The anterior cruciate ligament (ACL) originates from posterior part of the medial side of the lateral condyle of femur to anterior intercondylar notch between a transverse meniscal ligament and medial side of medial meniscus of tibia. Once ACL is disrupted, pain, effusion and atrophy are commonly observable and cause functional disability. Because of the functional limitations, athletic participation is severely restricted. ACL injury is more prevalent in physically active females compared to their male counterparts in the sports of basketball and soccer in high school and collegiate levels. Several attributes of females are considered risk factors for the higher ACL injury incidences and include: anatomy, physiology and neuromuscular/biomechanics. Among them, neuromuscular/biomechanics is the only modifiable risk factor. Performing neuromuscular training may change muscular strength profiles, which may lead to reduction in ACL injury incidence in female athletes. However, this principle was not fully examined. Also, neuromuscular compliance may play a role in muscular strength development and ACL injury incidences. Thus, the purpose of this dissertation was to investigate the effects of neuromuscular training compliance on muscular strength development and ACL injury incidence. The influence of hip abductor, hamstrings and quadriceps strength was examined in this project. The results of these studies indicate neuromuscular training is an effective intervention to reduce ACL injury incidence in female athletes, and there is an inverse dose-response relationship between compliance of the neuromuscular training and number of ACL incidences in female athletes. The effect of compliance on muscular strength development was inconsistent. The results of these studies support that compliance of neuromuscular training is a key to reduce ACL injury incidences; however, more studies are need to conclude neuromuscular training compliance effects on muscular strength development in female athletes.

A majority of low-income individuals living in public housing today are working or receiving some kind of assistance, but still struggle to make ends meet. Previous studies show that cost and availability are barriers to healthy eating for low-income individuals. The purpose of this study was to determine relationships among nutrition habits, health status, sources of income, and food and living resources for low-income residents in public housing. The study utilizes data collected over five years on the impact of the revitalization of the families. The sample was randomly selected from residents of the housing property in a Kentucky city. Results showed that low income is connected to limited access to healthy food options and individuals are more likely to be at risk for chronic health conditions such as diabetes or hypertension. When income and employment were low, families reported a greater rate of skipped meals, less consumption of daily meals, and more purchasing of high fat and sodium meals from convenience stores.

Background: The prevalence of childhood overweight in the United States continues to be a national public health problem. The child care and household environments play an important role in the nutrition, physical activity, and screen-time behaviors of preschoolers. Aims: This dissertation aimed to (1) estimate the prevalence of overweight and obesity in 3-5 year old children enrolled in child care centers in Miami-Dade County; (2) identify early life, dietary, and screen-time risk factors of overweight, and (3) assess child care centers' level of adherence to nutrition, physical activity, and screen-time regulations by center socioeconomic location (SEP). Methods: A total of 366 children ages 3-5 years old from 34 child care centers participated in the study. Caregivers completed a questionnaire on socioeconomic, early life, dietary, and screen-time factors. We measured children's heights and weights. Chi-square and logistic regression analyses were used to examine the association between child overweight and determinants. Results: the prevalence of overweight was 29.8% in this sample. The middle-SEP group had the highest prevalence of overweight (35.3%) when compared to low and high-SEP groups. Being Hispanic was associated with a three-fold risk of overweight/ obesity (AOR: 2.91, 95% CI 1.36, 6.21). Lack of daily fruit consumption increased the risk of overweight in Hispanic children. Middle-SEP children reported lowest consumption of fruits and vegetables. There were significant differences in breastfeeding practices by ethnicity and SEP. Assessment of child care practices resulted in all child care centers adhering to two-hour screen-time regulation for children older than 2-years old. Low and middle SEP centers fared better in serving of fruits , vegetables, and low fat/ fat free milk. The centers had incorporated quite and active play in their routines. Conclusions: This is the first study to examine prevalence by SEP in Miami-Dade County. Findings highlight opportunities for improvement in early life nutrition, as well as dietary and screen-time practices in the household and child care environments.

Despite the well-known benefits of physical activity, in 2012, only 37.5% of older adults aged 60 years or older met recommended aerobic physical activity levels and 16.1% met muscle-strengthening guidelines. Effective exercise programs can help combat the problem of inactivity but 50% of those who start participating in an exercise program drop out within first few weeks, preventing them from gaining any health benefits. Since fall 2008, the Healthy Aging Regional Collaborative of South Florida has offered EnhanceFitness (EF), an evidence-based physical activity program to older adults. This dissertation compared EF effectiveness at 4-, 8-, and 12-months and examined the factors that were associated with program completion. A paired sample t-test identified changes at 4-months and repeated measures design was used to identify changes from baseline to 4-, 8-, and 12- months. Logistic regression was used to identify correlates associated with completion. Between October 1, 2008 and December 31, 2012, 4,531 older adults (>=60 years) attended one or more EF sessions. Participants showed significant improvement in the number of chair stands performed in 30-seconds with mean change of 1.7, 1.6, and 2.0 respectively at 4-,8-,and 12- months (pp<0.001). Results suggest Black, non-Haitian men were less likely to complete the program when compared to white, non-Hispanic men (OR=0.41, p=0.02). Men who self-reported having at least one risk factor were more likely to complete the program (OR=1.81, p= 0.03). In addition, women who lived in Miami-Dade County (OR=2.13, ppppp<0.01). Effectiveness results revealed that all participants improved on outcome measures. However, improvement is more than double for those who completed recommended sessions (p

The study of obesity has evolved into one of the most important public health issues in the United States (U.S.), particularly in Hispanic populations. Mexican Americans, the largest Hispanic ethnic subgroup in the U.S., have been significantly impacted by obesity and related cardiovascular diseases. Mexican Americans living in the Lower Rio Grande Valley (the Valley) in the Texas-Mexico border are one of the most disadvantaged and hard-to-reach minority groups. Demographic factors, socioeconomic status, acculturation, and physical activity behavior have been found to be important predictors of health, although research findings are mixed when establishing predictors of obesity in this population. Furthermore, while obesity has long been linked to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and dyslipidemia; information on the relationships between obesity and these CVD risk factors have been mostly from non-minority population groups. Overall, research has been mixed in establishing the association between obesity and related CVD risk factors in this population calling attention to the need for further research. Nevertheless, identifying predictors of success for weight loss in this population will be important if health disparities are to be addressed. The overall objective of the findings presented in this dissertation was to attain a more informed profile of obesity and CVD risk factors in this population. In particular, we examined predictors of obesity, measures of obesity and association with cardiovascular disease risk factors in a sample of 975 Mexican Americans participating in a health promotion program in the Valley region. Findings suggest acculturation factors to be one of the most important predictors of obesity in this population. Results also point to the need of identifying other possible risk factors for predicting CVD risk. Finally, initial body mass index is an important predictor of weight loss in this population group. Thus, indicating that this population is not only amenable to change, but that improvements in weight loss are feasible. This finding strengthens the relevance of prevention programs such as Beyond Sabor for Mexican populations at risk, in particular, food bank recipients.

Objectives are (1) Describe HIV/HCV prevalence in TN and Central Appalachia; (2) Understand syringe access in pharmacy settings. Identify and refer clients to local syringe service programs.

No description available.

No description available.

HIV-related anemia is associated with increased risk of death. Prior studies suggest an inverse relationship between CD4 cell count and anemia, and a positive relationship between HIV-clinical stage and anemia. However, none have assessed the role of antiretroviral therapy (ART) treatment combinations in these relationships. Therefore, we conducted a cross-sectional study to evaluate the relationship between CD4 cell count, HIV clinical stage and anemia among 4803 Ugandan HIV-patients, and assessed the role of ART treatment combinations. We included HIV patients (> 15 years) receiving ART therapy combinations between 2010- 2015. We evaluated CD4 cell count and anemia using blood tests, and HIV-clinical staging was based upon the World Health Organization HIV-clinical staging system. Information on ART treatment combinations was obtained from patients’ medical records. Multinomial logistic regression was used to model the relationship between CD4 cell count, HIV clinical stages and anemia. We performed a sensitivity analysis to examine the role of ART treatment combinations. The odds of being severely anemic were highest among those classified in the low CD4 cell count category (<200cells/μL), and those at WHO stage IV. Odds Ratios were 3.7 (95% CI; 1.48-9.26) and 3.2 (95% CI; 1.75-5.70), respectively. Stratification by ART treatment combinations (TDF-based versus ADZ-based combination treatment) indicated an increase in the odds of being anemic with increase in HIV-clinical stage (stage II, OR: 1.99, 95% CI; 1.44-2.78; stage III, OR:3.17, 95% CI; 2.21-4.54, & stage IV, OR; 4.42, 95% CI; 2.68-7.30), for individuals receiving TDF-based treatment only. Results suggest that HIV-patients with a low CD4 cell count and, those in advanced HIV-clinical stages should consider regular hemoglobin follow-up to identify and treat anemia at its earliest stages.

Einleitung: Ultraviolette (UV) Strahlung – sei sie natürlich oder künstlich – kann zu Hautkrebs führen. In Verbindung mit Solarien, einer Hauptquelle künstlicher UV-Strahlung, wird häufig auf die Möglichkeit der Entstehung einer Bräunungssucht (oft auch „Tanorexie“) hingewiesen. Bisherige Instrumente zum Screening auf eine solche Bräunungssucht ergaben sich jedoch als nicht valide. Aus diesem Grund war es unser Ziel, ein in den USA neu entwickeltes Instrument, den Behavioral Addiction Indoor Tanning Screener (BAITS), auf Validität und Reliabilität zu testen. Methodik: Der BAITS ist ein kurzes Screeninginstrument, welches aus sieben Items (Antwortkategorien: ja/nein) besteht. Die englischsprachige Itembatterie wurde in einer fünfstufigen Prozedur ([1] Übersetzung ins Deutsche, [2] Expert Panel, [3] Rückübersetzung ins Englische, [4] kognitive Interviews, [5] Erstellung der finalen Version) übersetzt. Zur Überprüfung der Validität und Reliabilität zogen wir die Daten der ersten Welle des Nationalen Krebshilfe Monitorings zur Solariennutzung (NCAM) bestehend aus einem kognitiven Pretest (n = 15) und einer bundesweiten Repräsentativbefragung (n = 3.000) heran. Ergebnisse: Der kognitive Pretest ergab eine leichte Veränderung in der Formulierung eines Items. Insgesamt wurden in der bundesweiten Befragung 19,7% der aktuellen und 1,8% der ehemaligen Nutzer von Solarien positiv auf Symptome einer möglichen Bräunungssucht gescreent. Es fanden sich signifikante Zusammenhänge zwischen Solariennutzungsparametern und dem BAITS (Kriteriumsvalidität). Die interne Konsistenz (Reliabilität) ergab sich ebenfalls als gut (Kuder-Richardson-20 = 0,854) und der BAITS erwies sich als homogenes Konstrukt (Konstruktvalidität). Schlussfolgerungen: Verglichen mit anderen Kurzinstrumenten zur Messung von Symptomen einer möglichen Bräunungssucht ergab sich der BAITS als valideres und reliableres Tool. Aufgrund seiner Kürze und der binären Items ist er auch in großen Surveys einfach einzusetzen.