External Factors Influencing the Implementation of Policy, System, and Environmental Change Strategies Within Cooperative Extension.

. Multilevel approaches are important to promote the adoption of healthier practices at the individual and community levels. Cooperative Extension pairs policy, systems, and environmental (PSE) change approaches with direct education programs focused on individual and community health.

A Community Profile of Walking and Cycling for Exercise or Transportation in a Rural County in the Southeastern United States.

People living in rural areas of the United States, especially in the southern region, are much less likely to walk or cycle for leisure time or transportation. The purpose of this study is to provide a more detailed community-level estimate of walking and cycling behaviors and attitudes among adults living in a rural county (Hardeman County, TN) participating in a High Obesity Program (HOP) from the Centers for Disease Control and Prevention. Telephone interviews and online surveys regarding walking and cycling behaviors, attitudes, and perceptions of the built environment were completed by 634 adults.

Working With Rural Producers to Expand EBT in Farmers' Markets: A Case Study in Hardeman County, Tennessee.

Rural residents tend to eat less fruits and vegetables, placing them at higher risk of chronic diseases compared with urban residents. Farmers' markets can provide increased access to fresh produce for rural communities. Encouraging markets to accept Supplemental Nutrition Assistance Program (SNAP) benefits through Electronic Benefit Transfer (EBT) can expand access to healthy foods to low-income residents.

Effectiveness of diabetes education interventions in rural America: a systematic review.

The purpose of this systematic review is to summarize the characteristics of recent studies on diabetes education interventions in rural areas and identify the relative proportion of studies with characteristics of interest that showed a reduction in glycated hemoglobin (A1C). A systematic literature search was performed in Web of Science, PubMed and PsychInfo, using keywords and Medical Subject Heading terms. Articles conducted in rural areas of the United States tested an educational intervention for people with type 2 diabetes, and reported outcomes were identified.

Exploring Extension Agent Capacity and Readiness to Adopt Policy, Systems and Environmental Change Approaches.

Introduction: Enhanced Extension outreach strategies combine traditional direct education programs with public health approaches like policy, systems, and environmental (PSE) change. However, the Cooperative Extension system and county-based Family and Consumer Sciences (FCS) Extension agents have historically prioritized direct education programming and diffusion of enhanced outreach strategies has varied. Extension personnel may lack capacity and readiness for successful PSE change implementation.

Improving Lifestyle Behaviors After Breast Cancer Treatment Among African American Women With and Without Diabetes: Role of Health Care Professionals.

Background: Little is known about the effect of health professionals' advice on promoting healthy lifestyle behaviors (diet and exercise) among breast cancer patients.

Purpose: To identify predictors of receiving lifestyle advice from health professionals and its impact on healthy lifestyle behaviors.

Methods: We used data from a randomized controlled trial of an interactive, cancer-communication video program using African American breast cancer survivor stories for newly diagnosed African American breast cancer patients (Stages 0-III).

Pre-Existing Diabetes in Early Stage Breast Cancer Patients is Associated with Lack of Improvement in Quality of Life 2 Years After Diagnosis.

Purpose: Type 2 diabetes is a common comorbidity among breast cancer survivors. Our aim was to assess the association between diabetes and quality of life (QOL) in newly diagnosed early stage (0-IIA) breast cancer patients over a 2-year follow-up.

Methods: We used data from a longitudinal study of 549 breast cancer patients, aged ≥40 years.

Participants' perceptions of a group based program incorporating hands-on meal preparation and pedometer-based self-monitoring in type 2 diabetes.

Background: Nutrition education (portion sizes, balanced meals) is a cornerstone of diabetes management; however, moving from information to behavior change is challenging. Through a single arm intervention study, we recently demonstrated that combining education with group-based meal preparation training has measureable effects on weight, eating behaviour, and glycemic control in adults with type 2 diabetes. In the present study, we conducted an in-depth examination of participants' perceptions of this strategy, through focus group discussion, to delineate effective elements of the strategy from participants' perspectives.

Breakfast intake among adults with type 2 diabetes: influence on daily energy intake.

Objective: To assess the association between breakfast energy and total daily energy intake among individuals with type 2 diabetes.

Design: Cross-sectional study. Daily energy intake was computed from a 24 h dietary recall.

Increased risk of colorectal cancer in type 2 diabetes is independent of diet quality.

Background: Poor diet increases the risk of both colorectal cancer and type 2 diabetes. We investigated the role of diet in the association between diabetes and colorectal cancer.

Methods: We analyzed data from 484,020 individuals, aged 50-71 years who participated in the prospective National Institutes of Health-AARP Diet and Health Study and were cancer free at baseline (1995-1996).

Income disparity and risk of death: the importance of health behaviors and other mediating factors.

Background: Income disparities in mortality are profound in the United States, but reasons for this remain largely unexplained. The objective of this study was to assess the effects of health behaviors, and other mediating pathways, separately and simultaneously, including health insurance, health status, and inflammation, in the association between income and mortality.

Methods: This study used data from 9925 individuals aged 20 years or older who participated in the 1999-2004 National Health and Nutrition Examination Survey (NHANES) and were followed up through December 31, 2006 for mortality.

Influence of lifestyle factors on inflammation in men and women with type 2 diabetes: results from the National Health and Nutrition Examination Survey, 1999-2004.

Background: Type 2 diabetes is associated with low-grade systemic inflammation, increasing the risk for various adverse health outcomes.

Purpose: Our objective was to investigate the association between C-reactive protein (CRP), a marker for systemic inflammation, and lifestyle factors in a national sample of people with type 2 diabetes.

Methods: This study analyzed data from 1,086 men and women with diabetes, who completed the 1999-2004 NHANES.

Food after deprivation rewards the earlier eating.

Food intake can be increased by learning to anticipate the omission of subsequent meals. We present here a new theory that such anticipatory eating depends on an associative process of instrumental reinforcement by the nutritional repletion that occurs when access to food is restored. Our evidence over the last decade from a smooth-brained omnivore has been that food after deprivation rewards intake even when those reinforced ingestive responses occur long before the physiological signals from renewed assimilation.

Reinforcement of anticipatory eating by short as well as long fasts.

Rats can learn to anticipate the omission of subsequent meals by increasing food intake. Our previous reports have analysed group means at each trial but that does not allow for rats learning at different speeds. This paper presents instead a rat-by-rat analysis of all the raw data from previous experiments.

Differences in food intake among obese and nonobese women and men with type 2 diabetes.

Objective: Weight reduction is a key goal for the prevention of vascular complications in obese individuals with type 2 diabetes, but a nutritionally balanced intake is also important in this regard. We compared dietary intakes and vitamin supplement use between obese and nonobese women and men with type 2 diabetes to identify gaps in adherence to nutritional management guidelines.

Methods: We analyzed data from a longitudinal study of adults with type 2 diabetes, wherein participants were assessed once per season over 1 year.

Decreasing trend of tumor size and downstaging in breast cancer in Iran: results of a 15-year study.

The aim of this cross-sectional study was to show the characteristics of breast cancer across a period of 15 years according to pathological records in Tehran, Iran. In the year 1985, a 20-year study was designed and developed in five major hospitals in Tehran to study the burden and characteristics of breast cancer in Iran. This study is based on the data collected from 1986 through 2000.

Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods.

Background: Breast cancer remains an important public health problem. This study aimed to investigate about female knowledge of breast cancer and self-reported practice of breast self-examination in Iran.

Methods: This was a population-based survey carried out in Tehran, Iran.

Rats learn to eat more to avoid hunger.

Several recent experiments have provided evidence that the ingestion of a distinctive food by rats can be a learnt instrumental act as well as an associatively conditioned reaction. In the previous work, maintenance food was withheld for shorter and longer durations on different days following access to the training food. Extra eating before the longer fast was interpreted as avoidance of hunger.

Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study.

Background: Measuring quality of life in breast cancer patients is of importance in assessing treatment outcomes. This study examined the impact of breast cancer diagnosis and its treatment on quality of life of women with breast cancer.

Methods: This was a prospective study of quality of life in breast cancer patients.

Hyper-homeostatic learning of anticipatory hunger in rats.

Anticipatory hunger is a learnt increase in intake of food having a flavour or texture that predicts a long fast. This learning was studied in rats trained on a single food or a choice between protein-rich and carbohydrate-rich foods, presented for 1.5 h after 3 h without maintenance food at the start of the dark phase.

The role of depression in the development of breast cancer: analysis of registry data from a single institute.

Although controversial, the belief that developing breast cancer may be associated with psychological distress is not uncommon. The present study examined the role of psychological variables in the development of breast cancer in women attending a breast clinic for medical examination in Tehran, Iran. During a three-year period (1997-1999) a trained female nurse interviewed all women attending the Iranian Center for Breast Cancer (ICBC) before a confirmed diagnosis was made (N = 3000).

Breast self-examination: do religious beliefs matter? A descriptive study.

Background: A descriptive study was conducted in Tehran, Iran, to investigate the beliefs of Muslim women and their practices regarding screening modalities of breast cancer.

Methods: A questionnaire was specially designed and validated to collect data and was completed by 410 Muslim women.

Results: A vast majority of women (90 per cent) said that breast self-examination is not against their religious beliefs.

The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version.

Background: The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. This study aimed to translate and test the reliability and validity of the Iranian version of the HADS.

Methods: The English language version of the HADS was translated into Persian (Iranian language) and was used in this study.

Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial.

Depression is a major health problem and is not only underrecognized and undertreated but is associated with significant morbidity and mortality. Lavandula angustifolia Mill. (Lamiacae) is used to treat depression.

Novel mutations in the BRCA1 and BRCA2 genes in Iranian women with early-onset breast cancer.

Background: Breast cancer is the most common female malignancy and a major cause of death in middle-aged women. So far, germline mutations in the BRCA1 and BRCA2 genes in patients with early-onset breast and/or ovarian cancer have not been identified within the Iranian population.

Methods: With the collaboration of two main centres for cancer in Iran, we obtained clinical information, family history and peripheral blood from 83 women under the age of 45 with early-onset breast cancer for scanning of germline mutations in the BRCA1 and BRCA2 genes.