Diverse school community engagement with the North Carolina active routes to school project: a diffusion study.

BACKGROUND: Schools located in rural parts of the United States and North Carolina have benefited proportionally less from the federal Safe Routes to School (SRTS) program than their more urban counterparts. We investigated whether and how diverse elementary and middle school communities throughout North Carolina have engaged in a SRTS-inspired, multi-sectoral initiative called the Active Routes to School (ARTS) project over the course of 5 years (2013 through 2017). METHODS: Analyses included a study sample of 2602 elementary and middle schools in North Carolina, 853 that participated in the ARTS project over the five-year study period and 1749 that had not. Statistical models controlling for county- and school-level confounders predicted schools' involvement in walking and bicycling-promotive events, programs, and policies over time. RESULTS: Schools' engagement with ARTS Project programming increased significantly over the study period, with 33% of eligible schools participating with the project by the end of 2017. Participation was most common in promotional events. Such event participation predicted engagement with regularly recurring programming and school- and district-level establishment of biking- and walking-facilitative policies. Lower income schools were more likely to establish recurring bike and walk programs than wealthier schools, whereas rural schools were less likely than city schools to participate in promotional events, yet equally as likely as other schools to participate in recurring bike and walk programs. CONCLUSIONS: Schools' engagement with the North Carolina ARTS Project diffused despite many schools' rural geographies and lower socioeconomic status. Further, participation in one-time promotional events can portend schools' establishment of recurring walking and biking programs and supportive policies.

The Buddy Benefit: Increasing the Effectiveness of an Employee-Targeted Weight-Loss Program.

It is well known that significant others (particularly romantic partners) can influence people's weight management efforts. However, what constitutes effective support-and from which type of individual (e.g., romantic partner, family member, friend)-is unclear. Thus, framed by confirmation theory, we assessed the effectiveness and types of communication of a weight-loss "buddy" through reports of 704 individuals enrolled in a 15-week synchronous online weight-loss program. Roughly 54% of participants chose buddies; and those who did lost more weight and waist inches than those who were involved in the program without buddy support. We also found that a combination of high accepting and high challenging messages from buddies was associated with the greatest decrease in body mass index (BMI) as well as the greatest reduction in waist size. Furthermore, the support by romantic partners paralleled support by other types of buddies. Having a supportive buddy who was not a romantic partner was just as effective as turning to a romantic partner for assistance. This study underscores the important role of a buddy in supporting weight-loss program involvement and encourages individuals to consider enlisting the help of a buddy, as opposed to losing weight alone, in order to maximize weight management effectiveness.

Redefining the Team in Team-Based Care: Role of Public Health.

In North Carolina, our public health infrastructure consists of a state health department and 85 local health departments representing all 100 counties. The state health department, local health departments, health systems, and clinical providers work literally and figuratively as a team to improve the health of our citizens. In this article, we provide examples of the critical role of public health practitioners as part of the broader team addressing health, specifically in the areas of chronic disease, communicable disease, oral health, environmental health, and maternal and child health.

Dialectical behaviour therapy in an inpatient unit for women with a learning disability: Service users' perspectives.

There is a general lack of self-report data from service users with an intellectual disability (ID) about their views of psychological interventions. This research explored the views and experiences of female inpatients, with a diagnosis of a personality disorder and an ID, about dialectical behaviour therapy (DBT). Semi-structured interviews were used with 10 women, recruited from two independent mental health hospitals. The interviews were analysed using interpretative phenomenological analysis. Participants showed varying levels of understanding of DBT. Findings highlight the need for a standardized approach with a suitably adapted structure and curriculum to meet the needs of inpatients with an ID. Factors such as the therapeutic relationship were identified as playing a role in participants' motivation, engagement and participation in DBT.

The North Carolina Division of Public Health's vision for healthy and sustainable communities.

The North Carolina Division of Public Health is working to improve access to physical activity through changes in the built environment by participating in the Healthy Environments Collaborative and by leading the state's Communities Putting Prevention to Work project and the Shape Your World movement.

Scaffolding Inference-making for Adolescents with Disabilities that Impact Reading.

Middle and secondary grade students with disabilities that impact reading, including learning disabilities in reading (LD-R), high functioning autism (HFA), emotional and behavioral disorders (EBD), and students who are at-risk for reading failure due to the effect of poverty often struggle to make knowledge-based inferences while reading informational texts. As a result, this population of students is not able to read for understanding and learn from grade-level texts. Unfortunately, many special educators have had little preparation in how to develop their knowledge of inference-making or methods for explicitly teaching inference-making. Despite their lack of knowledge, special educators are often solely responsible for teaching skills that support reading comprehension, such as knowledge-based inference-making, to students with LD-R, EBD, HFA, and students reading below grade level. This article provides special educators, via self-directed learning, with information and resources to enhance their understanding of knowledge-based inferencing and methods for teaching knowledge-based inference-making to middle and secondary grade students with and at-risk for disabilities that impact reading achievement.

Error Patterns in the Knowledge-Based Inference-Making of Less Skilled Middle-Grade Readers: An Exploratory Study.

The primary aims of this mixed method study were to (a) examine the effectiveness of a brief inference intervention, (b) compare the types of knowledge-based inferencing errors less skilled middle grade readers make, and (c) evaluate if self-reported cognitive load relates to inferencing. Participants (n = 17) were randomly assigned to a graphic organizer-inference intervention (GO-Inference) (n = 9) or business as usual (BAU) condition (n = 8), and differences between groups were explored for each study purpose. Quantitative and qualitative results suggested that while less skilled readers in the GO-Inference condition made modest progress in forming knowledge-based inferences, they continued to struggle to distinguish relevant versus irrelevant information from text and/or retrieve knowledge necessary to form inferences. Students in the BAU condition were more likely to make errors such as providing irrelevant information or failing to respond. Additionally, students in the GO-Inference condition reported lower cognitive load during inference-making tasks.

Portable X-ray fluorescence (pXRF) calibration for analysis of nutrient concentrations and trace element contaminants in fertilisers.

With the increasing popularity of local blending of fertilisers, the fertiliser industry faces issues regarding quality control and fertiliser adulteration. Another problem is the contamination of fertilisers with trace elements that have been shown to subsequently accumulate in the soil and be taken up by plants, posing a danger to the environment and human health. Conventional characterisation methods necessary to ensure the quality of fertilisers and to comply with local regulations are costly, time consuming and sometimes not even accessible. Alternatively, using a wide range of unamended and intentionally amended fertilisers this study developed empirical calibrations for a portable handheld X-ray fluorescence (pXRF) spectrometer, determined the reliability for estimating the macro and micro nutrients and evaluated the use of the pXRF for the high-throughput detection of trace element contaminants in fertilisers. The models developed using pXRF for Mg, P, S, K, Ca, Mn, Fe, Zn and Mo had R2 values greater or equal to 0.97. These models also performed well on validation, with R2 values greater or equal to 0.97 (except for Fe, R2val = 0.55) and slope values ranging from 0.81 to 1.44. A second set of models were developed with a focus on trace elements in amended fertilisers. The R2 values of calibration for Co, Ni, As, Se, Cd and Pb were greater than or equal to 0.80. At concentrations up to 1000 mg kg-1, good validation statistics were also obtained; R2 values ranged from 0.97-0.99, except in one instance. The regression coefficients of the validation also had good prediction in the range of 0-100 mg kg-1 (R2 values were from 0.78-0.99), but not as well at lower concentrations up to 20 mg kg-1 (R2 values ranged from 0.10-0.99), especially for Cd. This study has demonstrated that pXRF can measure several major (P, Ca) and micro (Mn, Fe, Cu) nutrients, as well as trace elements and potential contaminants (Cr, Ni, As) in fertilisers with high accuracy and precision. The results obtained in this study is good, especially considering that loose powders were scanned for a maximum of 90 seconds without the use of a vacuum pump.

The role of state health departments in supporting community-based obesity prevention.

BACKGROUND: Recent national attention to obesity prevention has highlighted the importance of community-based initiatives. State health departments are in a unique position to offer resources and support for local obesity prevention efforts. COMMUNITY CONTEXT: In North Carolina, one-third of children are overweight or obese. North Carolina's Division of Public Health supports community-based obesity prevention by awarding annual grants to local health departments, providing ongoing training and technical assistance, and engaging state-level partners and resources to support local efforts. METHODS: The North Carolina Division of Public Health administered grants to 5 counties to implement the Childhood Obesity Prevention Demonstration Project; counties simultaneously carried out interventions in the community, health care organizations, worksites, schools, child care centers, and faith communities. OUTCOME: The North Carolina Division of Public Health worked with 5 local health departments to implement community-wide policy and environmental changes that support healthful eating and physical activity. The state health department supported this effort by working with state partners to provide technical assistance, additional funding, and evaluation. INTERPRETATION: State health departments are well positioned to coordinate technical assistance and leverage additional support to increase the strength of community-based obesity prevention efforts.

Effects of a behavior-based weight management program delivered through a state cooperative extension and local public health department network, North Carolina, 2008-2009.

INTRODUCTION: Eat Smart, Move More, Weigh Less (ESMMWL) is an adult weight management program developed in response to North Carolina Obesity Plan recommendations to make weight management interventions accessible to underserved populations. ESMMWL was designed to be delivered through the North Carolina Cooperative Extension and North Carolina Division of Public Health. Program coursework included content on evidence-based eating and physical activity behaviors and incorporated mindful eating concepts. The objectives of this study were to describe participant changes in weight and behaviors and to document the effectiveness of the program. METHODS: In this prospective pilot study, courses were delivered and data collected from January 2008 through June 2009. Instructors provided feedback about implementation. For participants, height, weight, and waist circumference were measured at baseline and completion. Participants completed a questionnaire about changes in their eating and physical activity behaviors, changes in their confidence to engage in weight management behaviors, and their satisfaction with the course. RESULTS: Seventy-nine instructors delivered 101 ESMMWL courses in 48 North Carolina counties. Most of the 1,162 completers were white women. Approximately 83% reported moving toward or attaining their goal. The average weight loss was 8.4 lb. Approximately 92% reported an increase in confidence to eat healthfully, and 82% reported an increase in confidence to be physically active. Instructors made suggestions for program standardization. CONCLUSION: This study demonstrated the effectiveness, diffusion, and implementation of a theoretically based weight management program through a state extension and local public health department network. Study of the sustainability of changes in eating and physical activity behaviors is needed.

A comparison of soil texture measurements using mid-infrared spectroscopy (MIRS) and laser diffraction analysis (LDA) in diverse soils.

Spectroscopic methods for the determination of soil texture are faster and cheaper than the standard methods, but how do the results compare? To address this question, laser diffraction analysis (LDA) and mid-infrared spectroscopy (MIRS) analysis have been compared to conventional sieve-pipette measurements of texture in diverse European and Kenyan soils. To our knowledge this comparison between LDA and MIRS has not been made previously. It has used soils with a broad range of organic carbon (OC) contents to investigate whether, as in other techniques, clay-OC aggregation affects the estimation of clay with MIRS. The MIRS predictions of clay content were much better than the LDA measurements, but both techniques gave good measurements of sand content. The MIRS over-estimated clay at low clay content and under-estimated at high clay content (calibration set R2 = 0.83). The LDA over-estimated clay by ~ 60% (calibration set R2 = 0.36), indicating that the widely used clay threshold of < 8 µm was too high, and < 4 µm was found to be more accurate. In samples with < 5% OC content, both the LDA and MIRS gave very good clay predictions (R2 = 0.88 and 0.81, respectively). But in predictions of clay content in samples with > 5% OC the LDA under-estimated (R2 = < 0.1) and MIRS over-estimated (R2 = 0.34) clay content. In soils with OC removed, the MIRS prediction of clay content improved, indicating interference between over-lapping spectral regions for organic and mineral constituents. Unlike granulometric measurements of texture such as the LDA, MIRS analysis is not subject to the limitations imposed by the shape and density of particles. It was concluded that in typical agricultural soils with < 5% OC and < 60% clay content, both techniques could be used for cheap, fast and reliable estimates of soil texture.

Serotonergic projections from the caudal raphe nuclei to the hypoglossal nucleus in male and female rats.

The respiratory control system is sexually dimorphic. In many brain regions, including respiratory motor nuclei, serotonin (5HT) levels are higher in females than in males. We hypothesized that there could be sex differences in 5HT input to the hypoglossal nucleus, a region of the brainstem involved in upper airway control. Adult Fischer 344 rats were anesthetized and a retrograde transsynaptic neuroanatomical tracer, Bartha pseudorabies virus (PRV), was injected into the tongue. Sections through the medulla were reacted immunocytochemically for the presence of (i) PRV, (ii) tryptophan hydroxylase (TPH; marker of 5HT neurons), (iii) PRV combined with TPH, and (iv) 5HT. Sex hormone levels were measured in female rats and correlated with TPH immunoreactivity, as hypoglossal 5HT levels vary with the estrous cycle. The number of PRV neurons was comparable in male and female rats. The number and distribution of TPH immunoreactive neurons in the caudal raphe nuclei were similar in male and female rats. The subset of 5HT neurons that innervate hypoglossal motoneurons was also similar in male and female rats. With the exception of the ventrolateral region of the hypoglossal nucleus, 5HT immunoreactivity was similar in male and female rats. These data suggest that sex differences in 5HT modulation of hypoglossal motoneurons in male and female rats are not the result of sex differences in TPH or 5HT, but may result from differences in neurotransmitter release and reuptake, location of 5HT synaptic terminals on hypoglossal motoneurons, pre- and postsynaptic 5HT receptor expression, or the distribution of sex hormone receptors on hypoglossal or caudal raphe neurons.

Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain.

PURPOSE OF REVIEW: There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management. RECENT FINDINGS: The practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable. This review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.

The Move More Scholars Institute: a state model of the physical activity and public health practitioners course.

Physical activity has been identified as a public health priority. In response, training and professional development opportunities have been created to increase the capacity of public health practitioners to address this issue. Currently, training resources are primarily reaching national- and state-level professionals. Local-level physical activity and public health practitioners can also benefit from these resources. The Move More Scholars Institute, a 4-day training course for community-based physical activity practitioners in North Carolina, was developed for local practitioners. This article will describe the planning of, implementation of, and initial response to the Move More Scholars Institute.

Academic self-handicapping: the role of self-concept clarity and students' learning strategies.

BACKGROUND: Self-handicapping is linked to students' personal motivations, classroom goal structure, academic outcomes, global self-esteem and certainty of self-esteem. Academic self-handicapping has yet to be studied with respect to students' consistency in self-description and their description of themselves as learners. AIMS: This study examined students' self-esteem and self-concept clarity as well as their tendencies to employ deep- or surface-learning approaches and self-regulate while learning in relation to their self-handicapping tendencies and exam performance. SAMPLE: Participants were 161 male and female Canadian, first-year university students. METHOD: Participants completed a series of questionnaires that measured their self-esteem, self-concept clarity, approaches to learning, self-regulation and reflections on performance prior to and following their exam. RESULTS: Self-handicapping was negatively correlated with self-concept clarity, deep learning, self-regulated learning and exam grades, and positively correlated with surface learning and test anxiety. Regression analyses showed that self-concept clarity, self-regulation, surface-learning and test anxiety scores predicted self-handicapping scores. Self-concept clarity, test anxiety scores, academic self-efficacy and self-regulation were predictors of mid-term exam grades. CONCLUSIONS: This study showed that students' self-concept clarity and learning strategies are related to their tendencies to self-handicap and their exam performance. The role of students' ways of learning and their self-concept clarity in self-handicapping and academic performance was explored.

Design and implementation of a nutrition and physical activity curriculum for child care settings.

BACKGROUND: Childhood overweight continues to increase in the United States. Children should begin establishing healthy eating and physical activity behaviors at a young age. CONTEXT: Many children spend a large part of their day in child care settings, whether in preschools or home day care settings. Child care providers in these settings have an opportunity to establish and reinforce habits that promote good health. However, the providers need training and creative educational materials to teach children about healthy eating and physical activity. Color Me Healthy is an educational program focusing on nutrition and physical activity that was developed for children aged 4 and 5 years by three of the authors (C.D., C.T., and L.P.). METHODS: In 2001 and 2002, the program was implemented in 47 North Carolina counties and the North Carolina Cherokee reservation. In December 2001, we used an information-dissemination model called Train the Trainer during a session to teach county teams comprising local public health professionals and cooperative extension employees how to teach child care providers in their communities to use the curriculum. The child care providers were then trained between March and August 2002. Follow-up evaluation forms were given to trained child care providers 8 weeks after the training. CONSEQUENCES: Of the providers who completed the evaluations (n = 486), 92.0% indicated that using the Color Me Healthy curriculum increased the physical activity of their students, and 91.8% indicated that it increased the children's knowledge about movement. In addition, 93.0% of providers also indicated that using Color Me Healthy had increased the children's knowledge about healthy eating. INTERPRETATION: Child care providers need educational materials on healthy eating and physical activity and should be trained to use them. The Train the Trainer model is an effective way to teach public health professionals to train child care providers on the Color Me Healthy curriculum materials about healthy eating and physical activity.

Using synchronous distance education to deliver a weight loss intervention: A randomized trial.

OBJECTIVE: To implement a randomized trial to evaluate the effectiveness of a weight loss program delivered using synchronous distance education compared with a wait-list control group with 6-month follow-up. METHODS: Adults with a body mass index (BMI) ≥25 were randomized to the intervention (n = 42) or wait-list control group (n = 38). The intervention group participated in a synchronous, online, 15-week weight loss program; weight loss was the primary outcome. Secondary measures included height, BMI, and confidence in ability to be physically active and eat healthy. Assessments occurred at three and four time points in the intervention and control group, respectively. RESULTS: Participants who completed the program lost significantly more weight (1.8 kg) than those in the wait-list control group (0.25 kg) at week 15 [F(1,61) = 6.19, P = 0.02] and had a greater reduction in BMI (0.71 vs. 0.14 kg/m(2) ), [F(1,61) = 7.45, P = 0.01]. There were no significant differences between the intervention and the wait-list control groups for change in confidence in ability to be physically active or eat healthy. Weight loss was maintained at 6 months. CONCLUSIONS: Use of synchronous distance education is a promising approach for weight loss. The results of this study will help to inform future research that employs Web-based interventions.