Impact of Experience Corps® Participation on Children's Academic Achievement and School Behavior.

This article reports on the impact of the Experience Corps® (EC) Baltimore program, an intergenerational, school-based program aimed at improving academic achievement and reducing disruptive school behavior in urban, elementary school students in Kindergarten through third grade (K-3). Teams of adult volunteers aged 60 and older were placed in public schools, serving 15 h or more per week, to perform meaningful and important roles to improve the educational outcomes of children and the health and well-being of volunteers. Findings indicate no significant impact of the EC program on standardized reading or mathematical achievement test scores among children in grades 1-3 exposed to the program. K-1st grade students in EC schools had fewer principal office referrals compared to K-1st grade students in matched control schools during their second year in the EC program; second graders in EC schools had fewer suspensions and expulsions than second graders in non-EC schools during their first year in the EC program. In general, both boys and girls appeared to benefit from the EC program in school behavior. The results suggest that a volunteer engagement program for older adults can be modestly effective for improving selective aspects of classroom behavior among elementary school students in under-resourced, urban schools, but there were no significant improvements in academic achievement. More work is needed to identify individual- and school-level factors that may help account for these results.

Impact of Experience Corps(®) participation on school climate.

We examined the impact of the Experience Corps(®) (EC) program on school climate within Baltimore City public elementary schools. In this program, teams of older adult volunteers were placed in high intensity (>15 h per week), meaningful roles in public elementary schools, to improve the educational outcomes of children as well as the health and well-being of volunteers. During the first year of EC participation, school climate was perceived more favorably among staff and students in EC schools as compared to those in comparison schools. However, with a few notable exceptions, perceived school climate did not differ for staff or students in intervention and comparison schools during the second year of exposure to the EC program. These findings suggest that perceptions of school climate may be altered by introducing a new program into elementary schools; however, research examining how perceptions of school climate are impacted over a longer period is warranted.

Acute effects of sex-specific sex hormones on heat shock proteins in fast muscle of male and female rats.

Heat shock protein (HSP) expression and sex hormone levels have been shown to influence several aspects of skeletal muscle physiology (e.g., hypertrophy, resistance to oxidative stress), suggesting that sex hormone levels can effect HSP expression. This study evaluated the effects of differing levels of sex-specific sex hormones (i.e., testosterone in males and estrogen in females) on the expression of 4: HSP70, HSC70, HSP25, and αB-crystallin in the quadriceps muscles of male and female rats. Animals were assigned to 1 of 3 groups (n = 5 M and F/group). The first group (Ctl) consisted of typically cage-housed animals that served as controls. The second group (H) was gonadectomized and received either testosterone (males) or estradiol (females) via injection for 12 consecutive days. The third group (Gx) was gonadectomized and injected as above, but with vehicle only, rather than hormones. Significant sex by condition interactions (P < 0.05 by two-way MANOVA) were found for all 4 proteins studied, except for HSP70, which exhibited a significant effect of condition only. The expression of all HSPs was greater (1.9-2.5-fold) in males vs. females in the Ctl group, except for HSP70, which was no different. Generally, gonadectomy appeared to have greater effects in males than females, but administration of the exogenous sex hormones tended to produce more robust relative changes in females than males. There were no differences in myosin composition in any of the groups, suggesting that changes in fiber type were not a factor in the differential protein expression. These data may have implications for sex-related differences in muscular responses to exercise, disuse, and injury.

The association between physical activity and hot flash severity, frequency, and duration in mid-life women.

The value of physical activity to reduce vasomotor symptoms has yet to be determined conclusively. As a result, we used a cross-sectional population-based design to examine the association between self reported physical activity level and hot flash symptoms in 45-54-year-old women. Participants (n = 603) completed a detailed survey to report physical activity level at work, home, and leisure as well as a detailed history of the frequency and severity of hot flash symptoms. Results showed that higher levels of physical activity were significantly associated with increasing odds of moderate or severe hot flashes (P for trend = 0.02). These findings suggest that there is a positive relation between physical activity and moderate or severe hot flash symptoms but no relation between physical activity and the reporting of any hot flashes, daily hot flashes, or hot flashes experienced for greater than 1 year.

Endogenous hormones, participant characteristics, and symptoms among midlife women.

OBJECTIVES: The primary aim of this study was to examine the associations between endogenous hormone levels and symptoms other than hot flashes in a sample of midlife women. METHODS: Data from a community-based sample of 603 women aged 45-54 years who had never used hormone therapy were analyzed. Each participant completed a questionnaire to obtain data on demographic and lifestyle characteristics as well as symptoms, including headache, insomnia, vision problems, vaginal discharge and dryness, irritability, and incontinence. In addition, each participant provided a blood sample that was used to measure estrogen, androgen, and sex hormone binding globulin (SHBG) concentrations by enzyme-linked immunosorbent assay. RESULTS: Prevalence rates of symptoms ranged from 51.4% (irritability) to 18.6% (vision problems). In adjusted analyses, the free estradiol index (FEI) was significantly and positively associated with the reporting of insomnia (odds ratio (OR) 1.28; 95% confidence interval (CI) 1.01-1.61). Further, higher SHBG levels were significantly associated with lower odds of reporting vision problems (OR 0.44; 95% CI 0.23-0.81). CONCLUSIONS: This study provides evidence that hormones are associated with insomnia and visual problems during midlife. However, some of these results conflict with previous findings. Given the overall paucity of literature on these issues, more investigation is warranted.

Physical activity and risk of hot flashes among women in midlife.

OBJECTIVE: Hot flashes commonly affect women during menopause and are among the primary menopausal complaints for which women seek medical treatment. Recent evidence of the potential risks posed by hormone therapies has led to interest in nonhormonal interventions, including physical activity. Studies evaluating the therapeutic effects of physical activity for relief of hot flashes have been limited by small sample size, problems with hot flash classification, and assumptions regarding the timing of risk and effect. The current study evaluated the association between physical activity prior to the time of the last menstrual period (LMP) and hot flashes in a large sample maintaining an appropriate sequence of physical activity and menopausal symptoms. METHODS: This study included 512 perimenopausal and postmenopausal women who participated in a population-based study of midlife health in the Baltimore metropolitan area. Questionnaires assessed self-reported physical activity levels at various ages as well as frequency and severity of hot flashes. Multiple logistic regression was used to evaluate the association between physical activity prior to LMP and each of the hot flash outcomes. RESULTS: Highly active women between the ages of 35 and 40 were significantly more likely to report moderate to severe hot flashes (OR = 1.70, p = 0.01) and daily hot flashes (OR = 1.79, p < 0.01) than minimally active women in unadjusted models. Adjustment for age and smoking status did not substantially alter these results. CONCLUSIONS: Frequent physical activity in midlife may be associated with risk of greater severity and frequency of menopausal hot flashes.

Positive Aging Expectations Are Associated With Physical Activity Among Urban-Dwelling Older Adults.

Purpose: Regular physical activity is a key component of healthy aging, but few older adults meet physical activity guidelines. Poor aging expectations can contribute to this lack of activity, since negative stereotypes about the aging process can be internalized and affect physical performance. Although prior cross-sectional studies have shown that physical activity and aging expectations are associated, less is known about this association longitudinally, particularly among traditionally underrepresented groups. It is also unclear whether different domains of aging expectations are differentially associated with physical activity. Design and Methods: The number of minutes/week of physical activity in which Baltimore Experience Corps Trial participants (N = 446; 92.6% African American) engaged were measured using the CHAMPS questionnaire, while their aging expectations were measured using the ERA-12 survey. Linear mixed effects models assessed the association between physical activity and aging expectations over 2 years, both in full and sex-stratified samples. Separate models were also fit for different ERA-12 domains. Results: We found that higher overall expectations regarding aging are associated with higher engagement in moderate- to high-intensity physical activity over a 2-year period of time for women only. When the ERA-12 domains were examined separately, only the physical domain was associated with physical activity, both in women and overall. Implications: Low expectations regarding physical aging may represent a barrier to physical activity for older adults. Given that most older adults do not meet recommended physical activity guidelines, identifying factors that improve aging expectations may be a way to increase physical activity levels in aging populations.

The effects of the menstrual cycle on anterior knee laxity: a systematic review.

Female athletes are at a 4- to 6-fold increased risk of anterior cruciate ligament (ACL) injury compared with male athletes. There are several medical, emotional and financial burdens associated with these injuries. Sex hormones may be involved in the ACL injury disparity, with potential associations reported between phases of the menstrual cycle and ACL injury rates. The reported relationships between ACL injury and menstrual status may be related to associated changes in ligament mechanical properties from cyclic fluctuations of female sex hormones. A PubMed electronic database literature search, including MEDLINE (1966-2005) and CINAHL (1982-2005), with the search terms 'menstrual cycle' and 'knee laxity' was used for this systematic review. Studies were included in this systematic review if they were prospective cohort studies and investigated the association between the menstrual cycle and anterior knee laxity in females. Nine prospective cohort studies, published as 11 articles, were included in the systematic review. Six of nine studies reported no significant effect of the menstrual cycle on anterior knee laxity in women. Three studies observed significant associations between the menstrual cycle and anterior knee laxity. These studies all reported the finding that laxity increased during the ovulatory or post-ovulatory phases of the cycle. A meta-analysis, which included data from all nine reviewed studies, corroborated this significant effect of cycle phase on knee laxity (F-value = 56.59, p = 0.0001). In the analyses, the knee laxity data measured at 10-14 days was >15-28 days which was >1-9 days. Future studies testing the relationship between the menstrual cycle and potentially associated parameters should consider the limitations outlined in this article and control for potential biases and confounders. Power analyses should be utilised. Subjects should be randomly entered into the studies at alternate points in the cycle, and standard and consistent data acquisition and reporting methods should be utilised. Future studies should clearly define what constitutes a 'normal' cycle and appropriate control subjects should be utilised. Furthermore, there is a need to define cycle phase (and timing within cycle phase) with actual hormone levels rather than a day of the cycle. Although hormone confirmations were provided in many of the studies that selected specific days to depict a particular cycle for all women, it is unknown from these data if they truly captured times of peak hormone values in all women. A combined systematic review and meta-analysis of the literature indicate that the menstrual cycle may have an effect on anterior-posterior laxity of the knee; however, further investigation is needed to confirm or reject this hypothesis.

Physical therapist examination, evaluation, and intervention following the surgical reconstruction of a grade III acromioclavicular joint separation.

BACKGROUND AND PURPOSE: This case report describes the examination, intervention, and outcome of a patient following the surgical reconstruction of a grade III acromioclavicular (AC) joint separation. Detailed postoperative interventions have not previously been described in the literature. CASE DESCRIPTION: The patient was a 34-year-old male college professor with a left grade III AC joint separation and no prior restrictions of upper-extremity function. After 12 weeks of presurgical treatment, the patient's complaints included crepitus and the inability to push open heavy doors. INTERVENTION: Surgical reconstruction of the AC joint and a 4-month graded exercise program were used. OUTCOME: The patient returned to preinjury levels of function 5 months after surgery with scores of 3.33/100 and 0/100 on the Disabilities of the Arm, Shoulder and Hand questionnaire and optional Sport/Music or Work Module, respectively. DISCUSSION: An intervention focusing on restoring shoulder strength, range of motion, flexibility, and neuromuscular control of the shoulder following a surgical reconstruction of the AC joint can lead to a successful functional outcome.

Sex, collagen expression, and anterior cruciate ligament strength in rats.

CONTEXT: Sex-specific responses to steroid sex hormones have been suggested as a potential cause for the disparate anterior cruciate ligament (ACL) injury rates between male and female athletes. Type 1 collagen (T1C) and type 3 collagen (T3C) are crucial structural components that define the ligament's ability to withstand tensile loads. Messenger RNA (mRNA) is an important mediator of downstream collagen synthesis and remodeling, but the sex-specific mechanisms of collagen mRNA expression and ACL strength are unknown. OBJECTIVE: To examine the influence of sex on T1C and T3C mRNA expression and mass-normalized stiffness and peak failure load in the ACLs of skeletally mature rats. DESIGN: Observational study. SETTING: Basic sciences and biomechanical testing laboratories. PATIENTS OR OTHER PARTICIPANTS: Nineteen 12-week-old male (n = 9) and female (n = 10) Sprague Dawley rats. MAIN OUTCOME MEASURE(S): We used real-time polymerase chain reaction to determine T1C and T3C mRNA expression and a hydraulic materials testing device to measure ACL stiffness and failure load. Nonparametric Wilcoxon rank sum tests were used to compare the groups. RESULTS: Female rats had lower amounts of T3C mRNA expression and higher normalized ACL tangent stiffness and failure load than male rats. CONCLUSIONS: These findings suggest that sex-specific differences in T1C and T3C mRNA expression may play an important role in the downstream mechanical properties of the ACL.

Descriptive epidemiology of collegiate men's lacrosse injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004.

OBJECTIVE: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's lacrosse and identify potential areas for injury prevention initiatives. BACKGROUND: During the sample period, the number of sponsoring institutions and the number of participants in men's college lacrosse grew significantly. Overall, an average of 18% of NCAA institutions participated in the annual NCAA Injury Surveillance System data collection for this sport. MAIN RESULTS: Over the sample period, athletes were almost 4 times more likely to sustain injuries in games than in practices (12.58 versus 3.24 injuries per 1000 athlete-exposures [A-Es], rate ratio = 3.9, 95% confidence interval = 3.7, 4.1). Approximately half of all game (48.1%) and practice (58.7%) injuries were to the lower extremity, followed by the upper extremity (26.2% in games, 16.9% in practices), and the head and neck (11.7% in games, 6.2% in practices). In games and practices, the most common injuries were ankle ligament sprains (11.3% and 16.4%, respectively). The disparity among preseason, regular-season, and postseason injuries may be due to athlete acclimatization to the rigors of the sport throughout the season. Changes in helmet design may account for the rise in the concussion rate since the 1995-1996 season. RECOMMENDATIONS: We recommend research into the mechanism of head injuries and the implications of design changes to protective helmets, as well as further investigation of the best designs for shoulder and chest protection.

Effect of testosterone on the female anterior cruciate ligament.

Injuries to the anterior cruciate ligament (ACL) result in immediate and long-term morbidity and expense. Young women are more likely to sustain ACL injuries than men who participate in similar athletic and military activities. Although significant attention has focused on the role that female sex hormones may play in this disparity, it is still unclear whether the female ACL also responds to androgens. The purpose of this study was to determine whether the female ACL was an androgen-responsive tissue. To identify and localize androgen receptors in the female ACL, we used Western blotting and immunofluorescent labeling, respectively, of ACL tissue harvested during surgery from young women (n = 3). We then measured ACL stiffness and assessed total testosterone (T) and free [free androgen index (FAI)] testosterone concentrations, as well as relative estradiol to testosterone ratios (E(2)/T and E(2)/FAI) at three consecutive menstrual stages (n = 20). There were significant rank-order correlations between T (0.48, P = 0.031), FAI (0.44, P = 0.053), E(2)/T (-0.71, P < 0.001), E(2)/FAI (-0.63, P = 0.003), and ACL stiffness near ovulation. With the influences of the other variables controlled, there were significant negative partial rank-order correlations between ACL stiffness and E(2)/T (-0.72, P < 0.001) and E(2)/FAI (-0.59, P = 0.012). The partial order residuals for T and FAI were not significant. These findings suggest that the female ACL is an androgen-responsive tissue but that T and FAI are not independent predictors of ACL stiffness near ovulation. Instead, the relationship between T, FAI, and ACL stiffness was likely influenced by another hormone or sex hormone binding globulin.

Mechanisms and management of stress fractures in physically active persons.

OBJECTIVE: To describe the anatomy of bone and the physiology of bone remodeling as a basis for the proper management of stress fractures in physically active people. DATA SOURCES: We searched PubMed for the years 1965 through 2000 using the key words stress fracture, bone remodeling, epidemiology, and rehabilitation. DATA SYNTHESIS: Bone undergoes a normal remodeling process in physically active persons. Increased stress leads to an acceleration of this remodeling process, a subsequent weakening of bone, and a higher susceptibility to stress fracture. When a stress fracture is suspected, appropriate management of the injury should begin immediately. Effective management includes a cyclic process of activity and rest that is based on the remodeling process of bone. CONCLUSIONS/RECOMMENDATIONS: Bone continuously remodels itself to withstand the stresses involved with physical activity. Stress fractures occur as the result of increased remodeling and a subsequent weakening of the outer surface ofthe bone. Once a stress fracture is suspected, a cyclic management program that incorporates the physiology of bone remodeling should be initiated. The cyclic program should allow the physically active person to remove the source of the stress to the bone, maintain fitness, promote a safe return to activity, and permit the bone to heal properly.