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African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women.
Methods
Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction.
Results
All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = −74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = −34 minutes/week) in comparison to PI participants (all P’s < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend.
Conclusions
A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women.
Increasing empirical evidence supports associations between neighborhood environments and physical activity. However, since most studies were conducted in a single country, particularly western countries, the generalizability of associations in an international setting is not well understood. The current study examined whether associations between perceived attributes of neighborhood environments and physical activity differed by country.
Methods
Population representative samples from 11 countries on five continents were surveyed using comparable methodologies and measurement instruments. Neighborhood environment × country interactions were tested in logistic regression models with meeting physical activity recommendations as the outcome, adjusted for demographic characteristics. Country-specific associations were reported.
Results
Significant neighborhood environment attribute × country interactions implied some differences across countries in the association of each neighborhood attribute with meeting physical activity recommendations. Across the 11 countries, land-use mix and sidewalks had the most consistent associations with physical activity. Access to public transit, bicycle facilities, and low-cost recreation facilities had some associations with physical activity, but with less consistency across countries. There was little evidence supporting the associations of residential density and crime-related safety with physical activity in most countries.
Conclusion
There is evidence of generalizability for the associations of land use mix, and presence of sidewalks with physical activity. Associations of other neighborhood characteristics with physical activity tended to differ by country. Future studies should include objective measures of neighborhood environments, compare psychometric properties of reports across countries, and use better specified models to further understand the similarities and differences in associations across countries.
This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults.
Methods
African American adults (mean age 59.9 ± 0.60 years; 59 % female) enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, assessed on two to three distinct occasions, each separated by approximately one month. The stability of pedometer measured PA was described as differences in mean steps/day across time, as intraclass correlation coefficients (ICC) by sex, age, and body mass index (BMI) category, and as percent of participants changing steps/day quartiles across time.
Results
Valid data were obtained for 270 participants on either two or three different assessment occasions. Mean steps/day were not significantly different across assessment occasions (p values > 0.456). The overall ICCs for steps/day assessed on either two or three occasions were 0.57 and 0.76, respectively. In addition, 85 % (two assessment occasions) and 76 % (three assessment occasions) of all participants remained in the same steps/day quartile or changed one quartile over time.
Conclusion
The current study shows that an overall mean steps/day estimate based on a 3-day monitoring period did not differ significantly over 4 – 6 months. The findings were robust to differences in sex, age, and BMI categories. A single 3-day monitoring period is sufficient to capture habitual physical activity in African American adults.
Neighborhood environment studies of physical activity (PA) have been mainly single-country focused. The International Prevalence Study (IPS) presented a rare opportunity to examine neighborhood features across countries. The purpose of this analysis was to: 1) detect international neighborhood typologies based on participants’ response patterns to an environment survey and 2) to estimate associations between neighborhood environment patterns and PA.
Methods
A Latent Class Analysis (LCA) was conducted on pooled IPS adults (N=11,541) aged 18 to 64 years old (mean=37.5 ±12.8 yrs; 55.6% women) from 11 countries including Belgium, Brazil, Canada, Colombia, Hong Kong, Japan, Lithuania, New Zealand, Norway, Sweden, and the U.S. This subset used the Physical Activity Neighborhood Environment Survey (PANES) that briefly assessed 7 attributes within 10–15 minutes walk of participants’ residences, including residential density, access to shops/services, recreational facilities, public transit facilities, presence of sidewalks and bike paths, and personal safety. LCA derived meaningful subgroups from participants’ response patterns to PANES items, and participants were assigned to neighborhood types. The validated short-form International Physical Activity Questionnaire (IPAQ) measured likelihood of meeting the 150 minutes/week PA guideline. To validate derived classes, meeting the guideline either by walking or total PA was regressed on neighborhood types using a weighted generalized linear regression model, adjusting for gender, age and country.
Results
A 5-subgroup solution fitted the dataset and was interpretable. Neighborhood types were labeled, “Overall Activity Supportive (52% of sample)”, “High Walkable and Unsafe with Few Recreation Facilities (16%)”, “Safe with Active Transport Facilities (12%)”, “Transit and Shops Dense with Few Amenities (15%)”, and “Safe but Activity Unsupportive (5%)”. Country representation differed by type (e.g., U.S. disproportionally represented “Safe but Activity Unsupportive”). Compared to the Safe but Activity Unsupportive, two types showed greater odds of meeting PA guideline for walking outcome (High Walkable and Unsafe with Few Recreation Facilities, OR= 2.26 (95% CI 1.18-4.31); Overall Activity Supportive, OR= 1.90 (95% CI 1.13-3.21). Significant but smaller odds ratios were also found for total PA.
Conclusions
Meaningful neighborhood patterns generalized across countries and explained practical differences in PA. These observational results support WHO/UN recommendations for programs and policies targeted to improve features of the neighborhood environment for PA.
The basis of social power which has expanded in the most dangerous way over the last few decades has been that of information control, and how that control is used. Misinformation and the intentional spread of misinformation referred to as disinformation, has become commonplace among various bodies of power to either expand their own influence or diminish opposing influence. The methods of disinformation utilized in the various spheres of politics, the commercial marketplace, and the media today are explored in depth to better contextualize and describe the problems that disinformation and its use pose in the world today.
This paper explores the well-known Atkins Diet, as it also places a strong regulation on macromolecule consumption, specifically carbohydrates, in order to assist with the weight loss process. A review of available literature will be used to investigate: the history of the diet, necessity of macromolecule consumption, the impact this has on the individual biochemical pathways (glycolysis/gluconeogenesis) and the microbiome as a whole, as well as overall success rates and long-term health complications/benefits. Additionally personal statements from various individuals who have experience with the diet, myself included, will be incorporated into a holistic analysis of the effectiveness and longevity of the Atkins weight-loss strategy.
COVID-19 has shocked the bedrock of society, impacting both human life and the economy. Accompanying this shock has been the psychological distress inflicted onto the general population as a result of the emotion strain stemming from isolation/quarantine policies, being sick with COVID-19, dealing with COVID-19 losses, and post-COVID syndrome and its effect on quality of life. The psychological distress has been experienced by the general population, but compared to middle age (30-50) and older adults (>50 years of age), it has been young adults (18-30 years old) who have been more psychologically affected (Glowacz & Schmits, 2020). Psychological distress, specifically anxiety and depression, has been exacerbated by feelings of uncertainty, fear of illness, losing loved ones, and fear of post-COVID syndrome. Post-COVID syndrome, as with other post-viral syndromes such as post viral SARS involve lingering symptoms such as myalgic encephalomyelitis or Chronic Fatigue Syndrome (CFS), and loss of motivation (Underhill, 2015). In addition to these symptoms, patients suffering from post-COVID syndrome have also presented brain inflammation and damaged brain blood vessels (Meinhardt et al., 2021), Endotheliitis (Varga et al., 2020), CV abnormalities and changes in glucose metabolism (Williams et al., 2020). CV abnormalities and changes in glucose metabolism are connected to chronic illnesses like diabetes and heart disease respectively. These chronic illnesses are then associated with higher risk for depression as a result of the stress induced by the symptoms and their impact on quality of life (NIMH, 2021). Further monitoring, and research will be important to gauge ultimate physiological and psychological impact of COVID-19.
This case study describes an adult patient whose brachial plexus injury was treated with various modalities and exercise. The participant of this study was a 76 year old female who sustained a brachial plexus injury during an elective reverse total shoulder arthroplasty. The initial evaluation reported only passive range of motion with 90 degrees shoulder flexion, 85 degrees abduction, and 30 degrees external rotation. Muscle testing yielded significantly limited wrist and digit extension strength. Testing of sensation found diminished protective sensation along the median nerve distribution, including the thumb, index finger, and middle finger. Occupational therapy was initiated for postoperative treatment of the shoulder as well as treatment of the brachial plexus palsy. Therapy consisted of static splinting for healing structures and sensory reeducation through massage, finding objects with the eyes occluded, and fluidotherapy. Additionally, various exercises and modalities for improving motion and strength were initiated, including proprioceptive neuromuscular reeducation, passive/active assist/active exercises, dynamic splinting, muscle stimulation, kinesio tape, functional activities, and tendon glides. After five months, active range of motion in the shoulder, elbow, and wrist was finally achieved and median nerve sensation had improved. After nine months, elbow motion was within normal limits and wrist motion had significantly improved. Upon muscle testing, the elbow, forearm, wrist, and hand had made significant gains in strength. However, shoulder strength and motion was still limited. Overall, treatment made a significant improvement in the patient’s functionality.