One of the most important medical and public health issues of today is obesity, defined as abnormal and excess fat accumulation. Obesity is linked to many health problems including metabolic syndrome (MS), hypertension, type II diabetes mellitus (T2DM), and cardiovascular disease (CVD). Recently, the incidence of these conditions has surged to epidemic proportions, especially in Western societies. Research has also linked obesity to cancer and osteoarthritis. Preventing, diagnosing, and treating obesity is challenging. The diagnosis of obesity is often unclear when it is made with generalized criteria such as the Body Mass Index (BMI). Obesity interventions generally include the often difficult lifestyle change to healthy diets and adequate exercise, which depends heavily upon patient compliance and discipline. Today's society is pushing for the discovery of a shortcut or of a "magic pill" to cure obesity. Consequently, many studies aim to identify therapeutic targets. The majority of current obesity research is focused on discovering and revealing the underlying mechanisms and genetic risk factors. Certain stages of development, such as childhood, are especially susceptible times to be exposed to stressors that lead to obesity. A developing concept is the intergenerational transmission of risk of obesity through epigenetics. Epigenetics is the study of the heritable changes in gene regulation and expression not caused by mutations or changes in DNA sequence. A person's genes may increase or decrease his or her susceptibility to obesity. In addition to genetic inheritance, parents may pass non-genetic alterations to their children. Changes can be mediated through methylation of deoxyribonucleic acids (DNA) and modifications to histones. These epigenetic changes may alter gene expression patterns and "program" offspring towards developing chronic metabolic disease. Many models have begun to show the effects of environmental perturbations on individuals and on several generations of future descendants. This review will analyze the current literature on obesity and evaluate this rapidly evolving field. Current obesity preventions and treatments will be surveyed. In addition, the relative impact of different contributors to obesity risk will be examined. The crossover between obesity and epigenetics may provide a deeper understanding of disease risk and developmental origins. Future directions of study will be proposed such as large-scale prospective studies to further characterize intergenerational transmission of risk.

The empirical knowledgebase of intergenerational programming (IGP) largely relies on anecdotal reports by staff and family members. The lack of concrete knowledge is particularly evident in the literature regarding IGP involving elders with dementia. In an effort to fill some of the voids in the current literature base, observations were conducted for seven weeks at a co-located child and adult day program to determine the effects of IGP on 10 older adult participants (M age =81 yrs., S.D. = 5.21). All participants (5 male and 5 female) were diagnosed with dementia by a physician and attended the adult day program regularly. Intergroup contact theory, which emphasizes interdependence between groups, informed the development and facilitation of the IGP activities. A structured scale was utilized to assess the elders' social behavior and affect during IGP. Control observations were conducted during adult-only activities representative of traditional dementia-care programming, and qualitative data were collected through participant interviews and facilitator journaling to corroborate the quantitative findings. T-test analyses revealed that the older adults exhibited significantly greater levels of group social behavior and significantly fewer instances of unoccupied behavior during IGP as compared to traditional adult-only activities. The adults also expressed significantly more positive affect during IGP than in the control activities. Findings from the qualitative inquiries supported the quantitative results by emphasizing the meaning and purpose of IGP for the elders. Results indicated that effectively planned and facilitated IGP is an appropriate and interesting activity for elders with dementia. / Master of Science

The Generation Connection Program (GCP), an intergenerational program transfer initiative, was examined as the focus of this study in order to determine how an enabling agency approach can advance the implementation and sustainability of innovative intergenerational programs throughout a community. Teachers and long term care staff from three sites with active programs and staff from two sites that had disbanded programs participated in this study. Additional data included field notes from intergenerational program activities and orientations observations, journal articles, implementation package materials, newspaper articles, and the GCP s internal written documents. This study was largely exploratory, as the critical factors for the successful transfer of social programs are not clearly understood. Five themes emerged from the data: the process of program transfer as a continual process, the transfer of knowledge and skills, building collaborative relationships between long term care staff and teachers, continual innovation, and building capacity through networks. The findings suggest that a community-based managed network approach, combining central agency leadership with capacity in long term care centers and schools/child care centers, can advance the implementation and institutionalization of intergenerational programs. / Master of Urban and Regional Planning

Individuals in certified nursing facilities (CNF) often experience social isolation and have limited opportunities to exercise. Bingocize®, an evidence-based healthpromotion program, is a combination of exercise and Bingo and provides opportunities for CNF resident interaction. Limited tools are available to quantify social engagement displayed by nursing home residents. Research suggests that intergenerational programming can positively affect social engagement. The present pilot study focused on the implementation of the Fun and Social Engagement (FUSE) evaluation to measure social engagement displayed by nursing home residents during Bingocize® sessions. The FUSE combined observation and self-report measures to yield a total social engagement score. Social engagement data were collected during Bingocize® sessions with university students interacting with residents and without student presence. Participants (M age = 82) included 35 residents from certified nursing facilities in Kentucky that receive funding from the Civil Money Penalty grant by Centers for Medicare and Medicaid Services. The purpose of this study was to determine if participants display increased positive social engagement during Bingocize® sessions when students are present versus when they are not, as well as if there is a difference between the participants’ self-report measure of engagement versus the observational report. Data were collected across four Bingocize® sessions, two with intergenerational programming and two without. Paired t-tests were conducted to determine overall participant engagement scores with and without student presence. Because of absenteeism, only two of the comparisons had a sufficient number of participants to analyze the effect of student presence. Comparing scores of the same residents, FUSE scores were higher in sessions with students present versus when students were not (p < .05). A two-sample t-test revealed that residents who reported happiness had higher observational scores than those who reported they were not happy. The results of this pilot study are tentative due to limited number of participants at some of the sessions. Future studies are needed to determine reliability of the FUSE. Nevertheless, this study suggests that the FUSE is a feasible tool for measuring fun and social engagement during Bingocize® and that university students have a positive effect on resident social engagement.