Effectiveness of the Reform • Empirical Evidence: • Gil et al. (2001) finds small gains to minority student from voucher program • National Center for education statistics: children in public schools do as well after controlling for demographic variables • Blueston (2008): parental background and community factors are significant
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National Institutes of Health Office Officeof ofthe theDirector Director National NationalInstitute Institute on onAging Aging National NationalInstitute Institute on onAlcohol AlcoholAbuse Abuse and andAlcoholism Alcoholism National NationalInstitute Institute of ofAllergy Allergyand and Infectious InfectiousDiseases Diseases National NationalInstitute Institute of ofArthritis Arthritisand and Musculoskeletal Musculoskeletal and andSkin SkinDiseases Diseases National NationalCancer Cancer Institute Institute National NationalInstitute Institute of ofChild ChildHealth Health and andHuman Human Development Development National NationalInstitute Instituteon on Deafness Deafnessand andOther Other Communication Communication Disorders Disorders National NationalInstitute Institute of ofDental Dentaland and Craniofacial Craniofacial Research Research National NationalInstitute Institute of ofDiabetes Diabetesand and Digestive Digestiveand and Kidney KidneyDiseases Diseases National NationalInstitute Institute on onDrug DrugAbuse Abuse National NationalInstitute Institute of ofEnvironmental Environmental Health HealthSciences Sciences National NationalEye Eye Institute Institute National NationalInstitute Institute of ofGeneral General Medical MedicalSciences Sciences National NationalHeart, Heart, Lung, Lung,and andBlood Blood Institute Institute National NationalHuman Human Genome GenomeResearch Research Institute Institute National NationalInstitute Institute of ofMental MentalHealth Health National NationalInstitute Institute of ofNeurological Neurological Disorders Disordersand and Stroke Stroke National NationalInstitute Institute of ofNursing NursingResearch Research National NationalInstitute Instituteof of Biomedical BiomedicalImaging Imaging and andBioengineering Bioengineering National NationalCenter Center for forComplementary Complementary and andAlternative Alternative Medicine Medicine Fogarty Fogarty International International Center Center National NationalCenter Center for forResearch Research Resources Resources National NationalLibrary Library of ofMedicine Medicine National NationalCenter Centeron on Minority Health Minority Healthand and Health HealthDisparities Disparities Clinical ClinicalCenter Center Center Centerfor for Information Information Technology Technology Center for Scientific Review
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National Institutes of Health Office of Extramural Research Office of the Director National Institute on Aging National Institute on Alcohol Abuse and Alcoholism National Institute of Allergy and Infectious Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases National Cancer Institute National Institute of Child Health and Human Development National Institute on Deafness and Other Communication Disorders National Institute of Dental and Craniofacial Research National Institute of Diabetes and Digestive and Kidney Diseases National Institute on Drug Abuse National Institute of Environmental Health Sciences National Eye Institute National Institute of General Medical Sciences National Heart, Lung, and Blood Institute National Human Genome Research Institute National Institute of Mental Health National Institute of Neurological Disorders and Stroke Fogarty International Center National Center for Research Resources National Center on Minority Health and Health Disparities National Center for Complementary and Alternative Medicine NIH Clinical Center Center for Information Technology National Library of Medicine Center for Scientific Review National Institute of Nursing Research National Institute of Biomedical Imaging and Bioengineering No funding authority3
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Academic Excellence -- Accreditation School School of of Education Education School School of of Pharmacy Pharmacy Accreditation Accreditation Council Council for for Pharmacy Pharmacy Education Education School of Dental Medicine National National Council Council for for the the Accreditation Accreditation of of Teacher Teacher Education (NCATE) Education (NCATE) National National Association Association of of School School Psychologists Psychologists American American Speech-Language-and-Hearing Speech-Language-and-Hearing Assn. Assn. American American Dental Dental Association Association School School of of Engineering Engineering (ABET) (ABET) Accreditation Accreditation Board Board for for Engineering Engineering Technology Technology American American Council Council for for Construction Construction Education Education 44 44 Baccalaureate Baccalaureate Degree Degree Options Options The The Graduate Graduate School School 45 45 Masters Masters Degrees Degrees Doctoral/Professional Doctoral/Professional Degrees Degrees Pharmacy Pharmacy and and Dental Dental Medicine Medicine Nursing and Education Engineering Nursing and Education Engineering School School of of Nursing Nursing CCNE CCNE Commission Commission on on Collegiate Collegiate Nursing Nursing Education Education College College of ofArts Arts and and Sciences Sciences National NationalAssociation Association of of Schools Schools of of Music, Music, Voice, Voice, and and Piano; Piano; National NationalAssociation Association of of Schools Schools of ofArt Art and and Design; Design; School of Business (AACSB) –Association Association to to American American Chemical Chemical Society; Society; Advance Collegiate Schools of Business Advance Collegiate Schools of Business American AmericanArt Art Therapy; Therapy; Association AssociationAccrediting Accrediting Council Council in in Journalism Journalism and and Mass Mass Communication; Communication; Council Council on on Social Social Work Work Education Education National National Association Association of of Schools Schools of of Public PublicAffairs Affairs and andAdministration; Administration; National NationalAssociation Association of of Schools Schools of of Theatre Theatre
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5. Mean projections and mean student scores are calculated. Student Projection1 Student Score 1 Student Projection 2 Student Score 2 Student Projection 3 Student Score 3 Student Projection 4 Student Score 4 Student Projection 5 Your School Student Score 5 Student Projection 6 Student Score 6 Student Projection 7 Student Score 7 Student Projection 8 Student Score 8 Student Projection 9 Student Score 9 Student Projection 10 Student Score 10 Student Projection 11 Student Score 11 Student Projection 12 Student Score 12 Student Projection 13 Student Score 13 Student Projection 14 Student Score 14 Student Projection 15 Student Score 15 Student Projection 16 Student Score 16 Student Projection 17 Student Score 17 Student Projection 18 Student Score 18 Student Projection 19 Student Score 19 Student Projection 20 Student Score 20 Mean Projected Score Mean Student Score Copyright © 2003. Battelle for Kids
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It’s really not this bad! Office Officeofofthe theDirector Director National NationalInstitute Institute on onAging Aging National NationalInstitute Institute on onAlcohol AlcoholAbuse Abuse and andAlcoholism Alcoholism National NationalInstitute Institute ofofAllergy Allergyand and Infectious InfectiousDiseases Diseases National NationalInstitute Institute ofofArthritis Arthritisand and Musculoskeletal Musculoskeletal and andSkin SkinDiseases Diseases National NationalCancer Cancer Institute Institute Eunice EuniceKennedy Kennedy Shriver ShriverNational NationalInstitute Institute ofofChild ChildHealth Healthand and Human HumanDevelopment Development National NationalInstitute Instituteon on Deafness Deafnessand andOther Other Communication Communication Disorders Disorders National NationalInstitute Institute ofofDental Dentaland and Craniofacial Craniofacial Research Research National NationalInstitute Institute ofofDiabetes Diabetesand and Digestive Digestiveand and Kidney Diseases Kidney Diseases National NationalInstitute Institute on onDrug DrugAbuse Abuse National NationalInstitute Institute ofofEnvironmental Environmental Health Sciences Health Sciences National NationalEye Eye Institute Institute National NationalInstitute Institute ofofGeneral General Medical Sciences Medical Sciences National NationalHeart, Heart, Lung, Lung,and andBlood Blood Institute Institute National NationalHuman Human Genome GenomeResearch Research Institute Institute National NationalInstitute Institute ofofMental MentalHealth Health National NationalInstitute Institute ofofNeurological Neurological Disorders Disordersand and Stroke Stroke National NationalInstitute Institute ofofNursing NursingResearch Research National NationalCenter Center for forComplementary Complementary and Alternative and Alternative Medicine Medicine John JohnE. E.Fogarty Fogarty International International Center Center National NationalCenter Center for forResearch Research Resources Resources National NationalLibrary Library ofofMedicine Medicine National NationalInstitute Instituteofof Biomedical BiomedicalImaging Imaging and andBioengineering Bioengineering Clinical ClinicalCenter Center Understanding NIH Center Centerfor for Information Information Technology Technology Slide 10 National NationalInstitute Instituteon on Minority MinorityHealth Healthand and Health Disparities Health Disparities Center Centerfor for Scientific ScientificReview Review 8 November 2017
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Strategic Goal 8: Service to Students and the Community NEW GOAL 2020: ORIGINAL Goal 2010: • • • Trinity will extend its educational and service talent to children, families and adults in neighborhoods, schools, civic organizations and other locations in the District of Columbia and the Washington Region. • Trinity will provide vital support services to students, faculty and staff in the campus community, as well as to neighbors and residents of D.C. and the larger Washington community. • Student and Campus Services: Trinity will provide a robust range of services for all campus populations. Each service department and program will provide an annual plan with service goals and objectives, resources required and an assessment plan, including: Through the Trinity Center for Women and Girls in Sports, Trinity will continue to offer wellness, fitness, recreational, educational and athletics programs and services to the larger Washington community as well as to the campus community; the annual plan for the Trinity Center includes measurable goals for these services; For the campus community, Trinity will create annual plans with measurable goals for service delivery and effectiveness, and customer satisfaction, in these areas for all schools: – – – – Academic Support Services, Health Services, Campus Ministry, Residence Life Student Government , Student Activities Enrollment Services Food Service, Bookstore, Facilities Services – – – – Academic Support Services, Health Services, Campus Ministry, Residence Life Student Government, Student Activities Enrollment Services Operations: Food Service, Bookstore, Facilities Services, Campus Safety • Trinity Center: Through the Trinity Center for Women and Girls in Sports, Trinity will continue to offer wellness, fitness, recreational, educational and athletics programs and services to the larger Washington community as well as to the campus community; the annual plan for the Trinity Center includes measurable goals for these services; • Community Service: Trinity continues to expand its outreach to the D.C. and Washington regional community through community service projects, clinical service, and partnerships. Each of these components will have a specific plan. 30
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Organizational Structure of NIH Office of the Director http://www.nih.gov/ic d National Institute on Aging National Institute on Alcohol Abuse and Alcoholism National Institute of Allergy and Infectious Diseases National Institute of Arthritis and Musculoskeletal and Skin Diseases National Cancer Institute National Institute of Child Health and Human Development National Institute on Deafness and Other Communication Disorders National Institute of Dental and Craniofacial Research National Institute of Diabetes and Digestive and Kidney Diseases National Institute on Drug Abuse National Institute of Environmental Health Sciences National Eye Institute National Institute of General Medical Sciences National Heart, Lung, and Blood Institute National Human Genome Research Institute National Institute of Mental Health National Institute of Neurological Disorders and Stroke National Institute of Nursing Research National Center on Minority Health and Health Disparities National Center for Complementary and Alternative Medicine Fogarty International Center National Center for Research Resources National Library of Medicine National Institute of Biomedical Imaging and Bioengineering No funding authority 18 18
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LETTER OF INTENT The effect of high intensity interval training versus moderate intensity training on anthropometric and cardiovascular health in children who are overweight or obese: A pilot study. PI Name: Ashwin Agrawal, DO, MA Stony Brook Children’s Hospital HSC T-11, Room 040 Stony Brook, NY 11794-8111 631-358-6106 [email protected] Funding Path Academic Pediatric Association Resident Investigator (RIA) Primary Mentor Name Peter Morelli, MD, FACC [email protected] Residency Program Director Name Robyn Blair, MD [email protected] Department Chair Name Margaret McGovern, MD [email protected] Participation Statement If funded, I agree to participate in any conference calls and/or in-person grantee meetings WORK IN PROGRESS…. PROBLEM, BACKGROUND AND SIGNIFICANCE: Approximately 30% of children in the United States are overweight/obese leading to a public health epidemic.[1] Pediatric obesity is linked to numerous acute and chronic health conditions including cardiovascular disease, diabetes, cancers, hypertension, and significant increase in all-cause mortality.[2, 3] Diet and exercise decrease the risk of obesity.[4] However, only 27% of children perform the recommended 60 minutes of daily exercise. [5] The American Academy of Pediatrics endorses that pediatricians assist children and their families with lifestyle modification such as diet and exercise to improve the physical, cognitive and mental state of children.[4] Fit Kids for Life (FKFL) is a 10 week lifestyle modification program developed and offered by Stony Brook Children’s since 1998 which incorporates nutritional guidance, wellness and a supervised exercise regimen for obese children in our community. Efficacy of pediatric obesity interventions is equivocal with many studies noting high attrition rates and poor long term adherence.[6-8] Factors that contribute to high attrition include: difficulty of exercise, repetitiveness/boredom from exercise routine or that weight loss was not visible. [6] Therefore, it is important to develop a novel, time efficient modality that will motivate, captivate and promote exercise and healthy nutrition for children to help reduce rates of pediatric obesity. Ideal intensity and duration of exercise programs for effective weight loss and improved health in pediatric populations is unclear.[6] Most pediatric obesity programs, including FKFL, have utilized moderate intensity training (MIT) which consists of exercise in 60 minute circuits.[6, 7] High intensity interval training programs (HIIT) have emerged and are effective at reducing weight and cardiovascular risk markers in adults.[9] Less is known abou the role of HIIT in the overweight/obese pediatric population. Early studies suggest that HIIT may have improved health benefits for children and adolescents. [10] Compared to MIT, HIIT programs employ short bursts of near maxim exercise intensity (HR ≥75% HR max) followed by brief rest periods and have a shorter duration (generally 30minutes). [10] HIIT programs have been found to be attractive to children and adolescents for several reasons including: 1) HIIT more closely mimics typical movements of children - short bouts (< 15 seconds) and high intensity, 2) HIIT can be delivered in a shorter timeframe, and 3) HIIT paradigms are more like playing a game which may decrease boredom, increase enjoyment and promote higher adherence.[11-13] Currently used outcome measures in pediatric obesity studies (such as height, weight, waist to hip ratio, Body mass Index [BMI], heart rate [HR] and blood pressure [BP]) may not be ideal. For example, BMI is influenced by linear growth and ineffective at quantifying body composition; waist circumference, while promoted by the WHO as a valid predictor of cardiovascular disease, is fraught with measurement reliability issues; and vascular health may not be reflected by BP and HR changes alone. Three dimensional (3D) body imaging is a new technique which may offer greater reliability in measuring body circumferences and inferring body composition. In addition, bio-electrical impedance has shown to evaluate fat content and muscle mass fairly accurately. In terms of cardiovascular health, brachial artery flow-mediated dilatation (FMD) is a safe, non-invasive technique which correlates strongly with coronary endothelial function and predicts cardiovascular disease.[14, 15] In the adult literature, FMD has revealed improved vascular health following exercise and diet, even in the absence of weight loss. Therefore, FMD may be a strong indicator of cardiovascular improvement following the FKFL program, and this outcome may reflect program success despite lack of change in anthropometric measures. Studies show improved vascular health (FMD) in adults even when body composition and weight have not changed, thus FMD may potentially be a more sensitive measure of exercise (and overall program) effect.[15] SPECIFIC AIMS: Specific Aim 1: To determine if high intensity interval training (HIIT) is a better alternative to moderate intensity training (MIT) for improvements in a) BMI and weight loss, b) body composition by a novel 3D body scanning method and bioelectric impedance and and, c) cardiovascular health measured by FMD and heart rate variability in children and adolescents who are overweight and obese. Specific Aim 2a: To determine if children/adolescents who complete HIIT program have better attendance and long term adherence to lifestyle changes compared to the MIT group. Specific Aim 2b: To determine if children in the HIIT program report higher enjoyment and satisfaction compared to the MIT group. HYPOTHESES: Hypothesis 1: Children who complete the FKFL HIIT protocol will have greater improvements in CV health (as measured by BMI, body composition, vital signs, and FMD) as compared Commented [1]: I would remove this line. BIA is not
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POLISHED AND READY TO GO STUDY TIMELINE: SPECIFIC AIMS: Specific Aim 1: To determine if high intensity interval training (HIIT) is a better alternative to moderate intensity training (MIT) for improvements in a) weight loss, b) body composition by a novel 3D body scanning method and bioelectric impedance and c) cardiovascular health measured by FMD and heart rate variability in children and adolescents Anticipated Outcomes and Relevance: It is expected that this study will help identify an exercise format that is more enjoyable and effective for overweight/obese children. This is very importan who are overweight and obese. Specific Aim 2a: To determine if children/adolescents who for our community as well as communities across the nation. Pediatricians and health complete HIIT program have better attendance and long term adherence to lifestyle changes compared to the MIT group. Specific Aim 2b: To determine if children in the HIIT program report professions require further guidance on how to create effective weight management programs so that the epidemic of pediatric obesity can be decreased and our study hopes to identify an high enjoyment compared to the MIT group. exercise program that will be more effective and fun.. This study will also help ascertain reliable HYPOTHESES: Hypothesis 1: Children who complete the FKFL HIIT protocol will have greater measures of body composition and cardiovascular healthy which may validated programs like improvements in CV health (as measured by BMI, body composition, vital signs, and FMD) as compared to children who complete the MIT protocol. Hypothesis 2a: Children who complete FKFL and may also: 1)demonstrate to physicians and families that lifestyle changes improve the HIIT protocol will have greater attendance (as measured during the 10 week program) and overall vascular health even if body composition improvements are negligible, and 2) prove that better adherence (as measured following 10 weeks post program) as compared to children who HIIT is a better exercise modality to offer and show that. This pilot data will inform the complete the FKFL MIT protocol. Hypothesis 2b: Children who complete the FKFL HIIT protocol methodology for a planned larger, multi-site study and a grant application to the American Heart Association. will report greater enjoyment and satisfaction with the program (as measured during the 10 References week program) and better enjoyment towards a healthy lifestyle (as measured following 10 1. Ogden, C.C., M. Fryar, C. and Flegal, K. , Prevalence of obesity among adults and weeks post program) as compared to children who complete the MIT protocol. METHODS: This pilot study will examine 2 groups (Group 1 = HIIT [n=30], Group 2=MIT [n=30]) youth: United States, 2011-2014. NCHS data brief, no 219. National Center for Health Statistics 2015. of children aged 8-17 who are overweight/obese who will complete the 10 weeks of GKGL 2. Daniels, S.R., The consequences of childhood overweight and obesity. Future Child, program. Children will then enter a 10 week “home program” where they will be asked to continue with exercise at home followed by a final measurement to assess retention. Sampling 2006. 16(1): p. 47-67. will occur from an established pool of patients who have been screened for the FKFL program. 3. Daniels, S.R., Complications of obesity in children and adolescents. Int J Obes (Lond), Measurements of cardiovascular health and anthropometric measurements will be performed 2009. 33 Suppl 1: p. S60-5. prior to the start of FKFL (Week 0) and at completion of FKFL (Week 10). To determine effect of 4. Daniels, S.R., S.G. Hassink, and N. Committee On, The Role of the Pediatrician in Primary Prevention of Obesity. Pediatrics, 2015. 136(1): p. e275-92. HIIT vs MIT on adherence, all measurements will be repeated at Week 20. A survey to gauge 5. Prevention, C.f.D.C.a., State indicator report on physical activity, 2014. 2014, U.S. enjoyment/satisfaction will be completed at 10 and 20 weeks. Depeartment of Health and Human Services: Atlanta, GA. 6. Lenders, C.M., et al., Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going? Curr Obes Rep, 2016. 5(2): p. 214-40. 7. Dias, K.A., et al., Exercise and Vascular Function in Child Obesity: A Meta-Analysis. Pediatrics, 2015. 136(3): p. e648-59. 8. Martin, A., et al., Lifestyle intervention for improving school achievement in overweight or
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