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• The current study is a longitudinal cohort study following stand-capable workstation intervention usage patterns in an in-situ environment.

Due to the increasing prevalence of childhood obesity, the association between classroom furniture and energy expenditure as well as physical activity was examined using a standing-desk intervention in three central-Texas elementary schools. Of the 480 students in the 24 classrooms randomly assigned to either a seated or stand-biased desk equipped classroom, 374 agreed to participate in a week-long data collection during the fall and spring semesters. Each participant’s data was collected using Sensewear® armbands and was comprised of measures of energy expenditure (EE) and step count. A hierarchical linear mixed effects model showed that children in seated desk classrooms had significantly lower (EE) and fewer steps during the standardized lecture time than children in stand-biased classrooms after adjusting for grade, race, and gender. The use of a standing desk showed a significant higher mean energy expenditure by 0.16 kcal/min (p < 0.0001) in the fall semester, and a higher EE by 0.08 kcal/min (p = 0.0092) in the spring semester. more...

The Physical Activity and Community Engagement Project utilized a comparative case study to understand how a theoretical framework called community health development (CHD) influences community capacity. Three rural communities (cases) developed interventions using a CHD framework. Researchers collected qualitative evidence measuring capacity and the CHD process for more than 3 years. Patterns identified seven capacity constructs relevant to CHD, including community history, civic participation, leadership, skills, resources, social and interorganizational networks, and critical reflection. Community health development focuses on population health improvement and strengthening community capacity. As such, it helps communities address local priorities and equips them to address future issues. more...

The Leon County Health Resource Commission sought to increase access to mental health services for their rural community. The commission formed a network of partners who collaborated to increase free transportation to mental health services outside the community and developed a telehealth-based counseling program through a counseling psychology training program. Learning opportunities emerged during the development and implementation of these activities for both the students and the community in how to successfully utilize and sustain this service. This article describes the telehealth counseling model, presents lessons learned in the process, and presents recommendations for others interested in utilizing similar strategies. more...

In order to assist staff in recognizing patients prone to violence and guide their clinical decision-making, this study summarizes mental health inpatient unit incidents over a one-year period. Results describe demographic and clinical information for patients, and evaluate risk assessment tools currently used to predict risk. A retrospective analysis included data on patients involved in incidents and frequency matched controls. There were a total of 44 incidents, caused by 38 unique patients. A constructed model to estimate patient characteristics and risk of violent incidents included involuntary admittance (OR 2.07, 95% CI 1.05-6.11, p = 0.039), more than one admission at the facility (OR 4.18, 95% CI 1.71-10.22, p = 0.002) and Global Subjective Irritability on day one (OR 4.24, 95% CI 1.77-10.16, p = 0.001). Violent incidents on the mental inpatient unit threaten safety and disrupt the therapeutic environment. The findings may be useful in aiding clinicians to quickly recognize patients that are prone to violence. more...

Exergames are an innovative type of physical activity that engages participants through interactive gameplay. One exergame growing in popularity is geocaching. Geocaching is a high-tech treasure hunt that uses GPS-enabled technology to locate hidden caches. Caches are hidden all over the world, and their coordinates are listed in an online forum ( Geocaching.com ). Exergames like geocaching are widely endorsed; however, there is a lot of information that still needs to be learned about why people participate in these activities.Thirty-four current geocachers were recruited from a larger geocaching study to learn about their motivations for engaging in the game. Individuals were asked to respond to a 30-minute phone interview, and 12 both consented and participated the interviews. Interviews assessed how individuals became involved in geocaching, how frequently they participated, who they went geocaching with, and their motivations behind geocaching. Interviews were recorded and then thematically coded.The majority of participants had geocached for more than 5 years and had learned about the activity through media. All 12 participants geocached at least once a week. The primary motivations behind geocaching were being outdoors, social interaction, physical activity, and relaxation. Individuals described geocaching as being part of a community. They typically made friends while geocaching or when they were on Geocaching.com and felt connected to other geocachers through their mutual interest.Geocaching and other exergames that use game-like properties to engage users, specifically though technology, have the potential to impact individual health through nontraditional methods of activity and socialization. more...

The authors present the results of a media documentary, Weight of the Nation, disseminated in rural communities in the Brazos Valley region of east central Texas. Researchers relied on a community-based participatory research strategy to assure community participation in the implementation and evaluation of the media documentary in rural communities. To measure the short-term effects of the documentary, the research team used a mixed-methods approach of quantitative panel data from a pre/post survey, qualitative meeting notes, and observations from facilitated discussion groups. Results showed short-term increases in behavioral intention, as well as an increase in self and collective efficacy of participants to make healthy changes at individual and community levels to reduce obesity. The findings suggest that Weight of the Nation is a catalyst for increasing awareness about obesity and initiating changes in intention and efficacy perceptions. more...

Since July 1st, 2009 in accord with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor have to be notified to the public health authorities. The aim of this extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In this paper data of the notifications in the year 2011 within the MDRO-Net Rhine-Main, an association of 7 public health authorities in the region, are reported in order to investigate whether the aims of the obligation for notification could be achieved.In 2011, 138 MRSA bloodstream infections, including 1 MRSA in liquor culture, were notified to the 7 health protection authorities, resulting in an incidence rate of 5.6/100,000 inhabitants. In urban regions with more hospitals available, the incidence rate was higher than in rural districts with less medical facilities (6.9 vs. 4.4/100,000 inhabitants). Only 46 (35%) of the patients with MRSA cultured in their blood had been detected via anamnesis as patients on risk for MRSA, and 59 (45%) had been screened for MRSA on admission. The incidence rate in the different hospitals was 0.041 ± 0.031/1,000 patient days (range 0-0.145/1,000 patient days).For the first time, data on notification of MRSA cultures in blood specimen are published from a whole MRE Network in Germany encompassing2.1 million inhabitants. Incidence rates per 100,000 inhabitants alone do not seem adequate to cope with the aims of the obligation for notification. Instead, reference to patient days in the respective clinic enables an external comparison to other medical institutions in the region and is a better base for discussion with these institutions on improvements of surveillance, screening and hygiene. more...

Examined the severity of depressive symptoms and the rates of probable depression assessed by different instruments that were included in two separate surveys of residents in a predominately rural region of the United States.Surveys of the Brazos Valley region in south central Texas were conducted and responses to the short form of the Center for Epidemiological Studies-Depression scale (in the 2006 survey) and the Patient Health Questionnaire-9 (in the 2010 survey) were analyzed.Regardless of instrument used, results indicate that women and African Americans are at greater risk for depression in this underserved region, but no unique effects were found for rural residency.Implications for research, assessment, program planning, and policy are discussed. more...

Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation. more...

The purpose of this study was to determine the relative electromyographic (EMG) activity of the upper and lower rectus abdominis and the external oblique muscles during 5 commonly performed abdominal strengthening exercises. Twenty-five healthy subjects participated in the study. EMG data were collected under isometric and dynamic conditions. The reverse curl resulted in the greatest amount of lower rectus activity, the v-sit and reverse curl exercises resulted in the greatest amount of external oblique activity, and the trunk curl, reverse curl, trunk curl with a twist, and v-sit all resulted in similar amounts of upper rectus EMG activity. The vacuum exercise resulted in moderate levels of external oblique EMG activity but very low levels of activity in the rectus abdominis. Our findings support the concept that abdominal strengthening exercises can differentially activate various abdominal muscle groups, but contradict some traditionally held assumptions regarding the effects of specific exercises. more...

Science-especially scientific investigations about toxic agents--has greatly improved our knowledge of toxic effects on humans in the last years. The fact that even very low concentrations of anthropogenic noxae can be harmful, is now well established. The population at large has developed considerable sensitivity and mind expansion for these problems, in respect of those pollutants, which can be expected to harm both human health and the environment. The fear that man-made pollution increases the risk of diseases is justified. For these reasons public health offices are being increasingly questioned practising and challenged by the population in General and also by physicians. Hence, in 1990 we decided to set up an advisory board in environmental medicine within the public health office to meet these demands. The idea behind this consulting project is to inform the community, the practitioners and especially the persons concerned with possible solutions of such problems. In the following we report on the planning, contents and aims of this programme. Summing up our experiences so far, we can say that the main task lies in the necessity to respond to individual problems of those who are concerned, of there who asked questions, and who take advantage of our offer. This is a difficult and demanding task, but it is worthwhile, because there is no alternative. Within a few months we successfully established the advisory board that has proved useful both to patients and to practising physicians. more...

The pharmacokinetics and the endocrine profile of a new low molecular somatostatin derivative, SMS 201–995, were investigated in a group of 35 normal subjects. Clearance studies (n = 6) for this peptide showed a prolonged half-life in plasma, 113 min, following single sc injections of 50 or 100 μg. Arginine stimulation tests (n = 6) were conducted immediately and 180 min after sc injection of 50 μg of SMS 201–995. The stimulatory effect of arginine on GH and insulin was counteracted by the peptide at the P < 0.001 and P < 0.02 significance level, respectively. Delayed arginine stimulation revealed a persistent blockade of the GH release (P < 0.02), whereas a recovery of the insulin response was observed. Plasma glucagon increments following a standard protein meal (n = 10) were significantly (P < 0.001) inhibited by previous sc injection of 50 μg of SMS 202–995. Pretreatment with 50 and 100 μ of SMS 202–995 sc (n = 9) inhibited (P < 0.001) the stimulatory effect of TRH (200 μg iv) on TSH without modifying basal levels. The injection of 100 μg/h during sleep completely abolished the nocturnal GH peak in 4 volunteers. No rebound rise after decline of the suppressive action on GH was recorded in any of the trials. Safety chemistries and blood coagulation studies remained normal and no side-effects or untoward reactions were recorded throughout the investigation. With its high potency, slow plasma clearance, and long action SMS 201–995 may represent a valuable tool in the long-term management of states of inappropriate GH secretion. more...

To strengthen existing evidence on the role of neighborhoods in chronic disease onset in later life, we investigated associations between multiple neighborhood features and 2-year onset of 6 common conditions using a national sample of older adults.Neighborhood features for adults aged 55 years or older in the 2002 Health and Retirement Study were measured by use of previously validated scales reflecting the built, social, and economic environment. Two-level random-intercept logistic models predicting the onset of heart problems, hypertension, stroke, diabetes, cancer, and arthritis by 2004 were estimated.In adjusted models, living in more economically disadvantaged areas predicted the onset of heart problems for women (odds ratio [OR] = 1.20; P.05). Living in more highly segregated, higher-crime areas was associated with greater chances of developing cancer for men (OR = 1.31; P.05) and women (OR = 1.25; P.05).The neighborhood economic environment is associated with heart disease onset for women, and neighborhood-level social stressors are associated with cancer onset for men and women. The social and biological mechanisms that underlie these associations require further investigation. more...