Sustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers' market use in low-income neighbourhoods.

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Objectives This study examines the cross-sectional associations of cognitive and physical function with life satisfaction in middle-class, community-dwelling adults aged 60 and older. Study Design Participants were 632 women and 410 men who had cognitive function tests (CFT) and physical function tasks (PFT) assessed at a clinic visit between 1988 and 1992, and who responded in 1992 to a mailed survey that included life satisfaction measures. Cognitive impairment was defined as ≤24 on MMSE, ≥132 on Trails B, ≤12 on Category Fluency, ≤13 on Buschke long-term recall, and ≤7 on Heaton immediate recall. Physical impairment was defined as participants’ self-reported difficulty (yes/no) in performing 10 physical functions. Multiple linear regression examined associations between life satisfaction and impairment on ≥1 CFT or difficulty with ≥1 PFT. Main Outcome Measures The Satisfaction with Life Scale (SWLS; range:0–26) and Life Satisfaction Index-Z (LSI-Z; range:5–35). Results Participants’ average age was 73.4 years (range=60–94). Categorically defined cognitive impairment was present in 40% of men and 47% of women. Additionally, 30% of men and 43% of women reported difficulty performing any PFT. Adjusting for age and impairment on ≥1 CFT, difficulty performing ≥1 PFT was associated with lower LSI-Z and SWLS scores in men (β=−1.73, −1.26, respectively, p<0.05) and women (β= −1.79, −1.93, respectively, p<0.01). However, impairment on ≥1 CFT was not associated with LSI-Z or SWLS score after adjusting for age and difficulty with ≥1 PFT. Conclusions Limited cognitive function was more common than limited physical function; however, limited physical function was more predictive of lower life satisfaction. Interventions to increase or maintain mobility among older adults may improve overall life satisfaction.

The Advancing the Patient Experience (APEX) in Chronic Obstructive Pulmonary Disease (COPD) registry (https:// www.apexcopd.org/) is the first primary care health system-based COPD registry in the United States. While its ultimate goal is to improve the care of patients diagnosed with COPD, the registry is also designed to describe real-life experiences of people with COPD, track key outcomes longitudinally, and assess the effectiveness of interventions. It will retrospectively and prospectively collect information from 3000 patients enrolled in 5 health care organizations. Information will be obtained from electronic health records, and from extended annual and brief questionnaires completed by patients before clinic visits. Core variables to be collected into the APEX COPD registry were agreed on by Delphi consensus and fall into 3 domains: demographics, COPD monitoring, and treatment. Main strengths of the registry include: 1) its size and scope (in terms of patient numbers, geographic spread and use of multiple information sources including patient-reported information); 2) collection of variables which are clinically relevant and practical to collect within primary care; 3) use of electronic data capture systems to ensure high-quality data and minimization of data-entry requirements; 4) inclusion of clinical, database development, management and communication experts; 5) regular sharing of key findings, both at international/national congresses and in peer-reviewed publications; and 6) a robust organizational structure to ensure continuance of the registry, and that research outputs are ethical, relevant and continue to bring value to both patients and physicians.

Hypertension (HTN) is a modifiable risk factor for cardiovascular disease (CVD). Renal artery calcium (RAC) may signal the presence of flow-limiting atherosclerotic disease that may contribute to changes in the kidney’s regulation of blood pressure. We hypothesized that RAC is independently associated with HTN. We examined a multi-ethnic cohort of 1,285 participants who underwent abdominal computed tomography (CT) scans in five US communities. After adjustment for age, gender, race/ethnicity, CVD risk factors, abdominal aortic calcium score and kidney function, the presence of RAC was associated with a 50% higher odds of HTN (OR: 1.54; 95% CI 1.11–2.13). Similarly, the presence of RAC was associated with a 8.5-mmHg higher systolic blood pressure (SBP), a 2.1 mmHg higher diastolic blood pressure (DBP), and a 7.4-mmHg higher pulse pressure (PP). In conclusion, independent of CVD risk factors, abdominal aortic calcium, and kidney function, the presence of RAC is associated with HTN prevalence.

This study examines the demographic representativeness of the County of San Diego Body Mass Index (BMI) Surveillance System to determine if the BMI estimates being obtained from this convenience sample of individuals who visited their healthcare provider for outpatient services can be generalized to the general population of San Diego. Height and weight were transmitted from electronic health records systems to the San Diego Immunization Registry (SDIR). Age, gender, and race/ethnicity of this sample are compared to general population estimates by sub-regional area (SRA) (n = 41) to account for regional demographic differences. A < 10% difference (calculated as the ratio of the differences between the frequencies of a sub-group in this sample and general population estimates obtained from the U.S. Census Bureau) was used to determine representativeness. In 2011, the sample consisted of 352,924 residents aged 2-100 years. The younger age groups (2-11, 12-17 years) and the oldest age group (≥65 years) were representative in 90, 75, and 85% of SRAs, respectively. Furthermore, at least one of the five racial/ethnic groups was represented in 71% of SRAs. This BMI Surveillance System was found to demographically represent some SRAs well, suggesting that this registry-based surveillance system may be useful in estimating and monitoring neighborhood-level BMI data.

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