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Meng Y, Zhu T, Chen W, Zhou H, Tao L, Wang X, Li M, Zhang X, Wang D, Wu X, Luo S, Hu C. Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior. Front Psychol 2024; 15:1377430. [PMID: 38659689 PMCID: PMC11041632 DOI: 10.3389/fpsyg.2024.1377430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB). Methods A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model. Results One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE. Conclusion This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.
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Affiliation(s)
- Yong Meng
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
- Legal Department, Zhejiang Drug Rehabilitation Administration, Hangzhou, China
| | - Ting Zhu
- Mental Health and Guidance Center, Ningbo University, Ningbo, China
| | - Wei Chen
- School of Education, Tianjin University, Tianjin, China
| | - Hongjie Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Lanping Tao
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Xiaoteng Wang
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Mengya Li
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Xiaofang Zhang
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Dongshi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Xingyue Wu
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Shaochen Luo
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Cheng Hu
- Shiliping Compulsory Isolated Detoxification Center, Quzhou, China
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Mariko H, Uban KA. The implications of socioeconomic factors on salivary bioscience methodological variables in a large pediatric multi-site study. Front Public Health 2023; 11:1088043. [PMID: 37427258 PMCID: PMC10327643 DOI: 10.3389/fpubh.2023.1088043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Salivary bioscience has found increased utilization within pediatric research, given the non-invasive nature of self-collecting saliva for measuring biological markers. With this growth in pediatric utility, more understanding is needed of how social-contextual factors, such as socioeconomic factors or status (SES), influence salivary bioscience in large multi-site studies. Socioeconomic factors have been shown to influence non-salivary analyte levels across childhood and adolescent development. However, less is understood about relationships between these socioeconomic factors and salivary collection methodological variables (e.g., time of saliva collection from waking, time of day of saliva collection, physical activity prior to saliva collection, and caffeine intake prior to saliva collection). Variability in salivary methodological variables between participants may impact the levels of analytes measured in a salivary sample, thus serving as a potential mechanism for non-random systematic biases in analytes. Methods Our objective is to examine relationships between socioeconomic factors and salivary bioscience methodological variables within the Adolescent Brain Cognitive Development Study© cohort of children aged 9-10 years old (n = 10,567 participants with saliva samples). Results We observed significant associations between household socioeconomic factors (poverty status, education) and salivary collection methodological variables (time since waking, time of day of sampling, physical activity, and caffeine intake). Moreover, lower levels of household poverty and education were significantly associated with more sources of potential bias in salivary collection methodological variables (e.g., longer times since waking, collections later in the day, higher odds of caffeine consumption, and lower odds of physical activity). Consistent associations were not observed with neighborhood socioeconomic factors and salivary methodological variables. Discussion Previous literature demonstrates associations between collection methodological variables and measurements of salivary analyte levels, particularly with analytes that are more sensitive to circadian rhythms, pH levels, or rigorous physical activity. Our novel findings suggest that unintended distortions in measured salivary analyte values, potentially resulting from the non-random systematic biases in salivary methodology, need to be intentionally incorporated into analyses and interpretation of results. This is particularly salient for future studies interested in examining underlying mechanisms of childhood socioeconomic health inequities in future analyses.
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Affiliation(s)
- Hawa Mariko
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, United States
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Kristina A. Uban
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, United States
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
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Eneanya ND, Adingwupu OM, Kostelanetz S, Norris KC, Greene T, Lewis JB, Beddhu S, Boucher R, Miao S, Chaudhari J, Levey AS, Inker LA. Social Determinants of Health and Their Impact on the Black Race Coefficient in Serum Creatinine-Based Estimation of GFR: Secondary Analysis of MDRD and CRIC Studies. Clin J Am Soc Nephrol 2023; 18:446-454. [PMID: 36723299 PMCID: PMC10103283 DOI: 10.2215/cjn.0000000000000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND The cause for differences in serum creatinine between Black and non-Black individuals incorporated into prior GFR-estimating equations is not understood. We explored whether social determinants of health can account for this difference. METHODS We conducted a secondary analysis of baseline data of the Modification of Diet in Renal Disease and Chronic Renal Insufficiency Cohort studies ( N =1628 and 1423, respectively). Data in both study cohorts were stratified by race (Black versus non-Black). We first evaluated the extent to which the coefficient of Black race in estimating GFR from creatinine is explained by correlations of race with social determinants of health and non-GFR determinants of creatinine. Second, we evaluated whether the difference between race groups in adjusted mean creatinine can be explained by social determinants of health and non-GFR determinants of creatinine. RESULTS In models regressing measured GFR on creatinine, age, sex, and race, the coefficient for Black race was 21% (95% confidence interval, 0.176 to 0.245) in Modification of Diet in Renal Disease and 13% (95% confidence interval, 0.097 to 0.155) in the Chronic Renal Insufficiency Cohort and was not attenuated by the addition of social determinants of health, alone or in combination. In both studies, the coefficient for Black race was larger at lower versus higher income levels. In models, regressing creatinine on measured GFR, age, and sex, mean creatinine was higher in Black versus non-Black participants in both studies, with no effect of social determinants of health. CONCLUSIONS Adjustment for selected social determinants of health did not influence the relationship between Black race and creatinine-based estimated GFR.
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Affiliation(s)
- Nwamaka D. Eneanya
- Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ogechi M. Adingwupu
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | | | - Keith C. Norris
- Department of Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Tom Greene
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Julia B. Lewis
- Department of Medicine, Division of Nephrology, Vanderbilt University, Nashville, Tennessee
| | - Srinivasan Beddhu
- Department of Internal Medicine, Division of Nephrology & Hypertension, University of Utah Health Sciences, Salt Lake City, Utah
| | - Robert Boucher
- Department of Internal Medicine, Division of Nephrology & Hypertension, University of Utah Health Sciences, Salt Lake City, Utah
| | - Shiyuan Miao
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Juhi Chaudhari
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Andrew S. Levey
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Lesley A. Inker
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
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Li L, Meng J. Network effects on physical activity through interpersonal vs. masspersonal communication with the core and acquaintance networks. Computers in Human Behavior 2022. [DOI: 10.1016/j.chb.2022.107594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lee SY, Jung S, Lee W. Status of Workers' Health Behavior and the Association between Occupational Characteristics and Health Behavior. Int J Environ Res Public Health 2022; 19:13021. [PMID: 36293597 PMCID: PMC9602100 DOI: 10.3390/ijerph192013021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
This study investigated differences in unhealthy lifestyle behaviors (ULBs) between workers and nonworkers and demonstrated the association of ULBs with occupational characteristics among workers. This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2019. For sociodemographic data, chi-squared tests were used to analyze categorical variables. Odds ratios (ORs) and 95% confidence intervals (CIs) for ULBs were estimated using Poisson regression models after adjusting for age, sex, educational level, and household income. The variables used were current smoking status, heavy drinking, and physical inactivity. Workers were associated with an increased risk of current smoking (adjusted OR (aOR) = 1.48, 95%CI = 1.41-1.56), heavy drinking (aOR = 1.79, 95%CI = 1.68-1.90), and physical inactivity (aOR = 1.07, 95%CI = 1.04-1.11) compared with nonworkers. Among workers, the differential risks of ULB according to occupational characteristics were as follows: skilled manual workers, self-employed workers, and workers working >40 h/week were at a higher risk of engaging in all ULBs than those in other occupational categories, paid workers, and workers working ≤40 h/week, respectively. Workers showed a higher risk of ULBs than nonworkers. The risk of ULBs differed according to occupational characteristics, highlighting the need for additional studies and detailed occupational health management.
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Affiliation(s)
- Seung-Yeon Lee
- Department of Family Medicine, International Healthcare Center, Seoul National University Bundang Hospital, Bundang-gu, Seongnam 13620, Korea
| | - Saemi Jung
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
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Nayak M, Wills K, Teychenne M, Cleland V. Impacts of life-events on sitting, TV viewing and computer use among women from disadvantaged neighbourhoods. BMC Public Health 2022; 22:1816. [PMID: 36153519 PMCID: PMC9508715 DOI: 10.1186/s12889-022-14190-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Little is known about how life events such as changes in parental or employment status influence sedentary behaviour (SB). Women from disadvantaged neighbourhoods are at particular risk of poor health, therefore, in this population group this study aimed to determine between changes in parental and employment status with sitting, television viewing (TV), and computer time.
Methods
Women (18–45 years) from socioeconomically disadvantaged neighbourhoods self-reported their employment status, number of children, sitting, TV, and computer time [(baseline (n = 4349), three (n = 1912) and 5 years (n = 1560)]. Linear (sitting) and negative binomial (TV and computer time) multilevel models adjusted for confounders were used to estimate the SB association with changes in life events.
Results
Compared to women who never had children during the study period, less sitting and computer time was observed for women when number of children remained unchanged, had their first child or additional child, and fewer children (< 18 years). Less TV was observed for women when number of children remained unchanged.
Compared to women who remained employed full-time during the study period, sitting and computer time decreased among women when they decreased or increased their working hours or when remained employed part-time/not working. TV time increased among women when they decreased their working hours.
Conclusion
Among women, declines in SB were observed amongst those experiencing life events. Interventions to decrease SB may consider targeting women with no children, and future research should further explore how changes in employment type (e.g., non-manual to manual jobs) impact SB.
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Ke Y, Shi L, Peng L, Chen S, Hong J, Liu Y. Associations between socioeconomic status and physical activity: A cross-sectional analysis of Chinese children and adolescents. Front Psychol 2022; 13:904506. [PMID: 36118481 PMCID: PMC9477139 DOI: 10.3389/fpsyg.2022.904506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesAlthough socioeconomic status (SES) has been shown to be an important determinant of physical activity (PA) in adults, the association in children and adolescents remains less consistent based on evidence from western developed countries. The purpose of this study, therefore, is to investigate associations between SES and PA among Chinese children and adolescents.MethodsA cross-sectional study was conducted with a self-reported questionnaire in China. The multi-stage stratified cluster sampling method was used, and 2,955 children and adolescents (8–17 years old, 53.4% girls) were enrolled in this study. SES was assessed by measuring parental education levels, perceived family wealth, and Family Affluence Scale II (FAS II). PA was assessed by reliable and valid items from the Health Behavior School-aged Children Surveillance questionnaires. Descriptive statistics were used to report sample characteristics, including demographic characteristics, levels of PA, and SES. The Chi-square test was applied to analyze the differences of PA in gender and school period. Binary logistic regression was used to analyze the association between SES and PA among children and adolescents.ResultsOverall, 10.4% of children and adolescents accumulated moderate-to-vigorous physical activity (MVPA) at least 60 min per day. Boys were more physically active than girls (14.1% vs. 7.2%, p < 0.001). Higher socioeconomic status was positively associated with higher physical activity levels among children and adolescents, especially using FAS and mother education level as SES measures. The association between SES and PA varied by gender and grade group, and the effects of SES are also different on weekdays and weekends.ConclusionThis study found socioeconomic disparities in PA among Chinese children and adolescents, and showed the importance of targeting children and adolescents with low SES intervention priority. Based on these research findings, it is suggested that SES, especially for FAS and mother education level, should be considered when designing and implementing the promotion of regular PA in children and adolescents. Health policymakers may use this information to develop interventions to reduce health inequalities among children and adolescents in the future.
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Affiliation(s)
- Youzhi Ke
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Lijuan Shi
- Department of Comprehensive Education and Preschool Education, Shanghai Teacher Training Center, Shanghai, China
| | - Lingqun Peng
- School of Physical Education, Shanghai University of Electric Power, Shanghai, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Jintao Hong
- Shanghai Research Institute of Sports Science, Shanghai, China
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai, China
- *Correspondence: Yang Liu,
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Soriano JE, Squair JW, Cragg JJ, Thompson J, Sanguinetti R, Vaseghi B, Emery CA, Grant C, Charbonneau R, Larkin-Kaiser KA, Phillips AA, Dujic Z. A national survey of physical activity after spinal cord injury. Sci Rep 2022; 12:4405. [PMID: 35292668 PMCID: PMC8924215 DOI: 10.1038/s41598-022-07927-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/28/2021] [Indexed: 11/11/2022] Open
Abstract
Physical activity is a powerful modifiable risk factor for disease and mortality. Physical activity levels in people with spinal cord injury (SCI) have not been quantified relative to uninjured individuals in a large population-based sample. We aimed to quantify and compare physical activity in people with and without SCI, and to examine the associations between physical activity, lifestyle, and socioeconomic factors. The 2010 Canadian Community Health Survey (n > 57,000) was used, which includes three measures that assess physical activity levels (i.e., leisure time activity frequency, leisure time activity intensity, and transportation time activity intensity). Bivariable and multivariable logistic regressions were performed and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were estimated. The odds of physical activity in people with SCI were 0.43 (95% CI 0.3–0.61), 0.53 (95% CI 0.36–0.75), and 0.42 (95% CI 0.28–0.61), across the three measures of physical activity, respectively. These differences persisted after adjustment for lifestyle, comorbidities, and socioeconomic factors. Physical activity is reduced in the SCI population compared with the general population. This knowledge is important to direct future research and guide the allocation of health care resources.
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Affiliation(s)
- Jan Elaine Soriano
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Jordan W Squair
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,MD/PhD Training Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jacquelyn J Cragg
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Faculty of Pharmaceutical Sciences, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Jennifer Thompson
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,University of Calgary, 78 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Rafael Sanguinetti
- Cumming School of Medicine, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Bita Vaseghi
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.,International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Faculty of Pharmaceutical Sciences, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology and Departments of Pediatric and Community Health Sciences, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Christopher Grant
- Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada
| | - Rebecca Charbonneau
- Division of Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada
| | - Kelly A Larkin-Kaiser
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, 93 Heritage Medical Research Building, 3310 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
| | - Zeljko Dujic
- Department of Integrative Physiology, School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia.
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Linière S, Nacher M, Drak Alsibai K, Mergeayfabre M, Hafsi N, Charpin A, Misslin-Tritsch C, Carod JF, Aurelus JM, De Toffol B, Ntoutoum A, Kakamba JB, Demar M, Helene-Pelage J, Adenis A, Sabbah N. Precariousness, Diabetes Control and Complications in French Guiana. Front Endocrinol (Lausanne) 2022; 13:937156. [PMID: 35937802 PMCID: PMC9355552 DOI: 10.3389/fendo.2022.937156] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The social parameters of an individual impact the incidence of cardiovascular diseases. French Guiana, an overseas French territory with a lower standard of living than France, has a prevalence of diabetes mellitus that is twice that of mainland France. In this context we aimed to study the relation between precariousness, diabetes complications and glycemic control. METHODS A multicenter prospective cohort was initiated since May 2019. 1243 patients were included and their outcomes and history were compared between the precarious and non-precarious based on their EPICES score, a score that measures social isolation and precariousness. RESULTS 73.3% of the sample was considered precarious. Retinopathy was significantly more frequent among the deprived. There were no significant differences for other macro or microvascular complications.There was a significant difference in Glycated Haemoglobin between the precarious and non-precarious groups (8.3% (67 mmol/l) vs 8.8% (73mmol/l)). After adjusting for potential confounders, precariousness was no longer associated with poor glycemic control; the independent factors significantly associated with poor glycemic control were: not being fluent in French, having creole or portugese as mother language, and not having any insurance. CONCLUSIONS Precariousness is a risk factor for retinal complications in patients with diabetes mellitus in French Guiana. In this chronic disease, the universal healthcare system alleviates health inequalities for many, but not all, diabetic complications.Translation and cultural mediation may further reduce health inequalities in this multicultural territory where a substantial proportion of the population is not fluent in French.
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Affiliation(s)
- Samuel Linière
- Department of General Medicine, Cayenne Hospital Center, Cayenne, French Guiana
| | - Mathieu Nacher
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | - Kinan Drak Alsibai
- Department of Pathology and Center of Biological Resources (CRB Amazonie), Cayenne Hospital Center, Cayenne, French Guiana
| | - Mayka Mergeayfabre
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | - Nezha Hafsi
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
| | - Aurelie Charpin
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | | | - Jean-François Carod
- Laboratory of Biology, Ouest, Guyanais Hospital Center, Saint Laurent, French Guiana
| | - Jean Markens Aurelus
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
| | - Bertrand De Toffol
- Department of Neurology, Cayenne Hospital Center, Cayenne, French Guiana
| | - André Ntoutoum
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
| | - John Bukasa Kakamba
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
| | - Magalie Demar
- Laboratory of Parasitology-Mycology (LHUPM), Cayenne Hospital Center, Cayenne, French Guiana
- EA3593, Amazon Ecosystems and Tropical Diseases, University of Guiana, Cayenne, French Guiana
| | - Jeannie Helene-Pelage
- Department of General Medicine, University of the French West Indies and Guiana, Pointe-à-Pitre, Guadeloupe
| | - Antoine Adenis
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | - Nadia Sabbah
- Clinical Investigation Center Antilles French Guiana (CIC INSERM 1424) Cayenne Hospital Center, Cayenne, French Guiana
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
- *Correspondence: Nadia Sabbah, ; orcid.org/0000-0002-7789-6728
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Saint-onge K, Bernard P, Kingsbury C, Houle J. “To Be Moving Is to Be Alive”: A Walk-Along Study Describing Older Public Housing Tenants’ Perceptions of Physical Activity. J Aging Phys Act 2022. [PMID: 36343626 DOI: 10.1123/japa.2021-0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/19/2022] [Accepted: 06/17/2022] [Indexed: 11/09/2022]
Abstract
Few studies have focused on older public housing tenants’ perceptions of physical activity. Greater understanding of how they define, appreciate, and engage in physical activity could lead to better targeted promotion and reduced health inequalities for this subgroup of the population. We conducted 26 walk-along interviews with older public housing tenants in Montreal (Canada). Tenants were aged 60–93 years and lived in either one of three study sites including a commercial, a residential, and a mixed land-use area. Physical activity was described as a multidimensional construct through six interdependent dimensions: physiological, emotional, interpersonal, occupational, intellectual, and existential. Participants perceived physical activity as having potential for both well-being and ill-being. Perceptions of physical activity were a function of age, physical capacity, gender, culture, revenue, and relation to community. These results support using a life-course perspective and a broader definition in promoting physical activity to older public housing tenants.
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Bahloul A, Ellouze T, Hammami R, Charfeddine S, Triki S, Abid L, Kammoun S. [Impact of socioeconomic factors on blood pressure control: Observational study about 2887 hypertensive patients]. Ann Cardiol Angeiol (Paris) 2021; 70:259-265. [PMID: 34144787 DOI: 10.1016/j.ancard.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/21/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite therapeutic progress, less than half of hypertensive patients are controlled. The objective of this study was to examine the links between blood pressure control and socioeconomic factors. METHODS We used data collected in the cardiology department of Sfax University Hospital as part of the Tunisian national hypertension registry. We studied the associations between the socio-economic variables (educational level, profession, medical insurance) and optimal blood pressure control (SBP<140mmHg and DBP<90mmHg) using logistic regression models. RESULTS The average age of our population was 65 and the sex ratio was 0.95. We found, as expected, the clinical and behavioral factors associated with a good blood pressure control, namely: female sex, low-sodium diet, therapeutic compliance, and regular physical activity. However, obesity and an increased number of antihypertensive drugs have been associated with poor blood pressure control. The study of the effect of socio-economic variables on BP control finds a significant gradient against the most disadvantaged social categories for our three social variables in the univariate analysis. The inclusion of clinical and behavioral factors in the multivariate analysis attenuated these associations but did not fully explain them. CONCLUSION Our study shows that there are social inequalities in the control of blood pressure. Social justice and improving living conditions are probably the real solutions to the problem of these social inequalities in health.
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Affiliation(s)
- A Bahloul
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie.
| | - T Ellouze
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - R Hammami
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Charfeddine
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Triki
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - L Abid
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Kammoun
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
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Reesor-Oyer L, Murillo R, LaVoy EC, O'Connor DP, Liu Y, Hernandez DC. Evaluation of the Role of Leisure Time Physical Activity and Sedentary Behavior Simultaneously on the Income-Overweight/Obesity Relationship. Int J Environ Res Public Health 2021; 18:3127. [PMID: 33803582 DOI: 10.3390/ijerph18063127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/22/2023]
Abstract
In the United States, overweight/obesity is more prevalent among those with low-income; higher income is related to greater leisure time physical activity (LTPA) and sedentary behavior (SB), which are inversely related to overweight/obesity. This study aimed to evaluate the role of LTPA and SB simultaneously in the income-overweight/obesity relationship. Cross-sectional data from the National Health and Nutrition Examination Survey (2007–2014) were utilized (n = 10,348 non-older adults (aged 20–59 years)). A multiple mediator structural equation model was conducted to evaluate the indirect effects from income to overweight/obesity (Body Mass Index ≥25 kg/m2) through LTPA and SB simultaneously, controlling for confounding variables, including diet, smoking, and alcohol consumption. As expected, greater income was negatively associated with overweight/obesity. Income indirectly influenced overweight/obesity through LTPA (Indirect effect: B = −0.005; CI = −0.01, −0.003), and through SB (Indirect effect: B = 0.008; CI = 0.005, 0.01), in opposing directions. The direct effect from income to overweight/obesity remained statistically significant. LTPA partially accounted for the negative relationship between income and overweight/obesity; SB reduced the strength of the negative relationship between income and overweight/obesity. Targeted behavior approaches for weight management may be beneficial. Increasing LTPA among adults with lower income and decreasing SB among adults with higher income may provide some overweight/obesity protection.
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Teran-Escobar C, Forestier C, Ginoux C, Isoard-Gautheur S, Sarrazin P, Clavel A, Chalabaev A. Individual, Sociodemographic, and Environmental Factors Related to Physical Activity During the Spring 2020 COVID-19 Lockdown. Front Psychol 2021; 12:643109. [PMID: 33796051 PMCID: PMC8008147 DOI: 10.3389/fpsyg.2021.643109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Research has shown important between-individual variations in physical activity (PA) during the COVID-19 lockdown. Objectives: The objectives of this is study are to examine the individual, sociodemographic, and environmental factors related to PA during the spring 2020 COVID-19 lockdown in France and to explore the mediating and moderating role of intention and self-efficacy toward PA in the relationships between sociodemographic/environmental variables and PA. Design: In this cross-sectional study, participants living in France (N = 386) completed an online survey between March 30 and April 10, 2020. Method: Minutes per week of moderate-to-vigorous PA during the lockdown; usual physical activity before the lockdown; and psychological (e.g., intention, self-efficacy, and autonomous and controlled motivation), sociodemographic (gender, age, and number of children), and environmental (habitat surface area and type of housing) factors were measured in the survey. Multiple linear regressions were used to investigate the role of these predictors on PA. Intention and self-efficacy were also examined as moderators and mediators of the association between sociodemographic/environmental factors and PA. Results: Usual physical activity before the COVID-19 lockdown, intention toward PA, habitat surface area, and controlled motivation significantly predicted PA during the lockdown. No mediating effects of intention or self-efficacy were found. Intention significantly moderated the association between gender and PA and the association between part-time work and PA. Conclusions: PA during the COVID-19 lockdown was mainly predicted by individual factors and notably usual PA. These results highlight the important role of habits in a highly changing context.
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Affiliation(s)
- Claudia Teran-Escobar
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France
- Laboratoire PACTE, Univ. Grenoble Alpes, Grenoble, France
| | - Cyril Forestier
- Laboratoire Motricité, Interactions, Performance, MIP - EA4334, Le Mans Université, Le Mans, France
| | - Clément Ginoux
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France
| | | | | | - Anna Clavel
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France
| | - Aïna Chalabaev
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France
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Abstract
BACKGROUND Promotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs). OBJECTIVE The objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations. DATA SOURCES A systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature. STUDY ELIGIBILITY CRITERIA Cost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria. STUDY APPRAISAL AND SYNTHESIS OF METHODS Screening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed. RESULTS The majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost-utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil. LIMITATIONS Meta-analysis was not performed due to heterogeneity of the studies. CONCLUSIONS AND RECOMMENDATIONS Economic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas. PROSPERO REGISTRATION NUMBER CRD42018099856.
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Affiliation(s)
- Priyanga Diloshini Ranasinghe
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
- Ministry of Health, Nutrition, Indegenous Medicine, Colombo 10, Sri Lanka
| | - Subhash Pokhrel
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
| | - Nana Kwame Anokye
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
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Burzynska AZ, Voss MW, Fanning J, Salerno EA, Gothe NP, McAuley E, Kramer AF. Sensor-measured sedentariness and physical activity are differentially related to fluid and crystallized abilities in aging. Psychol Aging 2020; 35:1154-1169. [PMID: 32969693 DOI: 10.1037/pag0000580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aerobic exercise and physical activity (PA) are known to benefit cognition in adulthood. However, a typical older adult spends most of the day sedentary or in light PA, behaviors that are typically poorly captured by questionnaires. To better understand the associations between time spent in different intensities of lifestyle PA and cognition, we measured average time spent daily in sedentariness, light, and moderate to vigorous PA using hip-worn sensors (ActiGraph accelerometers). We studied baseline data from 228 cognitively normal adults (Age 60-80) who took part in a clinical trial (clinical study identifier: NCT01472744). Fluid (processing speed, memory, and reasoning) and crystallized abilities (vocabulary knowledge) were assessed with the Virginia Cognitive Aging Battery. Adjusting for age, sex, and several modifiable socioeconomic, physical and functional health factors, time spent daily in moderate to vigorous PA was positively related with fluid abilities (perceptual speed and reasoning). Furthermore, we found that those spending more time sedentary performed better on vocabulary knowledge and reasoning tasks. In contrast, time spent in light PA was not related to either fluid or crystallized abilities. Our results add to the previous literature by providing the first sensor-based evidence that crystallized and fluid abilities in older age may be associated with engagement in different intensities of daily activity. Moreover, our findings suggest that the behavior of moderate to vigorous PA is at least as important in relation to cognition as the desirable long-term physiological effects of higher intensity PA and exercise. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Agnieszka Z Burzynska
- Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences
| | | | - Jason Fanning
- Department of Internal Medicine and Health and Exercise Sciences
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Abstract
Abstract
Purpose of Review
Physical inactivity is a worldwide problem, also affecting children with motor problems, such as developmental coordination disorder. We try to understand what motivates children to start, continue, and stop having an active lifestyle and explore the role that the social network of the child can have to stimulate an active lifestyle.
Recent Findings
Social network theory is useful for understanding individual and group behavior related to physical activity. Social networks, ranging from peers and parents to teachers and medical professionals were shown to play an important role in bringing about sustainable behavioral change. Up to now, little systematic research has been done into how social networks can be used to keep children with developmental coordination disorder (DCD) physically active and motivated.
Summary
Future studies should more systematically examine and target the social network of the child with DCD. This social network can then be used to develop interventions for a sustained physical active lifestyle leading to increased participation in the society.
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18
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Sweeney AM, Wilson DK, Brown A. A qualitative study to examine how differences in motivation can inform the development of targeted physical activity interventions for African American women. Eval Program Plann 2019; 77:101718. [PMID: 31539644 PMCID: PMC6900870 DOI: 10.1016/j.evalprogplan.2019.101718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/05/2019] [Accepted: 09/04/2019] [Indexed: 06/10/2023]
Abstract
Self-Determination Theory proposes that some people are motivated to initiate physical activity by externally-controlled reasons (e.g., physical appearance, approval from others), whereas others feel compelled by more autonomous sources of motivation (e.g., enjoyment, personal importance). This study used qualitative methods to examine whether individual differences in autonomous motivation offers a useful framework for developing targeted intervention programs for African American women. Focus groups (k = 6) were conducted to examine how different levels of autonomous motivation for physical activity related to differences in physical activity barriers and facilitators among African American women (N = 31). Sessions were audiotaped, transcribed, and coded by independent raters (r = 0.70). QSR NVivo 11 was used to analyze data, and themes were identified separately for women with low, medium, or high autonomous motivation. Those with high autonomous motivation focused on themes of wanting novelty, excitement, and competition, whereas those with low autonomous motivation focused on themes of wanting instrumental support and financial incentives for increasing engagement in physical activity. Implications for developing physical activity intervention programs for African American women that are targeted toward differences in autonomous motivation are discussed.
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Affiliation(s)
- Allison M Sweeney
- Department of Psychology, University of South Carolina, Columbia, SC, 29201, United States.
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, 29201, United States.
| | - Asia Brown
- Department of Psychology, University of South Carolina, Columbia, SC, 29201, United States.
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Moeini-Jazani M, Albalooshi S, Seljeseth IM. Self-Affirmation Reduces Delay Discounting of the Financially Deprived. Front Psychol 2019; 10:1729. [PMID: 31417458 PMCID: PMC6682614 DOI: 10.3389/fpsyg.2019.01729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 07/11/2019] [Indexed: 11/13/2022] Open
Abstract
Financial deprivation is associated with excessive discounting of delayed rewards. In the present research, we argue that this counterproductive tendency may be driven, at least in part, by the aversive and self-threatening nature of experiencing financial deprivation. Accordingly, we propose that self-affirmation-an intervention known to buffer negative consequences of psychological threats-may reduce delay discounting of the financially deprived. Results of two high-powered, preregistered experiments support this proposition. Specifically, in Study 1 (n = 546), we show that among participants with relatively lower income, self-affirmation effectively reduces delay discounting. In Study 2 (n = 432), we manipulate the feeling of financial deprivation and demonstrate that self-affirmation reduces delay discounting among those who feel financially deprived. We also examine the underlying process of this effect and find that self-affirmation bolsters a sense of personal control among those who feel financially deprived, which in turn reduces their delay discounting (Study 2). Overall, our findings suggest that the relationship between financial deprivation and delay discounting is malleable and psychological interventions that attenuate self-threats and bolster a sense of personal control can be applied to reduce myopic tendencies of the poor.
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Affiliation(s)
- Mehrad Moeini-Jazani
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Sumaya Albalooshi
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Ingvild Müller Seljeseth
- Department of Leadership and Organization, Kristiania University College, Oslo, Norway.,Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Oslo, Norway
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20
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Wang R, Liu Y, Lu Y, Yuan Y, Zhang J, Liu P, Yao Y. The linkage between the perception of neighbourhood and physical activity in Guangzhou, China: using street view imagery with deep learning techniques. Int J Health Geogr 2019; 18:18. [PMID: 31345233 PMCID: PMC6659285 DOI: 10.1186/s12942-019-0182-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/19/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Neighbourhood environment characteristics have been found to be associated with residents' willingness to conduct physical activity (PA). Traditional methods to assess perceived neighbourhood environment characteristics are often subjective, costly, and time-consuming, and can be applied only on a small scale. Recent developments in deep learning algorithms and the recent availability of street view images enable researchers to assess multiple aspects of neighbourhood environment perceptions more efficiently on a large scale. This study aims to examine the relationship between each of six neighbourhood environment perceptual indicators-namely, wealthy, safe, lively, depressing, boring and beautiful-and residents' time spent on PA in Guangzhou, China. METHODS A human-machine adversarial scoring system was developed to predict perceptions of neighbourhood environments based on Tencent Street View imagery and deep learning techniques. Image segmentation was conducted using a fully convolutional neural network (FCN-8s) and annotated ADE20k data. A human-machine adversarial scoring system was constructed based on a random forest model and image ratings by 30 volunteers. Multilevel linear regressions were used to examine the association between each of the six indicators and time spent on PA among 808 residents living in 35 neighbourhoods. RESULTS Total PA time was positively associated with the scores for "safe" [Coef. = 1.495, SE = 0.558], "lively" [1.635, 0.789] and "beautiful" [1.009, 0.404]. It was negatively associated with the scores for "depressing" [- 1.232, 0.588] and "boring" [- 1.227, 0.603]. No significant linkage was found between total PA time and the "wealthy" score. PA was further categorised into three intensity levels. More neighbourhood perceptual indicators were associated with higher intensity PA. The scores for "safe" and "depressing" were significantly related to all three intensity levels of PA. CONCLUSIONS People living in perceived safe, lively and beautiful neighbourhoods were more likely to engage in PA, and people living in perceived boring and depressing neighbourhoods were less likely to engage in PA. Additionally, the relationship between neighbourhood perception and PA varies across different PA intensity levels. A combination of Tencent Street View imagery and deep learning techniques provides an accurate tool to automatically assess neighbourhood environment exposure for Chinese large cities.
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Affiliation(s)
- Ruoyu Wang
- School of Geography and Planning, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
| | - Ye Liu
- School of Geography and Planning, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
| | - Yi Lu
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong, SAR China
| | - Yuan Yuan
- School of Geography and Planning, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
| | - Jinbao Zhang
- School of Geography and Planning, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
| | - Penghua Liu
- School of Geography and Planning, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Xingang Xi Road, Guangzhou, 510275 China
| | - Yao Yao
- School of Geography and Information Engineering, China University of Geosciences, Wuhan, 430074 China
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21
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Tang K, Wang H, Liu Y, Tan SH. Interplay of regional economic development, income, gender and type 2 diabetes: evidence from half a million Chinese. J Epidemiol Community Health 2019; 73:867-873. [PMID: 31164442 DOI: 10.1136/jech-2018-211091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 03/25/2019] [Accepted: 05/19/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Following the rapid economic growth, there has been a strong disparity of regional development and personal income in China. Type 2 diabetes mellitus (T2DM) may be influenced by socioeconomic status at both the societal and individual levels. This study examines the associations of regional economic development, household income and gender on T2DM. METHOD Data from the baseline of a Chinese population-based study of approximately 500 000 adults from 10 areas were analysed. Clinically identified and screen-detected T2DM were examined. Regional economic development was indicated by gross domestic product (GDP) per capita. A logistic regression-based method was used to calculate the adjusted prevalence. RESULT The prevalence of T2DM was significantly higher in medium GDP per capita areas for both males (7.04%, 95% CI 6.82% to 7.26%) and females (6.04%, 95% CI 5.86% to 6.22%) compared with areas of other levels of economic development. The different shapes of associations between household income and T2DM prevalence were observed in different GDP per capita areas. There were strong gender differences in terms of both the trend and strength of association between household income and T2DM prevalence. CONCLUSIONS Findings from this study underscore the importance of economic conditions and gender difference on T2DM. It suggests that strategies for diabetes prevention should address social-economic differences besides a person-centred approach.
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Affiliation(s)
- Kun Tang
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Hanyu Wang
- Institute for Medical Humanities, Peking University Health Science Centre, Beijing, China
| | - Yuning Liu
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Shi Hui Tan
- School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, China
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Cusatis R, Garbarski D. Different domains of physical activity: The role of leisure, housework/care work, and paid work in socioeconomic differences in reported physical activity. SSM Popul Health 2019; 7:100387. [PMID: 31193302 PMCID: PMC6526239 DOI: 10.1016/j.ssmph.2019.100387] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 11/12/2022] Open
Abstract
Inequality in socioeconomic status (SES)—education, income, and occupation—may further exacerbate the health gap between the “haves” and “have nots” by shaping health behaviors such as physical activity. For example, those in higher socioeconomic positions are consistently found to engage in more physical activity according to public health reports that focus on leisure activity. However, previous research investigating the role of SES in shaping engagement in housework, childcare, and paid work suggests different opportunities for physical activity. This discrepancy in how researchers ask questions about physical activity and the pathways people take to healthy activity raises the question: Do socioeconomic differences in physical activity look different when we look at other domains of physical activity beyond leisure? And, does how we measure SES matter? We draw on data from the American Time Use Survey (ATUS) to assess the roles of education, income, and occupation in the amount of time individuals spend in different types of physical activity. Results demonstrate that socioeconomic differences in physical activity change depending on the activity domain and, therefore, when all domains of physical activity are accounted for compared to leisure-only. Further, the measurement of SES matters: key indicators of SES (education, income, and occupation) have varying associations with levels and types of physical activity. Findings from this research have important implications for the assessment of physical activity across SES, ultimately impacting survey research and public health. Leisure questions of physical activity may not capture socioeconomic impacts on access and opportunity for activity. Less educated report more time in house/care and paid work compared to more educated. Higher income is associated with more reported leisure and less house/care work. Different occupations report significantly different amounts of activity at paid work. Socioeconomic differences in activity are contingent on domain of activity and SES indicator.
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Affiliation(s)
- Rachel Cusatis
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Dana Garbarski
- Department of Sociology, Loyola University Chicago, 1032 W. Sheridan Rd., 440 Coffey Hall, Chicago, IL 60660, USA
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Yuen JWM, Chang KKP, Wong FKY, Wong FY, Siu JYM, Ho HC, Wong MS, Ho JYS, Chan KL, Yang L. Influence of Urban Green Space and Facility Accessibility on Exercise and Healthy Diet in Hong Kong. Int J Environ Res Public Health 2019; 16:E1514. [PMID: 31035692 PMCID: PMC6539933 DOI: 10.3390/ijerph16091514] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/23/2019] [Accepted: 04/27/2019] [Indexed: 01/22/2023]
Abstract
Background A cross-sectional study using a convenience sampling method was conducted to understand how green space and accessibility of common public open spaces in compact urban areas affect physical activity and healthy diets of residents. Methods A total of 554 residents completed a structured questionnaire on quality of life, physical activity level and healthy eating practice. Particularly, categories of physical activity and durations were obtained by using the short form Chinese International Physical Activity Questionnaire (IPAQ-C), then the Metabolic Equivalent of Task (MET)-minutes/week was calculated using the formulae (walking minutes × walking days × 3.3) + (moderate-intensity activity minutes × moderate days × 4.0) + (vigorous-intensity activity minutes × vigorous-intensity days × 8.0). The percentage of green space was calculated based on a spatial buffer with a 500 m radius from participants' geocoded addresses using a SPOT ('Satellite Pour l'Observation de la Terre' in French) satellite image-derived vegetation dataset. Parks, promenade and sports facilities were examples of open spaces. Results The sampled population who lived with green space averaged 10.11% ± 7.95% (ranged 1.56-32.90%), with the majority (90%) performing physical activities at medium and high levels. MET-minutes/week was significantly associated (Pearson r = 0.092; p < 0.05) with the green space percentage. Relatively active residents commonly used open spaces within the district for performing exercise, in particular, parks and promenades were mostly used by older residents, while sports facilities by the younger groups at age 25-44 and <25 years. Conclusions Current findings suggested promotion of exercise could be achieved by the design or redesign of built environment to include more parks accessible to the residents with the increase of vegetation.
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Affiliation(s)
- John W M Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Katherine K P Chang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Frances K Y Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Fiona Y Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Judy Y M Siu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - H C Ho
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
| | - M S Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Janice Y S Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - K L Chan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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Al Tunaiji H, Davis JC, Mansournia MA, Khan KM. Population attributable fraction of leading non-communicable cardiovascular diseases due to leisure-time physical inactivity: a systematic review. BMJ Open Sport Exerc Med 2019; 5:e000512. [PMID: 31191969 PMCID: PMC6539142 DOI: 10.1136/bmjsem-2019-000512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/18/2022] Open
Abstract
Objective The aim of this systematic review was to investigate the methods used for estimating the population attributable fraction (PAF) to leisure-time physical inactivity (PI) of coronary artery diseases, hypertension and stroke in order to provide the best available estimate for PAF. Design Systematic review. Data sources Four electronic databases (MEDLINE/PubMed, EMBASE, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature) were searched from inception to August 2018. Eligibility criteria for selecting studies This review included prospective cohort studies, with men and women aged ≥18 years old, investigating the PAF attributable to leisure-time PI related to coronary artery diseases, hypertension and stroke. Results The PAF estimates of the three studies included were 13% (3%–22%) for ‘stage-1 hypertension’ subtype incidence due to ‘non-regular exercise’; 25% (10.4%–35.8%) for ‘stage-2 hypertension’ subtype incidence due to ‘activity of daily living’ and ‘vigorous-intensity sports’; and 8.5% (1.7%–16.7%) for ‘total: fatal and non-fatal’ cardiovascular events of ‘incidence and mortality’ endpoints due to non-accumulation of 550 kcal/week (subsets not specified). Conclusions The PAF estimate exhibited a protective dose–response relationship between hypertension and an increased amount of energy expenditure of leisure-time PI. In order to enhance accuracy of PAF estimates, the following steps are recommended: (1) to clearly define and state the working definition of leisure-time PI and dose using a reliable and valid objective measurement tool; (2) use a clear definition of outcome subtypes and endpoints using reliable and valid objective measures; and (3) estimate PAF using modelling techniques based on prospective data and ensuring to report 95% CI.
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Affiliation(s)
- Hashel Al Tunaiji
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada.,Sport Medicine & Sciences Unit, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Karim M Khan
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada
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25
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Cheval B, Sieber S, Guessous I, Orsholits D, Courvoisier DS, Kliegel M, Stringhini S, Swinnen SP, Burton-Jeangros C, Cullati S, Boisgontier MP. Effect of Early- and Adult-Life Socioeconomic Circumstances on Physical Inactivity. Med Sci Sports Exerc 2018; 50:476-485. [PMID: 29112624 DOI: 10.1249/mss.0000000000001472] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to investigate the associations between early- and adult-life socioeconomic circumstances and physical inactivity (level and evolution) in aging using large-scale longitudinal data. METHODS This study used the Survey of Health Ageing and Retirement in Europe, a 10-yr population-based cohort study with repeated measurements in five waves, every 2 yr between 2004 and 2013. Self-reported physical inactivity (waves 1, 2, 4, and 5), household income (waves 1, 2, 4, and 5), educational attainment (wave of the first measurement occasion), and early-life socioeconomic circumstance (wave 3) were collected in 22,846 individuals 50 to 95 yr of age. RESULTS Risk of physical inactivity was increased for women with the most disadvantaged early-life socioeconomic circumstances (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.20-1.86). With aging, the risk of physical inactivity increased for both sexes and was strongest for those with the most disadvantaged early-life socioeconomic circumstances (OR, 1.04 (95% CI, 1.02-1.06) for women; OR, 1.02 (95% CI, 1.00-1.05) for men), with the former effect being more robust than the latter one. The association between early-life socioeconomic circumstances and physical inactivity was mediated by adult-life socioeconomic circumstances, with education being the strongest mediator. CONCLUSIONS Early-life socioeconomic circumstances predicted high levels of physical inactivity at older ages, but this effect was mediated by socioeconomic indicators in adult life. This finding has implications for public health policies, which should continue to promote education to reduce physical inactivity in people at older ages and to ensure optimal healthy aging trajectories, especially among women with disadvantaged early-life socioeconomic circumstances.
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Affiliation(s)
- Boris Cheval
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Stefan Sieber
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Idris Guessous
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Dan Orsholits
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Delphine S Courvoisier
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Matthias Kliegel
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Silvia Stringhini
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Stephan P Swinnen
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Claudine Burton-Jeangros
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Stéphane Cullati
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
| | - Matthieu P Boisgontier
- Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND.,Swiss NCCR "LIVES-Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Geneva, SWITZERLAND
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Abstract
Neighborhood parks are important venues for the urban population to do moderate-to-vigorous physical activity in leisure time. Parks can be particularly important for low-income neighborhoods, whose residents suffer from high rates of chronic diseases and may have less access to fee-based fitness exercise facilities. This study assessed the contribution of parks to local populations' physical activity in 48 high-poverty neighborhoods in the city of Los Angeles, using systematic observation of park use and surveys of park users and residents conducted between 2013 and 2015. We found that parks accounted for approximately 2.1% (between-park SD = 1.4%) of moderate physical activity time and 3.1% (between-park SD = 2.1%) of vigorous physical activity time of the local population, both of which were notably lower than the city-level average previously reported. Parks' contribution to physical activity was positively associated with park size (β = 0.13, p < 0.0001) and negatively associated with poverty (β = - 0.10, p < 0.0001) and local population density (β = - 0.25, p = 0.005). Parks in high-poverty neighborhoods in Los Angeles are underutilized, and more efforts are needed to fully realize their potential for population health.
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Affiliation(s)
- Sujeong Park
- Pardee RAND Graduate School, 1776 Main street, Santa Monica, CA, 90405, USA.
| | - Bing Han
- RAND Corporation, Santa Monica, CA, USA
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27
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Cusatis R, Garbarski D. Which activities count? Using experimental data to understand conceptualizations of physical activity. SSM Popul Health 2018; 6:286-294. [PMID: 30480078 PMCID: PMC6240671 DOI: 10.1016/j.ssmph.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 10/05/2018] [Accepted: 10/07/2018] [Indexed: 12/11/2022] Open
Abstract
US health surveys consistently report that men and those with higher socioeconomic status (SES) engage in more physical activity than women and lower SES counterparts, using questions that ask about physical activity during leisure time. However, social characteristics such as gender and SES shape understandings of and access to leisure-based physical activity as well as other domains where healthy activity is available – namely house work, care work, and paid work. Thus, the physical activity of US adults may look different when what counts as physical activity expands beyond leisure activity. The current study uses Amazon’s Mechanical Turk platform to conduct a 2-by-2-by-2 factorial experiment that crosses three types of physical activities: leisure, house or care work, and paid work. We find that physical activity questions that prime respondents – that is, ask respondents – to consider house/care work or paid work lead to increased minutes reported of physical activity compared to not priming for physical activity, while asking about leisure is no different from having no physical activity primed. The effect on reported physical activity of priming with house/care work is stronger for women than men, demonstrating support for gendered specialization of time spent in the house and care work domain. The effects on reported physical activity of priming with house/care work and paid work are stronger for those with less education compared to more education, consistent with socioeconomic divisions in access to physical activity in house/care work and employment. This study highlights the contingence of our understanding of the physical activity of US adults on both its measurement in surveys and the social forces which shape understanding of and access to physical activity. Leisure questions may not capture gender and socioeconomic patterns shaping access to and opportunity for physical activity. Priming for house/care work or paid work increases minutes reported of physical activity compared to no prime. The effect on physical activity of priming respondents for house/care work is stronger for women than men. The effects on physical activity of priming with house/care work and paid work are stronger for those with less education. Understandings of physical activity of US adults relies on measurement and the social forces shaping access and opportunity.
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Affiliation(s)
- Rachel Cusatis
- Medical College of Wisconsin, CIBMTR, 9200 W. Wisconsin Ave., Suite C5500, Milwaukee, WI 53226, United States
| | - Dana Garbarski
- Department of Sociology, Loyola University Chicago, 1032 W. Sheridan Rd., 440 Coffey Hall, Chicago, IL 60660, United States
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28
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Kakinami L, Wissa R, Khan R, Paradis G, Barnett TA, Gauvin L. The association between income and leisure-time physical activity is moderated by utilitarian lifestyles: A nationally representative US population (NHANES 1999-2014). Prev Med 2018; 113:147-152. [PMID: 29753806 DOI: 10.1016/j.ypmed.2018.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Abstract
The objective of this study was to determine whether the relationship between income and leisure-time physical activity (LTPA) persists after accounting for a person's utilitarian PA (all non-LTPA), sociodemographic characteristics and transportation PA. Data were from eight cycles (1999-2014) of the nationally representative samples of the US adult population from the National Health and Nutrition Examination Survey (n = 35,239). Whether the poverty income ratio (0-1.3, 1.3-1.86, 1.86+ [reference]) was associated with minutes of LTPA (moderate, vigorous) after stratifying for utilitarian PA (sedentary, light, moderate, and vigorous) was assessed in multiple linear regressions adjusted for age, sex, race, education, marital status, weight status, hours worked, and minutes of transportation-related PA in the past week. Likelihood of meeting national physical activity recommendations was also assessed in multiple logistic regressions adjusting for the covariates described. For both sedentary and light utilitarian PA levels, compared to the reference, persons living in households of the lowest poverty income ratio were consistently associated with approximately 17-30 less minutes of moderate LTPA minutes per week, and 20-25 less minutes of vigorous LTPA across all survey cycles. Compared to the reference, the likelihood of meeting national PA recommendations was approximately 31-55% less for these households. The known association between lower income and lower LTPA persist, but is the most persistent and consistent for those with less active utilitarian (such as sedentary) lifestyles. Interventions aimed at increasing LTPA among people with low income and sedentary utilitarian lifestyles whether or not they are in the workforce are particularly needed.
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Affiliation(s)
- Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada; PERFORM Centre, Concordia University, 7200 Sherbrooke St West, Montreal, QC H4B 1R6, Canada.
| | - Rita Wissa
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada
| | - Rahid Khan
- Department of Economics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, 5757 Ave Decelles, Montréal, QC H3S 2C3, Canada; INRS-Armand-Frappier Institute, 531 Boul des Prairies, Laval, QC H7V 1B7, Canada
| | - Lise Gauvin
- Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St Denis St, Montreal, QC H2X 0A9, Canada; École de santé publique, Université de Montréal (ESPUM), PO Box 6128, Downtown Station, Montreal, QC H3C 3J7, Canada
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Mohamed R. Resident Perceptions of Neighborhood Conditions, Food Access, Transportation Usage, and Obesity in a Rapidly Changing Central City. Int J Environ Res Public Health 2018; 15:ijerph15061201. [PMID: 29880764 PMCID: PMC6025634 DOI: 10.3390/ijerph15061201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 11/16/2022]
Abstract
There is a lack of research on obesity that uses primary data and fine-grained information on neighborhoods. I use primary data for 367 participants in Detroit to examine neighborhood predictors of obesity. These data were supplemented with public data. I considered multilevel and spatial modeling, but the data lent itself best to ordinary least squares (OLS) regressions. I find that socioeconomic factors, the built environment, transportation usage, and perceptions of neighborhoods are important predictors of obesity. Importantly, litter is associated with higher levels of obesity. Planners can take measures to reduce litter and collaborate with other policy-makers to encourage less driving, though drawing direct lines of causality is complicated.
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Affiliation(s)
- Rayman Mohamed
- Urban Studies and Planning, Wayne State University, Detroit, MI 48202, USA.
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30
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Yang L, Hu L, Hipp JA, Imm KR, Schutte R, Stubbs B, Colditz GA, Smith L. Cross-sectional associations of active transport, employment status and objectively measured physical activity: analyses from the National Health and Nutrition Examination Survey. J Epidemiol Community Health 2018; 72:764-769. [PMID: 29730607 PMCID: PMC6086741 DOI: 10.1136/jech-2017-210265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/16/2018] [Accepted: 04/19/2018] [Indexed: 11/20/2022]
Abstract
Background To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative sample of US adults. Methods Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, BMI, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only), and self-reported leisure time physical activity. Results Patterns of active transport were similar between the employed (n=2,897) and unemployed (n=2,283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI: 15.7, 65.9) additional minutes MVPA per week in men and 57.9 (95% CI: 32.1, 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI: 9.2, 80.5), only. Conclusions Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women.
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Affiliation(s)
- Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Division of Public Health Sciences, School of Medicine, Washington University, Saint Louis, Missouri, USA
| | - Liang Hu
- Department of Sport Science, Zhejiang University College of Education, Hangzhou, China
| | - J Aaron Hipp
- Center for Geospatial Analytics, Department of Parks, Recreation and Tourism Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Kellie R Imm
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rudolph Schutte
- Department of Medical Science and Public Health, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Graham A Colditz
- Division of Public Health Sciences, School of Medicine, Washington University, Saint Louis, Missouri, USA
| | - Lee Smith
- Faculty of Science and Technology, Sports and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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31
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Shin HY, Kang HT, Lee JW, Lim HJ. The Association between Socioeconomic Status and Adherence to Health Check-up in Korean Adults, Based on the 2010-2012 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2018; 39:114-121. [PMID: 29629044 PMCID: PMC5876046 DOI: 10.4082/kjfm.2018.39.2.114] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 04/27/2017] [Accepted: 05/07/2017] [Indexed: 01/09/2023] Open
Abstract
Background We investigated the association between socioeconomic status and adherence to health check-ups in a Korean population aged 40 years or older. Methods This cross-sectional study included 12,311 participants who participated in the 2010–2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess each participant's socioeconomic status (household income, occupation, and education) and adherence to health check-ups. Results Men with a higher income (highest vs. lowest: odds ratio [OR], 1.799; 95% confidence interval [CI], 1.296–2.497) and men with a higher education level (≥12 vs. <6 years: OR, 1.488; 95% CI, 1.078–2.054) and office workers compared with manual workers (men: OR, 1.431; 95% CI, 1.077–1.902; women: OR, 1.783; 95% CI, 1.256–2.532) appeared to undergo more health check-ups. In particular, men and women with a higher income and education appeared more likely to undergo opportunistic health check-ups (men: highest vs. lowest income: OR, 2.380; 95% CI, 1.218–4.653; ≥12 vs. <6 years education: OR, 2.121; 95% CI, 1.142–3.936; women: highest vs. lowest income: OR, 4.042; 95% CI, 2.239–7.297; ≥12 vs. <6 years education: OR, 2.475; 95% CI, 1.283–4.775). Conclusion A higher socioeconomic status was associated with a higher rate of participation in health check-ups. More efforts are needed to identify the factors associated with disparity in adherence to health check-ups.
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Affiliation(s)
- Hyun-Young Shin
- Department of Family Medicine, Myongji Hospital, Goyang, Korea.,Department of Epidemiology and Health Promotion and Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyoung-Ji Lim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
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32
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Lee C, Tsenkova VK, Boylan JM, Ryff CD. Gender differences in the pathways from childhood disadvantage to metabolic syndrome in adulthood: An examination of health lifestyles. SSM Popul Health 2018; 4:216-224. [PMID: 29854905 PMCID: PMC5976858 DOI: 10.1016/j.ssmph.2018.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/07/2017] [Accepted: 01/29/2018] [Indexed: 01/05/2023] Open
Abstract
We investigate whether socioeconomic status (SES) in childhood shapes adult health lifestyles in domains of physical activity (leisure, work, chores) and diet (servings of healthy [i.e., nutrient-dense] vs. unhealthy [energy-dense] foods). Physical activity and food choices vary by gender and are key factors in the development of metabolic syndrome (MetS). Thus, we examined gender differences in the intervening role of these behaviors in linking early-life SES and MetS in adulthood. We used survey data (n = 1054) from two waves of the Midlife in the U.S. Study (MIDUS 1 and 2) and biomarker data collected at MIDUS 2. Results show that individuals who were disadvantaged in early life are more likely to participate in physical activity related to work or chores, but less likely to participate in leisure-time physical activity, the domain most consistently linked with health benefits. Women from low SES families were exceedingly less likely to complete recommended amounts of physical activity through leisure. Men from low SES consumed more servings of unhealthy foods and fewer servings of healthy foods. The observed associations between childhood SES and health lifestyles in adulthood persist even after controlling for adult SES. For men, lack of leisure-time physical activity and unhealthy food consumption largely explained the association between early-life disadvantage and MetS. For women, leisure-time physical activity partially accounted for the association, with the direct effect of childhood SES remaining significant. Evidence that material deprivation in early life compromises metabolic health in adulthood calls for policy attention to improve economic conditions for disadvantaged families with young children where behavioral pathways (including gender differences therein) may be shaped. The findings also underscore the need to develop gender-specific interventions in adulthood. Physical activity and healthy diet have been recommended to prevent/treat metabolic syndrome (MetS). Childhood SES is associated with development of MetS via physical activity and diet. Gender is key to understanding the behavioral pathways linking childhood SES and MetS. Low childhood SES is associated with unhealthy diet for men and insufficient leisure-time activity for both genders. Leisure-time activity and unhealthy diet mediate the effect of childhood SES on MetS, particularly for men.
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Affiliation(s)
- Chioun Lee
- Sociology, University of California, Riverside, USA
| | | | | | - Carol D Ryff
- Institute on Aging, University of Wisconsin, Madison, USA
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Fukuoka Y, Zhou M, Vittinghoff E, Haskell W, Goldberg K, Aswani A. Objectively Measured Baseline Physical Activity Patterns in Women in the mPED Trial: Cluster Analysis. JMIR Public Health Surveill 2018; 4:e10. [PMID: 29391341 PMCID: PMC5814604 DOI: 10.2196/publichealth.9138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/23/2017] [Accepted: 11/24/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Determining patterns of physical activity throughout the day could assist in developing more personalized interventions or physical activity guidelines in general and, in particular, for women who are less likely to be physically active than men. OBJECTIVE The aims of this report are to identify clusters of women based on accelerometer-measured baseline raw metabolic equivalent of task (MET) values and a normalized version of the METs ≥3 data, and to compare sociodemographic and cardiometabolic risks among these identified clusters. METHODS A total of 215 women who were enrolled in the Mobile Phone Based Physical Activity Education (mPED) trial and wore an accelerometer for at least 8 hours per day for the 7 days prior to the randomization visit were analyzed. The k-means clustering method and the Lloyd algorithm were used on the data. We used the elbow method to choose the number of clusters, looking at the percentage of variance explained as a function of the number of clusters. RESULTS The results of the k-means cluster analyses of raw METs revealed three different clusters. The unengaged group (n=102) had the highest depressive symptoms score compared with the afternoon engaged (n=65) and morning engaged (n=48) groups (overall P<.001). Based on a normalized version of the METs ≥3 data, the moderate-to-vigorous physical activity (MVPA) evening peak group (n=108) had a higher body mass index (P=.03), waist circumference (P=.02), and hip circumference (P=.03) than the MVPA noon peak group (n=61). CONCLUSIONS Categorizing physically inactive individuals into more specific activity patterns could aid in creating timing, frequency, duration, and intensity of physical activity interventions for women. Further research is needed to confirm these cluster groups using a large national dataset. TRIAL REGISTRATION ClinicalTrials.gov NCT01280812; https://clinicaltrials.gov/ct2/show/NCT01280812 (Archived by WebCite at http://www.webcitation.org/6vVyLzwft).
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Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing/Institute for Health & Aging, University of California, San Francisco, San Francisco, CA, United States
| | - Mo Zhou
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, CA, United States
| | - Eric Vittinghoff
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - William Haskell
- Stanford Prevention Research Center, Stanford University, Palo Alto, CA, United States
| | - Ken Goldberg
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, CA, United States.,Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Anil Aswani
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, CA, United States
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34
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Hopkins LC, Holben DH. Food insecure community gardeners in rural Appalachian Ohio more strongly agree that their produce intake improved and food spending decreased as a result of community gardening compared to food secure community gardeners. Journal of Hunger & Environmental Nutrition 2017. [DOI: 10.1080/19320248.2017.1364193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - David H. Holben
- Department of Nutrition & Hospitality Management, The University of Mississippi, Mississippi, USA
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35
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Abstract
BACKGROUND Obesity is caused by an imbalance between energy intake, i.e. eating and energy expenditure (EE). Severe obesity is more prevalent in women than men worldwide, and obesity pathophysiology and the resultant obesity-related disease risks differ in women and men. The underlying mechanisms are largely unknown. Pre-clinical and clinical research indicate that ovarian hormones may play a major role. OBJECTIVE AND RATIONALE We systematically reviewed the clinical and pre-clinical literature on the effects of ovarian hormones on the physiology of adipose tissue (AT) and the regulation of AT mass by energy intake and EE. SEARCH METHODS Articles in English indexed in PubMed through January 2016 were searched using keywords related to: (i) reproductive hormones, (ii) weight regulation and (iii) central nervous system. We sought to identify emerging research foci with clinical translational potential rather than to provide a comprehensive review. OUTCOMES We find that estrogens play a leading role in the causes and consequences of female obesity. With respect to adiposity, estrogens synergize with AT genes to increase gluteofemoral subcutaneous AT mass and decrease central AT mass in reproductive-age women, which leads to protective cardiometabolic effects. Loss of estrogens after menopause, independent of aging, increases total AT mass and decreases lean body mass, so that there is little net effect on body weight. Menopause also partially reverses women's protective AT distribution. These effects can be counteracted by estrogen treatment. With respect to eating, increasing estrogen levels progressively decrease eating during the follicular and peri-ovulatory phases of the menstrual cycle. Progestin levels are associated with eating during the luteal phase, but there does not appear to be a causal relationship. Progestins may increase binge eating and eating stimulated by negative emotional states during the luteal phase. Pre-clinical research indicates that one mechanism for the pre-ovulatory decrease in eating is a central action of estrogens to increase the satiating potency of the gastrointestinal hormone cholecystokinin. Another mechanism involves a decrease in the preference for sweet foods during the follicular phase. Genetic defects in brain α-melanocycte-stimulating hormone-melanocortin receptor (melanocortin 4 receptor, MC4R) signaling lead to a syndrome of overeating and obesity that is particularly pronounced in women and in female animals. The syndrome appears around puberty in mice with genetic deletions of MC4R, suggesting a role of ovarian hormones. Emerging functional brain-imaging data indicates that fluctuations in ovarian hormones affect eating by influencing striatal dopaminergic processing of flavor hedonics and lateral prefrontal cortex processing of cognitive inhibitory controls of eating. There is a dearth of research on the neuroendocrine control of eating after menopause. There is also comparatively little research on the effects of ovarian hormones on EE, although changes in ovarian hormone levels during the menstrual cycle do affect resting EE. WIDER IMPLICATIONS The markedly greater obesity burden in women makes understanding the diverse effects of ovarian hormones on eating, EE and body adiposity urgent research challenges. A variety of research modalities can be used to investigate these effects in women, and most of the mechanisms reviewed are accessible in animal models. Therefore, human and translational research on the roles of ovarian hormones in women's obesity and its causes should be intensified to gain further mechanistic insights that may ultimately be translated into novel anti-obesity therapies and thereby improve women's health.
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Affiliation(s)
- Brigitte Leeners
- Division of Reproductive Endocrinology, University Hospital Zurich, Frauenklinikstr. 10, CH 8091 Zurich, Switzerland.,Center for Integrative Human Physiology (ZIHP), University of Zurich, 8057 Zurich, Switzerland
| | - Nori Geary
- Department of Psychiatry, Weill Medical College of Cornell University, New York, NY 10065, USA
| | - Philippe N Tobler
- Center for Integrative Human Physiology (ZIHP), University of Zurich, 8057 Zurich, Switzerland.,Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, 8006 Zurich, Switzerland
| | - Lori Asarian
- Center for Integrative Human Physiology (ZIHP), University of Zurich, 8057 Zurich, Switzerland.,Institute of Veterinary Physiology, University of Zurich, 8057 Zurich, Switzerland
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36
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Li Y, Shi J, Yu S, Wang L, Liu J, Ren J, Gao S, Hui Z, Li J, Wu N, Yang B, Liu S, Qin M, Wang D, Liao X, Xing X, Du L, Yang L, Liu Y, Zhang Y, Zhang K, Qiao Y, He J, Dai M, Yao H. Effect of socioeconomic status on stage at diagnosis of lung cancer in a hospital-based multicenter retrospective clinical epidemiological study in China, 2005-2014. Cancer Med 2017; 6:2440-2452. [PMID: 28941012 PMCID: PMC5633542 DOI: 10.1002/cam4.1170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/22/2017] [Accepted: 07/31/2017] [Indexed: 12/03/2022] Open
Abstract
There is inconsistent evidence of associations between socioeconomic status (SES) and lung cancer stage in non‐Chinese populations up to now. We set out to determine how SES affects stage at diagnosis at both individual and area levels, from a hospital‐based multicenter 10‐year (2005–2014) retrospective clinical epidemiological study of 7184 primary lung cancer patients in mainland China. Individual‐level SES data were measured based on two indicators from case report forms of the study: an individual's education and occupation. Seven census indicator variables were used as surrogates for the area‐level SES with principal component analysis (PCA). Multivariate analysis was undertaken using binary logistic regressions and multinomial logit model to describe the association and explore the effect across tertiles on stage after adjusting for demographic variables. There was a significant stepwise gradient of effect across different stages in the highest tertile of area‐level SES, comparing with the lowest tertile of area‐level SES (ORs, 0.77, 0.67, and 0.29 for stage II, III, and IV). Patients with higher education were less likely to have stage IV lung cancer, comparing with the illiterate group (ORs, 0.52, 0.63, 0.71, 0.64 for primary school, middle school, high school, college degree or above subgroup, respectively). Findings suggest that the most socioeconomically deprived areas may be associated with a higher risk of advanced‐stage lung cancer, and increasing educational level may be correlated with a lower risk to be diagnosed at advanced stage in both men and women.
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Affiliation(s)
- Yuanqiu Li
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jufang Shi
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shicheng Yu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Le Wang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiansong Ren
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhouguang Hui
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junling Li
- Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Wu
- Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Boyan Yang
- Department of General Medicine, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shangmei Liu
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingfang Qin
- Division for Chronic Non-communicable Disease Prevention and Control, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Debin Wang
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xianzhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, China
| | - Xiaojing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Lingbin Du
- Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Yuqin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Yongzhen Zhang
- Department of Epidemiology, Shanxi Provincial Cancer Hospital, Taiyuan, China
| | - Kai Zhang
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Cancer Department of Physical Examination, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- Program Office for Cancer Screening in Urban China, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyan Yao
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
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Baima J, Omer ZB, Varlotto J, Yunus S. Compliance and safety of a novel home exercise program for patients with high-grade brain tumors, a prospective observational study. Support Care Cancer 2017; 25:2809-2814. [DOI: 10.1007/s00520-017-3695-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/31/2017] [Indexed: 11/24/2022]
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38
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Kopperstad Ø, Skogen JC, Sivertsen B, Tell GS, Sæther SMM. Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK). PLoS One 2017; 12:e0172932. [PMID: 28328994 PMCID: PMC5362079 DOI: 10.1371/journal.pone.0172932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/13/2017] [Indexed: 12/25/2022] Open
Abstract
Background Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors. Method Data from the community-based Hordaland Health Study (HUSK, 1997–99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950–1957 and 2,225 born in 1925–1927 (baseline age 40–49 and 70–74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model. Results PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67–0.84)) and younger individuals (HR 0.82 (95% CI 0.72–0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66–0.92)) and respiratory (HR 0.45 (95% CI 0.32–0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66–0.83). Conclusion Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial.
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Affiliation(s)
- Øyvind Kopperstad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Grethe S. Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Solbjørg Makalani Myrtveit Sæther
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- * E-mail:
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39
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Nordenvall R, Marcano AI, Adami J, Palme M, Mattila VM, Bahmanyar S, Felländer-Tsai L. The Effect of Socioeconomic Status on the Choice of Treatment for Patients With Cruciate Ligament Injuries in the Knee: A Population-Based Cohort Study. Am J Sports Med 2017; 45:535-540. [PMID: 27836904 DOI: 10.1177/0363546516672651] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The socioeconomic status (SES) of patients has been widely recognized as playing an important role in many health-related conditions, including orthopaedic conditions, in which a higher SES has been associated with a higher utilization of more advanced medical treatments such as drugs, diagnostics, and surgery. However, the association between SES and cruciate ligament surgery has not been thoroughly investigated. PURPOSE To evaluate the association between SES and choice of treatment in patients with a cruciate ligament injury. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All Swedish patients with a diagnosed cruciate ligament injury between 1987 and 2010 were identified from the Swedish National Patient Register (N = 98,349). The Longitudinal Integration Database for Health Insurance and Labor Market Studies (LISA) provided information on household income and highest achieved educational level, which were used as socioeconomic indices. The exposure was the SES of patients as determined by the household income and educational level, and the main outcome measure was treatment choice (surgical reconstruction vs nonoperative treatment). Poisson regression models estimated the association. RESULTS A total of 52,566 patients were included in the study; of these, 20,660 (39%) were treated operatively. Patients in the highest quartile of household income had a significantly higher likelihood of undergoing surgery than those in the lowest quartile (relative risk [RR], 1.16; 95% CI, 1.11-1.20). Patients classified as highly educated had a significantly increased likelihood of being treated operatively compared with those with a low education (RR, 1.29; 95% CI, 1.19-1.39). CONCLUSION This study provides a population-based validation that having a higher SES as determined by the household income and/or level of education increases the likelihood of undergoing operative treatment after a cruciate ligament injury. CLINICAL RELEVANCE All Swedish citizens are entitled by law to the same quality of health care; therefore, unmotivated differences in treatment between different socioeconomic groups are to be seen as a challenge. It is important to evaluate the specific mechanisms by which the patient's SES influences the decision of whether to treat a cruciate ligament injury operatively.
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Affiliation(s)
- Richard Nordenvall
- Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Alejandro I Marcano
- Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Johanna Adami
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mårten Palme
- Department of Economics, Stockholm University, Stockholm, Sweden
| | - Ville M Mattila
- Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden.,Department of Orthopedics and Trauma Surgery, Tampere University Hospital, Tampere, Finland
| | - Shahram Bahmanyar
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Li Felländer-Tsai
- Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
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40
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Dang LC, Castrellon JJ, Perkins SF, Le NT, Cowan RL, Zald DH, Samanez-Larkin GR. Reduced effects of age on dopamine D2 receptor levels in physically active adults. Neuroimage 2017; 148:123-129. [PMID: 28089678 DOI: 10.1016/j.neuroimage.2017.01.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 12/13/2022] Open
Abstract
Physical activity has been shown to ameliorate dopaminergic degeneration in non-human animal models. However, the effects of regular physical activity on normal age-related changes in dopamine function in humans are unknown. Here we present cross-sectional data from forty-four healthy human subjects between 23 and 80 years old, showing that typical age-related dopamine D2 receptor loss, assessed with PET [18F]fallypride, was significantly reduced in physically active adults compared to less active adults.
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Affiliation(s)
- Linh C Dang
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
| | - Jaime J Castrellon
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA
| | - Scott F Perkins
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA
| | - Nam T Le
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Ronald L Cowan
- Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Ave South, Nashville, TN 37212, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA; Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Ave South, Nashville, TN 37212, USA
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41
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Naik H, Qiu X, Brown MC, Eng L, Pringle D, Mahler M, Hon H, Tiessen K, Thai H, Ho V, Gonos C, Charow R, Pat V, Irwin M, Herzog L, Ho A, Xu W, Jones JM, Howell D, Liu G. Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity. ACTA ACUST UNITED AC 2016; 23:e546-e555. [PMID: 28050143 DOI: 10.3747/co.23.3166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. METHODS As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors. RESULTS Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001). CONCLUSIONS In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.
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Affiliation(s)
- H Naik
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - X Qiu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M C Brown
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Eng
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - D Pringle
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Mahler
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Hon
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - K Tiessen
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Thai
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - C Gonos
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - R Charow
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Pat
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Irwin
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Herzog
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - A Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - W Xu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - J M Jones
- Toronto General Research Institute, Toronto and
| | - D Howell
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - G Liu
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto;; Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Becerra MB, Herring P, Marshak HH, Banta JE. Social Determinants of Physical Activity Among Adult Asian-Americans: Results from a Population-Based Survey in California. J Immigr Minor Health 2015; 17:1061-9. [PMID: 25023491 DOI: 10.1007/s10903-014-0074-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objective of this study was to evaluate the key social determinants of physical activity among six Asian-American subgroups using public access 2007 California Health Interview Survey data. Physical activity was defined as meeting the American College of Sports Medicine recommendation of 450 metabolic equivalent-minutes per week. Factors positively associated with meeting physical activity recommendations included being bilingual among Chinese and Vietnamese, and increasing age for Chinese only. On the other hand, being middle aged, currently married, and low neighborhood safety were significantly associated with lower odds of meeting physical activity recommendations, as were being female for Japanese and Koreans, and living above the poverty level for Vietnamese. Such results highlight the heterogeneity among Asian-Americans and need for health messages targeted at specific subgroups. Additionally, the role of built environment, particularly in areas with high Filipino residents, should be a public health priority for increasing physical activity outcomes.
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43
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Abstract
Obesity poses lots of health risks in both developing and developed countries. One thing that remains unclear is the relationship between family income and weight gain. This paper explores the relationship between family income and Body Mass Index (BMI) given variations in individual choice towards basic consumption and life quality improvement consumption as income increases. We use a nationally representative longitudinal data from China, the China Health and Nutrition Survey (CHNS), to estimate the relationship between income and weight gain. We conduct both cross sectional and panel data analysis to study the causal effects of family income on weight development. Unlike other literature that found inverse relationship between prevalence of obesity and family income in developing countries, in this paper, we find that BMI will first increase with family income at a decreasing rate, and then decrease which suggests that the group of middle class may suffer the high risk of being overweight and obese.
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Affiliation(s)
- Fafanyo Asiseh
- College of Business and Economics, North Carolina Agricultural and Technical State University, 1601 E. Market Street, Greensboro, NC 27411 USA
| | - Jianfeng Yao
- College of Business and Economics, North Carolina Agricultural and Technical State University, 1601 E. Market Street, Greensboro, NC 27411 USA
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Abstract
Diabetes mellitus is a chronic metabolic disease with wide implications for well-being and social life. The aim of this cross-sectional, observational study was to describe possible differences in clinical characteristics, socio-economic factors and quality of life between diabetes patients in poor and good/acceptable metabolic control, as defined by levels of glycated haemoglobin A1c. From a population-based register of diabetes patients at a clinical chemistry department, we selected 96 subjects in poor metabolic control (HbA1c > 10%), and 96 subjects in good/acceptable (HbA1c 6.5 - 7.5%) metabolic control, matched for sex, age and duration of diabetes. Each participant was sent a self-administered questionnaire regarding medical history, family situation and socio-economic background, as well as self-rated health based on a validated instrument (SF-36). The diabetes patients in poor metabolic control reported more retinopathy, vascular complications and nervous problems than did the patients in acceptable metabolic control. Furthermore, the group in poor metabolic control was also characterized by a lower educational level, a higher number of sick leave days or disability pension and a lower degree of physical activity. Both of the diabetic groups reported lower scorings for physical functioning, general health, vitality and mental health, than did a comparable non-diabetic group from another study. In summary, diabetic patients in poor metabolic control have a lower educational level and report more complications, nervous problems, sick leave days and disability pensions than patients in good/acceptable metabolic control. The lower degree of physical activity adds to the problems of the first group and should be the target for intervention to achieve better metabolic control.
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Affiliation(s)
- Dick Larsson
- Health Centre Degeberga, County Hospital, Kristianstad
| | - Ibe Lager
- Department of Internal Medicine, County Hospital, Kristianstad
| | - Peter M. Nilsson
- Department of Community Health Sciences, University of Lund, Lund, Sweden
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45
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Fitgerald JT, Singleton SP, Neale AV, Prasad AS, Hess JW. Activity Levels, Fitness Status, Exercise Knowledge, and Exercise Beliefs among Healthy, Older African American and White Women. J Aging Health 1994; 6:296-313. [DOI: 10.1177/089826439400600302] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined self-reported activity, measured fitness status, exercise knowledge, and exercise beliefs of 48 African American and 51 White females in good health between the ages of 50 and 80 years enrolled in a health promotion project. Examination of fitness status by ethnicity indicated a higher level of fitness among White females. Ethnic differences were found on 2 of 6 exercise belief items and 2 of 3 exercise knowledge questions. A multiple regression analysis found that activity level was predicted by the knowledge question concerning heart rate during exercise necessary to maintain fitness, the belief concerning the difficulty "to stick to a regular schedule of physical activity," and the belief concerning the difficulty "to find the time to exercise on a regular basis." The findings suggest that health promotion efforts need to determine exercise attitudes and beliefs of older women, provide basic exercise knowledge, and include fitness programs designed specifically for older women.
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Abstract
This study describes the associations between social factors and leisure-time physical activity levels in young people. Important concepts from Bandura's social learning theory and Bourdieu's theory of social position and lifestyles were used as theoretical frameworks. Baseline data were collected from a sample of 827 students (11-14 years old) and their parents in 1979. In 1991, the same students, now aged 23 to 26 years, participated in a follow-up ( N = 514, 62.2 percent of baseline). At the follow-up, females were significantly more physically active if highly educated. The only statistically significant factor associated with males' activity levels was activity levels at baseline. Males were more physically active than females at baseline, but in young adulthood there was no significant gender difference. There was an interaction between gender and education in that highly educated females exercised significantly more than less educated females. This was not the case for males.
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Affiliation(s)
- Lisbet Øygard
- Research Centre for Health Promotion, Bergen, Norway
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47
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Attwood S, van Sluijs E, Sutton S. Exploring equity in primary-care-based physical activity interventions using PROGRESS-Plus: a systematic review and evidence synthesis. Int J Behav Nutr Phys Act 2016; 13:60. [PMID: 27206793 PMCID: PMC4875625 DOI: 10.1186/s12966-016-0384-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 05/10/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Little is known about equity effects in primary care based physical activity interventions. This review explored whether differences in intervention effects are evident across indicators of social disadvantage, specified under the acronym PROGRESS-Plus (place of residence, race/ethnicity, occupation, gender, religion, education, social capital, socioeconomic status, plus age, disability and sexual orientation). METHODS Six bibliographic databases were systematically searched for randomised controlled trials (RCTs) of physical activity interventions conducted in primary care. Harvest plots were used to synthesize findings from RCTs reporting subgroup or interaction analyses examining differences in intervention effects across levels of at least one PROGRESS-Plus factor. RESULTS The search yielded 9052 articles, from which 173 eligible RCTs were identified. Despite PROGRESS-Plus factors being commonly measured (N = 171 RCTs), differential effect analyses were infrequently reported (N = 24 RCTs). Where reported, results of equity analyses suggest no differences in effect across levels or categories of place of residence (N = 1RCT), race (N = 4 RCTs), education (N = 3 RCTs), socioeconomic status (N = 3 RCTs), age (N = 16 RCTs) or disability (N = 2 RCTs). Mixed findings were observed for gender (N = 22 RCTs), with some interventions showing greater effect in men than women and others vice versa. Three RCTs examined indicators of social capital, with larger post-intervention differences in physical activity levels between trial arms found in those with higher baseline social support for exercise in one trial only. No RCTs examined differential effects by participant occupation, religion or sexual orientation. CONCLUSION The majority of RCTs of physical activity interventions in primary care record sufficient information on PROGRESS-Plus factors to allow differential effects to be studied. However, very few actually report details of relevant analyses to determine which population subgroups may stand to benefit or be further disadvantaged by intervention efforts.
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Affiliation(s)
- S Attwood
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Sciences, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. .,Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.
| | - E van Sluijs
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Sciences, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - S Sutton
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
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Nasser RL, Branco JC, Lara DR, Vecchio FBD, Wiener C, Mesquita P, Souza LDDM, Silva RAD, Jansen K. [Leisure-time physical activity and licit substance use in a population sample of young adults]. Cien Saude Colet 2016; 21:63-70. [PMID: 26816164 DOI: 10.1590/1413-81232015211.18862014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 03/25/2015] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to assess the prevalence and factors associated with leisure-time physical activity, as well as to verify its association with licit substance use in a population sample of young adults. It is a cross-sectional population-based study with young adults aged between 18 and 35 years old, living in the urban area of the city of Pelotas in the Brazilian State of Rio Grande do Sul. Sample selection was performed by clusters, being composed of 1953 individuals, among the 82 selected census tracts. The practice of physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). The chi-square and Poisson regression tests were used for statistical analysis. The prevalence of young adults active in leisure-time physical activity was 25.3%; most were single males between 18 and 23 years, belonging to the people in the highest economic bracket and not smoking on a daily basis. Specific strategies should be developed to promote an active and healthy lifestyle, focusing on incentives for older, lower income class women who smoke.
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Affiliation(s)
- Roberta Lacerda Nasser
- Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, RS, Brasil,
| | | | | | | | - Carolina Wiener
- Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, RS, Brasil,
| | - Paula Mesquita
- Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, RS, Brasil,
| | | | | | - Karen Jansen
- Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, RS, Brasil,
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49
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Dogra S, Shah S, Patel M, Tamim H. Effectiveness of a Tai Chi intervention for improving functional fitness and general health among ethnically diverse older adults with self-reported arthritis living in low-income neighborhoods: a cohort study. J Geriatr Phys Ther 2016; 38:71-7. [PMID: 24762392 DOI: 10.1519/jpt.0000000000000016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Tai Chi (TC) is a form of low to moderate physical activity that has been shown to significantly impact health and functional fitness among older adults; the impact of TC on the health and functional fitness of older adults with arthritis is not well understood. The purpose of this study was to assess the effectiveness of a 16-week TC intervention for improving functional fitness and self-reported general health among older adults with arthritis who were born outside Canada and were residing in low-income neighborhoods. METHODS A 16-week intervention was conducted among older adults residing in 1 of 2 specified low-income neighborhoods in Canada. The analysis was limited to those who self-reported having arthritis (n = 102). Participants were encouraged to attend 2 moderate-intensity TC sessions per week for a total of 120 minutes. Functional fitness and health were assessed at baseline and at 16 weeks. RESULTS Average attendance was 1.1 sessions per week. Functional fitness assessment results indicated that right-hand grip strength (25.6 ± 8.2 to 26.7 ± 7.8 kg), left-hand grip strength (24.9 ± 7.3 to 26.8 ± 7.1 kg), 30-second arm curl (15.6 ± 5.0 to 18.6 ± 5.7 repetitions/30 s), Timed Up-and-Go (7.4 ± 2.6 to 6.9 ± 2.6 s), and 30-second chair stand (12.0 ± 3.9 to 15.4 ± 5.8 s) improved significantly (P < 0.05) from baseline to 16 weeks. Results from the Short Form-36 indicate that physical functioning (73.1 ± 19.9 to 80.3 ± 19.4; P = 0.001), general health (61.5 ± 20.9 to 66.0 ± 20.4; P = 0.03), vitality (61.5 ± 18.9 to 67.5 ± 20.2; P = 0.008), and mental health (74.3 ± 16.5 to 78.5 ± 17.7; P = 0.04) also improved significantly over the intervention period. Improvements in physical health and physical function scores were clinically meaningful. DISCUSSION AND CONCLUSIONS Participating in TC for 16 weeks led to significant improvements in functional fitness and components of physical and mental health among older adults with self-reported arthritis. Tai Chi seems to be a valuable mode of physical activity for this population.
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Affiliation(s)
- Shilpa Dogra
- 1Faculty of Health Sciences, Kinesiology Department, University of Ontario Institute of Technology, Oshawa, Ontario, Canada. 2School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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50
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Vanderloo LM, Tucker P. An objective assessment of toddlers' physical activity and sedentary levels: a cross-sectional study. BMC Public Health 2015; 15:969. [PMID: 26410376 PMCID: PMC4584128 DOI: 10.1186/s12889-015-2335-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/23/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Little evidence exists on the physical activity and sedentary time of Canadian toddlers; this study objectively measured such behaviors and compared participants' activity levels to national guidelines. Levels of screen-viewing among toddlers were also explored. METHODS Forty toddlers (mean age = 25.7 months) wore Actical accelerometers for seven consecutive days (15 s epoch). Parents/guardians completed a wear-time log and a demographic and screen-viewing questionnaire. Descriptive analyses were used to determine participants' levels of physical activity and sedentary time, to identify whether toddlers were meeting physical activity/sedentary guidelines, and to explore demographic variables. T-tests were used to assess whether toddlers' activity levels differed based on cut-points applied and various demographic and screen-related variables. Regression analyses were conducted to examine associations between toddlers' sedentary time and screen-viewing levels. RESULTS Toddlers engaged in 37.27 (SD = 3.79) to 49.40 (SD = 3.29) mins/hr of sedentary time, 9.79 (SD = 2.90) to 18.78 (SD = 3.22) mins/hr of light-intensity physical activity (LPA), 0.82 (SD = 0.72) to 3.95 (SD = 1.93) mins/hr of moderate- to vigorous-intensity physical activity (MVPA), and 10.60 (SD =3.29) to 22.73 (SD = 3.97) mins/hr of total physical activity (TPA), based on the Trost et al. and the Canadian Health Measures Survey (CHMS) cut-points respectively; these rates were significantly different (p <.001). On at least 1 day, 17.5 % (Trost et al. cut-points) and 97.5 % (CHMS cut-points) of the sample met or exceeded the Canadian physical activity guidelines. No statistically significant differences in sedentary time or physical activity (all intensities) based on sex were reported (p <.001); however, LPA (CHMS cut-points) did significantly differ based on childcare attendance (p <.05). Approximately 93.2 % of participants watched television, and 56.8 % utilized computers. Only 18.8 and 25.0 % of children under 2 years and 70.8 and 62.5 % of 2-3 years olds met the screen-use recommendation of the sedentary behavior guidelines on weekdays and weekend days, respectively. DISCUSSION AND CONCLUSION The implications of this work suggest that a greater understanding of toddlers' activity patterns is needed; additional mechanisms of promoting active behaviors among this group should be explored.
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Affiliation(s)
- Leigh M Vanderloo
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, 1201 Elborn College, Rm 2585, London, ON, N6G 1H1, Canada.
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, 1201 Elborn College, Rm 2547, London, ON, N6G 1H1, Canada.
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