 28 m by 120 m at Cape Hallett, Victoria Land, Antarctica. This site was relocated and remapped in January 2004 and changes were assessed using GIS techniques. This appears to be the longest available time period for assessing vegetation change in Antarctica. The analysis indicated that considerable change had occurred in moss and algae distribution patterns and this seems to have been caused by increased water supply, particularly in wetter areas. There was also evidence of some change in lichen distribution. The extent of the change indicates that vegetation cover can be used for monitoring change in areas as extreme as the Ross Sea region. For this analysis to be successful it was important that the mapping techniques used were totally explicit and could easily be replicated. Fortunately, Rudolph had defined his cover classes and the site was also clearly marked. The application of GIS mapping techniques allows the mapping to be more explicitly defined and easily replicated

Evaluation of a school-based physical activity intervention in Alexandra Township

Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg. Evaluation of Healthnutz included assessing its feasibility and acceptability, and short-term changes in learners’ physical fitness, knowledge and attitudes. Methods. To assess feasibility and acceptability, a situational analysis and focus groups with teachers and programme monitors were conducted. Pre-post fitness testing (3-month interval) was conducted with learners, and a questionnaire assessed changes in learners’ knowledge, attitudes, self-efficacy, and perceived barriers to physical activity, in control and intervention schools. Results. At implementation, teachers identified the need for more physical activity in the school environment and were positive about Healthnutz. Follow-up focus group discussions suggested that it was positively impacting teachers, learners and the school in general. Scores for sit and reach (p<0.001), sit ups (p<0.02) and shuttle run (p<0.0001) improved significantly in intervention but not control schools. A significant decrease was observed in learners’ perceived external barriers to physical activity (p<0.0001) along with a positive change in learners’ self-efficacy for physical activity (p<0.05). Conclusions. Healthnutz raised awareness of the importance of physical activity in intervention schools. Findings indicate that even limited exposure to a physical activity intervention can lead to a significant improvement in aspects of learners’ fitness, knowledge, attitudes and perceptions regarding physical activity. Furthermore, training and support of teachers needs to be nonjudgemental and empowering

Orbiter Boundary Layer Transition Prediction Tool Enhancements

Updates to an analytic tool developed for Shuttle support to predict the onset of boundary layer transition resulting from thermal protection system damage or repair are presented. The boundary layer transition tool is part of a suite of tools that analyze the local aerothermodynamic environment to enable informed disposition of damage for making recommendations to fly as is or to repair. Using mission specific trajectory information and details of each d agmea site or repair, the expected time (and thus Mach number) of transition onset is predicted to help define proper environments for use in subsequent thermal and stress analysis of the thermal protection system and structure. The boundary layer transition criteria utilized within the tool were updated based on new local boundary layer properties obtained from high fidelity computational solutions. Also, new ground-based measurements were obtained to allow for a wider parametric variation with both protuberances and cavities and then the resulting correlations were calibrated against updated flight data. The end result is to provide correlations that allow increased confidence with the resulting transition predictions. Recently, a new approach was adopted to remove conservatism in terms of sustained turbulence along the wing leading edge. Finally, some of the newer flight data are also discussed in terms of how these results reflect back on the updated correlations

Revising Diabetes Programming for Black Men and Their Families

Type-2 diabetes has increased 160% for African American males in the United States. This two-part study’s purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men’s lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life

Determinants of Agricultural Pesticide Concentrations in Carpet Dust

Background: Residential proximity to agricultural pesticide applications has been used as a surrogate for exposure in epidemiologic studies, although little is known about the relationship with levels of pesticides in homes

Efficacy and Safety of Intravitreal Gene Therapy for Leber Hereditary Optic Neuropathy Treated within 6 Months of Disease Onset.

PURPOSE: To evaluate the efficacy of a single intravitreal injection of rAAV2/2-ND4 in subjects with visual loss from Leber hereditary optic neuropathy (LHON). DESIGN: RESCUE is a multicenter, randomized, double-masked, sham-controlled, phase 3 clinical trial. PARTICIPANTS: Subjects with the m.11778G>A mitochondrial DNA mutation and vision loss ≤6 months from onset in 1 or both eyes were included. METHODS: Each subject's right eye was randomly assigned (1:1) to treatment with rAAV2/2-ND4 (single injection of 9 × 1010 viral genomes in 90 μl) or to sham injection. The left eye received the treatment not allocated to the right eye. MAIN OUTCOME MEASURES: The primary end point was the difference of the change from baseline in best-corrected visual acuity (BCVA) between rAAV2/2-ND4-treated and sham-treated eyes at week 48. Other outcome measures included contrast sensitivity, Humphrey visual field perimetry, retinal anatomic measures, and quality of life. Follow-up extended to week 96. RESULTS: Efficacy analysis included 38 subjects. Mean age was 36.8 years, and 82% were male. Mean duration of vision loss at time of treatment was 3.6 months and 3.9 months in the rAAV2/2-ND4-treated eyes and sham-treated eyes, respectively. Mean baseline logarithm of the minimum angle of resolution (logMAR) BCVA (standard deviation) was 1.31 (0.52) in rAAV2/2-ND4-treated eyes and 1.26 (0.62) in sham-treated eyes, with a range from -0.20 to 2.51. At week 48, the difference of the change in BCVA from baseline between rAAV2/2-ND4-treated and sham-treated eyes was -0.01 logMAR (P = 0.89); the primary end point of a -0.3 logMAR (15-letter) difference was not met. The mean BCVA for both groups deteriorated over the initial weeks, reaching the worst levels at week 24, followed by a plateau phase until week 48, and then an improvement of +10 and +9 Early Treatment Diabetic Retinopathy Study letters equivalent from the plateau level in the rAAV2/2-ND4-treated and sham-treated eyes, respectively. CONCLUSIONS: At 96 weeks after unilateral injection of rAAV2/2-ND4, LHON subjects carrying the m.11778G>A mutation treated within 6 months after vision loss achieved comparable visual outcomes in the injected and uninjected eyes