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Computer-based, standardized, comprehensive testing is becoming a popular assessment tool in nursing education. This study sought to determine student response and satisfaction regarding such testing at a large state nursing school. Surveys that reviewed the entire testing process were provided to all students taking the computerized testing. Student feedback led to revisions for future testing. [ABSTRACT FROM AUTHOR]

Background: Air pollution is a modifiable risk factor for dementia. Yet, studies on specific sources of air pollution (i.e., toxic chemical emissions from industrial facilities) and dementia risk are scarce. We examined associations between toxicity-weighted concentrations of industrial pollution and dementia outcomes among a large, multi-site cohort of older adults., Methods: Participants (n = 2770) were ≥ 65 years old (Mean = 75.3, SD = 5.1 years) from the Cardiovascular Health Cognition Study (1992-1999). Toxicity-weighted concentrations were estimated using the Risk Screening Environmental Indicator (RSEI) model which incorporates total reported chemical emissions with toxicity, fate, and transport models. Estimates were aggregated to participants' baseline census tract, averaged across 1988-1992, and log2-transformed. Dementia status was clinically adjudicated in 1998-1999 and categorized by subtype (Alzheimer's, vascular, mixed). We assessed whether RSEI-estimated toxicity-weighted concentrations were associated with 1) odds of prevalent dementia and 2) incident dementia risk by subtype., Results: After adjusting for individual and census-tract level covariates, a doubling in toxicity-weighted concentrations was associated with 9 % higher odds of prevalent dementia (OR = 1.09, 95 % CI: 1.00, 1.19). In discrete-time survival models, each doubling in toxicity-weighted concentrations was associated with a 16 % greater hazard of vascular dementia (HR = 1.16, 95 % CI: 1.01, 1.34) but was not significantly associated with all-cause, Alzheimer's disease, or mixed dementia (p's > 0.05)., Discussion: Living in regions with higher toxicity-weighted concentrations was associated with higher odds of prevalent dementia and a higher risk of incident vascular dementia in this large, community-based cohort of older adults. These findings support the need for additional studies to examine whether toxic chemical emissions from industrial and federal facilities may be a modifiable target for dementia prevention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: With rapidly growing members of the Islamic faith, health care providers should expect to care for Muslim patients regardless of their chosen specialty. The quality of care provided hinges on their knowledge and understanding of Islam. This study aimed to analyze the influence of an educational animation on undergraduate nursing students' cultural comfort and knowledge concerning the health care needs of Muslims., Methods: An educational animation was created addressing the unique health care needs of Muslim patients. Surveys (pre, post, 6 weeks) ( n = 658) assessed cultural comfort and knowledge on covered topics., Results: Student knowledge (pre: 12.4 ± 0.1; post: 14.4 ± 0.2; p < .01) and cultural comfort (pre: 4.0 ± 0.03; post: 4.1 ± 0.03; p < .05) increased after viewing the online educational animation. The increase in knowledge was sustained at 6 weeks. Students recommended additional topics for the future., Discussion: This study highlights how an innovative educational animation can enhance students' understanding of providing care for Muslim patients, positively impacting patient outcomes., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Only 21% of U.S. women meet the recommended physical activity guidelines, placing them at increased risk for long-term conditions such as heart disease and diabetes. Physical activity is influenced by individual and interpersonal factors (e.g., romantic partners). Individual factors, such as positive affect, are associated with lower mortality risk and improved health behaviors., Objectives: This secondary data analysis, guided by Fredrickson's Broaden and Build Theory, aims to examine the relationship between positive affect of married women (n = 115 couples) and their physical activity behavior on the same- and next- day, while also considering their spouses' positive affect., Methods: Two population average models assessed the relationship of calm and happy (positive affect) to physical activity. Physical activity was assessed as the sum of the minutes of moderate-to-vigorous physical activity (MVPA) over the prior 24 hours. Covariates of age, baseline activity frequency, education, marital quality, and race/ethnicity were also included., Results: Women's happiness ( β = 0.15, p < .005), not calmness ( β = -0.03, p = .60), was found to have a significant association with same-day MVPA. Spouses' happiness ( β = 0.11, p = .045) was significantly associated with women's next-day MVPA while their calmness ( β = -0.04, p = .44) was not., Conclusions: The results of this study support that incorporating positive affect could be valuable for improving physical activity behaviors. Spouse reports provide additional context to consider in physical activity promotion research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Energy and dietary quality are known to differ between weekdays and weekends. Data-driven approaches that incorporate time, amount, and duration of dietary intake have previously been used to partition participants' daily weekday dietary intake time series into clusters representing weekday temporal dietary patterns (TDPs) linked to health indicators in United States adults. Yet, neither the relationship of weekend day TDPs to health indicators nor how the TDP membership may change from weekday to weekend is known., Objectives: This study was conducted to determine the association between TDPs on weekdays and weekend days and health indicators [diet quality, waist circumference (WC), body mass index (BMI), and obesity] and their overlap among participants., Methods: A weekday and weekend day 24-hour dietary recall of 9494 nonpregnant United States adults aged 20-65 years from the cross-sectional National Health and Nutrition Examination Survey 2007-2018 was used to determine the timing and amount of energy intake. Modified dynamic time warping and kernel k-means algorithm clustered participants into 4 TDPs on weekdays and weekend days. Multivariate regression models determined the associations between TDPs and health indicators, controlling for potential confounders and adjusting for the survey design and multiple comparisons. The percentages of overlap in cluster membership between TDPs on weekdays and weekend days were also determined., Results: United States adults with a TDP of evenly spaced, energy-balanced eating occasions, representing the TDP of more than one-third of all adults on weekdays and weekends, had significantly higher diet quality, lower BMI, WC, and odds of obesity when compared to those with other TDPs. Membership of most United States adults to TDPs varied from weekdays to weekends., Conclusions: Both weekday and weekend TDPs were significantly associated with health indicators. TDP membership of most United States adults was not consistent on weekdays and weekends., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Daily temporal patterns of energy intake (temporal dietary patterns [TDPs]) and physical activity (temporal physical activity patterns [TPAPs]) have been independently and jointly (temporal dietary and physical activity patterns [TDPAPs]) associated with health and disease status indicators., Objective: The aim of this study was to compare the number and strength of association between clusters of daily TDPs, TPAPs, and TDPAPs and multiple health and disease status indicators., Design: This cross-sectional study used 1 reliable weekday dietary recall and 1 random weekday of accelerometer data to partition to create clusters of participants representing the 3 temporal patterns. Four clusters were created via kernel-k means clustering algorithm of the same constrained dynamic time warping distance computed over the time series for each temporal pattern., Participants/setting: From the National Health and Nutrition Examination Survey (2003-2006), 1,836 US adults aged 20 through 65 years who were not pregnant and had valid diet, physical activity, sociodemographic, anthropometric, questionnaire, and health and disease status indicator data were included., Main Outcome Measures: Health status indicators used as outcome measures were body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, triglycerides, high-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure; disease status indicators included obesity, type 2 diabetes mellitus, and metabolic syndrome., Statistical Analyses Performed: Multivariate regression models determined associations between the clusters representing each pattern and health and disease status indicators, controlling for confounders and adjusting for multiple comparisons. The number of significant differences among clusters and adjusted R 2 and Akaike information criterion compared the strength of associations between clusters of patterns and continuous and categorical health and disease status indicators., Results: TDPAPs showed 21 significant associations with health and disease status indicators, including body mass index, waist circumference, obesity, and type 2 diabetes; TDPs showed 19 significant associations; and TPAPs showed 8 significant associations., Conclusions: TDPAPs and TDPs had stronger and more numerous associations with health and disease status indicators compared with TPAPs. Patterns representing the integration of daily dietary habits hold promise for early detection of obesity., (Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: Twitter, a microblogging service, allows users to post short messages (tweets) and link posts through hashtags, creating online communities to enable dissemination of health education. The objective of this descriptive study was to examine Twitter's #PhysicalActivity health education and promotion efforts, including differences in response before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic., Design Setting and Methods: A codebook was developed to conduct a quantitative content analysis of #PhysicalActivity tweets before and during the COVID-19 pandemic. Twitter's Advanced Search parameters included minimum 1 reply, 25 likes and 5 retweets. Tweets were double-coded for user characteristics, community response, tweet elements (video, photo, link, questions, events, original text, survey/response, journal article, infographic) and intended audience. T -tests examined differences in researcher-generated NET response (replies + retweets + likes) between COVID-19 and comparison years., Results: Data were collected from 400 tweets. Eighty percent of tweets were from personal accounts, with over half indicating the possession of a health professional degree. Twenty-nine percent of tweets gave behavioural recommendations of which 56.8% provided a rationale. Nearly all used at least two components, text and photos most common. The general public was the most intended audience with health professionals second. While the NET response was greater during COVID-19 ( M = 139.6, SD = 156.8) than prior to it ( M = 116.8, SD = 105.1), the difference was not statistically significant ( p = .091)., Conclusion: Twitter platform provided an opportunity to disseminate health education, specifically for the promotion of physical activity, while adhering to public health recommendations to #StaySafeStayHome. Our findings provide insights into engaging this online community to inform future physical education and promotion dissemination., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2023.)

Background: Breast cancer and its treatment are associated with aberrant patterns of resting state functional connectivity (rsFC) between the hippocampus and several areas of the brain, which may account for poorer cognitive outcomes in patients. Higher cardiorespiratory fitness (CRF) has been associated with enhanced rsFC and cognitive performance; however, these associations have not been well studied in breast cancer. We examined the relationship between CRF, rsFC of the hippocampus, and cognitive performance among women newly diagnosed with breast cancer., Methods: Thirty-four postmenopausal women newly diagnosed with Stage 0-IIIa breast cancer ( M age = 63.59 ± 5.73) were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. During baseline assessments, participants completed functional brain imaging, a submaximal CRF test, and cognitive testing. Whole-brain, seed-based analyses were used to examine the relationship between CRF and hippocampal rsFC, with age, years of education, and framewise displacement included as covariates. Cognition was measured with a battery of validated neurocognitive measures, reduced to seven composite factors., Results: Higher CRF was positively associated with greater rsFC of the hippocampus to a cluster within the dorsomedial and dorsolateral frontal cortex ( z -max = 4.37, p = 0.003, cluster extent = 1,020 voxels). Connectivity within cluster peaks was not significantly related to cognitive factors (all p s > 0.05)., Discussion: CRF was positively associated with hippocampal rsFC to frontal cortex structures, comprising a network of regions commonly suppressed in breast cancer. Future longitudinal research is needed to explore whether baseline rsFC predicts long-term cognitive resilience in breast cancer., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

A broad set of factors are associated with falling (e.g., age, sex, physical activity, vision, health), but their co-occurrence is understudied. Our objectives were to quantify the number and pattern of co-occurring fall-related factors. Data were obtained from the U.S. National Health and Nutrition Examination Survey (N = 1,957, 60-85 years). Twenty fall-related factors were included (based on previous research), covering a wide range including cognitive, motor, sensory, health, and physical activity measures. The number and pattern of co-occurring fall-related factors were quantified with logistic regression and cluster analyses, respectively. Most participants (59%) had ≥4 fall-risk factors, and each additional risk factor increased the odds of reporting difficulty with falling by 1.28. The identified clusters included: (1) healthy, (2) cognitive and sensory impaired, and (3) health impaired. The mean number of co-occurring fall-related factors was 3.7, 3.8, and 7.2, for clusters 1, 2, and 3, respectively (p&lt;0.001). These observations indicate that co-occurrence of multiple fall-risk factors was common in this national sample of U.S. older adults and the factors tended to aggregate into distinct clusters. The findings support the protective effect of physical activity on fall-risk, the association between gait speed and falls, and the detrimental effect of health-related factors on difficulty with falls (e.g., arthritis, prescription medications). Cluster analyses revealed a complex interplay between sex and BMI that may alter the role of BMI in the etiology of falls. Cluster analyses also revealed a large detrimental effect of health-related factors in cluster 3; it is important to extend current fall interventions (typically focused on balance, flexibility, strength, cognitive, fear factors) to include health-related interventions that target factors such as BMI and arthritis., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Rietdyk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Although physical activity is linked to multiple health outcomes, a majority of Americans do not meet physical activity guidelines, often with precipitous declines among older adults. Marital quality is a less-explored, but important, factor that may influence physical activity, as spouses often influence each other's health behaviors., Methods: We use nationally representative panel data to investigate whether positive and negative dimensions of marital quality influence physical activity, and whether age and gender moderate these relationships., Results: We find that both marital support and strain are related to higher odds of more frequent active exercise and walking, pointing to the complex influence of marital quality. Marital support became increasingly important to higher levels of walking frequency as men aged., Discussion: This study provides new information on the ways in which both positive and negative dimensions of marital quality may contribute to trajectories of physical activity across the life course.

Data-driven temporal dietary patterning (TDP) methods were previously developed. The objectives were to create data-driven temporal dietary patterns and assess concurrent validity of energy and time cut-offs describing the data-driven TDPs by determining their relationships to BMI and waist circumference (WC). The first day 24-h dietary recall timing and amounts of energy for 17,915 U.S. adults of the National Health and Nutrition Examination Survey 2007−2016 were used to create clusters representing four TDPs using dynamic time warping and the kernel k-means clustering algorithm. Energy and time cut-offs were extracted from visualization of the data-derived TDPs and then applied to the data to find cut-off-derived TDPs. The strength of TDP relationships with BMI and WC were assessed using adjusted multivariate regression and compared. Both methods showed a cluster, representing a TDP with proportionally equivalent average energy consumed during three eating events/day, associated with significantly lower BMI and WC compared to the other three clusters that had one energy intake peak/day at 13:00, 18:00, and 19:00 (all p < 0.0001). Participant clusters of the methods were highly overlapped (>83%) and showed similar relationships with obesity. Data-driven TDP was validated using descriptive cut-offs and hold promise for obesity interventions and translation to dietary guidance.

Despite considerable advances in recent years, challenges in delivery and storage of biological drugs persist and may delay or prohibit their clinical application. Though nanoparticle-based approaches for small molecule drug encapsulation are mature, encapsulation of proteins remains problematic due to destabilization of the protein. Reverse micelles composed of decylmonoacyl glycerol (10MAG) and lauryldimethylamino-N-oxide (LDAO) in low-viscosity alkanes have been shown to preserve the structure and stability of a wide range of biological macromolecules. Here, we present a first step on developing this system as a future platform for storage and delivery of biological drugs by replacing the non-biocompatible alkane solvent with solvents currently used in small molecule delivery systems. Using a novel screening approach, we performed a comprehensive evaluation of the 10MAG/LDAO system using two preparation methods across seven biocompatible solvents with analysis of toxicity and encapsulation efficiency for each solvent. By using an inexpensive hydrophilic small molecule to test a wide range of conditions, we identify optimal solvent properties for further development. We validate the predictions from this screen with preliminary protein encapsulation tests. The insight provided lays the foundation for further development of this system toward long-term room-temperature storage of biologics or toward water-in-oil-in-water biologic delivery systems.

Background: Diet and physical activity (PA) are independent risk factors for obesity and chronic diseases including type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). The temporal sequence of these exposures may be used to create patterns with relations to health status indicators., Objectives: The objectives were to create clusters of joint temporal dietary and PA patterns (JTDPAPs) and to determine their association with health status indicators including BMI, waist circumference (WC), fasting plasma glucose, glycated hemoglobin, triglycerides, HDL cholesterol, total cholesterol, blood pressure, and disease status including obesity, T2DM, and MetS in US adults., Methods: A 24-h dietary recall and random day of accelerometer data of 1836 participants from the cross-sectional NHANES 2003-2006 data were used to create JTDPAP clusters by constrained dynamic time warping, coupled with a kernel k-means clustering algorithm. Multivariate regression models determined associations between the 4 JTDPAP clusters and health and disease status indicators, controlling for potential confounders and adjusting for multiple comparisons., Results: A JTDPAP cluster with proportionally equivalent energy consumed at 2 main eating occasions reaching ≤1600 and ≤2200 kcal from 11:00 to 13:00 and from 17:00 to 20:00, respectively, and the highest PA counts among 4 clusters from 08:00 to 20:00, was associated with significantly lower BMI (P < 0.0001), WC (P = 0.0001), total cholesterol (P = 0.02), and odds of obesity (OR: 0.2; 95% CI: 0.1, 0.5) than a JTDPAP cluster with proportionally equivalent energy consumed reaching ≤1600 and ≤1800 kcal from 11:00 to 14:00 and from 17:00 to 21:00, respectively, and high PA counts from 09:00 to 12:00., Conclusions: The joint temporally patterned sequence of diet and PA can be used to cluster individuals with meaningful associations to BMI, WC, total cholesterol, and obesity. Temporal patterns hold promise for future development of lifestyle patterns that integrate additional temporal and contextual activities., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Introduction: Get WalkIN' is a 12-week, e-mail-based walking promotion program. The purpose of this study was to (1) compare sociodemographics of participants who enrolled versus completed the program; and (2) evaluate program feasibility/acceptability from perspectives of program participants and county-based Extension Educators who implemented the program., Methods: Participants (N = 875), recruited by county-based Extension Educators, were asked Likert-scale questions (eg, ease of reading the e-mails and frequency of e-mails) to assess program acceptability and open-ended questions regarding improvements. Educators (N = 55) were asked Likert-scale and open-ended questions regarding program training, recruitment, strengths, and areas for improvement. Descriptive statistics summarized participant characteristics, acceptability, and feasibility data. Open-ended responses were analyzed using thematic analysis., Results: There were no significant sociodemographic differences between participants (N = 875) who started the program and completed the program (n = 438). Participants reported intervention e-mails were easy to read (mean = 4.5 ± 0.7), understand (mean = 4.5 ± 0.7), and encouraged more walking (mean = 4.1 ± 0.9). Participants would like to connect/interact with other participants/Educators, have more monitoring tools for accountability, and more visuals/videos embedded within e-mails. Educators reported program training was adequate, e-mail messages were helpful and easy to use, and requested more visuals (eg, videos) to help with recruitment. Educators thought adding a social component (eg, kick-off walk or walking group) would be helpful., Conclusions: This Extension-delivered walking program is acceptable to participants and feasible to deliver. However, participants and Educators reported they would like more interaction, even if virtual. Future e-mail-based programs should consider ways to incorporate social interaction among users as well as provide a wide variety of recruitment resources.

Despite the clear benefits of an active lifestyle, most American adults fail to meet physical activity (PA) guidelines. Because of its safety and ease, walking is a promising population-level strategy to increase PA. There is a need to further understand why adults do and do not participate in walking. This study provides a broader understanding of barriers and motivators of walking prior to starting a walking program. Four years of baseline data from a community-based walking program were analyzed (n = 1491). Descriptive statistics summarized participant characteristics, barriers, reinforcements, and current PA. Chi-square tests were used to assess differences in the barrier and reinforcement responses between participant's PA level and age categories. Open-ended responses were analyzed using thematic analysis. On average, participants were white (96%), middle-aged (52 ± 13 years old) females (92%). Poor weather and time were frequently reported barriers to walking. Open-ended responses (n = 141) identified additional barriers of lack of motivation (n = 37), joint issues (n = 29), fatigue (n = 24), safety or lack of environmental supports (n = 17), family or work demands (n = 15), and lacking a walking partner (n = 9). Good weather, health, and weight loss were frequently reported motivators. Additional motivators (n = 282) identified included stress relief and mental health (n = 82), social time (n = 70), dog care (n = 41), other health benefits (n = 38), connect with nature (n = 19), enjoyment (14), occupation (n = 11), and environmental and community supports (n = 6). Findings highlight the importance of understanding participant barriers and motivators for PA before starting a program. Future research should examine how reported barriers and motivators are related to program completion and adherence. Tailoring community-based programs to address specific barriers and motivators may enable more participants to effectively change and maintain PA.

Affective states, such as feelings of anger and excitement, are linked to health outcomes and behaviors. The benefits of physical activity for individual affect is known; however, how affect influences physical activity participation is less understood. Using Whittemore and Knafl's framework, this integrative review examines the influence of affect on adult physical activity. using six databases, 19 articles published between 1997 and 2019. Themes found include support for the influence of positive affect on increased physical activity, a temporal aspect of affect, a variety of measurement tools, and varying uses of theoretical frameworks across studies. Advanced practice nurses and registered nurses may improve patient health behaviors, such as physical activity, by incorporating affect-focused assessments. Review findings support consideration of affect in physical activity counseling. Further research using theory-driven methods and consistent affect assessments is needed to test the complex relationship between affect and physical activity.

Objective: Children and adolescents have greater resting cerebral blood flow (rCBF) during periods of rapid brain growth. Overweight and obesity have a global impact on brain cerebrovascular health in adults, but whether these effects are discernable in adolescents with overweight and obesity remains unknown. This study examined differences in rCBF between adolescents with a healthy weight (HW) and adolescents with overweight or obesity (OW)., Methods: The current study focused on analyzing data from 58 participants (mean age = 15.43 [SD 1.37] years). Participants were classified into OW (n = 38) and HW groups (n = 20) according to the Centers for Disease Control and Prevention's guidelines for children. Voxelwise t tests between the HW and OW groups were conducted to test for regional group differences in rCBF, controlling for age and sex. Mean rCBF was extracted from a gray matter mask to compare global rCBF between the HW and OW groups., Results: The HW group had greater rCBF compared with the OW group in five clusters, with peaks in the cerebellum, precentral gyrus, and supplementary motor area. No clusters survived correction for the OW > HW contrast. Global rCBF did not significantly differ between the groups (p = 0.09)., Conclusions: These results suggest that overweight and obesity in adolescence are associated with discernable reductions in blood flow to specific brain regions rather than having a global impact on rCBF., (© 2021 The Obesity Society.)

Few attempts have been made to incorporate multiple aspects of physical activity (PA) to classify patterns linked with health. Temporal PA patterns integrating time and activity counts were created to determine their association with health status. Accelerometry data from the National Health and Nutrition Examination Survey 2003-2006 was used to pattern PA counts and time of activity from 1999 adults with one weekday of activity. Dynamic time warping and kernel k-means clustering partitioned 4 participant clusters representing temporal PA patterns. Multivariate regression models determined associations between clusters and health status indicators and obesity, type 2 diabetes, and metabolic syndrome. Cluster 1 with a temporal PA pattern of the lowest activity counts reaching 4.8e 4 cph from 6:00-23:00 was associated with higher body mass index (BMI) (β = 2.5 ± 0.6 kg/m 2 , 95% CI: 1.0, 4.1), higher waist circumference (WC) (β = 6.4 ± 1.3 cm, 95% CI: 2.8, 10.0), and higher odds of obesity (OR: 2.4; 95% CI: 1.3, 4.4) compared with Cluster 3 with activity counts reaching 9.6e 4 -1.2e 5 cph between 16:00-21:00. Cluster 1 was also associated with higher BMI (β = 1.5 ± 0.5 kg/m 2 , 95% CI: 0.1, 2.8) and WC (β = 3.6 ± 1.3 cm, 95% CI: 0.1, 7.0) compared to Cluster 4 with activity counts reaching 9.6e 4 cph between 8:00-11:00. A Temporal PA pattern with the lowest PA counts had significantly higher mean BMI and WC compared to temporal PA patterns of higher activity counts performed early (8:00-11:00) or late (16:00-21:00) throughout the day. Temporal PA patterns appear to meaningfully link to health status., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Obesity is a costly and pervasive risk factor that requires attention to reduce chronic disease rates. This study evaluated the effect of a lifestyle medicine intervention, Complete Health Improvement Program (CHIP), on reducing weight, blood pressure, lipid levels, and hemoglobin A1c. A secondary aim was to build a preliminary predictive model for computing new participants' potential weight change from CHIP. We evaluated pre- and post-intervention biometric data of 68 individuals who completed a 10-week CHIP intervention at a Midwestern university clinic. Significant reductions ( p < 0.05) were observed in weight, diastolic blood pressure, total cholesterol, low-density lipoprotein, and A1c. Regression analyses indicated that the best linear model for predicting change in weight was a one-predictor model with systolic blood pressure. The CHIP intervention effectively promoted weight loss and meaningful reductions in chronic disease risk factors. Larger samples are needed for future regression analyses to create a more robust linear model.

Background: Walking at a brisk pace is widely recommended to promote health. When partners walk together, walking activity is increased and maintained due to enhanced social support and accountability, but at least one person must adjust their gait speed. Decreased gait speed could compromise health benefits, which may be especially relevant for the aging population., Research Question: Do adults change gait speed when walking with their romantic partner, relative to walking alone, and is the change in speed affected by age or pathway conditions?, Methods: Participants were 141 individuals from 72 romantic couples; age range 25-79 years. The three couple conditions were walking alone, walking with their partner, and walking while holding hands with their partner. The two pathway conditions were clear pathway and pathway with obstacles. Gait speed was modeled as a function of the couple conditions, pathway conditions, and covariates (gender, age, relationship duration, and physical activity) using mixed-effects (3-level) regression., Results: In both pathway conditions, both partners reduced speed when walking together (p < 0.001), and reduced speed further while holding hands (p < 0.001), when compared to walking alone. These effects were unchanged when covariates were included in the model. Further, speed was slower on the obstructed pathway for all participants, but the magnitude of slowing was greater with increasing age (p < 0.001) and in females (p=0.03)., Significance: Across the adult lifespan, when walking together, both partners decreased gait speed by a clinically meaningful amount (≥0.05 m/s). While walking with a partner may increase walking activity due to social support, reduced speed when walking together may unintentionally reduce health benefits and gait quality in both partners. Future research should identify how health is impacted by the trade-off between increased walking activity and reduced gait speed when romantic partners walk together., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Abstract: Placebo analgesia is hypothesized to involve top-down engagement of prefrontal regions that access endogenous pain inhibiting opioid pathways. Fibromyalgia (FM) patients have neuroanatomical and neurochemical alterations in pathways relevant to placebo analgesia. Thus, it remains unclear whether placebo analgesic mechanisms would differ in FM patients compared to healthy controls (HCs). Here, using placebo-analgesia-inducing paradigms that included verbal suggestions and conditioning manipulations, we examined whether behavioral and neural placebo analgesic responses differed between 32 FM patients and 46 age- and sex-matched HCs. Participants underwent a manipulation scan, where noxious high and low heat were paired with the control and placebo cream, respectively, and a placebo experimental scan with equal noxious heat temperatures. Before the experimental scan, each participant received saline or naloxone, an opioid receptor antagonist. Across all participants, the placebo condition decreased pain intensity and unpleasantness ratings, decreased activity within the right insula and bilateral secondary somatosensory cortex, and modulated the neurologic pain signature. There were no differences between HCs and FM patients in pain intensity ratings or neural responses during the placebo condition. Despite the perceptual and neural effects of the placebo manipulation, prefrontal circuitry was not activated during the expectation period and the placebo analgesia was unaltered by naloxone, suggesting placebo effects were driven more by conditioning than expectation. Together, these findings suggest that placebo analgesia can occur in both HCs and chronic pain FM patients, without the involvement of opioidergic prefrontal modulatory networks., (Copyright © 2020 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)

Advances in community and public health are needed to address contemporary health needs, particularly poor health outcomes related to the social determinants of health and inequity. Nurses are ideally placed to promote meaningful advances in community and public health, collectively referred to as population health. Nurse educators can promote a deeper understanding of core population health concepts by threading these concepts throughout the academic nursing curricula in addition to standalone population or public health courses. Strategies for incorporating population health concepts in a variety of courses can be conceptualized through the themes emphasizing context, honoring community voices, cultivating community connection, and fostering leadership in social responsibility. Nurse educators with expertise in population health can serve as a resource for faculty as these strategies are implemented. Teaching population health provides exciting opportunities for innovative approaches to facilitate students to link their practice to wider social contexts. Further steps to strengthen the public and community health workforce will still be needed to meet population health needs., (© 2020 Wiley Periodicals LLC.)

Background: The integration of time with dietary patterns throughout a day, or temporal dietary patterns (TDPs), have been linked with dietary quality but relations to health are unknown., Objective: The association between TDPs and selected health status indicators and obesity, type 2 diabetes (T2D), and metabolic syndrome (MetS) was determined., Methods: The first-day 24-h dietary recall from 1627 nonpregnant US adult participants aged 20-65 y from the NHANES 2003-2006 was used to determine timing, amount of energy intake, and sequence of eating occasions (EOs). Modified dynamic time warping (MDTW) and kernel k-means algorithm clustered participants into 4 groups representing distinct TDPs. Multivariate regression models determined associations between TDPs and health status, controlling for potential confounders, and adjusting for the survey design and multiple comparisons (P <0.05/6)., Results: A cluster representing a TDP with evenly spaced, energy balanced EOs reaching ≤1200 kcal between 06:00 to 10:00, 12:00 to 15:00, and 18:00 to 22:00, had statistically significant and clinically meaningful lower mean BMI (P <0.0001), waist circumference (WC) (P <0.0001), and 75% lower odds of obesity compared with 3 other clusters representing patterns with much higher peaks of energy: 1000-2400 kcal between 15:00 and 18:00 (OR: 5.3; 95% CI: 2.8, 10.1), 800-2400 kcal between 11:00 and 15:00 (OR: 4.4; 95% CI: 2.5, 7.9), and 1000-2600 kcal between 18:00 and 23:00 (OR: 6.7; 95% CI: 3.9, 11.6)., Conclusions: Individuals with a TDP characterized by evenly spaced, energy balanced EOs had significantly lower mean BMI, WC, and odds of obesity compared with the other patterns with higher energy intake peaks at different times throughout the day, providing evidence that incorporating time with other aspects of a dietary pattern may be important to health status., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition.)

In Canada's oil sands region, classic boreal hydrology (i.e., winter low flow followed by peaks during spring freshet and then summer flow recession) combined with erosion of both natural and anthropogenically-exposed bitumen results in seasonal and inter-annual variability in stream water chemistry. Using data collected from all seasons over three years (2012-2015), we investigated the mechanisms driving spatial and temporal change in the concentration of 26 water quality parameters for six rivers draining Canada's oil sands region. Mantel tests showed a strong spatial aggregation of climatic drivers (average daily precipitation, accumulated precipitation, snow water equivalent) associated with west versus east discharge patterns. Wavelet analysis highlighted unique watershed attributes, in particular the importance of developed area in lowering responsiveness to seasonal precipitation. Concentrations of most chemical parameters (20 of 23) showed distinct temporal patterns that were correlated with seasonal changes in hydrology which, in turn, were related to changes in weather. Comparison of concentrations observed in this study with those reported in the scientific literature for the same watersheds showed 81% of comparisons differed significantly. This was likely due to the short duration of previous field campaigns and thus the sampling of a very narrow window of the annual streamflow regime., Competing Interests: Declaration of competing interest The authors declare no conflict of interest or competing financial interest., (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)

Activin A promotes fetal mouse testis development, including driving Sertoli cell proliferation and cord morphogenesis, but its mechanisms of action are undefined. We performed ribonucleic acid sequencing (RNA-seq) on testicular somatic cells from fetal activin A-deficient mice (Inhba KO) and wildtype littermates at embryonic day (E) E13.5 and E15.5. Analysis of whole gonads provided validation, and cultures with a pathway inhibitor discerned acute from chronic effects of altered activin A bioactivity. Activin A deficiency predominantly affects the Sertoli cell transcriptome. New candidate targets include Minar1, Sel1l3, Vnn1, Sfrp4, Masp1, Nell1, Tthy1 and Prss12. Importantly, the testosterone (T) biosynthetic enzymes present in fetal Sertoli cells, Hsd17b1 and Hsd17b3, were identified as activin-responsive. Activin-deficient testes contained elevated androstenedione (A4), displayed an Inhba gene dose-dependent A4/T ratio, and contained 11-keto androgens. The remarkable accumulation of lipid droplets in both Sertoli and germ cells at E15.5 indicated impaired lipid metabolism in the absence of activin A. This demonstrated for the first time that activin A acts on Sertoli cells to determine local steroid production during fetal testis development. These outcomes reveal how compounds that perturb fetal steroidogenesis can function through cell-specific mechanisms and can indicate how altered activin levels in utero may impact testis development., (© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Little is known about the perceptions and attitudes of participants who volunteer in studies involving authorized deception. Thus, this cross-sectional pilot study measured, for the first time, the perceptions about participation in an authorized-deception placebo analgesia study in chronic pain patients with fibromyalgia and assessed whether their perceptions differed from healthy controls., Methods: An anonymous survey with questions about trust in research and willingness to participate in future research involving deception was mailed to participants in both groups after completion of the parent study. Statistical analyses were performed using the Mann-Whitney U and chi-square tests (31 controls and 16 fibromyalgia patients were included in the analyses)., Results: The majority of participants expressed little or no concern about the deception, still trusted the scientific process, and found the debriefing procedure helpful and worthwhile. Group differences were found in willingness to 1) participate in the parent study had the deceptive element been disclosed in advance (controls = definitely, fibromyalgia patients = probably, U = 341.5, P = 0.01) and 2) participate in future studies (controls = definitely, fibromyalgia patients = probably, U = 373, P < 0.001)., Conclusions: Despite slightly less favorable responses of fibromyalgia patients and the relatively small size of the study, these findings suggest that attitudes and perceptions about participating in an authorized placebo study remain positive in both healthy and chronic pain populations., (© 2019 American Academy of Pain Medicine.)

Using the RE-AIM framework, this study evaluates the statewide dissemination of an evidenced-based, email-delivered physical activity intervention implemented through Cooperative Extension. The Get WalkIN' program is comprised of 16 email messages sent over 12 weeks. Email messages target social cognitive theory constructs of self-efficacy, goal-setting, self-monitoring, and social support. Program reach, effectiveness, adoption, implementation, and maintenance were assessed with quantitative measures in a pre-post design. Findings indicate that within the Extension system, program adoption was high and program maintenance was moderate. Program effectiveness was demonstrated with an increase of 77.1 ± 49.9 min in weekly walking post-program. This increase in walking was maintained 3 months post-program. Capturing data on the implementation process was challenging. Overall, the results indicate success in program adoption and maintenance with further efforts needed to improve follow-up data collection from participants., (Copyright © 2020 Richards, Woodcox and Forster.)

Type 2 diabetes is a major public health concern. Management of this condition has focused on behavior modification through diet and exercise interventions. A growing body of evidence has focused on temporality of dietary intake and exercise and potential effects on health. This review summarizes current literature that investigates the question "how does the timing of exercise relative to eating throughout the day effect postprandial response in adults?" Databases PubMed, Scopus, Cochrane Library, CINAHL, and SPORTDiscus were searched between March-May 2019. Experimental studies conducted in healthy adults (≥18 y) and those with type 2 diabetes were included. Full texts were examined by at least two independent reviewers. Twenty studies with a total of 352 participants met the inclusion criteria. The primary finding supports that exercise performed post-meal regardless of time of day had a beneficial impact on postprandial glycemia. There was insufficient evidence regarding whether timing of exercise performed pre- vs. post-meal or vice versa in a day is related to improved postprandial glycemic response due to inherent differences between studies. Future studies focusing on the investigation of timing and occurrence of meal intake and exercise throughout the day are needed to inform whether there is, and what is, an optimal time for these behaviors regarding long-term health outcomes., Competing Interests: The authors declare no conflict of interest.

Background: Despite promotion of physical activity guidelines, less than one third of U.S. adults are sufficiently active and an even larger number of older adults fail to meet guidelines. To address this major public health issue, it is essential to broadly consider determinants of physical activity., Aims: This study explores how physical activity behavior is affected by the experience of major life events and considers the stress experienced due to these events across the life course., Method: Nationally representative panel data from the Americans' Changing Lives survey (1986-2012) was used to analyze a growth model with age-based trajectories to examine the relationship between major life events and physical activity overall and separately by gender and race., Results: In the overall sample, retiring was associated with greater physical activity at baseline. As respondents aged, entering into retirement was associated with decreased physical activity, while a parent or friend dying was associated with greater physical activity. Differences by gender and race were also seen over time., Conclusions: Results show that when considering physical activity trajectories, experiencing these major life events is not always detrimental, and in some cases may be beneficial. Considering these impacts is important in planning effective health promotion interventions to increase and promote maintenance of physical activity, while paying attention to specific differences by gender and race.

We explored the ongoing question of whether placebo analgesia alters afferent nociceptive processing in a novel paradigm designed to minimize the role of response bias in placebo measurement. First, healthy adult participants received a standard heat placebo induction and conditioning procedure using a topical "analgesic" cream applied to one arm. During a subsequent placebo testing procedure, participants rated stimuli on the placebo-treated arm and untreated arm, using a task that minimized subjects' ability to guess the expected response, thus reducing experimenter demand. Retrospectively participants reported moderate analgesia effectiveness (mean=5.3/10), but for individual temperature ratings, only 2 subjects exhibited a perceptual placebo response >5 points. Next, these subjects completed a novel, exploratory task designed to measure changes in inter-arm in discriminative accuracy that would be expected from changes in afferent nociception. Both placebo responders (but no non-responders) showed reduced discriminative ability when the hotter stimulus occurred on the placebo arm, an effect consistent with alterations in nociceptive afferent flow and unlikely to be caused by response bias.

Amphiphilic alpha-helices are common motifs used in numerous biological systems including membrane channels/pores and antimicrobial peptides (AMPs), and binding proteins, and a variety of synthetic biomaterials. Previously, an amphiphilic peptide with lysine-containing motifs was shown to reversibly bind the anionic porphyrin meso-Tetra(4-sulfonatophenyl)porphyrin (TPPS 4 2- ) and promote the formation of excitonically coupled conductive J-aggregates. The work presented here focuses on the use of this amphiphilic peptide and derivatives as a potential antimicrobial agent. AMPs are naturally occurring components of the innate immune system, which selectively target and kill bacteria. Sequence derivatives were synthesized in which the position of the Trp, used as a fluorescence reporter, was changed. Additional variants were synthesized where the hydrophobic amino acids were replaced with Ala to reduce net hydrophobicity or where the cationic Lys residues were replaced with diaminopropionic acid (Dap). All peptide sequences retained the ability to bind TPPS 4 2- and promote the formation of J-aggregates. The peptides all exhibited a preference for binding anionic lipid vesicles compared to zwitterionic bilayers. The Trp position did not impact antimicrobial activity, but the substituted peptides exhibited markedly lower efficacy. The Dap-containing peptide was only active against E. coli and P. aeruginosa , while the Ala-substituted peptide was inactive at the concentrations tested. This trend was also evident in bacterial membrane permeabilization. The results indicate that the amphiphilic porphyrin binding peptides can also be used as antimicrobial peptides. The cationic nature is a driver in binding to lipid bilayers, but the overall hydrophobicity is important for antimicrobial activity and membrane disruption., Competing Interests: Conflict of interest All authors declare no potential financial or personal conflict of interest.

Background: Physical activity behavior is influenced by numerous factors including motivation, social interactions, and the walkability of the environment., Aim: To examine how social contexts and environmental features affect physical activity motivational processes across time., Methods: Participants (N=104) completed 3 monthly online surveys assessing self-determination theory constructs, social partners in physical activity, neighborhood walkability, and weekly physical activity. Longitudinal path analysis examined the degree to which physical activity was predicted by individual goals, orientation, and autonomy support and whether these associations were meditated by motivation and moderated by the social and environmental contexts of physical activity., Results: The effect of controlled exercise orientations on physical activity was mediated by autonomous motivation. This association was stronger among those who perceived less crime in their neighborhoods., Discussion: To improve the ability to tailor physical activity counseling it is important to understand how each person views exercise situations and to understand his/her social and neighborhood environments., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Research suggests that the discriminative and affective aspects of touch are processed differently in the brain. Primary somatosensory cortex is strongly implicated in touch discrimination, whereas insular and prefronal regions have been associated with pleasantness aspects of touch. However, the role of secondary somatosensory cortex (S2) is less clear. In the current study we used inhibitory repetitive transcranial magnetic stimulation (rTMS) to temporarily deactivate S2 and probe its role in touch perception. Nineteen healthy adults received two sessions of 1-Hz rTMS on separate days, one targeting right S2 and the other targeting the vertex (control). Before and after rTMS, subjects rated the intensity and pleasantness of slow and fast gentle brushing of the hand and performed a 2-point tactile discrimination task, followed by fMRI during additional brushing. rTMS to S2 (but not vertex) decreased intensity ratings of fast brushing, without altering touch pleasantness or spatial discrimination. MRI showed a reduced response to brushing in S2 (but not in S1 or insula) after S2 rTMS. Together, our results show that reducing touch-evoked activity in S2 decreases perceived touch intensity, suggesting a causal role of S2 in touch intensity perception., (Published by Elsevier B.V.)

Total mercury levels in aquatic birds and fish communities have been monitored across the Canadian Great Lakes by Environment and Climate Change Canada (ECCC) for the past 42 years (1974-2015). These data (22 sites) were used to examine spatio-temporal variability of mercury levels in herring gull (Larus argentatus) eggs, lake trout (Salvelinus namaycush), walleye (Sander vitreus), and rainbow smelt (Osmerus mordax). Trends were quantified with dynamic linear models, which provided time-variant rates of change of mercury concentrations. Lipid content (in both fish and eggs) and length in fish were used as covariates in all models. For the first three decades, mercury levels in gull eggs and fish declined at all stations. In the 2000s, trends for herring gull eggs reversed at two sites in Lake Erie and two sites in Lake Ontario. Similar trend reversals in the 2000s were observed for lake trout in Lake Superior and at a single station in Lake Ontario. Mercury levels in lake trout continued to slowly decline at all of the remaining stations, except for Lake Huron, where the levels remained stable. A post-hoc Bayesian regression analysis suggests strong trophic interactions between herring gulls and rainbow smelt in Lake Superior and Lake Ontario, but also pinpoints the likelihood of a trophic decoupling in Lake Huron and Lake Erie. Continued monitoring of mercury levels in herring gulls and fish is required to consolidate these trophic shifts and further evaluate their broader implications., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

Despite educational programs, sudden infant death syndrome (SIDS) rates remain unacceptably high, especially among low-income and African-American populations. The purpose of this review is to examine reasons for parental noncompliance with supine sleep recommendations. A database search in Cochrane Database of Systematic Reviews, PubMed, EBSCOhost, and CINAHL was conducted using keywords SIDS, prevention and control, parental compliance, nursing, supine position, Back to Sleep campaign, and Safe to Sleep campaign. Literature was included from 2002 to 2014. Types of studies included randomized control trials, literature reviews, and descriptive studies. Literature from academic journals was also included. Included literature discussed parental knowledge, the Back to Sleep and the Safe to Sleep campaigns, compliance with recommendations from the American Academy of Pediatrics (AAP), and interventions and education. Seventeen studies were included that used data collection methods, including surveys, focus groups, face-to-face interviews, and questionnaires. Major trends identified as being associated with noncompliance included parent knowledge, sources of advice, infant comfort and quality of infant sleep, safety concerns (i.e., choking), race/ethnicity, education level, and income. Noncompliance was highest among single, less-educated, low-income, or African-American parents.

The purpose of this study was to evaluate the ability of two concurrent randomized controlled interventions based on social cognitive theory to increase walking. A second purpose was to compare the efficacy of the intervention between two distinct groups: dog owners and non-dog owners. Adult dog owners ( n = 40) and non-dog owners ( n = 65) were randomized into control or intervention groups. Intervention groups received bi-weekly emails for first 4 weeks and then weekly email for the next 8 weeks targeting self-efficacy, social support, goal setting, and benefits/barriers to walking. Dog owner messages focused on dog walking while non-dog owners received general walking messages. Control groups received a 1-time email reviewing current physical activity guidelines. At 6 months, both intervention groups reported greater increases in walking and maintained these increases at 12 months. The greatest increases were seen in the dog owner intervention group. In conclusion, dog owners accumulated more walking, which may be attributed to the dog-owner relationship.

There is preclinical and clinical evidence that vagus nerve stimulation modulates both pain and mood state. Mechanistic studies show brainstem circuitry involved in pain modulation by vagus nerve stimulation, but little is known about possible indirect descending effects of altered mood state on pain perception. This possibility is important, since previous studies have shown that mood state affects pain, particularly the affective dimension (pain unpleasantness). To date, human studies investigating the effects of vagus nerve stimulation on pain perception have not reliably measured psychological factors to determine their role in altered pain perception elicited by vagus nerve stimulation. Thus, it remains unclear how much of a role psychological factors play in vagal pain modulation. Here, we present a rationale for including psychological measures in future vagus nerve stimulation studies on pain.

Purpose: The purpose of this integrative review is to 1) describe intervention attributes, 2) describe the role of nurses in community PA promotion, and 3) describe the efficacy of the interventions in terms of PA behavior change., Methods: Computerized database and ancestry search strategies located distinct intervention trials between 1990 and 2015., Results: Thirteen national and international studies with 2,353 participants were reviewed. Multi-dose, face-to-face, group-based interventions with or without individual-based contacts for 6months or less were the most common intervention delivery modes. Only 40% (n=5) of the studies integrated health behavior theory into intervention design. Less than half of the studies demonstrated efficacy in increasing PA., Conclusions: Results suggest that group-based community interventions, such as exercise classes, group walking and group education/counseling, may be more effective in increasing PA compared to individual-based education. Additional rigorously designed studies are warranted to explore the indicators for successful community-based PA promotion., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The purpose of this systematic review is to analyze current lifestyle intervention literature conducted in U.S. rural areas to identify the most effective and impactful interventions on physical activity outcomes. Quality of studies was assessed using the Cochrane Collaboration's risk of bias tool. Exploratory calculations of effect size and 95% confidence intervals were performed to demonstrate trends in clinical importance. Eight trials which included 1,399 adult participants met the inclusion criteria for review. Two trials reported a significant difference in the increase of physical activity between groups with medium to large effect sizes. Interventions which are very personalized or tailored and/or include many intervention contacts appear to be most effective. However, the small number of studies, mixed findings, and the risk of bias limit our ability to draw conclusion., (© The Author(s) 2015.)

Background: To facilitate physical activity (PA) adoption and maintenance, promotion of innovative population-level strategies that focus on incorporating moderate-intensity lifestyle PAs are needed., Objective: The purpose of this randomized controlled trial was to evaluate the Dogs, Physical Activity, and Walking intervention, a 3-month, social cognitive theory (SCT), e-mail-based PA intervention., Methods: In a longitudinal, repeated-measures design, 49 dog owners were randomly assigned to a control (n = 25) or intervention group (n = 24). The intervention group received e-mail messages (twice weekly for 4 weeks and weekly for 8 weeks) designed to influence SCT constructs of self-efficacy, self-regulation, outcome expectations and expectancies, and social support. At baseline and every 3 months through 1 year, participants completed self-reported questionnaires of individual, interpersonal, and PA variables. Linear mixed models were used to assess for significant differences in weekly minutes of dog walking and theoretical constructs between groups (intervention and control) across time. To test self-efficacy as a mediator of social support for dog walking, tests for mediation were conducted using the bootstrapping technique., Results: With the exception of Month 9, participants in the intervention group accumulated significantly more weekly minutes of dog walking than the control group. On average, the intervention group accumulated 58.4 more minutes (SD = 18.1) of weekly dog walking than the control group (p < .05). Self-efficacy partially mediated the effect of social support variables on dog walking., Discussion: Results indicate that a simple SCT-based e-mail intervention is effective in increasing and maintaining an increase in dog walking among dog owners at 12-month follow-up. In light of these findings, it may be advantageous to design dog walking interventions that focus on increasing self-efficacy for dog walking by fostering social support.

Purpose: The purpose of this study is to: (1) identify characteristics associated with dog owners who walk their dog, (2) describe the frequency and duration of walking the dog, and (3) determine whether dog owners who walk their dog participate in more physical activity than dog owners who do not walk their dog and non-dog owners., Design: A cross-sectional study design was used., Setting: The study setting was nationwide., Subjects: Adults (n = 4010) participating in the 2005 ConsumerStyles mail-panel survey were the study subjects., Measures: Measures used were demographic, physical activity, dog ownership, and dog walking questions from the 2005 ConsumerStyles mail-panel survey., Analysis: Chi-square tests and analyses of variance were conducted to examine participant characteristics associated with dog walking and to describe the frequency and duration of dog walking. Analysis of covariance was used to determine whether dog owners who walk their dog participate in more physical activity than dog owners who do not walk their dog and non-dog owners., Results: Among dog owners, 42% reported some dog walking in a typical week. Dog owners walked their dog an average 4.3 ± 0.1 times and 128.8 ± 5.6 minutes per week. There were no significant differences in weekly minutes of moderate or vigorous physical activity across the dog-ownership and dog walking groups., Conclusion: Most dog owners did not walk their dog. Dog owners were not more active than non-dog owners, except when considering the activity obtained via dog walking., (© The Author(s) 2016.)

Promotion of physical activity has been a public health priority for decades. The purpose of this integrative review is to examine the effectiveness of nurse-delivered physical activity interventions conducted in primary care settings. Computerized database and ancestry search strategies located distinct intervention trials between 1990 and 2014. Nineteen national and international studies with 7,350 participants were reviewed. The most common intervention was physical activity counseling with supportive or motivational contacts. Few studies utilized exercise training, device-based exercise monitoring, or exercise prescriptions. The most common follow-up durations were 3 to 12 months. Half the studies integrated health behavior theoretical frameworks into the intervention. Almost 80% of the studies reported significant increases in walking, moderate or vigorous physical activity, or overall physical activity in the intervention groups. Interventions successful in increasing physical activity most often utilized tailored techniques such as providing "stage of change"-specific strategies or helping patients set individualized goals., (© The Author(s) 2015.)

Touch plays a significant role in human social behavior and social communication, and its rewarding nature has been suggested to involve opioids. Opioid blockade in monkeys leads to increased solicitation and receipt of grooming, suggesting heightened enjoyment of touch. We sought to study the role of endogenous opioids in perception of affective touch in healthy adults and in patients with fibromyalgia, a chronic pain condition shown to involve reduced opioid receptor availability. The pleasantness of touch has been linked to the activation of C-tactile fibers, which respond maximally to slow gentle touch and correlate with ratings of pleasantness. We administered naloxone to patients and healthy controls to directly observe the consequences of µ-opioid blockade on the perceived pleasantness and intensity of touch. We found that at baseline chronic pain patients showed a blunted distinction between slow and fast brushing for both intensity and pleasantness, suggesting reduced C-tactile touch processing. In addition, we found a differential effect of opioid blockade on touch perception in healthy subjects and pain patients. In healthy individuals, opioid blockade showed a trend toward increased ratings of touch pleasantness, while in chronic pain patients it significantly decreased ratings of touch intensity. Further, in healthy individuals, naloxone-induced increase in touch pleasantness was associated with naloxone-induced decreased preference for slow touch, suggesting a possible effect of opioid levels on processing of C-tactile fiber input. These findings suggest a role for endogenous opioids in touch processing, and provide further evidence for altered opioid functioning in chronic pain patients.