Attending with family members, completion rate and benefits accrued from chronic disease self-management program.

OBJECTIVES: Chronic Disease Self-Management Program (CDSMP) has been demonstrated effective in addressing the self-management of chronic conditions among older adults. With a higher attrition rate, this study investigated whether attending with family members influenced completion of and benefits accrued from the CDSMP. METHODS: The baseline data were collected from CDSMP participants in New York State (n = 4184), and the follow-up data were collected from completers (attended 4+ sessions) (n = 293). Multi-level logistic regression was employed to predict the association between family accompany and program completion. Paired sample t-test was used to compare the differences in benefits from CDSMP after six months. RESULTS: Attending with family members was associated with a higher likelihood of completing the CDSMP (OR = 1.626, p < .05). All completers reported small but significant improvements in self-rated health at six months (p < .001), and the changes were greater for those with family members. Males, caregivers, those aged 65 to 84 years old, with college or above education, were more accompanied by family members. Workshops in senior centers, libraries, or educational institutions attracted more family companions. DISCUSSION: Engaging family members may increase CDSMP participants' motivation to complete the program. CDSMP providers should encourage participants to attend with their family members.

Translating the Chronic Disease Self-Management Program for Community-Dwelling Adults With Developmental Disabilities.

Objective: The study was to test the feasibility of supplementary materials (DD-CDSMP) supporting people with developmental disabilities who are aging to participate in the Chronic Disease Self-Management Program (CDSMP). CDSMP is a six-session group intervention designed to increase self-management of chronic health conditions. Method: Supplementary materials were utilized within two CDSMP workshops. Each workshop involved seven to nine persons with developmental disabilities and five to seven staff. Supplementary materials to the existing intervention manual were reviewed using a framework for modifications and adaptions for evidence-based interventions. Process interviews with leaders and participants, pre- and posttests on self-management activity and satisfaction surveys assessed outcomes and feasibility. Results: Classes were successfully held with a 70% completer rate, and all materials proved useful. Discussion: People with developmental disabilities as they age tend to have more comorbid conditions than the general population. Developing and implementing materials and strategies to making self-management more accessible to people with developmental disabilities in mainstream rather than segregated settings will improve the quality of people's lives.

Assessing the Effectiveness of the Aging Mastery Program.

Background: Successful aging is best determined by active management and self-determination of one’s aging roadmap. Some individuals are ready to respond to these challenges, others may benefit from assistance that might be offered through an evidence-based intervention. The Aging Mastery Program® (AMP) has been developed to meet these needs. Method: In a cross over design the intervention was tested in ten senior centers and aging network agencies looking at impacts upon general health and quality of life, patient activation, physical activity and advanced care planning. Results: There was a statistically significant (tested at a 0.05 level) level of improvement found in physical activity and advanced care planning. Conclusion: Findings support the program's effectiveness and its value as an evidence-based intervention for older adult programming.

Caregiving Load and Respite Service Use: A Comparison between Older Caregivers and Younger Caregivers.

Study aims were to explore differences in predictors of respite care use between older (aged 65+) and younger caregivers (aged 18-64 years), and associations between caregiving load and respite care use using multivariate logistic regression analysis and unpaid caregiver (n= 10,500) data from the 2009 California Health Interview Survey. Caregiving load comprised number of care recipients, weekly hours in caregiving, and caregiving duration. Variables with a significant association with respite care for older caregivers were female gender, income, and health insurance. For younger caregivers, respite care use associations were with ethnicity, caregiving relationship, education, and availability of substitute help.

Improving the Reach of the National Diabetes Prevention Program Within a Health Disparities Population: A Bronx New York Pilot Project Crossing Health- and Community-Based Sectors.

INTRODUCTION: Diabetes affects upward of 30% of South Bronx residents. The Centers for Disease Control and Prevention's National Diabetes Prevention Program (NDPP) reduces risk of progression to diabetes, yet implementation has been elusive within health disparities populations. METHODS: This community-based, collaborative project piloted the NDPP in the South Bronx and evaluated implementation challenges and enablers. The New York State training group prepared community peer lifestyle coaches recruited by a community organization. A professional society trained academic detailers from local faculty. An interview process evaluated community needs and public health officials' beliefs. A portal managed by the New York State training group collected demographic and biometric data from the community participants and facilitated online registration. Data from interviews and observations were coded systematically using a thematic analysis framework. RESULTS: We were successful at recruiting and training 14 lifestyle coaches and 7 academic detailers, as well as recruiting members of the health disparities population in the South Bronx into the program. Fifty-two individuals completed the first 6 months of the yearlong program, attending an average of 12.7 of 16 sessions. By week 16, weight loss averaged 7.4 lbs and many had doubled their minutes of physical activity. Local electronic referral and feedback systems were developed. DISCUSSION: Health professionals, their teams, public health centers, and communities can work together to prevent diabetes by enhancing the reach of the NDPP to health disparities populations. Peer education using lifestyle coaches can provide a trustworthy process for crossing the boundaries between health teams and community support groups.

Understanding implementation of best practices for working with the older homeless through the lens of self-determination theory.

Five in-depth, semistructured interviews on what constitutes best practices were conducted with key professionals experienced in serving the homeless population. A practice model emerged from the interviews wherein client self-determination was considered a keystone. Self-determination theory was then used as a framework for understanding the best practices that emerged, and the relationship between client self-determination and positive outcomes. Implications are discussed for the older homeless, highlighting that although general best practices are applicable for this subgroup, the unique factors of an aging homeless population must be incorporated into best practice discussions.

Supramolecular aggregation of block copolymers in the solid state as assisted by the selective formation of inclusion crystals.

Supramolecular self-assembly of a host molecule with selected blocks of triblock copolymers enabled the formation of inclusion 2D nanocrystals that connect consecutive copolymer chains. Indeed, the selective inclusion of ethylene oxide (EO) blocks in inclusion crystals and the phase segregation of PO blocks of poly(ethylene oxide-b-propylene oxide-b-ethylene oxide) (EO(n)PO(m)EO(n)) triblock copolymers provide an efficient route to create alternated crystalline lamellae and amorphous layers, forming a well-organized material. The spontaneous formation of the supramolecular architectures was realized by a solvent-free mechanochemical approach or by thermal treatment of the copolymer and host (tris-o-phenylenedioxycyclotriphosphazene), as demonstrated by in situ synchrotron X-ray diffraction. The driving force for the fabrication of crystalline inclusion compounds with selected EO segments is based on the establishment of cooperative noncovalent intermolecular interactions, while steric effects prevent the formation of the inclusion crystal with the remaining PO blocks. The 2D (1)H-(13)C solid state and fast-(1)H MAS NMR provide direct evidence of the intimate interactions between the host and EO block and the topology of the block copolymer in the material. The large magnetic susceptibility generated by the aromatic host nanochannels surrounding the included EO chains was interpreted by ab initio calculations (HF-GIAO/DGDZVP) that carefully reproduce the chemical shifts associated with the effects of guest-host interactions. The theoretical calculations enable the measurement of short intermolecular distances between the host and the target block, demonstrating the existence of a diffuse network of multiple CH···π host-guest interactions that improve the robustness of the supramolecular architecture. The overall evidence enforces the strategy of combining the use of block copolymers and clathrate-forming molecules to fabricate organized materials through noncovalent interactions.

2D multinuclear NMR, hyperpolarized xenon and gas storage in organosilica nanochannels with crystalline order in the walls.

The combination of 2D 1H-13C and 1H-29Si solid state NMR, hyperpolarized 129Xe NMR, synchrotron X-ray diffraction, together with adsorption measurements of vapors and gases for environmental and energetic relevance, was used to investigate the structure and the properties of periodic mesoporous hybrid p-phenylenesilica endowed with crystalline order in the walls. The interplay of 1H, 13C, and 29Si in the 2D heteronuclear correlation NMR measurements, together with the application of Lee-Goldburg homonuclear decoupling, revealed the spatial relationships (<5 angstroms) among various spin-active nuclei of the framework. Indeed, the through-space correlations in the 2D experiments evidenced, for the first time, the interfaces of the matrix walls with guest molecules confined in the nanochannels. Organic-inorganic and organic-organic heterogeneous interfaces between the matrix and the guests were identified. The open-pore structure and the easy accessibility of the nanochannels to the gas phase have been demonstrated by highly sensitive hyperpolarized (HP) xenon NMR, under extreme xenon dilution. Two-dimensional exchange experiments showed the exchange time to be as short as 2 ms. Through variable-temperature HP 129Xe NMR experiments we were able to achieve an unprecedented description of the nanochannel space and surface, a physisorption energy of 13.9 kJ mol-1, and the chemical shift value of xenon probing the internal surfaces. These results prompted us to measure the high storage capacity of the matrix towards benzene, hexafluorobenzene, ethanol, and carbon dioxide. Both host-guest, CH...pi, and OH...pi interactions contribute to the stabilization of the aromatic guests (benzene and hexafluorobenzene) on the extended surfaces. The full carbon dioxide loading in the channels could be detected by synchrotron radiation X-ray diffraction experiments. The selective adsorption of carbon dioxide (ca. 90 wt %) vs that of oxygen and hydrogen, together with the permanent porosity, high thermal stability, and high degree of order, makes this a suitable matrix for purifying hydrogen in clean-energy generation.

A single-crystal imprints macroscopic orientation on xenon atoms.

A porous single-crystal collects xenon atoms from the gas phase and orients them macroscopically, as highlighted by hyperpolarized xenon NMR.