Sutter Health

STUDY OF MUSCLE, MOBILITY AND AGING (SOMMA)

PREVENTION OF FRACTURES IN PATIENTS WITH PARKINSON'S DISEASE

LONG TERM FRACTURE RISK AND CHANGE IN PERIPHERAL BONE IN THE OLDEST OLD MEN: THE MROS STUDY

STUDY OF OSTEOPOROTIC FRACTURES

OUTCOMES OF SLEEP DISORDERS IN OLDER MEN

EFFECTS OF SUCCESSFUL OSA TREATMENT ON MEMORY AND AD BIOMARKERS IN OLDER ADULTS (ESSENTIAL) - THE PREVALENCE OF ALZHEIMER DISEASE (AD) IS HIGH AND PROJECTED TO INCREASE. FURTHER, EPIDEMIOLOGICAL DATA SUGGESTS THAT ~15% OF AD RISK MAY BE ATTRIBUTED TO SLEEP PROBLEMS. OBSTRUCTIVE SLEEP APNEA (OSA) IS ALSO COMMON AMONG THE ELDERLY (30-55%), AND OUR PRIOR WORK HAS ESTABLISHED THAT COGNITIVELY NORMAL OLDER WOMEN WITH OSA HAVE NEARLY DOUBLE THE 5-YEAR RISK OF DEVELOPING MILD COGNITIVE IMPAIRMENT (MCI) OR DEMENTIA. FURTHER, WE SHOWED THAT: I. OSA PATIENTS TREATED WITH POSITIVE AIRWAY PRESSURE (PAP) EXPERIENCED SIGNIFICANT OVERNIGHT INCREASES IN PLASMA NEUROFILAMENT LIGHT (NFL), A MARKER OF NEURAL INJURY, WITH STRONG TRENDS FOR AD- SPECIFIC BIOMARKERS (I.E. AΒ40 AND TAU) AFTER PAP WITHDRAWAL; II. OSA PREDICTED LONGITUDINAL INCREASES IN AD BIOMARKERS; AND, III. PAP TREATMENT DELAYED THE ONSET OF MCI IN SUBJECTS WITH REPORTED OSA. THERE IS THEREFORE STRONG EVIDENCE SUGGESTING THAT OSA TREATMENT COULD BE AN IMPORTANT PREVENTION STRATEGY FOR AD. HOWEVER, TRIALS FOR TREATMENT OF OSA TO SLOW COGNITIVE DECLINE AND PROGRESSION TO AD FACE A NUMBER OF CHALLENGES. FIRST, THE MOST EFFECTIVE THERAPY (PAP) HAS POOR ADHERENCE. A SECOND CHALLENGE IS DEFINING THE TARGET POPULATION: PRIOR TRIALS TARGETED OSA PATIENTS WITH MCI/AD, WHO HAVE MORE ADVANCED DISEASE AND COULD BE LESS AMENABLE TO TREATMENT. A THIRD CHALLENGE IS IDENTIFYING COGNITIVE TESTING THAT IS SENSITIVE TO SLEEP DISRUPTION, AND LINKED TO INCREASED AD RISK. (TO CAPTURE EFFECTS OF OSA ON THE OFFLINE PROCESSING PHASE REQUIRES SLEEP-DEPENDENT MEMORY PARADIGMS, IN WHICH THE ENCODING AND RECALL OF INFORMATION ARE SEPARATED BY A PERIOD OF SLEEP WITH/WITHOUT OSA). FINALLY, A RANDOMIZED TRIAL OF SUFFICIENT DURATION TO TEST THE EFFECTS OF TREATMENT OF OSA ON RISK OF INCIDENT AD IS NOT FEASIBLE. OUR PROPOSED TRIAL, EFFECTS OF SUCCESSFUL OSA TREATMENT ON MEMORY AND AD BIOMARKERS IN OLDER ADULTS (ESSENTIAL), ADDRESSES THESE CHALLENGES. ESSENTIAL IS A 5-YEAR STUDY OF COGNITIVELY NORMAL OLDER ADULTS WITH NEWLY DIAGNOSED OSA, AGES 55-75, RECRUITED FROM 4 WELL-ESTABLISHED SLEEP CLINICS. OSA PATIENTS (N=200) WILL BE RANDOMIZED TO EITHER: I) A 3-MONTH OSA TREATMENT BY ANY COMBINATION OF PAP, OAT, AND POSITIONAL THERAPY THAT RESULTS IN AN “EFFECTIVE” IMPROVEMENT IN THE APNEA-HYPOPNEA INDEX (AHI); II) A WAITLIST CONTROL GROUP TO RECEIVE TREATMENT AT THE CONCLUSION OF THE 3-MONTH INTERVENTION PERIOD. EFFECTIVELY TREATED INDIVIDUALS (~150) AND UNTREATED INDIVIDUALS (~100) WILL THEN BE FOLLOWED FOR UP TO 24 MONTHS TO COMPARE WHETHER SUSTAINED IMPROVEMENTS IN AHI ARE ASSOCIATED WITH BETTER COGNITIVE FUNCTION AND AD BIOMARKER CHANGE PROFILES AS COMPARED TO UNTREATED CONTROLS. PARTICIPANTS WILL UNDERGO PSG, ACTIGRAPHY, COGNITIVE TESTS, AND BLOOD DRAWS AT BASELINE, 3 AND 24 MONTHS. OUR AIMS ARE: 1) TO COMPARE 3-MONTH CHANGE IN PLASMA AD BIOMARKERS (NFL, P-TAU, AΒ) BETWEEN THOSE RANDOMIZED TO OSA TREATMENT AND WAIT-LIST CONTROL GROUPS; 2) TO COMPARE 3-MONTH CHANGE IN COGNITION BETWEEN THE OSA TREATMENT AND WAIT-LIST CONTROL GROUPS; 3) TO EXAMINE IF SUSTAINED REDUCTION IN AHI OVER 24 MONTHS AMONG EFFECTIVELY TREATED PARTICIPANTS VERSUS UNTREATED CONTROLS IS ASSOCIATED WITH BETTER 24-MONTH CHANGE PROFILES FOR AD BIOMARKERS AND COGNITION.

OSTEOPOROTIC FRACTURES IN MEN (MROS) - SAN FRANCISCO COORDINATING CENTER

EFFECTS OF SUCCESSFUL OSA TREATMENT ON MEMORY AND AD BIOMARKERS IN OLDER ADULTS (ESSENTIAL) - THE PREVALENCE OF ALZHEIMER DISEASE (AD) IS HIGH AND PROJECTED TO INCREASE. FURTHER, EPIDEMIOLOGICAL DATA SUGGESTS THAT ~15% OF AD RISK MAY BE ATTRIBUTED TO SLEEP PROBLEMS. OBSTRUCTIVE SLEEP APNEA (OSA) IS ALSO COMMON AMONG THE ELDERLY (30-55%), AND OUR PRIOR WORK HAS ESTABLISHED THAT COGNITIVELY NORMAL OLDER WOMEN WITH OSA HAVE NEARLY DOUBLE THE 5-YEAR RISK OF DEVELOPING MILD COGNITIVE IMPAIRMENT (MCI) OR DEMENTIA. FURTHER, WE SHOWED THAT: I. OSA PATIENTS TREATED WITH POSITIVE AIRWAY PRESSURE (PAP) EXPERIENCED SIGNIFICANT OVERNIGHT INCREASES IN PLASMA NEUROFILAMENT LIGHT (NFL), A MARKER OF NEURAL INJURY, WITH STRONG TRENDS FOR AD- SPECIFIC BIOMARKERS (I.E. ASS40 AND TAU) AFTER PAP WITHDRAWAL; II. OSA PREDICTED LONGITUDINAL INCREASES IN AD BIOMARKERS; AND, III. PAP TREATMENT DELAYED THE ONSET OF MCI IN SUBJECTS WITH REPORTED OSA. THERE IS THEREFORE STRONG EVIDENCE SUGGESTING THAT OSA TREATMENT COULD BE AN IMPORTANT PREVENTION STRATEGY FOR AD. HOWEVER, TRIALS FOR TREATMENT OF OSA TO SLOW COGNITIVE DECLINE AND PROGRESSION TO AD FACE A NUMBER OF CHALLENGES. FIRST, THE MOST EFFECTIVE THERAPY (PAP) HAS POOR ADHERENCE. A SECOND CHALLENGE IS DEFINING THE TARGET POPULATION: PRIOR TRIALS TARGETED OSA PATIENTS WITH MCI/AD, WHO HAVE MORE ADVANCED DISEASE AND COULD BE LESS AMENABLE TO TREATMENT. A THIRD CHALLENGE IS IDENTIFYING COGNITIVE TESTING THAT IS SENSITIVE TO SLEEP DISRUPTION, AND LINKED TO INCREASED AD RISK. (TO CAPTURE EFFECTS OF OSA ON THE OFFLINE PROCESSING PHASE REQUIRES SLEEP-DEPENDENT MEMORY PARADIGMS, IN WHICH THE ENCODING AND RECALL OF INFORMATION ARE SEPARATED BY A PERIOD OF SLEEP WITH/WITHOUT OSA). FINALLY, A RANDOMIZED TRIAL OF SUFFICIENT DURATION TO TEST THE EFFECTS OF TREATMENT OF OSA ON RISK OF INCIDENT AD IS NOT FEASIBLE. OUR PROPOSED TRIAL, EFFECTS OF SUCCESSFUL OSA TREATMENT ON MEMORY AND AD BIOMARKERS IN OLDER ADULTS (ESSENTIAL), ADDRESSES THESE CHALLENGES. ESSENTIAL IS A 5-YEAR STUDY OF COGNITIVELY NORMAL OLDER ADULTS WITH NEWLY DIAGNOSED OSA, AGES 55-75, RECRUITED FROM 4 WELL-ESTABLISHED SLEEP CLINICS. OSA PATIENTS (N=200) WILL BE RANDOMIZED TO EITHER: I) A 3-MONTH OSA TREATMENT BY ANY COMBINATION OF PAP, OAT, AND POSITIONAL THERAPY THAT RESULTS IN AN “EFFECTIVE” IMPROVEMENT IN THE APNEA-HYPOPNEA INDEX (AHI); II) A WAITLIST CONTROL GROUP TO RECEIVE TREATMENT AT THE CONCLUSION OF THE 3-MONTH INTERVENTION PERIOD. EFFECTIVELY TREATED INDIVIDUALS (~150) AND UNTREATED INDIVIDUALS (~100) WILL THEN BE FOLLOWED FOR UP TO 24 MONTHS TO COMPARE WHETHER SUSTAINED IMPROVEMENTS IN AHI ARE ASSOCIATED WITH BETTER COGNITIVE FUNCTION AND AD BIOMARKER CHANGE PROFILES AS COMPARED TO UNTREATED CONTROLS. PARTICIPANTS WILL UNDERGO PSG, ACTIGRAPHY, COGNITIVE TESTS, AND BLOOD DRAWS AT BASELINE, 3 AND 24 MONTHS. OUR AIMS ARE: 1) TO COMPARE 3-MONTH CHANGE IN PLASMA AD BIOMARKERS (NFL, P-TAU, ASS) BETWEEN THOSE RANDOMIZED TO OSA TREATMENT AND WAIT-LIST CONTROL GROUPS; 2) TO COMPARE 3-MONTH CHANGE IN COGNITION BETWEEN THE OSA TREATMENT AND WAIT-LIST CONTROL GROUPS; 3) TO EXAMINE IF SUSTAINED REDUCTION IN AHI OVER 24 MONTHS AMONG EFFECTIVELY TREATED PARTICIPANTS VERSUS UNTREATED CONTROLS IS ASSOCIATED WITH BETTER 24-MONTH CHANGE PROFILES FOR AD BIOMARKERS AND COGNITION.

CLINICAL & IMMUNOLOGICAL STUDY OF TREATMENT WITHDRAWAL IN E-AG NEGATIVE HEPATITIS B

CHANGE IN SLEEP AND COGNITION IN OLDER WOMEN

INTEGRATIVE RESOURCE TO DEVELOP TRANSLATIONAL STRATEGIES TO PROMOTE LONGEVITY

STUDY OF MUSCLE, MOBILITY AND AGING: SOMMA2 - THE STUDY OF MUSCLE MOBILITY AND AGING (SOMMA) IS A COHORT UNIQUELY DESIGNED TO IDENTIFY FUNDAMENTAL AGE- RELATED PATHWAYS CONTRIBUTING TO IMPORTANT CLINICAL AND GERONTOLOGIC OUTCOMES. NEWLY ELUCIDATED BIOLOGIC PATHWAYS OF AGING HAVE FUELED AN EXPLOSION OF NOVEL APPROACHES HYPOTHESIZED TO EXTEND HEALTH SPAN. HOWEVER, HOW THESE PATHWAYS CONTRIBUTE TO SALIENT HEALTH OUTCOMES IN OLDER ADULTS SUCH AS DISABILITY AND DEMENTIA-FREE SURVIVAL IS NOT KNOWN. SOMMA2 EXTENDS SOMMA1, WHICH TESTS THE PARADIGM THAT PROPERTIES OF MUSCLE, INCLUDING MUSCLE MITOCHONDRIAL ENERGETICS, PREDICT THE ONSET OF OBJECTIVE MOBILITY DISABILITY I.E., THE INABILITY TO WALK 400M. NEVERTHELESS, SOMMA1 ESTABLISHED A RICH REPOSITORY OF MUSCLE TISSUE, BLOOD, AND PHENOTYPING, TO EXPAND RESEARCH TO OTHER PATHWAYS AND CLINICAL ENDPOINTS. SOMMA2 BUILDS ON THIS FOUNDATION. IT INTEGRATES THE TALENTS OF SOME OF THE NATION’S LEADING AGING RESEARCHERS TO UNDERSTAND THE BIOLOGICAL DRIVERS OF AGE-RELATED CHANGES IN PHYSICAL FUNCTION AND THE ONSET OF DISABILITY AND DEATH. SOMMA2 WILL ADD 600 NEW PARTICIPANTS TO INCREASE ITS DIVERSITY AND PROVIDE SUFFICIENT POWER TO TEST WHETHER BIOLOGICAL PATHWAYS PREDICT OUR COMPOSITE OUTCOME OF ADL DISABILITY, DEMENTIA, OR DEATH, AND THE CO-PRIMARY OUTCOME OF OBJECTIVE MOBILITY DISABILITY. SOMMA2 WILL ALSO GATHER UNPRECEDENTED LONGITUDINAL DATA WITH REPEAT MUSCLE BIOPSIES TO IDENTIFY CHANGES IN BIOLOGICAL PATHWAYS IN MUSCLE TISSUE THAT ARE ASSOCIATED WITH AGE-RELATED CHANGES IN MUSCLE POWER AND CARDIOPULMONARY FITNESS (VO2 PEAK). SOMMA2 WILL STUDY DISTINCT BUT INTERRELATED BIOLOGICAL PATHWAYS OF AGING. DNA DAMAGE AND INSUFFICIENT REPAIR LEAD TO DNA MUTATIONS AND CLONAL HEMATOPOIESIS. INCREASING OXIDATIVE STRESS DAMAGES LIPIDS AND PROTEINS IN MUSCLE WITH AGING, LEADING TO DECLINES IN MUSCLE POWER AND FITNESS. DNA DAMAGE AND MITOCHONDRIAL DYSFUNCTION MAY TRIGGER CELLULAR SENESCENCE IN MUSCLE AND THE PRO- INFLAMMATORY SENESCENCE ASSOCIATED SECRETORY PHENOTYPE (SASP). SOMMA2 WILL ALSO USE LONGITUDINAL TRANSCRIPTOMICS IN MUSCLE TO TEST HYPOTHESES RELATED TO DNA DAMAGE/REPAIR AND SENESCENCE, AND TO DISCOVER OTHER PATHWAYS THAT INFLUENCE CHANGE IN POWER AND FITNESS. SOMMA2 WILL EMPLOY REPEATED SINGLE NUCLEUS SNRNA SEQ TO REVEAL HOW CHANGES IN DIFFERENT MUSCLE-RESIDENT CELL TYPES WITH AGING CONTRIBUTE TO THE LOSS OF POWER AND FITNESS. SOMMA HAS ALREADY BECOME A MAJOR RESOURCE FOR INVESTIGATORS, PARTICULARLY YOUNG SCIENTISTS, TO STUDY DIVERSE FACETS OF AGING AND PROVIDE CAREER DEVELOPMENT OPPORTUNITIES. SOMMA WILL CONTINUE TO RELEASE DATA TO THE SCIENTIFIC COMMUNITY, PROVIDE DATA AND SPECIMENS, AND OFFER ANALYTIC HELP. SOMMA2 WILL SERVE AS A TRANSLATIONAL AGING RESEARCH ENGINE FOR DECADES TO COME.

OSTEOPOROTIC FRACTURES IN MEN

COMPREHENSIVE EVALUATION OF AGING-RELATED CLINICAL OUTCOMES AND GEROPROTEINS

TARGETING BPTF IN THE THERAPY OF BRAF-MUTANT MELANOMA

VALIDATION OF GENOMIC TARGETS IN MELANOMA

ERADICATING RACISM AND STRIVING FOR EXCELLENCE IN HIV CARE (ERASE). - FOR 31 YEARS, EAST BAY AIDS CENTER (EBAC) HAS BEEN IMPROVING HEALTH OUTCOMES FOR PEOPLE LIVING WITH HIV AND THOSE AT-RISK, AS THE MOST COMPREHENSIVE SERVICE PROVIDER IN OAKLAND, CALIFORNIA. WITH PS21-2102 FUNDS, EBAC PROPOSES TO SCALE UP A SUCCESSFUL PILOT PROGRAM, ERADICATING RACISM AND STRIVING FOR EXCELLENCE IN HIV CARE (ERASE), THE FIRST PROGRAM IN THE REGION TO SPECIFICALLY FOCUS ON ADDRESSING STRUCTURAL BARRIERS BLACK MEN WHO HAVE SEX WITH MEN (BMSM) AGES 17+ FACE IN ACCESSING CARE. ERASE WILL USE A BOLD, INNOVATIVE APPROACH TO SERVICE DELIVERY, MOVING THE NEEDLE SIGNIFICANTLY IN REDUCING NEW INFECTIONS, INCREASING ACCESS TO CARE, AND PROMOTING HEALTH EQUITY FOR BMSM AND THEIR NETWORKS IN THE SAN FRANCISCO BAY AREA?S EAST BAY REGION.WEAVING TOGETHER A SET OF EVIDENCE-BASED, CULTURALLY-RESPONSIVE, AND CLIENT-CENTERED APPROACHES IN A ?STATUS-NEUTRAL? FRAMEWORK, EBAC ANTICIPATES PROVIDING 500 TESTS TO BMSM UNAWARE OF THEIR HIV STATUS, LINKING 75 BMSM TO HIV PREVENTION SERVICES (INCLUDING PREP AND NPEP), AND LINKING 75 BMSM TO ANTIRETROVIRAL HIV THERAPY EACH YEAR. ERASE?S CORE PROGRAM MODEL INCLUDES: INTENSIVE HIV AND HEALTH NAVIGATION SERVICES REGARDLESS OF HIV STATUS; MULTI-PRONGED TESTING STRATEGIES INCLUDING MOBILE, ON-SITE, AND INTEGRATED SCREENINGS; DEDICATED CASE MANAGEMENT AND SOCIAL WORK SERVICES TO CONNECT CLIENTS TO ALL AVAILABLE RESOURCES; A ?CLINIC WITHOUT WALLS? MODEL THAT REDUCES BARRIERS FOR BMSM; TARGETED COMMUNITY OUTREACH STRATEGIES; AND REGIONAL COLLABORATION AMONG PARTNERS IN THE LOCAL HIV PREVENTION ECOSYSTEM.EBAC WILL LEVERAGE EXTENSIVE EXISTING HEALTHCARE AND ADMINISTRATIVE INFRASTRUCTURE, INCLUDING IN-HOUSE CLINICAL SERVICES, A SPECIALTY PHARMACY, LABORATORY SERVICES, BENEFITS ENROLLMENT SPECIALISTS, MENTAL HEALTH AND SUBSTANCE USE SERVICES, HEALTH EDUCATION AND PREVENTATIVE SERVICES, URGENT CARE/EMERGENCY DEPARTMENT, PRIMARY AND SPECIALTY MEDICAL CARE, AND ANON-CALL PHYSICIAN, ALL UNDER ONE ROOF. WE WILL LEVERAGE EBAC ?S ONGOING ROLES AND RELATIONSHIPS WITH THE ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, EAST BAY GETTING TO ZERO COALITION, FAMILY CARE NETWORK, AND OTHERS TO PROMOTE AN EFFECTIVE REGIONAL RESPONSE, WORKING STRATEGICALLY TO AUGMENT AND MAXIMIZE EXISTING PREVENTION AND TREATMENT EFFORTS.

MULTI-CENTER TRIAL OF LIMITING PGY2&3 RESIDENT WORK HOURS ON PATIENT SAFETY-DCC

IMMUNE RESPONSE GENE POLYMORPHISMS AND AMD: EXAMINING HLA-KIR EPISTASIS

HIGH FIELD NEUROIMAGING OF EPILEPSY

MOLECULAR AND CELLULAR STUDIES OF CA2+ TRANSPORT ATPASE

PHIP AS A BIOMARKER OF TRIPLE-NEGATIVE MELANOMA

A DOSE RANGING STUDY OF MODAFINIL FOR METHAMPHETAMINE DEPENDENCE

MINDFULNESS AND MIGRAINE: A RANDOMIZED CONTROLLED TRIAL

CANNABINOIDS CONTROL BREAST CANCER PROGRESSION THROUGH ID-1

CIRCADIAN RHYTHM GENES AND SLEEP DISTURBANCES IN THE ELDERLY

METHAMPHETAMINE PHARMACOTHERAPY DEVELOPMENT CENTER

LONG-TERM FRACTURE RISK IN OLDER MEN: THE MROS STUDY

CLINICAL PHARMACOLOGY OF 3,4-METHYLENEDIOXY AMPHETAMINES

DETERMINATION OF SKELETAL MUSCLE MASS BY CREATINE DILUTION

MOLECULAR CLASSIFICATION OF PRIMARY CUTANEOUS MELANOMA

GENETICS AND COMORBIDITY OF MIGRAINE

COMPREHENSIVE HIV AND AIDS STRATEGY FOR EXCELLENCE (CHASE) - EAST BAY ADVANCED CARE (EBAC) IS PARTNERING WITH OPTIONS RECOVERY SERVICES (OPTIONS) TO PROVIDE HIV AND SUBSTANCE USE PREVENTION SERVICES FOR RACIAL AND ETHNIC MINORITY POPULATIONS IN ALAMEDA COUNTY AT HIGH-RISK FOR SUBSTANCE USE DISORDERS AND/OR CO-OCCURRING SUBSTANCE ABUSE AND MENTAL DISORDERS. OUR PREVENTION NAVIGATOR PROJECT PLANS TO PROVIDE SERVICES TO 100 UNDUPLICATED PARTICIPANTS IN EACH OF YEARS 1 THROUGH 5, FOR A TOTAL OF 500 UNDUPLICATED PARTICIPANTS OVER THE LIFE OF THE GRANT. PARTICIPANTS WILL REPRESENT A COMBINATION OF MSM, BLACK MSM, AND MSMW, AND AMONG THESE, THOSE WHO IDENTIFY AS LGBTQI+, WHO ARE NOT IN STABLE HOUSING, AND WHO ARE UNDER CRIMINAL JUSTICE SUPERVISION. AGES WILL RANGE FROM 18 TO 65. IF FUNDED, OUR COMPREHENSIVE HIV AND AIDS STRATEGY FOR EXCELLENCE (CHASE) PROJECT WILL STRENGTHEN EBAC'S ABILITY TO PROVIDE HIV EVIDENCE-BASED INTERVENTIONS AND STRATEGIES. WE WILL ALSO USE FUNDING TO CONTRACT WITH OPTIONS, AN EXPERIENCED PROVIDER OF SUBSTANCE PREVENTION SERVICES. THIS WILL ALLOW US TO EXPAND OUR SUBSTANCE USE PREVENTION SERVICES AND EXTEND OUR OUTREACH. IN ADDITION, WE WILL ALLOCATE FUNDS TO CONDUCT EXTENSIVE OUTREACH SERVICES TO HIGH-RISK POPULATIONS USING SOCIAL MEDIA AND SOCIAL MARKETING STRATEGIES AND IN PERSON VENUES; HIV, VIRAL HEPATITIS AND STI TESTING AND COLLECTING URINE AND BLOOD SPECIMENS, MAKE REFERRALS FOR PERSONS WITH SUDS AND HIV FOR APPROPRIATE TREATMENT, AND EDUCATE PROVIDERS ON SUBSTANCE USE AND HIV CARE AND TREATMENT SERVICES AS WELL AS PRE-EXPOSURE PROPHYLAXIS AND POST-EXPOSURE PROPHYLAXIS. TO ADDRESS SUBSTANCE MISUSE, HIGH RISK BEHAVIORS RELATED TO HIV AND OTHER BEHAVIORAL PROBLEMS FACING ALAMEDA COUNTY, WE IDENTIFIED THREE PRIMARY GOALS: 1) BUILD THE CAPACITY OF THE EBAC AND OPTIONS TO TARGET AND DELIVER EFFECTIVE HIV AND SUBSTANCE USE PREVENTION SERVICES FOR HIGH-RISK RACIAL AND ETHNIC MINORITY POPULATIONS; 2) IMPLEMENT EFFECTIVE, EVIDENCE-BASED HIV AND SUBSTANCE USE PREVENTION SERVICES, GUIDED BY OUR STRATEGIC PLAN: AND 3) FACILITATE POSITIVE OUTCOMES FOR PROJECT PARTICIPANTS. OUR MEASURABLE OBJECTIVES INCLUDE TARGETS RELATED TO BUILDING CAPACITY, RECRUITING PARTICIPANTS, IMPLEMENTING EVIDENCE-BASED SERVICES, AND FOR PARTICIPANT GAINS IN THE AREAS OF HIV-AWARENESS, SUBSTANCE USE, ACCESSING AND COMPLYING WITH TREATMENT, AND REDUCING HIV VIRAL LOADS. THE PROJECT WILL BE STAFFED BY QUALIFIED EBAC PERSONNEL AND OVERSEEN BY THE PROJECT DIRECTOR. EBAC, IN PARTNERSHIP WITH OPTIONS AND GUIDED BY THE STRATEGIC PREVENTION FRAMEWORK, WILL ADDRESS SUBSTANCE MISUSE, HIGH RISK BEHAVIORS RELATED TO HIV AND OTHER BEHAVIORAL HEALTH PROBLEMS AMONG OUR POPULATIONS OF FOCUS. SPECIFICALLY, WE PLAN TO: 1. ASSESS NEED: IDENTIFY THE POPULATIONS OF FOCUS, RACIAL/ETHNIC MINORITY POPULATIONS VULNERABLE TO SUD/COE, HIV, VIRAL HEPATITIS AND STIS, BY CONDUCTING A TWO-PRONGED NEEDS ASSESSMENT TO COLLECT DATA ON THE NATURE OF SUBSTANCE MISUSE AND RELATED HARMFUL BEHAVIORS, RISK AND PROTECTIVE FACTORS, AND LOCAL CAPACITY FOR PREVENTION. 2. BUILD CAPACITY: MOBILIZE AND BUILD OUR CAPACITY TO ADDRESS SUD/COE, HIV/AIDS, VIRAL HEPATITIS, AND STIS, AND PROVIDE PREVENTION SERVICES 3. DEVELOP A STRATEGIC PLAN: DEVELOP A DATA-DRIVEN, COMPREHENSIVE MAI PREVENTION NAVIGATOR STRATEGIC PLAN THAT IS CULTURALLY AND LINGUISTICALLY AGE-APPROPRIATE. 4. IMPLEMENT STRATEGIC PLAN: IMPLEMENT EVIDENCE-BASED, TRAUMA-INFORMED, RECOVERY- SUPPORTING, AND CULTURALLY-SENSITIVE AND RESPONSIVE STRATEGIES IDENTIFIED IN THE STRATEGIC PLAN, SUCH AS TEST EVERYWHERE, INTEGRATED SCREENINGS AND SERVICE LINKAGES, RAPID ART, ERASE, PEER MENTORING, INTENSIVE CASE MANAGEMENT, AND RELAPSE PREVENTION THERAPY. 5. EVALUATE PROJECT PERFORMANCE: ASSESS PROJECT PERFORMANCE, MONITOR AND EVALUATE PROJECT ACTIVITIES, OUTCOMES AND DISPARITY IMPACT STATEMENT ON AN ONGOING BASIS, TO INFORM ADJUSTMENTS IN THE IMPLEMENTATION PLAN AND ENSURE CONTINUAL QUALITY IMPROVEMENT.

STUDY OF ENERGY AND AGING

ELECTRONIC HEALTH RECORD DATA AND PREDICTIVE ANALYTIC METHODS FOR HF

RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM - ELIGIBLE ENTITY TYPE: NOT FOR PROFIT RURAL HOSPITAL PROJECT DIRECTOR CONTACT INFORMATION: ELLIE POPADIC, POPADIE@SUTTERHEALHT.ORG 800 E. WASHINGTON BLVD. CRESCENT CITY, CA 95531; 707-464-8857 RESIDENCY PROGRAM DIRECTOR CONTACT INFORMATION: TARA SCOTT, MD, SCOTTT3@SUTTERHEALTH.ORG 3569 ROUNDBARN CIRCLE, SANTA ROSA, CA 95403; 707-696-6947 RESIDENCY SPECIALTY & TYPE: FAMILY MEDICINE, 1-2 RTT SPONSORING INSTITUTION: SUTTER COAST HOSPITAL RURAL TARGET AREA: DEL NORTE COUNTY, CA FUNDING AMOUNT REQUESTED: $750,000 PROGRAM SUSTAINABILITY OPTION: 1 AND 3 PROJECTED NUMBER OF RESIDENTS: 6 EXPECTED ACGME ACCREDITATION DATE: 7/1/2023 EXPECTED RESIDENCY MATRICULATION DATE: 7/1/2024 SUTTER COAST HOSPITAL (SCH), A NOT-FOR-PROFIT RURAL HOSPITAL LOCATED IN DEL NORTE COUNTY, CALIFORNIA, SEEKS TO DEVELOP A RURAL TRAINING TRACT (RTT) PROGRAM IN FAMILY MEDICINE (FM) IN PARTNERSHIP WITH SUTTER SANTA ROSA REGIONAL HOSPITAL’S (SSRRH) EXISTING FAMILY MEDICINE RESIDENCY PROGRAM. BOTH SUTTER COAST HOSPITAL AND SUTTER SANTA ROSA REGIONAL HOSPITAL ARE AFFILIATES OF THE SUTTER HEALTH ORGANIZATION. THE MISSION OF THE ORGANIZATION IS TO “ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTHCARE SERVICE.” BOTH DEL NORTE COUNTY, CA, AND CURRY COUNTY, OR WHICH COMPRISES MOST OF THE HOSPITAL’S SERVICE AREA, ARE MEDICALLY UNDERSERVED AREAS, AND HEALTH PROFESSIONS SHORTAGE AREAS FOR PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH. THE POPULATION OF DEL NORTE COUNTY SUFFERS DISPROPORTIONATELY FROM HEALTH DISPARITIES, INCLUDING A LACK OF PRIMARY CARE PROVIDERS (RATIO 2,985 RESIDENTS: 1 PROVIDER). THE SERVICE AREA’S PREMATURE AGE-ADJUSTED MORTALITY IS TWICE AS HIGH AS THE OVERALL RATE FOR THE STATE OF CALIFORNIA. THE OVERARCHING GOAL OF THE FAMILY MEDICINE RTT PROGRAM IS TO ADDRESS THE PHYSICIAN SHORTAGE IN DEL NORTE COUNTY AND TO IMPROVE THE HEALTH OUTCOMES OF THE COUNTY’S POPULATION, FOR WHOM ACCE SS TO PRIMARY HEALTH CARE IS LIMITED. SSRRH WILL SERVE AS THE URBAN ACADEMIC MEDICAL CENTER FOR THE FIRST YEAR OF TRAINING, AND SCH AS THE RURAL SETTING WHERE THE FINAL TWO YEARS OF TRAINING WILL OCCUR. RESIDENTS WILL RETURN TO SSRRH DURING THEIR SECOND AND THIRD YEARS ONLY IF THAT IS ESSENTIAL TO MEET VOLUME REQUIREMENTS IN SPECIALTIES NOT AVAILABLE IN THE RURAL SETTING. THE FM RTT RESIDENTS WILL SPEND MORE THAN 51% OF THEIR TIME AT RURAL SCH, PROVIDING THEM WITH THE DEPTH AND BREADTH OF KNOWLEDGE NEEDED TO MEET PATIENTS’ COMPLEX HEALTH CARE NEEDS IN RURAL UNDERSERVED COMMUNITIES. THIS COLLABORATIVE EFFORT BETWEEN SCH AND SSRRH WILL HELP ADDRESS THE GROWING NEED FOR FAMILY MEDICINE SERVICES IN RURAL DEL NORTE COUNTY BY IMMEDIATELY CREATING MORE RESIDENT PROVIDERS WHO CAN OFFER A CONTINUITY IN OUTPATIENT PRACTICE STARTING IN YEAR 2 OF TRAINING, AND BE RETAINING GRADUATES OF THE PROGRAM IN THE SERVICE AREA FOLLOWING THEIR TRAINING, AS STUDIES SHOW THAT PHYSICIANS TRAINED IN RTT PROGRAMS ARE MORE LIKELY TO PRACTICE IN THE RURAL SETTING. PROGRAM OBJECTIVES AND GOALS INCLUDE DESIGNING THE PROGRAM CURRICULUM TO MEET THE COMPLEX HEALTH NEEDS OF RURAL DEL NORTE COUNTY; HIRING QUALIFIED STAFF; SUBMITTING A NEW PROGRAM APPLICATION TO THE ACCREDITATION COUNCIL OF GRADUATE MEDICAL EDUCATION (ACGME) TO ACHIEVE ACCREDITATION BY JULY 1, 2023; RECRUITING 6 FM RESIDENTS AND RETAINING AT LEAST 50% OF THEM POST-GRADUATION IN RURAL DEL NORTE COUNTY; SUSTAINING THE FM RTT PROGRAM THROUGH A COMBINATION OF FUNDING STREAMS; PUBLICLY REPORTING ON RESIDENT CAREER OUTCOMES FOR AT LEAST 5 YEARS AFTER THE FIRST GRADUATING CLASS. THE RTT WILL SUPPORT 2 RESIDENTS IN THE FIRST YEAR, 2 IN THE SECOND YEAR AND 2 IN THE THIRD YEAR, SUPPORTING A TOTAL OF 6 RESIDENTS PER YEAR AT FULL COMPLEMENT. ONCE THE PROGRAM HAS ACHIEVED AN ACCREDITATIONS STATUS OF CONTINUED ACCREDITATION FROM ACGME, PROGRAM LEADERSHIP MAY REQUEST A COMPLIMENT SIZE INCREASE. SCH HAS NOT RECEIVED ANY HRSA

RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM

DYSTROGLYCAN IN EPITHELIAL ARCHITECTURE AND FUNCTION

"DRUG INDUCED LIVER INJURY NETWORK"

FOLIC ACID AND B VITAMINS TO PREVENT FRACTURE IN WOMEN

PHENOTYPES OF AGING & SENESCENCE

A PILOT TRIAL OF NALTREXONE FOR METHAMPHETAMINE ADDICTION - ROLE OF THE A118G SNP

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

DEVELOPING MULTI-GENIC ANTI-BREAST CANCER THERAPIES

FUNCTIONAL ANALYSIS OF HISTOLOGIC GRADE IN BREAST CANCER

AN ESTIMATED 750 RSVP MEMBERS WILL SERVE. OF THIS NUMBER, 160 RSVP MEMBERS WILL BE PLACED IN OUTCOME ASSIGNMENTS. SOME OF THEIR ACTIVITIES WILL INCLUDE FOOD DISTRIBUTION, DISTRIBUTING INFORMATION, COMPANIONSHIP, AND FOOD DELIVERY. THE PRIMARY FOCUS AREA OF THIS PROJECT IS HEALTHY FUTURES. AT THE END OF THE THREE-YEAR GRANT, 80% OF THE UNDUPLICATED RECIPIENTS OF SERVICE WILL RESULT IN INCREASED FOOD SECURITY FOR THEMSELVES AS A RESULT OF THE CNCS SUPPORTED VOLUNTEER ACTIVITY. THE CNCS FEDERAL INVESTMENT OF $ 159,122 WILL BE SUPPLEMENTED BY $ 100,989.00 IN SUPPORTIVE FUNDING.

ENGAGES PERSONS 55 AND OLDER IN VOLUNTEER SERVICE IN THEIR COMMUNITIES

MODULATION OF GLIOMA GROWTH AND INVASION BY HCMV GLYCOPROTEIN B

RETIRED AND SENIOR VOLUNTEER PROGRAM

NOVEL COMPUTED TOMOGRAPHY (CT) IMAGING BIOMARKERS IN OLDER ADULTS FOR PREDICTING ADVERSE GERIATRIC HEALTH OUTCOMES - BLOOD-BASED BIOMARKERS HAVE BEEN WIDELY USED IN STUDYING VARIOUS METABOLIC PATHWAYS CONTRIBUTING TO AGING, INCLUDING ENERGY METABOLISM, CHRONIC INFLAMMATION, CELLULAR SENESCENCE, AND ENDOTHELIAL FUNCTION. LIKE BLOOD- DERIVED BIOMARKERS, IMAGING-BASED BIOMARKERS CAN BE EVALUATED AS POTENTIAL PREDICTORS OF AGING OUTCOMES. FOR STUDY OF NON-NEUROLOGIC AGING, BIOMARKERS DERIVED FROM COMPUTED TOMOGRAPHY (CT) OFFER GREAT PROMISE. RECENT ADVANCES IN SCANNER TECHNOLOGY AND IMAGE PROCESSING MEAN THAT MOST CT EXAMINATIONS CAN BE OBTAINED IN LESS THAN ONE MINUTE, LOWERING PARTICIPANT BURDEN. IN ADDITION, RADIATION DOSES HAVE BEEN LOWERED AND THE INTRA- AND INTER-SCANNER VARIABILITY HAS IMPROVED. IN PARALLEL, MACHINE LEARNING TOOLS ALLOW FOR AUTOMATED IMAGE PROCESSING AND SEGMENTATION, INCREASING EFFICIENCY OF IMAGE ANALYSIS, AND REDUCING BIAS. FOR THESE REASONS, CT IS INCREASINGLY BEING USED TO STUDY SKELETAL MUSCLE AND ADIPOSE TISSUE. ON CT, MUSCLE QUANTITY IS TYPICALLY MEASURED BY CROSS-SECTIONAL AREA (CSA). MUSCLE QUALITY IS TRADITIONALLY QUANTIFIED BY SKELETAL MUSCLE DENSITY (SMD) AND INTERMUSCULAR ADIPOSE TISSUE (IMAT) CROSS-SECTIONAL AREA. IN ADDITION TO BEING A MEASURE OF MUSCLE QUALITY, IMAT MAY BE CONSIDERED AS A MEASURE OF FAT QUANTITY. WE RECENTLY DEVELOPED AND VALIDATED AN AUTOMATED MACHINE LEARNING TOOL TO DETERMINE TRADITIONAL CT MEASURES OF MUSCLE AND ADIPOSE TISSUE QUANTITY AND QUALITY. TO BETTER CHARACTERIZE TISSUE QUALITY, WE HAVE ALSO APPLIED "RADIOMIC" TEXTURE ANALYSIS TO MUSCLE TISSUE ON CT IMAGES. TEXTURE ANALYSIS REFERS TO THE QUANTIFICATION OF IMAGE VOXEL INTER-RELATIONSHIPS AND PROVIDES A MEASURE OF TISSUE HETEROGENEITY. TO OUR KNOWLEDGE, THIS TECHNIQUE HAS NEVER BEEN APPLIED TO CT IMAGES FROM COMMUNITY-BASED EPIDEMIOLOGICAL STUDIES. WE PROPOSE TO RELATE THESE CT-BASED ASSESSMENTS OF MUSCLE AND ADIPOSE TISSUES TO IMPORTANT GERIATRIC OUTCOMES, FOCUSING ON HIP AND OTHER FRACTURES AS WELL AS FALLS, PHYSICAL PERFORMANCE, AND STRENGTH. WE WILL COMPLETE THESE ANALYSES ON ARCHIVED CT IMAGES IN MROS (A PROSPECTIVE COHORT STUDY OF HEALTHY AGING IN OLDER MEN, WITH A PARTICULAR FOCUS ON OSTEOPOROSIS) AND HEALTH ABC (A PROSPECTIVE COHORT STUDY OF NON-DISABLED BLACK AND WHITE OLDER ADULTS). ABDOMINAL CT IMAGES WERE COLLECTED AT THE BASELINE EXAM FOR MROS MEN IN THE UNITED STATES (N~3700 IN 2000-2), MROS MEN IN HONG KONG (N~400 IN 2001-3), AND HEALTH ABC (N~3000 IN 1997-8). HEALTH ABC ALSO COLLECTED CT IMAGES AT THE MID-THIGH. IN HEALTH ABC, MID-THIGH AND ABDOMINAL CT IMAGES WERE REPEATED IN A SUBSET FIVE YEARS LATER (N~600 IN 2000-3). WE WILL ADD THREE AIMS: 1) TEST THE HYPOTHESIS THAT THAT GREATER MUSCLE AND FAT TISSUE HETEROGENEITY FEATURES AT THE ABDOMEN AND MID-THIGH ARE ASSOCIATED WITH INCREASED RISK OF HIP AND OTHER FRACTURES, 2) TEST THE HYPOTHESIS GREATER MUSCLE AND FAT TISSUE HETEROGENEITY FEATURES AT THE ABDOMEN AND MID-THIGH ARE ASSOCIATED WITH LOWER STRENGTH AND POOR PHYSICAL PERFORMANCE (WALKING SPEED AND CHAIR STANDS); THEIR DECLINE OVER TIME; AND RISK OF FALLS, AND 3) CHARACTERIZE CHANGES IN MUSCLE AND FAT TISSUE HETEROGENEITY FEATURES AT THE MID-THIGH OVER 6 YEARS.

ROTATING NIGHT SHIFTS, SLEEP DURATION, AND THE RISK OF COLORECTAL ADENOMA

REST-ACTIVITY RHYTHMS ASSOCIATED WITH AGING TRAITS IN THE ELDERLY.

EXPANSION AND VALIDATION OF A COLON CANCER INCIDENCE MODEL IN MEN AND WOMEN

MITOCHONDRIAL DNA MUTATIONS IN PANCREATIC CANCER

CONTROL OF BREAST CANCER BY THE ENDOCANNABINOID SYSTEM

ENGAGES PERSONS 55 AND OLDER IN VOLUNTEER SERVICE IN THEIR COMMUNITIES

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

COGNITIVE PROGRESSION AMONG OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE AND MILD COGNITIVE IMPAIRMENT: THE ROLES OF SLEEP AND PHYSICAL FRAILTY - PROJECT SUMMARY INDIVIDUALS WITH SUBJECTIVE COGNITIVE DECLINE (SCD) AND MILD COGNITIVE IMPAIRMENT (MCI) ARE SIGNIFICANTLY MORE LIKELY TO HAVE INCREASED AD BIOMARKERS (E.G. AMYLOID Β) AND HIGHER RISKS OF DEVELOPING ALZHEIMER’S DISEASE AND RELATED DEMENTIAS (ADRD). SLEEP DISTURBANCES HAVE BEEN ASSOCIATED WITH INCREASED RISKS PRECLINICAL AD, ADRD, AND ALL-CAUSE DEMENTIA. HOWEVER, MOST OF THESE STUDIES FOCUS ON SLEEP’S ASSOCIATION WITH THE INCIDENCE OF SCD, MCI, OR DEMENTIA INDIVIDUALLY, RATHER THAN THE PROGRESSION OF COGNITIVE IMPAIRMENT FROM SCD TO MCI TO DEMENTIA. THE LATTER IS OF KEY CLINICAL IMPORTANCE WHEN ATTEMPTING TO HALT OR TREAT AD PROGRESSION. IN ADDITION TO SLEEP, RECENT STUDIES HAVE SHOWN THAT PHYSICAL FRAILTY IS ALSO CLOSELY INTERRELATED WITH COGNITIVE IMPAIRMENT, WITH EVIDENCE THAT THEY PREDICT ONE ANOTHER, SHARE COMMON RISK FACTORS, AND HAVE SIMILAR POTENTIAL MECHANISMS. THE CO-EXISTENCE OF BOTH PHYSICAL FRAILTY AND COGNITIVE IMPAIRMENT (MCI/SCD), ALSO KNOWN AS COGNITIVE FRAILTY, IS SUPPOSED TO BE A PREDICTOR OF SEVERE HEALTH CONSEQUENCES WITH THE SYNERGIC NEGATIVE EFFECTS OF BOTH. HOWEVER, THIS SYNERGIC EFFECT ON FUTURE COGNITIVE DECLINE AND PROGRESSION TO DEMENTIA IS STILL UNDEREXAMINED IN THE LITERATURE. MOREOVER, GIVEN THE INTERRELATIONSHIP BETWEEN PHYSICAL FRAILTY AND COGNITIVE IMPAIRMENT, IT IS POSSIBLE THAT PHYSICAL FRAILTY MODERATES THE ASSOCIATIONS BETWEEN SLEEP DISTURBANCES AND PROGRESSION FROM SCD/MCI TO DEMENTIA. THEREFORE, THE OVERALL GOAL OF THIS PROJECT IS TO INVESTIGATE THE ROLES OF SLEEP DISTURBANCES AND PHYSICAL FRAILTY IN SCD/MCI’S COGNITIVE PROGRESSION AND EXPLORE WHETHER PHYSICAL FRAILTY IS A MODERATOR OF SLEEP’S ASSOCIATION WITH THE COGNITIVE PROGRESSION. IN THE F99 PHASE, THE PI WILL USE SIX WAVES OF LONGITUDINAL HEALTH AND RETIREMENT STUDY DATA FROM THE 2010 TO 2020 TO EXAMINE THE ASSOCIATIONS OF BASELINE SELF-REPORTED INSOMNIA SYMPTOMS AND PHYSICAL FRAILTY WITH 10-YEAR COGNITIVE TRAJECTORIES AND SUBSEQUENT INCIDENCE OF MCI/DEMENTIA IN SCD. IN THE K00 PHASE, THE PI WILL SHIFT THE POPULATION TO MCI, A MORE ADVANCED AD STAGE, WITH A FOCUS ON ACTIGRAPHY-MEASURED SLEEP AND NEUROIMAGING COGNITION MEASURES. THE PI WILL USE THE UK BIOBANK DATA TO EXAMINE THE ASSOCIATIONS OF SLEEP (BOTH ACTIGRAPHY-DERIVED AND SELF- REPORTED) AND PHYSICAL FRAILTY WITH BRAIN STRUCTURE (MAGNETIC RESONANCE IMAGING DATA), SUBSEQUENT COGNITIVE FUNCTION, AND INCIDENT ADRD AMONG OLDER ADULTS WITH MCI. IN BOTH PHASES, PHYSICAL FRAILTY WILL BE EXAMINED AS A MODERATOR IN THE ASSOCIATIONS BETWEEN SLEEP AND COGNITIVE OUTCOMES. THIS RESEARCH WILL HELP TO PINPOINT AT- RISK POPULATIONS FOR ADRD, ADVANCE UNDERSTANDING OF THE ROLES OF SLEEP AND PHYSICAL FRAILTY IN ADRD PROGRESSION IN SCD AND MCI, AND SUGGEST STRATEGIES FOR DELAYING AD/DEMENTIA PROGRESSION THROUGH THE LENS OF SLEEP AND PHYSICAL FRAILTY. FURTHER, THE TRAINING OBJECTIVES NESTED IN THE F99 AND K00 PHASES OF THIS AWARD WILL ALLOW THE PI TO GAIN NECESSARY KNOWLEDGES AND SKILLS TO DEVELOP INTO AN INDEPENDENT INVESTIGATOR IN AGING RESEARCH, WITH A FOCUS ON THE SLEEP AND COGNITIVE HEALTH IN OLDER ADULTS.

AN ESTIMATED 20 FOSTER GRANDPARENT VOLUNTEERS WILL SERVE. OF THIS NUMBER, 17 FOSTER GRANDPARENTS WILL BE PLACED IN OUTCOME ASSIGNMENTS. SOME OF THEIR ACTIVITIES WILL INCLUDE ASSISTING IN THE CLASSROOM, ASSISTING IN THE CLASSROOM HEAD START, AND TUTORING PUBLIC SCHOOL. THE PRIMARY FOCUS AREA OF THE PROJECT IS EDUCATION. AT THE END OF THE THREE-YEAR GRANT, 110 CHILDREN WILL HAVE DEMONSTRATED GAINS IN SCHOOL READINESS IN TERMS OF SOCIAL AND/OR EMOTIONAL DEVELOPMENT. THE CNCS FEDERAL INVESTMENT OF $55,539 WILL BE SUPPLEMENTED BY $115, 576 OF SUTTER BAY HOSPITALS DBA MILLS-PENINSULA HEALTH SERVICES GRANTEE INVESTMENT.

ZOLPIDEM AND COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA IN OLDER ADULTS

EARLY LIFE ANTHROPOMETRY, IGF PATHWAY POLYMORPHISMS, AND COLORECTAL CANCER RISK

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

ENGAGES PERSONS 55 AND OLDER IN SUPPORTIVE SERVICE TO CHILDREN IN NEED

AN ELECTRONIC HEALTH RECORD BASED DASHBOARD-DRIVEN INTERVENTION TO IMPROVE IDENTIFICATION AND MANAGEMENT OF PREVENTIVE CARE FOR CARDIOVASCULAR DISEASE

RADIOADAPTIVE RESPONSE AND BREAST CANCER

MITOCHONDRIAL DNA VARIATION IN HUMAN ENERGY EXPENDITURE AND METABOLIC RATE

FOSTER GRANDPARENT PROGRAM

ENGAGES PERSONS 55 AND OLDER IN SUPPORTIVE SERVICE TO CHILDREN IN NEED

AN ESTIMATED 600 RSVP MEMBERS WILL SERVE. FROM THIS MEMBERSHIP, 168 RSVP MEMBERS WILL BE PLACED IN OUTCOME ASSIGNMENTS. THE PRIMARY FOCUS AREA OF THIS PROJECT IS HEALTHY FUTURES. AT THE END OF THE THREE-YEAR GRANT, 75% OF THE UNDUPLICATED RECIPIENTS OF MEALS ON WHEELS SERVICES AND BROWN BAG FOOD DISTRIBUTION PROGRAM WILL REPORT AN INCREASED SENSE OF FOOD SECURITY. SEVENTY-FIVE PERCENT OF UNDUPLICATED RECIPIENTS OF SERVICE WILL INDICATE THAT THEY HAVE INCREASED SOCIAL SUPPORT AND AN INDIVIDUAL CAPACITY FOR INDEPENDENT LIVING THROUGH THE SERVICE OF VOLUNTEERS WITH A PEER COUNSELING PROGRAM. AN ADDITIONAL 75% OF UNDUPLICATED CLIENTS WILL REPORT INCREASED KNOWLEDGE OF THEIR HEALTH AS A RESULT OF THE SERVICES THEY RECEIVE FROM TRAINED HICAP COUNSELORS WHO ARE MEMBERS OF RSVP. THE CNCS FEDERAL INVESTMENT OF $166,622 WILL BE SUPPLEMENTED BY $94,466.00 IN SUPPORTIVE FUNDING REPRESENTING A TOTAL BUDGET OF $261,088.

THE NO FRACTURE PLANNING GRANT

RETIRED AND SENIOR VOLUNTEER PROGRAM

RURAL HEALTH CLINIC VACCINE CONFIDENCE PROGRAM

AN ESTIMATED 13 FOSTER GRANDPARENT VOLUNTEERS WILL SERVE. OF THIS NUMBER, 13 FOSTER GRANDPARENTS WILL BE PLACED IN OUTCOME ASSIGNMENTS. SOME OF THEIR ACTIVITIES WILL INCLUDE MENTORING/ASSISTING IN THE CLASSROOM, INCLUDING HEAD START, AND TUTORING PUBLIC SCHOOL. THE PRIMARY FOCUS AREA OF THE PROJECT IS EDUCATION. AT THE END OF THE THREE-YEAR GRANT, 27 CHILDREN WILL HAVE DEMONSTRATED GAINS IN SCHOOL READINESS IN TERMS OF SOCIAL AND/OR EMOTIONAL DEVELOPMENT AND 14 CHILDREN WILL IMPROVE THEIR ACADEMIC PERFORMANCE THROUGH TUTORING. THE CNCS FEDERAL INVESTMENT OF $65,970 WILL BE SUPPLEMENTED BY $97,364 OF NON-FEDERAL RESOURCES.

SENIOR COMPANION PROGRAM

4TH INTERNATIONAL SYMPOSIUM ON CANCER METASTASIS AND THE LYMPHOVASCULAR SYSTEM

HEALTH CARE INNOVATION CHALLENGE

MOLECULAR DETERMINANTS OF MELANOMA SUSCEPTIBILITY AND PROGRESSION