You've Got a Friend in Me: Fostering Social Connection Among College Students Through Peer-Led Physical Activity.

Social connection and physical activity (PA) are essential health behaviors necessary for young adults to thrive. The majority of college students in the United States are not meeting PA recommendations and simultaneously report concerning rates of loneliness, depression, anxiety, and fatigue; all factors that contribute to poor psychological well-being and reduce students' abilities to sustain academic success. These mental and physical health indicators have only worsened due to the stress, isolation, and uncertainty experienced during the COVID-19 pandemic. Fitness Buddies (FB) is a free peer-led PA program designed to combat loneliness, stress, anxiety, depression, and low PA, by providing students the opportunity to connect with one another through PA. FB participants are matched with a peer leader for weekly PA sessions based on activity interests and schedules. The FB program model shifts the focus of traditional PA programs, from prescribing and monitoring PA duration, intensity and modalities, to supporting psychological well-being through satisfaction of the three basic psychological needs of competence, autonomy, and relatedness within peer PA-based relationships. In the first pilot phase of implementation, students reported improved situational affect, to include reduced stress and anxiety, following participation in the FB program for one academic semester. Participants also reported the development of quality peer relationships and a sense of belonging to the campus community, both of which had previously been lacking. The FB program model is an innovative and cost-efficient strategy to supporting college students' psychological well-being and long-term success.

A model for estimating the economic impact of secondhand smoke exposure: a study in Indiana.

OBJECTIVE: This study estimated the economic cost of health services and premature loss-of-life costs from secondhand smoke (SHS) exposure in Indiana. DESIGN AND SETTING: Costs of SHS-related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to SHS exposure both for adults and children. Estimated direct costs included hospital inpatient costs, loss-of-life costs, and ambulatory care costs where available, based on the most currently available Indiana hospital discharge data, vital statistics, census data, and nationally published research. PARTICIPANTS: Attributable risk values were applied to the number of deaths and hospital discharges in Indiana in 2008 and 2010, respectively, to estimate the number of individuals impacted by SHS exposure. All cost estimates were adjusted to 2010 US dollar values. RESULTS: The direct cost of health care and premature loss of life in Indiana attributed to SHS was estimated to be $1.3 billion in 2010--$237.8 million in health care costs and $879.0 million in premature loss of life for adults and $89.4 million in health care costs and $98.6 million in premature loss of life for children. The estimated population for Indiana in 2010 was 6 483 802 resulting in SHS-related costs of $201 per capita. DISCUSSION: This study demonstrated a model that could be used to estimate the costs of health care and premature mortality from exposure to SHS at a state or local level. These data may be used to support the education of the public, community leaders, and state policy makers regarding the magnitude of the problem and the compelling need to implement interventions to better protect the health of citizens and their economic prosperity.

Consolidating the Academic End of a Community-Based Participatory Research Venture to Address Health Disparities.

Although there is strong support for community engagement and community-based participatory research (CBPR) from public health entities, medical organizations, and major grant-funding institutions, such endeavors often face challenges within academic institutions. Fostering the interest, skills, and partnerships to undertake participatory research projects and truly impact the community requires an interdisciplinary team with the competencies and values to engage in this type of research. Discussed in this article is how a CBPR-focused team evolved at a southern university, with emphasis on the activities that supported group identity, contributed to its evolution, and positioned the group to speak with authority in promoting CBPR as a tool for addressing health disparities.

Diabetes and urinary incontinence in 50- to 90-year-old women: a cross-sectional population-based study.

OBJECTIVE: The purpose of this study was to examine the association between urinary incontinence and diabetes in a large community-based population of women. STUDY DESIGN: The Health and Retirement Study is a large multistage area probability sample of households in the United States. Data were collected from 10,678 women aged 50 to 90 years. Dependent variables were no, mild, and severe incontinence. Independent variables consisted of demographic and health data. Diabetes was dichotomized into insulin-requiring (IRDM) and non-insulin-requiring disease (NIRDM). Survey-based ordered logistic regression was used to simultaneously analyze associations between incontinence groups. RESULTS: Urinary incontinence was reported by 22% (2319/10,678) of women. IRDM was associated with urinary incontinence (odds ratio [OR] 1.63; 95% CI 1.28-2.09), but NIRDM was not (OR 1.20; 95% CI 1.00-1.45). CONCLUSION: IRDM is independently associated with urinary incontinence in women ages 50 to 90 years, independent of patient body mass index, comorbidities, or age.

Characteristics of individuals who fell while receiving home health services.

BACKGROUND AND PURPOSE: Many patients receiving home health services are at risk for falling, but fall risk factors have not been previously investigated in this population. A retrospective record review was used to describe individuals who fell while being served by a home health agency. SUBJECTS: The 98 individuals who fell while receiving home health services were compared with a random sample of 98 subjects served by the home health agency during the same period who did not report falling. METHODS: Subjects were compared by age, sex, days of receiving home health services, number of falls prior to admission to the home health agency, diagnosis, medication category, home health services received, and type of health care coverage. In the group with falls, causes of falls and interventions were described. RESULTS: The group with falls had comorbidities of neurological and cardiovascular impairment, took more medications associated with increased risk of falling, and had almost 3 times the number of falls prior to admission than the group without falls. DISCUSSION AND CONCLUSION: Home care providers should consider medical history, medication usage, and fall history as risk factors for falls in the home environment.

Physiotherapy and spinal nerve root adhesion: a caution.

BACKGROUND AND PURPOSE: The term 'spinal neuropathic pain' has been coined to describe the chronic neuropathic pain that results when spinal nerve roots are aggravated by scar tissue. (It is different from the pain of spinal cord injury.) Such patients have longstanding back and radicular pain (nerve root pain, predominantly in the limbs) caused by scar or inflammatory tissue around the nerve roots. The pathology of such patients' pain means that special consideration needs to be given to the fact that such adhesions compromise nerve biomechanics and that movement generates additional pain. Patients with such spinal neuropathic pain often do not do well from conventional physiotherapy. Exacerbation (flare-up) frequently follows the exercise routines in common practice. METHOD: Individual patient experience was collected from an internet support group, and the results were tabulated. RESULTS: All patients considered stretching, flexing and strenuous exercise to be harmful. A few reported that gentle exercise with instruction not to cause pain was beneficial. Some patients received advice not to do physiotherapy once they had been diagnosed with arachnoiditis. CONCLUSIONS: The treatment of patients with spinal neuropathic pain warrants special consideration as far as physiotherapy is concerned: patients should only be prescribed gentle, individually tailored exercise. It is hoped the present small study will promote understanding and the development of better therapy.

Exercise training utilizing body weight-supported treadmill walking with a young adult with cerebral palsy who was non-ambulatory.

PURPOSE: The purpose of this case report is to determine the effects of exercise training using body weight-supported treadmill walking (BWSTW) with an 18-year-old male diagnosed with Cerebral palsy (CP) who was non-ambulatory and not receiving physical therapy. CASE DESCRIPTION: Outcome measures included the Pediatric Quality of Life Inventory (PedsQL), the Pediatric Evaluation of Disability Inventory (PEDI), heart rate (HR), rate of perceived exertion, 3-minute walk test and physiological cost index (PCI). BWSTW sessions took place twice a week for 6 weeks with a reduction of approximately 40% of the patient's weight. RESULTS: Over-ground 3-minute walk test distance and PCI were essentially unchanged. BWSTW exercise time increased by 67% with a 43% increase in speed while average working HR decreased by 8%. BWSTW PCI decreased by 26%. PedsQL parent report improved in all domains. PedsQL self-report demonstrated a mild decrease. PEDI showed improvements in self-care and mobility. DISCUSSION: Exercise utilizing BWSTW resulted in a positive training effect for this young adult with CP who was non-ambulatory. Developing effective and efficient protocols for exercise training utilizing BWSTW may aid in the use of this form of exercise and further quantify outcomes. Ensuring that young adults with CP have safe and feasible options to exercise and be physically active on a regular basis is an important role of a physical therapist.

Effectiveness of multimodal pain management protocol in total knee arthroplasty patients.

BACKGROUND: Numerous methods for postoperative pain management after total knee arthroplasty (TKA) are reported. Multimodal pain management approaches, including peripheral nerve blocks and systemic analgesia, have been shown to decrease patient pain, increase patient satisfaction with pain control, decrease length of stay (LOS), and improve patient outcomes. PURPOSE/METHODS: To compare patient outcomes (pain scores, LOS, postoperative nausea and vomiting, and movement) between 66 TKA patients of a single orthopaedic surgeon in 2010 who received a multimodal approach to 45 historical (control) patients in 2009 who did not receive a multimodal pain management protocol. RESULTS: Patients who were treated with the multimodal pain protocol had significantly lower pain scores in the immediate postoperative period, less postoperative nausea and vomiting day of surgery, and a decrease in LOS by half a day despite increased buckling and increased level of assistance with ambulation. CONCLUSION: The multimodal pain approach improved patient outcomes in TKA patients.

The value of blowing up a balloon.

Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. A therapeutic exercise that promotes optimal posture (diaphragm and lumbar spine position), and neuromuscular control of the deep abdominals, diaphragm, and pelvic floor (lumbar-pelvic stabilization) is desirable for utilization with patients who demonstrate suboptimal respiration and posture. This clinical suggestion presents a therapeutic exercise called the 90/90 bridge with ball and balloon. This exercise was designed to optimize breathing and enhance both posture and stability in order to improve function and/or decrease pain. Research and theory related to the technique are also discussed.

Effects of aerobic conditioning and strength training on a child with Down syndrome: a case study.

PURPOSE: To determine the effects of a home exercise program of combined aerobic and strength training on fitness with a 10.5-year-old girl with Down syndrome (DS). Measurements included cardiovascular variables, strength, body composition, flexibility, and skill. METHODS: The subject participated in a home exercise program: 30 to 60 minutes of moderate- to high-intensity exercise five to six days per week for six weeks. The cardiovascular variables monitored were heart rate, respiration rate, and oxygen consumption during a submaximal treadmill stress test. Other measures included 10-repetition maximal strength of selected muscle groups, body mass index, flexibility, Gross Motor Scales of the Bruininks-Oseretsky Test of Motor Proficiency, and anaerobic muscle power. RESULTS: Improvements in submaximal heart and respiration rates, aerobic performance, muscle strength and endurance, gross motor skills, and anaerobic power were observed for this subject. Body weight and flexibility were unchanged. CONCLUSIONS: For this subject, a combined aerobic and strength-training program resulted in improved cardiopulmonary functions not observed in previous studies of subjects with DS.

Development and implementation of an interdisciplinary plan of care.

In January 2002 Aurora Health Care Metro Region chartered an interdisciplinary team to develop a process and structure for patient-centered interdisciplinary care planning. This unique endeavor created a process that includes the patient, family, and all clinical disciplines involved in planning and providing care to patients from system point of entry throughout the entire acute care episode. The interdisciplinary plan of care (IPOC) demonstrates the integration of prioritized problems, outcomes, and measurement toward goal attainment. This article focuses on the journey of this team to the successful implementation of an IPOC.

The acquisition of exogenous algal symbionts by an octocoral after bleaching.

Episodes of coral bleaching (loss of the symbiotic dinoflagellates) and coral mortality have occurred with increasing frequency over the past two decades. Although some corals recover from bleaching events, the source of the repopulating symbionts is unknown. Here we show that after bleaching, the adult octocoral Briareum sp. acquire dinoflagellate symbionts (Symbiodinium sp.) from the environment. Uptake of exogenous symbionts provides a mechanism for response to changes in the environment and resilience in the symbiosis.