Obesity among American Indian young adults is a significant health problem. There is an increase in the prevalence rate of diseases associated with obesity which tend to have high medical costs and high mortality rates. Fruit and vegetable consumption, exercise, gender and education are factors which could affect obesity among American Indians. Therefore, the primary purpose of the current study was to determine if there was an association between certain factors (fruit and vegetable consumption, exercise, gender and education level) and obesity among young American Indian adults in North Dakota. The secondary purpose was to determine if there was a statistically significant difference in obesity prevalence between American Indian young adults and non-American Indian young adults in North Dakota. Secondary data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey was used for the study. Binary logistic regression analysis odds ratio was used to analyze the data in the study. Exercise, education and fruit and vegetable consumption did not show statistical significance. Gender was the only statistically significant factor. Recommendations were made for the specific population and future studies based on the results of the study.

The significance of this study was to evaluate multiple underlying factors among African Americans in Shreveport, Louisiana and the influence of those factors on their relationship with HIV/AIDS. This is extremely important for two very reasons. First, in the past 30 years since the initial presentation of HIV/AIDS into society, a shift in the demographic of the infected individuals has resulted in African Americans becoming the new face of HIV/AIDS in the United States. Secondly, African Americans are only 12 to 13% of the United States population, but they represent more than 45% of all new HIV/AIDS cases reported annually. In order to evaluate this significance, this study employed multinomial logistic regression to examine the potential influence of specific underlying factors present among African Americans and the relationship of those factors to HIV/AIDS. Such factors, including incarceration, the influence of drugs or alcohol prior to sex, HIV/AIDS under-recognition, stigma, the number of sexual partners, poverty, and inflammatory sexual transmitted diseases were assessed for their significance. The populations defined in this study were sexually active African American adult men and women, aged 18 to 45, residing in predominantly black urban and rural geographical areas within Shreveport, Louisiana. There were 103 participants included in this study among the population previously mentioned. These cases were selected by a cluster of area probability sampling method. The research was quantitative, utilizing primary data from African American adult subjects who reside in predominantly black urban and rural geographical areas via an anonymous online survey. The statistical measures that were used in this study included descriptive statistics and regression analysis. The results of this study sought to demonstrate an association between the presences of the above mentioned underlying factors and the relationship of HIV/AIDS among African Americans living in Shreveport, Louisiana. Based on the results of this study, it was determined that a relationship between specific underlying factors among African Americans and HIV/AIDS status do exist. More specifically, results indicated that the factors incarceration, substance use prior to sex, and inflammatory sexually transmitted diseases all had statistical influence on the HIV/AIDS status of African Americans in Shreveport, Louisiana.

Context: Dyskinesis has been linked to deficits in muscular strength and neuromuscular control of the scapular stabilizers. Often, when treating overhead athletes with pathological shoulders, Athletic Trainers focus on rotator cuff and scapular muscle strength to find resolution, yet the role of the lower trapezius strength in scapular dyskinesis is not well understood. Objective: To identify differences among varying levels of scapular dyskinesis on lower trapezius muscle thickness and strength. To identify the relationship between lower trapezius muscle thickness and strength with varying levels of scapular dyskinesis . To identify the relationship between pain and function within varying levels of scapular dyskinesis. Design: Expost- factor descriptive design. Setting: Indiana State University Applied Medicine Research Center. Participants: Fifty participants (age=25.18±5.90y; mass=71.67±13.15kg; height=173.5±10.2in; males=23/50, 46%, females=27/50, 64%; right-handed=48/50, 96%, lefthanded= 2/50, 4%) completed the study. Interventions: We evaluated scapular dyskinesis using the clinical visualization technique identifying each scapula as normal, with subtle or with obvious dyskinesis. Participants, depending on body mass, lifted a 3lb (mass<150lb [68kg]) or 5lb (mass>150lb [68kg]) weight overhead in flexion (5 repetitions) and abduction (5 repetitions), while a trained clinician observed for normal scapulohumeral rhythm, dysrhythmia, or scapular winging. Participants completed the Penn Shoulder Scale, a reliable and internally consistent self-report questionnaire with subscales on pain (0-30 points) and function (0-60 points). Main Outcome Measures: We evaluated strength with a hand-held dynamometer (microFET2, Hoggan Scientific, ±1%) with a single arm outstretched overhead in a “Y” position. The strength testing was performed at the same time as the diagnostic ultrasound (GE LOGIQ®e 2008) measurement of muscle thickness. We used separate one way analyses of variance to examine the size and strength of the lower trapezius and compared it over three levels of scapular dyskinesis to identify the differences in the dominant limb (DL) and non-dominant limb (NDL). We used a Spearman rho correlation to determine the relationship between scapular dyskinesis, muscle strength, and muscle thickness in DLs and NDLs. We conducted Kruskal-Wallis nonparametric one-way analyses of variance to compare pain and function subscales over the three levels of scapular dyskinesis in dominant and non-dominant limbs. Results: We did not identify any significant differences between DL scapular dyskinesis visual inspection categories on the strength (F2,49=0.596, p=0.555, 1-β=0.93) and thickness variables (F2,48=0.714, p=0.495, 1-β=0.51). We did not identify any significant difference between NDL scapular dyskinesis visual inspection categories on the strength (F2,49=2.382, p=0.103, 1-β=0.96) and thickness variables (F2,47=0.631, p=0.537, 1-β=0.54). We identified no significant correlation between DL or NDL scapular dyskinesis and strength (DL Spearman’s rho= -0.160, p=0.266; NDL Spearman’s rho=-0.106, p=0.466) or thickness (DL Spearman’s rho=-0.175, p=0.230; NDL Spearman’s rho=-0.091, p=0.537). We did identify a significant and strong relationship between DL strength and thickness (Spearman’s rho=0.706, p<0.001) and a significant and moderate relationship between NDL strength and thickness (Spearman’s rho=0.414, p=0.003). : We did not identify any significant differences for pain (χ2=5.561, df=2, p=0.062, 1-β=1.00) among the normal (n=15, mean=29.40±1.68), subtle (n=14, mean=28.93±2.73) or obvious (n=21, mean=27.43±3.74) dyskinesis levels in the dominant limb. We did not identify any significant differences for function (χ2=1.386, df=2, p=0.500, 1-β=1.00) among the normal (n=15, mean=58.20±3.32), subtle (n=14, mean=59.00±1.47) or obvious (n=21, mean=56.86±5.97) dyskinesis levels in the dominant limb. We did not identify any significant differences for pain (χ2=0.937, df=2, p=0.626, 1-β=0.99) among the normal (n=11, mean=27.64±4.18), subtle (n=15, mean=29.33±1.50) or obvious (n=24, mean=28.79±2.00) dyskinesis levels in the non-dominant limb. We did not identify any significant differences for function (χ2=0.391, df=2, p=0.822, 1- β=0.91) among the normal (n=11, mean=58.09±2.21), subtle (n=15, mean=58.40±2.29) or obvious (n=24, mean=58.54±2.09) dyskinesis levels in the non-dominant limb. Conclusion: Our findings suggest that lower trapezius strength and thickness have little impact on the presence of scapular dyskinesis. As such, neuromuscular control should be studied to better understand the multifactorial issue of scapular dyskinesis. Our findings also confirmed our hypothesis that muscle strength and thickness are strongly correlated, particularly in the dominant limb. Also, without the exacerbation of overhead activity, dyskinesis may be subclinical yielding little to no pathologic consequences.

Context: Instrument Assisted Soft Tissue Mobilization (IASTM) and massage therapy are manual techniques that claim to be able to increase blood flow to treated areas. There are no studies on human subjects that have directly investigated the effects of IASTM on blood flow. Objective: To compare the effects of Graston Technique (GT) and Massage therapy on calf blood flow, using skin temperature measures (a valid, indirect measureof blood flow), on the lower leg. Design: Single-blinded prospective, longitudinal, controlled, repeated-measures design. Setting: Research Laboratory Participants: 28 volunteers participated in the study (Age=23±3; Males=14/28 (50%); Females=14/28 (50%); Girth=39.5±4.3l; Skinfold=27.9±5.6) Interventions: Each participant received 10-minute treatment (Massage and IASTM) in two separate sessions with the non-treatment leg used as a control. Main Outcome Measures: We measured baseline skin temperature on the calf prior to treatment, and again every 5min after treatment for a total of 60min. We evaluated differences between conditions (4) and time (13) with a repeated measures ANOVA. Significance was set at p<0.05 a-priori. Results: We identified significant differences with Greenhouse-Geisser corrections between conditions (F2.4,61.2=39.252, p<0.001, ES=0.602) and time (F2.1,54.4=192.8, p<0.001, ES=0.881), but failed to achieve a significant main effect (F2.1,53.5=2.944, p=0.060, 1-β=0.558). The massage condition (32.05±0.16°C) yielded significantly higher skin temperatures as compared to the massage control (30.53±0.14°C, p<0.001), GT (31.11±0.20, p<0.001), and GT control (30.32±0.14,p<0.001) conditions. Only the control conditions were not significantly different from one another (p=0.189). We also identified significant differences in time, whereas the baseline (25.83±0.30°C) acquired prior to treatment was significantly lower than all other temperature measurements (p<0.001). Moreover, temperatures at 5min (30.21±0.12°C), 10min (31.00±0.30°C), and 15min (31.65±0.12°C) showed significant increases (p<0.001). After 15min, the skin temperatures continued to rise and each time point was statistically different from the baseline and up to the 25min peak temperature (31.76±0.12°C), but these differences were not clinically significant differences (<0.80°C). Conclusion: This study demonstrated that massage and GT increase skin temperature. A rise in temperature theoretically indicates an increase in blood flow to the area. Blood flow increases theoretically stimulate the delivery of nutrients and oxygen to tissues in the body, increase tissue mobility, and increase muscle flexibility. Massage had a higher temperature increase when compared to GT, but both techniques increased temperature consistently for up to 25min post treatment. Further research is needed to conclude how deep this temperature and blood flow increase is occurring in the muscle tissue. If a clinician’s therapeutic goal is to increase temperature and blood flow, both massage and GT would be good treatment choices with massage yielding significantly higher temperature and blood flow. Word Count: 422

Background: Rhabdomyolysis is a potentially life-threatening syndrome characterized by the breakdown of skeletal muscle fibers resulting in the release of proteins into general circulation. Common practice for diagnosing exertional rhabdomyolysis (ER) is using biochemical markers for muscle damage; creatine kinase (CK) and myoglobin (Mb) are proteins detected in the bloodstream after muscle injury or trauma. Serum creatinine is the best biochemical marker for calculating renal function. Measuring GFR is not common when assessing ER. Purpose: The aim of this study is to help predict ER. Methods: Ninety-three athletes volunteered for the research study. Participants were asked to give blood three times throughout a competitive season. Results: Overall, Mb and GFR were lower than normal value and creatinine and CK were higher than normal value. In addition, neither CK nor Mb can predict GFR. Conclusions: The major finding of the current study is that the predicting GFR and ER is a difficult task. In addition, baseline levels of CK and Mb could be higher than normal values in college athletes.

In the last few years the United States has been on the decline in the fields of science and technology. The American Physiological Society (APS) has developed a program to engage young minds with scientists. Physiology Understanding Week (PhUn) is the APS initiative to use interactive experiments to engage school-age children with science and physiology. Even though PhUn Week has been going on since 2005, systematic assessment of the activities effects is rare. Here, we sought to assess if an APS PhUn Week activity enhances physiology understanding and interest in science in second grade children form a rural area. The assessment design was a pre/post PhUn Week activity survey. The PhUn Week event included two parts: 1) on stage ‘magic’ show, performing live experiments about the neurological, cardiovascular, and renal systems, and 2) small-group hands-on activities featuring the respiratory, renal, cardiovascular, and neurological systems. Two days before and within a week and 12 weeks after the event the children answered a brief 19-question survey including 3 general questions about their interest in science, 1 about their future profession, and 15 specific questions about the topics covered during the event. (3 cardiovascular, 4 respiratory, 4 renal, 4 neurological). The third graders acted as a control group as they did not see the PhUn Week event until after the completion of the first two assessment attempts. Two-hundred children attended the PhUn week event. One-hundred sixty five took all three attempts.The average pre-event survey score was 45.8% (±13.1%) and two thirds of the children liked science. After the event, the average survey score was 65.3% (±14.5%)(significantly higher when compared to pre-event, p<0.001) and 83% of the children liked science. This APS PhUn week assessment showed an improvement in knowledge and appreciation for science in second grade children from a rural area.

Annually, millions of Muslim pilgrims take the journey to Makkah, Kingdom of Saudi Arabia (KSA) to perform the holy pilgrimage. Due to the potential ramifications of such a large gathering, caring for the needs of pilgrims occupies the top priority among the Kingdom’s concerns. This research was conducted to investigate the level of the health related services that were provided during the 2012 Hajj to the pilgrims and Hajj agencies to ensure the safety and accessibility of the public services. With the support from the Ministry of Hajj, 225 Saudi citizens residing in Jeddah, participated in 2012 Hajj answered and completed the study survey. A total of 48 employees who worked in Hajj agencies as a subsidiary to the Ministry of Hajj were also selected for the study and completed the survey. For the data collection, electronic questionnaires were provided to both pilgrims and Hajj agencies. The collected data was analyzed using SPSS 20.0 program. The study aimed to evaluate the new preparedness plan for the event and provide feedback for decision makers. The results showed that on average the majority of pilgrims were satisfied with the overall services (85%). Moreover, on an average 76.8% of the pilgrims were satisfied about the health and the accommodation services in 2012 Hajj. However, there was no significant difference of satisfaction on the overall services in various age groups but there was significant difference in health and general services among various educational levels (p=0.034). Similarly, on average the majority of the agents were satisfied with the overall services during Hajj 2012 (83.1%) but there was no significant difference on overall service satisfaction among agents having different educational levels.

The purpose of the present study was to examine the relationship between diabetics’ socioeconomic status, self-efficacy, education levels, gender, and ethnicity and their medication and physical activity (i.e., healthy exercise) adherence regarding to their physicians and health educators’ counsels. Also, the study investigated whether or not the respondents adhered to medication prescription and physical activity routines. The study used a non-probability convenience sampling technique to recruit 102 type 2 diabetics (female, n = 65 and male, n = 37) from Indiana and Illinois Counties surrounding Vigo County, Indiana. The respondents reported their self-care activities throughout the seven days prior to completing the study questionnaire. A positive (direct) relationship between self-efficacy and healthy exercise, and a positive association between gender and self-efficacy were found (P < 0 .5). Besides, while the majority of the respondents adhered to medication treatment, nonetheless medication non-compliance level among the patients was alarming. Interventions that can boost patients’ confidence to successfully engage in the Centers for Disease Control and Prevention (CDC) and the American Diabetes Association (ADA)’s endorsed physical activity routines may be helpful. These interventions may include diabetes education follow-ups to improve patients’ self-efficacy scores (M = 4.73). Also, healthcare professionals may need to develop more operational plans to improve medication adherence levels among type two diabetics. Moreover, the present study suggests that diet and exercise treatments may be considered as potentials that can lead future success for blood glucose control among type 2 diabetics.

Context: many patients have pain and restricted motion due to myofascial adhesions. Clinicians use both manual and instrument assisted soft tissue mobilization (IASTM) techniques to treat myofascial adhesions. The main difference between manual therapies and IASTM is that IASTM claims that their instruments can accurately qualitatively detect myofascial adhesions through their resonance capability. However, the validity of this capability has yet to be researched. Objective: To determine the validity of using IASTM to detect myofascial adhesions through secondary diagnostic ultrasound analysis. Design: Correlational validity study. Setting: Athletic Training Laboratory. Patients or other participants: nineteen men (age = 22.4 ± 2.5) and eleven women (age = 21.2 ± 1.9). Data collection and analysis: From the thirty participants, one hundred adhesions were found and imaged. We calculated the percent level of agreement between the two rates, and then considered chance by using a κ coefficient to understand the relationship between the two rates of diagnostic us. Results: We identified an 83% level of agreement between raters. However, when chance was considered, we found a poor inter-rater reliability (κ= 0.344, p<0.001). Conclusions: There is moderate evidence that IASTM is successful in quantitatively detecting myofascial adhesions. Sources creating instrument resonance other than myofascial adhesions may include blood vessels or adipose nodules. Future investigation should further examine what specifically IASTM is detecting through its resonance, if not myofascial adhesions. Key words: instrument assisted soft tissue mobilization, Graston technique, diagnostic ultrasound, myofascia, fascial adhesions

Studies have shown that legumes can be an effective fat replacer in baked goods. However, little research has been conducted addressing black beans as a fat replacer in brownies. The purpose of this study was to determine the overall acceptability, palatability, and nutrient content of brownies made using black bean puree as a replacement for shortening. Using black beans as fat replacers in baked goods reduces total calories and fat content yielding a more nutritionally acceptable product. Today’s obesity epidemic justifies exploring lower calorie options for baked products. Black beans were chosen due to their dark color which will unlikely alter the color of the brownies. Black beans were used to replace 30%, 60%, and 90% of the shortening by weight in a control brownie formula. One hundred sixty seven untrained students from Indiana State University evaluated the product using a 9-point hedonic scale. One-way ANOVA revealed significant differences in appearance, odor, mouthfeel, taste, and total score when replacing shortening with black beans (p<0.05). For all tested sensory characteristics, Bonferroni post hoc testing indicated that 30% fat replacement was not significantly different from the control. Also, 30% fat replacement compared with the control showed a reduction in 12 calories and 1.52g fat per 1.15 ounce serving. Using an acceptability level of 20 for total score, the control, 30, 60, and 90% fat replacement were rated as acceptable. This study showed that pureed black beans can replace as much as 90% of the fat (by weight) in brownies, while yielding an acceptable and more nutritious product. However, overall acceptability, determined by total score, was lower in brownies with higher concentrations of fat replacement.