A social ecological approach of community efforts to promote physical activity and weight management.

Obesity and physical inactivity are major public health problems in the United States. Campus-Community partnerships have the potential to address the community health and quality of life issues at the local level. The purposes of this study were: (a) to identify groups who are at risk for being overweight and physically inactive; (b) to identify a relationship between broad social ecological layers and weight and exercise levels; and (c) to identify community features that are associated with weight and exercise levels. Interventions for physical activity and weight reduction should consider the social ecological framework, including environmental and social influences.

Detecting Subclinical Change in Cognitive Functioning in Older Adults: Part II: Initial Validation of the Method.

Repeated measures of cognitive functioning may provide a clinically feasible supplement to standard operational criteria for the diagnosis of delirium or toxic or metabolic encephalopathies in older adults. This research reports on the feasibility of detecting change in cognitive functioning through repeated assessments. The findings demonstrate that the method of identifying excessive cognitive changes through repeated assessments is not compromised by fatigue or practice effects. Further, a controlled drug trial validated this method for detecting change in a situation in which investigators would expect mild cognitive change to occur. Significant change in memory functioning was detected after administration of 50 mg of diphenhydramine. The results suggest that repeated monitoring of cognitive functioning may be an objective tool for measuring cognitive change that may facilitate the identification of subclinical toxic and metabolic encephalopathies.

Detecting Subclinical Change in Cognitive Functioning in Older Adults: Part I: Explication of the Method.

This research reports on the practicality of performing repeated measures of cognitive functioning in older adults. The detection of acute or subacute changes in cognitive functioning in the clinical setting could be facilitated by the development of an objective screening tool. Such a tool would not depend on the observation of symptoms only in pathological states, but rather, would depend on monitoring the cognitive functioning of patients over time. These repeated assessments allow us to define the magnitude of normal fluctuations in performance, thereby allowing us to define the magnitude of change in performance that represents a significant decrement or improvement in functioning. The findings reveal that routine monitoring of cognitive performance could allow identification of acute or subacute cognitive change in older adults.