Digital Commons Network^™

Metabolic And Inflammatory Biomarkers Are Associated With Epigenetic Aging Acceleration Estimates In The Goldn Study, Marguerite R. Irvin, Stella Aslibekyan, Anh Do, Degui Zhi, Bertha Hidalgo, Steven A. Claas, Vinodh Srinivasasainagendra, Steve Horvath, Hemant K. Tiwari, Devin M. Absher, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Recently, epigenetic age acceleration-or older epigenetic age in comparison to chronological age-has been robustly associated with mortality and various morbidities. However, accelerated epigenetic aging has not been widely investigated in relation to inflammatory or metabolic markers, including postprandial lipids.

Methods: We estimated measures of epigenetic age acceleration in 830 Caucasian participants from the Genetics Of Lipid Lowering Drugs and diet Network (GOLDN) considering two epigenetic age calculations based on differing sets of 5′-Cytosine-phosphate-guanine-3′ genomic site, derived from the Horvath and Hannum DNA methylation age calculators, respectively. GOLDN participants underwent a standardized high-fat meal challenge after fasting for at least …

A Model For Rigorously Applying The Exploration, Preparation, Implementation, Sustainment (Epis) Framework In The Design And Measurement Of A Large Scale Collaborative Multi-Site Study, Jennifer E. Becan, John P. Bartkowski, Danica K. Knight, Tisha R. A. Wiley, Ralph Diclemente, Lori Ducharme, Wayne N. Welsh, Diana Bowser, Kathryn Mccollister, Matthew Hiller, Anne C. Spaulding, Patrick M. Flynn, Andrea Swartzendruber, Megan F. Dickson, Jacqueline Horan Fisher, Gregory A. Aarons

Center on Drug and Alcohol Research Faculty Publications

Background

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

Methods

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the …

Supporting A Spectrum Of Users: Serving Individuals On The Autism Spectrum, Rachel Combs

Library Presentations

No abstract provided.

Epigenome-Wide Association Study Of Metabolic Syndrome In African-American Adults, Tomi Akinyemiju, Anh N. Do, Amit Patki, Stella Aslibekyan, Degui Zhi, Bertha Hidalgo, Hemant K. Tiwari, Devin Absher, Xin Geng, Donna K. Arnett, Marguerite R. Irvin

Epidemiology and Environmental Health Faculty Publications

Background: The high prevalence of obesity among US adults has resulted in significant increases in associated metabolic disorders such as diabetes, dyslipidemia, and high blood pressure. Together, these disorders constitute metabolic syndrome, a clinically defined condition highly prevalent among African-Americans. Identifying epigenetic alterations associated with metabolic syndrome may provide additional information regarding etiology beyond current evidence from genome-wide association studies.

Methods: Data on metabolic syndrome and DNA methylation was assessed on 614 African-Americans from the Hypertension Genetic Epidemiology Network (HyperGEN) study. Metabolic syndrome was defined using the joint harmonized criteria, and DNA methylation was assessed using the Illumina HumanMethylation450K Bead …

Hiv Clustering In Mississippi: Spatial Epidemiological Study To Inform Implementation Science In The Deep South, Thomas J. Stopka, Lauren Brinkley-Rubinstein, Kendra Johnson, Philip A. Chan, Marga Hutcheson, Richard A. Crosby, Deirdre Burke, Leandro Mena, Amy Nunn

Health, Behavior & Society Faculty Publications

Background: In recent years, more than half of new HIV infections in the United States occur among African Americans in the Southeastern United States. Spatial epidemiological analyses can inform public health responses in the Deep South by identifying HIV hotspots and community-level factors associated with clustering.

Objective: The goal of this study was to identify and characterize HIV clusters in Mississippi through analysis of state-level HIV surveillance data.

Methods: We used a combination of spatial epidemiology and statistical modeling to identify and characterize HIV hotspots in Mississippi census tracts (n=658) from 2008 to 2014. We conducted spatial analyses of all …

How Much Do We Spend? Creating Historical Estimates Of Public Health Expenditures In The United States At The Federal, State, And Local Levels, Jonathon P. Leider, Beth Resnick, David Bishai, F. Douglas Scutchfield

Health Management and Policy Faculty Publications

The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how …

Pre-Diagnostic Biomarkers Of Metabolic Dysregulation And Cancer Mortality, Tomi Akinyemiju, Justin Xavier Moore, Suzanne E. Judd, Maria Pisu, Michael Goodman, Virginia J. Howard, Leann Long, Monika Safford, Susan C. Gilchrist, Mary Cushman

Epidemiology and Environmental Health Faculty Publications

INTRODUCTION: The obesogenic milieu is a pro-tumorigenic environment that promotes tumor initiation, angiogenesis and metastasis. In this prospective cohort, we examined the association between pre-diagnostic metabolic biomarkers, plasma adiponectin, resistin, leptin and lipoprotein (a), and the risk of cancer mortality.

METHODS: Prospective data was obtained from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort of Blacks and Whites followed from 2003 through 2012 for cancer mortality. We determined the association between metabolism biomarkers (log-transformed and tertiles) and risk of cancer mortality using Cox Proportional Hazards models with robust sandwich estimators to calculate the 95% confidence intervals (CIs), …

Non-Retrieval Of Inferior Vena Cava Filters As A Patient Safety Concern: Evaluation Of A New Process Improvement Project To Increase Retrieval Rates In A Vascular And Interventional Radiology Clinic, Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han, Driss Raissi

Pharmacy Practice and Science Faculty Publications

Background: Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval.

Methods: For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic …

A Systematic Review Of Consumer Preference For E-Cigarette Attributes: Flavor, Nicotine Strength, And Type, Samane Zare, Mehdi Nemati, Yuqing Zheng

Agricultural Economics Faculty Publications

Objective

Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.

Method

A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.

Results

66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were …

A Longitudinal Analysis Of The Impact Of Child Custody Loss On Drug Use And Crime Among A Sample Of African American Mothers, Kathi L. H. Harp, Carrie B. Oser

Health Management and Policy Faculty Publications

This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother’s care by authorities).

Methods—Using data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime.

Results—Results indicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate …

In-Hospital Mortality And Post-Surgical Complications Among Cancer Patients With Metabolic Syndrome, Tomi Akinyemiju, Swati Sakhuja, Neomi Vin-Raviv

Epidemiology and Environmental Health Faculty Publications

Background

Metabolic syndrome (MetS) is an important etiologic and prognostic factor for cancer, but few studies have assessed hospitalization outcomes among patients with both conditions.

Methods

Data was obtained from the Healthcare Cost and Utilization project Nationwide Inpatient Sample (HCUP-NIS). Study variables were assessed using ICD-9 codes on adults aged 40 years and over admitted to a US hospital between 2007 and 2011 with primary diagnosis of either breast, colorectal, or prostate cancer. We examined in-hospital mortality, post-surgical complications, and discharge disposition among cancer patients with MetS and compared with non-MetS patients.

Results

Hospitalized breast (OR: 0.31, 95% CI: 0.20–0.46), …

Demographic, Presentation, And Treatment Factors And Racial Disparities In Ovarian Cancer Hospitalization Outcomes, Tomi F. Akinyemiju, Gurudatta Naik, Kemi Ogunsina, Daniel T. Dibaba, Neomi Vin-Raviv

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: This study examines whether racial disparities in hospitalization outcomes persist between African-American and White women with ovarian cancer after matching on demographic, presentation, and treatment factors.

METHODS: Using data from the Nationwide Inpatient Sample database, 5,164 African-American ovarian cancer patients were sequentially matched with White patients on demographic (e.g., age, income), presentation (e.g., stage, comorbidities), and treatment (e.g., surgery, radiation) factors. Racial differences in-hospital length of stay, post-operative complications, and in-hospital mortality were evaluated using conditional logistic regression models.

RESULTS: White ovarian cancer patients had relatively higher odds of post-operative complications when matched on demographics (OR 1.35, 95% CI …

Wellness And Multiple Sclerosis: The National Ms Society Establishes A Wellness Research Working Group And Research Priorities, Robert W. Motl, Ellen M. Mowry, Dawn M. Ehde, Nicholas G. Larocca, Kathy E. Smith, Kathleen Costello, Lynne Shinto, Alexander V. Ng, Amy B. Sullivan, Barbara Giesser, Kevin K. Mccully, Bo Fernhall, Malachy Bishop, Matthew Plow, Patrizia Casaccia, Nancy D. Chiaravalloti

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: People with multiple sclerosis (MS) have identified “wellness” and associated behaviors as a high priority based on “social media listening” undertaken by the National MS Society (i.e. the Society).

Objective: The Society recently convened a group that consisted of researchers with experience in MS and wellness-related research, Society staff members, and an individual with MS for developing recommendations regarding a wellness research agenda.

Method: The members of the group engaged in focal reviews and discussions involving the state of science within three approaches for promoting wellness in MS, namely diet, exercise, and emotional wellness.

Results: That process informed a …

Rural Family Physicians In Patient Centered Medical Homes Have A Broader Scope Of Practice, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview

• Rural family physicians often have a broader scope of practice, defined as the range of clinical and procedural services that they provide, than urban family physicians. The Patient Centered Medical Home (PCMH) model of care is intended to provide accessible and comprehensive care, but little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.
• Using data from 18,846 family physicians nationally, we found that rural family physicians working in PCMH practices generally provide a wider scope of clinical and procedural services than those not working in PCMH practices.

Rural Family Physicians Have A Broader Scope Of Practice Than Urban Family Physicians, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Little is known about whether rural family physicians provide a broader scope of practice, defined as the range of clinical and procedural services that they provide, than metropolitan family physicians.
• Using data from 18,846 family physicians, we examined variations in the provision of 21 clinical services (e.g., inpatient care, home visits, and obstetrics) and 18 procedural services (e.g., prenatal ultrasound, endoscopy, and office skin procedures) across metropolitan, large rural, small rural, and frontier areas.
• We found that the percentage of family physicians providing each type of clinical and procedural service rises with increasing rurality.

Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, Jeffery C. Talbert, Aric Schadler, Patricia R. Freeman

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2014, the overall mean vaccination rate in urban areas was 4.66 compared to a mean vaccination rate of 2.81 in rural areas, indicating a 40% lower mean vaccination rate in rural communities.
• The majority of pneumococcal vaccine services delivered to fee-for-service Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (22.2%) of these services.
• The proportion of pneumococcal vaccine services delivered by pharmacy providers was significantly greater in rural versus urban counties (29.4% vs. 21.1%).
• Consistent with previous literature, county characteristics positively associated with pneumococcal vaccine service delivery include …

An Exome-Wide Sequencing Study Of Lipid Response To High-Fat Meal And Fenofibrate In Caucasians From The Goldn Cohort, Xin Geng, Marguerite R. Irvin, Bertha Hidalgo, Stella Aslibekyan, Vinodh Srinivasasainagendra, Ping An, Alexis C. Frazier-Wood, Hemant K. Tiwari, Tushar Dave, Kathleen Ryan, Jose M. Ordovas, Robert J. Straka, Mary F. Feitosa, Paul N. Hopkins, Ingrid Borecki, Michael A. Province, Braxton D. Mitchell, Donna K. Arnett, Degui Zhi

Epidemiology and Environmental Health Faculty Publications

Our understanding of genetic influences on the response of lipids to specific interventions is limited. In this study, we sought to elucidate effects of rare genetic variants on lipid response to a high-fat meal challenge and fenofibrate (FFB) therapy in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) cohort using an exome-wide sequencing-based association study. Our results showed that the rare coding variants in ITGA7, SIPA1L2, and CEP72 are significantly associated with fasting LDL cholesterol response to FFB (P = 1.24E-07), triglyceride postprandial area under the increase (AUI) (P = 2.31E-06), and triglyceride postprandial …

Global Survey Of Clinical Oncology Workforce, Aju Mathew

Internal Medicine Faculty Publications

A lack of well-trained clinical oncologists can result in significant cancer health disparities. The magnitude of this problem around the world is poorly described in the literature. A comprehensive global survey of the clinical oncology workforce was conducted. Data on the number of clinical oncologists in 93 countries were obtained from 30 references. The mortality-to-incidence ratio was estimated by using data on incidence and mortality rates from the GLOBOCAN 2012 database; the ratio was > 70% in 26 countries (28%), which included 21 countries in Africa (66%) and five countries in Asia (26%). Eight countries had no clinical oncologist available to …

Genome-Wide Interactions With Dairy Intake For Body Mass Index In Adults Of European Descent, Caren E. Smith, Jack L. Follis, Hassan S. Dashti, Toshiko Tanaka, Mariaelisa Graff, Amanda M. Fretts, Tuomas O. Kilpeläinen, Mary K. Wojczynski, Kris Richardson, Mike A. Nalls, Christina-Alexandra Schulz, Yongmei Liu, Alexis C. Frazier-Wood, Esther Van Eekelen, Carol Wang, Paul S. De Vries, Vera Mikkilä, Rebecca Rohde, Bruce M. Psaty, Torben Hansen, Mary F. Feitosa, Chao-Qiang Lai, Denise K. Houston, Luigi Ferruci, Ulrika Ericson, Zhe Wang, Renée De Mutsert, Wendy H. Oddy, Ester A. L. De Jonge, Ilkka Seppälä, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Scope: Body weight responds variably to the intake of dairy foods. Genetic variation may contribute to inter‐individual variability in associations between body weight and dairy consumption.

Methods and results: A genome‐wide interaction study to discover genetic variants that account for variation in BMI in the context of low‐fat, high‐fat and total dairy intake in cross‐sectional analysis was conducted. Data from nine discovery studies (up to 25 513 European descent individuals) were meta‐analyzed. Twenty‐six genetic variants reached the selected significance threshold (p‐interaction <10⁻⁷⁾, and six independent variants (LINC01512‐rs7751666, PALM2/AKAP2‐rs914359, ACTA2‐rs1388, PPP1R12A‐rs7961195, LINC00333‐rs9635058, …

Implementing A Mobile Health System To Integrate The Treatment Of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study, Andrew Quanbeck, David H. Gustafson, Lisa A. Marsch, Ming-Yuan Chih, Rachel Kornfield, Fiona Mctavish, Roberta Johnson, Randall T. Brown, Marie-Louise Mares, Dhavan V. Shah

Health and Clinical Sciences Faculty Publications

Background: Despite the near ubiquity of mobile phones, little research has been conducted on the implementation of mobile health (mHealth) apps to treat patients in primary care. Although primary care clinicians routinely treat chronic conditions such as asthma and diabetes, they rarely treat addiction, a common chronic condition. Instead, addiction is most often treated in the US health care system, if it is treated at all, in a separate behavioral health system. mHealth could help integrate addiction treatment in primary care.

Objective: The objective of this paper was to report the effects of implementing an mHealth system for addiction in …

The Use Of External Change Agents To Promote Quality Improvement And Organizational Change In Healthcare Organizations: A Systematic Review, Esra Alagoz, Ming-Yuan Chih, Mary Hitchcock, Randall Brown, Andrew Quanbeck

Health and Clinical Sciences Faculty Publications

Background: External change agents can play an essential role in healthcare organizational change efforts. This systematic review examines the role that external change agents have played within the context of multifaceted interventions designed to promote organizational change in healthcare-specifically, in primary care settings.

Methods: We searched PubMed, CINAHL, Cochrane, Web of Science, and Academic Search Premier Databases in July 2016 for randomized trials published (in English) between January 1, 2005 and June 30, 2016 in which external agents were part of multifaceted organizational change strategies. The review was conducted according to PRISMA guidelines. A total of 477 abstracts were identified …

Pharmacists' Role In Harm Reduction: A Survey Assessment Of Kentucky Community Pharmacists' Willingness To Participate In Syringe/Needle Exchange, Amie Goodin, Amanda Fallin-Bennett, Traci Green, Patricia R. Freeman

Nursing Faculty Publications

Background: Pharmacists' role in harm reduction is expanding in many states, yet there are limited data on pharmacists' willingness to participate in harm reduction activities. This study assessed community pharmacists' willingness to participate in one harm reduction initiative: syringe/needle exchange.

Methods: In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both …

The Application Of An Implementation Science Framework To Comprehensive School Physical Activity Programs: Be A Champion!, Justin B. Moore, Russell L. Carson, Collin A. Webster, Camelia R. Singletary, Darla M. Castelli, Russell R. Pate, Michael W. Beets, Aaron Beighle

Kinesiology and Health Promotion Faculty Publications

Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding what should be implemented, but little guidance and few resources are available regarding how to effectively implement a CSPAP. Implementation science provides a number of conceptual frameworks that can guide implementation of a CSPAP, but few published studies have employed an implementation science framework to a CSPAP. Therefore, we developed …

Stories Of Strength: Chicago Latin@S' Navigation Of Health, Well-Being, And Chronic Disease, Lilian L. Milanés

Theses and Dissertations--Anthropology

Health inequalities take many forms related to race, gender, socioeconomic status, ethnic, language and many other axes throughout communities around the world. Type two diabetes, high blood pressure, and high cholesterol are examples of conditions (among many others) that disproportionately affect Latino@s in the U.S.. The research of this dissertation is based on fieldwork conducted throughout several predominantly Latin@ neighborhoods in Chicago, IL. This dissertation examines how Latin@s in Chicago navigate health and well-being, and how they engage in agentive strategies in the face of chronic disease. I recorded individual life histories and semi-structured interviews, focus groups, and participant observation …

Older Adult Men’S Emotional Bonds With Their Dogs, Ranell L. Mueller

Theses and Dissertations--Gerontology

Knowledge of the deeper meanings of attachment to companion animals is limited, particularly in terms of older adults. This study employed a modified grounded theory method, a phenomenological lens and a life course perspective to gather and analyze data garnered from individual interviews and panel discussions in order to investigate the multiple dimensions of older adult men’s relationships with their companion animal dogs. Individual audio-recorded in-depth interviews and repeated panel discussions with a sub-group of the participants, convened as a panel over a three-month period, explored behavioral and emotional manifestations of attachment and the emotional bond to their companion animal …

A Breast Prosthesis Infection Update: Two-Year Incidence, Risk Factors And Management At Single Institution, Ashley Nadia Boustany, Shady Elmaraghi, Nneamaka Agochukwu, Benjamin Cloyd, Adam J. Dugan, Brian Rinker

Surgery Faculty Publications

Background: Infection following augmentation and prosthetic-based breast reconstruction can cause significant physical and psychological distress for patients. It may delay adjuvant therapies and compromise aesthetic outcomes. The aim of this study is to identify modifiable risk factors for infection and identify common bacterial isolates to achieve optimal outcomes for patients.

Methods: A retrospective cohort study was performed for patients undergoing implant-based breast reconstruction over a 2-year period. In each case, we documented demographics, co-morbidities, complications and antibiotic use. We reviewed treatments, infectious species cultured where applicable and all outcomes.

Results: A total of 292 patients met the inclusion criteria. Fifty-five …

Modeling Geographic Factors And Assessing Their Accuracy In Identifying Health Disparities In Fayette County, Ian Jones

Lewis Honors College Capstone Collection

The purpose of this capstone is to conduct a review of existing literature to determine the effects of a variety of geographic variables on health and wellness. The student will use their findings to create a visual aid to displaying these geographic factors and their distributions within Fayette County. Furthermore, the student will analyze the intersection of these variables to predict potential pockets of discrepancy within Fayette County. Based on this analysis, the student will propose possible interventions with a basis in current literature. This project will provide the student with the opportunity to conduct a study of existing literature, …

Examination Of Resistance Settings Based On Body Weight For The 3-Minute All-Out Critical Power Test, Marlene J. Schulte, Jody L. Clasey, Bradley S. Fleenor, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

There are conflicting suggestions regarding the most valid resistance (3-5% of body weight) to use for the critical power (CP) 3-min all-out (CP_3min) test to estimate CP and anaerobic work capacity (AWC). The purpose of this study was to determine if the CP and AWC estimates from the CP_3min test were affected by the percentage of body weight used to set the resistance on a Monark cycle ergometer. Ten recreationally trained participants (mean ± SD: Age: 22.2 ± 2.2 yrs.) completed the CP_3min test at resistances of 4.5% (CP_4.5%) and 3% (CP_3%) …

Effects Of Very Short-Term Dynamic Constant External Resistance Exercise On Strength And Barbell Velocity In Untrained Individuals, M. Travis Byrd, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

This study examined the effect of an upper body dynamic constant external resistance (DCER) exercise (barbell bench press [BP]), using the very short-term training (VST) model on strength and barbell velocity. Ten (5 females, 5 males) subjects (mean ± SD age: 21.4 ± 2.8 yrs; height: 1.75 ± 0.12 m; body mass: 83 ± 8.8 kg) completed two pre-test visits (pre-test 1 and pre-test 2) to serve as the within subjects control, three training visits, and one post-test visit. The subject’s 1 repetition maximum (1RM) for the BP as well as the mean (BP_MV) and peak (BP_{PV …}

Health Promotion In Elementary School Students, Madelyn J. Miles

Lewis Honors College Capstone Collection

The following project was created to address the rising epidemic of childhood obesity. Childhood obesity is caused by many factors such as genetics, metabolism, community and neighborhood design, diet, exercise, and short sleep duration (Center for Disease Control: Childhood Obesity Facts). Social determinants of health, systems of oppression, and stigma can all influence the obesity epidemic. These include but are not limited to social status, location, culture, age, sexuality, ethnicity, and race. These identities can influence affordability and access to healthcare and further contribute to the obesity epidemic. It is important to understand these issues as a future provider. A …